1. (a) Blood specimen collection for hospital births. For all live hospital births, the physician, or licensed or certified birth attendant shall order the collection of a newborn screening blood specimen prior to transfusion, as early as possible after 24 hours of age or immediately prior to discharge, whichever comes first. Since prompt identification of newborns at risk for screened disorders is extremely important, the specimen shall be collected as early as possible after 24 hours of age. Specimens shall be collected on a single Newborn Screening Form Kit using capillary or venous blood. Umbilical cord blood is not recommended for use. The hospital is responsible for collecting specimens on all newborns.

   1. (1) If the initial specimen for any newborn is collected at or prior to 24 hours of age, the hospital and the physician are responsible for notifying the newborn's parent(s) or guardian(s) verbally and in writing, utilizing the parent educational form on the Newborn Screening Form Kit, that a repeat specimen must be submitted as soon as possible after 24 hours of age. The infant's physician is responsible for ensuring that the repeat specimen is collected.
   2. (2) The hospital is responsible for submitting a satisfactory specimen and for documenting all requested information on the Form Kit including the parent's/guardian's name, address, and phone or alternate phone number, the provider ordering the newborn screen, and the infant's physician.
   3. (3) The hospital is responsible for documenting specimen collection and results in the infant's hospital record.
   4. (4) Newborns who are transferred from one hospital to another shall have specimen collection documented in the infant's hospital record. It is the responsibility of the infant's physician and the receiving hospital to ensure the specimen is collected and submitted to the Program.
   5. (5) It is the responsibility of the hospital and physician to ensure that all newborns are screened prior to discharge. If anewborn is discharged prior to specimen collection, it is the responsibility of the hospital to notify the Newborn Screening Program Coordinator as soon as possible. The infant's physician is responsible for ensuring the specimen is collected as required.

2. (b) Screening for premature/sick newborns. For all premature/sick newborns, the physician shall order the collection of a newborn screening blood specimen prior to transfusion, as early as possible after twenty-four (24) hours of age, but no later than three to seven days of age, or immediately prior to discharge, whichever comes first. Since prompt identification ofnewborns at risk for screened disorders is extremely important, the specimen shall be collected as early as possible after twenty-four (24) hours of age. It is recommended that a repeat newborn screening specimen be collected at fourteen (14) days of age. Specimens shall be collected on the Newborn Screening Form Kit using capillary or venous blood. Umbilical cord blood is not recommended for use. The hospital and the physician are responsible for ensuring that specimens are collected on all premature/sick newborns.

   1. (1) Premature/sick newborns screened at or prior to twenty-four (24) hours of age must be re-screened between seven to fourteen (7-14) days of age.
   2. (2) Premature/sick newborns who could not be screened prior to a transfusion should be screened by the seventh (7th) day of life, with a repeat specimen collected whena blood specimen will again reflect the newborn's own metabolic processes and hemoglobin type (the accepted time period to determine hemoglobin type is ninety to one hundred and twenty (90 to 120) days after transfusion).
   3. (3) The recommended follow-up study for an abnormal thyroid screen in a premature newborn is a serum free T4 (measured by direct dialysis or an equivalent method) and thyroid stimulating hormone (TSH) level at seven to fourteen (7-14) days of age.

3. (c) Specimen collection for out-of-hospital births.

   1. (1) For all newborns who are not born in a hospital, the infant's physician, or licensed or certified birth attendant is responsible for collection and submission of a satisfactory newborn screening blood specimen as early as possible after twenty-four (24) hours of age. If there is not a physician, or licensed or certified birth attendant involved in a non-hospital birth, the person attending the birth and the parents of the newborn are responsible for collection and submission of a satisfactory newborn screening specimen.
   2. (2) If a physician examines a child in the first three months of life who was not born in a hospital, or was born out of state, the physician will verify that the child has been screened. If the child has not been screened or if results of screening are not available, the physician is responsible for collecting and submitting a satisfactory newborn screening blood specimen.

Amended at 8 Ok Reg 3115, eff 7-12-91 (emergency)

Amended at 9 Ok Reg 1475, eff 5-1-92

Amended at 12 Ok Reg 41, eff 10-5-94 (emergency)

Amended at 12 Ok Reg 1685, eff 6-12-95

Amended at 15 Ok Reg 121, eff 10-15-97 (emergency)

Amended at 15 Ok Reg 1979, eff 5-26-98

Amended at 21 Ok Reg 1286, eff 5-27-04

Amended at 22 Ok Reg 392, eff 12-21-04 (emergency)

Amended at 22 Ok Reg 794, eff 5-12-05

Amended at 25 Ok Reg 105, eff 10-2-07 (emergency)

Amended at 25 Ok Reg 1153, eff 5-25-08

Amended at 31 Ok Reg 1596, eff 9-12-14

Amended at 36 Ok Reg 1688, eff 9-13-19

Amended at 38 Ok Reg 2040, eff 9-11-21