Or. Admin. R. 309-018-0105 - Definitions
(1) "Abuse of an
Adult" means the circumstances defined in OAR 407-045 for abuse of an adult
with mental illness.
(2) "Abuse of
a Child" means the circumstances defined in ORS
419B.005.
(3) "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.
(4)
"Adolescent" means an individual from 12 through 17 years of age or those
individuals who are determined to be developmentally appropriate for youth
services.
(5) "Adult" means a
person 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.
(6) "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.
(7) "ASAM Criteria" means the most current
edition of the American Society of Addiction Medicine (ASAM) for the Treatment
of Addictive, Substance-related, and Co-Occurring Conditions, which is a
clinical guide to develop patient-centered service plans and make objective
decisions about admission, continuing care, and transfer or discharge for
individuals and is incorporated by reference in these rules.
(8) "Authority" means the Oregon Health
Authority.
(9) "Behavioral Health
Treatment" means treatment for mental health, substance use disorders, and
problem gambling.
(10) "Brief
Intervention" means an early intervention for those 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.
(11) "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 needed medical, social, educational, entitlement, and
other applicable services.
(12)
"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.
(13) "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.
(14) "Chief Officer" means
the Chief Health Systems Officer of the Health Systems Division or
designee.
(15) "Clinical
Supervision" means oversight by a qualified clinical supervisor of substance
use, problem gambling, or mental health services and supports provided
according to this rule, including ongoing evaluation and improvement of the
effectiveness of those services and supports.
(16) "Clinical Supervisor" means a person
qualified to oversee and evaluate substance use, problem gambling, or mental
health services and supports.
(17)
"Co-occurring Substance Use and Mental Health Disorders (COD)" means the
existence of a diagnosis of both a substance use disorder and a mental health
disorder.
(18) "Community Health
Worker" or "CHW" means an individual who meets qualification criteria adopted
by the authority under ORS
414.665
(Traditional health workers utilized by coordinated care
organizations)
(19) "Court" means
the last convicting or ruling court unless specifically noted.
(20) "Criminal Records Check" means the
Oregon Criminal Records Check and the processes and procedures required by OAR
943-007-0001 through 943-007-0501.
(21) "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.
(22) "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 person 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.
(23)
"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.
(24)
"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.
(25) "Diagnosis" means the principal mental
health, substance use or problem gambling diagnosis listed in the Diagnostic
and Statistical Manual of Mental Disorders (DSM). The diagnosis is determined
through the assessment and any examinations, tests, or consultations suggested
by the assessment and are the medically appropriate reason for
services.
(26) "Division" means the
Health Systems Division of the Oregon Health Authority, or its
designee.
(27) "DSM" means the most
recent version of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association.
(28) "Emergent" means the onset of symptoms
requiring attention within 24 hours to prevent serious deterioration in mental
or physical health or threat to safety.
(29) "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.
(30)
"Entry" means the act or process of acceptance and enrollment into services
regulated by this rule.
(31) "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.
(32) "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.
(33) "Gender Identity"
means a person's self-identification of gender without regard to legal or
biological identification, including but not limited to persons identifying
themselves as male, female, transgender, and transsexual.
(34) "Gender Presentation" means the external
characteristics and behaviors that are socially defined as either masculine or
feminine, such as dress, mannerisms, speech patterns, and social
interactions.
(35) "Grievance"
means a formal complaint submitted to a provider verbally or in writing by an
individual or the individual's chosen representative, pertaining to the denial
or delivery of services and supports.
(36) "Guardian" means an individual appointed
by a court of law to act as guardian of a minor or a legally incapacitated
person.
(37) "HIPAA" means the
federal 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).
(38) "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.
(39) "Institutions of
Mental Disease" or "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).
(40) "Incident Report" means a written
description of any incident involving an individual or child of an individual
receiving services occurring on the premises of the program or involving
program staff or a Service Plan activity including but not limited to injury,
major illness, accident, act of physical aggression, medication error,
suspected abuse or neglect, or any other unusual incident that presents a risk
to health and safety.
(41)
"Individual" means any individual being considered for or receiving services
and supports regulated by these rules.
(42) "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.
(43) "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 Abuse Prevention and Treatment (SAPT) Block Grant to reduce the
adverse health effects of substance use, promote the health of the individual,
and reduce the risk of disease transmission.
(44) 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.
(45) "Intern" or "Student" means an
individual who provides a paid or unpaid program service to complete a
credentialed or accredited educational program recognized by the State of
Oregon.
(46) "Level of Care" means
the range of available services provided from the most integrated setting to
the most restrictive and most intensive in an inpatient setting.
(47) "Licensed Health Care Professional"
means a practitioner of the healing arts acting within the scope of his or her
practice under State law who is licensed by a recognized governing board in
Oregon.
(48) "Licensed Medical
Practitioner (LMP)" means an individual 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 demonstrate the ability to conduct a mental health assessment and
provide medication management.
(49) "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.
(50)
"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.
(51) "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.
(52) "Medically
Appropriate" means services and medical supplies required for prevention,
diagnosis, or treatment of a physical or behavioral health condition or
injuries and that are:
(a) Consistent with the
symptoms of a health condition or treatment of a health condition;
(b) Appropriate with regard to standards of
good health practice and generally recognized by the relevant scientific
community and professional standards of care as effective;
(c) Not solely for the convenience of an
individual or a provider of the service or medical supplies; and
(d) The most cost effective of the
alternative levels of medical services or medical supplies that can be safely
provided to an individual.
(53) "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.
(54) "Medication Assisted Treatment (MAT)"
means the use of medication in combination with counseling and behavioral
therapies for the treatment of substance use disorders.
(55) "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).
(56) "Oregon Health Authority" means the
Oregon Health Authority of the State of Oregon.
(57) "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.
(58) "Peer" means any
individual 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.
(59) "Peer-Delivered Services" are
community-based services and supports provided by peers and peer support
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.
(60) "Peer Support
Specialist" means a qualified individual 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. A peer support specialist
shall be:
(a) A self-identified individual
currently or formerly receiving substance use, problem gambling or mental
health services;
(b) A
self-identified individual in recovery from a substance use disorder who meets
the abstinence requirements for recovering staff in substance use disorders
treatment and recovery programs;
(c) A self-identified individual in recovery
from problem gambling; or
(d) A
person who has experience parenting a child who:
(A) Is a current or former consumer of mental
health or substance use treatment; or
(B) Is facing or has faced difficulties in
accessing education and health and wellness services due to a mental health or
behavioral health barrier.
(61) "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.
(62) "Peer Delivered
Services Supervisor" means a qualified individual certified as a PSS or PWS
with at least one year of experience as a PSS or PWS in behavioral health
services to evaluate and guide PSS and PWS program staff in the delivery of
peer delivered services and supports.
(63) "Peer Wellness Specialist" means an
individual 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. A peer wellness specialist
shall be:
(a) A self-identified individual
currently or formerly receiving mental health services; or
(b) A self-identified individual in recovery
from a substance use or gambling disorders who meets the abstinence
requirements for recovering staff in substance use disorders or gambling
treatment programs; or
(c) A family
member of an individual who is a current or former recipient of substance use,
mental health, or problem gambling services.
(64) "Problem Gambling Treatment Staff" means
a person certified or licensed by a health or allied provider agency to provide
problem gambling treatment services that include assessment, development of a
Service Plan, group and family counseling.
(65) "Program" means a particular type or
level of service that is organizationally distinct.
(66) "Program Administrator" or "Program
Director" means a person with appropriate professional qualifications and
experience who is designated to manage the operation of a program.
(67) "Program Staff" means an employee or
person who, by contract with the program, provides a service and who has the
applicable competencies, qualifications, or certification required in this rule
to provide the service.
(68)
"Provider" means an organizational entity or qualified individual that is
operated by or contractually affiliated with a community mental health program
or contracted directly with the Division for the direct delivery of substance
use, problem gambling, or mental health services and supports.
(69) "Publicly Funded" means financial
support, in part or in full, with revenue generated by a local, state, or
federal government.
(70) "Quality
Assessment and Performance Improvement" means the structured, internal
monitoring and evaluation of services to improve processes, service delivery,
and service outcomes.
(71)
"Recovery" means a process of healing and transformation for a person to
achieve full human potential and personhood in leading a meaningful life in
communities of his or her choice.
(72) "Representative" means a person 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.
(73) "Resilience" means the universal
capacity that a person uses to prevent, minimize, or overcome the effects of
adversity. Resilience reflects a person's strengths as protective factors and
assets for positive development.
(74) "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
III of ASAM PCC.
(75) "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.
(76) "Screening"
means the process to determine whether the individual needs further assessment
to identify circumstances requiring referrals or additional services and
supports.
(77) "Service Delivery
Rules" means the OAR describing specific regulatory standards for the possible
array of services covered by certificates issued under chapter 309, division
8.
(78) "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.
(79) "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.
(80) "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.
(81) "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.
(82) "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.
(83) "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.
(84)
"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.
(85) "Substance Abuse Prevention and
Treatment Block Grant" or "SAPT Block Grant" 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.
(86) "Substance Use
Disorders" means disorders related to the taking of a drug of abuse including
alcohol to the side effects of a medication and to a toxin exposure. The
disorders include substance use disorders such as substance dependence and
substance abuse and substance-induced disorders, including substance
intoxication, withdrawal, delirium, and dementia, as well as substance induced
psychotic disorder, mood disorder, etc., as defined in DSM criteria.
(87) "Substance Use Disorders Treatment and
Recovery Services" means outpatient, intensive outpatient, and residential
services and supports for individuals with substance use disorders.
(88) "Substance Use Disorders Treatment
Staff" means a person certified or licensed by a health or allied provider
agency to provide substance use disorders treatment services that include
assessment, development of a Service Plan, and individual, group, and family
counseling.
(89) "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.
(90) "Transfer" means the process of
assisting an individual to transition from the current services to the next
appropriate setting or level of care.
(91) "Transitioning" means a 90-day period
which begins when an individual is discharged from an inpatient or residential
stay back to a community setting.
(92) "Trauma Informed Services" means
services that are reflective of 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.
(93) "Treatment" means
the planned, medically appropriate, individualized program of medical,
psychological, and rehabilitative procedures, experiences and activities
designed to remediate symptoms of a DSM diagnosis that are included in the
Service Plan.
(94) "Urinalysis
Test" means an initial test and, if positive, a confirmatory test:
(a) An initial test shall include, at a
minimum, a sensitive, rapid, and inexpensive immunoassay screen to eliminate
"true negative" specimens from further consideration;
(b) A confirmatory test is a second
analytical procedure used to identify the presence of a specific drug or
metabolite in a urine specimen. The confirmatory test shall be by a different
analytical method from that of the initial test to ensure reliability and
accuracy;
(c) All urinalysis tests
shall be performed by laboratories meeting the requirements of OAR 333-024-0305
to 333-024-0365.
(95)
"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.
(96) "Variance"
means an exception from a provision of these rules, granted in writing by the
Division, upon written application from the provider. Duration of a variance is
determined on a case-by-case basis.
(97) "Volunteer" means an individual who
provides a program service or who takes part in a program service and who is
not an employee of the program and is not paid for services. The services shall
be non-clinical unless the individual has the required credentials to provide a
clinical service.
(98) "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
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