justicedao/ipfs_state_laws huggingface dataset:
415-012-0090 Variances (1) A variance request must be made in writing: (a) For an initial application, it should be included with the application documents; (b) If the provider is an agency under contract with the local mental health authority, it must submit the request through the local mental health authority to the Division; and (c) If the provider is not under contract to the local mental health authority, the request should be submitted directly to the Division. (2) The request should include the following: (a) The reason for the proposed variance or exception; (b) The alternative practice proposed; and (c) For an exception, a plan and timetable for compliance with the section of the rule from which the exception is sought. (3) The Division whose decision shall be final shall approve or deny the request for variance or exception. (4) The Division shall notify the provider requesting the variance or exception and the community mental health program of the decision. (5) A variance granted by the Division shall be attached to and become part of the license. Continuance of the variance shall be reviewed at the time the license is considered for renewal. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010-430.030, ORS 430.306, ORS 430.397, ORS 430.405, ORS 430.450, ORS 430.630, ORS 430.850 & ORS 443.400 History: ADS 4-2018, amend filed 05/10/2018, effective 05/10/2018 ADS 3-2017, temporary amend filed 12/01/2017, effective 12/01/2017 through 05/29/2018 ADS 8-2016, f. & cert. ef. 12-14-16 ADS 2-2016(Temp), f. 6-28-16, cert. ef. 7-1-16 thru 12-27-16 ADS 4-2013, f. & cert. ef. 5-3-13 ADS 2-2008, f. & cert. ef. 11-13-08 ADAP 2-1993, f. & cert. ef. 11-5-93
415-020-0000 Purpose These rules prescribe standards for the development and operation of Opioid Treatment Programs approved by the Health Systems Division of the Oregon Health Authority. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 9-2016, f. & cert. ef. 12-14-16 ADS 6-2016(Temp), f. & cert. ef. 8-10-16 thru 2-5-17 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0000 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0010 Program Approval (1) Letter of Approval: No person or governmental entity shall operate an Opioid Treatment Program (OTP) without a letter of approval from the State Opioid Treatment Authority in Oregon. (2) Application: To receive a certificate for the provision of behavioral health treatment services an OTP must meet the criteria under OAR 309-008-0100 to 309-008-1600; in addition, the OTP must: (a) Meet the standards set forth in these rules and any other administrative rules applicable to the program; (b) Comply with the federal regulations contained in 42 CFR Part 2 and 42 CFR Part 8; (c) Submit documentation of accreditation as an opioid treatment program by an accreditation body approved by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) under 42 CFR Part 8; and (d) Specify in the application the identity and financial interest of any person (if the person is a corporation, the name of any stockholder holding stock representing an interest of 5 percent or more) or other legal entity who has an interest of 5 percent or more or 5 percent of a lease agreement for the facility. (3) Renewal: The renewal of a Certificate shall be governed by OAR 309-008-0100 to 309-008-1600. (4) Denial, Revocation, Nonrenewal, Suspension: The denial, revocation, nonrenewal, or suspension of a letter of approval or license for an opioid treatment program may be based on any of the grounds set forth in OAR 309-008-1100. (5) Federal Protocols: The program shall be responsible for filing and maintaining all necessary protocols and documentation required by the National Institute on Drug Abuse (NIDA), the Federal Substance Abuse and Mental Health Services Administration (SAMHSA), and the Federal Drug Enforcement Administration (DEA). Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2023, amend filed 04/07/2023, effective 04/07/2023 ADS 1-2022, amend filed 03/25/2022, effective 03/28/2022 ADS 3-2021, temporary amend filed 09/29/2021, effective 10/01/2021 through 03/29/2022 ADS 2-2021, temporary amend filed 09/21/2021, effective 10/01/2021 through 03/29/2022 ADS 9-2016, f. & cert. ef. 12-14-16 ADS 6-2016(Temp), f. & cert. ef. 8-10-16 thru 2-5-17 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0010 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0017 Patient Records (1) Patient Recordkeeping: Each program shall: (a) Accurately record all information about patients as required by these rules in the permanent patient record; (b) Maintain each patient record to assure identification, accessibility, uniform organization, and completeness of all components required by these rules and in a manner to protect against damage or separation from the permanent patient or program record; (c) Keep all documentation current .unless specified otherwise, within seven days of delivering the service or obtaining the information; (d) Include the signature of the person providing the documentation and service; (e) Not falsify, alter, or destroy any patient information required by these rules to be maintained in a patient record or program records; (f) Document all procedures in these rules requiring patient consent and the provision of information to the patient on forms describing what the patient has been asked to consent to or been informed of, and signed and dated by the patient. If the program does not obtain documentation of consent or provision of required information, the reasons must be specified in the patient record and signed by the person responsible for providing the service to the patient; (g) Require that errors in the permanent record be corrected by lining out the incorrect data with a single line in ink, adding the correct information, and dating and initialing the correction. Errors may not be corrected by removal or obliteration through the use of correction fluid or tape so they cannot be read; and (h) Permit inspection of patient records upon request by the Division to determine compliance with these rules. (2) Patient and Fiscal Record Retention: Patient records shall be kept for a minimum of seven years. If a program is taken over or acquired by another program, the original program is responsible for assuring compliance with the requirements of 42 CFR § 2.19(a)(1) or (b), whichever is applicable. If a program discontinues operations, the program is responsible for: (a) Transferring fiscal records required to be maintained under section (1) of this rule to the Division if it is a direct contract or to the community mental health program or managed care plan administering the contract, whichever is applicable; and (b) Destroying patient records or, with patient consent, transferring patient records to another program. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 5-2013, f. & cert. ef. 6-7-13
415-020-0030 Diagnostic Assessment (1) Written Procedure: The Opioid Treatment Program shall develop and implement a written procedure for assessing each patient's treatment needs consistent with The ASAM Criteria . (2) The diagnostic assessment shall be documented in the permanent patient record. It shall consist of the elements described in The ASAM Criteria and documentation of the patient's self-identified cultural background. Cultural information documented should include level of acculturation, knowledge of own culture, primary language, spiritual or religious interests, and cultural attitudes toward alcohol and other drug use. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2023, amend filed 04/07/2023, effective 04/07/2023 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0030 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0035 Treatment Planning and Documentation of Treatment Progress (1) The Opioid Treatment Program (OTP) shall develop treatment plans, progress notes, and discharge plans consistent with The ASAM Criteria . (2) Treatment Plan: The OTP shall develop an individualized treatment plan within 30 days of admission and shall be documented in the patient's record. The treatment plan shall: (a) Describe the primary patient-centered issues; (b) Focus on one or more individualized treatment plan objectives that are consistent with the patient's strengths and abilities and that address the primary obstacles to recovery; (c) Define the treatment approach, which shall include services and activities to be used to achieve the individualized objectives; (d) Document the participation of significant others in the planning process and the treatment where appropriate; and (e) Document the patient's participation in developing the content of the treatment plan and any subsequent modifications, with the patient's signature. (3) Documentation of Progress: The treatment staff shall document in the permanent record any current obstacles to recovery and the patient's progress toward achieving the individualized objectives in the treatment plan. (4) Treatment Plan Review: The permanent patient record shall document that the treatment plan is reviewed and modified continuously as needed and as clinically appropriate, consistent with The ASAM Criteria, (5) Modifications: Changes in the patient's treatment needs identified by the review process must be addressed by modifications in the treatment plan. Any modifications to the treatment plan shall be made in conjunction with the patient. (6) Treatment Summary: No later than 30 days after the last service contact, the program shall document in the permanent patient record a summary describing the contact and the patient’s progress toward the treatment objectives, consistent with The ASAM Criteria and any reason for discharge. (7) Discharge Plan: Upon successful completion or planned interruption of the treatment services, the treatment staff and patient shall jointly develop a discharge plan. The discharge plan shall include a relapse prevention plan, which has been jointly developed by the counselor and patient. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2023, amend filed 04/07/2023, effective 04/07/2023 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0035 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0050 Transitional Treatment (1) The Opioid Treatment Program shall provide transitional care for patients for who continued opioid agonist medication maintenance is no longer deemed appropriate. (2) Transitional treatment services shall be provided with the purpose of assisting the patient to establish and maintain a stable, drug-free lifestyle. Transitional treatment will help prepare the patient to begin a reduction in opioid agonist medication dosage and shall be continued while the patient undergoes reduction in doses. The treatment shall continue following the final dose of opioid agonist medication, consistent with the clinical needs of the patient and consistent with The ASAM Criteria . Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2023, amend filed 04/07/2023, effective 04/07/2023 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0050 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0053 Unsupervised Use of Opioid Agonist Medications (1) Any patient in comprehensive maintenance treatment may receive a single take-home dose for a day that the clinic is closed for business, including Sundays, and state or federal holidays. (2) Decisions on dispensing opioid treatment medications to patients for unsupervised use shall be made by the program medical director. In determining whether a patient is responsible in handling opioid medications and may be permitted unsupervised use, the medical director shall consider the following criteria; (a) Absence of drugs of abuse, including alcohol; (b) Regularity of program attendance; (c) Absence of serious behavioral problems at the program; (d) Absence of criminal activity while enrolled at the program; (e) Stability of the patient's home environment and social relationships; (f) Length of time in comprehensive maintenance treatment; (g) Assurance that take-home medication can be safely stored in the patient's home; and (h) Whether the rehabilitative benefit the patient derives from decreasing the frequency of program attendance outweighs the potential risks of diversion. (3) Decisions to approve unsupervised use of opioid medications, including the rationale for the approval, shall be documented in the patient record. (4) If it is determined that a patient is responsible in handling opioid agonist medications, the supply shall be limited to the following schedule; (a) During the first 90 days of treatment, the take-home supply is limited to a single dose each week, in addition to take-home doses allowed when the clinic is closed; (b) During the second 90 days of treatment, the take-home supply is limited to two doses per week, in addition to take-home doses allowed when the clinic is closed; (c) During the third 90 days of treatment, the take-home supply is limited to three doses per week, in addition to take-home doses allowed when the clinic is closed; (d) In the remaining months of the first year, a patient may be given a maximum 6-day supply of take-home medication; (e) After one year of continuous abstinence in treatment, a patient may be given a maximum two-week supply of take-home medication; (f) After two years of continuous abstinence treatment, a patient may be given a maximum one-month supply of take-home medication. (5) The dispensing restrictions set forth in 4(a) through 4(f) of this rule do not apply to the partial agonist opioid medication, buprenorphine and buprenorphine products. Patients must meet criteria established in 2(a) through 2(h) of this rule for unsupervised use of buprenorphine and buprenorphine products. Statutory/Other Authority: ORS 413.042 & 430.256 Statutes/Other Implemented: ORS 430.010 & 430.560 - 430.590 History: ADS 5-2013, f. & cert. ef. 6-7-13 ADS 1-2013(Temp), f. 1-11-13, cert. ef. 1-14-13 thru 7-12-13 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03
415-020-0054 Diversion Control Plan Each Opioid Treatment Program shall have a diversion control plan to reduce possibilities for diversion of controlled substances from legitimate treatment to illicit use. The plan shall include the following; (1) A mechanism for continuous monitoring of clinical and administrative activities, to reduce the risk of medication diversion; and (2) A mechanism for problem identification, prevention, and correction of diversion problems. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03
415-020-0070 Medical Services (1) There shall be at least one program physician, licensed nurse practitioner or licensed physicians’ assistant available to supervise the initial medical evaluation, supervise follow-up care and to supervise the patient medication schedules, who is licensed under the appropriate State law and registered under the appropriate State and Federal laws to order narcotic drugs for patients. (2) The licensed physician, licensed nurse practitioner or licensed physicians’ assistant assumes responsibility for the amounts of narcotic drugs administered or dispensed and shall record and countersign all changes in the dosage schedule. (3) Licensed nurse practitioners or licensed physicians’ assistants are only allowed to order and approve dosages or changes in dosage schedule if the program in question has received prior approval from the State Opioid Treatment Authority or their designated alternate. (4) Administering of narcotic agonist medications shall be performed by a registered nurse, licensed practical nurse, or other healthcare professional authorized by federal and state law to administer narcotic agonist medications under the direction and supervision of the program administrator. (5) Dispensing services shall be provided under the direction and supervision of the program physician, provided that the agent is a pharmacist or other healthcare professional authorized under federal and state law to dispense narcotic agonist medications. (6) The medical director shall assure that the program's medical services are in full compliance with the standards, ethics, and licensure requirements of the medical profession and these rules. (7) The program shall adopt, maintain, and implement written procedures for acquiring patient physical examinations including medical histories and any laboratory tests or other special examination required by the medical director including the required content of those examinations and procedures. The medical director shall review and approve all such examination procedures. Physical examinations shall be completed before administering the first dose of an opioid agonist medication. (8) The opioid treatment program shall adopt, maintain, and implement a policy and procedure to maintain the health and safety of patients and staff. This shall include: (a) Control measures for infectious diseases such as hepatitis, tuberculosis, and AIDS; (b) Informed consent for testing and medical treatment; and (c) Medication monitoring. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 1-2022, amend filed 03/25/2022, effective 03/28/2022 ADS 3-2021, temporary amend filed 09/29/2021, effective 10/01/2021 through 03/29/2022 ADS 2-2021, temporary amend filed 09/21/2021, effective 10/01/2021 through 03/29/2022 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0070 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0080 Volunteers An Opioid Treatment Program utilizing volunteers shall have the following standards for volunteers: (1) Policy Required: A written policy regarding the use of volunteers that shall include: (a) Specific tasks and responsibilities of volunteers; (b) Procedures and criteria used in selecting volunteers, including sobriety requirements for individuals recovering from the disease of alcohol or other drug abuse; (c) Specific accountability and reporting requirements of volunteer; and (d) Specific procedure for reviewing the performance of volunteers and providing direct feedback to them. (2) Orientation and Training: The program shall document that the volunteers complete an orientation and training program specific to their responsibilities before they participate in assignments. The orientation and training shall: (a) Include a review of the program's philosophical approach to treatment; (b) Include information on confidentiality regulations and patient's rights; (c) Specify how volunteers are to respond to and follow procedures for unusual incidents; (d) Explain the program's channels of communication, reporting requirements, and accountability requirements for volunteers; (e) Explain the procedure for reviewing the volunteer's performance and providing feedback to the volunteer; and (f) Explain the procedure for discontinuing a volunteer's participation. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0080 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0085 Building Requirements (1) Applicable Codes: Each Opioid Treatment Program shall maintain up-to-date documentation verifying that they meet applicable building codes, and state and local fire and safety regulations. The program must check with local government to make sure all applicable local codes have been met. (2) Space Where Services Provided: Each Opioid Treatment Program shall provide space for services including but not limited to intake, assessment and , counseling, and telephone conversations that assures the privacy and confidentiality of clients and is furnished in an adequate and comfortable fashion including plumbing, sanitation, heating, and cooling. (3) Disabled Accessibility: Programs shall be accessible to persons with disabilities pursuant to Title II of the Americans with Disabilities Act if the program receives any public funds or Title III of the Act if no public funds are received. (4) Emergency Procedures: Programs shall adopt and implement emergency policies and procedures, including an evacuation plan and emergency plan in case of fire, explosion, accident, death or other emergency. The policies and procedures and emergency plans shall be current and posted next to the telephone used by staff. In addition, programs shall maintain a 24 hour telephone answering capability to respond to facility and patient emergencies; (5) Disaster Plan: The program must develop and regularly update a disaster plan that outlines the program response to disasters of human or natural origin that may render the program's facility unusable. The plan must address the following; (a) How emergency dosing will be implemented; and (b) Identification of emergency links to other community agencies. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 5-2013, f. & cert. ef. 6-7-13 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0085 HR 4-1988, f. & cert. ef. 5-10-88
415-020-0090 Variances Requirements and standards for requesting and granting variances or exceptions are found in OAR 309-008-1600. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 183, 430.560 & 430.590 History: ADS 9-2016, f. & cert. ef. 12-14-16 ADS 6-2016(Temp), f. & cert. ef. 8-10-16 thru 2-5-17 ADS 2-2008, f. & cert. ef. 11-13-08 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0090 HR 4-1988, f. & cert. ef. 5-10-88