Or. Admin. Code § 309-019-0105 - Definitions
(1) "Abuse of an
Adult" means the circumstances defined in ORS
430.735, OAR Chapter 943,
Division 45 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 (ADL) 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, toileting, and
cognition.
(5) "Acute Care
Psychiatric Hospital" means a hospital or facility that provides 24 hours-a-day
psychiatric, multi-disciplinary, inpatient, or residential stabilization, care,
and treatment.
(6) "Adolescent"
means an individual from 12 through 21 years of age or those individuals
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 needs 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)
"ASAM" means The American Society of Addiction Medicine (ASAM).
(9) "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.
(10) "ASAM Co-Occurring
Capable" means an array of psychiatric and mental health services that meet the
individuals' needs are made available to individuals when indicated, by the
program or coordinated by the program.
(11) "ASAM Co-occurring Enhanced" means
mental health services that include psychiatric evaluation, medication
management and therapy are made available to the individuals, when indicated,
by the program. Program staff are cross trained on substance use disorders and
mental health treatment and can document the relationship between the disorders
and the individual's level of functioning.
(12) "ASAM Dimensional Criteria" means the
documented data demonstrates that the individual meets the criteria per ASAM
dimension, as described in The ASAM Criteria, for the ASAM Level of Care
assessed.
(13) "ASAM Enhanced
Service designation(s)" as described in The ASAM Criteria, Third Edition,
includes service types per ASAM Level of Care that the program may choose to
apply and be approved by the Division to render, to either adults or
adolescents, when it corresponds to an ASAM Level of Care that is certified by
the Division.
(14) "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.
(a) "Early Intervention ASAM Level of Care
0.5 (ASAM Level 0.5)" means organized services designed to explore and address
problems or risk factors that may be related to substance use and assist
individuals in recognizing the harmful consequences of high-risk substance use
and addictive behavior. ASAM Level 0.5 may be delivered as a Driving Under the
Influence of Intoxicants (DUII) service where the length and number of contacts
may be mandated, and completion of the program may be a prerequisite to the
reinstatement of driving privileges. Individuals eligible for this ASAM level
of care do not meet DSM-5-TR diagnostic criteria for a substance use
disorder.
(b) "Outpatient Substance
Use Disorder Services ASAM Level of Care 1" means organized services delivered
in a variety of settings and include a vast array of outpatient services and
supports, which are tailored to the severity and function of the individual and
typically are less than 9 contact hours per week. ASAM Level 1 programs enhance
access to care and facilitate earlier engagement into treatment. Services and
supports address major lifestyle, attitudinal and behavioral issues related to
the substance use that detract from progress towards service plan
goals.
(c) "Intensive Outpatient
Substance Use Disorder Services ASAM Level of Care 2.1" means structured
services and supports, mostly comprised of counseling and education. Mental
health services are either offered by the program or tightly coordinated with a
community provided. When planning a transition to ASAM Level 1 services, a
program may provide less than the minimum number of contact hours for up to two
weeks: 9 for adults and 6 for children.
(d) "Partial Hospitalization Services ASAM
Level of Care 2.5" means clinically intensive programming of 20 contact hours
or more per week, which is specified by the service plan. Needs identified in
Dimensions 1, 2 and 3 warrant daily monitoring or management within an
outpatient or combined in a residential setting. Programs staff
interdisciplinary teams and offer intensive case management. Psychiatric and
medical services are either offered by the program or coordinated.
(15) "ASAM Risk Assessment
Component" means the portions of a substance use disorders assessment that
include an Immediate Need Profile and a rating of severity for each of the ASAM
dimensions in a multidimensional assessment, which inform the Level of Care
placement decision and the services and supports included in the service
plan.
(16) "ASAM Service Types"
means the ASAM Levels of Care, Co-occurring Capable services, Co-occurring
Enhanced services, and any other defined service that is described in The ASAM
Criteria and when approved, included within the certificate.
(17) "Assertive Community Treatment (ACT)"
means an evidence-based practice designed to provide comprehensive treatment
and support services to individuals with serious and persistent mental illness.
ACT is intended to serve individuals who have severe functional impairments and
who have not responded to traditional psychiatric outpatient treatment. ACT
services are provided by a single multi-disciplinary team, which typically
includes a psychiatrist, a nurse, and at least two case managers and are
designed to meet the needs of each individual and to help keep the individual
in the community and out of a structured service setting, such as residential
or hospital care. ACT is characterized by the following:
(a) Low client to staff ratios;
(b) Providing services in the community
rather than in the office;
(c)
Shared caseloads among team members;
(d) Twenty-four-hour staff
availability;
(e) Direct provision
of all services by the team (rather than referring individuals to other
agencies); and
(f) Time-unlimited
services.
(18)
"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 outpatient substance use disorders services, the
assessment is multi-dimensional and consistent with The ASAM Criteria third
edition.
(19) "Authority" means the
Oregon Health Authority.
(20)
"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.
(21) "Behavioral health clinician" means a
practitioner of behavioral health services whose authorized scope of practice
includes substance use and mental health diagnosis and treatment.
(22) "Behavioral Health Treatment" means
treatment for mental health, substance use disorders, and problem
gambling.
(23) "Behavior Support
Plan" means the individualized proactive support strategies used to support
positive behavior.
(24) "Behavior
Support Strategies" means proactive supports designed to replace challenging
behavior with functional, positive behavior. The strategies address
environmental, social, neuro-developmental, and physical factors that affect
behavior.
(25) "Best Practice Risk
Assessment" has the meaning given that term in OAR
309-023-0110.
(26) "Board Registered Associate or Board
Registered Intern" means a post-graduate who is listed as active on the
applicable Oregon Board registry with one of the following qualifications:
(a) Psychologist Associate Residents as
described in OAR 858-010-0037;
(b) Licensed Psychologist Associate under
continued supervision as described in OAR
858-010-0038;
(c) Licensed Professional Counselor intern or
Marriage and Family Therapist intern registered with the Oregon Board of
Licensed Professional Counselors and Therapists as described in OAR
833-050-0011;
(d) Certificate of Clinical Social Work
Associate issued by the Oregon Board of Licensed Social Workers as described in
OAR 877-020-0009; or
(e) Registered Bachelor of Social Work issued
by the Oregon Board of Licensed Social Workers as described in OAR
877-015-0105.
(27) "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.
(28) "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, the family, 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.
(29) "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.
(30) "Certificate of
Approval" means the document issued by the Authority that identifies and
declares certification of a provider pursuant to OAR chapter 309, division
008.
(31) "Chief Officer" means the
Chief Health Systems Officer of the Division or designee.
(32) "Child" means an individual under the
age of 18. An individual with Medicaid eligibility who needs services specific
to children, adolescents, or young adults in transition shall be considered a
child until age 21 for purposes of these rules.
(33) "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.
(34) "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.
(35) "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.
(36) "Cognitive
Ability" means a general mental capability involving reasoning, problem
solving, planning, abstract thinking, complex idea comprehension and learning
from experience.
(37) "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.
(38)
"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.
(39)
"Co-occurring Capable Substance Use Disorder Programs" means, consistent with
The ASAM Criteria, arrangements are in place for coordination and collaboration
between addiction and mental health services, internally and with external
community partners. Program staff must be trained and qualified to address the
interaction between mental health symptoms or conditions and the substance use
disorder, and the interactional effect on readiness to change, the severity of
risk and the subsequent planning of services and supports.
(40) "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.
(41)
"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.
(42) "Community Health Worker (CHW)" means a
person 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.
(43) "Community Mental Health Program (CMHP)"
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 Chapter 309, Division 014.
(44)
"Conditional Release" means placement by a court or the Psychiatric Security
Review Board (PSRB) of an individual found eligible under ORS
161.327 or
161.336 for supervision and
treatment in a community setting.
(45) "Consistent with ASAM Criteria" means a
documented intervention containing information that demonstrates use of and
adherence to the description of components contained within The ASAM Criteria,
Third Edition.
(46) "Coordinated
Care Organization (CCO)" means a corporation, governmental agency, public
corporation, or other legal entity that is certified as meeting the criteria
adopted by the Authority under ORS
414.625 to be accountable for
care management and to provide integrated and coordinated health care for each
of the organization's members.
(47)
"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.
(48) "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.
(49) "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.
(50) "Crisis Intervention" has the meaning
given that term in OAR
309-023-0110.
(51) "Crisis Line Services" means phone-based
services that establish immediate communication links and provide supportive
interventions and information for individuals in an urgent or emergent
situation.
(52) "Crisis Plan" means
an individualized document designed in collaboration with the individual served
to help anticipate and prevent future crisis episodes and direct interventions
in the instance of a crisis.
(53)
"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.
(54) "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.
(55) "Culturally Responsive" means services
that are respectful of and relevant to the beliefs, practices, culture and
linguistic needs of diverse consumer/client 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.
(56) "Culturally Specific Program" means a
program designed to meet the unique service needs of a specific culture and
that provides services to a majority of individuals representing that
culture.
(57) "Declaration for
Mental Health Treatment" means a written statement of an individual's
preferences concerning their mental health treatment. The declaration is made
when the individual is able to understand and legally make decisions related to
such treatment. It is honored, as clinically appropriate, in the event the
individual becomes unable to make such decisions.
(58) "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 medically necessary reason
for services.
(59) "Division" means
the Health Systems Division of the Oregon Health Authority, or its
designee.
(60) "Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5-TR)" means the
textbook used to diagnose and classify mental disorders that is published by
the American Psychiatric Association.
(61) "Driving Under the Influence of
Intoxicants (DUII) Substance Use Disorders Rehabilitation Program" means a
program of treatment and therapeutically oriented education services for an
individual who is either:
(a) A violator of
ORS 813.010 (Driving Under the
Influence of Intoxicants); or
(b) A
defendant participating in a diversion agreement under ORS
813.200.
(62) "Emergent" means the onset of symptoms
requiring attention within 24 hours to prevent serious deterioration in mental
or physical health or threat to safety.
(63) "Employment Support Services" means
services approved by 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.
(64)
"Enhanced Care Services (ECS)" and "Enhanced Care Outreach Services (ECOS)"
means intensive behavioral and rehabilitative mental health services to
eligible individuals who reside in Aging and People with Disabilities (APD)
licensed homes or facilities.
(65)
"Entry" means the act or process of acceptance and enrollment into services
regulated by this rule.
(66) "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.
(67) "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, or legal or social relationships. Family also means
any natural, formal, or informal support persons identified as important by the
individual.
(68) "Family Support"
means the provision of peer-delivered services to people defined as family to
the individual. It includes support to caregivers at community meetings,
assistance to families in system navigation and managing multiple appointments,
supportive home visits, peer support, parent mentoring and coaching, advocacy,
and furthering efforts to develop natural and informal community
supports.
(69) "Gender Identity"
means an individual's self-identification of gender without regard to legal or
biological identification including but not limited to individuals identifying
themselves as male, female, transgender, gender transitioning and transitioned,
non-binary, intersex, and gender diverse.
(70) "Gender Expression" means the external
characteristics and behaviors that are socially defined as masculine, feminine,
or androgynous such as dress, mannerisms, speech patterns, and social
interactions.
(71) "Geographic
Service Area" means the geographic area within the county boundaries in which
the CMHP operates.
(72) "Grievance"
means a formal complaint submitted to a provider verbally or in writing by an
individual or the individual's representative.
(73) "Guardian" means an individual appointed
by a court of law to act as guardian of a minor or a legally incapacitated
individual. Guardian may also mean legal representative.
(74) "Health Insurance Portability and
Accountability Act (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).
(75) "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.
(76)
"Housing Support Services" means services approved by 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.
(77) "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).
(78) "Incident" means any event involving an
individual or 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, accident, act of physical
aggression, medication error, suspected abuse or neglect, or any other type
unusual or critical event that presents a risk to health and safety of any
persons. Critical incidents are reported to the Division.
(79) "Incident Report" means a written
description of any incident.
(80)
"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).
(81) "Individual" means any individual being
considered for or receiving services and supports regulated by these
rules.
(82) "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.
(83) "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.
(84) "Intensive In-Home
Behavioral Health Treatment (IIBHT) for Children" means an intensive,
community-based level of care for youth ages 0-20 years with complex mental
health needs who are at risk for an out of home placement or who are stepping
down from a higher level of care. IIBHT includes access to an array of services
including individual and family therapy, case management, psychiatric services,
skills training, peer-delivered services, and proactive 24 hours 7 days a week
crisis response. A Certificate of Approval from the Oregon Health Authority is
required to render IIBHT services to eligible youth and families. For the
purposes of IIBHT, "in home" means services delivered in the home, school, or
other community setting, as specified by the individual and family.
(85) "Intensive Outpatient Services and
Supports (IOSS)" means a specialized set of comprehensive in-home and
community-based supports and mental health treatment services for children that
are developed by the child and family team and delivered in the most integrated
setting in the community.
(86)
"Interdisciplinary Team (IDT)" means a group of program staff that have primary
responsibility for the development of a Service Plan for an individual
receiving services.
(87) "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 and 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.
(88) "Juvenile
Psychiatric Security Review Board (JPSRB)" means the entity described in ORS
161.385.
(89) "Legal Representative" means a person
who has been legally designated by court order to make financial or health care
decisions for another individual. The legal representative only has authority
to act within the scope and limits of the legal representative's authority as
designated by the court or other agreement. Legal representatives acting
outside of the legal representative's authority or scope shall meet the
definition of authorized representative.
(90) "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
(91) "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.
(92) "Licensed
Medical Practitioner (LMP)" means a person 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;
(b) Nurse
practitioner licensed to practice in the State of Oregon; or
(c) Physician's assistant licensed to
practice in the State of Oregon;
(d) Whose training, experience, and
competence demonstrate the ability to conduct a medical exam, a mental health
assessment and provide medication management; and
(e) For IOSS and ITS providers, a
Board-Certified or Child and Adolescent Psychiatrist licensed to practice in
the State of Oregon or a Psychiatric Nurse Practitioner under the consultation
of a board-certified or board-eligible child and adolescent psychiatrist
licensed to practice in the State of Oregon.
(93) "Linkage agreement" has the meaning
given that term in OAR
309-032-0860.
(94) "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 composed of two or more boards of county
commissioners.
(95)
"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.
(96) "Medicaid" means the federal
grant-in-aid program to state governments to provide medical assistance to
eligible individuals under Title XIX of the Social Security Act.
(97) "Medical Director" means a physician
licensed to practice medicine in the State of Oregon and 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.
(98) "Medical Treatment Staff" means medical
personnel directly responsible for the delivery or oversight of client care and
treatment, and who are properly trained, educated, and credentialed to deliver
withdrawal management and substance use disorders services.
(99) "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.
(100) "Medication Assisted Treatment (MAT)"
means the use of medication in combination with counseling and behavioral
therapies for the treatment of substance use disorders.
(101) "Mental Health Intern" means 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. The program staff
shall:
(a) Be enrolled in a graduate program
that will result in a degree in psychology, social work, or related field of
behavioral science, or an equivalent degree as evidenced by providing
transcripts indicating applicable coursework meeting the required competencies
and approved by the OHA-approved certification or licensing body;
(b) Have a collaborative educational
agreement between the Division-certified provider and the graduate program for
the student; and
(c) Work under the
direct and active supervision of a qualified supervisor employed or contracted
by the provider of services, within the scope of practice and competencies
identified by the collaborative educational agreement, and within the policies
and procedures for the credentialing of program staff as established by the
provider.
(102) "Mobile
Crisis Services" means mental health services for individuals in crisis
provided by mental health practitioners who respond to behavioral health crises
onsite at the location in the community where the crisis arises and who provide
a face-to-face therapeutic response. The goal of mobile crisis services is to
help an individual resolve a psychiatric crisis in the most integrated setting
possible and to avoid unnecessary hospitalization, inpatient psychiatric
treatment, involuntary commitment, and arrest or incarceration.
(103) "Mobile Crisis Response Time" means the
time from the point when a professional decision is made that a face-to-face
intervention is required to the time the actual face-to-face intervention takes
place in the community.
(104)
"Mobility" means assisting the individual with mobility, transfers and
repositioning including turning or adjusting padding for physical comfort or
pressure relief and encouraging or assisting with range of motion exercises and
the use of devises that assist with mobility.
(105) "Motivational Enhancement Therapy"
(MET) means a person-centered approach to therapy that focuses on improving an
individual's motivation to change.
(106) "Motivational Therapies" means
evidence-based interventions for people experiencing substance use disorder,
such as motivational interviewing, cognitive behavioral therapy, and
motivational enhancement therapy.
(107) "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).
(108) "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.
(109) "Nursing Services" means services that
are provided by a registered nurse (RN) or a licensed practical nurse (LPN)
within the scope of practice as defined in OAR chapter 851 division
045.
(110) "Outpatient Problem
Gambling Treatment Services" means all outpatient treatment services and
supports provided to individuals with gambling related problems and their
families.
(111) "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 means attempts made to
engage or re-engage an individual in services by such means as letters or
telephone calls.
(112) "Partial
Hospitalization or Day Treatment Substance Use Disorder (SUD) Services ASAM
Level 2.5" means a planned, structured array of services and supports,
consistent with The ASAM Criteria for Level of Care 2.5, that offer 20 or more
therapeutic contact hours of high intensity treatment per week. Contact is in a
less restrictive level of care than residential SUD treatment, 24-hour care is
not required.
(113) "Peer" means
program staff supporting an individual or the individual's family member who
has similar life experience, either as a current or former recipient of mental
health or 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.
(114) "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.
(115) "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.
(116) "Peer Support
Specialist (PSS)" 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.
(117) "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.
(118) "Peer
Wellness Specialist (PWS)" means s 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.
(119)
"Pre-engagement Services" means services delivered prior to completion of an
assessment, service plan, and/or commencement of formal treatment in order to
engage high risk/high need individuals in ongoing treatment services and to
avoid crisis events and higher levels of care.
(120) "Problem Gambling Approved
Certification Consultant" means individual who is a Certified Gambling
Addiction Counselor, level II (CGACII) for a minimum of two years and has a
minimum of 12 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.
(121) "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.
(122) "Program" means
an organized system of services and supports delivered by a provider designed
to address the treatment needs of individuals and families.
(123) "Program Administrator" or "Program
Director" means program staff with appropriate professional qualifications and
experience who is designated to manage the operation of a program.
(124) "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.
(125) "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.
(126)
"Psychiatric Security Review Board (PSRB)" means the entity described in ORS
161.295 through
161.400.
(127) Psychiatrist" means a physician
licensed by the Oregon Medical Board and who has completed an approved
residency training program in psychiatry.
(128) "Psychologist" means a person who is
currently licensed to practice psychology by the Oregon Board of
Psychology.
(129) "Publicly Funded"
means financial support, in part or in full, with revenue generated by a local,
state, or federal government.
(130)
"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.
(131) "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.
(132) "Qualified Person" means program staff
who is a QMHP or a QMHA and is identified by the PSRB and JPSRB in its
Conditional Release Order. This individual is designated by the provider to
deliver or arrange and monitor the provision of the reports and services
required by the Conditional Release Order.
(133) "Quality Assessment and Performance
Improvement" means the structured, internal monitoring and evaluation of
services to improve processes, service delivery, and service
outcomes.
(134) "Recovery" means a
process of healing and transformation for an individual to achieve their full
human potential and personhood in leading a meaningful life as they define it
in communities of their choice.
(135) "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, Division employee,
attorney, or legal guardian.
(136)
"Resilience" means the universal capacity that an individual uses to prevent,
minimize, or overcome the effects of adversity. Resilience reflects an
individual's strengths as protective factors and assets for positive
development.
(137) "Respite Care"
means planned and emergency supports designed to provide temporary relief from
care giving to maintain a stable and safe living environment. Respite care may
be provided in or out of the home. Respite care includes supervision and
behavior support consistent with the strategies specified in the service
plan.
(138) "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.
(139) "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 actions to use when self-harm, harm to others or suicide ideation is
elevated or following suicidal behavior.
(140) "Screening" means the process to
determine whether the individual needs further assessment to identify
circumstances requiring referrals or additional services and
supports.
(141) "Screening
Specialist" means a person who possesses valid certification issued by the
Division to conduct DUII evaluations.
(142) "Service Plan" means a comprehensive
plan for services and supports provided to or coordinated for an individual and
their family, as applicable, that is reflective of the assessment and the
intended outcomes of service.
(143)
"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.
(144) "Service Record" means the written or
electronic documentation regarding an individual and resulting from entry into
services, assessment, orientation, services and supports planning, services and
supports provided, and transfer.
(145) "Services" means those activities and
treatments described in the service plan and rendered, that are intended to
support 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's desired
outcomes.
(146) "Signature" means
any written or electronic means of entering the name, date of authentication,
and credentials of the program staff providing a specific service or the
individual authorizing services and supports. Signature also means any written
or electronic means of entering the name and date of authentication of the
individual, guardian, or any authorized representative of the individual
receiving services.
(147) "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.
(148) "Stabilization" means the application
of medical and psychosocial services and supports and 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 patient's ability to maintain safety while
enhancing their recovery, so they can successfully reintegrate into identified
community settings.
(149) "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.
(150) "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.
(151) "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.
(152) "Substance Use
Disorders (SUDs)" 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.
(153) "Substance Use Disorders Treatment and
Recovery Services" means outpatient, intensive outpatient, and residential
services and supports for individuals with substance use disorders.
(154) "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.
(155) "Subsyndromal
symptomology" means the individual demonstrates or complains of symptoms,
suggesting a particular disorder or condition, that do not meet the threshold
of the defined criteria for that disorder or condition, and so a diagnosis of
that disorder or condition cannot be assigned.
(156) "Successful DUII Completion" means that
the DUII program has documented in its records that for the period of service
deemed necessary by the program, the individual has:
(a) Met the completion criteria approved by
the Division;
(b) Met the terms of
the fee agreement between the provider and the individual; and
(c) Demonstrated 90 days of continuous
abstinence prior to completion.
(157) "Suicide Risk Assessment" means a
comprehensive evaluation, usually performed by a clinician, to evaluate
suspected suicide risk in an individual, estimate the immediate danger, and
decide on a course of treatment. May also be called Risk Assessment.
(158) "Suicide Screening" means a procedure
in which a validated tool, or protocol is used to identify individuals who may
be at risk for suicide.
(159)
"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.
(160) "Transfer" means the process of
assisting an individual to transition from the current services to the next
identified setting or ASAM level of care.
(161) "Transitioning" means a 90-day period
which begins when an individual is discharged from an inpatient or residential
stay back to a community setting.
(162) "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.
(163) "Treatment" means
the planned, individualized program of medical, psychological, and
rehabilitative procedures, experiences, and activities designed to remediate
symptoms of a DSM-5-TR diagnosis.
(164) "Triage" means a classification process
to determine priority needs.
(165)
"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.
(166) "Urgent" means
the onset of symptoms requiring attention within 24 hours to prevent a serious
deterioration in an individual's mental or physical health or threat to
safety.
(167) "Variance" means an
exception from a provision of these rules granted in writing by the Division
pursuant to the process regulated by OAR
309-008-1600 upon written
application from the provider. Approval and duration of a variance is
determined on a case-by-case basis.
(168) "Volunteer" means a person who performs
a service willingly and without pay.
(169) "Warm Handoff" has the meaning given
that term in OAR 309-032-0860.
(170) "Wellness" means an approach to
healthcare that emphasizes good physical and mental health, preventing illness,
and prolonging life.
(171)
"Wraparound" means a high-fidelity model of team-based intensive care
coordination for children and their families based on National Wraparound
Initiative values and principles.
(172) "Young Adult in Transition" means an
individual who is developmentally transitioning into independence, sometime
between the ages of 14 and 25.
Notes
Statutory/Other Authority: ORS 161.390, 413.042, 430.256 & 430.640
Statutes/Other Implemented: ORS 161.390 - 161.400, 428.205 - 270, 430.010, 430.205- 430.210, 430.254 - 430.640, 430.850 - 430.955, 743A.168 & 414.665
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.