Sections I - VII categorize key legal provisions implicating EPT as follows:
Existing statutes/regulations that specifically address the ability
of authorized health care providers to provide a prescription for a patient’s
partner(s) without prior evaluation for certain STDs. Section I includes
statutory or regulatory provisions that specifically address whether a health
care provider may provide a prescription for a patient’s partner without
a prior evaluation or relationship with the partner. While these provisions
may be limited in their application, they may effectually either authorize
or prohibit EPT in specific circumstances. For example, a few states feature
statutes or regulations that directly authorize some health care professionals
to conduct EPT. These laws typically specify the STDs for which EPT is authorized
as well as the health care professionals who are authorized to conduct EPT.
Specific judicial decisions concerning EPT (or like practices). Section
II includes judicial decisions (case law) that implicate the legality of EPT
or “like practices” (practices that are legally similar to EPT).
Case law decisions are legally binding in their jurisdictions and set legal
precedent for future decisions.
Specific administrative opinions by the Attorney General or medical
or pharmacy boards concerning EPT (or like practices). Section III
includes publicly-available decisions by state administrative bodies that
discuss the legality of EPT or like practices. These decisions can include
opinions of the state Attorney General, actions by medical disciplinary boards,
advisory decisions or resolutions of medical or pharmacy boards, or general
policy guidelines. Attorney General opinions are only binding on the party
who sought the opinion, but the opinion may indicate how EPT may be regarded
in the future.
Legislative bills or prospective regulations concerning EPT (or
like practices). Section IV includes recent legislative or regulatory
actions that would authorize or prohibit EPT or like practices. Although
these bills or regulations have not been passed into law, they provide a
glimpse as to potential future legality of EPT.
Laws that incorporate via reference guidelines as acceptable practices
(including EPT). Section V includes legal provisions that allow public
health or clinical practices to be incorporated by reference through specific
guidelines. Even if the current legal status of EPT in a jurisdiction is unclear,
EPT could become legally permissible if a designated published guideline, agency,
or official adopted EPT as an acceptable treatment method. The contents of
these guidelines are incorporated by reference, which means they have the force
of law in that jurisdiction. Legalization of EPT may thus be furthered by consulting
with the organization that publishes the guideline or the agency official to
recognize EPT as an acceptable treatment method for specific STDs provided
such recommendation does not conflict with other legal provisions. The following
abbreviations are used in this column of the table:
“CDC STD Treatment Guidelines” refers to Sexually Transmitted
Diseases Treatment Guidelines published by CDC through its Morbidity and
Mortality Weekly Reports (which explicitly supports the use of EPT for certain
STDs and populations);
“APHA’s CCD Manual” refers to the Control of Communicable
Diseases in Man published by the American Public Health Association; and
“AAP’s Red Book” refers to the Red Book: Report of
the Committee on Infectious Diseases published by the American Academy of Pediatrics.
Prescription requirements. Section
VI includes statutory or regulatory provisions that relate to prescription
drug laws (other than for controlled substances) in each jurisdiction to
the extent they may impact EPT. This may include:
laws that require prescription
orders or labels to indicate identifying information about the person for
whom the prescription is intended. If identifying information is not required,
it may facilitate a physician writing a prescription for a patient to deliver
to her partner without identifying the partner. While these laws do not necessarily
implicate the legality of EPT, they affect how EPT may be implemented in
practice. If patient-identifying information is required, a physician may
not be legally permitted to provide a blank prescription or an “extra
dose” for the patient to deliver to the partner. Instead, such a prescription
may have to be made out in the partner’s name;
laws that concern
the pharmacists’ need to verify a physician-patient relationship or
that an individual has been examined by a physician prior to dispensing pharmaceutical
products; or
laws that require a pharmacist to ensure that drugs are dispensed to an ultimate user of the prescription.
Assessment of the legal status of EPT. Section
VII provides an assessment whether the various laws of the jurisdiction tend
to support or reject the legality of EPT. One of three conclusions is indicated
for each jurisdiction:
- EPT
is permissible for certain practitioners and conditions; - EPT
is potentially allowable subject to additional actions or policies (this may
include specific interpretations of inconsistent or amorphous provisions,
supporting policies consistent with legal authorization, or incorporation
by reference into treatment guidelines); or - EPT
is likely prohibited.
Each of these initial conclusions is followed by brief comments providing some
justification for the assessment.
Limitations
The information presented here is not legal advice, nor is it a comprehensive
analysis of all the legal provisions that could implicate the legality of
EPT in a given jurisdiction. Rather, it provides a comparative snapshot of
legal
provisions that may highlight legislative, regulatory, judicial laws and policies
concerning EPT based on currently available information. This snapshot is subject
to change. Measuring the legal weight of non-binding legal sources, such as
policy guidance documents or administrative decisions, must be done locally
within the context of applicable statutes and regulations. The data and assessment
are intended to be used as a tool to assist state and local health departments
as they determine locally appropriate ways to control STDs. Assessment of local
statutes was not undertaken, with the exception of the District of Columbia.
Assessment of tribal laws for sovereign nations was also not undertaken.