Current through Register Vol. 63, No. 9, September 1, 2024
Providers are responsible for all program staff. Programs must
maintain the following minimum staffing standards:
(1) Program staff in the following positions
must meet applicable credentialing or licensing standards, including those set
forth in OAR 415-050.
(2) Program
administrators or program directors must demonstrate competence in leadership,
program planning and budgeting, fiscal management, supervision of program
staff, personnel management, program staff performance assessment, use of data,
reporting, program evaluation, quality assurance, and developing and
coordinating community resources. Professional qualifications and experience
must include:
(a) Five years of paid full-time
experience in withdrawal management, with at least one year in a paid
administrative capacity; or
(b) A
Bachelor's degree in a relevant field and four years of paid full-time
experience in withdrawal management with at least one year in a paid
administrative capacity; or
(c) A
Master's degree in a relevant field and three years of paid full-time
experience in withdrawal management with at least one year in a paid
administrative capacity; and
(d)
Knowledge and experience demonstrating competence in planning and budgeting,
fiscal management, supervision, personnel management, employee performance
assessment, data collection, and reporting.
(3) Supervisors, including clinical
supervisors in all programs must demonstrate competence in leadership,
wellness, oversight and evaluation of services, staff development,
stabilization and care coordination planning, case management and coordination,
utilization of community resources, group, family and patient therapy or
counseling, documentation and rationale for services to promote intended
outcomes and implementation of all provider policies.
(4) Programs must utilize a written staffing
plan that adheres to these rules, reflects the licensed ASAM Level(s) of care,
specifies typical staffing patterns and instructs how staff coverage will be
added throughout high acuity and emergency situations, and must ensure at a
minimum:
(a) The level of nursing care is
appropriate to the number of patients and severity of patient needs;
(b) Medical treatment staff rendering medical
services are credentialed medical personnel who are trained and competent to
implement physician-approved protocols for patient observation and supervision,
and facilitation of patient's transition to continuing care; and
(c) Medical treatment staff who assess and
treat patients must be able to obtain and interpret information regarding the
medical presentation and needs of patients. Such knowledge includes the signs
and symptoms of alcohol and other drug intoxication and withdrawal, as well as
the stabilization and monitoring of those conditions and how to facilitate
entry into ongoing care.
(5) Medical Treatment Staff must be:
(a) Qualified to assess and treat
patients;
(b) Trained and competent
to implement physician-approved protocols for patient observation and
supervision;
(c) Trained and
competent to facilitate patient's transition to continuing care; and
(d) Able to obtain and interpret information
regarding the medical presentation and needs of patients. Such knowledge
includes the signs and symptoms of alcohol and other drug intoxication and
withdrawal, as well as the stabilization and monitoring of those conditions and
how to facilitate entry into ongoing care:
(6) Medical Treatment Staff includes, but is
not limited to:
(a) Licensed Medical
Professional (LMP) licensed by the Oregon Medical Board;
(b) Licensed Practical Nurse (LPN) licensed
by the Oregon State Board of Nursing;
(c) Registered Nurse (RN) licensed by the
Oregon State Board of Nursing; and
(d) Advanced Practice Nurse including
Clinical Nurse Specialist and Certified Nurse Practitioner licensed by the
Oregon Board of Nursing.
(7) Certified Nursing Assistants (nursing
assistant or CNA) support the medical treatment staff in the observation,
monitoring and response to medical symptoms, and other duties assigned that are
within the scope of their qualifications, training and credentials.
(8) Each program must maintain, at a minimum,
the following qualified staff to oversee operations and who demonstrate the
following at the time of hire:
(a) Medical
Director with specialty credentialing, training or experience in addiction
medicine or addiction psychiatry and is actively credentialed in the State of
Oregon; and
(b) Nursing Manager
currently licensed by the Oregon Board of Nursing, or verified documentation
the following education and/or work experience; and
(c) Program Administrator or Program Director
with professional qualifications and experience meeting those described in
these rules, who is designated to manage the administrative operations of a
withdrawal management program.
(9) When applicable to the staffing pattern
of the withdrawal management program, clinical supervisors of substance use
disorder treatment services must meet qualification and credentialing
requirements detailed in OAR 309-018.
(10) When applicable to the staffing pattern
of the withdrawal management program, there must be a Peer-delivered Services
Supervisor 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, for
programs that offer Peer services.
(11) The substance use disorders treatment
staff must:
(a) Have training knowledge or
experience demonstrating competence in the treatment of substance use
disorders, including the management of substance withdrawal; patient
evaluation; motivational counseling techniques; and de-escalation;
(b) Operate within the scope of their
credential, training and education; and
(c) Be currently credentialed by a Division
recognized credentialing body.
(12) The Withdrawal Management Technician
staff are not required to be credentialed and there are no qualifying
prerequisites. When working as a withdrawal management technician, the
following conditions apply:
(a) Have knowledge
of or experience in, or be trained by the Program in recognizing the signs and
symptoms of withdrawal, motivational enhancement techniques, and de-escalation;
and
(b) Operate within the scope of
their training, education and assigned duties.
(13) The Student Intern or Intern must:
(a) Render services and supports under the
direct supervision of a qualified supervisor employed 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;
and
(b) The Student Intern program
staff must:
(A) Be currently enrolled in an
undergraduate education program for a degree in psychology, social work, or
other related field of behavioral science; or
(B) Have a collaborative educational
agreement between the Division-certified provider and the educational program
for the student; or
(C) The Student
Intern program staff must be working towards obtaining a behavioral health
credential.
(14) Peer Support Specialists and Peer
Wellness Specialists, including family and youth support and wellness
specialists, must meet the requirements in OAR 410-180-0300 to 0380 for
certification and continuing education.
(a) A
Peer Support Specialist and Peer Wellness Specialist must be:
(A) Someone self-identified as currently or
formerly receiving mental health, problem gambling or substance use
services;
(B) Someone
self-identified as in recovery from a substance use disorder;
(C) Someone self-identified as in recovery
from problem gambling; or
(D)
Someone who has experience parenting a child who:
(i) Is a current or former recipient of
mental health or substance use treatment; or
(ii) Is facing or has faced difficulties in
accessing education and health and wellness services due to a mental health or
behavioral health barrier.
(b) A Peer Support Specialist and Peer
Wellness Specialist must demonstrate:
(A) The
ability to support others in their recovery or resiliency;
(B) Personal life experience and tools of
self-directed recovery and resiliency; and
(C) Demonstrate cultural responsiveness and
effective communication.
(15) Volunteer is a program staff who
provides, or assists with providing, a service who is not an employee of the
program and is not paid for services. The services must not be behavioral
health or medical unless the program staff has the required qualifications or
credentials to provide the corresponding service or support. When the service
is behavioral health or medical, the volunteer is classified as a Program Staff
and is held to all the standards of a Program Staff within these
rules.
(16) Program staff include,
but are not limited to the following credentials and titles:
(a) Licensed Medical Professional (LMP)
licensed by the Oregon Medical Board;
(b) Licensed Practical Nurse (LPN) licensed
by the Oregon State Board of Nursing;
(c) Registered Nurse (RN) licensed by the
Oregon State Board of Nursing;
(d)
Advanced Practice Nurse including Clinical Nurse Specialist and Certified Nurse
Practitioner licensed by the Oregon Board of Nursing;
(e) Psychologist licensed by the Oregon Board
of Psychology;
(f) Professional
Counselor (LPC) or Marriage and Family Therapist (LMFT) licensed by the Oregon
Board of Licensed Professional Counselors and Therapists;
(g) Clinical Social Worker (CSW) licensed by
the Oregon Board of Licensed Social Workers;
(h) Licensed Master Social Worker (LCSW)
licensed by the Oregon Board of Licensed Social Workers as described in OAR
877-015-0105;
(i) Licensed
Psychologist Associate granted independent status as described in OAR
858-010-0039;
(j) Licensed
Occupational Therapist licensed by the Oregon Occupational Therapy Licensing
Board;
(k) Board registered
interns, including:
(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 Associate
or Marriage and Family Therapist Associate 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.
(l) Registered Bachelor of Social Work issued
by the Oregon Board of Licensed Social Workers as described in OAR
877-015-0105; or
(m) Substance Use
Disorders (SUD) Treatment Staff, which includes, but is not limited to:
(A) Master Addiction Counselor (MAC)
certified by NAADAC, the Association for Addiction Professionals;
(B) Certified Alcohol and Drug
Counselor-Registered (CADC-R);
(C)
Certified Alcohol and Drug Counselor-I (CADC-I);
(D) Certified Alcohol and Drug Counselor-II
(CADC-II); and
(E) Certified
Alcohol and Drug Counselor-III (CADC-III).
(n) Peer-Support Specialist (PSS) as defined
in OAR 410-180-0305;
(o)
Peer-delivered Services Supervisor;
(p) Peer Wellness Specialist;
(q) Student Intern;
(r) Withdrawal Management Technician;
and
(s) Volunteer.
Statutory/Other Authority: ORS
413.042 & ORS
430.256
Statutes/Other Implemented: ORS
430.306 & ORS
430.345-430.375
