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(s) and Level(s) of Care listed on their
certificate. ASAM Level 2.1 services and supports may be rendered within an
ASAM Level 3.1 service setting that is owned and operated by the same
provider.
(5) In addition to any
other requirements described in these rules and applicable statutes, programs
certified to render adolescent or adult residential ASAM Level 2.1 services
shall, at a minimum, meet and maintain documentation demonstrating ongoing
compliance with each of the following standards:
(a) The individual meets ASAM dimensional
admission criteria for ASAM Level 2.1 when:
(A) Adult ASAM dimensional admission criteria
is met in Dimensions 2, 3 and one of 4, 5, or 6;
(B) Adolescent ASAM dimensional admission
criteria is met in Dimensions 1 and 2, and the severity specifications in at
least one of Dimensions 3, 4, 5, or 6;
(C) Diagnostic criteria for a substance use
or other addictive disorder, per DSM-5-TR, or the probability of such a
diagnosis is determined through collateral information; and
(D) 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 include:
(A) A Medical Director or LMP with
credentialing, training or experience in addiction medicine 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 adolescents.
(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) 9 to 19
hours of weekly treatment contact for adults;
(b) 6 to 19 hours of weekly treatment contact
for adolescents;
(c) Services
rendered by the program:
(A) Individual, group
and family therapy; and
(B)
Psychoeducation and motivational strategies.
(d) Services rendered by the program or
coordinated through consultation and referral:
(A) Offer or coordinate access to urinalysis
testing and other toxicology and laboratory testing services;
(B) Psychiatric and medical
services;
(C) Medication
management;
(D) Occupational or
recreational;
(E)
Skill-building;
(F) Case
management; and
(G) Peer delivered
services.
(e) If an
adult individual no longer requires 9 or more hours of structured programming
per week or adolescent no longer requires 6 or more hours of structured
programming per week and is not yet stable enough to transition to ASAM Level
1, the program may lessen the minimum required hours per week for a maximum of
two weeks while focusing on stabilization and transition to Level 1.
(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 2.1 may choose to also be certified
to render any of the following Enhanced Service types:
(a) ASAM Level 2.1 Co-occurring Capable
services. Programs certified to render Co-occurring Capable ASAM Level 2.1
services shall render ASAM Level of Care 2.1 services as described in this rule
and also, at a minimum:
(A) Ensure individuals
admitted have documented co-occurring mental disorders and are able to tolerate
and benefit from a co-occurring capable program, or experience troublesome but
subsyndromal symptomology.
(B) Be
certified to render services in accordance with OAR
309-019-0145 Intensive
Co-occurring Disorders Services;
(C) Be appropriate for individuals with
co-occurring disorders when the services are integrated into the program;
and
(D) Arrange medical and
psychiatric consultation and medication management.
(b) ASAM Level 2.1 Co-occurring Enhanced
services. Programs certified to render Co-occurring Enhanced ASAM Level 2.1
services shall render ASAM Level of Care 2.1 services as described in this rule
and also, at a minimum:
(A) Render services as
described by ASAM Level of Care 2.1 Co-occurring Capable program
rules.
(B) Have access to consult
with an LMP; and
(C) Render a
comprehensive assessment with history and examination by an LMP within a
reasonable timeframe given the current risk assessment and immediate needs
profile.
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
