Or. Admin. Code § 309-008-0200 - Definitions
(1) "ASAM Criteria"
means the most current publication of the American Society of Addiction
Medicine criteria; Treatment Criteria for Addictive, Substance-Related, and
Co-Occurring Conditions, which is a clinical guide used in matching individuals
to appropriate levels of care, and incorporated by reference in these
rules.
(2) "Applicant" means any
provider with an existing certificate listed in OAR
309-008-0100(2)
to provide behavioral health treatment services or any person, organizational
provider, tribal organization, or Community Mental Health Program seeking
initial certification listed in OAR
309-008-0100(2)
by submitting an application to provide behavioral health treatment
services.
(3) "Behavioral Health"
means mental health, mental illness, addictive health, and addiction and
gambling disorders.
(4) "Behavioral
Health Treatment Services" means mental health treatment, substance use
disorder treatment, and problem gambling treatment services.
(5) "Certificate" means the document issued
by the Division that identifies and declares provider certification. A letter
accompanying issuance of the certificate shall detail the scope and approved
service delivery locations of the certificate.
(6) "Certification Review" means an
assessment of a provider or applicant by the Division or by another state
agency or contractor on behalf of the Division for the purpose of assessing
compliance with these rules with applicable service delivery rules and other
applicable regulations.
(7)
"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 pursuant to OAR
309-014-0000.
(8) "Condition" means a provision attached to
a new or existing certificate that limits or restricts the scope of the
certificate or imposes additional requirements on the applicant or
provider.
(9) "Coordinated Care
Organization" (CCO) means an entity that has been contracted by the Authority
to provide coordinated and integrated health services.
(10) "Director" means the Director of the
Oregon Health Authority or designee.
(11) "Division" means the Health Systems
Division of the Oregon Health Authority or designee.
(12) "Division Staff" means those staff
employed by the Division to conduct certification activities under these rules
or a contracted entity delegated the authority by the Division to conduct
certification activities under these rules.
(13) "Individual" means the person requesting
or receiving behavioral health treatment services from a provider certified by
the Division.
(14) "Individual
Services Records" means documentation, written or electronic, regarding an
individual including information relating to entry, assessment, orientation,
services and supports planning, services and supports provided, and
transfer.
(15) "Initial
Certification" means a certificate issued to a new provider.
(16) "Non-Inpatient Provider" means a
provider not contractually affiliated with the Division, a CMHP, or other
Division contractor, providing behavioral health treatment services under group
health insurance coverage that seeks or maintains Division approval under ORS
743A.168.
(17) "Oregon Health Authority" (Authority)
means the agency established in ORS Chapter 413 that administers the funds for
Titles XIX and XXI of the Social Security Act. It is the single state agency
for the administration of the medical assistance program under ORS chapter 414.
For purposes of these rules, divisions of the Oregon Health Authority include
the Public Health Division and the Health Systems Division.
(18) "Plan of Correction" (POC) means a
written plan and attached supporting documentation created by the provider when
required by the Division to address findings of noncompliance with these rules
or applicable service delivery rules.
(19) "Provider" means an individual,
organizational provider as defined in ORS
430.637(1)(b),
tribal organization, or CMHP that holds a current certificate listed in OAR
309-008-0100(2)
to provide behavioral health treatment services pursuant to these and
applicable service delivery rules.
(20) "Program Staff" includes employees of
the provider, individuals who provide services by contract with the provider,
program administrators, directors, or others who manage the provision of
services, and the provider itself when the provider is an individual or group
of individuals.
(21) "Program
Director" means an individual with appropriate professional qualifications and
experience as regulated by the applicable service delivery rules listed on the
certificate who is designated to manage the operation of a program.
(22) "Public Funds" means financial support,
in part or in full, provided directly or indirectly by a local, state, or
federal government.
(23)
"Regulatory Standard" means a rule, condition, or requirement describing the
following information for products, systems, or practices:
(a) Classification of components;
(b) Specification of materials, performance,
or operations; or
(c) Delineation
of procedures.
(24)
"Service Delivery Rules" means the OARs describing the specific regulatory
standards for each of the types of behavioral health treatment services the
Division certifies.
(25) "Service
Delivery Location" means the office, facility, location, or other physical
premises where the applicant or provider intends to provide or currently
provides behavioral health treatment services.
(26) "Services" means those activities and
treatments intended to assist the individual's transition to recovery from a
substance use disorder, gambling disorder, or mental health condition, and to
promote resiliency and rehabilitative and functional individual and family
outcomes.
(27) "Substantial
Compliance" means a level of adherence to applicable administrative rules,
statutes, and other applicable regulations that even if one or more
requirements is not met in the determination of the Division does not:
(a) Constitute a danger to the health,
welfare, or safety of any individual or to the public;
(b) Constitute a willful, negligent, or
ongoing violation of the rights of any individuals as set forth in
administrative rules; or
(c)
Constitute impairment to the accomplishment of the Division's purposes in
approving or supporting the applicant or provider.
(28) "Substantial Failure to Comply" means a
level of adherence to applicable administrative rules, statutes, contractual
requirements, and other applicable regulations that in the determination of the
Division:
(a) Constitutes a danger to the
health, welfare, or safety of any individual or to the public;
(b) Constitutes a willful, negligent, or
ongoing violation of the rights of individuals as set forth in applicable
administrative rules; or
(c)
Constitutes impairment to the accomplishment of the Division's purposes in
approving or supporting the applicant or provider.
(29) "Treatment" means the planned, medically
appropriate, individualized program of medical, psychological, and
rehabilitative procedures, and experiences and activities designed to remediate
symptoms of a DSM diagnosis.
Notes
Statutory/Other Authority: ORS 179.040, 179.505, ORS 413.042, 413.032-413.033, 426.072, 426.175, 426.236, 426.500, 430.010, 430.021, 430.256, 430.357, 430.560, 430.640, 430.870, ORS 743A.168 & 743.556
Statutes/Other Implemented: ORS 413.520, 426.060, 426.140, 430.010, 430.254, 430.335, 430.590, 430.620 & 430.637
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