DEPARTMENT OF HEALTH AND HUMAN SERVICES  
BUREAU OF EPIDEMIOLOGY AND POPULATION HEALTH DIVISION  
OF ENVIRONMENTAL HEALTH  
REPORTING OF POISONINGS DUE TO THE USE OF PRESCRIPTION OR  
ILLICIT DRUGS  
(By authority conferred on the department of health and human services by section  
8 of the critical health problems reporting act, 1978 PA 312, MCL 325.78, sections 2221,  
2226, 2233, and 5111 of the public health code, 1978 PA 368, MCL 333.2221, 333.2226,  
333.2233, and 333.5111, and Executive Reorganization Order No. 2015-1, MCL  
400.227)  
R 325.76 Definitions.  
Rule 6. As used in these rules:  
(a) “Department" means the department of health and human services.  
(b) “Drug” means any of the following as provided in section 17703 of the public  
health code, 1978 PA 368, MCL 333.17703:  
(i) A substance recognized or for which the standards or specifications are  
prescribed in the official compendium.  
(ii) A substance intended for use in the diagnosis, cure, mitigation, treatment, or  
prevention of disease in human beings or other animals.  
(iii) A substance, other than food, intended to affect the structure or a function  
of the body of human beings or other animals.  
(iv) A substance intended for use as a component of a substance specified in  
subdivision (i), (ii), or (iii), but not including a device or its components, parts, or  
accessories.  
(c) "Health facility" means any facility or agency licensed under article 17 of the  
public health code, 1978 PA 368, MCL 333.20101 to 333.22260, that provides health  
care services. "Health facility" includes a hospital, clinical laboratory, surgical  
outpatient facility, health maintenance organization, nursing home, home for the aged,  
rural health county medical care facility, and ambulance operation. “Health facility”  
does not include any facility or agency that is prohibited by law under 42 CFR part 2  
from releasing records on substance abuse disorders.  
(d) "Health professional" means a person licensed under article 15 of the public  
health code, 1978 PA 368, MCL 333.16101 to 333.18838, in medicine, osteopathic  
medicine, as a physician's assistant, or nurse practitioner.  
(e) “Illicit drugs” means any Schedule 1 drug, new and emerging psychoactive  
substances, or Schedule 2-5 drugs that are not obtained directly from, or pursuant to, a  
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valid prescription or order of a practitioner while acting in the course of the  
practitioner's professional practice.  
(f) "Local health department" means a public health department established  
under the provisions of part 24 of the public health code, 1978 PA 368, MCL  
333.2401 to 333.2498, to protect the public health and prevent disease within a  
specific geographic area.  
(g) "Poison" means a substance which, when ingested, inhaled or absorbed,  
injected into, or developed within the body, causes damage to structure or  
disturbance of function in the body.  
(h) "Poisoning" means any morbid condition, including death, that is related to,  
characterized by, affected by, induced by, or a product of a poison as defined in  
subrule (g)."  
(i) "Public health investigation" means the collection of medical, epidemiologic,  
exposure, and other information to determine the magnitude and cause of illness or  
injury, which is used to determine appropriate actions to prevent or mitigate additional  
illness or injury.  
(j) “Substance use disorder services” means substance use disorder prevention,  
treatment, and rehabilitation services established under the provisions of article 6 of the  
public health code, 1978 PA 368, MCL 333.6230 to 333.6251, to reduce the  
consequences of substance use disorders in individuals and communities.  
History: 2019 AACS.  
R 325.77 Reporting requirement; timeframe; reports provided without  
request; electronic reporting.  
Rule 7. (1) Health professionals and health facilities shall provide reports when  
requested by the department or local health department for routine public health  
surveillance and/or investigation of specific events. The department or local health  
department shall notify health professionals and health facilities when reports of  
prescription or illicit drug poisonings shall be submitted. Both of the following apply:  
(a) Reports shall be made within 5 working days following request by the  
department or local health department.  
(b) Reports shall be provided to the department or local health department that  
makes the request.  
(2) Reports may be provided by health professionals and health facilities, without  
departmental or local health department request, when the reporting entity believes that  
public health investigation is needed to protect the public.  
(3) Nothing in this rule shall be construed to relieve a health professional or  
health facility from reporting to any other entity as required by state, federal, or local  
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statutes or regulations or in accordance with accepted standard of practice, except that  
reporting in compliance with this rule satisfies the reporting requirements of the public  
health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(4) The department shall develop procedures and systems to enable electronic  
laboratory and case reporting by health care providers and facilities to reduce  
reporting burden and ensure efficiency and security of information sharing.  
History: 2019 AACS.  
R 325.78 Patient information; diagnostic and clinical information to be  
reported.  
Rule 8. (1) Reportable information is information specifically related to patients  
with known or suspected poisonings due to use of prescription or illicit drugs,  
including fatal and nonfatal overdoses.  
(2) International Classification of Disease Codes (ICD) for medicinal and  
illicit drug poisonings and toxicological laboratory evidence shall be considered  
evidence of poisoning.  
(3) The health professional or health facility shall submit its report in a format  
that ensures the inclusion of the information listed under subdivisions (a) to (e) of this  
subrule as applicable.  
(a) All of the following information with respect to the patient shall be provided:  
(i) Last and first name and middle initial.  
(ii) Sex.  
(iii) Race, if available.  
(iv) Ethnic group, if available.  
(v) Birth date or age.  
(vi) Residential address.  
(vii) Telephone number.  
(viii) If the individual is a minor, the name of a parent or guardian.  
(b) If the reporting entity is a health care provider or health facility other than  
a clinical laboratory, the following diagnostic information shall be provided, in  
addition to information specified in subdivision (a) of this subrule.  
(i) The date of diagnosis.  
(ii) The diagnosis, including ICD diagnostic code, if available.  
(iii) Brief narrative of the poisoning event, including date, location, and type of  
medicine or drug involved, and any other information considered by the health  
professional or health facility to be related to health of the public.  
(iv) Brief narrative of the patient’s signs and symptoms, clinical findings, results  
of diagnostic tests, and clinical outcome.  
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(c) If the reporting entity is a clinical laboratory, the following information shall be  
provided in addition to information specified in subdivision (a) of this subrule.  
(i) Unique specimen ID or accession number, or both.  
(ii) Name of the clinical test performed.  
(iii) Test result, including units of measurement and LOINC and SNOMED codes.  
(iv) Laboratory reference range including units of measurement.  
(v) Date the laboratory test was ordered.  
(d) Name, address, telephone, and other contact information shall be provided for  
the reporting health professional. If the reporting entity is a health facility, contact  
information for the diagnosing, treating, and/or ordering physician shall be provided.  
(e) Name, address, telephone and other contact information for the health  
facility shall be provided if the reporting entity is the facility.  
History: 2019 AACS.  
R 325.79 Investigation and collaboration; storage of information;  
confidentiality.  
Rule 9. (1) The department or local public health department, upon receiving a  
report under  
subrule (2) of this rule, may investigate to determine the accuracy of the report, a  
patient's source of drug, and adverse health effects resulting from the poisoning due  
to drugs.  
(2) The department and local public health departments shall collaborate in the  
development of procedures for processing reports of poisonings and conducting  
follow-up investigations to ensure efficient, non-duplicative, and effective public  
health response.  
(3) Requests by the department or local public health departments for individual  
medical and epidemiologic information to validate the completeness and accuracy of  
reporting are specifically authorized.  
(4) Information from reported cases shall be kept in a secure manner when not in  
use. Information stored electronically shall be maintained in a secure manner, accessible  
only by department or local health department program staff through password  
protected user accounts.  
(5) Except as provided in subrule (6) of this rule, the department and local health  
departments shall maintain the confidentiality of all reports and other information  
received under these rules and shall not release reports or information that may be used  
to directly link the information to a particular individual.  
(6) The department and local health departments may release reports or  
information, otherwise protected under subrule (5) of this rule, under any of the  
following conditions:  
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(a) If the department has received written consent from the individual, or from the  
individual’s parent or legal guardian, requesting the release of information.  
(b) As necessary for the department to carry out its duties under the public health  
code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(c) If necessary for the purpose of public health activities designed to prevent  
poisonings due to use of prescription or illicit drugs.  
(d) If necessary for the purpose of research designed to develop or contribute to  
generalizable knowledge, with documented approval by the department’s institutional  
review board.  
(e) If the director of the department determines that release of information is  
crucial to protect the public health against an imminent threat or danger.  
(7) Nothing in this rule shall be construed to relieve or preempt any other  
entities from investigating hazards associated with drug poisonings under state,  
federal, or local statutes or regulations.  
(8) Reports submitted to the department or local health department under Rule 7  
are not public records and are exempt from disclosure pursuant to the freedom of  
information act, 1976 PA 442, MCL 15.231 to 15.246.  
(9) Reports and information submitted to the legislature by the department as  
necessary to carry out its duties shall not contain any identifiable information.  
Aggregate information concerning public health that is released to the public shall  
not contain information that allows individuals to be identified.  
History: 2019 AACS.  
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;