309-021-0110 IIBHT Definitions (1) “Authority” means the Oregon Health Authority. (2) “Behavioral Health Treatment” means treatment for mental health, substance use disorders, and problem gambling. (3) “Best Practice Risk Assessment” has the meaning given that term in OAR 309-023-0110. (4) “Care Coordination” means a process-oriented activity to facilitate ongoing communication and collaboration to meet multiple needs. Care coordination includes facilitating communication between the person or family served, 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. (5) "Case Management” means the services provided to assist individuals who reside in a community setting or are transitioning to a community setting in gaining access to desired medical, social, educational, entitlement, and other applicable services. (6) “Certificate of Approval” means the document issued by the Authority that identifies and declares certification of a provider pursuant to OAR chapter 309, division 008. (7) "Clinical Supervision" means oversight by a qualified clinical supervisor of the rendering of physical health, substance use, problem gambling, and mental health services and supports, according to these rules, including ongoing evaluation and improvement of the effectiveness of those services and supports. (8) "Clinical Supervisor" means program staff qualified to oversee and evaluate the rendering of physical health, substance use, problem gambling, or mental health services and supports. (9) “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 organization’s members. (10) "Crisis" means either 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 or death. (11) "Crisis and Safety Plan" means an individualized document developed by the youth/young adult and their family in collaboration with the IIBHT team to address potential crises that could occur for the youth and their family, and to ensure everyone's safety. It shall include 24-hour, 7-days-a-week response; formal, informal, and natural supports; back-up care, as applicable; details leading to crises; successful strategies that have worked in the past; and strength-based strategies that prevent escalation and maintain safety (12) "Diagnosis" means the principal mental health, substance use, or problem gambling diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5-TR). The diagnosis is determined through the assessment and any examinations, tests, or consultations suggested by the assessment and are medically necessary reason for services. (13) “Division” means the Behavioral Health Division of the Oregon Health Authority, or its designee. (14) “Entry” means the act or process of acceptance and enrollment into services regulated by this rule. (15) "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. (16) "Family Support" means the provision of peer-delivered services to people 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. (17) "Family Support Specialist” means an individual certified and listed on the registry as a Family Support Specialist in accordance with ORS 410-180-0305, and who has completed specialized training approved by the Authority. A Family Support Specialist is a formal member of the IIBHT team whose role is to support the family (18) “In-Home” means that IIBHT services shall be delivered at times and locations that are convenient to the youth and their family and IIBHT staff are available to provide services in the home, school, or other community setting, as specified by the individual and family. (19) “Incident Report” means a written description of any incident. (20) “Individual” means any individual being considered for or receiving services and supports regulated by these rules. (21) "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, if applicable, have consented to the services on, or prior to, the first date of service. (22)“Intensive In-Home Behavioral Health Treatment (IIBHT)” means an intensive, community-based level of care for youth and young adults under the age of 21, with complex mental health needs who requiring multiple weekly, mental health services and supports to maintain in the community. They may be at risk for an out of home placement or may be stepping down from a higher level of care IIBHT includes access to an array of services including individual and family therapy, case management, psychiatric services, skills training, peer-delivered services, and proactive 24 hours 7 days a week crisis response. A Certificate of Approval from the Oregon Health Authority is required to render IIBHT services to eligible youth and families. (23) “Intensive In-Home Behavioral Health Treatment (IIBHT) team” means any staff member assigned by the Certified IIBHT Provider that has been identified to provide services and supports as outlined in the service plan to a youth, young adult and/or their family while enrolled in IIBHT services (24) "Level of Care" means the type, frequency, and duration of medically necessary and medically appropriate services provided from the most integrated setting to the most restrictive and intensive inpatient setting (25) "Licensed Medical Practitioner (LMP)” means a person 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; (b) Nurse practitioner licensed to practice in the State of Oregon; or (c) Physician's assistant licensed to practice in the State of Oregon; (d) Whose training, experience, and competence demonstrate the ability to conduct a medical exam, a mental health assessment and provide medication management; and (26) “Natural Supports” means individuals in the youth and family’s own community, social, cultural or spiritual networks, such as friends, extended family members, neighbors, and other individuals as identified by the youth and family, providing supports, who are not financially compensated for their time. (27) “Peer” means program staff supporting an individual or the individual's family member who has similar life experience, either as a current or former recipient of mental health or substance use, problem gambling, or mental health services, or as a family member of an individual who is a current or former recipient of substance use, problem gambling, or mental health services. (28) “Peer-Delivered Services” are community-based services and supports provided by peers, peer support specialists, and peer wellness specialists to individuals or family members with similar lived experience. These services are intended to support individuals and families to engage individuals in ongoing treatment and to live successfully in the community. (29) “Peer Support Specialist (PSS)” means a qualified program staff 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 as resources are made available. (30) “Proactive Support and Crisis Response” means that youth and their families have 24/7/365 access to program staff via phone support and that a face-to-face response is available to the youth and families as needed to assist the youth and family and prevent unnecessary emergency room visit and law enforcement. Program staff must have access to the youth’s Crisis and Safety Plan and complete the required documentation. (31) "Program" means an organized system of services and supports delivered by a provider designed to address the treatment needs of individuals and families. (32) "Program Staff" means personnel who renders a clinical service or support. Program staff could include, for example, be an employee, contractor, intern, or volunteer who is rendering or assisting with rendering clinical services or supports. (33) “Provider” means an organizational entity or qualified person that is certified or licensed by the Division for the direct delivery of substance use, problem gambling, or mental health services and supports. (34) Psychiatrist" means a physician licensed by the Oregon Medical Board and who has completed an approved residency training program in psychiatry. (35) "Qualified Mental Health Associate (QMHA)” means mental health program staff delivering services under the direct supervision of a QMHP who meets the minimum qualifications as authorized by the LMHA or designee and specified in OAR 309-019-0125. (36) "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. (37) "Risk Assessment" means an evaluation of the level or severity of risk the individual is experiencing and how each interact. (38) "Screening" means the process to determine whether the individual needs further assessment to identify circumstances requiring referrals or additional services and supports. (39) "Service Plan" means a comprehensive plan for services and supports provided to or coordinated for an individual and their family, as applicable, that is reflective of the assessment and the intended outcomes of service. (40) “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. (41) “Service Record” means the written or electronic documentation regarding an individual and resulting from entry into services, assessment, orientation, services and supports planning, services and supports provided, and transfer. (42) "Services" means those activities and treatments described in the service plan and rendered, that are intended to support 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’s desired outcomes. (43) "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, personal relationships, drug and alcohol awareness, behavior support, symptom management, accessing community services, and daily living. (44) “Suicide Risk Assessment” means a comprehensive evaluation, usually performed by a clinician, to evaluate suspected suicide risk in an individual, estimate the immediate danger, and decide on a course of treatment. May also be called Risk Assessment. (45) “Suicide Screening” means a procedure in which a validated tool, or protocol is used to identify individuals who may be at risk for suicide. (46) “Supports” means activities, referrals, and supportive relationships designed to enhance the services delivered to individuals and families for the purpose of facilitating progress toward intended outcomes. (47) “Transfer” means the process of assisting an individual to transition from the current services to the next identified setting or ASAM level of care. (48) “Trauma Informed Services” means services that reflect the consideration and evaluation of the role that trauma plays in the lives of people seeking mental health, substance use, or problem gambling 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. (49) "Treatment" means the planned, individualized program of medical, psychological, and rehabilitative procedures, experiences, and activities designed to remediate symptoms of a DSM-5-TR diagnosis. (50) “ 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. (51) “Youth” is the universal term used to describe all individuals, children, adolescents, and teenagers from birth through the age of 17 enrolled in IIBHT services. (52) “Youth Peer Support Specialist” means an individual certified and listed on the registry as a Youth Peer Support Specialist in accordance with ORS 410-180-0305, and who has completed specialized training approved by the Authority. (53) “Young adults” is the accepted term to describe individuals between the ages of 18 and 20 years of age enrolled in IIBHT services. Statutory/Other Authority: ORS 413.042, 430.640 & 430.705 Statutes/Other Implemented: ORS 430.010, 430.205 & 430.708 History: BHS 3-2025, adopt filed 02/27/2025, effective 03/01/2025