309-022-0105 Definitions (1) “Abuse of a Child” means the circumstances defined in ORS 419B.005. (2) “Adolescent” means an individual from 12 through 17 years of age, or individuals determined to be developmentally appropriate for youth services. (3) "ASAM Criteria" means the most current edition of the American Society of Addiction Medicine (ASAM) for the treatment of addictive, substance-related, and co-occurring conditions, which is a clinical guide to develop patient-centered service plans and make objective decisions about admission, continuing care, and transfer or discharge for individual. (4) “Assessment” means the process of obtaining sufficient information through a face-to-face interview to determine a diagnosis and to plan individualized services and supports. (5) “Authority” means the Oregon Health Authority. (6) “Behavioral Health” means mental health, mental illness, addictive health, and addiction disorders. (7) “Behavior Support Plan” means the individualized proactive support strategies that are used to support positive behavior. (8) “Behavior Support Strategies” mean proactive supports designed to replace challenging behavior with functional, positive behavior. The strategies address environmental, social, neuro-developmental, and physical factors that affect behavior. (9) “Care Coordination” means a process-oriented activity to facilitate ongoing communication and collaboration to meet multiple needs. Care coordination includes facilitating communication between the family, natural supports, community resources, and involved providers and agencies; organizing, facilitating, and participating in team meetings; and providing for continuity of care by creating linkages to and managing transitions between levels of care and transitions for young adults in transition to adult services. (10) “Certificate” means the document issued by the Division that identify and declare certification of a provider pursuant to OAR 309-008-0100 to 309-008-1600. A letter accompanying issuance of the certificate details the scope and approved service delivery locations of the certificate. (11) “Chemical Restraint” means the administration of medication for the acute management of potentially harmful behavior. (12) “Chief Officer or Director” means the Chief Health Systems Officer of the Authority or designee. (13) “Child” means an individual under the age of 18. An individual with Medicaid eligibility in need of services specific to children, adolescents, or young adults in transition shall be considered a child until age 21. (14) “Children’s Emergency Safety Intervention Specialist (CESIS)” means a Qualified Mental Health Professional (QMHP) licensed to order, monitor, and evaluate the use of seclusion and restraint in accredited and certified facilities providing intensive mental health treatment services to individuals less than 21 years of age. (15) “Clinical Supervision” means oversight by a qualified clinical supervisor of addictions and mental health services and supports, including ongoing evaluation and improvement of the effectiveness of those services and supports. (16) “Clinical Supervisor” means an individual qualified to oversee and evaluate addictions or mental health services and supports. (17) “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. (18) “Co-occurring Substance Use and Mental Health Disorders (COD)” means the existence of both a substance use disorder and a mental health disorder. (19) “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. (20) “Criminal Records Check” means the Oregon Criminal Records Check and the processes and procedures required by OAR 943-007-0001 through 943-007-0501. (21) “Crisis” means an actual or perceived urgent or emergent situation that occurs when an individual’s stability or functioning is disrupted and there is an immediate need to resolve the situation to prevent a serious deterioration in the individual’s mental or physical health or to prevent referral to a significantly higher level of care. (22) “Cultural Competence” means the process by which people and systems respond respectfully and effectively to individuals of all cultures, languages, classes, races, ethnic backgrounds, disabilities, religions, genders, sexual orientations, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each. (23) “Declaration for Mental Health Treatment” means a written statement of an individual’s preferences concerning their mental health treatment. The declaration is made when the individual can understand and legally make decisions related to the treatment. It is honored, as clinically appropriate, in the event the individual becomes unable to make treatment decisions. (24) “Diagnosis” means the principal mental health, substance use, or problem gambling diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The diagnosis is determined through the assessment and any examinations, tests, or consultations suggested by the assessment and is the medically appropriate reason for services. (25) “Division” means the Health Systems Division. (26) “DSM” means the most recent version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. (27) “Emergency Safety Intervention” means the use of seclusion or personal restraint as an immediate response to an unanticipated threat of violence or injury to an individual or others. (28) “Emergency Safety Intervention Training” means a Division-approved course that includes an identified instructor, a specific number of face-to-face instruction hours, a component to assess competency of the course materials, and an established curriculum including the following: (a) Prevention of emergency safety situations using positive behavior support strategies identified in the individual’s behavior support plan; (b) Strategies to safely manage emergency safety situations; and (c) De-escalation and debriefing. (29) “Emergency Safety Situation” means an unanticipated behavior that places the individual or others at serious threat of violence or injury if no intervention occurs and that calls for an emergency safety intervention. (30) “Emergent” means the onset of symptoms requiring attention within 24 hours to prevent serious deterioration in mental or physical health or threat to safety. (31) “Entry” means the act or process of acceptance and enrollment into services regulated by this rule. (32) “Face to Face” means a personal interaction where all participants can see, hear, or otherwise perceive accordingly to their ability, the words and facial expressions of each other in person or through telehealth services where there is a live streaming audio and video, if clinically appropriate. (33) “Family” means the biological or legal parents, siblings, other relatives, foster parents, legal guardians, spouse, domestic partner, caregivers, and other primary relations to the individual whether by blood, adoption, or legal or social relationships. Family also means any natural, formal, or informal support persons identified as important by the individual. (34) “Family Support” means the provision of peer delivered services to individuals defined as family to the individual. It includes support to caregivers at community meetings, assistance to families in system navigation and managing multiple appointments, supportive home visits, peer support, parent mentoring and coaching, advocacy, and furthering efforts to develop natural and informal community supports. (35) “Family Support Specialist” means an individual who meets qualification criteria under OAR chapter 410 division 180 and provides peer delivered services to a family member who has experience parenting a child who is a current or former consumer of mental health or addiction treatment or is facing or has faced difficulties in accessing education, health, and wellness services due to a mental health or behavioral health barrier. (36) “Gender Identity” means an individual’s self-identification of gender without regard to legal or biological identification, including but not limited to individuals identifying themselves as male, female, transgender, and transsexual. (37) “Gender Presentation” means the external characteristics and behaviors that are socially defined as either masculine or feminine, such as dress, mannerisms, speech patterns, and social interactions. (38) “Grievance” means a formal complaint submitted to a provider verbally or in writing by an individual or the individual’s chosen representative pertaining to the denial or delivery of services and supports. (39) “Guardian” means an individual appointed by a court of law to act as guardian of a minor or a legally incapacitated individual. (40) “Health Systems Services and Supports” means all services and supports including but not limited to Outpatient Community Mental Health Services and Supports for Children and Adults, Intensive Treatment Services for Children, Outpatient and Residential Substance Use Disorders Treatment Services, and Outpatient and Residential Problem Gambling Treatment Services. (41) “HIPAA” means the federal Health Insurance Portability and Accountability Act of 1996 and the regulations published in Title 45, parts 160 and 164, of the Code of Federal Regulations (CFR). (42) “Individual” means any person being considered for or receiving services and supports regulated by these rules. (43) “Informed Consent for Services” means that the service options, risks, and benefits have been explained to the individual and guardian, if applicable, in a manner that they comprehend, and the individual and guardian have consented to the services on or prior to the first date of service. (44) “Integrated Psychiatric Residential Treatment Facility and Residential Substance Use Disorders Treatment Program” or “IPSR” or “Integrated Program” means a residential program that is licensed to provide both residential substance use disorders treatment and psychiatric residential treatment services to children and adolescents in the same facility. (45) “Intensive Outpatient Services and Supports (IOSS)” means a specialized set of comprehensive in-home and community-based supports and mental health treatment services for children that are developed by the child and family team and delivered in the most integrated setting in the community. (46) “Intensive Treatment Services (ITS)” means the range of services in the system of care comprised of Psychiatric Residential Treatment Facilities (PRTF) and Psychiatric Day Treatment Services (PDTS), or other services as determined by the Division that provide active psychiatric treatment for children with severe emotional disorders and their families. (47) “Interdisciplinary Team” means the group of people designated to advise in the planning and provision of services and supports to individuals receiving ITS services and may include multiple disciplines or agencies. For Psychiatric Residential Treatment Facilities (PRTF), the composition of the interdisciplinary team shall be consistent with the requirements of 42 CFR Part 441.156. (48) “Interim Referral and Information Services” means services provided by a substance use disorders treatment provider to individuals on a waiting list and whose services are funded by the Substance Abuse Prevention and Treatment (SAPT) Block Grant to reduce the adverse health effects of substance use, promote the health of the individual, and reduce the risk of disease transmission. (49) “Intern” or “Student” means an individual who provides a paid or unpaid program service to complete a credentialed or accredited educational program recognized by the State of Oregon. (50) “Juvenile Psychiatric Security Review Board (JPSRB)” means the entity described in ORS 161.385. (51) “Level of Care” means the range of available services provided from the most integrated setting to the most restrictive and most intensive in an inpatient setting. (52) “License” means a document or documents issued by the Division that identify and declare the provider to be licensed pursuant to OAR chapter 415 division 012 and applicable provider rules. (53) “Licensed Health Care Professional” means a practitioner of the healing arts acting within the scope of their practice under state law who is licensed by a recognized governing board in Oregon. (54) “Licensed Medical Practitioner (LMP)” means an individual who meets the following minimum qualifications as documented by the Local Mental Health Authority (LMHA) or designee: (a) Physician licensed to practice in the State of Oregon; or (b) Nurse practitioner licensed to practice in the State of Oregon; or (c) Physician’s assistant licensed to practice in the State of Oregon; and (d) Whose training, experience, and competence demonstrate the ability to conduct a mental health assessment and provide medication management. (e) For IOSS and ITS providers, LMP means a board-certified or board-eligible child and adolescent psychiatrist licensed to practice in the State of Oregon. (55) “Local Mental Health Authority (LMHA)” means one of the following entities: (a) The board of county commissioners of one or more counties that establishes or operates a CMHP; (b) The tribal council in the case of a federally recognized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or (c) A regional local mental health authority comprised of two or more boards of county commissioners. (56) “Mandatory Reporter” means any public or private official, as defined in ORS 419B.005(3), who comes in contact with or has reasonable cause to believe that an individual has suffered abuse or that any individual with whom the official comes in contact with has abused the individual. Pursuant to ORS 430.765(2), psychiatrists, psychologists, clergy, and attorneys are not mandatory reporters for information received through communications that are privileged under ORS 40.225 to 40.295. (57) “Mechanical Restraint” means any device attached or adjacent to the resident’s body he or she cannot easily remove and that restricts freedom of movement or normal access to their body. Mechanical restraint is prohibited in the services regulated by these rules. (58) “Medicaid” means the federal grant-in-aid program to state governments to provide medical assistance to eligible persons under Title XIX of the Social Security Act. (59) “Medical Director” means a physician licensed to practice medicine in the State of Oregon and who is designated by a substance use disorders treatment program to be responsible for the program’s medical services, either as an employee or through a contract. (60) “Medical Supervision” means an LMP’s review and approval, at least annually, of the medical appropriateness of services and supports identified in the service plan for each individual receiving mental health services for one or more continuous years. (61) “Medically Appropriate” means services and medical supplies required for prevention, diagnosis, or treatment of a physical or behavioral health condition or injuries and that are: (a) Consistent with the symptoms of a health condition or treatment of a health condition; (b) Appropriate regarding standards of good health practice and generally recognized by the relevant scientific community and professional standards of care as effective; (c) Not solely for the convenience of an individual or a provider of the service or medical supplies; and (d) The most cost effective of the alternative levels of medical services or medical supplies that can be safely provided to an individual. (62) “Mental Health Intern” means an individual who meets qualifications for QMHA but does not have the necessary graduate degree in psychology, social work, or a behavioral science field to meet the educational requirement of QMHP. The individual shall: (a) Be currently enrolled in a graduate program for a master’s degree in psychology, social work, or in a behavioral science field; (b) Have a collaborative educational agreement with the CMHP or other provider and the graduate program; (c) Work within the scope of their practice and competencies identified by the policies and procedures for credentialing of clinical staff as established by the provider; and (d) Receive, at minimum, weekly supervision by a qualified clinical supervisor employed by the provider of services. (63) “Outreach” means the delivery of behavioral health services, referral services, and case management services in non-traditional settings including but not limited to the individual’s residence, shelters, streets, jails, transitional housing sites, drop-in centers, single room occupancy hotels, child welfare settings, educational settings, or medical settings. It also refers to attempts made to engage or re-engage an individual in services by means such as letters or telephone calls. (64) “Peer” means any individual supporting an individual or a family member who has similar life experience, either as a current or former recipient of substance use or mental health services, or as a family member of an individual who is a current or former recipient of substance use or mental health services. (65) “Peer Delivered Services” means community-based services and supports provided by peers and peer support specialists to individuals or family members with similar lived experience. These services are designed to support individuals and families and to engage individuals in ongoing treatment to live successfully in the community. (66) "Peer Support Specialist" means a qualified individual providing peer-delivered services to an individual or family member with similar life experience under the supervision of a qualified clinical supervisor and a qualified peer-delivered services supervisor. A peer support specialist shall be certified by the Authority’s Office of Equity and Inclusion as required by OAR 410-180-0300 to 0380 and be: (a) A self-identified individual currently or formerly receiving substance use or mental health services; (b) A self-identified individual in recovery from a substance use disorder who meets the abstinence requirements for recovering staff in substance use disorders treatment and recovery programs; (c) A self-identified individual in recovery from problem gambling; or (d) An individual with experience parenting a child who: (A) Is a current or former consumer of mental health or substance use treatment; or (B) Is facing or has faced difficulties in accessing education and health and wellness services due to a mental health or behavioral health barrier. (67) “Personal Restraint” means the application of physical force without the use of any device for the purpose of restraining the free movement of an individual’s body to protect the individual or others from immediate harm. Personal restraint does not include briefly holding without undue force an individual to calm or comfort him or her or holding an individual’s hand to safely escort him or her from one area to another. Personal restraint may be used only in approved ITS or Integrated/IPSR programs as an emergency safety intervention under OAR 309-022-0175. (68) “Problem Gambling Treatment Staff” means an individual certified or licensed by a health or allied provider agency to provide problem gambling treatment services that include assessment, development of a service plan, and group and family counseling. (69) “Program” means a particular type or level of service that is organizationally distinct. (70) “Program Administrator” or “Program Director” means an individual with appropriate professional qualifications and experience who is designated to manage the operation of a program. (71) “Program Staff” means an employee or individual who by contract with the program provides a service and has the applicable competencies, qualifications, or certification required in these rules to provide the service. (72) “Prone restraint” means a restraint in which a child in care is held face down on the floor. (73) “Provider” means an individual or 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 or license under OAR 415-012-0000 to provide behavioral health treatment services pursuant to these and applicable service delivery rules. (74) “Psychiatric Day Treatment Services (PDTS)” means the comprehensive, interdisciplinary, non-residential, community-based program certified under these rules consisting of psychiatric treatment, family treatment, and therapeutic activities integrated with an accredited education program. (75) “Psychiatric Residential Treatment Facility (PRTF)” means facilities that are structured residential treatment environments with daily 24-hour supervision and active psychiatric treatment including Psychiatric Residential Treatment Services (PRTS), Secure Children’s Inpatient Treatment Programs (SCIP), Secure Adolescent Inpatient Treatment Programs (SAIP), and Sub-acute Psychiatric Treatment for children who require active treatment for a diagnosed mental health condition in a 24-hour residential setting. (76) “Psychiatric Residential Treatment Services (PRTS)” means services delivered in a PRTF that include 24-hour supervision for children who have serious psychiatric, emotional, or acute mental health conditions that require intensive therapeutic counseling and activity and intensive staff supervision, support, and assistance. (77) “Psychiatrist” means a physician licensed pursuant to ORS 677.010 to 677.228 and ORS 677.410 to 677.450 by the Board of Medical Examiners for the State of Oregon and who has completed an approved residency training program in psychiatry. (78) “Psychologist” means a psychologist licensed by the Oregon Board of Psychologist Examiners. (79) “Publicly Funded” means financial support, in part or in full, with revenue generated by a local, state, or federal government. (80) “Qualified Mental Health Associate (QMHA)” means an individual delivering services under the direct supervision of a QMHP who meets the minimum qualifications as authorized by the LMHA or designee. (81) “Qualified Mental Health Professional (QMHP)” means a LMP or any other individual meeting the minimum qualifications as authorized by the LMHA or designee. (82) “Quality Assessment and Performance Improvement” means the structured, internal monitoring and evaluation of services to improve processes, service delivery, and service outcomes. (83) “Recovery” means a process of healing and transformation for an individual to achieve full human potential and personhood in leading a meaningful life in communities of their choice. (84) “Reportable Incident” means a serious incident involving an individual in an ITS program that shall be reported in writing to the Division within 24 hours of the incident, including but not limited to serious injury or illness, act of physical aggression that results in injury, suspected abuse or neglect, involvement of law enforcement or emergency services, or any other serious incident that presents a risk to health and safety. (85) “Representative” means an individual who acts on behalf of an individual at the individual’s request with respect to a grievance, including but not limited to a relative, friend, Division employee, attorney, or legal guardian. (86) “Residential Problem Gambling Treatment Program” means a publicly or privately-operated program licensed in accordance with OAR 415-012-0100 through 415-012-0225 that provides assessment, treatment, rehabilitation, and twenty-four-hour observation and monitoring for individuals with gambling related problems. (87) “Residential Substance Use Disorders Treatment Program" has the meaning given that term in OAR 309-018-0105. (88) “Resilience” means the universal capacity that an individual uses to prevent, minimize, or overcome the effects of adversity. Resilience reflects an individual’s strengths as protective factors and assets for positive development. (89) “Respite Care” means planned and emergency supports designed to provide temporary relief from care giving to maintain a stable and safe living environment. Respite care may be provided in or out of the home. Respite care includes supervision and behavior support consistent with the strategies specified in the service plan. (90) “Screening” means the process to determine whether the individual needs further assessment to identify circumstances requiring referrals or additional services and supports. (91) “Seclusion” means the involuntary confinement of a resident alone in a room or an area from which the resident is physically prevented from leaving. Seclusion may be used only in approved ITS programs as an emergency safety intervention. (92) “Secure Children’s Inpatient Programs (SCIP) and Secure Adolescent Inpatient Programs (SAIP)” means ITS programs that are designed to provide inpatient psychiatric stabilization and treatment services to children up to age 14 for SCIP services and individuals under the age of 21 for SAIP services who require a secure intensive treatment setting. (93) “Secure Transportation Services” means a child-caring agency licensed by the Oregon Department of Human Services (ODHS) that provides secure transportation or secure escort services for children on defined by ORS 418.205. (94) “Service Note” means the written record of services and supports provided, including documentation of progress toward intended outcomes consistent with the timelines stated in the service plan. (95) “Service Plan” means a comprehensive plan for services and supports provided to or coordinated for an individual and their family that is reflective of the assessment and the intended outcomes of service. (96) “Service Record” means the documentation, written or electronic, regarding an individual and resulting from entry, assessment, orientation, services and supports planning, services and supports provided, and transfer. (97) “Services” means the activities and treatments described in the service plan that are intended to assist the individual’s transition to recovery from a substance use disorder, problem gambling disorder, or mental health condition and to promote resiliency and rehabilitative and functional individual and family outcomes. (98) “Signature” means any written or electronic means of entering the name, date of authentication, and credentials of the individual providing a specific service or the individual authorizing services and supports. Signature also means any written or electronic means of entering the name and date of authentication of the individual receiving services, the guardian of the individual receiving services, or any authorized representative of the individual receiving services. (99) “Skills Training” means providing information and training to individuals and families designed to assist with the development of skills in areas including but not limited to anger management, stress reduction, conflict resolution, self-esteem, parent-child interactions, peer relations, drug and alcohol awareness, behavior support, symptom management, accessing community services, and daily living. (100) “Sub-Acute Psychiatric Care” means services that are provided by nationally accredited providers to children who need 24-hour intensive mental health services and supports provided in a secure setting to assess, evaluate, stabilize, or resolve the symptoms of an acute episode that occurred as the result of a diagnosed mental health condition. (101) "Substance Abuse Prevention and Treatment Block Grant" or “SAPT Block Grant” means the federal block grants for prevention and treatment of substance abuse under Public Law 102-321 (31 U.S.C. 7301-7305) and the regulations published in Title 45 Part 96 of the Code of Federal Regulations. (102) "Substance Use Disorders" means disorders related to the taking of a drug of abuse such as alcohol, the side effects of a medication, or toxin exposure. The disorders include but are not limited to substance use disorders including but not limited to substance dependence and substance abuse and substance-induced disorders, including substance intoxication, withdrawal, delirium, and dementia, as well as substance induced psychotic disorder and mood disorder, as defined in DSM criteria. (103) “Substance Use Disorders Treatment and Recovery Services” means outpatient, intensive outpatient, or residential services and supports for individuals with substance use disorders. (104) “Substance Use Disorders Treatment Staff” means an individual certified or licensed by a health or allied provider agency to provide substance use disorders treatment services such as assessment, development of a service plan, and individual, group, and family counseling. (105) “Supine restraint” means a restraint in which a child in care is held face up on the floor. (106) “Supports” means activities, referrals, and supportive relationships designed to enhance the services delivered to individuals and families for facilitating progress toward intended outcomes. (107) “Transfer” means the process of assisting an individual to transition from the current services to the next appropriate setting or level of care. (108) “Trauma Informed Services” means services that are reflective of the consideration and evaluation of the role that trauma plays in the lives of people seeking mental health and substance use services, including recognition of the traumatic effect of misdiagnosis and coercive treatment. Services are responsive to the vulnerabilities of trauma survivors and are delivered in a way that avoids inadvertent re-traumatization and facilitates individual direction of services. (109) “Treatment” means the planned, medically appropriate, individualized program of medical, psychological, and rehabilitative procedures, experiences, and activities designed to remediate symptoms of a DSM diagnosis that are included in the service plan. (110) “Urgent” means the onset of symptoms requiring attention within 48 hours to prevent a serious deterioration in an individual’s mental or physical health or threat to safety. (111) "Urinalysis Test" means an initial test or, if positive, a confirmatory test conducted by a laboratory meeting the requirements of OAR 333-024-0305 to 333-024-0365: (a) An initial test shall include, at a minimum, a sensitive, rapid, and inexpensive immunoassay screen to eliminate "true negative" specimens from further consideration; (b) A confirmatory test is a second analytical procedure used to identify the presence of a specific drug or metabolite in a urine specimen. The confirmatory test shall be by a different analytical method from that of the initial test to ensure reliability and accuracy. (112) “Variance” means an exception from a provision of these rules granted in writing by the Division upon written application from the provider. Duration of a variance is determined on a case-by-case basis. (113) “Volunteer” means an individual who provides a program service or who takes part in a program service and who is not an employee of the program and is not paid for services. The services shall be non-clinical unless the individual has the required credentials to provide a clinical service. (114) “Wellness” means an approach to healthcare that emphasizes good physical and mental health, preventing illness, and prolonging life. (115) “Wraparound” means a voluntary and definable care planning process that results in a unique set of community services and supports individualized for a youth and family to achieve a positive set of outcomes. (116) “Young Adult in Transition” means an individual who is developmentally transitioning into independence, sometime between the ages of 14 and 25. Statutory/Other Authority: ORS 161.390, 413.042, 430.256, 426.490 - 426.500, 428.205 - 428.270, 430.640 & 443.450 Statutes/Other Implemented: ORS 109.675, 161.390-161.400, 179.505, 413.520 - 413.522, 426.380 - 426.395, 426.490 - 426.500, 430.010, 430.205 - 430.210, 430.240 - 430.640, 430.850 - 430.955, 443.400 - 443.460, 443.991 & 743A.168 History: BHS 5-2023, minor correction filed 01/31/2023, effective 01/31/2023 BHS 4-2023, amend filed 01/27/2023, effective 02/01/2023 BHS 24-2018, amend filed 12/27/2018, effective 01/25/2019 BHS 16-2018, temporary amend filed 07/17/2018, effective 08/01/2018 through 01/27/2019 MHS 7-2017, f. & cert. ef. 6-23-17 MHS 27-2016(Temp), f. & cert. ef. 12-29-16 thru 6-26-17 MHS 21-2016, f. & cert. ef. 12-1-16 MHS 9-2016(Temp), f. 6-28-16, cert. ef. 7-1-16 thru 12-27-16 MHS 5-2014, f. & cert. ef. 2-3-14 MHS 8-2013(Temp), f. 8-8-13, cert. ef. 8-9-13 thru 2-5-14