Idaho New Law Alert – July 2020
Laws are effective July 1, 2020 unless otherwise noted.
Drug History Review Requirement (effective October 1, 2020)
Prior to prescribing a schedule II, III, or IV opioid analgesic or benzodiazepine for outpatient use, a prescriber (or the prescriber’s delegate) must review the patient’s prescription drug history for the preceding twelve months and “evaluate the data for indicators of drug diversion or misuse.” This requirement does NOT apply to prescriptions in a quantity intended to last no more than three days, nor does it apply at the scene of an emergency, at a skilled nursing facility, or in hospice care. Physicians who have not already done so are encouraged to register with the Prescription Drug Monitoring Program.
Establishing Doctor-Patient Relationship via Telehealth
If a provider and patient do not have an established treatment relationship, Idaho’s Telehealth Access Act previously required the use of “two-way audio and visual interaction” between the patient and provider for the purpose of establishing care. Under the new law, the use of two-way audio and visual interaction is no longer required in every scenario. Rather, providers must use “telehealth technologies sufficient to conduct a patient evaluation and appropriate to diagnose and treat the patient.” Of note, telehealth services do not include “audio in isolation without access to and review of the patient’s medical records, electronic mail messages that are not compliant with HIPAA, or fax transmissions.”
Life Sustaining Treatment of Unemancipated Minors: “Simon’s Law”
This legislation requires that:
- At least one parent or guardian of an unemancipated minor child, who is under the care of a doctor and healthcare facility, is notified (orally and in writing in most cases) 48 hours prior to a doctor instituting an order to withhold life-sustaining treatment (artificial life-sustaining procedures; artificial nutrition and hydration.) Reasonable attempts must also be made to notify any other parent or legal guardian who has custodial or visitation rights. Notification and attempts to notify should be documented in the patient’s medical record contemporaneously. (Note: In this statute, “unemancipated minor” is narrowly defined as a minor who is not married or in active military service. Existing Idaho statutes defining emancipated minor also include a minor who has been married in the past, has been judiciously emancipated, or who is living on their own and is self-sufficient.)
- Unless the parent or legal guardian agrees, an order to withhold life-sustaining treatment shall not be instituted until at least 48 hours after oral and written notice.
- The parent or guardian may request a transfer of their child to either another treatment facility or to home. They have 15 days in which to arrange the transfer, and during that time the hospital or health care facility must continue provision of artificial, life-sustaining procedures.
Qualified Immunity for Medical Student Volunteers
Medical students are now included among the healthcare providers who are afforded qualified immunity for their uncompensated work in free medical clinics and community health screening events. The student must be providing services under the direct supervision and scope of practice of a physician or another appropriately licensed individual and patients must be notified that the individual is a student. As with other providers, the immunity applies only if the patient executes a written release in advance of the services being rendered acknowledging the limited liability.
APRN Authority to Sign or Certify
APRNs have the authority to practice independently of physician supervision, yet many Idaho statutes still require a physician signature for documents such as disabled parking permits, jury exemptions, disabled hunter permits, athletic physicals, or mental health declarations. This legislation provides signature authority to APRNs when an established provision of law within their scope of practice requires a physician’s signature. It does not expand APRN scope of practice.