1.               The state’s demographics, geography, economy and urbanization

 

Demographics

In the 2020 Census, Oklahoma, the 28th most populous state, accounted for 1.2% of the United States population. The state’s population of approximately 3.9 million individuals had grown by 5.5% since the 2010 Census. A rural state, Oklahoma has three large cities. Oklahoma City, the state’s centrally located capital, is the largest of these and home to 17% (681,000 residents) of the state’s population. About 100 miles to the northeast is Tulsa, a city accounting for 10% (413,000 residents) of the state’s population. Nearly 90 miles southwest of the capital, sits Lawton, a city consisting of 90,000 residents, or 2.3% of Oklahoma’s population.

 

Nearly a quarter (24.1%, 953,000) of the Oklahoma population is less than 18 years of age. Individuals aged 65 years and older make up 16.4% of the population, and roughly 61% of the population is between 18 and 64 years of age. The male-female ratio is about 1:1, with slightly more females (2.0 million) than males (1.97 million). Females of childbearing age (15-44 years) number 781,000, about 20% of the total population. The number of females aged 15-19 years account for 128,700, about 16% of childbearing age females. The number of women aged 30-34 has increased by nearly 12% between 2010 and 2020, rising from 118,800 to 132,500.

 

Where residents choose to live varies by race and ethnicity. Largest in number, the white population tends to be geographically diffuse, while African Americans generally reside in the Oklahoma City and Tulsa metropolitan areas. The American Indian population has a larger presence in the northeast quadrant of the state, a legacy of the U.S. government’s removal programs of the 19th century. In 2020, 77% of Oklahoma’s population was classified as white, while American Indians represented 11% and African Americans comprised 9% of the state’s population. Approximately 3% of the population was categorized as Asian or Pacific Islander. The Hispanic population has grown from 8% (302,000) of the total population in 2010 to 11% (452,500) in 2020, a growth of 50% over the time period. Oklahoma is home to the largest number of federally recognized American Indian tribal governments (38).

 

Data from the U.S. Bureau of Economic Analysis indicate that Oklahoma’s per capita personal income was $53,156 in 2021, ranking 42nd among all states, and representing about 84% of the national average of $63,444. U.S. Census Bureau data show that 15.3% (606,000 people) of Oklahoma residents were living in poverty in 2020, an increase from 15.2% the previous year. Females (16.5%) were more likely to be living in poverty than were males (14.0%). Among children less than 18 years of age, 20.7% lived in poverty in 2020. Poverty status was more likely in minority populations when compared to the white population, with Native Hawaiian or Other Pacific Islanders (33.1%) having the highest percentage of residents in poverty, followed by African Americans (26.2%) and American Indians (20.0%).

 

Oklahoma’s birth rate was 12.0 births per 1,000 total population in 2020, ranking 41st among other states, and about 9% higher than the comparable U.S. birth rate (11.4). Since 2010, the birth rate has decreased by 15%, with the state averaging about 51,500 births per year. Similarly, the fertility rate has decreased from 71.9 births per 1,000 females aged 15-44 years to 60.9 over the same time period. Oklahoma has experienced a strong decrease in the rate of births to teens but still ranks poorly when compared nationally. In 2020, Oklahoma’s teen birth rate for females ages 15-19 was 25.0 births per 1,000 population, ranking 4th for the highest (worst) teen birth rate.

 

Geography

Positioned in the South-Central region of the United States, Oklahoma has a diverse geography, with a quarter of its land mass covered by forests. The state is home to four mountain regions – the Arbuckle Mountains, in south-central Oklahoma; the Ouachita Mountains, in the southeast; the Ozark Plateau, in the northeast; and the Wichita Mountains, in the southwest part of the state. Oklahoma is one of only four states with more than 10 distinct ecological regions. To the west, the state has semi-arid plains, while in the state’s center, transitional prairies and woodlands give way to the elevated terrain of the Ozark and Ouachita Mountains, which stretch out to Oklahoma’s eastern border. Oklahoma is landlocked in the center of the 48 contiguous states, bordered by Arkansas, Colorado, Kansas, Missouri, New Mexico, and Texas.

 

Economy

Oklahoma is a major producer of natural gas, oil, and agricultural products. The state’s economic base relies on aviation, energy, telecommunications, and biotechnology. The two largest metropolitan centers, Oklahoma City and Tulsa, serve as the primary economic anchors for the state. The top employers by workforce size for Oklahoma include the Department of Defense (69,000 employees, military and civilian) and Walmart Associates, Inc. (38,500). In the health sector, INTEGRIS Health has 9,600 employees, followed by Saint Francis Hospital (6,400), Mercy Health and the University of Oklahoma Health Sciences Center (5,900 each), OU Medical Center (5,200), St. Anthony/SSM Health Hospital (4,000), and St. John’s Medical Center (3,800).

 

Oklahoma’s real gross domestic product (GDP), the output of all goods and services produced by the economy in current dollars, totaled $195.0 billion in 2021, according to data from the U.S. Bureau of Economic Analysis, up by 2.5% from 2015 ($190.2 billion). The private sector comprises 85% of Oklahoma’s real GDP, with government making up the remainder (15%). As a percentage of GDP, the industry share in the economy was led by natural resources and mining (20%), the FIRE sector (i.e., finance, insurance, and real estate) (13%), manufacturing and information (12%), trade (10%), education and health services (7%), and transportation and utilities (6%).

 

Gaming (lotteries and casinos) continue to be a major contributor to the state’s economy. The state of Oklahoma collected over $163 million in tribal gaming exclusivity fees in fiscal year 2021, a 32.5% increase from the fiscal year 2020. Those fees were based on $2.74 billion in tribal gaming revenue. Exclusivity fees were distributed to the Education Reform Revolving Fund ($143.2 million), the General Revenue Fund ($19.5 million), and the Department of Mental Health and Substance Abuse Services ($250,000). This distribution of fees is determined by Oklahoma statute.

 

Data from the U.S. Bureau of Labor Statistics for calendar year 2021 showed that annual average unemployment rate for Oklahoma was 3.8%, ranking the state 13th nationally and approximately 28% lower than the US unemployment rate at that time. Of the state’s 77 counties, 39 counties had an unemployment rate less than the state average, 36 counties had a rate in excess of the state average, and 2 counties had the same unemployment rate for 2021. County unemployment rates ranged from 1.7% (Beaver County, located in the state’s panhandle) to 7.3% (Latimer County, southeast region of state). Oklahoma’s employment-population ratio, the number of working age persons who are employed divided by the total population of working age persons, was 58.3 in 2021, slightly lower than the national rate (58.4).

 

Urbanization

Approximately 61% of the Oklahoma population resides in the metropolitan statistical areas (MSAs) of Oklahoma City (1,441,647; 36%) and Tulsa (1,023,988; 25%), while a much smaller proportion of the state’s citizens lives in the Lawton MSA (127,543; 3%). The remainder of the Oklahoma population resides in rural cities and towns. The Oklahoma City MSA is made up of seven counties (Canadian, Cleveland, Grady, Lincoln, Logan, McClain, and Oklahoma) surrounding the principal city, Oklahoma City. Population growth in the Oklahoma City MSA was modest between 2020 and 2021, increasing by 0.9%. The Tulsa MSA is comprised of the seven counties (Creek, Okmulgee, Osage, Pawnee, Rogers, Tulsa, and Wagoner) encircling the principal city, Tulsa. Population growth in the Tulsa MSA reached just 0.7% between 2020 and 2021. With similar rate of growth, the Lawton MSA, made up of Comanche and Cotton counties, grew by 0.7% over the same time period.

 

2. The state’s unique strengths and challenges that impact the health status of its MCH population (e.g., availability and access to health care services)

 

Oklahoma’s MCH Service has developed close partnerships, both internal and external to the Oklahoma State Department of Health (OSDH), including other state agencies and community organizations. Since 2009, with the inception of the Preparing for a Lifetime, It’s Everyone’s Responsibility, the statewide infant mortality reduction initiative, MCH has collaborated with OSDH service areas to staff the initiative, perform analyses, formulate and implement strategies, and develop MCH-related programming. Internal partners include the Chronic Disease Service; Injury Prevention Service; Family Support and Prevention Services; Screening and Special Services; Nursing Service; WIC Service; SoonerStart/Early Intervention; Center for Health Statistics; Immunization Service; and the county health departments (CHD). These service areas and CHDs have participated in other past and current state and national efforts as well, including the Maternal Health Innovation Program, CoIIN to Reduce Infant Mortality, the Oklahoma Perinatal Quality Improvement Collaborative, the Period of Purple Crying Program, the MCH Safe Sleep Project, and the Oklahoma Maternal Health Task Force, as well as other activities not mentioned here.

 

Joining the internal partners mentioned above were entities external to OSDH, who contribute in large and meaningful ways. Sister agencies like the Oklahoma Health Care Authority (OHCA), the state’s Medicaid agency, the Oklahoma Department of Human Services (DHS), the Oklahoma Commission on Children and Youth (OCCY), and the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) are frequent and routine collaborators on the many efforts to improve and promote health in the maternal, infant, and child populations. Other colleagues in MCH-related work include those from the Oklahoma Hospital Association, the Office of Perinatal Quality Improvement (OPQI), Tulsa Health Department, the Oklahoma City-County Health Department, the Oklahoma Family Network, and the Southern Plains Tribal Health Board (SPTHB). These relationships continued to be drawn on, as well as new ones created, to inform the 2021-2025 Title V MCH Five-Year Needs Assessment. The many partnerships and collaborations developed and maintained by Oklahoma Title V programs were essential for achieving MCH goals, particularly during the pandemic.

 

Oklahoma has experienced a number of successes related to health outcomes and behaviors. Every Week Counts, a partnership among MCH, OPQI, and state birthing facilities active between 2011 and 2014, brought about a 96% reduction in the number of early elective deliveries. In January 2017, the March of Dimes recognized MCH’s achievement of lowering the preterm birth rate by 8% since 2010 by awarding the state with the Virginia Apgar Prematurity Campaign Leadership Award. However, for the four reporting years 2016 through 2019, the state observed an increase in preterm birth rate, similar to the nation’s, rising from a low of 10.3% in 2015 to 11.5% in 2019. In 2020, Oklahoma did observe improvement in preterm birth with the rate falling to 11.2%. Despite still having the 4th highest birth rate among teens aged 15-19, Oklahoma has experienced significant declines in the last two decades. In 2020, the teen birth rate for this population group was 25.0 births per 1,000 female population, a decrease of 8.8% over the recorded rate of 27.4 in 2019. While Oklahoma’s 2020 teen birth rate was still much higher than the comparable national rate (15.4), it was a remarkable improvement since the year 2000, when the state rate was recorded at 59.1 (decrease of greater than 50%). Another improvement includes the uptake in the use of long-acting reversible contraceptives (LARCs), the result of program emphasis on providing LARCs, when indicated, for women not seeking to become pregnant. With the efforts of the Preparing for a Lifetime initiative, along with other state activities, Oklahoma’s infant mortality rate (IMR) has decreased from 8.6 per 1,000 live births in 2007 to 6.0 in 2020, a relative decrease of 30% over the study period. Still, IMR varies sharply among race/ethnic groups in Oklahoma with African American infants dying at more than twice the rate of white infants. Moreover, the trend among other minority groups (American Indian, Asian/Pacific Islander, and Hispanic) shows rising rates of infant mortality.

 

Oklahoma identified its first case of COVID-19 on March 6, 2020 and the first confirmed COVID-19 death on March 18, 2020. From the onset of the pandemic through mid-April 2022, more than 1,038,224 known cases and 15,815 provisional COVID-19 deaths have been recorded in the state. Oklahoma’s governor, Kevin Stitt, issued Executive Order 2020-7 on March 15, 2020, declaring a state of emergency in the State of Oklahoma, effective for all 77 state counties, and activating the State Emergency Operations Plan. The executive order was effective for 30 days but amended repeatedly over the course of 2020, then superseded by ensuing executive orders. On May 3, 2021, Governor Stitt with Executive Order 2021-11, withdrew from the state of emergency, which had been issued with Executive Order 2021-7 to continue emergency status for the coronavirus pandemic. Since the initiation of the vaccine rollout in the state, approximately 2.2 million individuals have been fully vaccinated with more than 5.8 million doses administered. The Oklahoma Pandemic Center for Innovation and Excellence was founded in October 2020 by the Stitt administration as an initiative to protect Oklahoma residents from future pandemics.

 

According to Oklahoma Works, there were 9,700 Oklahoma business locations which temporarily or permanently discontinued operations between March 2020 and January 2021. Industries hit hardest included retail (1,165); professional, scientific, and technical services (1,070); and health care and social support services (1,017). In May 2021, the Oklahoma Employment Security Commission reported that it paid out greater than $5 billion in unemployment benefits since the beginning of the coronavirus pandemic in March 2020. The state’s unemployment rate in March 2020 was 3.2%, rising sharply with the onset of the pandemic to reach 13.0% in April 2020. Since that time, the unemployment rate steadily declined to 4.2% by March 2021. The annual average unemployment rate for Oklahoma in 2021 was 3.8%, nearly back to the level observed prior to the onset of the coronavirus pandemic.

 

3. The defined roles, responsibilities and targeted interests of the state health agency and how they influence the delivery of Title V services

 

With Governor Kevin Stitt assuming office in January 2019, state health and human services were re-organized under the Cabinet Secretary of Health and Mental Health and the Cabinet Secretary of Human Services. Respectively, these positions are held by Kevin Corbett and Justin Brown. Health and Human Services agencies in Oklahoma include the OSDH, DHS, ODMHSAS, Department of Rehabilitation Services, Office of Juvenile Affairs, OHCA, OCCY, Office of Disability Concerns, and the J.D. McCarty Center.

 

The Oklahoma State Department of Health, created under Oklahoma Statute Title 63 § 1-105, is responsible for protecting and improving the public’s health status through strategies that focus on preventing disease. OSDH programs and services are configured under three Deputy Commissioner areas: Community Health Services, Quality Assurance and Regulatory Services, and Health Preparedness. Community Health Services (CHS) is comprised of the county health departments, Family Health Services, Personal Health Services, Nursing Services, and Records and Community Health Systems. Family Health is home to the MCH Service, along with Screening and Special Services, Family Support and Prevention Service, Dental Health Service, WIC Service, and SoonerStart. Services comprising Personal Health include Community Development, Chronic Disease Service, Injury Prevention Service, and Immunization Service.

 

Oklahoma administers the MCH Title V Block Grant through two state agencies, the OSDH and the DHS. OSDH, as the state health agency, is authorized to receive and disburse the MCH Title V Block Grant funds as provided in Title 63 of the Oklahoma Statutes, Public Health Code, Sections 1-105 through 1-108. These sections created the OSDH, originally charged the Commissioner of Health to serve under the Board of Health, and outlined the Commissioner of Health's duties as "general supervision of the health of citizens of the state." In 2018, new legislation was enacted making the Board of Health an advisory body to the Commissioner of Health, who is now appointed by the state’s governor. Title 10 of the Oklahoma Statutes, Section 175.1 et. seq., grants the authority to administer the CSHCN Program to the DHS.

 

The MCH Title V Program is located in the OSDH within Family Health Services (FHS). Joyce Marshall, Director of the MCH Service, is directly responsible to the Assistant Deputy Commissioner of the FHS, Tina Johnson, who is directly responsible to the Deputy Commissioner of Community Health Services, Mendy Spohn. Ms. Spohn reports directly to the Commissioner of Health, Keith Reed, who was appointed by Governor Stitt upon the resignation of Lance Frye, MD, in October 2021. Gitanjali Pai, MD, is the Chief Medical Officer for the OSDH.

 

Programs administered in some part with Title V funds include: Preparing for a Lifetime, It’s Everyone’s Responsibility infant mortality reduction initiative; Maternal Mortality Review; Pregnancy Risk Assessment Monitoring System (PRAMS), The Oklahoma Toddler Survey (TOTS), and the Youth Risk Behavior Survey (YRBS) surveillance programs; adolescent pregnancy projects throughout the state; State Systems Development Initiative (SSDI); Fetal and Infant Mortality Review; School Health; Oklahoma Birth Defects Registry; Becoming Baby Friendly Oklahoma; and, other-related programs and initiatives.

 

The Title V CSHCN Program is located in the DHS within the Health Related and Medical Services (HR&MS) unit. HR&MS is organizationally placed under the Adult and Family Services Division. Carla McCarrell-Williams, the CSHCN Director, is directly responsible to the Deputy Director of Programs Linda Cavitt, AFS Assistant Director for Program Operations Shawn Franks, and AFS Director Deborah Smith. Title V CSHCN provides funding for respite through periodic vouchers to caregivers and through short-term inpatient stays and camps at the J.D. McCarty Center, adaptive equipment, and supplemental formula not covered by Title XIX. Likewise, funding and supports are provided to several groups at the University of Oklahoma Health Sciences Center (OUHSC) and OU Children’s Medical Center to enhance services for CSHCN families. These groups include Oklahoma Family Network (family-to-family support), Family Support 360 Center (family health system navigation), Family Partners JumpStart Clinic (developmental and behavioral screening services), Sooner SUCCESS (comprehensive system of health and educational services), the Comprehensive Sickle Cell Pediatric Clinic (healthcare transition services) and the Oklahoma Infant Transition Program (family support for newborns in the NICU). Parent Promise Community Hope Center and Center for Children and Families, Inc. (CCFI) Community Hope Center recently began receiving funding to lift up families of CSHCN through social service network navigation and assistance with securing concrete supports. The Community Hope Centers (CHC’s) infuse the science of Hope and promote self-sufficiency and resilience. Title V CSHCN also collaborates with Child Welfare Services at DHS to provide funding for psychological evaluation assessments not covered by Medicaid.

 

4. Components of the state’s systems of care for meeting the needs of underserved and vulnerable populations, including CSHCN. This discussion may include, but is not limited to, the following descriptors:

 

1.               Population served;

Overall, in FFY 2020, 2,076 Oklahoma children with special health care needs received direct services from a Title V partner. Per the National Survey of Children’s Health, there were an estimated 223,770 children in Oklahoma with a special health care need in 2019-2020.

 

Note: The number of children served is a conservative estimate intended to reduce the risk of duplication. Additionally, Title V representatives continue to encourage collaboration across partners and to reach out to families in under-served populations by speaking at family support group meetings and attending local health conferences that address children with special health care needs.

 

2. Health services infrastructure (e.g., number of children’s hospitals, pediatric specialists, accountable care organizational structure, etc.);

The state has three Children's Hospitals – the Children’s Hospital at Saint Francis in Tulsa, the Children’s Hospital at OU Medical Center in Oklahoma City, and the INTEGRIS Children’s Hospital at Baptist Medical Center, also in Oklahoma City. The Children’s Hospital at Saint Francis provides comprehensive medical care through inpatient and outpatient services and a network of more than 100 pediatricians and 65 pediatric subspecialists covering eastern Oklahoma. The Children’s Hospital at OU Medical Center has 314 inpatient beds and is the only freestanding pediatric hospital in Oklahoma solely dedicated to the treatment of children. During the height of COVID, the hospital transitioned PICU beds to adult beds to accommodate needs. Its NICU contains 93 beds (level V NICU) providing the highest level of neonatal care in the state. INTEGRIS Children’s includes a 40-bed level III NICU, a 26-bed pediatrics unit, and a 10-bed pediatric intensive care unit.

 

According to the Oklahoma Board of Medical Licensure and Supervision, there were 693 active pediatricians in the state in July 2022.

 

OHCA administers two health programs for the state. The first is SoonerCare, Oklahoma's Medicaid program. SoonerCare works to improve the health of qualified Oklahomans by ensuring that medically necessary benefits and services are available. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage. Under certain circumstances, Insure Oklahoma extends coverage to dependents within the household, which may include children with special health care needs.

 

5. Integration of services, such as physical, social and behavioral services;

 

Oklahoma has 77 counties with 68 county health departments where families of children and youth with special health care needs can access reproductive health care, vaccines, and, in some cases, mental health services. This allows families affordable access to care, some services at no charge while others have sliding scale fees.

 

Additionally, 66 counties in Oklahoma have Systems of Care Wrap Around for youth experiencing serious emotional disturbance. Wrap Around provides a Family Support Provider offering mentoring and systems navigation as well as a Care Coordinator supporting access to necessary medical, mental health, school and social services. Oklahoma also has 18 Community Mental Health Centers, where free and sliding scale mental health services can be accessed, as well as, 93 Federally Qualified Health Center sites which provide medical care and, in many cases, dental, vision and mental health care.

 

Children and youth with special health care needs may also receive services while they are in school. There are 250 nurses across the state in schools providing a limited scope of services. Many school districts contract with mental health providers to provide services during and after the school day. All of these services add to the services available in the child's community.

 

1.               Financing of services (e.g., managed care arrangements and Medicaid  

           eligibility).

Medicaid (SoonerCare) is managed by OHCA, Oklahoma's Medicaid agency. CHIP funding is blended with other Medicaid dollars to ensure better access for more children. Some examples include funding long-acting reversible contraceptives for adolescents and providing cribs to Medicaid-eligible families. In March 2022, Oklahoma had 974 children 18 years and under accessing SoonerCare via TEFRA. Additionally, 18,091 children received SoonerCare based on their Aged/Blind/Disability (ABD) status. Both groups, TEFRA and ABD, have high medical needs and/or significant disabilities and are better able to access needed medical/mental health services because of their access to SoonerCare. The OHCA also manages Insure Oklahoma, which is a premium assistance program for families of low-income status. In addition, several community, state and national programs provide access to grants and other funds to assist youth in receiving needed durable medical equipment, respite, co-pay assistance, etc. These vital funds fill gaps where families cannot afford to meet their child's needs.

 

On June 20, 2020, Oklahoma voters passed State Question 802 by a slim majority vote to expand Medicaid eligibility to adults aged 19-64 with income less than or equal to 138% of the federal poverty level. Eligible enrollees began signing up for the program on June 1, 2021. Although the original plan by the Governor was to implement managed care administered by private companies for those eligible for SoonerCare expansion in June 2021, the Oklahoma Supreme Court invalidated the plan because justices said it did not receive required legislative approval. More than 291,000 individuals have benefited from expanded eligibility in the last year. In 2022, Oklahoma passed legislation that privatizes Medicaid for certain populations, implementing a managed care structure that administers services through capitated payment plans, to begin October 1, 2023.

 

6.               Specific state statutes and other regulations that have relevance to the  

           MCH Block Grant authority and impact the state’s MCH and CSHCN  

           programs.

 

MCH serves as a resource and provides education to state legislators and their staff prior to and during the legislative session each year to assist in the setting of state policy and procedure. Analyses of bills are accomplished each year during session to identify issues that may present obstacles to improving the health of Oklahoma's maternal and child health population. These written analyses are shared with legislators and their legislative staff by the Commissioner of Health and the OSDH Legislative Liaison. MCH also participates in state boards, task forces, work groups, and committees during and between sessions per request of members of the state legislature or as appointed by the governor. MCH is able to provide to the legislative process the latest in national health care policy and practice; information on national, regional, and state health care issues and practices; and the most recent available national, regional, and state data for the maternal and child health population.

 

The following is a list of some of the legislative bills that were monitored by OSDH and MCH during the 2nd regular session of the 58th legislature (2022). SB indicates a Senate bill, HB, a House bill.

 

Abortion

SB 612, signed by Governor Stitt on April 22, 2022, prohibits the performance of an abortion in the state, except to save the life of a pregnant woman in a medical emergency. Violation of this law is a felony with a person convicted of performing an abortion subject to up to a $100,000 fine and confinement in the Oklahoma Department of Corrections, not to exceed 10 years.

 

SB 1503, immediately in effect upon passage by Governor Stitt on May 3, 2022, creates the Oklahoma Heartbeat Act, a measure providing that a physician my not knowingly perform or induce an abortion unless it has been determined there is no detectable fetal heartbeat. The Act requires the physician to perform a certain test with specified criteria and that certain information be included in the medical record of the pregnant woman. The measure does not apply should the physician believe a medical emergency exists, thus, preventing compliance with the Act.

 

HB 4327, immediately in effect upon passage by Governor Stitt on May 26, 2022, authorizes individuals to take civil action against those who perform abortions or help a person obtain an abortion. The woman seeking an abortion cannot be sued under this legislation. The law contains exceptions for abortions performed to save the life of the mother in a medical emergency, and provides an exception in cases of rape or incest reported to law enforcement.

 

Suicide Prevention

On April 21, 2022, Governor Stitt signed into law SB 1307, which requires school districts and charter schools serving students in grades 7th through 12th to issue student ID cards with the National Suicide Prevention Lifeline and the Crisis Text Line. Further, the bill allows for institutions within the Oklahoma State System of Higher Education and private institutions of higher education in the state to issue student ID cards with the telephone number for the National Suicide Prevention Lifeline, the Crisis Text Line, and the campus police or security telephone number. Law becomes effective July 1, 2023.

 

CPR and First Aid

SB 1462, which became Ava’s Law following the governor’s signature on April 21, 2022, requires that all persons licensed to practice medicine and surgery in Oklahoma; as well as Advance Practice Registered Nurses and those who provide prenatal, delivery, infant care services, provide resources and information about CPR and basic first aid to women who are pregnant or plan to have a baby. The OSDH is charged with compiling educational resources on infant cardiopulmonary resuscitation and basic first aid to include contact information for training programs and to make this information available on its webpages. Law becomes effective November 1, 2022.

 

State Commissioner of Health

SB 709 exempted potential candidates for the position of Commissioner of Health from existing qualifications. Prior to the passage of this bill, candidates for the position had to meet at least one of the following criteria: possess a doctor of medicine degree and a license to practice medicine in Oklahoma; possess an osteopathic medicine degree and a license to practice medicine in Oklahoma; possess a doctoral degree in public health or public health administration; or possess a master of science degree and at least five years of supervisory experience in the administration of health services. SB 709 stipulates that the Commissioner of Health serves at the pleasure of the governor and shall be exempt from the above qualifications if they possess at least a master’s degree and has experience in management of state agencies or large projects. This bill was enacted into law as of April 26, 2022.

 

Vital Records

SB 1100 limits the biological sex designation on a birth certificate to either male or female and shall not be nonbinary or any symbol representing a nonbinary designation. Bill was enacted into law immediately upon the governor’s signature dated April 26, 2022.

 

Vision Screening

HB 3823 specifies that licensed optometrists and ophthalmologists may perform vision screening for children enrolling in kindergarten, first and third grade. The bill exempts these professionals from the standards and training requirements created by the Infant and Children’s Health Advisory Council. Governor Stitt signed HB 3828 on April 29, 2022, and the bill will be enacted into law on November 1, 2022.

 

Tobacco Use Prevention

HB 3315 removes the fine associated with persons under 21 who purchase tobacco, nicotine, or vapor products, and requires them to complete an education or tobacco use cessation program approved by the OSDH. The law removes language permitting cities and towns to enact and municipal police officers to enforce ordinances prohibiting and penalizing the purchase or possession of such products by a person less than 21 years of age. Governor Stitt signed HB 3315 on May 16, 2022, and the law will become effective November 1, 2022.

 

Congenital Anomalies

Signed by Governor Stitt on April 29, 2022, SB 1203, to be enacted as Courtney’s Law in November 2022, requires any health care facility, health care provider, or genetic counselor providing prenatal care, postnatal care, or genetic counseling upon receipt of a positive result for a chromosomal disorder test, will provide the parents with specific disorder information as prepared by the OSDH. Information will be culturally appropriate for woman or family in question.

 

Medicaid Program

SB 1337, signed into law by Governor Stitt in May 26, 2022, allows private health care providers to be awarded contracts to managed Medicaid for patients in Oklahoma. The law requires the OHCA to issue request for proposals (RFP) for all Medicaid services other than dental services for certain Medicaid populations – pregnant women, children, newborns, parents and caretaker relatives, and the expansion population. OHCA must specify covered and not covered services in the RFPs and to implement the program by October 1 2023, pending approval by the Centers for Medicare and Medicaid Services (CMS).