Or. Admin. Code § 309-008-0200

Current through Register Vol. 63, No. 12, December 1, 2024

Section 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.

Or. Admin. Code § 309-008-0200

MHS 16-2016, f. 11-28-16, cert. ef. 11/30/2016; MHS 15-2017, temporary amend filed 12/01/2017, effective 12/01/2017 through 05/29/2018; BHS 11-2018, amend filed 05/10/2018, effective 5/10/2018

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