Idaho News: Board Initiated 2011 Statute Changes

June 8, 2011 9:56 am

Originally published in the June 2011 Idaho Board of Pharmacy Newsletter

Statute changes are effective on July 1, 2011, unless noted that they are enacted with an emergency clause. Full text of these changes can be viewed at the Idaho State Board of Pharmacy’s Web site at http://bop .accessidaho.org.

Limited Prescriptive Authority for Pharmacists: §54-1704 was changed to allow pharmacists to prescribe pursuant to the following parameters:

1. Agents for active immunization when prescribed for patients 12 years of age or older. Please note that immunization administrations rules were also promulgated in 2011.
2. Dietary fluoride supplements when prescribed according to the American Dental Association’s (ADA) recommendations for persons whose drinking water is proven to have a fluoride content below the United States Department of Health and Human Services’ (HHS) recommended concentration. The ADA recommendations can be found at http://jada.ada.org/content/141/12/1480.full. HHS current recommended optimal level is 0.7 to 1.2 mg/L, however, HHS has proposed a change to 0.7mg/L. Read more about this proposed change at www.hhs.gov/news/press/2011pres/01/pre_pub_ frn_ fluoride.html.

Electronic Prescribing of Controlled Substances (CS): §37-2723 and §37-2725 were revised to allow the electronic prescribing of CS. These changes included an emergency clause, so they are currently in effect. Therefore, once systems become certified, as per federal law, e-prescribing of CS will be legal in Idaho.

Changes to CS Schedules: §37-2735, Schedule I, was updated to reflect recent changes in federal law and to schedule the known active ingredients in products commonly referred to as “Spice” and “Bath Salts.”

Drug Outlet Changes: Within §54-1705, the definitions of drug order, drug outlets, institutional facility, limited service outlet, and practitioner were updated, including the various locations where these terms were used. Along with changes to §54-1729, Registration and Licensure of Facilities, and in some cases additional, future, promulgated rules, the Board now has/will have the ability to register additional drug outlets, such as:

• drug outlets that perform pharmaceutical care, without having to meet the minimum standards in rule, such as a stock of Food and Drug Administration-approved drugs;
• drug outlets that do business into Idaho, such as wholesalers of durable medical equipment; or
• facilities with employees or personnel engaged in distribution of drugs or devices, such as dispensing practitioner offices.

Prospective Drug Review and Counseling: §54-1739 replaces the struck §54-1749, requires a prospective drug review before filling all prescriptions, retains the patient or caregiver’s right to refuse counseling, retains the exemption for in-patients of hospitals, and includes changes such as:

• Mandatory, pharmacist counseling on new medications, not new prescriptions. A renewed medication that is given a new prescription number is not a new medication. Mandatory offer to counsel by a pharmacist or technician on all refills or renewed prescriptions, with subsequent, appropriate, pharmacist counseling if accepted.
• Counseling shall include such supplemental written materials as required by law or are customary in that practice setting (eg, Medguides).
• Counseling shall not be required for in-patients of an institutional facility when licensed health care professionals administer the medications, a change that eliminates the exemption for patients of some assisted living facilities, etc.

Additionally, §54-1739 applies to dispensing practitioners and mail service pharmacies, however, if face to face counseling is not possible in any practice setting, then a reasonable effort shall be made to contact the patient or caregiver, such as through written material.