HB1005 HFLR Page 1 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 HOUSE OF REPRESENTATIVES - FLOOR VERSION STATE OF OKLAHOMA 1st Session of the 58th Legislature (2021) HOUSE BILL 1005 By: Bush and Pae of the House and Montgomery of the Senate AS INTRODUCED An Act relating to the Uniform Controll ed Dangerous Substances Act; amending 63 O.S. 2011, Section 2 -101, as last amended by Section 1, Chapter 101, O.S.L. 2020 (63 O.S. Supp. 2020, Section 2 -101), which relates to definitions; defining term; modifying definitions; amending 63 O.S. 2011, Sectio n 2-101.1, which relates to drug paraphernalia; providing exception; authorizing certain entities to engage in harm-reduction services; requiring registration with the State Department of Health; providing for certain allowable activities for specified period of time; providing reporting requirements; directing promulgation of rules; providing for codification; and declaring an emergency . BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 63 O. S. 2011, Section 2-101, as last amended by Section 1, Chapter 101, O.S.L. 2020 (63 O.S. Supp. 2020, Section 2-101), is amended to read as follows: HB1005 HFLR Page 2 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 2-101. As used in the Uniform Controlled Dangerous Substances Act: 1. "Administer" means the direct application of a controlled dangerous substance, whether by injection, inhalation, ingestion or any other means, to the body of a patient, animal or research subject by: a. a practitioner (or, in the presence of the practitioner, by the authorized agent o f the practitioner), or b. the patient or research subject at the direction and in the presence of the practitioner; 2. "Agent" means a peace officer appointed by and who acts on behalf of the Director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control or an authorized person who acts on behalf of or at the direction of a person who manufactures, distributes, dispenses, prescribes, administers or uses for scientific purposes controlled dangerous substances but does not include a common o r contract carrier, public warehouser or employee thereof, or a person required to register under the Uniform Controlled Dangerous Substances Act; 3. "Board" means the Advisory Board to the Director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control; 4. "Bureau" means the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control; HB1005 HFLR Page 3 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 5. "Coca leaves" includes cocaine and any compound, manufacture, salt, derivative, mixture or preparation of coca leaves, except derivatives of coca leav es which do not contain cocaine or ecgonine; 6. "Commissioner" or "Director" means the Director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control; 7. "Control" means to add, remove or change the placement of a drug, substance or immed iate precursor under the Uniform Controlled Dangerous Substances Act; 8. "Controlled dangerous substance " means a drug, substance or immediate precursor in Schedules I through V of the Uniform Controlled Dangerous Substances Act or any drug, substance or immediate precursor listed either temporarily or permanently as a federally controlled substance. Any conflict between state and federal law with regard to the particular schedule in which a substance is listed shall be resolved in favor of state law; 9. "Counterfeit substance " means a controlled substance which, or the container or labeling of which without authorization, bears the trademark, trade name or other identifying marks, imprint, number or device or any likeness thereof of a manufacturer, distributor or dispenser other than the person who in fact manufactured, distributed or dispensed the substance; 10. "Deliver" or "delivery" means the actual, constructive or attempted transfer from one person to another of a controlled HB1005 HFLR Page 4 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 dangerous substance or drug paraphernalia, whether or not there is an agency relationship; 11. "Dispense" means to deliver a controlled dangerous substance to an ultimate user or human research subject by or pursuant to the lawful order of a practitioner, including the prescribing, administering, packaging, labeling or compounding necessary to prepare the substance for such distribution. "Dispenser" is a practitioner who delivers a controlled dangerous substance to an ultimate user or human research subject; 12. "Distribute" means to deliver other than by administering or dispensing a controlled dangerous substance; 13. "Distributor" means a commercial entity engaged in the distribution or reverse distribution of narcotics and dangerous drugs and who complies with all regulati ons promulgated by the federal Drug Enforcement Administration and the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control; 14. "Drug" means articles: a. recognized in the official United States Pharmacopoeia Pharmacopeia, official Homeopathic Pharmacopoeia of the United States, or official National Formulary, or any supplement to any of them, b. intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals, HB1005 HFLR Page 5 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 c. other than food, intended to affect the structure or any function of the body of man or other animals, and d. intended for use as a component of any article specified in this paragraph; provided, however, the term "drug" does not include devices or their components, parts or accessories; 15. "Drug-dependent person" means a person who is using a controlled dangerous substance and who is in a state of psychic or physical dependence, or both, arising from administration of that controlled dangerous substance on a continuous basis. Drug dependence is characterized by behavioral and other responses which include a strong compulsion to take the substance on a continuous basis in order to experience its psychic effects, or to avoid the discomfort of its absence; 16. "Harm-reduction services" means programs established to: a. reduce the spread of infectious diseases related to injection drug use, b. reduce drug dependency, overdose deaths, and associated complications, and c. increase safe recovery and disposal of used syringes and sharp waste; 17. "Home care agency" means any sole proprietorship, partnership, association, corporation, or other organization which administers, offers, or provides home care services, for a fee or HB1005 HFLR Page 6 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 pursuant to a contract for such services, to clients in their place of residence; 17. 18. "Home care services" means skilled or personal care services provided to clients in their place of residence for a fee; 18. 19. "Hospice" means a centrally administered, nonprofit or profit, medically directed, nurse -coordinated program which provides a continuum of home and inpatient care for the terminally ill patient and the patient 's family. Such term shall also include a centrally administered, nonprofit or profit, medically directed, nurse-coordinated program if such program is l icensed pursuant to the provisions of the Uniform Controlled Dangerous Substances Act. A hospice program offers palliative and supportive care to meet the special needs arising out of the physical, emotional and spiritual stresses which are experienced du ring the final stages of illness and during dying and bereavement. This care is available twenty - four (24) hours a day, seven (7) days a week, and is provided on the basis of need, regardless of ability to pay. "Class A" Hospice refers to Medicare certif ied hospices. "Class B" refers to all other providers of hospice services; 19. 20. "Imitation controlled substance " means a substance that is not a controlled dangerous substance, which by dosage unit appearance, color, shape, size, markings or by repres entations made, would lead a reasonable person to believe that the substance is a controlled dangerous substance. In the event the appearance of the HB1005 HFLR Page 7 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 dosage unit is not reasonably sufficient to establish that the substance is an "imitation controlled subst ance", the court or authority concerned should consider, in addition to all other factors, the following factors as related to "representations made " in determining whether the substance is an "imitation controlled substance": a. statements made by an owne r or by any other person in control of the substance concerning the nature of the substance, or its use or effect, b. statements made to the recipient that the substance may be resold for inordinate profit, c. whether the substance is packaged in a manner normally used for illicit controlled substances, d. evasive tactics or actions utilized by the owner or person in control of the substance to avoid detection by law enforcement authorities, e. prior convictions, if any, of an owner, or any other person in control of the object substance, under state or federal law related to controlled substances or fraud, and f. the proximity of the substances to controlled dangerous substances; 20. 21. "Immediate precursor" means a substance which the Director has found to be and by regulation designates as being the HB1005 HFLR Page 8 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 principal compound commonly used or produced primarily for use, and which is an immediate chemical intermediary used, or likely to be used, in the manufacture of a controlled dangerous substance, the control of which is necessary to prevent, curtail or limit such manufacture; 21. 22. "Laboratory" means a laboratory approved by the Director as proper to be entrusted with the custody of controlled dangerous substances and the use of controlled dangerous substan ces for scientific and medical purposes and for purposes of instruction; 22. 23. "Manufacture" means the production, preparation, propagation, compounding or processing of a controlled dangerous substance, either directly or indirectly by extraction from substances of natural or synthetic origin, or independently by means of chemical synthesis or by a combination of extraction and chemical synthesis. "Manufacturer" includes any person who packages, repackages or labels any container of any controlled dang erous substance, except practitioners who dispense or compound prescription orders for delivery to the ultimate consumer; 23. 24. "Marijuana" means all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture or preparation of such plant, its seeds or resin, but shall not include: HB1005 HFLR Page 9 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 a. the mature stalks of such plant or fiber produced from such stalks, b. oil or cake made from the seeds of such plant, including cannabidiol derived from the seeds of the marijuana plant, c. any other compound, manufacture, salt, derivative, mixture or preparation of such mature stalks (except the resin extracted therefrom), including cannabidiol derived from mature stalks, fiber, oil or cake, d. the sterilized seed of such plant which is incapable of germination, e. for any person participating in a clinical trial to administer cannabidiol for the treatment of severe forms of epilepsy pursuant to S ection 2-802 of this title, a drug or substance approved by the federal Food and Drug Administration for use by those participants, f. for any person or the parents, legal guardians or caretakers of the person who have received a written certification from a physician licensed in this state that the person has been diagnosed by a physician as having Lennox-Gastaut syndrome, Dravet syndrome, also known as Severe Myoclonic Epilepsy of Infancy, or any other severe form of epilepsy that is not adequately HB1005 HFLR Page 10 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 treated by traditional medical therapies, spasticity due to multiple sclerosis or due to paraplegia, intractable nausea and vomiting, appetite stimulation with chronic wasting diseases, the substance cannabidiol, a nonpsychoactive cannabinoid, found in the plant Cannabis sativa L. or any other preparation thereof, that has a tetrahydrocannabinol concentration of not more than three -tenths of one percent (0.3%) and that is delivered to the patient in the form of a liquid, g. any cannabidiol drug or substance appro ved by the federal Food and Drug Administration-approved cannabidiol drug or substance , or h. industrial hemp, from the plant Cannabis sativa L. and any part of such plant, whether growing or not, with a delta-9 tetrahydrocannabinol concentration of not mo re than three-tenths of one percent (0.3%) on a dry weight basis which shall only be grown pursuant to the Oklahoma Industrial Hemp Program and may be shipped intrastate and interstate; 24. 25. "Medical purpose" means an intention to utilize a controlled dangerous substance for physical or mental treatment, for diagnosis, or for the prevention of a disease condition not in HB1005 HFLR Page 11 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 violation of any state or federal law and not for the purpose of satisfying physiological or psychological dependence or other abuse; 25. 26. "Mid-level practitioner" means an Advanced Practice Registered Nurse as defined and within parameters specified in Section 567.3a of Title 59 of the Oklahoma Statutes, or a certified animal euthanasia technician as defined in Section 698.2 of Title 59 of the Oklahoma Statutes, or an animal control officer registered by the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control under subsection B of Section 2 -301 of this title within the parameters of such officer 's duty under Sections 501 th rough 508 of Title 4 of the Oklahoma Statutes; 26. 27. "Narcotic drug" means any of the following, whether produced directly or indirectly by extraction from substances of vegetable origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis: a. opium, coca leaves and opiates, b. a compound, manufacture, salt, derivative or preparation of opium, coca leaves or opiates, c. cocaine, its salts, optical and geometric isomers, and salts of isomers, d. ecgonine, its derivatives, their salts, isomers and salts of isomers, and e. a substance, and any compound, manufacture, salt, derivative or preparation thereof, which is chemically HB1005 HFLR Page 12 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 identical with any of the substances referred to in subparagraphs a through d of this paragraph, except that the words "narcotic drug" as used in Section 2 - 101 et seq. of this title shall not include decocainized coca leaves or extracts of coca leaves, which extracts do not contain cocaine or ecgonine; 27. 28. "Opiate" or "opioid" means any Schedule II, III, IV or V substance having an addiction -forming or addiction -sustaining liability similar to morphine or being capable of conversion into a drug having such addiction -forming or addiction -sustaining liability. The terms do not incl ude, unless specifically designated as controlled under the Uniform Controlled Dangerous Substances Act, the dextrorotatory isomer of 3 -methoxy-n-methyl-morphinan and its salts (dextromethorphan). The terms do include the racemic and levorotatory forms; 28. 29. "Opium poppy" means the plant of the species Papaver somniferum L., except the seeds thereof; 29. 30. "Peace officer" means a police officer, sheriff, deputy sheriff, district attorney 's investigator, investigator from the Office of the Attorney G eneral, or any other person elected or appointed by law to enforce any of the criminal laws of this state or of the United States; HB1005 HFLR Page 13 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 30. 31. "Person" means an individual, corporation, government or governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity; 31. 32. "Poppy straw" means all parts, except the seeds, of the opium poppy, after mowing; 32. 33. "Practitioner" means: a. (1) a medical doctor or osteopathic physician, (2) a dentist, (3) a podiatrist, (4) an optometrist, (5) a veterinarian, (6) a physician assistant or Advanced Practice Registered Nurse under the supervision of a licensed medical doctor or osteopathic physician, (7) a scientific investigator, or (8) any other person, licensed, registered or otherwise permitted to prescribe, distribute, dispense, conduct research with respect to, use for scientific purposes or administer a controlled dangerous substance in the course of professional practice or research in this state, or b. a pharmacy, hospital, laboratory or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect HB1005 HFLR Page 14 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 to, use for scientific purposes or administer a controlled dangerous substance in the course of professional practice or research in this state; 33. 34. "Production" includes the manufacture, planting, cultivation, growing or harvesting of a controlled dangerous substance; 34. 35. "State" means the State of Oklahoma or any other state of the United States; 35. 36. "Ultimate user" means a person who lawfully possesses a controlled dangerous substance for the person 's own use or for the use of a member of the person 's household or for administration to an animal owned by the person or by a member of the pers on's household; 36. 37. "Drug paraphernalia" means all equipment, products and materials of any kind which are used, intended for use, or fashioned specifically for use in planting, propagating, cultivating, growing, harvesting, manufacturing, compounding , converting, producing, processing, preparing, testing, analyzing, packaging, repackaging, storing, containing, concealing, injecting, ingesting, inhaling or otherwise introducing into the human body, a controlled dangerous substance in violation of the U niform Controlled Dangerous Substances Act including, but not limited to: a. kits used, intended for use, or fashioned specifically for use in planting, propagating, cultivating, growing HB1005 HFLR Page 15 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 or harvesting of any species of plant which is a controlled dangerous substance or from which a controlled dangerous substance can be derived, b. kits used, intended for use, or fashioned specifically for use in manufacturing, compounding, converting, producing, processing or preparing controlled dangerous substances, c. isomerization devices used, intended for use, or fashioned specifically for use in increasing the potency of any species of plant which is a controlled dangerous substance, d. testing equipment used, intended for use, or fashioned specifically for use in ide ntifying, or in analyzing the strength, effectiveness or purity of controlled dangerous substances, e. scales and balances used, intended for use, or fashioned specifically for use in weighing or measuring controlled dangerous substances, f. diluents and adulterants, such as quinine hydrochloride, mannitol, mannite, dextrose and lactose, used, intended for use, or fashioned specifically for use in cutting controlled dangerous substances, HB1005 HFLR Page 16 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 g. separation gins and sifters used, intended for use, or fashioned specifically for use in removing twigs and seeds from, or in otherwise cleaning or refining, marijuana, h. blenders, bowls, containers, spoons and mixing devices used, intended for use, or fashioned specifically for use in compounding controlled dangerous su bstances, i. capsules, balloons, envelopes and other containers used, intended for use, or fashioned specifically for use in packaging small quantities of controlled dangerous substances, j. containers and other objects used, intended for use, or fashioned specifically for use in parenterally injecting controlled dangerous substances into the human body, k. hypodermic syringes, needles and other objects used, intended for use, or fashioned specifically for use in parenterally injecting controlled dangerous substances into the human body except as authorized by Section 3 of this act, l. objects used, intended for use, or fashioned specifically for use in ingesting, inhaling or otherwise introducing marijuana, cocaine, hashish or hashish oil into the human bod y, such as: HB1005 HFLR Page 17 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (1) metal, wooden, acrylic, glass, stone, plastic or ceramic pipes with or without screens, permanent screens, hashish heads or punctured metal bowls, (2) water pipes, (3) carburetion tubes and devices, (4) smoking and carburetion masks, (5) roach clips, meaning objects used to hold burning material, such as a marijuana cigarette, that has become too small or too short to be held in the hand, (6) miniature cocaine spoons and cocaine vials, (7) chamber pipes, (8) carburetor pipes, (9) electric pipes, (10) air-driven pipes, (11) chillums, (12) bongs, or (13) ice pipes or chillers, m. all hidden or novelty pipes, and n. any pipe that has a tobacco bowl or chamber of less than one-half (1/2) inch in diameter in which there is any detectable residue o f any controlled dangerous substance as defined in this section or any other substances not legal for possession or use; HB1005 HFLR Page 18 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 provided, however, the term "drug paraphernalia" shall not include separation gins intended for use in preparing tea or spice, clamps used for constructing electrical equipment, water pipes designed for ornamentation in which no detectable amount of an illegal substance is found or pipes designed and used solely for smoking tobacco, traditional pipes of an American Indian tribal religious ceremony, or antique pipes that are thirty (30) years of age or older; 37. 38. a. "Synthetic controlled substance " means a substance: (1) the chemical structure of which is substantially similar to the chemical structure of a controlled dangerous substance in Schedule I or II, (2) which has a stimulant, depressant, or hallucinogenic effect on the central nervous system that is substantially similar to or greater than the stimulant, depressant or hallucinogenic effect on the central nervous system of a controlled dangerous substance in Schedule I or II, or (3) with respect to a particular person, which such person represents or intends to have a stimulant, depressant, or hallucinogenic effect on the central nervous system that is substantially similar to or greater than the stimulant, HB1005 HFLR Page 19 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 depressant, or hallucinogenic effect on the central nervous system of a controlled dangerous substance in Schedule I or II. b. The designation of gamma butyrolactone or any other chemical as a precursor, pursuant to Section 2 -322 of this title, does not preclude a finding pursuant to subparagraph a of this paragraph that the chemical is a synthetic controlled substance. c. "Synthetic controlled substance " does not include: (1) a controlled dangerous substance, (2) any substance for which there is an approved new drug application, (3) with respect to a particular person any substance, if an exemption is in effect for investigational use, for that person under the provisions of Section 505 of the Federal Food, Drug and Cosmetic Act, Title 21 of the United States Code, Section 355, to the extent conduct with respect to such substance is pursuant to such exemption, or (4) any substance to the extent not intended for human consumption before such an exemption takes effect with respect t o that substance. HB1005 HFLR Page 20 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 d. Prima facie evidence that a substance containing salvia divinorum has been enhanced, concentrated or chemically or physically altered shall give rise to a rebuttable presumption that the substance is a synthetic controlled substance; 38. 39. "Tetrahydrocannabinols " means all substances that have been chemically synthesized to emulate the tetrahydrocannabinols of marijuana; 39. 40. "Isomer" means the optical isomer, except as used in subsections C and F of Section 2 -204 of this title and paragraph 4 of subsection A of Section 2 -206 of this title. As used in subsections C and F of Section 2 -204 of this title, "isomer" means the optical, positional or geometric isomer. As used in paragraph 4 of subsection A of Section 2 -206 of this title, the term "isomer" means the optical or geometric isomer; 40. 41. "Hazardous materials" means materials, whether solid, liquid or gas, which are toxic to human, animal, aquatic or plant life, and the disposal of which materials is controlled by state or federal guidelines; 41. 42. "Anhydrous ammonia" means any substance that exhibits cryogenic evaporative behavior and tests positive for ammonia; 42. 43. "Acute pain" means pain, whether resulting from disease, accidental or intentional trauma or other c ause, that the practitioner reasonably expects to last only a short period of time. HB1005 HFLR Page 21 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 "Acute pain" does not include chronic pain, pain being treated as part of cancer care, hospice or other end -of-life care, or pain being treated as part of palliative care; 43. 44. "Chronic pain" means pain that persists beyond the usual course of an acute disease or healing of an injury. "Chronic pain" may or may not be associated with an acute or chronic pathologic process that causes continuous or intermittent pain over months or years; 44. 45. "Initial prescription " means a prescription issued to a patient who: a. has never not previously been issued a prescription for the drug or its pharmaceutical equivalent in the past year, or b. requires a prescription for the dru g or its pharmaceutical equivalent due to a surgical procedure or new acute event and has previously had a prescription for the drug or its pharmaceutical equivalent within the past year. When determining whether a patient was previously issued a prescription for a drug or its pharmaceutical equivalent, the practitioner shall consult with the patient and review the medical record and prescription monitoring information of the patient; 45. 46. "Patient-provider agreement" means a written contract or agreement that is executed between a practitioner and a patient, HB1005 HFLR Page 22 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 prior to the commencement of treatment for chronic pain using an opioid drug as a means to: a. explain the possible risk of development of physical or psychological dependence in the patient and pre vent the possible development of addiction, b. document the understanding of both the practitioner and the patient regarding the patient -provider agreement of the patient, c. establish the rights of the patient in association with treatment and the obligat ions of the patient in relation to the responsible use, discontinuation of use, and storage of opioid drugs, including any restrictions on the refill of prescriptions or the acceptance of opioid prescriptions from practitioners, d. identify the specific me dications and other modes of treatment, including physical therapy or exercise, relaxation or psychological counseling, that are included as a part of the patient -provider agreement, e. specify the measures the practitioner may employ to monitor the compliance of the patient including, but not limited to, random specimen screens and pill counts, and f. delineate the process for terminating the agreement, including the consequences if the practitioner has HB1005 HFLR Page 23 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 reason to believe that the patient is not complying with the terms of the agreement. Compliance with the "consent items" shall constitute a valid, informed consent for opioid therapy. The practitioner shall be held harmless from civil litigation for failure to treat pain if the event occurs because of nona dherence by the patient with any of the provisions of the patient-provider agreement; 46. 47. "Serious illness" means a medical illness or physical injury or condition that substantially affects quality of life for more than a short period of time. "Serious illness" includes, but is not limited to, Alzheimer 's disease or related dementias, lung disease, cancer, heart failure, renal failure, liver failure or chronic, unremitting or intractable pain such as neuropathic pain; and 47. 48. "Surgical procedure" means a procedure that is performed for the purpose of structurally altering the human body by incision or destruction of tissues as part of the practice of medicine. This term includes the diagnostic or therapeutic treatment of conditions or disease pr ocesses by use of instruments such as lasers, ultrasound, ionizing, radiation, scalpels, probes or needles that cause localized alteration or transportation of live human tissue by cutting, burning, vaporizing, freezing, suturing, probing or manipulating b y closed reduction for major dislocations HB1005 HFLR Page 24 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 or fractures, or otherwise altering by any mechanical, thermal, light-based, electromagnetic or chemical means. SECTION 2. AMENDATORY 63 O.S. 2011, Section 2 -101.1, is amended to read as f ollows: Section 2-101.1 In determining whether an object is "drug paraphernalia", a court or jury shall consider, in addition to all other logically relevant factors, the following: 1. Statements by an owner or by anyone in control of the object concerning its use; 2. The proximity of the object, in time and space, to a direct violation of the Uniform Controlled Dangerous Substances Act; 3. The proximity of the object to controlled dangerous substances; 4. The existence of any residue of controlled dan gerous substances on the object; 5. Direct or circumstantial evidence of the intent of an owner, or of anyone in control of the object, to deliver it to any person who intends to use the object to facilitate a violation of the Uniform Controlled Dangerous Substances Act. The innocence of an owner, or of anyone in control of the object, as to a direct violation of this act shall not prevent a finding that the object is intended for use, or fashioned specifically for use, as drug paraphernalia; HB1005 HFLR Page 25 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 6. Instructions, oral or written, provided with the object which either state directly or imply that the object is to be used for the consumption of controlled dangerous substances; 7. Descriptive materials accompanying the object which explain or depict its use as an object for the consumption of controlled dangerous substances; 8. The manner in which the object is displayed for sale; 9. Whether the owner, or anyone in control of the object, is a legitimate supplier of like or related items to the community, such as a licensed distributor or dealer of tobacco products; 10. Direct or circumstantial evidence of the ratio of sales of the object or objects to the total sales of the business enterprise; 11. The existence and scope of legitimate uses for the object in the community; and 12. Expert testimony concerning its use. Provided, nothing in this section shall apply to objects in the possession of harm-reduction services providers as authorized by Section 3 of this act. SECTION 3. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2-1101 of Title 63, unless there is created a duplication in numbering, reads as follows: A. Until July 1, 2026, the following are hereby authorized to engage in harm-reduction services: HB1005 HFLR Page 26 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. Government entities including, but not limited to, the State Department of Health and the Oklahoma Department of Mental Health and Substance Abuse Services; provided, no state dollars shall be used to purchase hypodermic needles; 2. Religious institutions or churches; 3. Nonprofit organizations; 4. For-profit companies; 5. Nongovernment entities partnering with a government agency; and 6. Tribal governments. B. Those offering harm-reduction services shall register with the State Department of Health and may engage in the following activities in order to reduce the use of drugs, prevent outbreaks of infectious diseases, and reduce morbidity among people who use injection drugs: 1. Offer referrals and resources to treat substance use disorders; 2. Provide education on the risk of transmission of infectious diseases, including human immunodeficiency virus (HIV) and viral hepatitis; 3. Rapid testing for HIV, hepatitis C, and sexually transmitted infections (STIs); 4. Referrals for medical and me ntal health services; 5. Collect used hypodermic needles for safe disposal ; HB1005 HFLR Page 27 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 6. Possess and distribute hypodermic needles, cleaning kits, test kits, and opioid antagonists; and 7. Rapid substance-testing products used, intended for use, or fashioned specifically for use in identi fying or analyzing the potency or toxicity of unknown substances. C. Registered providers of harm -reduction services shall report at least quarterly to the State Department of Health: 1. The number of clients served, including b asic demographic information; 2. Number and type of referrals provided; 3. Number of syringes, test kits, and antagonists distributed; 4. Number of used syringes collected; and 5. Number of rapid HIV and viral hepatitis tests performed, including the number of reactive test results. D. The State Department of Health shall promulgate rules for the implementation of this section. SECTION 4. It being immediately necessary for the preservation of the public peace, health or safety, an emer gency is hereby declared to exist, by reason whereof this act shall take effect and be in full force from and after its passage and approval. COMMITTEE REPORT BY: COMMITTEE ON PUBLIC SAFETY, dated 02/09/2021 - DO PASS, As Coauthored.