Oklahoma Administrative Code › Title 450 - Department of Mental Health and Substance Abuse Services › Chapter 18 - Standards and Criteria for Substance Related and Addictive Disorder Treatment Services › Subchapter 1 - General Provisions › Section 450:18-1-2 - Definitions

Current through Vol. 41, No. 20, July 1, 2024
The following words or terms, when used in this chapter,
				  shall have the following meaning, unless the context clearly indicates
				  otherwise:
"Abuse"
means the causing or permitting of harm
				  or threatened harm to the health, safety, or welfare of a consumer by a staff
				  responsible for the consumer's health, safety, or welfare, including but not
				  limited to: non-accidental physical injury or mental anguish; sexual abuse;
				  sexual exploitation; use of mechanical restraints without proper authority; the
				  intentional use of excessive or unauthorized force aimed at hurting or injuring
				  the resident; or deprivation of food, clothing, shelter, or healthcare by a
				  staff responsible for providing these services to a consumer.
"Acute intoxication or withdrawal potential"
means one dimension to be considered in consumer placement, continued stay, and
				  discharge and is an evaluation of the consumer's withdrawal patterns and
				  current level of intoxication and potential for withdrawal complications as it
				  impacts level of care decision making.
"Admission"
means the acceptance of a consumer
				  by a treatment program to receive services at that program.
"Admission criteria"
means those criteria which
				  shall be met for admission of a consumer for services.
"Adult"
means any individual eighteen (18) years
				  of age or older.
"ASAM"
means the American Society of Addiction
				  Medicine.
"ASAM levels of care"
means the different
				  options for treatment as described in the current edition of the ASAM criteria
				  that vary according to the intensity of the services offered. Each treatment
				  option is a level of care.
"ASAM criteria"
means the most current edition
				  of the American Society of Addiction Medicine's published criteria for
				  admission to treatment, continued services, and discharge.
"ASAM level 1"
means Outpatient Services for
				  adolescents and adults. This level of care typically consists of less than nine
				  (9) hours of services per week for adults or less than six (6) hours of
				  services per week for adolescents. Services may be delivered in a wide variety
				  of settings.
"ASAM level 3"
means residential and inpatient
				  services and encompasses ASAM levels 3.1, 3.3, 3.5 and 3.7.
"ASAM level 3.1"
means Clinically Managed
				  Low-Intensity Residential Services for adolescents and adults. This level of
				  care typically provides at least five (5) hours of clinical services a week and
				  provides a twenty-four (24) hour living support and structure with trained
				  personnel. The corresponding service description for this level of care is
				  Halfway House Services.
"ASAM level 3.3"
means Clinically Managed
				  Population-Specific High-Intensity Residential Services. This level of care is
				  for adults only and typically offers twenty-four (24) hour care with trained
				  personnel and is designed to accommodate individuals with cognitive or other
				  impairments, including co-occurring disorders. The corresponding service
				  description for this level of care is Residential Treatment for Adults with
				  Co-Occurring Disorders.
"ASAM level 3.5"
means Clinically Managed
				  Medium-Intensity Residential Services for adolescents and Clinically Managed
				  High-Intensity Residential Services for adults. This level of care provides
				  twenty-four (24) hour care and offers a wide range of therapeutic services. The
				  corresponding service descriptions for this level of care are Residential
				  Treatment and Intensive Residential Treatment.
"ASAM level 3.7"
means Medically Monitored
				  High-Intensity Inpatient Services for adolescents and Medically Monitored
				  Intensive Inpatient Withdrawal Management for adults. This level of care
				  provides twenty-four (24) hour nursing care with physician supervision and
				  medication availability. This level of care is appropriate for individuals
				  withdrawing from alcohol or other drugs with subacute biomedical and emotional,
				  behavioral, or cognitive problems severe enough to require inpatient treatment
				  but for whom hospitalization is not necessary. The corresponding service
				  description for this level of care is Medically Supervised Withdrawal
				  Management.
"Assessment"
means those procedures by which a
				  program provides an on-going evaluation process with the consumer as outlined
				  in applicable rules throughout OAC 450 to collect pertinent information needed
				  as prescribed in applicable rules and statutes to determine courses of actions
				  or services to be provided on behalf of the consumer. Assessment may be
				  synonymous with the term evaluation.
"Behavioral health services"
means a wide range
				  of diagnostic, therapeutic, and rehabilitative services used in the treatment
				  of mental illness, substance use disorders, and co-occurring disorders.
"Biomedical condition and complications"
means
				  one dimension to be considered in placement, continued stay, and discharge and
				  is an evaluation of the consumer's current physical condition and history of
				  medical and physical functioning as it impacts level of care decision making.
"Biopsychsocial assessment"
means face-to-face
				  interviews conducted by a Licensed Behavioral Health Professional (LBHP) or
				  Licensure Candidate designed to elicit historical and current information
				  regarding the behaviors, experiences, and support systems of a consumer, and
				  identify the consumer's strengths, needs, abilities, and preferences for the
				  purpose of guiding the consumer's recovery plan.
"Care management"
means a type of case
				  management in residential substance use disorder (ASAM Level 3) treatment
				  settings that includes assessment, development of a care plan, and referral and
				  linkage to community supports and community-based or lower level of care
				  services to promote continued recovery after the individual discharges from the
				  treatment facility.
"Case management"
means planned referral,
				  linkage, monitoring, support, and advocacy provided in partnership with a
				  consumer to assist that consumer with self-sufficiency and community tenure and
				  take place in the individual's home, in the community, or in the facility, in
				  accordance with a service plan developed with and approved by the consumer and
				  qualified staff.
"Child"
or
"Children"
means any
				  individuals under eighteen (18) years of age.
"Client"
See "Consumer.
"Community-based Structured Crisis Center"
or
"CBSCC"
means a program of non-hospital emergency services for
				  mental health and substance use disorder crisis stabilization as authorized by
				  43A O.S. §3-317 including, but not limited to, observation, evaluation,
				  emergency treatment, and referral, when necessary, for inpatient psychiatric or
				  substance use disorder treatment services. This service is limited to CMHCs who
				  are certified by the Department of Mental Health and Substance Abuse Services
				  or facilities operated by the Department of Mental of Substance Abuse Services.
"Community mental health center"
or
"CMHC"
means a facility offering a comprehensive array of
				  community-based mental health services including, but not limited to, inpatient
				  treatment, outpatient treatment, partial hospitalization, emergency care,
				  consultation and education, and certain services at the option of the center
				  including, but not limited to, prescreening, rehabilitation services, pre-care
				  and aftercare, training programs, and research and evaluation.
"Consultation"
means the act of providing
				  information or technical assistance to a particular group or individual seeking
				  resolution of specific problems. A documented process of interaction between
				  staff members or between facility staff and unrelated individuals, groups, or
				  agencies for the purpose of problem solving or enhancing their capacities to
				  manage consumers or facilities.
"Consumer"
means an individual, adult,
				  adolescent, or child, who has applied for, is receiving or has received
				  evaluation or treatment services from a facility operated or certified by
				  ODMHSAS or with which ODMHSAS contracts and includes all persons referred to in
				  OAC Title 450 as client(s) or patient(s) or resident(s) or a combination
				  thereof.
"Consumer advocacy"
means all activities on
				  behalf of the consumer to assist with or facilitate resolution of problems in
				  the acquisition of resources or services needed by the consumer.
"Consumer record"
means the collection of
				  written information about a consumer's evaluation or treatment that includes
				  the admission data, evaluation, treatment or service plan, description of
				  treatment or services provided, continuing care plan, and discharge information
				  on an individual consumer.
"Continuing care"
means providing a specific
				  period of structured therapeutic involvement designed to enhance, facilitate,
				  and promote transition from a current level of services to support ongoing
				  recovery.
"Contract"
means a document adopted by the
				  governing authority of a treatment facility and any other organization,
				  facility, or individual, which specifies services, personnel, or space to be
				  provided by the program, as well as the monies to be expended in exchange.
"Co-occurring disorder" (COD)
means any
				  combination of mental health symptoms and substance use disorder symptoms or
				  diagnoses that affect a consumer and are typically determined by the current
				  Diagnostic and Statistical Manual of Mental Disorders.
"Co-occurring disorder capability"
means the
				  organized capacity within any type of program to routinely screen, identify,
				  assess, and provide properly matched interventions to consumer's with
				  co-occurring disorders.
"Correctional institution"
means any penal or
				  correctional facility, jail, reformatory, detention center, work farm, halfway
				  house, or residential community program operated by, or under contract to, the
				  United States, a state, a territory, a political subdivision of a state or
				  territory, or an Indian tribe, for the confinement or rehabilitation of persons
				  charged with or convicted of a criminal offense, or other persons held in
				  lawful custody. Other persons held in lawful custody include juvenile offenders
				  adjudicated delinquent, aliens detained awaiting deportation, persons committed
				  to mental institutions through the criminal justice system, witnesses, or
				  others awaiting charges or trial. Programs which are providing treatment
				  services within a correctional facility may be exempt from certain services
				  described in this chapter which cannot be provided due to circumstance.
"Crisis Diversion"
means an unanticipated,
				  unscheduled situation requiring supportive assistance, face-to-face or
				  telephone, to resolve immediate problems before they become overwhelming and
				  severely impair the individual's ability to function or maintain in the
				  community.
"Crisis intervention"
means actions taken and
				  services provided to address emergency psychological, physiological, and safety
				  aspects of alcohol, drug-related, and mental health crises.
"Cultural competency"
means the ability to
				  recognize, respect, and address the unique needs, worth, thoughts,
				  communications, actions, customs, beliefs, and values that reflect an
				  individual's racial, ethnic, religious, sexual orientation, and/or social
				  group.
"Day school"
means the provision of therapeutic
				  and accredited academic services on a regularly scheduled basis.
"Department"
or
"ODMHSAS"
means the
				  Oklahoma Department of Mental Health and Substance Abuse Services.
"Detoxification"
means the process of
				  eliminating the toxic effects of drugs and alcohol from the body. Supervised
				  detoxification methods include social detoxification and medical monitoring or
				  medical management and are intended to avoid withdrawal complications.
"DHS"
or
"OKDHS"
means the Oklahoma
				  Department of Human Services.
"Diagnosis"
means the determination of a
				  disorder as defined by current DSM criteria and in accordance with commonly
				  accepted professional practice standards.
"Dietitian"
or
"Dietician"
means an
				  individual trained and licensed in the development, monitoring, and maintenance
				  of food and nutrition in accordance with the Oklahoma State Board of Medical
				  Licensure and Supervision.
"Discharge criteria"
means individualized
				  measures by which a program and the consumer determine readiness for discharge
				  or transition from services being provided by that facility. These may
				  reference general guidelines as specified in facility policies or procedures
				  and/or in published guidelines including, but not limited to, the current ASAM
				  criteria for individuals with substance use disorders, but should be
				  individualized for each consumer and articulated in terms of consumer
				  behaviors, resolutions of specific problems, and attainment of goals developed
				  in partnership with the participant and the provider.
"Discharge planning"
or
"transition
				  planning"
means the process, begun at admission, of determining a
				  consumer's continued need for treatment services and of developing a plan to
				  address ongoing consumer post-treatment and recovery needs. Discharge planning
				  may or may not include a document identified as a discharge plan.
"Discharge summary"
means a clinical document in
				  the treatment record summarizing the consumer's progress during treatment, with
				  goals reached, continuing needs, and other pertinent information including
				  documentation of linkage to aftercare.
"DOC"
or
"ODOC"
means the Oklahoma
				  Department of Corrections.
"Documentation"
means the provision of written,
				  dated, and authenticated evidence to substantiate compliance with standards,
				  e.g., minutes of meetings, memoranda, schedules, notices, logs, records,
				  policies, procedures, and announcements.
"DSM"
means the most current edition of the
				  Diagnostic and Statistical Manual of Mental Disorders published by the American
				  Psychiatric Association.
"Education"
means the dissemination of relevant
				  information specifically focused on increasing the awareness of the community
				  and the receptivity and sensitivity of the community concerning mental health,
				  substance-related and addictive disorders, or other related problems and
				  services related to the specific focus of treatment.
"Emergency services"
means a twenty-four (24)
				  hour capability for assessment, intervention, and resolution of a consumer's
				  crisis or emergency provided in response to unanticipated, unscheduled
				  emergencies requiring prompt intervention to resolve immediate, overwhelming
				  problems that severely impair the individual's ability to function or remain in
				  the community and may include placement of the individual in a protective
				  environment, withdrawal management, individual and group consultation, and
				  medical assessment.
"Emotional, behavioral or cognitive conditions and
				  complications"
means one dimension to be considered in consumer
				  placement, continued stay, and discharge and is an evaluation of the consumer's
				  historical and current emotional, behavioral, or cognitive status including the
				  presence and severity of any diagnosed mental illnesses, as well as, the level
				  of anxiety, depression, impulsivity, guilt, and behavior that accompanies or
				  follows these emotional states and historical information, as it impacts on
				  level of care decision making.
"Evaluation"
See "Assessment."
"Evidence based practice"
means programs or
				  practices that are supported by research methodology and have produced
				  consistently positive patterns of results when replicated within the intent of
				  the published guidance.
"Executive director"
means the person hired by
				  the governing authority to direct all the activities of the organization; may
				  be used synonymously with administrative director, administrator, chief
				  executive officer, and director.
"Face-To-Face"
for the purposes of the delivery
				  of behavioral health care, means a face-to-face physical contact and in-person
				  encounter between the health care provider and the consumer, including the
				  initial visit. The use of telemedicine shall be considered a face-to-face
				  encounter.
"Facilities"
or
"facility"
means
				  entities as described in Title 43A O.S. § 1-103(7), community mental
				  health centers, residential mental health facilities, community-based
				  structured crisis centers, certified services for the alcohol and drug
				  dependent, programs of assertive community treatment, eating disorder
				  treatment, gambling disorder treatment, and narcotic treatment programs.
"Family"
means the parents, brothers, sisters,
				  other relatives, foster parents, guardians, and others who perform the roles
				  and functions of family members in the lives of consumers.
"Follow-up"
means the organized method of
				  systematically determining the status of consumers after they have been
				  discharged to determine post-treatment outcomes and utilization of
				  post-treatment referrals.
"Gambling disorder treatment services"
means
				  treatment activities for consumers by a gambling treatment professional that
				  include, but are not limited to, the following:
(A) Assessment and diagnostic impression, ongoing;
(B) Treatment planning and revision, as necessary;
(C) Individual, group and family therapy;
(D) Case management;
(E) Psychosocial rehabilitation; and
(E) Discharge planning.
"Goals"
means broad general statements of
				  purpose or intent that indicates the general effect the facility or service is
				  intended to have.
"Guardian"
means an individual who has been
				  given the legal authority for managing the affairs of another individual.
"Halfway house"
means low intensity substance
				  use disorder treatment in a supportive living environment to facilitate the
				  individual's reintegration into the community, most often following completion
				  of primary treatment. Corresponding ASAM Treatment Level: Level III.1,
				  Clinically managed Low Intensity Residential Services.
"Halfway house for persons with children"
means
				  a halfway house that includes services for the recovering person's children who
				  will reside with him or her in the house. Corresponding ASAM Treatment Level:
				  Level III.1, Clinically managed Low Intensity Residential Services.
"Infant"
means any child from birth up to 3
				  years of age.
"Initial contact"
means a person's first contact
				  with the facility, e.g., a request for information or service by telephone or
				  in person.
"Inpatient services"
means the process of
				  providing care to persons who require twenty-four (24) hour supervision in a
				  hospital or other suitably equipped medical setting as a result of acute or
				  chronic medical or psychiatric illnesses and professional staff providing
				  medical care according to a treatment plan based on documentation of need.
"Intervention"
means a process or technique
				  intended to facilitate behavior change.
"Licensed Behavioral Health Professional"
or
"LBHP"
means:
(A) An Allopathic or Osteopathic Physician with a current
				  license and board certification in psychiatry or board eligible in the state in
				  which services are provided, or a current resident in psychiatry;
(B) An Advanced Practice Registered Nurse licensed as a
				  registered nurse with a current certification of recognition from the board of
				  nursing in the state in which services are provided and certified in a
				  psychiatric mental health specialty;
(C) A Clinical Psychologist who is duly licensed to practice
				  by the State Board of Examiners of Psychologists;
(D) A Physician Assistant who is licensed in good standing in
				  Oklahoma and has received specific training for and is experienced in
				  performing mental health therapeutic, diagnostic, or counseling functions;
(E) A practitioner with a license to practice in the state in
				  which services are provided by one of the following licensing boards:
(i) Social Work (clinical specialty only);
(ii) Professional Counselor;
(iii) Marriage and Family Therapist;
(iv) Behavioral Practitioner; or
(v) Alcohol and Drug Counselor.
"Licensed physician"
means an individual with an
				  M.D. or D.O. degree who is licensed in the State of Oklahoma to practice
				  medicine.
"Licensed practical nurse"
means an individual
				  who is a graduate of an approved school of nursing and is licensed in the State
				  of Oklahoma to provide practical nursing services.
"Licensure"
means the process by which an agency
				  of government grants permission to persons or health facilities meeting
				  qualifications to engage in a given occupation or business or use a particular
				  title.
"Licensure Candidate"
means practitioners
				  actively and regularly receiving board approved supervision, and extended
				  supervision by a fully licensed clinician if board's supervision requirement is
				  met but the individual is not yet licensed, to become licensed by one of the
				  following licensing boards:
(A) Psychology;
(B) Social Work (clinical specialty only);
(C) Professional Counselor;
(D) Marriage and Family Therapist;
(E) Behavioral Practitioner; or
(F) Alcohol and Drug Counselor.
"Life skills"
means abilities and techniques
				  necessary to function independently in society.
"Medical care"
means those diagnostic and
				  treatment services which, under the laws of the jurisdiction in which the
				  facility is located, can only be provided or supervised by a licensed
				  physician.
"Medical withdrawal management"
means diagnostic
				  and treatment services performed by licensed facilities for acute alcohol or
				  drug intoxication, delirium tremens, and physical and neurological
				  complications resulting from acute intoxication. Medical withdrawal management
				  includes the services of a physician and attendant medical personnel including
				  nurses, interns, and emergency room personnel, the administration of a medical
				  examination and a medical history, the use of an emergency room and emergency
				  medical equipment if warranted, a general diet of three meals each day, the
				  administration of appropriate laboratory tests, and supervision by properly
				  trained personnel until the person is no longer medically incapacitated by the
				  effects of alcohol or drugs. [43 A O.S. § 3-403(5)] It is an organized
				  service delivered by medical and nursing professionals that provides for
				  twenty-four (24)-hour medically directed evaluation and withdrawal management
				  in an acute care inpatient setting. Services are delivered under a defined set
				  of physician-approved policies and physician-managed procedures or medical
				  protocols. Corresponding ASAM Service Level: Level 4-WM, Medically Managed
				  Intensive Inpatient Withdrawal Management.
"Medical services"
means the administration of
				  medical procedures by a physician, registered nurse, nurse practitioner,
				  physician's assistant, or dentist and in accordance with a documented treatment
				  plan and medical supervision available to provide the consumer with the service
				  necessitated by the prevalent problem identified and includes physical
				  examinations, withdrawal management from alcohol or drugs, methadone
				  maintenance, dental services, or pharmacy services, etc.
"Medically supervised withdrawal management"
means withdrawal management outside of a medical setting, directed by a
				  physician who has attendant medical personnel including nurses for intoxicated
				  consumers, and consumer's withdrawing from alcohol and other drugs, presenting
				  with no apparent medical or neurological symptoms as a result of their use of
				  substances that would require hospitalization as determined by an examining
				  physician. Corresponding ASAM Service Level: Level 3.7-WM, Medically Monitored
				  Inpatient Withdrawal Management. Withdrawal management is intended to stabilize
				  and prepare consumers in accessing treatment.
"Medication"
means any prescription or
				  over-the-counter drug that is taken orally, injected, inserted, applied
				  topically, or otherwise administered by staff or self- administered by the
				  consumer for the appropriate treatment or prevention of medical or psychiatric
				  issues.
"Medication assisted treatment"
means the use of
				  medications, in combination with counseling and behavioral therapies, to
				  provide a whole patient approach to the treatment of substance use disorders.
"Medication-self administration"
means the
				  consumers administer their own medication to themselves, or their children,
				  with staff observation.
"Neglect"
means:
(A) the failure of staff to provide adequate food, clothing,
				  shelter, medical care or supervision which includes, but is not limited to,
				  lack of appropriate supervision that results in harm to a consumer;
(B) the failure of staff to provide special care made
				  necessary by the physical or mental condition of the consumer;
(C) the knowing failure of staff to provide protection for a
				  consumer who is unable to protect his or her own interest; or
(D) staff knowingly causing or permitting harm or threatened
				  harm through action or inaction that has resulted or may result in physical or
				  mental injury.
"Non-medical withdrawal management"
means
				  withdrawal management services for intoxicated consumers and consumers
				  withdrawing from alcohol or other drugs presenting with no apparent medical or
				  neurological symptoms as a result of their use of substances. Corresponding
				  ASAM Service Level: Level 3.2-WM, Clinically managed Residential Withdrawal
				  Management Withdrawal management is intended to stabilize and prepare consumers
				  in accessing treatment.
"Objectives"
means a specific statement of
				  planned accomplishments or results that are specific, measurable, attainable,
				  realistic, and time-limited.
"ODMHSAS"
means the Oklahoma Department of
				  Mental Health and Substance Abuse Services.
"Oklahoma Administrative Code"
or
"OAC"
means the publication authorized by 75 O.S. § 256 known
				  as The Oklahoma Administrative Code or, prior to its publication, the
				  compilation of codified rules authorized by 75 O.S. § 256(A)(1)(a) and
				  maintained in the Office of Administrative Rules.
"OSDH"
means the Oklahoma State Department of
				  Health.
"Outpatient services"
means an organized,
				  nonresidential treatment service in regularly scheduled sessions intended for
				  individuals not requiring a more intensive level of care or those who require
				  continuing services following more intensive treatment regimens. For substance
				  use disorder treatment services, the corresponding ASAM Treatment Level is
				  Level I, Outpatient Treatment.
"Peer Recovery Support Specialist"
or
"PRSS"
means an individual who meets the qualifications and is
				  certified as a PRSS pursuant to OAC 450:53.
"Performance Improvement"
or
"PI"
means an approach to the continuous study and improvement of the processes of
				  providing health care services to meet the needs of consumers and others.
				  Synonyms, and near synonyms, include continuous quality improvement, continuous
				  improvement, organization-wide quality improvement, and total quality
				  management.
"Personnel record"
means a chart or file
				  containing the employment history and actions relevant to individual employee
				  or volunteer activities within an organization and may contain application,
				  evaluation, salary data, job description, citations, credentials, etc.
"PICIS"
is a comprehensive management
				  information system based on national standards for mental health and substance
				  abuse databases. It is a repository of diverse data elements that provide
				  information about organizational concepts, staffing patterns, consumer
				  profiles, program or treatment focus, and many other topics of interest to
				  clinicians, administrators, and consumers. It includes unique identifiers for
				  agencies, staff, and consumers that provide the ability to monitor the course
				  of consumer services throughout the statewide ODMHSAS network. PICIS collects
				  data from hospitals, community mental health centers, substance abuse agencies,
				  community residential mental health facilities, prevention programs, and
				  centers for the homeless which are operated or funded in part by ODMHSAS.
"Play therapy"
means a form of action therapy
				  that uses, but is not limited to, sand play, fairy tales, art and puppetry to
				  encourage communication in children who have inadequate or immature
				  verbalization skills or who verbalize excessively due to defensiveness.
"Policy"
means statements of facility intent,
				  strategy, principle, or rules in the provision of services; a course of action
				  leading to the effective and ethical provision of services.
"Prevention"
means the assessment, development,
				  and implementation of strategies designed to prevent the adverse effects of
				  mental illness, substance use disorders, addiction, and trauma.
"Procedures"
means the written methods by which
				  policies are implemented.
"Process"
means information about what a program
				  is implementing and the extent to which the program is being implemented as
				  planned.
"Program"
means a structured set of activities
				  designed and structured to achieve specific objectives relative to the needs of
				  the consumers or patients.
"Progress notes"
means a chronological written
				  description of services provided to a consumer, resident, client, or patient
				  that documents, utilizing acceptable documentation practices, the consumer's
				  response related to the intervention plan or services provided.
"Psychiatrist"
means a licensed physician who
				  specializes in the assessment and treatment of individuals having psychiatric
				  disorders and who is fully licensed to practice medicine in the state in which
				  he or she practices and is certified in psychiatry by the American Board of
				  Psychiatry and Neurology or has equivalent training or experience.
"Psychotherapy"
or
"Therapy"
means
				  a goal directed process using generally accepted clinical approaches provided
				  face-to-face by a Licensed Behavioral Health Professional (LBHP) or Licensure
				  Candidate with consumers in individual, group, or family settings to promote
				  positive, emotional, or behavioral change.
"Readiness to change"
means one dimension to be
				  considered in consumer placement, continued stay, and transition and is an
				  evaluation of the consumer's current emotional and cognitive awareness of the
				  need to change, coupled with a commitment to change.
"Recovery"
means an ongoing process of discovery
				  and/or rediscovery that must be self-defined, individualized, and may contain
				  some, if not all, of the fundamental components of recovery as outlined by the
				  Substance Abuse and Mental Health Services Administration (SAMHSA).
"Recovery/living environment"
means one
				  dimension to be considered in consumer placement, continued stay, and discharge
				  and is an evaluation of the consumer's current recovery environment, current
				  relationships, degree of support for recovery, current housing, employment
				  situation, availability of alternatives, and historical information as it
				  impacts on level of care decision making.
"Registered nurse"
means an individual who is a
				  graduate of an approved school of nursing and is licensed in the State of
				  Oklahoma to practice as a registered nurse.
"Rehabilitation services"
means face-to-face
				  individual or group services provided by qualified staff to develop skills
				  necessary to perform activities of daily living and successful integration into
				  community life. Rehabilitation services for substance use disorders are also
				  referred to as skill development services.
"Relapse"
means the process which may result in
				  the return to the use of substances after a period of abstinence.
"Relapse potential, continued use, or continued problem
				  potential"
means one dimension to be considered in consumer placement,
				  continued stay, and discharge and is an evaluation of the consumer's attitudes,
				  knowledge, and coping skills, as well as the likelihood that the consumer will
				  relapse from a previously achieved and maintained abstinence and/or stable and
				  healthy mental health function. If an individual has not yet achieved
				  abstinence and/or stable and healthy mental health function, this dimension
				  assesses the likelihood that the individual will continue to use alcohol or
				  other drugs and/or continue to have mental health problems.
"Residential treatment-substance abuse"
means
				  treatment for a consumer in a live-in setting which provides a regimen
				  consisting of twenty-four (24) treatment hours per week. This level of care
				  should correspond with the ASAM Service Level: Level 3.5, Clinically managed
				  High-Intensity Residential Services.
"Residential treatment for persons with
				  children-substance abuse"
means a residential treatment facility that
				  includes services for the recovering person's children who will reside with him
				  or her in the residential facility. Corresponding ASAM Service Level (Parent
				  Only): Level 3.5 Clinically Managed High-Intensity Residential Services.
"Screening"
means the process to determine
				  whether the person seeking assistance needs further comprehensive assessment.
"Service plan"
or
"Treatment plan"
means the document used during the process by which a LBHP or a Licensure
				  Candidate and the consumer together and jointly identify and rank problems,
				  establish agreed-upon immediate short-term and long-term goals, and decide on
				  the treatment process and resources to be utilized.
"Service Provider"
means a person who is allowed
				  to provide treatment services within the regulation and scope of their
				  certification level or license.
"Significant others"
means those individuals who
				  are, or have been, significantly involved in the life of the consumer.
"Socialization"
means all activities, which
				  encourage interaction and the development of communication, interpersonal,
				  social, and recreational skills and can include consumer education.
"Substance-related and addictive disorders"
means a substance-related disorder involving problems related to the use of ten
				  distinct classes of drugs: alcohol; caffeine; cannabis; hallucinogens;
				  inhalants; opioids; sedatives, hypnotics and anxiolytics; stimulants; tobacco;
				  and other (unknown) substances. Substance-related disorders fall into one of
				  two categories, substance use disorders and substance induced disorders. A
				  substance use disorder is a cluster of cognitive, behavioral and physiological
				  symptoms indicating the consumer continues using the substance(s) despite
				  significant substance-related problems. A substance-induced disorder is a
				  reversible substance-specific syndrome due to the recent ingestion of a
				  substance. Addictive disorders involve repetitive clusters of behaviors that
				  activate reward systems similar to those activated by drugs and create
				  behavioral symptoms comparable to those produced by substance use disorders
				  such as compulsive gambling.
"Substance use disorder treatment services"
means the coordination of treatment activities for consumers by service
				  provider that includes, but is not limited to, the following:
(A) Screening, diagnostic impression, and assessment.
(B) Treatment planning and revision, as necessary.
(C) Continuing care review to assure continuing stay and
				  discharge criteria are met.
(D) Case management services.
(E) Reports and record keeping of consumer related data.
(F) Consultation that facilitates necessary communication in
				  regard to consumers.
(G) Discharge planning that assists consumers in developing
				  continuing care plans and facilitates transition into post-treatment recovery.
(H) Individual, group, and family therapy.
(I) Rehabilitation services.
(J) Peer recovery support services.
(K) Crisis intervention services.
"Substance-use disorders"
means alcohol or drug
				  dependence or psychoactive substance use disorder as defined by current DSM
				  criteria or by other standardized and widely accepted criteria.
"Substance withdrawal"
means a state of being in
				  which a group of symptoms of variable clustering and degree of severity occur
				  on cessation or reduction of use of a psychoactive substance that has been
				  taken repeatedly, usually for a prolonged period and/or in high doses. The
				  syndrome may be accompanied by signs of physiological disturbance. Onset and
				  course of the withdrawal state are time-limited and are related to the type of
				  substance and the dose being used immediately before abstinence.
"Supportive services"
refers to assistance with
				  the development of problem-solving and decision making skills to maintain or
				  achieve optimal functioning within the community and can include consumer
				  education.
"Therapeutic hour(s)"
means the amount of time
				  in which the consumer is engaged with a service provider identifying,
				  addressing, and/or resolving issues that are related to the consumer's
				  treatment plan.
"Tobacco"
means any nicotine delivery product or
				  device that is not approved by the U.S. Food and Drug Administration (FDA) for
				  the purpose of nicotine dependence treatment, including, but not limited to
				  cigarettes, cigars, snuff, chewing tobacco, electronic cigarettes and vaping
				  devices.
"Trauma informed capability"
means the capacity
				  for a facility and all its programs to recognize and respond accordingly to the
				  presence of the effects of past and current traumatic experiences in the lives
				  of its consumers.
"Treatment"
means the broad range of emergency,
				  inpatient, intermediate and outpatient services and care including diagnostic
				  evaluation, medical, psychiatric, psychological and social service care,
				  vocational rehabilitation, and career counseling. [43A O.S. § 3-403(11)].
"Treatment hours - residential"
means the
				  structured hours in which a consumer is involved in receiving professional
				  services to assist in achieving recovery.
"Treatment session-outpatient"
means each
				  face-to-face contact with a consumer in a therapeutic setting whether
				  individually or in a group.
"Volunteer"
means any person who is not on the
				  program's payroll, but provides services and fulfills a defined role within the
				  program and includes interns and practicum students.
"Wellness"
means the condition of good physical,
				  mental, and emotional health, especially when maintained by an appropriate
				  diet, exercise, and other lifestyle modifications.
"Withdrawal Management"
means the process of
				  eliminating the toxic effects of substances from the body. Withdrawal
				  management methods include social detoxification and medical monitoring or
				  medical management and are intended to avoid withdrawal complications.
Added at 13 Ok Reg 2769,
				  eff 7-1-96; Amended at 14 Ok Reg 1934, eff 5-27-97; Amended at 16 Ok Reg 1523,
				  eff 7-1-99; Amended at 17 Ok Reg 2131, eff 7-1-00; Amended at 19 Ok Reg 2375,
				  eff 7-1-02; Amended at 22 Ok Reg 2109, eff 7-1-05; Amended at 23 Ok Reg 1953,
				  eff 7-1-06; Amended at 24 Ok Reg 2580, eff 7-12-07; Amended at 25 Ok Reg 2532,
				  eff 7-11-08; Amended at 27 Ok Reg 2237, eff
				  7-11-10