Current through Register Vol. 63, No. 9, September 1, 2024
Programs shall be certified by the Division in accordance with
OAR 309 Division 008 in order to render outpatient substance use disorder
treatment and recovery services. A certificate issued to a program shall be
effective for a duration not to exceed three years from the date of issue and
may be renewed, conditioned, denied, suspended, or revoked by the Division in
the manner set forth in OAR 309-008. Certified programs shall meet the
standards set forth in these rules and all applicable statutes.
(1) Currently certified providers shall
submit complete outpatient substance use disorder treatment and recovery
services applications to render each selected ASAM Level(s) of Care and any
optional Enhanced ASAM Service Designation(s) no later than October 1,
2023.
(2) Division approved ASAM
level(s) of Care and optional Enhanced ASAM Service designation(s), if any,
shall be added to the outpatient substance use disorder treatment and recovery
services certificate starting January 1, 2024.
(3) Effective April 1, 2024, all outpatient
substance use disorder treatment programs must have a valid certificate
designating each the following ASAM Level(s) of Care and any optional Enhanced
ASAM Service designation(s) that they are certified by the Division to
provide.
(4) Each program shall
operate within the scope of the service and ASAM Level of Care types listed on
their certificate.
(5) In addition
to any other requirements described in these rules and applicable statutes,
programs certified to render adolescent or adult residential ASAM Level 1
services shall, at a minimum, meet and maintain documentation demonstrating
ongoing compliance with each of the following standards:
(a) ASAM Level of Care 1 programs shall
ensure the individual meets ASAM dimensional admission criteria:
(A) ASAM dimensional admission criteria in
each of the Dimensions;
(B)
Diagnostic criteria for a substance use, substance-induced or other addictive
disorder, per DSM-5-TR, or the probability of such a diagnosis is determined
through collateral information; and
(C) When the ASAM Level of Care placement is
not the same as the ASAM Level of Care assessed, the documentation shall
include a rationale for this discrepancy.
(b) Program staff shall include:
(A) Medical Director or LMP who shall be
available for complex case consultation; and
(B) Adolescent programs shall have program
staff knowledgeable about adolescent development and experienced in engaging
and working with adolescent.
(c) Arrange transfer of individuals to all
other ASAM Levels of Care as indicated; and
(d) Provide instruction on accessing
emergency services by telephone 24 hours per day, 7 days per week.
(6) Programs shall provide an
array of weekly services and supports that are designed to meet the needs of
the individual and their clinical severity through the number of planned hours
per week and the type of planned services and supports. Programs shall ensure
the following minimum standards:
(a) Less than
9 hours of weekly treatment contact for adults;
(b) Less than 6 hours of weekly treatment
contact for adolescent;
(c)
Designed to meet the needs of the individual and their clinical severity
through the number of planned hours per week and the type of planned services
and supports;
(d) Address
lifestyle, thinking, belief, and behavioral patterns that are identified as
barriers to the improvement of functioning;
(e) Offer education, monitoring and disease
management;
(f) Offer or coordinate
access to medical, psychiatric, including medication management, psychological
services in a timeframe that matches the severity of the need;
(g) Offer or coordinate access to urinalysis
testing and other toxicology and laboratory testing services; and
(h) Have direct affiliation or referral
relationship with higher levels of care and medication management.
(7) ASAM Enhanced Service
designation(s) are service types that the program may choose to apply to render
to either adults or adolescents when it corresponds to an ASAM Level of Care
that is certified by the Division. Programs certified to render Outpatient
Substance Use Disorder Services ASAM Level 1 may choose to also be certified to
render any of the following Enhanced Service types:
(a) ASAM Level 1 Co-occurring Capable
services. Programs certified to render Co-occurring Capable ASAM Level 1
services shall render ASAM Level of Care 1 services as described in this rule
and also, at a minimum:
(A) Individuals
admitted have co-occurring mental disorders that meet the stability criteria
for a co-occurring capable program, or experience troublesome but subsyndromal
symptomology; and
(B) The mental
health services are either rendered by community partners and closely
coordinated or rendered by program staff who are qualified, credentialed and
working within their scope.
(b) ASAM Level 1 Co-occurring Enhanced
services. Programs certified to render Co-occurring Enhanced ASAM Level 1
services shall render ASAM Level of Care 1 services as described in this rule
and also, at a minimum:
(A) Be certified to
render services in accordance with OAR
309-019-0145 Intensive
Co-occurring Disorders Services;
(B) Render services as described in ASAM
Level 2.5 Co-occurring Capable Program rules;
(C) Include individuals whose co-occurring
disorders are documented as either:
(i)
Moderate severity and needing ongoing monitoring; or
(ii) High severity and chronic but have
stabilized to the extent where these services are potentially
beneficial.
(D) Offer
the following services:
(i) Monitor and
manage psychotropic medication;
(ii) Mental health treatment; and
(iii) Services that address the interaction
between mental health and substance use disorders.
Statutory/Other Authority: ORS
161.390,
413.042,
430.256 &
430.640
Statutes/Other Implemented: ORS
161.390-161.400,
428.205-428.270,
430.010,
430.205-430.210,
430.254-430.640,
430.850-430.955 &
743A.168
