Idaho: Advanced Practice Provider Laws and Regulations
Published on:
Physician Assistants
Qualifications [IDAPA 22.01.03. Subsection 021.01-06]:
Graduate accredited PA program; bachelor’s degree; NCCPA exam.
MD Supervision of Physician Assistant [IDAPA 22.01.04, Subsections 020.01 – 020.06]:
- Supervising physicians must register with Idaho’s Board of Medicine and generally may supervise no more than three (3) PAs at a time. The Board may authorize a physician to supervise a total of six (6) PAs contemporaneously if necessary, to provide adequate medical care and upon prior petition documenting adequate safeguards to protect the public health and safety.
The supervising MD must:
- Accept full responsibility for the medical acts and patient services provided by PA and graduate PAs and for the supervision of such acts which include:
(a) Conduct onsite visit at least monthly to personally observe the quality of care provided;
(b) Conduct periodic review of a sample of records to evaluate medical services provided. When applicable, review shall include an evaluation of adherence to the delegation of services agreement between the MD and PA; and,
(c) Hold regularly scheduled conferences.
- Report to the Board all patient complaints received against the PA or graduate PA which relate to quality and nature of medical care or patient services rendered.
- Must always be available either in person or by phone to supervise, direct and counsel PA.
- Outline the scope and nature of the supervision in a delegation of services agreement, as set forth in IDAPA 22.01.03, “Rules for the Licensure of PA,” subsection 030.04.
- Disclose to patients the fact that the PA is not an MD. This can be accomplished with nametags, correspondence, oral statements, office signs or other procedures.
- Shall not utilize or authorize the PA to use any pre-signed prescriptions.
Physician Assistant prescribing medications [IDAPA 22.01.03, Subsections 042.01- 042.05]:
- A PA may apply to the Idaho Board of Medicine for approval to prescribe Schedule II-V and non-controlled substances. The application must include documentation that he/she has completed a pharmacology course (at least 30 hours), frequency with which the supervising MD will review prescriptions written, and a signed affidavit from the supervising MD certifying that the PA is qualified to prescribe the drugs for which the PA is seeking approval and authorization.
- To be authorized to prescribe Schedule II-V drugs, the PA must register with DEA and Idaho Board of Pharmacy.
- A PA may issue written or oral prescriptions for legend drugs and controlled drugs, Schedule II-V in accordance with approval and authorization granted by the Board of Medicine, the current delegation of services agreements and shall be consistent with the regular prescriptive practice of the supervising MD.
- Prescription forms used by PA must be printed with the name, address, and telephone number of the PA and of the supervising MD.
- Shall maintain accurate records, accounting for all prescriptions written and medications delivered.
- The PA who has prescriptive authority may request, receive, sign for and distribute professional samples of drugs and devices in accordance with his current Delegation of Services Agreement and consistent with the regular prescriptive practice of the supervising physician.
Advanced Practice Registered Nurses (APRNs) [Idaho Statutes Title 54, Chapter 14, 54-1409] [IDAPA 23.01.01, Subsection 285.01-285.03] :
Generally defined in Idaho as “Advanced Practice Registered Nurse (APRN):” Licensed professional RN who graduated from a nationally accredited NP program, passed a qualifying examination recognized by the Board, and has current certification from a national organization recognized by the Board.
Also see the APRN Compact Idaho Statutes Title 54, Chapter 14, 54-1419.
Scope of Practice for APRNs [IDAPA 23.01.01, Subsection 280.02(a)-(g)]:
APRN’s scope of practice is authorized by the Board of Nursing. An APRN shall:
a) Provide client services for which the APRN is educationally prepared and for which competence has been achieved and maintained;
b) Recognize his/her limits of knowledge and experience and shall consult and collaborate with and refer to other health care professionals as appropriate;
c) Evaluate and apply current evidence-based research findings relevant to the advanced nursing practice role;
d) Assume responsibility and accountability for health promotion and maintenance as well as the assessment, diagnosis and management of client conditions to include the use of pharmacologic and non-pharmacologic interventions and the prescribing and dispensing of pharmacologic and non-pharmacologic agents;
e) Use advanced practice knowledge and skills in teaching and guiding clients and other health care team members;
f) Have knowledge of the statutes and rules governing advanced nursing practice, and shall practice within the established standards for the advanced nursing practice role and population focus; and,
g) Practice consistent with [the Decision-making model] Subsections 400.01 and 400.02 of these rules.
Idaho APRNs Qualifications:
Nurse Practitioner [IDAPA 23.01.01, Subsection 280.05]:
“In addition to core standards, the APRN in the role of certified nurse practitioner provides initial and ongoing comprehensive primary care services to clients including, but not limited to, diagnosis and management of acute and chronic disease, and health promotion, disease prevention, health education counseling, and identification and management of the effects of illness on clients and their families.” Also see definition IDAPA 23.01.01, Subsection 271.06.
Nurse Midwife [IDAPA 23.01.01, Subsection 280.03]:
“In addition to the core standards, the APRN in the role of certified nurse midwife provides the full range of primary health care services to women throughout the lifespan, including gynecologic care, family planning services, preconception care, prenatal and postpartum care, childbirth, care of the newborn and reproductive health care treatment of the male partners of female clients.” Also see definition IDAPA 23.01.01, Subsection 271.05.
Certified Nurse Specialist [IDAPA 23.01.01, Subsection 280.04]:
“In addition to core standards, the APRN in the role of clinical nurse specialist provides services to patients, care providers and health care delivery systems including, but not limited to, direct care, expert consultation, care coordination, monitoring for quality indicators and facilitating communication between patients, their families, members of the health care team and components of the health care delivery system.” Also see definition IDAPA 23.01.01, Subsection 271.08.
Nurse Anesthetist [IDAPA 23.01.01, Subsection 280.06]:
“In addition to core standards, the APRN in the role of certified registered nurse anesthetist provides the full spectrum of anesthesia care and anesthesia-related care and services to individuals across the lifespan whose health status may range across the wellness-illness continuum to include healthy persons; persons with immediate, severe or life-threatening illness or injury; and persons with sustained or chronic health conditions.” Also see definition IDAPA 23.01.01, Subsection 271.07.
Idaho APRNs Prescribing and Dispensing Medications:
Defined [IDAPA 23.01.01, Subsection 271.15]:
Properly licensed APPN may prescribe, deliver, distribute and dispense pharmacologic and non-pharmacologic agents to a client in compliance with Board rules and applicable federal and state law. Pharmacologic agents include legend and Schedule II-V controlled substances.
Training [IDAPA 23.01.01, Subsection 315.01(a)-(c)]:
APRN who applies for authorization to prescribe medications must have a current APRN Idaho license, provide evidence of completion of 30 hours of post-basic education in pharmacotherapeutics, and write prescriptions in compliance with applicable state and federal laws and signing the prescription with the abbreviation for the applicable category of advanced nursing practice, the identification number assigned by the Board and, where applicable, the Idaho controlled substance registration number and federal DEA registration.
APRN/patient relationship required for prescribing and dispensing [IDAPA 23.01.01, Subsection 315.05(a)]:
“An advanced practice registered nurse shall not dispense pharmacologic agents except in the course of his/her professional practice and when a bona fide advanced practice registered nurse/patient relationship has been established. A valid relationship will exist when the advanced practice registered nurse has obtained sufficient knowledge of the patient’s medical condition through examination and has assumed responsibility for the health care of the patient.”