309-035-0105 Temporary rule language in effect until 06/27/2026. Definitions As used in these rules, the following definitions apply: (1) "Abuse" means abuse as defined in ORS 430.735. (2) "Activities of Daily Living (ADL)" means those personal and functional activities required by a resident for continued well-being, that are essential for health and safety. ADLs include eating, bathing, dressing, toileting, transferring (including mobility and ambulation) and maintaining continence. (3) "Adult" means an individual 18 years of age or older. (4) “Advance Directive” or “Advance Directive for Health Care” means the legal document signed by a resident that provides health care instructions in the event the resident is no longer able to give directions regarding their wishes, as described in ORS 127.505 to 127.660. “Advance Directive for Health Care” does not include Physician Orders for Life-Sustaining Treatment (POLST). (5) "Aid to Physical Functioning" means any special equipment ordered for a resident by a Licensed Medical Professional (LMP) or other qualified health care professional that maintains or enhances the individual’s physical functioning. (6) "Applicant" means the individual or entity, including the Division, who owns, seeks to own or operate, or maintains and operates a program and is applying for a license. (7) "Approved" means authorized or allowed by the Authority or designee. (8) “Authority” means the Oregon Health Authority or designee. (9) "Authorized Representative" means any adult with longstanding involvement in assuring the Individual's health and safety, appointed to participate in service planning process, and is: (a) Chosen and appointed by the individual or their legal representative, if applicable (b) Not a paid provider of Home and Community Based Services (HCBS) and supports; (c) Authorized, in writing or other method that clearly indicates consenting choice, by the Individual or legal representative, if applicable, to serve as the Individual's representative in connection with the provision of funded supports; and (d) Responsible to act as the authorized representative until the Individual, or legal representative, if applicable, modifies the authorization or notifies the authority or authority's contractor that the authorized representative is no longer authorized to act on their behalf. (10) “Background Check” means criminal records check and an abuse check. (11) "Building Code" means the Oregon Structural Specialty Code adopted by the Building Codes Division of the Oregon Department of Consumer and Business Services. (12) "Care" means services including but not limited to supervision; protection; assistance with activities of daily living such as bathing, dressing, grooming or eating; management of money; transportation; recreation; and the provision of room and board. (13) “CMS" means the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (14) "Community Mental Health Program (CMHP)" means the organization of all or a portion of services for individuals with mental health conditions, operated by or contractually affiliated with a local mental health authority. CMHP’s operate in a specific geographic area of the state under an intergovernmental agreement or direct contract with the Division. (15) "Competitive Integrated Employment" means full-time or part-time work: (a) At minimum wage or higher, at a rate that is not less than the customary rate paid by the employer for the same or similar work performed by other employees who are not individuals with disabilities, and who are similarly situated in similar occupations by the same employer, and who have similar training, experience, and skill; (b) With eligibility for the level of benefits provided to other employees; (c) At a location where the employee interacts with other persons who are not individuals with disabilities (not including supervisory personnel or individuals who are providing services to such employee) to the same extent that individuals who are not individuals with disabilities and who are in comparable positions interact with other persons; and (d) As appropriate, presents opportunities for advancement that are similar to those for other employees who are not individuals with disabilities and who have similar positions. (16) "Contract" means a formal written agreement between the CMHP, CCO, Oregon H e alth Plan contractor, or the Division and a provider. (17) “Coordinated Care Organization (CCO)” means a corporation, governmental agency, public corporation, or other legal entity that is certified as meeting the criteria adopted by the Authority under ORS 414.625 to be accountable for care management and to provide integrated and coordinated health care for each of the CCO's members. (18) "Crisis-Respite Services" means providing services to individuals who are RTF residents for up to 30 days. (19) “Critical Incident” means any incident that caused harm or created a potential risk of harm to a resident including: (a) Abuse, neglect, or exploitation; (b) Misuse or unauthorized use of restraints or seclusion; (c) Medication error resulting in consultation with a poison control center or medical professional, an emergency department or urgent care visit, hospitalization or death; and (d) Suspected overdose. (e) Serious injury. (f) Contact with law enforcement or emergency services. (g) Death. (20) “Culturally Responsive” means services that are respectful of and relevant to the beliefs, practices, culture and linguistic needs of diverse consumer/client populations and communities whose members identify as having particular cultural or linguistic affiliations. Cultural responsiveness describes the capacity to respond to the issues of diverse communities. It thus requires knowledge and capacity at different levels of intervention: systemic, organizational, professional, and patient. (21) “Deputy Director” means the deputy director of the Behavioral Health Division of the Oregon Health Authority or designee. (22) "Direct Care Staff" means program staff responsible for providing services for a resident. (23) "Division" means the Behavioral Health Division of the Oregon Health Authority or designee. (24) “Division Staff” means individuals employed by the Division or individuals delegated by the Division to conduct licensing activities under these rules. (25) "DSM" means the most currently edition of the "Diagnostic and Statistical Manual of Mental Disorders " published by the American Psychiatric Association. (26) "Emergency Admission" means an admission to a program made on an urgent basis due to the pressing service needs of the individual. (27) “Employee” means a person, not residing at the program, who is employed by a licensee who receives wages, a salary, or is otherwise paid by the licensee for providing the service. (28) "Evacuation Capability" means the ability of occupants, including residents and program staff as a group, to evacuate the building or relocate from a point of occupancy to a point of safety as defined in the Oregon Structural Specialty Code. The category of evacuation capability is determined by documented evacuation drill times or scores on National Fire Protective Association (NFPA) 101A 2025 edition worksheets. There are three categories of evacuation capability: (a) Impractical: A group, even with staff assistance, who cannot reliably move to a point of safety in a timely manner, determined by an evacuation capability score of five or greater or with evacuation drill times more than 13 minutes; (b) Slow: A group that can move to a point of safety in a timely manner, determined by an evacuation capability score greater than 1.5 and less than five or with evacuation drill times over three minutes but not more than 13 minutes; (c) Prompt: A group with an evacuation capability score of 1.5 or less or equivalent to that of the general population or with evacuation drill times of three minutes or less. The Division shall determine evacuation capability for programs in accordance with the NFPA 101A 2025 edition. Programs that are determined to be "Prompt" may be used in Group R occupancies classified by the building official in accordance with the building code. (29) “Eviction” means a court action that may be initiated after the involuntary transfer or discharge process is complete by a program against a resident to remove the resident from their unit. (30) "Exclusion Lists" mean the following federal lists that exclude listed individuals from receiving federal awards or monies, not limited to Medicaid and Medicare programs: (a) The U.S. Office of Inspector General's Exclusion List at www.exclusions.oig.hhs.gov; and (b) The U.S. General Services Administration's System for Award Management Exclusion List at www.sam.gov. (31) "Fire Code" means the Oregon Fire Code as adopted by the State of Oregon Fire Marshal. (32) “Gender expression” means a person’s gender-related appearance and behavior, whether or not these are stereotypically associated with the sex the person was assigned at birth. (33) "Gender identity" means an individual’s internal, deeply held knowledge or sense of the individual’s gender, regardless of physical appearance, surgical history, genitalia, legal sex, sex assigned at birth, or name and sex as it appears in medical records or as it is described by any other individual, including a family member, guardian, or legal representative of the individual. An individual’s gender identity is the last gender identity expressed by an individual who lacks the present ability to communicate. (34) "Gender nonconforming" means having a gender expression that does not conform to stereotypical expectations of one’s gender. (35) "Gender transition" means a process by which an individual begins to live according to that individual’s gender identity rather than the sex the person was assigned at birth. The process may include changing the individual’s clothing, appearance, name or identification documents, or undergoing medical treatments. (36) “HCB” means Home and Community-Based. (37) “Home and Community Based Service (HCBS)” means services and supports that assist eligible individuals to remain in their home or community in accordance with the Code of Federal Regulations, approved Medicaid State Plan authorities and Oregon Administrative Rules. (38) “Home and Community-Based Settings” or “HCB Settings” means a physical location meeting the qualities of 42 CFR §441.710(a)(1) and (2), OAR 410-173-035, and OAR 411-004-0020 where a resident receives Home and Community-Based Services. (39) "Home-Like" means an environment that promotes the dignity, security, and comfort of residents through the provision of personalized care and services and encourages independence, choice, and decision-making by the resident. (40) “Imminent Danger” means a situation in which a program’s non-compliance with one or more licensing requirements has caused or is likely to cause serious injury, harm, impairment, or death to one or more residents in the near future if the program does not take immediate action to correct and protect resident health and safety. (41) “Incident Report” means a written description of any incident involving a resident receiving services including but not limited to injuries, major illness, accidents, acts of aggression, medication errors, or other incidents that present a risk to health and safety. (42) “Independent and Qualified Agent (IQA)” means an entity meeting the provider qualification requirements identified in 42 CFR §441.730 and under contract with the Division who: (a) Determines 1915(i) program eligibility initially, annually, when an individual’s circumstances or needs change significantly, or upon individual request; (b) Provides education and technical assistance regarding HCBS and settings; (c) Coordinates and assists the individual in directing the person-centered planning process; (d) Drafts, documents, regularly reviews and updates person-centered service plans; (e) Prior authorizes HCBS Residential Services as described in these rules; (f) Conducts quality assurance and quality improvement activities; (g) Completes the face-to-face needs-based assessment in person; and (h) Performs transition management. (43) "Individually Based Limitation (IBL)" means any limitation to the qualities outlined in OAR 309-035-0195 and OAR 410-173-0040 due to health and safety risks. An IBL is based on specific assessed needs and only implemented with the resident's or resident's representative's informed consent as described in OAR 309-035-0195 and OAR 410-173-0005. (44) "Informed Consent" means: That options, risks, and benefits of the services outlined in these rules have been explained to the resident or the resident’s legal representative in a manner that they understand; and (45) “Instrumental Activities of Daily Living (IADLs)” means those self-management activities performed by an individual on a day-to-day basis that are essential to basic self-care and independent living. IADLs include, but are not limited to, housekeeping, including laundry, shopping, transportation, medication management, and meal preparation. (46) "Legal Representative" means a person who has been legally designated by court order to make financial or health care decisions for a resident. The legal representative only has authority to act within the scope and limits to the authority designated by the court or other agreement. (47) “Licensed Independent Practitioner (LIP)” means a physician, nurse practitioner, or naturopathic physician as defined in ORS 426.005. (48) "Licensed Medical Professional (LMP)" means an individual who meets the following minimum qualifications as documented by the Local Mental Health Authority (LMHA) or designee: (a) Holds at least one of the following educational degrees and valid licensures: (A) Physician licensed to practice in the State of Oregon; (B) Nurse Practitioner licensed to practice in the State of Oregon; or (C) Physician Assistant licensed to practice in the State of Oregon; and (b) Whose training, experience, and competence demonstrate the ability to conduct a comprehensive mental health assessment and provide medication management. (49) “Licensee” means the individual or entity who applied for and to whom a license has been issued to operate a residential treatment facility or residential treatment home. (50) "Local Mental Health Authority (LMHA)" means a Local Mental Health Authority as defined in ORS 430.630. (51) "LGBTQIA2S+" means lesbian, gay, bisexual, transgender, queer, intersex, asexual, Two Spirit, nonbinary, or other minority gender identity or sexual orientation. These terms are defined below: (a) "Lesbian" means the sexual orientation of an individual who is female, feminine, or nonbinary and who is physically, romantically, or emotionally attracted to other women. Some lesbians may prefer to identify as gay, a gay woman, queer, or in other ways. (b) "Gay" means the sexual orientation of an individual attracted to people of the same gender. Although often used as an umbrella term, it is used more specifically to describe men attracted to men. (c) "Bisexual" means an individual who has the potential to be physically, romantically, or emotionally attracted to people of more than one gender, not necessarily at the same time, in the same way, or to the same degree. (d) "Transgender" means having a gender identity or gender expression that differs from the sex one was assigned at birth, regardless of whether one has undergone or is in the process of undergoing gender-affirming care. Being transgender does not imply any specific sexual orientation. Therefore, transgender people may identify as straight, gay, lesbian, bisexual, etc. (e) "Queer" means individuals who do not identify as exclusively straight or an individual who has non-binary or gender-expansive identities: (A) Queer is often used as a catch-all to refer to the LGBTQIA2S+ population . (B) This term was previously used as a slur but has been reclaimed by many parts of the LGBTQIA2S+ movement. It can also include transgender people who identify as male or female. The term should only be used to refer to a specific person if that person self-identifies as queer. (f) "Intersex" means someone born with a variety of differences in their sex traits and reproductive anatomy. Intersex traits greatly vary, including differences in, but not limited to, hormone production and reproductive anatomy. (g) "Asexual" or "Ace" means a complete or partial lack of sexual attraction or lack of interest in sexual activity with others. Asexuality exists on a spectrum, and asexual people may experience no, little, or conditional sexual attraction. Many people who are asexual still identify with a specific romantic orientation. (h) "2S" or "Two-Spirit" is a term used within some Indigenous communities, encompassing cultural, spiritual, sexual, and gender identity. The term reflects complex indigenous understandings of gender roles, spirituality, and the long history of sexual and gender diversity in Indigenous cultures. The definition and common use of the term two-spirit may vary among Tribes and Tribal communities. (i) The "+" means other identities and expressions of gender, romantic and sexual orientation, including minority gender identities. (52) "Medication" means any drug, chemical, compound, suspension, or preparation in suitable form for use as a curative or remedial substance either internally or externally by any individual. (53) "Mental or Emotional Disorder" means a primary Axis I or Axis II DSM diagnosis, other than an intellectual or developmental disability or a substance abuse disorder that limits a resident's ability to perform activities of daily living. (54) "Mental Health Assessment" means the process of obtaining sufficient and clinically relevant information through face-to-face interview, observation, examination, testing, and review of previous treatment records to determine a diagnosis and to plan individualized services and supports. Mental health assessments must be completed by a provider meeting the qualifications of a Qualified Mental Health Professional (QMHP). (55) “Naloxone” means an FDA-approved short-acting, non-injectable, opioid antagonist medication used for the emergency treatment and temporary rapid reversal of known or suspected opioid overdose. (56) "Nonbinary" means an individual who does not identify exclusively as a man or a woman. Non-binary people may identify as being both a man and a woman, somewhere in between, or as falling completely outside these categories. While many also identify as transgender, not all non-binary people do. Non-binary can also be used as an umbrella term encompassing identities such as agender, bigender, genderqueer, or gender-fluid. (57) "Nursing Care" means the practice of nursing by a licensed nurse, including tasks and functions that are delegated by a registered nurse to an individual other than a licensed nurse, which are governed by ORS Chapter 678 and rules adopted by the Oregon State Board of Nursing in OAR chapter 851. (58) “Opioid” means natural, synthetic, or semi-synthetic chemicals normally prescribed to treat pain. This class of drugs includes, but is not limited to, illegal drugs such as heroin, natural drugs such as morphine and codeine, synthetic drugs such as fentanyl and tramadol, and semi-synthetic drugs such as oxycodone, hydrocodone, and hydromorphone. (59) “Opioid Overdose” means a medical condition that causes depressed consciousness and mental functioning, decreased movement, depressed respiratory function and the impairment of the vital functions as a result of taking opiates in an amount larger than can be physically tolerated. (60) “Opioid Overdose Kit” means an ultraviolet light-protected hard case containing a minimum of two doses of an FDA-approved short-acting, non-injectable, opioid antagonist medication, one pair non-latex gloves, one face mask, one disposable face shield for rescue breathing, and a short-acting, non-injectable, opioid antagonist medication administration instruction card. (61) “Person-Centered Service Plan (PCSP)” means the written document prepared by the IQA or the person-centered service plan coordinator that details the supports, desired outcomes, activities, and resources required for an Individual to achieve and maintain personal goals, health, and safety as described in OAR 410-173-0025. The PCSP must be completed and signed. The PCSP is not satisfied by a document primarily prepared by a provider. (62) "Person-Centered Service Plan Coordinator" means the individual who may be a case manager, service coordinator, personal agent, or other individual designated by the Division to provide case management services or person-centered service planning for and with a resident. (63) "Prescribing Practitioner" means a physician, nurse practitioner, physician assistant, chiropractor, dentist, ophthalmologist, or other healthcare practitioner with prescribing authority. (64) "P.R.N. (pro re nata) Medications and Treatments" means those medications and treatments that have been ordered to be given as needed. (65) "Program" means the Residential Treatment Facility or Residential Treatment Home licensed by the Division and may refer to the setting grounds, caregiver, staff, or services as applicable to the context. (66) "Program Administrator" means the individual designated by the licensee as responsible for the daily operation and maintenance of the RTH or RTF or the program administrator’s designee. (67) “Program Staff” means an employee, volunteer, direct care staff, or individual who, by contract with a program, provides a service to a resident. (68) "Progress Notes" means the continuous notations in the resident’s record documenting significant information concerning the resident and summarizing progress made relevant to the objectives outlined in the residential service plan. (69) "Protection" means the necessary actions taken by the program to prevent abuse, mistreatment, or exploitation of the resident to prevent self-destructive acts and to safeguard the resident’s property and funds when used in the relevant context. (70) “Provider” means the program administrator, individual, or organizational entity licensed by the Division that operates the program and provides services to residents. (71) "PSRB” means the Oregon Psychiatric Security Review Board. (72) “Qualified Mental Health Professional (QMHP)” means mental health program staff LMP or any other program staff meeting the minimum qualifications as authorized by the LMHA or designee and specified in OAR 309-019-0125. (73) “Representative” refers to both “Authorized Representative” and “Legal Representative” as defined in these rules, unless otherwise stated. (74) "Residency Agreement" means the written, legally enforceable agreement between a provider and a resident or the resident’s legal representative when the resident receives services. The Residency Agreement identifies the rights and responsibilities of the resident and the provider. The Residency Agreement provides the resident protection from eviction substantially equivalent to landlord-tenant laws, unless otherwise required by administrative rule or statute. (75) “Resident” means any individual being considered for placement or is currently residing in a licensed program receiving residential services regulated by these rules on a 24-hour basis, except as excluded under ORS 443.400. (76) “Resident Service Record” means a resident’s records maintained by the program pursuant to OAR 309-035-0130(4). (77) "Residential Service Plan" means an individualized, written plan outlining the care and treatment to be provided to a resident in or through the program based upon an individual assessment of needs. The residential service plan may be a section or subcomponent of the resident's overall mental health treatment plan when the program is operated by a mental health service agency that provides other services to the resident. (78) "Residential Treatment Facility (RTF)" means a program licensed by the Division to provide services and supports on a 24-hour basis for six to 16 residents as described in ORS 443.400(11). An RTF does not include the entities set out in ORS 443.405. (79) “Residential Treatment Home (RTH)” means a program that is licensed by the Division and operated to provide services and supports on a 24-hour basis for up to five residents as defined in ORS 443.400(12). A RTH does not include the entities set out in ORS 443.405. (80) "Restraints" means any chemical or physical methods or devices that are intended to restrict or inhibit the movement, functioning, or behavior of a resident. (81) "Room and Board" means compensation for the provision of meals, a place to sleep, basic utilities, and tasks such as housekeeping and laundry to residents. (82) "Seclusion" means placing a resident in a locked room. A locked room includes a room with any type of door-locking device, such as a key lock, spring lock, bolt lock, foot pressure lock, or physically holding the door shut. (83) "Secure Residential Treatment Facility (SRTF)" means any Residential Treatment Facility, or portion thereof, approved by the Division that restricts a resident’s exit from the setting using approved locking devices on exit doors, gates, or other closures. (84) “Self-Administration of Medication” means the act of a resident placing a medication in or on the resident’s own body. The resident identifies the medication and the times and manners of administration and places the medication internally or externally on the resident’s own body without assistance. (85) “Serious Physical Harm” means injury that would warrant medical treatment beyond basic first aid. (86) “Services and Supports” means those services defined as habilitation services and psychosocial rehabilitation services under OAR 410-172-0705(1)(j) and (v) and provided to residents as outlined in OAR 410-172-0710. (87) "Setting" means one or more buildings and adjacent grounds on contiguous properties that are used in the operation of a program. (88) "Sexual orientation" means romantic or sexual attraction, or a lack of romantic or sexual attraction, to other people. (89) “Stock supply” means any volume of medications that are not dispensed to a specific resident and not labeled with the specific name of the resident. (90) “Substantial compliance” means a level of compliance with state law and with rules of the Oregon Health Authority such that any identified deficiencies pose a risk of no more than negligible harm to the health or safety of residents. (91) "Supervision" means a program staff’s observation and monitoring of a resident or oversight of a program staff by the program administrator applicable to the context. (92) “Supervisory Entity” means the court or state agency that has the legal authority to place an individual with a provider or to set legal conditions for the individual to follow to be placed or remain in the community, as provided in ORS chapters 161 and 426. Supervisory entity includes the state agency’s designee, and any person or entity that is legally responsible for monitoring the individual, coordinating care, and providing status reports to the supervising court or state agency. (93) “Residency Transfer" means the time at which the resident ceases to reside in the program and includes the transfer of the resident to another program but does not include absences from the program for the purpose of taking a planned vacation, visiting family or friends, or receiving time-limited medical or psychiatric treatment. (94) “Transition Planning” means a strategic process designed to prepare residents for a successful move from the program into another living arrangement. (95) "Treatment" means a planned, individualized program of medical, psychological or rehabilitative procedures, experiences and activities, designed to relieve or minimize mental, emotional, physical, or other symptoms or social, educational, or vocational disabilities resulting from or related to the mental or emotional disturbance, physical disability, or alcohol or drug problem. (96) "Unit" means the bedroom and other space of a resident receiving services from a program, as agreed to in the Residency Agreement. Unit includes private single occupancy and dual occupancy bedrooms shared with a roommate. (97) “Volunteer” means an individual who provides a service or takes part in a service provided to one or more residents receiving supportive services in a program or other provider and who is not a paid employee of the program or other provider. Statutory/Other Authority: ORS 413.042 & 443.450 Statutes/Other Implemented: ORS 443.400 - 443.465 & 443.991 History: BHS 32-2025, temporary amend filed 12/30/2025, effective 01/01/2026 through 06/27/2026 BHS 4-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2024, amend filed 04/11/2024, effective 04/11/2024 BHS 1-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 04/11/2024 BHS 41-2023, temporary amend filed 10/12/2023, effective 10/15/2023 through 04/11/2024 BHS 5-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 5-2017, f. & cert. ef. 6-8-17 MHS 2-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 13-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHS 5-2012, f. 5-3-12, cert. ef. 5-4-12 MHS 10-2011(Temp), f. & cert. ef. 12-5-11 thru 5-31-12 MHS 4-2008, f. & cert. ef. 6-12-08 MHS 13-2007, f. & cert. ef. 8-31-07 MHS 6-2007(Temp), f. & cert. ef. 5-25-07 thru 11-21-07 MHD 4-2005, f. & cert. ef. 4-1-05 MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98 MHD 9-1985, f. & ef. 6-7-85 MHD 9-1984(Temp), f. & ef. 12-10-84