justicedao/ipfs_state_laws huggingface dataset:
309-021-0150 IIBHT Referrals and Admissions (1) IIBHT providers must have policies and procedures in place which outline their process for reviewing and responding to referrals as quickly as possible in order to address the needs of complex youth and young adults in crisis and avoid the need for emergency department use or higher level of care. (2) IIBHT Providers must have policies and procedures in place which outline their response to referrals and admissions in accordance with these rules and for partnering with local hospital emergency departments (EDs) and local school districts to address youth mental health crises and referrals. (3) Providers shall accept completed referrals from mental health outpatient programs, residential treatment facilities, Community Mental Health Programs, Coordinated Care Organizations, Oregon Department of Human Services, youth/young adults and/or their families, and other community partners when accompanied by the following: (a) All referrals must utilize the IIBHT Universal Referral Form provided by OHA; and (b) Include documentation by a QMHP or LMP with recent and direct experience treating or assessing the youth which include clinical justification for this level of care. (4) IIBHT providers shall track all referrals to IIBHT services including at a minimum the date of the referral, approval or denial date, and either the denial reason or estimated date of admission. IIBHT providers will submit documentation to OHA quarterly or as requested. (5) Per the CCO and IIBHT program’s referral policies, the deciding entity shall communicate the determination decision within 5 business days of receipt of an IIBHT referral to the referring party. This determination shall reference appropriate medical necessity and appropriateness standards for acceptance or denial. If there is insufficient information to process the referral, the deciding entity will respond to the referring party requesting the additional information. (6) Youth shall be enrolled into IIBHT services within 14 days of the referral being approved. If the provider is unable to enroll the youth/young adult into IIBHT services within 14 days, the provider must notify their CCO immediately. The CCO shall work with the youth/young adult and their family to: (a)provide ongoing care coordination and support, (b) ensure that interim alternative community-based services are in place, (c) communicate with the IIBHT provider to facilitate IIBHT enrollment as soon as possible to prevent the need for higher levels of care. 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
309-021-0170 Treatment Review Meetings (1) IIBHT Treatment Review meetings shall meet the following requirements: (a) Treatment Review meetings shall include, at minimum: (A) The youth/young adult (when clinically appropriate) and their family; (B) Natural supports as approved by the youth/young adult and their family; (C) The youth/young adult’s assigned IIBHT QMHP; and (D) Any other internal or external providers working with the youth/young adult and their family, including mobile crisis representatives if offered by an external organization, or that are chosen by the youth/young adult and their family. (b) An IIBHT treatment review meeting shall be held as often as requested by the youth/young adult and their family, but no less than one time every 90 calendar days. At each meeting, the team shall document the review of: (A) Successes and strengths of the youth/young adult and their family (B) Review of progress towards Service Plan goals, objectives, and interventions; (C) Any updates to the services and supports as determined by the review; (D) Any updates to psychiatric services and recommendations since the last review; (E) Any updates to the Crisis and Safety Plan as determined by the review; (F) Additional interventions to meet the needs of the youth/young adult and their family; (G) Any updates to discharge criteria and transition plan timelines needed for a successful transition from IIBHT services; (H) Youth/young adult and their family’s overall satisfaction with services and supports and any requested changes, updates or adjustment requested. (2) If the youth/young adult is a participant in Fidelity Wraparound, the IIBHT Treatment Review meeting may be included in the regular scheduled Wraparound meeting. The IIBHT provider shall ensure that all IIBHT documentation requirements are met. 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
309-021-0180 Proactive Phone Support and In-person Crisis Response (1) IIBHT shall include 24/7/365 support for youth/young adults and their families in the event of a behavioral health crisis. (a) Crisis support shall be available as outlined in the youth/young adult’s individualized Crisis and Safety Plan to provide proactive support and use of skills to deescalate crises (b) Support shall be available by phone at a minimum, and many crises may be managed proactively by phone. When appropriate and requested by the youth/young adult and/or family, support will be offered in person. (2) IIBHT proactive phone support and in-person crisis response shall include the provision and documentation of the following: (a) IIBHT providers shall maintain a policy outlining their procedure that insures youth/young adults and their families enrolled in IIBHT are able to access 24/7/365 proactive phone support and in-person crisis response. (b) IIBHT providers that are unable to provide 24/7/365 in person crisis response shall establish a Memo of Understanding (MOU) with their local Mobile Crisis Intervention team to provide crisis response to IIBHT-enrolled youth/young adults and their families between the hours of midnight and 7am. (c) IIBHT providers must ensure that any staff covering the proactive phone support and/or in-person crisis response for IIBHT meets the following requirements: (A) Staff must be trained in crisis intervention, suicide screening and de-escalation; and (B) Staff must have access to a QMHP who can provide clinical support and consultation; and (C) Staff must have access to the youth/young adult’s most up to date crisis and safety plan (d) All crisis responses must be clearly documented in the youth/young adult’s service record. Documentation must include the following: (A) A description of the incident; (B) A description of the interventions used; (C) A summary of the debrief with the child and family; and (D) Any recommendations for updates to the Crisis and Safety Plan and/or the Service Plan, and a timeframe for the next team meeting. 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
309-022-0100 Purpose and Scope (1) OAR 309-022-0100 through OAR 309-022-0192 prescribe minimum standards for services and supports provided by addictions and mental health providers approved by the Health Systems Division (Division) of the Oregon Health Authority (Authority) to operate under: (a) An Intensive Treatment Services (ITS) certificate; or (b) A Child and Adolescent Integrated Psychiatric Residential Treatment Facility and Residential Substance Use Disorders Treatment Program license (also called an “Integrated license” or “IPSR” program or license). (2) OAR 309-022-0100 through OAR 309-022-0105 and OAR 309-022-0195 through OAR 309-0122-0230 prescribe minimum standards for services and supports provided by addictions and mental health providers approved by the Division to serve as a Children’s Emergency Safety Intervention Specialist (CESIS). (3) In addition to applicable requirements in OAR 410-120-0000 through 410-120-1980 and OAR 943-120-0000 through 943-120-1550, these rules specify standards for services and supports provided in Intensive Treatment Services (ITS) for children and adolescents. (4) Entities providing or seeking to operate a child and adolescent Integrated Psychiatric Residential Treatment Facility and Residential Substance Use Disorders Treatment Program (IPSR) shall: (a) Meet all the requirements for ITS providers; (b) Meet all the requirements for residential substance use disorder treatment programs in OAR 309-018-0100 through 309-018-0215, except as described in subsection (d) below; (c) Not be required to obtain a separate license under OAR 309-018-0100 through 309-018-0215 as long as the entities have a valid IPSR license under OAR chapter 309, division 022; (d) Meet the requirements for individual rights set forth in OAR 309-018-0115, except that seclusion and restraint may be administered as set forth in OAR 309-022-0175; (e) Comply with the requirements of OAR 309-022-0175 and OAR chapter 309, division 022 to the extent that seclusion and restraint is administered; and (f) Be subject to the rules in OAR chapter 415, division 012 with respect to the IPSR/Integrated license or application for a license. 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 10-2021, temporary amend filed 05/12/2021, effective 05/12/2021 through 11/07/2021 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 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
309-022-0110 Provider Policies (1) All providers shall develop and implement written personnel policies and procedures compliant with these rules, including: (a) Personnel qualifications and credentialing; (b) Mandatory abuse reporting, compliant with ORS 430.735-430.768 and OAR 943-045-0250 through 943-045-0370; (c) Criminal records checks, compliant with ORSs 181.533 through 181.575 and OAR 943-007-0001 through 0501; and (d) Fraud, waste, and abuse in federal Medicaid and Medicare programs compliant with OAR 410-120-1380 and 410-120-1510. (e) Drug Free Workplace. (2) All providers shall develop and implement written service delivery policies and procedures compliant with these rules: (a) Policies shall be available to individuals and family members upon request; and (b) Service delivery policies and procedures shall include at a minimum: (A) Fee agreements; (B) Confidentiality and compliance with HIPAA, Federal Confidentiality Regulations (42 CFR, Part 2), and state confidentiality regulations as specified in ORSs 179.505 and 192.518 through 192.530; (C) Compliance with Title 2 of the Americans with Disabilities Act of 1990 (ADA); (D) Grievances and appeals; (E) Individual rights; (F) Quality assessment and performance improvement; (G) Crisis and suicide prevention and response; (H) Incident reporting; (I) Family involvement; (J) Trauma-informed service delivery consistent with the Division Trauma Informed Services Policy; (K) Provision of culturally and linguistically appropriate services; and (L) Peer delivered services. (3) In addition to the personnel and service delivery policies required of all providers, residential program providers shall develop and implement written policies and procedures for the following: (a) Medical protocols and medical emergencies; (b) Medication administration, storage, and disposal; (c) General safety and emergency procedures to include an evacuation plan and emergency plan in case of fire, explosion, accident, death, or other emergencies. The evacuation and emergency procedures and plans shall be current and posted in a common area; (d) Suicide risk assessment; (e) Emergency safety interventions in ITS programs; and (f) Proactive and positive behavior support consistent with OAR 309-022-0165. 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 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 8-2013(Temp), f. 8-8-13, cert. ef. 8-9-13 thru 2-5-14
309-022-0120 Licensing and Credentialing Program staff in the following positions must meet applicable credentialing or licensing standards, including those outlined in these rules: (1) CESIS; (2) Clinical Supervisor; (3) LMP; (4) Medical Director; (5) QMHA; and (6) QMHP. Statutory/Other Authority: ORS 161.390, 413.042, 426.490 - 426.500, 428.205 - 428.270, 430.256, 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: 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
309-022-0150 Minimum Program Requirements ITS providers shall meet the following general requirements: (1) Maintain the organizational capacity and interdisciplinary treatment capability to deliver clinically and developmentally appropriate services in the medically appropriate amount, intensity, and duration for each child specific to the child's diagnosis, level of functioning, and the acuity and severity of the child's psychiatric symptoms. (2) Maintain 24-hour, seven days per week treatment responsibility for children in the program. (3) Non-residential programs shall maintain on-call capability at all times to respond directly or by referral to the treatment needs of children, including crises, 24 hours per day, and seven days per week. (4) Inform the Division and the legal guardian within twenty-four hours of reportable incidents. (5) Maintain linkages with primary care physicians, CMHPs, and MHOs and the child's parent or guardian to coordinate necessary continuing care resources for the child. (6) Maintain linkages with the applicable education service district or school district to coordinate and provide the necessary educational services for the children and integrate education services in all phases of assessment, service and support planning, active treatment, and transition planning. 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 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 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
309-022-0165 Behavior Support Services Behavior support services shall be proactive, recovery-oriented, individualized, and designed to facilitate positive alternatives to challenging behavior, as well as to assist the individual in developing adaptive and functional living skills. All providers shall: (1) Develop and implement individual behavior support strategies, based on a functional or other clinically appropriate assessment of challenging behavior. (2) Document the behavior support strategies and measures for tracking progress as a behavior support plan in the service plan. (3) Establish a framework that assures individualized positive behavior support practices throughout the program and articulates a rationale consistent with the philosophies supported by the Division, including the Division’s Trauma-informed Services Policy. (4) Obtain informed consent from the parent or guardian, when applicable, in the use of behavior support strategies and communicate both verbally and in writing the information to the individual and guardian in a language understood by the individual and in a developmentally appropriate manner. (5) Establish outcome-based tracking methods to measure the effectiveness of behavior support strategies in: (a) Reducing or eliminating the use of emergency safety interventions; and (b) Increasing positive behavior. (6) Require all program staff to receive annual training in Collaborative Problem Solving, Positive Behavior Support or other Evidence-based Practice to promote positive behavior support. (7) Review and update behavior support policies, procedures, and practices annually. 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 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 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
309-022-0170 Emergency Safety Interventions Providers of ITS services shall: (1) Adopt policies and procedures for emergency safety interventions as part of a crisis prevention and intervention policy. The policy shall be consistent with the provider’s trauma-informed services policies and procedures. (2) Inform the individual and their parent or guardian of the provider’s policy regarding the use of personal restraint and seclusion during an emergency safety situation by both furnishing a written copy of the policy and providing an explanation in the individual’s primary language that is developmentally appropriate. (3) Obtain a written acknowledgment from the parent or guardian that they are informed of the provider’s policies and procedures regarding the use of personal restraint and seclusion. (4) Prohibit the use of mechanical restraint, chemical restraint and prone restraints. (5) Prohibit the use of supine restraints unless licensed as a SCIP or SAIP program. (6) Establish an emergency safety interventions committee or designate this function to an already established quality assessment and performance improvement committee. Committee membership shall minimally include a program staff with designated clinical leadership responsibilities, the person responsible for staff training in crisis intervention procedures, and other clinical personnel not directly responsible for authorizing the use of emergency safety interventions. The committee shall: (a) Monitor the use of emergency safety interventions to assure that individuals are safe-guarded and their rights are always protected; (b) Meet at least monthly and shall report in writing to the provider’s quality assessment and performance improvement committee at least quarterly regarding the committee’s activities, findings, and recommendations; (c) Analyze emergency safety interventions to determine opportunities to prevent their use, increase the use of alternatives, improve the quality of care and safety of individuals receiving services, and recommend whether follow up action is needed; (d) Review and update emergency safety intervention policies and procedures annually; (e) Conduct individual and aggregate review of all incidents of personal restraint and seclusion; and (f) Report the aggregate number of personal restraints and incidents of seclusion to the Division within 30 days of the end of each calendar quarter. 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 History: 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 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
309-022-0185 Quality Assessment and Performance Improvement (1) Each provider shall develop and implement a structured and ongoing process to assess, monitor, and improve the quality and effectiveness of services provided to individuals and their families, including: (a) A quality improvement committee; and (b) A performance improvement process documented in a performance improvement plan. (2) The quality improvement committee shall include representatives of individuals served and their families and shall meet at least quarterly to: (a) Identify and assess the following indicators of quality: (A) Access to services; (B) Outcomes of services; (C) Systems integration and coordination of services; and (D) Utilization of services. (b) Review incident reports, emergency safety intervention documentation, grievances, and other documentation as applicable; (c) Identify measurable and time-specific performance objectives and strategies to meet the objectives and measure progress; (d) Recommend policy and operational changes necessary to achieve performance objectives; and (e) Reassess and, if necessary, revise objectives and methods to measure performance on an ongoing basis to ensure sustainability of improvements. (3) The quality assessment and performance improvement process shall be documented in a performance improvement plan that shall include: (a) Performance objectives aimed at improving services; and (b) Strategies designed to meet the performance objectives and measure progress. 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 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 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
309-022-0192 Variance (1) Requirements and standards for requesting and granting variances or exceptions are found in OAR 309-008-1600 and OAR 415-012-0090. (2) Granting a variance for one request does not set a precedent that must l be followed by the Division when evaluating subsequent requests for variance. Statutory/Other Authority: ORS 161.390, 413.042, 430.256, 428.205 - 428.270 & 430.640 Statutes/Other Implemented: ORS 109.675, 161.390 - 161.400, 179.505, 413.520 - 413.522, 430.010, 430.205 - 430.210, 430.240 - 430.640, 430.850 - 430.955, 461.549 & 743A.168 History: 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