Beginning in 2015, the newly enacted Medical Treatment Laws Information Act imposes educational requirements on Oklahoma health care providers related to patient end-of-life treatment decision-making. Two groups of professionals are affected by the law. The first group includes physicians, physician assistants, nurse practitioners, and nurses who provide healthcare services at inpatient facilities. The second group includes healthcare executives – the CEO or administrator, members of the board of directors, and general counsel – of inpatient facilities. Inpatient facilities include hospitals, nursing facilities, specialized inpatient facilities for developmentally disabled persons, nursing care components of continuum of care facilities, and nursing care components of life care communities.

The purpose of the Act is to educate healthcare providers, healthcare executives, and patients and their families about the specific state laws affecting end-of-life treatment. Those laws include the Hydration and Nutrition for Incompetent Patients Act; Nondiscrimination in Treatment Act, Oklahoma Advance Directive Act, Oklahoma DNR Act, and the Assisted Suicide Prevention Act. This new law was initiated by The Oklahomans for Life Coalition, an organization that has voiced concerns that healthcare providers and patients may not be aware of their rights and responsibilities under these Oklahoma laws.

Educational Requirements

Healthcare providers and the designated healthcare executives (including board members of inpatient facilities) must annually certify in writing that they have read a publication titled: Oklahoma Health Care Providers’ Responsibilities and Rights under Certain Medical Treatment Laws.

The Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) prepared and mailed the publication to thousands of licensed healthcare providers in December.

Additionally, all healthcare providers and designated executives must participate in a one-hour online training course every two years and certify completion of the training. The OSBMLS is currently developing the online training course, which is expected to be available on its website by February 1. The one-hour training may count toward the continuing education requirements of healthcare providers.

Patient Disclosure Statement

The new law also requires inpatient facilities to provide patients with a disclosure statement entitled: Information for Patients and Their Families: Your Medical Treatment Rights under Oklahoma Law.

The disclosure statement must be provided to patients at the time they provide information about patient rights and advance directives in accordance with Medicare regulations.

Other Obligations

Inpatient facilities must maintain for four years certificates showing that healthcare providers and required executives and board members have satisfied these requirements. New healthcare providers, executives and board members must satisfy these requirements within 14 days of becoming employed by an inpatient facility, becoming a board member, or becoming a medical staff member or allied health professional. The records are subject to inspection by the State Department of Health during licensure surveys.

Steps to Ensure Compliance

Inpatient facilities should take the following steps:

• Designate a responsible person, such as the facility’s compliance officer, who will be responsible for compliance.
• Identify the individuals who are now legally obligated to read the publication, participate in online training, provide information to patients, and make the certification. Those individuals include:

1. Employed physicians, physician assistants, nurse practitioners, and nurses who provide care to inpatients or emergency room patients
2. Physicians, physician assistants, and nurse practitioners who are members of the medical staff or allied professional staff and provide care to inpatients or emergency room patients
3. CEO or administrator of the facility
4. Members of the governing board
5. Employed legal counsel

• Obtain the required written certifications from each of the individuals by February 1.
• For newly hired or appointed licensed professionals, administrative executives and board members, obtain written certifications within 14 days of employment or appointment.
• Require that the individuals participate in online training as part of their continuing education.
• Maintain a file of the certifications and evidence of participation in online training for a minimum of four calendar years following the calendar year to which they apply.
• Provide the required patient disclosure statement to patients and their families.