415-050-0130 Staffing Standards 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 History: ADS 3-2023, adopt filed 04/07/2023, effective 04/07/2023