Michigan Office of Administrative Hearings and Rules  
611 West Ottawa Street; 2nd Floor, Ottawa Building  
Lansing, MI 48933  
Phone: (517) 335-8658 FAX: (517) 335-9512  
AGENCY REPORT TO THE  
JOINT COMMITTEE ON ADMINISTRATIVE RULES (JCAR)  
Under the Administrative Procedures Act (APA), 1969 PA 306, the agency that has the statutory authority  
to promulgate the rules must complete and submit this form electronically to the Michigan Office of  
Administrative Hearings and Rules (MOAHR) at o’berryd@michigan.gov.  
1. Agency Information:  
Agency name: Health and Human Services  
Division/Bureau/Office: Bureau of Epidemiology and Population Health  
Name, title, phone number, and e-mail of person completing this form: Mary E Brennan, MDHHS  
Regulatory Affairs  
Officer, 517-284-4850,  
Name of Departmental Regulatory Affairs Officer reviewing this form: Mary E Brennan  
2. Rule Set Information:  
MOAHR assigned rule set number: 2018-074 HS  
Title of proposed rule set: Reporting of Poisonings Due to the Use of Prescription or Illicit Drugs  
3. Purpose for the proposed rules and background:  
With the dramatic increase in the rise of overdoses and deaths caused by prescription medications  
and illicit “street” drugs, tracking the information is difficult as there is no requirement that health  
professionals and health facilities report this information. Without the information, the State is  
unable to proportionately leverage resources to each county to combat the overdoes/death epidemic  
occurring in this State.  
With the increase in the popularity and continual addition of new synthetic opioid “street” drugs and  
associated increase in overdoses and associated deaths, the Department needs to collect the data  
from health professionals and health facilities quickly to assess critical needs of counties and their  
population and provide appropriate health warnings, rehabilitation, and preventative care for  
Michigan citizens. As the impact of the opioid crisis evolves, the Department of Health and Human  
Services needs to understand the use of other drugs in the population.  
4. Summary of proposed rules:  
The proposed rules would require, when requested by MDHHS, facilities and health care  
professionals as defined in the rules, to provide data regarding overdoses of prescription or illicit  
drugs, whether or not they result in death. The rules identify the data required, the timeframes, and  
confidentiality standards associated with that data.  
5. List names of newspapers in which the notice of public hearing was published and publication  
dates (attach copies of affidavits from each newspaper as proof of publication).  
Marquette Mining Journal-Publication Date: February 18, 2019; Oakland Press-Publication Date:  
February 20, 2019 , Battle Creek Enquirer-Publication Date: February 19, 2019  
6. Date of publication of rules and notice of public hearing in Michigan Register:  
Revised: April 22, 2019  
MCL 24.242 and 24.245  
Agency Report to JCAR – Page 2  
March 1, 2019  
7. Time, date, location, and duration of public hearing:  
Tuesday, March 12, 2019. MDHHS South Grand Building, 333 S. Grand Ave., Rooms 1K and 1L,  
Lansing, MI 48909. 1:00 p.m. to 3:30 p.m.  
8. Provide the link the agency used to post the regulatory impact statement and cost-benefit  
analysis on its website:  
9. List of the name and title of agency representative(s) attending public hearing:  
Sarah Lyon Callo, State Epidemiologist and MDHHS Director of Epidemiology and Population  
Health; Matthew Buck, State Administrative Assistant to Ms. Lyon Callo; Jared Welehodsky,  
MDHHS Department Analyst, Policy, Planning and Legislative Services  
10. Persons submitting comments of support:  
Ms. Paige Fults, Ms. Amanda Kogowoski  
11. Persons submitting comments of opposition:  
Dr. Joyce L. deJong, D.O.  
Revised: April 22, 2019  
MCL 24.242 and 24.245  
Michigan Office of Administrative Hearings and Rules  
611 West Ottawa Street; 2nd Floor, Ottawa Building  
Lansing, MI 48933  
Phone: (517) 335-8658 FAX: (517) 335-9512  
12. Identify any changes made to the proposed rules based on comments received during the public comment period:  
Name & Organization  
Comments Made at  
Public Hearing  
Written Comments  
Agency Rationale for  
Change  
Rule Number  
& Citation  
Changed  
1. Health Care Association  
of Michigan, Michigan  
Council of Nurse  
"The definition of  
'poisoning' is vague.  
Poisoning uses the  
term 'morbid  
condition' without  
giving the definition  
of morbid in the  
rules."  
Current language:  
R 325.76(h):  
(h) "Poisoning" means a  
"Poisoning"  
Practitioners, Michigan  
Health & Hospital  
Association, Michigan  
Osteopathic Association,  
Michigan State Medical  
Society  
morbid condition, including means any  
death, produced by a poison. morbid  
condition,  
MDHHS agrees that the  
definition needs to be  
including death,  
that is related  
to,  
expanded to provide for a  
clearer definition of “morbid characterized  
condition.”  
by, affected by,  
induced by, or  
a product of a  
poison as  
defined in  
subrule (g)."  
R 325.77(1):  
Health  
2. Ms. Paige Fults,  
Michigan Health and  
Hospital Association  
(MHA), on behalf of  
"We would request that a  
formal definition of "drug  
overdose" be included in the  
rules, if possible. […  
Current Language:  
1) Health professionals and  
health facilities shall provide professionals  
reports when requested by  
the department or local  
health department. The  
department or local health  
department shall notify  
health professionals and  
and health  
MHA, Michigan Council W]ithout this clear  
facilities shall  
provide reports  
when requested  
by the  
of Nurse Practitioners,  
Michigan Osteopathic  
Association, Michigan  
State Medical Society  
definition, facilities and  
health care providers raise  
the fact that they didn't  
know if it was related and  
what you wanted reported  
department or  
health facilities when reports local health  
Revised: April 22, 2019  
MCL 24.242 and 24.245  
Agency Report to JCAR – Page 2  
had to do with medication  
of prescription or illicit drug department for  
toxicity, medication side  
effects, poly pharmacy, or  
sedation due to opioid use."  
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.  
routine public  
health  
surveillance  
and/or  
investigation of  
specific events.  
The department  
or local health  
department shall  
notify health  
professionals  
and health  
(b) Reports shall be  
provided to the department  
or local health department  
that makes the request.  
facilities when  
reports of  
The Department does agree  
that reporters would need a  
clear understanding of what  
type of poisonings (i.e.,  
poisonings resulting from  
exposure to particular  
substances) and under which  
conditions (i.e., context of  
poisoning event) should be  
reported to the Department  
in order to fulfill the intent  
of this ruleset. For this  
reason, the Department will  
publish specific requests on  
at least an annual basis,  
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  
under the authority granted  
by the Public Health Code  
(PA 368 of 1978) and this  
ruleset, detailing which  
substance poisonings should local health  
be reported and when (see department that  
Revised: April 22, 2019  
MCL 24.242 and 24.245  
Agency Report to JCAR – Page 2  
above: item #1). The intent  
of this rule set is to identify  
events of public health  
concern and necessitating a  
public health response. The  
intent is that the request  
could come in two ways: a  
routine surveillance data  
request, utilizing existing  
data feeds to identify  
makes the  
request.  
emerging trends; or, through  
a Specific Event  
Investigation Request in the  
case of a suspected outbreak  
of poisonings. This is the  
logic that will applied to  
determine whether a  
particular poison should be  
included in the published  
requests.  
13. Date report completed:  
5-28-2019  
Revised: April 22, 2019  
MCL 24.242 and 24.245  
;