Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 566 - Comprehensive Breast and Cervical Cancer Detection and Treatment
Subchapter 3 - Screening Service Provision
Section 310:566-3-1 - Service provision of the Oklahoma Comprehensive Breast and Cervical Cancer Early Detection Program

(1) Program and Fiscal Management will be conducted by ensuring strategic planning, implementation, coordination, integration, and evaluation of all programmatic activities and administrative systems, as well as the development of key communication channels and oversight mechanisms to aid in these processes. Program Management will ensure that infrastructure adequately supports service delivery.

(2) Service Delivery directly provided or provided through contractual arrangements of specific and appropriate clinical procedures to detect breast and/or cervical abnormalities for women enrolled in the Oklahoma Breast and Cervical Cancer Early Detection Program. In the Oklahoma Breast and Cervical Cancer Early Detection Program appropriate clinical screening procedures include clinical breast examinations (CBE), mammograms, screening pelvic exams and pap tests. Appropriate clinical diagnostic procedures include diagnostic mammography, ultrasound of the breast, surgical consultation, biopsy of the cervical or breast, colopscopy of the cervix, and electrical loop excisional biopsies of the cervix. Women should receive patient education directed toward breast self-examination (BSE) and risk reduction.

(3) Referral, Tracking and Follow-up will be conducted utilizing a data system to monitor an enrolled woman's receipt of screening/re-screening, diagnostic, and treatment procedures. The enrolled woman will be notified of the results of the service delivery whether the results are normal, benign, or abnormal. The data system will provide tracking of appropriate and timely clinical services following an abnormal test result and/or diagnosis of cancer. Enrolled women with abnormal Pap smears or breast screening procedures will be provided comprehensive referral directing the woman to appropriate additional diagnostic or treatment services. The comprehensive referral will be written. Follow-up will be conducted to seek information about whether services were timely, completed, or met.

(4) Case Management will be provided and involve establishing, brokering, and sustaining a system of available clinical (screening, diagnostic, and treatment) and essential support services for all Oklahoma Breast and Cervical Cancer Early Detection Program enrolled women, and assisting clients diagnosed with cancer through the Program to obtain needed diagnostic and treatment services.

(5) Quality Assurance and Improvement will be conducted utilizing established standards, systems, policies and procedures to monitor, assess and identify practical methods for improvement of the program and its components. Quality assurance tools will include utilizing FDA and ACR minimum standards for mammography facilities and CLIA minimum standards for cytopathology and pathology laboratories. Quality assurance contributes to the identification of corrective actions to be taken to remedy problems found as a result of investigating quality of care.

(6) Professional Education will be provided through a variety of channels and activities that enable professionals to perform their jobs competently, identify needs and resources, and contribute to ensuring that health care delivery systems provide positive clinical outcomes.

(7) Population Based Public Education and Outreach will be provided that involves the systematic design and delivery of clear and consistent messages about breast and cervical cancer and the benefits of early detection, using a variety of methods and strategies to reach priority populations. Outreach activities should focus on women who have never been screened or rarely been screened and work toward the removal of barriers to care, i.e.: the need for childcare, respite care, interpreter services and transportation through collaborative activities with other community organizations.

(8) Coalitions and Partnerships will be developed to bring together groups and individuals who establish a reciprocal agreement for sharing resources and responsibilities to achieve the common goal of reducing breast and cervical cancer mortality.

(9) Surveillance will be conducted utilizing continuous, proactive, timely and systematic collection, analysis, interpretation and dissemination of breast and cervical cancer screening behaviors, incidence, prevalence, survival, and mortality of breast and/or cervical cancer. Epidemiological studies will be conducted utilizing Minimum Data Elements and other data sources to establish trends of disease, diagnosis, treatment, and research needs. Program planning, implementation, and evaluation shall be based on the epidemiological evidence.

(10) Evaluation will be conducted through systematic documentation of the operations and outcomes of a program, compared to a set of explicit or implicit standards or objectives. The Oklahoma Breast and Cervical Cancer Prevention and Treatment Advisory Committee shall review the service delivery contractual agreements as to their outcomes. The Oklahoma Breast and Cervical Cancer Prevention and Treatment Advisory Committee shall make recommendations based on the evaluation in its annual report.