The following words and terms, when used in this
Subchapter, shall have the following meaning, unless the context clearly
means obtaining approval from a person for the procedure
after providing an explanation of the necessity for the procedure involved, any
known risks involved and, when appropriate, any alternative course of care.
"Informed consent" means
voluntary written consent from a person who received full, accurate, and
sufficient information and explanation about a child's medical condition,
medication, and treatment to enable the person to make a knowledgeable decision
without being subjected to any deceit or coercion.
"Separate and specific
consent" means a licensed physician, psychiatrist, or other medical
professional recommended a treatment or medication and requires an additional
consent form provided by the professional be signed to authorize the treatment
to occur or medication to be administered.
means information provided and explained in plain language by the prescribing
physician or physician's representative to the consent-giver including, but not
limited to, the:
(i) medical care and
treatment or the medication;
reason for prescribing the treatment or medication and the medication's purpose
or intended results;
effects, risks, and contraindications including the effects of stopping the
(iv) method for
administering the treatment or medication and dosage range, when
(v) potential drug
(vii) behavioral health
or other services used to complement the use of the psychotropic medication,
when applicable; and
treatment interventions considered by the physician that may include, but are
not limited to, medical, mental health, behavioral, counseling, or other
"DHS custody" means a child is in the voluntary, emergency,
temporary, or permanent custody of DHS.
means, per Section 1-3-102 of Title 10A of the
Oklahoma Statutes (10A O.S. § 1-3-102) medical care or treatment that is
either extraordinary or routine and ordinary.
Extraordinary medical care and treatment
includes, but is not limited to:
(iv) invasive or
Routine and ordinary medical care and
treatment does not include any type of extraordinary care or treatment and
includes, but is not limited to:
necessary medical and dental examinations and treatments;
(ii) medical screenings;
(iii) clinical laboratory tests;
(iv) blood testing;
(v) preventative care;
(vi) health assessments;
(vii) physical examinations;
(ix) contagious or infectious disease
(x) tests and care
required for treatment of illness and injury including x-rays, stitches, and
(xi) the provision of
"Placement provider" means
the person, foster parent, or administrator of a facility providing out-of-home
care for a child in DHS custody.
means medications with well-demonstrated efficacy in the treatment of mental
disorders through the modification of behavior, mood, and emotions.
Medical services for the
child in DHS custody in out-of-home care.
DHS is required to provide
medical care necessary to preserve the child's health, per Oklahoma Children's
Code provisions, 10A O.S. § 1-7-103. The child in DHS custody receives:
(1) Early Periodic, Screening, Diagnosis, and
Treatment (EPSDT) screening according to the schedule of frequency or at a
minimum, an annual physical exam. In addition, DHS provides, within 21-calendar
days of entering custody, a standardized assessment for each child placed in
DHS emergency custody, to evaluate the physical, developmental, medical, mental
health, and educational needs, including health problems requiring immediate
treatment, diagnosis of infections and communicable diseases, and an evaluation
of injuries or other signs of abuse or neglect.
(2) a yearly behavioral health or
developmental screening, and when recommended a behavioral health or
developmental assessment, within 60-calendar days of the screening;
(3) a yearly dental exam when the child is
over 3 years of age. A child under 3 years of age receives dental services as
(4) an initiation of
immunizations that are kept current;
(5) a visual and hearing evaluation exam and
corrective lenses or hearing aids, when indicated;
(6) outpatient or inpatient behavioral mental
health treatment, when appropriate;
(7) physician's services when the child is
sick. This service is not considered a physical exam;
contagious or infectious disease
screenings, including Human Immunodeficiency Virus (HIV) exams or testing, are
provided as needed or upon request by a placement provider in a manner
consistent with the Centers for Disease Control guidelines for time and testing
frequency, per Oklahoma Administrative Code
(9) follow-up and referral
services as recommended by a qualified professional.
Consent for medical
DHS authority to
consent to routine and ordinary medical care and treatment.
DHS may consent to routine and ordinary
medical care and treatment when the child is in DHS custody. DHS makes
reasonable attempts, per 10A O.S. § 1-3-102, when the child is in
voluntary, emergency, or temporary custody to:
(i) notify the child's parent or legal
guardian of the provision of routine and ordinary medical care and treatment;
(ii) keep the parent or legal
guardian involved in the care.
(B) DHS may authorize the placement provider,
in writing, through the placement provider agreement, to consent to routine and
ordinary medical care and treatment needed for the child upon the advice of a
licensed physician, including psychotropic medication.
Consent for extraordinary medical
(A) DHS employees are not
authorized to consent to extraordinary medical care and treatment for any child
in DHS voluntary, emergency, temporary, or permanent custody.
When the child is in DHS voluntary,
emergency, or temporary custody, consent for the child's extraordinary medical
care and treatment is obtained from the parent or legal guardian, unless the:
(i) parent is unavailable to provide
(ii) parent refuses to
(iii) care and
treatment is related to the suspected abuse or neglect.
Court authority is required for
extraordinary medical care and treatment when the:
(i) child is in DHS permanent
(ii) parent is unavailable
to provide consent;
refuses to provide consent; or
care and treatment is related to the suspected abuse or neglect.
When the recommended
extraordinary medical care and treatment is not the result of a
life-threatening emergency requiring immediate medical intervention, the court,
per 10A O.S. § 1-3-102:
(i) holds a
hearing, upon the application of the district attorney and notice to all
(ii) may authorize the
recommended extraordinary care and treatment.
(E) DHS does not, in any circumstance,
consent to a child's abortion, sterilization, termination of life support, or
to a Do Not Resuscitate order. The court may authorize the withdrawal of
life-sustaining medical treatment or the denial of the administration of
cardiopulmonary resuscitation on behalf of the child in DHS custody, upon the
written recommendation of a licensed physician, after notice to the parties,
and a hearing.
Medical consent for child in protective custody.
Per 10A O.S. § 1-3-102, when the
child taken into protective custody without a court order, requires emergency
medical care prior to the emergency custody hearing, a peace officer, court
employee, or the court may authorize treatment as necessary to safeguard the
health and life of the child when the:
treatment is related to the suspected abuse and neglect;
(ii) parent or guardian is unavailable to
consent to the treatment recommended by a physician; or
(iii) parent or guardian refuses to consent
to the treatment recommended by a physician.
(B) Before a peace officer, court employee,
or the court authorizes treatment based on the unavailability of the parent or
legal guardian, law enforcement exercises diligence in locating the parent or
guardian, when known.
Consent for medical care for the
child in his or her own home.
The parent of the child in DHS custody
placed in his or her own home consents to routine and ordinary medical care and
treatment and extraordinary medical care and treatment needed by the child. In
the event of parental refusal, DHS may consent to routine and ordinary medical
care and treatment needed by a child in DHS custody, per OAC 340:75-14-3
In the event of parental refusal to consent to extraordinary medical care and
treatment needed by a child in DHS custody, DHS complies with procedures, per
Consent for extraordinary medical care for the child who traveled
out-of-state. When the child is out-of-state and requires extraordinary
medical care and treatment, the judge may authorize the physician or medical
facility to provide the extraordinary medical care via a verbal or written
medical procedures. Medical procedures that are experimental may not be
compensable through SoonerCare (Medicaid) and are considered to be
extraordinary medical care and treatment that must be authorized by the parent
or court order.
Okla. Admin. Code §
Register, Volume 36, Issue 24, September 3, 2019, eff.
Register, Volume 37, Issue 24, September 1, 2020, eff.