Legislation

HB 1948, Prescription Monitoring Program (PMP) goes into effect November 1, 2015.  The legislation clarifies language related to the Uniform Controlled Dangerous Substance Act and establishes a Prescription Monitoring Program for all prescribers: osteopathic and allopathic physicians, dentists, veterinarians, optometrists, nurses, and podiatrists. The bill requires these prescribers to access the PMP “prior to prescribing or authorizing for refill if 180 days have elapsed prior to the previous access and check, of opiates, synthetic opiates, semisynthetic opiates, benzodiazepine, or carisoprodol to a patient of record”.

HB 1948 grants the sole responsibility for enforcement of the patient screening requirements to the licensing entity for each profession subject to the Act and a listing of the top 20 prescribers of controlled dangerous substances will be sent to their licensing entity.  Click here to view the Oklahoma Hospital Association post including FAQs. Click here to view HB 1948.

Oklahoma will soon be one of the few states with a child passenger safety law that meets the recommendations of the American Academy of Pediatrics.  This new child passenger safety law goes into effect November 1, 2015.  The Oklahoma State Department of Health Injury Prevention Service has just released this educational poster to help you explain this new law to your patients.  To order this poster and/or brochure in either English or Spanish, contact 405-271-3430.  Please provide: the name or your organization, the mailing address, contact person at that organization and their contact information along with the number of English or Spanish posters and/or brochures you need.

Effective November 1, 2015 all fetal deaths (aka stillbirths) that occur in Oklahoma at 12+ weeks gestation are required to be reported to the Oklahoma State Department of Health (OSDH). Historically, the law has required the reporting of all fetal deaths which occurred at 20 or more weeks gestation. However, the definition of fetal death was amended during the 2015 legislative session with the creation of “Ashlen’s Law“.

OSDH has released some guidance on reporting stillbirth/fetal deaths. Click here to access their recommendations.

In accordance with Oklahoma Statutes [63 O.S. § 1-317(a)]: “No later than July 1, 2017, physicians licensed in this state shall be required to sign and file death certificates using the prescribed electronic system.” Also according to Oklahoma Statutes, a death certificate “shall be filed with the State Department of Health within three days after such death”.

The Oklahoma State Department of Health (OSDH) urges Oklahoma physicians to enroll in ROVER to electronically certify death certificates.

For more information, please see below.
ROVER Complete Death Certificates Electronically
Physician User Guide
Birth Clerk User Guide

This spring, the Oklahoma Legislature passed a bill that changes the laws surrounding opioid prescriptions. What does the legislation do?

Senate Bill 1446 places limits on the number of opioid pills that physicians can prescribe and puts in place safeguards to help curb the potential for opioid abuse. Starting on Nov. 1, physicians will only be able to initially prescribe a week’s worth of opioid drugs to manage acute pain and must limit the dosage to the lowest effective dose. Before renewing the prescription for up to seven more days, the law requires a consultation with the patient to determine that the patient needs the prescription and that the prescription does not present a risk for abuse, addiction, or diversion. If after the initial 14 days the physician determines that the patient still needs opioids to manage pain, the physician must follow the procedures to treat chronic pain that are outlined below. Additionally, the law places greater responsibility on physicians by requiring one hour of continuing education in pain management or in opioid abuse and addiction each year before the physician renews his or her license to practice and by providing for disciplinary action if a practitioner fails to check the Oklahoma Prescription Monitoring Program database. The law also aims to generally increase communication between prescribers and patients by requiring documented discussions on the risks associated with opioids.

Click here to view the rest of the article.

For further clarification, click here to view a letter from the Attorney General’s office on SB 1446.

Burkes, Paula (2018, Oct 19). Opioid prescribing laws to change Nov. 1, 2018. NewsOK. Retrieved from https://newsok.com/

Why was this changed?

On July 22, 2016 the President signed into law Public Law 114-198, the Comprehensive Addiction and Recovery Act (CARA) of 2016. This law amended certain sections of the Child Abuse Prevention and Treatment Act (CAPTA). CAPTA is the key federal legislation that provides guidance and funding to state child welfare agencies in support of prevention, assessment, investigation, prosecution and treatment activities. Previous to CARA, states were required by CAPTA to have policies and procedures relating to “infants born and identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure.” In 2010, the provision was amended by Congress to also include infants affected by Fetal Alcohol Spectrum Disorder. The 2016 CARA required that states remove the term “illegal” as applied to substance abuse affecting infants and to specifically require that plans of safe care address the needs of both infants and their families or caretakers. As a result, Oklahoma State Statute had to be amended in order to come into compliance with federal law. HB 3104 was signed by the governor on May 8, 2018 and took immediate effect.

What was changed?

In the previous Oklahoma statute, the definition of “Drug-endangered child” included the sentence, “The term also includes newborns who test positive for a controlled dangerous substance, with the exception of those substances administered under the care of a physician.” That sentence has been removed from the definition, removing the exception. Newborns who test positive for a controlled dangerous substance (see lists here – Title 63, Chapter 2, Article 2) should be reported to the Department of Human Services, regardless of if the substance had been prescribed to mother. Infants who are diagnosed with Neonatal Abstinence Syndrome or Fetal Alcohol Spectrum Disorder should also be reported.

Who should report an infant that tests positive?

The description of who should report has been broadened. With amendments (strikethrough has been removed, underlined has been added), the following description is included: “Every physician, surgeon, or other health care professional including doctors of medicine, licensed osteopathic physicians, residents and interns, or any other health care professional attending the birth of a child who or midwife involved in the prenatal care of expectant mothers or the delivery or care of infants shall promptly report to the Department instances in which an infant tests positive for alcohol or a controlled dangerous substance shall promptly report the matter to the Department. This shall include infants who are diagnosed with Neonatal Abstinence Syndrome or Fetal Alcohol Spectrum Disorder.”

Read the entire Enrolled HB3104 to view all revisions.

Documentation in the Hospital

Providing a thorough discharge summary for a newborn who has tested positive is of utmost importance. Including details on follow-up appointments and treatment plans in the discharge instructions will greatly assist in the follow-up of these cases.

How does one make a report?

The preferred method of reporting is by calling the Department of Human Services’ Statewide 24-hour Child Abuse Hotline at 1-800-522-3511. Only one member of the team caring for the infant needs to report. The following information will be asked:

• The names, addresses, ages and whereabouts of the child and the child’s parents, or other persons responsible for the child’s welfare, such as at the school, work, daycare, or hospital;
• Information pertaining to support systems for the family, other individuals who may be aware of the abuse or neglect, or any safety-related issues child welfare may need to be aware of prior to making contact with the family, such as domestic violence, presence of weapons, or use of illegal substances;
• The nature and extent of the abuse or neglect;
• Any historical information on the family related to the safety and well-being of the children and their parents or other identified caretakers; and
• Any other information that might be helpful in establishing the cause of the injuries and the identity of the person responsible.

Download form to help organize information to be reported

If a reporter does not have all of the information listed above, he or she should go ahead and report the details of what is known concerning the suspicion of abuse or neglect.

Download the OKDHS guide to reporting child abuse

Download the OKDHS Hotline Referral Form

A new Oklahoma statute related to perinatal mental health went into effect November 1, 2019. This statute, from enrolled SB 419, requires Oklahoma hospitals and licensed health care professionals to educate their patients for perinatal mental health disorders. Licensed health care professionals are also required to screen for perinatal mental health disorders at prenatal, postnatal, and pediatric care visits.

Download more information about SB 419