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STATE OF OKLAHOMA
1st Session of the 58th Legislature (2021)
HOUSE BILL 2798 By: Pfeiffer
AS INTRODUCED
An Act relating to health care; amending 36 O.S.
2011, Section 6802, which relates to telemedicine;
defining term; amending Section 1, Chapter 228,
O.S.L. 2017 (59 O.S. Supp. 2020, Section 478), which
relates to definitions; defining term; 43A O.S. 2011,
Section 1-103, as last amended by Section 29, Chapter
475, O.S.L. 2019 (43A O.S. Supp. 2020, Section 1 -
103), which relates to definition s; defining term;
and providing an effective date .
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 36 O.S. 2011, Section 6802, is
amended to read as follows:
Section 6802. As used in this act, "telemedicine" means the
practice of health care delivery, diagnosis, consultation,
treatment, including but not limited to, the treatment and
prevention of strokes, transfer of medical data, or exchange of
medical education information by means of aud io, video, or data
communications. Telemedicine is not a consultation provided by
telephone or facsimile machine mode of delivering health care
through the use of synchronous or asynchronous telecommunications
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technologies capable of assisting a provider to deliver patient
health care services, including but not limited to assessment,
diagnosis, treatment, and remote monitoring of a patient,
consultation with a patient, transfer of medical data, patient and
professional health-related education, public hea lth services, and
health administration , in compliance with all applicable state and
federal laws, including the Health Insurance Portability and
Accountability Act (HIPAA), Section 1320 of Title 42 of the United
States Code, and the Health Information Tec hnology for Economic and
Clinical Health Act (HITECH), Sections 300jj through 300jj -52 of
Title 42 of the United States Code .
SECTION 2. AMENDATORY Section 1, Chapter 228, O.S.L.
2017 (59 O.S. Supp. 2020, Section 478), is amended to read as
follows:
Section 478. A. As used in this act:
1. "Store and forward technologies " means the transmission of a
patient's medical information from an originating site to the
physician or practitioner at the distant site; provided, photographs
visualized by a telecommunications system shall be specific to the
patient's medical condition and adequate for furnishing or
confirming a diagnosis or treatment plan;
2. "Telemedicine" means the practice of health care delivery,
diagnosis, consultation, e valuation and treatment, transfer of
medical data or exchange of medical education information by means
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of a two-way, real-time interactive communication, not to exclude
store and forward technologies, between a patient and a physician
with access to and r eviewing the patient 's relevant clinical
information prior to the telemedicine visit.
"Telemedicine" and "store and forward technologies " shall not
include consultations provided by telephone audio -only
communication, electronic mail, text message, instant messaging
conversation, website questionnaire, nonsecure video conference or
facsimile machine mode of delivering health care through the use of
synchronous or asynchronous telecommunications technologies capable
of assisting a provider to deliver patient health care services,
including but not limited to assessment, diagnosis, treatment, and
remote monitoring of a patient, consultation with a patient,
transfer of medical data, patient and professional health -related
education, public health services, and health administration, in
compliance with all applicable state and federal laws, including the
Health Insurance Portability and Accountability Act (HIPAA), Section
1320 of Title 42 of the United States Code, and the Health
Information Technology for Econom ic and Clinical Health Act
(HITECH), Sections 300jj through 300jj -52 of Title 42 of the United
States Code.
SECTION 3. AMENDATORY 43A O.S. 2011, Section 1 -103, as
last amended by Section 29, Chapter 475, O.S.L. 2019 (43A O.S. Supp .
2020, Section 1-103), is amended to read as follows:
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Section 1-103. When used in this title, unless otherwise
expressly stated, or unless the context or subject matter otherwise
requires:
1. "Department" means the Department of Mental Health and
Substance Abuse Services;
2. "Chair" means the chair of the Board of Mental Health and
Substance Abuse Services;
3. "Mental illness" means a substantial disorder of thought,
mood, perception, psychological orientation or memory that
significantly impairs judgm ent, behavior, capacity to recognize
reality or ability to meet the ordinary demands of life;
4. "Board" means the Board of Mental Health and Substance Abuse
Services as established by the Mental Health Law;
5. "Commissioner" means the individual selecte d and appointed
by the Board to serve as Commissioner of Mental Health and Substance
Abuse Services;
6. "Indigent person" means a person who has not sufficient
assets or resources to support the person and to support members of
the family of the person la wfully dependent on the person for
support;
7. "Facility" means any hospital, school, building, house or
retreat, authorized by law to have the care, treatment or custody of
an individual with mental illness, or drug or alcohol dependency,
gambling addiction, eating disorders, an opioid substitution
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treatment program, including, but not limited to, public or private
hospitals, community mental health centers, clinics, satellites or
facilities; provided, that facility shall not mean a child guidance
center operated by the State Department of Health;
8. "Consumer" means a person under care or treatment in a
facility pursuant to the Mental Health Law, or in an outpatient
status;
9. "Care and treatment" means medical care and behavioral
health services, as we ll as food, clothing and maintenance,
furnished to a person;
10. Whenever in this law or in any other law, or in any rule or
order made or promulgated pursuant to this law or to any other law,
or in the printed forms prepared for the admission of consumer s or
for statistical reports, the words "insane", "insanity", "lunacy",
"mentally sick", "mental disease" or "mental disorder" are used,
such terms shall have equal significance to the words "mental
illness";
11. "Licensed mental health professional " means:
a. a psychiatrist who is a diplomate of the American
Board of Psychiatry and Neurology,
b. a psychiatrist who is a diplomate of the American
Osteopathic Board of Neurology and Psychiatry,
c. a physician licensed pursuant to the Oklahoma
Allopathic Medical and Surgical Licensure and
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Supervision Act or the Oklahoma Osteopathic Medicine
Act,
d. a clinical psychologist who is duly licensed to
practice by the State Board of Examiners of
Psychologists,
e. a professional counselor licensed pursuant to the
Licensed Professional Counselors Act,
f. a person licensed as a clinical social worker pursuant
to the provisions of the Social Worker 's Licensing
Act,
g. a licensed marital and family therapist as defined in
the Marital and Family Therapist Licensure Act,
h. a licensed behavioral practitioner as defined in the
Licensed Behavioral Practitioner Act ,
i. an advanced practice nurse as defined in the Oklahoma
Nursing Practice Act,
j. a physician's assistant who is licensed in good
standing in this state, or
k. a licensed drug and alcohol counselor/mental health
(LADC/MH) as defined in the Licensed Alcohol and Drug
Counselors Act;
12. "Mentally incompetent person " means any person who has been
adjudicated mentally or legally incompetent by an appropriate
district court;
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13. a. "Person requiring treatment " means a person who
because of his or her mental illness or drug or
alcohol dependency:
(1) poses a substantial risk of immediate physical
harm to self as manifested by evidence or serious
threats of or attempts at sui cide or other
significant self-inflicted bodily harm,
(2) poses a substantial risk of immediate physical
harm to another person or persons as manifested
by evidence of violent behavior directed toward
another person or persons,
(3) has placed another perso n or persons in a
reasonable fear of violent behavior directed
towards such person or persons or serious
physical harm to them as manifested by serious
and immediate threats,
(4) is in a condition of severe deterioration such
that, without immediate interv ention, there
exists a substantial risk that severe impairment
or injury will result to the person, or
(5) poses a substantial risk of immediate serious
physical injury to self or death as manifested by
evidence that the person is unable to provide for
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and is not providing for his or her basic
physical needs.
b. The mental health or substance abuse history of the
person may be used as part of the evidence to
determine whether the person is a person requiring
treatment or an assisted outpatient. The mental
health or substance abuse history of the person shall
not be the sole basis for this determination.
c. Unless a person also meets the criteria established in
subparagraph a or b of this paragraph, "person
requiring treatment" or an "assisted outpatient" shall
not mean:
(1) a person whose mental processes have been
weakened or impaired by reason of advanced years,
dementia, or Alzheimer 's disease,
(2) a person with intellectual or developmental
disability as defined in Title 10 of the Oklahoma
Statutes,
(3) a person with seizure disorder,
(4) a person with a traumatic brain injury, or
(5) a person who is homeless.
d. A person who meets the criteria established in this
section but who is medically unstable, or the facility
holding the person is unable to treat the additional
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medical conditions of that person, should be
discharged and transported in accordance with Section
1-110 of this title;
14. "Petitioner" means a person who files a petition alleging
that an individual is a person requiring treatment or an assisted
outpatient;
15. "Executive director" means the person in charge of a
facility as defined in this section;
16. "Private hospital or facility " means any general hospital
maintaining a neuro-psychiatric unit or ward, or any private
hospital or facility for care and treatment of a person having a
mental illness, which is not supported by the state or federal
government. The term "private hospital" or "facility" shall not
include nursing homes or other facilities maintained primarily for
the care of elderly and disabled persons;
17. "Individualized treatment plan " means a proposal developed
during the stay of an individual in a facility, under the provisions
of this title, which is specifically tailored to the treatment needs
of the individual. Each plan shall clearly include the following:
a. a statement of treatment goals or objectives, based
upon and related to a clinical evaluation, which can
be reasonably achieved within a designated time
interval,
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b. treatment methods and procedures to be used to obtain
these goals, which methods and procedures are related
to each of these goals and which include specific
prognosis for achieving each of these goals,
c. identification of the types of professional personnel
who will carry out the treatment procedu res, including
appropriate medical or other professional involvement
by a physician or other health professional properly
qualified to fulfill legal requirements mandated under
state and federal law,
d. documentation of involvement by the individual
receiving treatment and, if applicable, the accordance
of the individual with the treatment plan, and
e. a statement attesting that the executive director of
the facility or clinical director has made a
reasonable effort to meet the plan 's individualized
treatment goals in the least restrictive environment
possible closest to the home community of the
individual;
18. "Telemedicine" means the practice of health care delivery,
diagnosis, consultation, evaluation, treatment, transfer of medical
data, or exchange of medical education information by means of
audio, video, or data communications. Telemedicine uses audio and
video multimedia telecommunication equipment which permits two -way
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real-time communication between a health care practitioner and a
patient who are not in the same physical location. Telemedicine
shall not include consultation provided by telephone or facsimile
machine mode of delivering health care through t he use of
synchronous or asynchronous telecommunications technologies ca pable
of assisting a provider to deliver patient health care services,
including but not limited to assessment, diagnosis, treatment, and
remote monitoring of a patient, consultation with a patient,
transfer of medical data, patient and professional health -related
education, public health services, and health administration, in
compliance with all applicable state and federal laws, including the
Health Insurance Portability and Accountability Act (HIPAA), Section
1320 of Title 42 of the United States Code, and the Health
Information Technology for Economic and Clinical Health Act
(HITECH), Sections 300jj through 300jj -52 of Title 42 of the United
States Code;
19. "Recovery and recovery support " means nonclinical services
that assist individuals and families to recover from al cohol or drug
problems. They include social support, linkage to and coordination
among allied service providers, including but not limited to
transportation to and from treatment or employment, employment
services and job training, case management and ind ividual services
coordination, life skills education, relapse prevention, housing
assistance, child care, and substance abuse education;
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20. "Assisted outpatient" means a person who:
a. is either currently under the care of a facility
certified by the Dep artment of Mental Health and
Substance Abuse Services as a Community Mental Health
Center, or is being discharged from the custody of the
Oklahoma Department of Corrections, or is being
discharged from a residential placement by the Office
of Juvenile Affairs,
b. is suffering from a mental illness,
c. is unlikely to survive safely in the community without
supervision, based on a clinical determination,
d. has a history of lack of compliance with treatment for
mental illness that has:
(1) prior to the filing of a petition, at least twice
within the last thirty -six (36) months been a
significant factor in necessitating
hospitalization or treatment in a hospital or
residential facility, including admission to a
community-based structured crisis center as
certified by the Oklahoma Department of Mental
Health and Substance Abuse Services, or receipt
of services in a forensic or other mental health
unit of a correctional facility, or a specialized
treatment plan for treatment of mental illness in
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a secure juvenile facility or placement in a
specialized residential program for juveniles, or
(2) prior to the filing of the petition, resulted in
one or more acts of serious violent behavior
toward self or others or threats of, or attempts
at, serious physical harm to sel f or others
within the last twenty -four (24) months,
e. is, as a result of his or her mental illness, unlikely
to voluntarily participate in outpatient treatment
that would enable him or her to live safely in the
community,
f. in view of his or her treatme nt history and current
behavior, is in need of assisted outpatient treatment
in order to prevent a relapse or deterioration which
would be likely to result in serious harm to the
person or persons as defined in this section, and
g. is likely to benefit fro m assisted outpatient
treatment; and
21. "Assisted outpatient treatment " means outpatient services
which have been ordered by the court pursuant to a treatment plan
approved by the court to treat an assisted outpatient 's mental
illness and to assist the p erson in living and functioning in the
community, or to attempt to prevent a relapse or deterioration that
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may reasonably be predicted to result in suicide or the need for
hospitalization.
SECTION 4. This act shall become effective Novembe r 1, 2021.
58-1-6768 AB 01/05/21