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ENGROSSED SENATE AMENDMENT
TO
ENGROSSED HOUSE
BILL NO. 2686 By: West (Rick) and Waldron of
the House
and
Burns of the Senate
An Act relating to mental health; amending 43A O.S.
2021, Section 3-601, which relates to opioid
substitution treatment programs and addicted
persons; mandating drug screens; and providing an
effective date.
AMENDMENT NO. 1. Page 1, strike the title, enacting clause and
entire bill and insert
“An Act relating to substance abuse services;
creating the Hannah McKenzie Act of 2023; providing
short title; amending 43A O.S. 2021, Section 3 -601,
which relates to opioid substitution treatment
programs; requiring opioid substitution treatment
programs to comply with certa in federal requirements;
requiring drug abuse testing to be directly observed;
broadening grounds for certain penalties; amending 59
O.S. 2021, Section 478.1, which relates to
establishment of physician -patient relationship
through telemedicine; adding exc eption to certain
restriction; providing for noncodifi cation; and
declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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SECTION 1. NEW LAW A new section of law not to be
codified in the Oklahoma Statutes reads as follows:
This act shall be known and may be ci ted as the “Hannah McKenzie
Act of 2023”.
SECTION 2. AMENDATORY 43 A O.S. 2021, Section 3-601, is
amended to read as follows:
Section 3-601. A. Any Class II controlled dangerous subs tance,
when used in this state by an opioid sub stitution treatment program
for persons with a history of opioid addiction to or physiologic
dependence on controlled dangerous substances, shall only be u sed:
1. In treating persons with a history of addicti on;
2. In treating persons with a one-year history of opioid
addiction to or physiolog ic dependence on control led dangerous
substances, as defined by the Code of Federal Regulations, and
documentation of attempting another type of treatment; or
3. If clinically appropriate, the program physician may waive
the requirement of a one -year history of opioid addiction for
consumers within six (6) months of release from a penal institution,
for consumers with a pregnancy verified by the program physician, or
for consumers having previously received treatment for opioid
addiction and within two (2) years of discharge from that treatment
episode.
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B. Any conviction for a violation of the provis ions of this
section or any rules promulgated pursuant to the provisions of this
section shall be a felony.
C. For the purposes of this section, “opioid substitution
treatment program” means a person, private physician , or
organization that administers or dispenses an opioid drug to a
narcotic addict for the purposes of detoxification or maintenance
treatment or provides, when necessary and appropriate, comprehensive
medical and rehabilitation services. A private physi cian who
administers buprenorphine wi th a waiver from the Drug Enforcement
Administration shall not be considered an opioid substitution
treatment program.
D. An opioid substitution treatment program shall be certified
by the Board of Mental Health and Subst ance Abuse Services, or the
Commissioner of Mental Health and Substance Abuse Services upon
delegation by the Board, and registered with the federal Drug
Enforcement Administration for the use of an opioid drug to treat
narcotic addiction.
D. E. The Board of Mental Health and Substance Abuse Se rvices
shall promulgate rules and standards for the certification of all
programs, private facilities, and organi zations which provide opioid
substitution treatment directed to those physiologically dependent
on or addicted to opioids. These facilities an d organizations shall
be known as “Opioid Substitution Treatment Programs”. Only
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certified facilities may receiv e and assist opioid-dependent and
addicted persons by providing Class II controlled substances in
opioid substitution treatment and rehabilitat ion.
E. F. The Board of Mental Health and Substance Abuse Services
shall promulgate rules and standards regulati ng the treatment and
services provided by opioid substitution treatment p rograms.
Failure to comply with rul es and standards promulgated by the B oard
shall be grounds for revocation, suspension or nonrenewal of
certification.
F. G. An opioid substitution treatment program shall comply
with all federal requirements for opioid treatment programs provided
by 42 C.F.R., Subpart C including but not limited to t he requirement
to provide drug abuse testing services provided by 42 C.F.R.,
Section 8.12(f)(6). Drug abuse testing shall be dire ctly observed
by an employee or contractor of the opioid substitution treatment
program.
H. Opioid substitution treatment pro grams shall notify the
Department of Mental Health and Substance Abuse Services of plans to
close or relocate within a minimum of thirty ( 30) days prior to
closure or relocation.
G. I. Failure to comply with rules and standards promulgated by
the Board of Mental Health and Substance Abuse Services pursuant to
this section or failure to comply with the requirements of 42
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C.F.R., Subpart C shall be grounds for reprimand, suspension,
revocation or nonrenewal of certification.
SECTION 3. AMENDATORY 59 O.S. 2021, Section 478.1, is
amended to read as fol lows:
Section 478.1. A. Unless otherwise prohibited by law, a valid
physician-patient relationship may be established by an allopathic
or osteopathic physician with a patient located in this state
through telemedicine, provided that the physician:
1. Holds a license to practice medicine in this state;
2. Confirms with the patient the patient 's identity and
physical location; and
3. Provides the patient with the treating physician 's identity
and professional credentials.
B. Telemedicine encounters shal l comply with the Health
Insurance Portability and Accountability Act of 1996 and ensure that
all patient communications and records are secure and confidential.
C. Telemedicine encounte rs in this state shall not be used to
establish a valid physician -patient relationship for the purpose of
prescribing opiates, synthetic opiates, semisynthetic opiates,
benzodiazepine or carisprodol, but may be unless the encounter is
used to prescribe opioid:
1. Opioid antagonists or partial agonists pursuant to Sections
1-2506.1 and 1-2506.2 of Title 63 of the Oklahoma Statutes ; or
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2. A Schedule III, IV, or V controlled dangerous substance
approved by the United States F ood and Drug Administration for
medication assisted treatment or detoxification treatment for
substance use disorder.
D. A physician-patient relationship shall not be created solely
based on the receipt of patient health information by a physician.
The duties and obligations created by a physician-patient
relationship shall not apply until the physician affirmatively:
1. Undertakes to diagnose and treat the patient; or
2. Participates in the diagnosis and treatment of the patient.
SECTION 4. It being immediately necessary for the preservation
of the public peace, health or safety, an em ergency 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. ”
Passed the Senate the 26th day of April, 2023.
Presiding Officer of the Senate
Passed the House of Repre sentatives the ____ day of _______ ___,
2023.
Presiding Officer of the House
of Representatives
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ENGROSSED HOUSE
BILL NO. 2686 By: West (Rick) and Waldron of
the House
and
Burns of the Senate
An Act relating to mental health; amending 43A O.S.
2021, Section 3-601, which relates to opioid
substitution treatment programs and addicted
persons; mandating drug screens; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLA HOMA:
SECTION 5. AMENDATORY 43 A O.S. 2021, Section 3-601, is
amended to read as follows:
Section 3-601. A. Any Class II controlled dangerous substance,
when used in this state by an opioid substitution treatment program
for persons with a history of opioid addiction to or physiologic
dependence on controlled dangerous substances, shall only be used:
1. In treating persons with a history of addiction ;
2. In treating persons with a one -year history of opioid
addiction to or physiolog ic dependence on control led dangerous
substances, as defined by the Code of Federal Regulations, and
documentation of attem pting another type of treatment; or
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3. If clinically appro priate, the program physician may waive
the requirement of a one -year history of opioid addiction for
consumers within six (6) months of release from a penal institution,
for consumers with a pregn ancy verified by the program physician, or
for consumers having previously received treatment for opioid
addiction and within two (2) years of discharge from that treatment
episode.
Provided, however, that persons who are participating in the
opioid substitution treatment program, pursuant to this subsection,
shall be administered a minimum of eight random, witnessed, urine
drug screens annually.
B. Any conviction for a violation of the provis ions of this
section or any rules promulgated pursuant to th e provisions of this
section shall be a felony.
C. For the purposes of this section, "opioid substitution
treatment program" means a person, private physician , or
organization that administers or dispenses an opioid drug to a
narcotic addict for the purpo ses of detoxification or maintenance
treatment or provides, when necessary and appropriate, comprehensive
medical and rehabilitation services. A private physi cian who
administers buprenorphine wi th a waiver from the Drug Enforcement
Administration shall n ot be considered an opioid substitution
treatment program. An opioid substitution treatment program shall
be certified by the Board of Mental Health and Subst ance Abuse
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Services, or the Commissio ner of Mental Health and Substance Abuse
Services upon delegation by the Board, and registered with the
federal Drug Enforcement Administration for the use of an opioid
drug to treat narcotic addiction.
D. The Board of Mental Health and Substance Abuse Se rvices
shall promulgate rules and standards for the certific ation of all
programs, private facilities, and organization s which provide opioid
substitution treatment directed to those physiologically dependent
on or addicted to opioids. These facilities an d organizations shall
be known as "Opioid Substitution Treat ment Programs". Only
certified facilities may receive and assist opioid-dependent and
addicted persons by providing Class II controlled substances in
opioid substitution treatment and rehabilitat ion.
E. The Board of Mental Health and Substance Abuse Serv ices
shall promulgate rules and standards regulating the tr eatment and
services provided by opioid substitution treatment p rograms.
Failure to comply with rul es and standards promulgated by the B oard
shall be grounds for revocation, suspension or nonrenew al of
certification.
F. Opioid substitution treatment prog rams shall notify the
Department of Mental Health and Substance Abuse Services of plans to
close or relocate within a minimum of thirty ( 30) days prior to
closure or relocation.
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G. Failure to comply with rules and standards promulgated by
the Board of Mental Health and Substance Abuse Services pursuant to
this section shall be grounds for reprimand, sus pension, revocation
or nonrenewal of certification.
SECTION 6. This act shall be come effective November 1, 2023.
Passed the House of Representatives the 23rd day of March, 2023.
Presiding Officer of the House
of Representatives
Passed the Senate the ____ day of __________, 2023.
Presiding Officer of the Senate