Oklahoma Administrative Code › Title 450 - Department of Mental Health and Substance Abuse Services › Chapter 24 - Standards and Criteria for Comprehensive Community Addiction Recovery Centers › Subchapter 1 - General Provisions › Section 450:24-1-2 - 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:
"Ambulatory Withdrawal Management without extended
				  on-site monitoring"
means withdrawal management within an outpatient
				  setting, directed by a physician and has attendant medical personnel including
				  nurses for intoxicated consumers, and consumers withdrawing from alcohol and
				  other drugs, presenting with no apparent medical or neurological symptoms as a
				  result of their use of substances require ambulatory withdrawal management as
				  determined by an examining physician. This corresponds to ASAM Service Level:
				  Level 1-WM Ambulatory withdrawal management without extended on-site
				  monitoring.
"ASAM"
means the American Society of Addiction
				  Medicine.
"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 2.1"
means Intensive Outpatient
				  Services for adolescents and adults. This level of care typically consists of
				  nine (9) or more hours of service a week for adults or six (6) or more hours of
				  service a week for adolescents. Services are delivered as organized outpatient
				  services during the day, before or after work or school, in the evening, and/or
				  on weekends.
"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. 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.
"Case management services"
means planned
				  referral, linkage, monitoring and 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.
"Clinical privileging"
means an organized method
				  for treatment facilities to authorize an individual permission to provide
				  specific care and treatment services to consumers within well-defined limits,
				  based on the evaluation of the individual's license, education, training,
				  experience, competence, judgment, and other credentials.
"Comprehensive Community Addiction Recovery
				  Center"
or
"CCARC"
means a facility offering a
				  comprehensive array of community-based substance use disorder treatment
				  services, including but not limited to, outpatient services, Intensive
				  outpatient services, ambulatory withdrawal management services, emergency care,
				  consultation and education; and, certain services at the option of the center,
				  including but not limited to, prescreening, rehabilitative services, aftercare,
				  training programs, research and evaluation.
"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 CCARC's
				  who are certified by the Department of Mental Health and Substance Abuse
				  Services or facilities operated by the Department of Mental Health and
				  Substance Abuse Services.
"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"
includes 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
"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 consumers with
				  co-occurring disorders.
"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.
"Crisis stabilization"
means emergency,
				  psychiatric, and substance use disorder treatment services for the resolution
				  of crisis situations and may include placement of an individual in a protective
				  environment, basic supportive care, and medical assessment, and, if needed,
				  referral to an ODMHSAS certified facility having nursing and medical support
				  available.
"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.
"Emergency examination"
means the examination of
				  a person who appears to be a mentally ill person, an alcohol-dependent person,
				  or drug-dependent person and a person requiring treatment, and whose condition
				  is such that it appears that emergency detention may be warranted by a licensed
				  mental health professional to determine if emergency detention of the person is
				  warranted.
"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.
"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
(F) Discharge planning.
"Independent living skills, assistance in development
				  of"
means all activities directed at assisting individuals in the
				  development of skills necessary to live and function within the community,
				  e.g., cooking, budgeting, meal planning, housecleaning, problem-solving,
				  communication and vocational skills.
"Intensive outpatient services"
means an
				  organized, non-residential outpatient treatment services with scheduled
				  sessions that provide a range of nine (9) to fifteen (15) treatment hours per
				  week for adults or six (6) to twelve (12) treatment hours per week for
				  children. Intensive outpatient services may offer evening outpatient services
				  several nights per week or be incorporated into an inpatient or residential
				  treatment program in which the consumer participates in daytime treatment
				  services but goes home at night. This corresponds to ASAM patient Placement
				  Criteria Treatment Level: Level II.1 Intensive outpatient.
"Levels of care"
means the different options for
				  treatment as described in the current edition of the ASAM criteria that vary
				  according to the services offered. Each treatment option is a level of care.
"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 mental health professional"
or
"LMHP"
as defined in Title 43A § 1-103(11).
"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.
"Linkage"
refers to the communication and
				  coordination with other service providers to assure timely appropriate
				  referrals between the CCARC and other providers.
"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.
"On-premise meal service"
means meals that are
				  prepared and cooked in a commercial kitchen located on the facility premises.
"Outpatient services"
means an organized,
				  non-residential treatment service in regularly scheduled session intended for
				  individuals not requiring a more intensive level of care or those who require
				  continuing services following more intensive treatment regimens. This
				  corresponds to ASAM criteria Treatment Level I, Outpatient Treatment. Services
				  can address early intervention needs and increase in frequency and intensity up
				  to 9 treatment hours per week.
"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.
"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.
"Psychotherapy"
or
"Therapy"
means a
				  goal directed process using generally accepted clinical approaches provided
				  face-to-face by a LBHP or Licensure Candidate with consumers in individual,
				  group or family settings to promote positive emotional or behavioral change.
"Rehabilitation Services"
means face-to-face
				  individual or group services provided by qualified staff to develop skill
				  necessary to perform activities of daily living and successful integration into
				  community life.
"Screening"
means the process to determine
				  whether the person seeking assistance needs further comprehensive assessment.
"Service area"
means a geographic area
				  established by the Department of Mental Health and Substance Abuse Services for
				  support of mental health and substance use disorder treatment services [43A
				  O.S.§3-302(1)].
"Service plan"
or
"Treatment plan"
means the document used during the process by which a LBHP or 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.
"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.
"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.
"Urgent Recovery Clinic"
means a program of
				  non-hospital emergency services for mental health and substance use crisis
				  response including, but not limited to, observation, evaluation, emergency
				  treatment, and referral, when necessary to a higher level of care. This service
				  is limited to CMHCs and Comprehensive Community Addiction Recovery Centers
				  (CCARCs) certified by ODMHSAS or facilities operated by ODMHSAS.
"Vocational assessment services"
means a process
				  utilized to determine the individual's functional work-related abilities and
				  vocational preferences for the purpose of the identification of the skills and
				  environmental supports needed by the individual in order to function more
				  independently in an employment setting, and to determine the nature and
				  intensity of services which may be necessary to obtain and retain employment.
"Vocational placement services"
means a process
				  of developing or creating an appropriate employment situation matched to the
				  functional abilities and choices of the individual for the purpose of
				  vocational placement. Services may include, but are not limited to, the
				  identification of employment positions, conducting job analysis, matching
				  individuals to specific jobs, and the provision of advocacy with potential
				  employers based on the choice of the individual served.
"Vocational preparation services"
means services
				  that focus on development of general work behavior for the purpose of
				  vocational preparation such as the utilization of individual or group
				  work-related activities to assist individuals in understanding the meaning,
				  value and demands of work; to modify or develop positive work attitudes,
				  personal characteristics and work behaviors; to develop functional capacities;
				  and to obtain optimum levels of vocational development.
"Wellness"
means the condition of good physical,
				  mental and emotional health, especially when maintained by an appropriate diet,
				  exercise, and other lifestyle
Added at 28 Ok Reg 2025,
				  eff 10-1-11