Or. Admin. R. 309-018-0105 - Definitions
(1) "Abuse of an
Adult" means the circumstances defined in ORS
430.735 and OAR Chapter 407,
Division 45 for abuse of an adult with mental illness or who is receiving
residential substance use disorder treatment or withdrawal management
services.
(2) "Abuse of a Child"
means the circumstances defined in ORS
419B.005 and ORS
418.257
(3) "Active Supervision" means a designated
supervisor is physically present who provides direct or indirect observation of
the program staff, to determine if the service or task is being completed
properly and providing intervention and consultation as needed.
(4) "Activities of Daily Living or
Instrumental Activities of Daily Living (IADL)" means those personal functional
activities required by an individual for continued well-being, which are
essential for health and safety. Activities include eating, dressing, and
grooming, bathing and personal hygiene, mobility, elimination, and
cognition.
(5) "Admission" means
the act or process of enrollment into services as regulated by Chapter 309
Division 18 rules.
(6) "Adolescent"
means an individual from 12 through 21 years of age or those individuals who
are determined to be developmentally appropriate for such services.
(7) "Adult" means an individual 18 years of
age or older or an emancipated minor. An individual with Medicaid eligibility,
who is in need of services specific to children, adolescents, or young adults
in transition, shall be considered a child until age 21 for the purposes of
these rules. Adults who are between the ages of 18 and 21, who are considered
children for purposes of these rules, shall have all rights afforded to adults
as specified in these rules.
(8)
"The ASAM Criteria " means the criteria in the Third edition of The American
Society of Addiction Medicine (ASAM) for the assessment, level of care
placement and treatment of addictive, substance-related, and co-occurring
conditions. The ASAM Criteria is a clinical guide to developing
patient-centered service plans and making objective decisions about admission,
continuing care, and transfer or discharge for individuals. The ASAM Criteria
is incorporated by reference in these rules.
(9) "ASAM Dimensional Admission Criteria"
means the specifications described in the ASAM Criteria for determining that an
individual is appropriately admitted to a program based on six ASAM assessment
dimensions. The criteria, dimensions and number of dimensions indicated differs
per level of care and is described within The ASAM Criteria, Third
Edition.
(10) "ASAM Level of Care"
means one of several discrete intensities of services and supports, as
described within The ASAM Criteria, Third Edition, within a substance use
disorders program that are delivered in a structured, programmatic fashion, by
a Division certified outpatient or licensed residential provider.
(11) "ASAM Level of Care 3.1" Clinically
Managed Low-Intensity Residential Substance Use Disorder Services means a
licensed residential setting as described in The ASAM Criteria, Third Edition
with 24-hour structure and support that offers at least 5 hours per week of
low-intensity substance use treatment services. Services and supports are
designed to facilitate the uptake of recovery skills, relapse prevention, and
emotional coping skills. Services and the milieu support individuals in
addressing reintegration into family, work, education and other pro-social
activities and communities. Programs facilitate reintegration and transition to
lower levels of care.
(12) "ASAM
Level of Care 3.3" Clinically Managed Population-Specific High-Intensity
Substance Use Disorder Residential Services means a licensed residential
setting as described in The ASAM Criteria, Third Edition with a 24-hour,
structured recovery environment and high-intensity substance use treatment
services and supports that meet the functional limitations of the individuals.
The functional limitations appropriate for placement in this level of care are
primarily cognitive and can be either temporary or permanent. When nursing
supervision adequate to the identified needs is available, individuals who also
have medical conditions may be placed in this level of care.
(13) "ASAM Level of Care 3.5" Clinically
Managed High-Intensity Substance Use Disorder Residential Services means a
24-hour supportive living environment with a habilitative focus with a reliance
on the treatment community. Severe substance use and social or emotional
limitation(s) are treated in this level of care, where an emphasis on targeted
interventions reduces the risk of relapse, reinforces prosocial behaviors,
assists with integration into a health community, and offers basic life skills
training. Duration at this level of care is marked by the acquisition of coping
and relapse prevention skills so that relapse is no longer imminently
dangerous. Individuals admitted to this level of care meet the DSM-5-TR
criteria for moderate or severe substance use disorder(s) and may have
co-occurring mental health disorder(s) meeting DSM-5-TR criteria or experience
difficulties with mood, behavior or cognition that are problematic but do not
meet diagnostic criteria.
(14)
"ASAM Level of Care 3.7" Medically Monitored Intensive Substance Use Disorder
Inpatient Services, means a planned and structured program of 24-hour,
professionally directed evaluation, observation, medical monitoring and
substance use treatment. Individuals admitted to this level of care have
subacute biomedical and emotional or cognitive conditions that are severe
enough to need a residential setting but not need medically managed inpatient
services. This level of care addresses the needs of individuals who have
functional limitations in Dimensions 1, 2 and 3. Services are delivered by an
interdisciplinary staff that are appropriately credentialed. See also,
"Bio-medical Enhanced ASAM Level of Care 3.7" and "Co-Occurring Enhanced ASAM
Level of Care 3.7"
(15) "ASAM Level
of Care Determination" means documentation in the service record that justifies
the change in a Level of Care placement, whether the placement is more
intensive or less intensive, completed in a multidimensional format that
captures what has changed for the individual and resulted in the change in
placement. It is the result of an evaluation of the level of care rating for
each dimension, the interactions of each dimension, and the individual's
preferred level of care. These are used together to inform the determination of
overall level of care assessment and placement decisions, with a rationale for
any discrepancy.
(16) "Assessment"
means the process of obtaining sufficient information through a face-to-face
interview to determine a diagnosis and to plan individualized services and
supports. For residential substance use disorder treatment programs, the
assessment is multidimensional and consistent with The ASAM Criteria third
edition
(17) "Authority" means the
Oregon Health Authority.
(18)
"Baseline evaluation" means an identification of the current status that an
individual expresses a desire to change in order to identify the starting
point(s) for measuring progress by using pre-determined benchmarks, such as a
Likert Scale. Progress can then be determined by using the same benchmarks to
obtain additional ratings of the identified status, and using the additional
ratings to make comparisons between the starting rating and subsequent ratings,
from which a measure of change can be assessed.
(19) "Behavioral Health Clinician" means a
practitioner of behavioral health services whose authorized scope of practice
includes substance use and mental health diagnosis and treatment.
(20) "Behavioral Health Treatment" means
treatment for mental health, substance use disorders, and problem
gambling.
(21) "Bio-medical
Enhanced ASAM Level of Care 3.1" means ASAM Level of Care 3.1 Clinically
Managed Low-Intensity Residential Substance Use Disorder Services programs that
also offers onsite or closely facilitates off-site the medical services needed
to assess and treat co-occurring bio-medical conditions, and the intensity of
on-site nursing care meets each individual's identified needs.
(22) "Bio-medical Enhanced ASAM Level of Care
3.3" means, in addition to the definition of ASAM Level of Care 3.3 Clinically
Managed Population-Specific High-Intensity Substance Use Disorder Residential
Services, medical services are rendered by medical staff working within their
scope and staffed in a manner that meets the identified needs.
(23) "Bio-medical Enhanced ASAM Level of Care
3.5" means, in addition to the definition of ASAM Level of Care 3.5 Clinically
Managed High-Intensity Substance Use Disorder Residential Services these
programs offer medical services that are rendered by medical staff working
within their scope, and the medical services are staffed in a manner such that
the medical oversight and treatment meet the identified needs.
(24) "Bio-medical Enhanced ASAM Level of Care
3.7" means in addition to the definition of ASAM Level of Care these programs
offer medical services that are rendered by medical staff working within their
scope, and the medical services are staffed in a manner such that the medical
oversight and treatment meet the identified needs.
(25) "Brief Intervention" means an early
intervention for individuals using substances, by utilizing tribal-based,
evidence-based, or culturally based practice designed to engage and motivate
individuals at risk of substance use disorder and related health problems to
seek services and/or support. Brief interventions can also be used to encourage
those with more serious dependence or disorders to accept more intensive
treatment. Brief interventions are intended to address problematic or risky
substance use that presents with or without a previous diagnosis.
(26) "Care Coordination" means a
process-oriented activity to facilitate ongoing communication and collaboration
to meet multiple needs. Care coordination includes facilitating communication
between the person or family served, natural supports, community resources, and
involved providers and agencies; organizing, facilitating, and participating in
team meetings; and providing for continuity of care by creating linkages to and
managing transitions between levels of care and transitions for young adults in
transition to adult services.
(27)
"Case Management" or "Targeted Case Management" means the services provided to
assist individuals who reside in a community setting or are transitioning to a
community setting in gaining access to desired medical, social, educational,
entitlement, and other applicable services.
(28) "Certificate" means the document or
documents issued by the Division, which identifies and declares certification
of a provider pursuant to OAR
309-008-0100 to
309-008-1600. A letter
accompanying issuance of the certificate shall detail the scope and approved
service delivery locations of the certificate.
(29) "Child" means an individual under the
age of 18. An individual with Medicaid eligibility, who is in need of services
specific to children, adolescents, or young adults in transition, shall be
considered a child until age 21 for purposes of these rules.
(30) "Clinical Supervision" means oversight
by a qualified clinical supervisor of the rendering of physical health,
substance use, problem gambling, and mental health services and supports,
according to these rules, including ongoing evaluation and improvement of the
effectiveness of those services and supports.
(31) "Clinical Supervisor" means program
staff qualified to oversee and evaluate the rendering of physical health,
substance use, problem gambling, or mental health services and
supports.
(32) "Community Mental
Health Program (CMHP)" means the organization of various services for
individuals with a mental health diagnosis or addictive disorders operated by
or contractually affiliated with a local mental health authority and operated
in a specific geographic area of the state under an agreement with the Division
an entity that is responsible for planning and delivery of safety net services
for persons with mental or emotional disturbances, drug abuse problems, and
alcoholism and alcohol abuse in a specific geographic area of the state under a
contract with the Division or a local mental health authority and pursuant to
OAR 309-014.
(33) "Cognition"
refers to how the individual is able to use information, make decisions, and
ensure their daily needs are met. There are four components to cognition:
self-preservation, decision-making, ability to make one's self understood, and
unsafe behaviors.
(34) "Cognitive
Ability" means a general mental capability involving reasoning, problem
solving, planning, abstract thinking, complex idea comprehension and learning
from experience.
(35) "Cognitive
Impairment" means a behavioral health condition or disability which impacts the
individual's cognitive abilities to perform Activities of Daily Living (ADL) or
Instrumental Activities of Daily Living (IADL), regardless of whether the
individual may be physically capable of performing ADLs or IADLs. For example,
a cognitive impairment could prevent an individual from knowing when or how to
carry out the task.
(36)
Collaborative Educational Agreement" means an individualized written
arrangement between an accredited college or university and a
Division-certified provider pertaining to a student's internship or field
placement experience.
(37)
"Consistent with ASAM Criteria" means containing information that demonstrates
use of and adherence to the description of components contained within The ASAM
Criteria, Third Edition.
(38)
"Co-Occurring Enhanced ASAM Level of Care 3.1" means ASAM Level of Care 3.1
Clinically Managed Low-Intensity Residential Substance Use Disorder Services
programs that also offer onsite or closely facilitate off-site psychiatric
services that meet the individual's identified needs, including medication
evaluation and laboratory services. Individuals admitted to this care have
documented mental health disorder(s) that may or may not meet criteria for a
DSM-5-TR diagnosis.
(39)
"Co-Occurring Enhanced ASAM Level of Care 3.3" means in addition to the
definition of ASAM Level of Care 3.3 Clinically Managed Population-Specific
High-Intensity Substance Use Disorder Residential Services, psychiatric
services are rendered by psychiatrists and other qualified behavioral health
clinicians trained in the interactions between psychotropic medications and
substance use.
(40) "Co-Occurring
Enhanced ASAM Level of Care 3.5" means in addition to the definition of ASAM
Level of Care 3.5 Clinically Managed High-Intensity Substance Use Disorder
Residential Services, these programs offer onsite or closely facilitate
off-site psychiatric, medication evaluation and laboratory services that meets
the individual's identified needs within 24 hours, as indicated by the severity
and urgency of the condition. These programs are staffed by psychiatrists and
other qualified behavioral health clinician trained in the interactions between
psychotropic medications and substance use. Individuals admitted to this level
of care meet the diagnostic criteria for a mental health disorder as well as a
substance use disorder, as defined by the DSM-5-TR.
(41) "Co-Occurring Enhanced ASAM Level of
Care 3.7" means in addition to the definition of ASAM Level of Care these
programs offer onsite psychiatric and medication evaluation, and nursing
observation and care that meets the individual's identified needs, as indicated
by the severity and urgency of the condition. These programs are staffed by
psychiatrists and other qualified medical and behavioral health clinicians
trained in the interactions between psychotropic medications and substance use.
Individuals admitted to this level of care meet the diagnostic criteria for a
mental health disorder as well as a substance use disorder, as defined by the
DSM-5-TR.
(42) "Co-occurring
Enhanced Substance Use Disorder Programs" means, consistent with The ASAM
Criteria, Third Edition, a setting where integrated services address
concurrently unstable mental health and substance use disorder conditions.
There is a focus on the integration of mental health and substance use
disorders throughout the staffing, services, and program content, as well as
the use of Motivational Enhancement therapies throughout services.
(43) "Co-occurring Substance Use, Problem
Gambling, and Mental Health Disorders (COD)" means the existence of a diagnosis
for a substance use disorder, problem gambling disorder, and/or a mental health
disorder.
(44) "Community Health
Worker (CHW)" means personnel who meets qualification criteria adopted by the
authority under ORS 414.665 and who is certified
pursuant to the requirements in OAR
410-180-0310.
(45) "Court" means a criminal court, drug
court, circuit court, juvenile court or last convicting or ruling court in this
state with jurisdiction over the individual.
(46) "Criminal Records Check" means
documenting the criminal background check results for all employees, contracted
staff, interns and volunteers considered to be program staff that render
medical or behavioral health services and supports or have access to protected
health information such as service records or billing information.
(47) "Crisis" means either an actual or
perceived urgent or emergent situation that occurs when an individual's
stability or functioning is disrupted and there is an immediate need to resolve
the situation to prevent a serious deterioration in the individual's mental or
physical health or to prevent referral to a significantly higher level of care
or death.
(48) "Crisis Plan" means
an individualized document designed in collaboration with the individual served
to help anticipate and prevent future crisis episodes and to direct
interventions in the instance of a crisis.
(49) "Crisis Stabilization Services" means
providing evaluation and treatment to individuals experiencing a crisis. Crisis
Services may be provided prior to completion of an intake. These services are
intended to stabilize the individual in crisis, prevent further deterioration
and provide immediate treatment and intervention in a location best suited to
meet the needs of the individual and in the least restrictive environment
available.
(50) "Cultural
Competence" means the process by which people and systems respond respectfully
and effectively to people of all cultures, languages, classes, races, ethnic
backgrounds, disabilities, religions, genders, sexual orientations, and other
diversity factors in a manner that recognizes, affirms, and values the worth of
individuals, families, and communities and protects and preserves the dignity
of each.
(51) "Culturally
Responsive" means services that are respectful of and relevant to the beliefs,
practices, culture and linguistic needs of diverse populations and communities
whose members identify as having particular cultural or linguistic
affiliations. Cultural responsiveness describes the capacity to respond to the
issues of diverse communities and requires knowledge and capacity at different
levels of intervention: systemic, organizational, professional, and
individual.
(52) "Culturally
Specific Program" means a program that is designed to meet the unique service
needs of a specific culture and that provides services to a majority of
individuals representing that culture.
(53) "Diagnosis" means the principal mental
health, substance use or problem gambling diagnosis listed in the Diagnostic
and Statistical Manual of Mental Disorders, fifth edition (DSM-5-TR). The
diagnosis is determined through the assessment and any examinations, tests, or
consultations suggested by the assessment and are the medically necessary
reason for services.
(54)
"Division" means the Health Systems Division of the Oregon Health Authority, or
its designee.
(55) "Diagnostic and
Statistical Manual of Mental Disorders, DSM-5-TRFifth Edition, (DSM-5-TR)"
means the textbook used to diagnose and classify mental disorders that is
published by the American Psychiatric Association.
(56) "Emergent" means the onset of symptoms
requiring attention within 24 hours to prevent serious deterioration in mental
or physical health or threat to safety.
(57) "Employment Support Services" means
services approved by the division, determined to be necessary and provided to
an individual to obtain and maintain employment in the community as they are
transitioning from an inpatient or residential facility that provides substance
use disorder treatment.
(58)
"Entry" means the act or process of acceptance and enrollment into services
regulated by this rule.
(59)
"Episode of Care" means care that begins at treatment admission and ends at
discharge.
(60) "Face-to-Face"
means a personal interaction where both words can be heard and facial
expressions can be seen in person or through telehealth services where there is
a live streaming audio and video, if clinically appropriate.
(61) "Family" means the biological or legal
parents, siblings, other relatives, foster parents, legal guardians, spouse,
domestic partner, caregivers, and other primary relations to the individual
whether by blood, adoption, legal, or social relationships. Family also means
any natural, formal, or informal support persons identified as important by the
individual.
(62) "Gender Identity"
means an individual's self-identification of gender without regard to legal or
biological identification, including but not limited to an individual
identifying themselves as male, female, transgender, and transsexual.
(63) "Gender Expression" means the external
characteristics and behaviors that are socially defined as either masculine or
feminine, such as dress, mannerisms, speech patterns, and social
interactions.
(64) "Grievance"
means a formal complaint submitted to a provider verbally or in writing by an
individual or the individual's chosen representative.
(65) "Guardian" means an individual appointed
by a court of law to act as guardian of a minor or a legally incapacitated
person.
(66) "Habilitation or
Habilitative" means medically necessary for the maintenance, learning or
improving skills and function for daily living. Services are designed to help
an individual improve their level of independence and includes, but is not
limited to, services provided in order to help an individual acquire, retain,
or improve skills in Activities of Daily Living (ADL) and Instrumental
Activities of Daily Living (IADL), community survival skills, communication,
self-help, socialization, and adaptive skills necessary to reside successfully
in an individual's home or a community-based setting.
(67) "Health Insurance Portability and
Accountability Act (HIPAA)" means the federal[MSM1] Health Insurance
Portability and Accountability Act of 1996 and the regulations published in
Title 45, parts 160 and 164, of the Code of Federal Regulations
(CFR).
(68) "Health Systems
Services and Supports" means all services and supports including but not
limited to Outpatient Community Mental Health Services and Supports for
Children and Adults, Intensive Treatment Services for Children, Outpatient and
Residential Substance Use Disorders Treatment Services, and Outpatient and
Residential Problem Gambling Treatment Services.
(69) "Housing Support Services" means
services approved by the division, provided to an individual to obtain and
reside in an independent community setting and are tailored to the goal of
maintaining an individual's personal health and welfare in a home and
community-based setting as they are transitioning from an inpatient or
residential facility that provides substance use disorder treatment.
(70) "Immediate Need Profile" means the
portion of an assessment that includes the identification of the most severe
and destabilizing or life-threatening conditions, in order to inform the
determination of the level of risk, the level of care placement and need for
immediate intervention(s).
(71)
"Institutions of Mental Disease (IMD)" means a hospital, nursing facility, or
other institution of more than 16 beds that is primarily engaged in providing
diagnosis, treatment, or care of persons with mental diseases, which includes
substance use disorders (SUDs).
(72) "Incident" means any event involving an
individual or the child of an individual receiving services occurring on the
premises of the program or involving program staff or any individual, occurring
on the premises of the program, or during a service plan activity and
including, but not limited to death, injury, major illness or medical event,
accident, act of physical aggression, medication error, suspected abuse or
neglect, or any other type of unusual or critical event that presents a risk to
the health and/ or safety of any person. Critical incidents are reported to the
Division.
(73) "Incident Report"
means a written description of any incident.
(74) "Individual" means any individual being
considered for or receiving services and supports regulated by these
rules.
(75) "Informed Consent for
Services" means that the service options, risks and benefits have been
explained to the individual and guardian, if applicable, in a manner that they
comprehend, and the individual and guardian, if applicable, have consented to
the services on, or prior to, the first date of service.
(76) "Intensive Case Management" means the
management of an array of services and supports that assist the individual in
meeting service plan objectives, includes an evaluation of needs and offers to
meet those needs through skill building, outreach, advocation, and arranging
support services through the provider or external community
providers.
(77) "Interim Referral
and Information Services" means services provided by a substance use disorders
treatment provider to individuals on a waiting list and whose services are
funded by the Substance Use Prevention Treatment Recovery (SUPTR) Block Grant
to reduce the adverse health effects of substance use, promote the health of
the individual, and reduce the risk of disease transmission.
(78) "Institution" means an establishment
that furnishes (in single or multiple facilities) food, shelter, and some
treatment or services to four or more persons unrelated to the
proprietor.
(79) "Institutions of
Mental Disease (IMD)" means a hospital, nursing facility, or other institution
of more than 16 beds that is primarily engaged in providing diagnosis,
treatment, or care of individuals with mental diseases, which includes
substance use disorders (SUDs).
(80) "Level of Care" means the type,
frequency, and duration of medically necessary services provided from the most
integrated setting to the most restrictive and intensive inpatient
setting.
(81) "Level of Care
Determination" means documentation in the service record that justifies the
change in a Level of Care placement, whether the placement is more intensive or
less intensive, completed in a 6-Dimensional format that captures what has
changed for the individual and resulted in the change in placement. The Level
of Care Determination shall include the assessed level of care, the placed
level of care, the individual's preferred level of care, and a rationale if
there is a difference between the assessed and placed levels of care.
(82) "Licensed Health Care Professional"
means a practitioner of the healing arts acting within the scope of their
practice under State law who is licensed by a recognized governing board in
Oregon.
(83) "Licensed Medical
Practitioner (LMP)" means aperson who meets the following minimum
qualifications as documented by the Local Mental Health Authority (LMHA) or
designee:
(a) Physician licensed to practice
in the State of Oregon; or
(b)
Nurse practitioner licensed to practice in the State of Oregon; or
(c) Physician's Assistant licensed to
practice in the State of Oregon; and
(d) Whose training, experience, and
competence demonstrates the ability to conduct a medical exam, a mental health
assessment and provide medication management.
(84) "Local Mental Health Authority (LMHA)"
means one of the following entities:
(a) The
board of county commissioners of one or more counties that establishes or
operates a CMHP;
(b) The tribal
council in the case of a federally recognized tribe of Native Americans that
elects to enter into an agreement to provide mental health services;
or
(c) A regional local mental
health authority comprised of two or more boards of county
commissioners.
(85)
"Low-Barrier" means the absence of programmatic barriers to service delivery
including practice induced stigma. Fundamental elements of Low Barrier
services:
(a) Take a harm reduction approach,
including the immediate goal of improving quality of life and protecting
against loss of life;
(b) Offer
treatment that meets the unique needs of each individual;
(c) Recognize unique recovery trajectories
that are personal to each individual and are not dictated by treatment
providers;
(d) Enable individuals
to engage in treatment services, including medication for substance use
disorders, without administrative delays or lengthy intake processes;
(e) Provide treatment without appointment
requirements, prior missed appointments cannot be used to hinder access to
treatment;
(f) Address
transportation barriers;
(g)
Facilitate access to treatment, services and supports including mental,
physical, dental and other ancillary health care services and supports
throughout the treatment episode of care;
(h) Eliminate or facilitate minimal travel
between multiple service providers; and
(i) Involve service providers in outreach
services and community engagement.
(86) "Low-intensity" means a term used by The
ASAM Criteria, Third Edition, in the title for ASAM Level 1 services, which are
described in The ASAM Criteria, Third Edition, as generally less than 9
treatment contact hours per week and delivered by non-physician addiction
professionals to individuals who are able to control their use or maintain
abstinence with minimal support while pursuing recovery goals.
(87) "Mandatory Reporter" means anyone
required by law, as defined in ORS
419B.005 or
430.735, who is required to
report suspected abuse or neglect of a child, elderly person, or other adult as
required by law in ORS
430.765, or ORS
419B.010, or ORS
124.060.
(88) "Medicaid" means the federal
grant-in-aid program to state governments to provide medical assistance to
eligible persons under Title XIX of the Social Security Act.
(89) "Medical Director" means a physician
licensed to practice medicine in the State of Oregon and who is designated by a
substance use disorders treatment program to be responsible for the program's
medical services, either as an employee or through a contract.
(90) "Medical Treatment Staff" means program
staff who are properly trained, educated, and credentialed to deliver medical
services and who, while working within their scope of practice, are directly
responsible for the delivery or oversight of withdrawal management services.
"
(91) "Medically Necessary" means
health services and items that are required for an individual to address one or
more of the following:
(a) The prevention,
diagnosis, or treatment of an individual's condition or disorder that results
in behavioral health impairments; or
(b) The ability for a client or member to
achieve age-appropriate growth and development; and
(c) A medically necessary service must also
be medically appropriate.
(92) "Medication" means any drug, chemical,
compound, suspension, or preparation in suitable form for use as a curative or
remedial substance either internally or externally by any patient.
(93) "Medication Administration Record" means
the documentation of the administration of written or verbal orders for
medication, laboratory, and other medical procedures issued by an LMP acting
within the scope of his or her license.
(94) "Medication Assisted Treatment (MAT)"
means the use of medication in combination with counseling and behavioral
therapies for the treatment of substance use disorders.
(95) "Mental Health Intern" means mental
health program staff who meet qualifications for QMHA and are currently
enrolled in a graduate program approved by the Division-approved certification
or licensing body but does not have the necessary graduate degree in
psychology, social work, or related field of behavioral science, or have an
equivalent degree as determined by the Division-approved certification or
licensing body.
(96) "Milieu Staff"
means the type of staff providing support to program staff and the individuals
receiving services by monitoring the common areas, providing direction and
redirection to individuals receiving services, assisting individuals in getting
requests and needs met, taking actions to maintain the safety of the
individuals, and informing Substance Use Disorders Treatment Staff of events as
to assist in the holding a trauma-informed environment.
(97) "Motivational Enhancement Therapy" (MET)
means a person-centered approach to therapy that focuses on improving an
individual's motivation to change.
(98) "Non-Institutions of Mental Disease
(non-IMD)" means a hospital, nursing facility, or other institution with less
than 16 beds that is primarily engaged in providing diagnosis, treatment, or
care of persons with mental diseases, which includes substance use disorders
(SUDs).
(99) "Non-Medicaid Service
Data" means data collected through the mandated state data system regarding
services paid for by any source other than Medicaid and includes, but is not
limited to:
(a) Diagnosis;
(b) Date of service;
(c) Place of service;
(d) Procedure code;
(e) Modifier;
(f) Number of service units; and
(g) Billed charges.
(100) "Nursing Services" means services that
are provided by a registered nurse (RN) or a licensed practical nurse (LPN),
Advanced Practice Nurse including Clinical Nurse Specialist, or Certified Nurse
Practitioner, licensed by the Oregon Board of Nursing within the scope of
practice as defined in OAR chapter 851 division 045.
(101) "On-site" means staff are physically
present within the licensed facility, on duty, readily accessible and available
to assist individuals.
(102)
"Oregon Health Authority (Authority) or (OHA)" means the Oregon Health
Authority of the State of Oregon.
(103) "Outreach" means the delivery of
behavioral health services, referral services, and case management services in
non-traditional settings, including but not limited to the individual's
residence, shelters, streets, jails, transitional housing sites, drop-in
centers, single room occupancy hotels, child welfare settings, educational
settings, or medical settings. It also refers to attempts made to engage or
re-engage an individual in services by such means as letters or telephone
calls.
(104) "Peer" means any
person supporting an individual or the individual's family member who has
similar life experience, either as a current or former recipient of substance
use, problem gambling, or mental health services, or as a family member of an
individual who is a current or former recipient of substance use, problem
gambling, or mental health services.
(105) "Peer-Delivered Services" are
community-based services and supports provided by peers, peer support
specialists, and peer wellness specialists to individuals or family members
with similar lived experience. These services are intended to support
individuals and families to engage individuals in ongoing treatment and to live
successfully in the community.
(106) "Peer-Delivered Services Supervisor"
means qualified program staff, with at least one year of experience as a PSS or
PWS in behavioral health services, who is responsible for evaluating and
guiding PSS and PWS program staff in the delivery of peer-delivered services
and supports.
(107) "Peer Support
and Peer Wellness Specialist Supervision" means supervision by a qualified
clinical supervisor and a qualified peer-delivered services supervisor as
resources are available. The supports provided include guidance in the unique
discipline of peer-delivered services and the roles of peer support specialists
and peer wellness specialists.
(108) "Peer Support Specialist" means a
qualified program staff providing peer-delivered services to an individual or
family member with similar life experience under the supervision of a qualified
clinical supervisor and a qualified peer-delivered services supervisor as
resources are made available.
(109)
"Peer Wellness Specialist" means a program staff who supports an individual in
identifying behavioral health service and support needs through community
outreach, assisting individuals with access to available services and
resources, addressing barriers to services, and providing education and
information about available resources and behavioral health issues in order to
reduce stigma and discrimination toward consumers of behavioral health services
and to provide direct services to assist individuals in creating and
maintaining recovery, health, and wellness under the supervision of a qualified
clinical supervisor and a qualified peer-delivered services supervisor as
resources are made available.
(110)
"Problem Gambling Approved Certification Consultant" means program staff who is
a Certified Gambling Addiction Counselor, level II (CGACII) for a minimum of
two years and has a minimum of ten hours of clinical supervision education. The
purpose of the position is to provide consultation for CGAC candidates on 1)
Fundamentals of Problem Gambling Treatment case conceptualization 2) the
process and requirements of earning certification as a CGAC. This is a Mental
Health and Addiction Certification Board of Oregon (MHACBO)
distinction.
(111) "Problem
Gambling Treatment Staff" means program staff certified or licensed by a
Division recognized credentialing body to provide problem gambling treatment
services that include assessment, development of a Service Plan, group and
family counseling.
(112) "Program"
means an organized system of services and supports delivered by a provider
designed to address the treatment needs of individuals and families.
(113) "Program Administrator" or "Program
Director" means program staff with appropriate professional qualifications and
experience who is designated to manage the operation of a program.
(114) "Program Staff" means personnel who
renders a clinical service or support. Program staff could include, for
example, be an employee, contractor, intern, or volunteer who is rendering or
assisting with rendering clinical services or supports.
(115) "Provider" means an organizational
entity or qualified person that is certified or licensed by the Division for
the direct delivery of substance use, problem gambling, or mental health
services and supports.
(116)
"Publicly Funded" means financial support, in part or in full, with revenue
generated by a local, state, or federal government.
(117) Psychiatrist" means a physician
licensed by the Oregon Medical Board and who has completed an approved
residency training program in psychiatry.
(118) "Psychologist" means a person who is
currently licensed to practice psychology by the Oregon Board of
Psychology.
(119) "Qualified Mental
Health Associate (QMHA)" means mental health program staff delivering services
under the direct supervision of a QMHP who meets the minimum qualifications as
authorized by the LMHA or designee and specified in OAR
309-019-0125.
(120) "Qualified Mental Health Professional
(QMHP)" means mental health program staff LMP or any other program staff
meeting the minimum qualifications as authorized by the LMHA or designee and
specified in OAR 309-019-0125.
(121) "Quality Assessment and Performance
Improvement" means the structured, internal monitoring and evaluation of
services to improve processes, service delivery, and service
outcomes.
(122) "Recovery" means a
process of healing and transformation for an individual to achieve full human
potential and personhood in leading a meaningful life as they define it in
communities of their choice.
(123)
"Recovery Environment" means the quality and extent of the services and
supports, offered within and coordinated by a program, that influence treatment
outcomes and connect the individual to external recovery supports.
(124) "Rehabilitative Behavioral Health
Services" means medical or remedial services recommended by a licensed medical
practitioner or other licensed practitioner to reduce impairment to an
individual's functioning associated with the symptoms of a mental disorder or
substance use disorder and are intended to restore functioning to the highest
degree possible.
(125)
"Representative" means someone who acts on behalf of an individual at the
individual's request with respect to a grievance, including but not limited to
a relative, friend, employee of the Division, attorney, or legal
guardian.
(126) "Resilience" means
the universal capacity that an individual uses to prevent, minimize, or
overcome the effects of adversity. Resilience reflects a person's strengths as
protective factors and assets for positive development.
(127) "Residential Substance Use Disorders
Treatment Program" means a publicly or privately operated program as defined in
ORS 430.010 that provides
assessment, treatment, rehabilitation, and twenty-four hour observation and
monitoring for individuals with substance use dependence, consistent with Level
3 of The ASAM Criteria, Third Edition.
(128) "Residential Problem Gambling Treatment
Program" means a publicly or privately operated program that is licensed in
accordance with OAR 415-012-0000 through
415-012-0090 that provides
assessment, treatment, rehabilitation, and twenty-four-hour observation and
monitoring for individuals with gambling related problems.
(129) "Risk Assessment" means an evaluation
of the level or severity of risk the individual is experiencing and how each
interact, resulting in an overall risk assessment rating.
(130) "Safety Plan" means a best practice,
research-based, individualized, and directive document developed through a
collaborative process in which the provider assists the individual in listing
strategies to use when self-harm, harm to others or suicide ideation is
elevated or following suicidal or parasuicidal behavior.
(131) "Screening" means the process to
determine whether the individual needs further assessment to identify
circumstances requiring referrals or additional services and
supports.
(132) "Seclusion" means
the involuntary confinement of a resident alone in a room or an area from which
the resident is physically prevented from leaving.
(133) "Service Delivery Rules" means the OAR
describing specific regulatory standards for the possible array of services
covered by certificates issued under OAR 309-008.
(134) "Service Note" means the written record
of services and supports provided, including documentation of progress toward
intended outcomes, consistent with the timelines stated in the service
plan.
(135) "Service Plan" means a
comprehensive plan for services and supports provided to or coordinated with an
individual and his or her family, as applicable, that is reflective of the
assessment and the intended outcomes of service.
(136) "Service Plan Review" means a
documented, clinical review by a Substance Use Disorders Treatment Staff of the
individual's response to the services and supports provided thus far and
includes a current ASAM Level of Care recommendation.
(137) "Service Record" means the
documentation, written or electronic, regarding an individual and resulting
from entry, assessment, orientation, services and supports planning, services
and supports provided, and transfer.
(138) "Services" means those activities and
treatments described in the Service Plan that are intended to assist the
individual's transition to recovery from a substance use disorder, problem
gambling disorder, or mental health condition and to promote resiliency and
rehabilitative and functional individual and family outcomes.
(139) "Signature" means any written or
electronic means of entering the name, date of authentication, and credentials
of the person providing a specific service or the person authorizing services
and supports. Signature also means any written or electronic means of entering
the name and date of authentication of the individual receiving services, the
guardian of the individual receiving services, or any authorized representative
of the individual receiving services.
(140) "Skills Training" or "Skills
Restoration" means providing information and training to individuals and
families designed to assist with the development of skills in areas including
but not limited to anger management, stress reduction, conflict resolution,
self-esteem, parent-child interactions, personal relationships, drug and
alcohol awareness, behavior support, symptom management, accessing community
services, and daily living.
(141)
"Specialty Program" means a licensed Residential Substance Use Disorder
treatment program that focuses on providing treatment to specialized
populations. Treatment programming and planning must be specialized to the
population and individual being served.
(142) "Stabilization" means the application
of medical and psychosocial services and supports in a manner that results in
the reduction of symptomology and increase in skill level to support and
redirect patients to the most appropriate and least restrictive setting.
Services are directed at restoring patients' ability to maintain safety while
enhancing their recovery, so they can successfully reintegrate into identified
community settings.
(143) "Status
Data" means data collected through the mandated state data system and includes,
but is not limited to:
(a) Initial admission,
diagnostic, and demographics data;
(b) Updates and changes as needed through the
individual's enrollment in services; and
(c) Discharge or other discontinuation of
services.
(144) "Student
Intern" or "Intern" means a program staff who provides a paid or unpaid program
service and does not qualify as a Mental Health Intern.
(145) "Substance Use, Prevention, Treatment
and Recovery Block Grant" or "SUPTR Block Grant" or "SUPTR" means the federal
block grants for prevention and treatment of substance abuse under
Public Law
102-321 (31 U.S.C. 7301-7305)
and the regulations published in Title 45 Part 96 of the Code of Federal
Regulations.
(146) "Substance Use
Disorders" (SUD) as defined in DSM-5-TR, means disorders related to the taking
of a drug of abuse including alcohol, the side effects of a medication, or a
toxin exposure. The disorders include substance use disorders and
substance-induced disorders, which include substance intoxication and
withdrawal, and substance-related disorders such as delirium, neuro-cognitive
disorders, and substance-induced psychotic disorder.
(147) "Substance Use Disorders Treatment and
Recovery Services" means outpatient, intensive outpatient, and residential
services and supports for individuals with substance use disorders.
(148) "Substance Use Disorders Treatment
Staff" means one type of program staff certified by a Division-approved
certification body to render substance use disorders treatment
services.
(149) "Supports" means
activities, referrals, and supportive relationships designed to enhance the
services delivered to individuals and families for the purpose of facilitating
progress toward intended outcomes.
(150) "Transfer" means the process of
assisting an individual to transition from the current services to the next
identified setting or ASAM level of care.
(151) "Transitioning" means a 90-day period
which begins when an individual is discharged from an inpatient or residential
stay back to a community setting.
(152) "Trauma Informed Services" means
services that reflect the consideration and evaluation of the role that trauma
plays in the lives of people seeking mental health, substance use, or problem
gambling services, including recognition of the traumatic effect of
misdiagnosis and coercive treatment. Services are responsive to the
vulnerabilities of trauma survivors and are delivered in a way that avoids
inadvertent re-traumatization and facilitates individual direction of
services.
(153) "Treatment" means
the planned, medically necessary, individualized program of medical,
psychological, and rehabilitative procedures, experiences and activities
designed to remediate symptoms of a DSM-5-TR-TR diagnosis.
(154) "Unethical" means any conduct that is
incongruent with the American Counseling Association's (ACA) Code of Ethics.
The fact that a given conduct is not specifically addressed by an ethical
standard does not mean that it is necessarily either ethical or unethical. Lack
of awareness or misunderstanding of an ethical standard is not itself a defense
to a charge of unethical conduct.
(155) "Urinalysis Test" means a sensitive,
rapid, and inexpensive immunoassay screen that identifies the presence of a
specific drug or metabolite in a urine specimen to eliminate "true negative"
specimens from further consideration.
(156) "Urgent" means the onset of symptoms
requiring attention within 48 hours to prevent a serious deterioration in an
individual's mental or physical health or threat to safety.
(157) "Variance" means an exception from a
provision of these rules granted in writing by the Division pursuant to the
process regulated by OAR
415-012-0090 upon written
application from the provider. Approval and duration of a variance is
determined on a case-by-case basis.
(158) "Volunteer" means a person who performs
a service willingly and without pay.
(159) "Wellness" means an approach to
healthcare that emphasizes good physical and mental health, preventing illness,
and prolonging life.
Notes
Statutory/Other Authority: ORS 413.042, 430.256, 428.205 - 428.270, 430.640 & 443.450
Statutes/Other Implemented: ORS 109.675, 179.505, 413.520 - 413.522, 430.010, 430.205 - 430.210, 430.254 - 430.640, 430.850 - 430.955, 443.400 - 443.460, 443.991, 461.549, 743A.168, 414.025 & 14.665
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.