Oregon Administrative Rules › Chapter 415 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: ADDICTION SERVICES › Division 50 - STANDARDS FOR ALCOHOL DETOXIFICATION CENTERS › Section 415-050-0105 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions apply to 415-050-0100  through
				415-050-0195.
(1) "Abuse of an Adult"
			 means the circumstances defined in ORS
			 430.735 and OAR Chapter 407,
			 Division 45 for abuse of an adult with mental illness or who is receiving
			 residential substance use disorder treatment or withdrawal management
			 services.
(2) "Admission" means the
			 act or process of enrollment into services regulated by these rules.
(3) "ASAM" means The American Society of
			 Addiction Medicine, Third Edition (ASAM).
(4) "The ASAM Criteria " means the criteria
			 in the Third Edition of The American Society of Addiction Medicine (ASAM)
			 Criteria for the assessment, level of care placement and treatment of
			 addictive, substance-related, and co-occurring conditions. The ASAM Criteria is
			 a clinical guide to developing patient-centered service plans and making
			 objective decisions about admission, continuing care, and transfer or discharge
			 for patients. The ASAM Criteria is incorporated by reference in these
			 rules.
(5) "ASAM Dimensional
			 Admission Criteria" means the specifications described in the ASAM Criteria for
			 determining that a patient is appropriately admitted to a program based on six
			 ASAM assessment dimensions. The criteria, dimensions and number of dimensions
			 indicated differs per level of care and is described within The ASAM Criteria,
			 Third Edition.
(6) "ASAM Level of
			 Care" means one of several discrete intensities of services and supports, as
			 described within The ASAM Criteria, Third Edition, within a substance use
			 disorders program that are delivered in a structured, programmatic fashion, by
			 a certified outpatient or licensed residential provider.
(7) "Adolescent" means an individual from 12
			 through 21 years of age or those individuals who are determined to be
			 developmentally appropriate for such services.
(8) "Adolescent ASAM Level 3.7-WM Medically
			 Monitored Withdrawal Management (ASAM Level 3.5-WM)" means a medical, inpatient
			 setting as described in The ASAM Criteria, Third Edition that provides 24-hour
			 medically monitored intensive inpatient withdrawal management services for
			 adolescent patients assessed at ASAM Level 3.7-WM. Adolescent patients meeting
			 criteria to be admitted to this level of care experience moderate to severe
			 withdrawal syndrome and therefore require 24-hour nursing care and LMP visits
			 as needed.
(9) "Adult" means an
			 individual 18 years of age or older or an emancipated minor. An individual with
			 Medicaid eligibility, who is in need of services specific to children,
			 adolescents, or young adults in transition, shall be considered a child until
			 age 21 for the purposes of these rules. Adults who are between the ages of 18
			 and 21, who are considered children for purposes of these rules, shall have all
			 rights afforded to adults as specified in these rules.
(10) "Adult ASAM Level 3.2-WM Clinically
			 Managed Residential Withdrawal Management (ASAM Level 3.2-WM)" means a setting
			 as described in The ASAM Criteria, Third Edition in which patients experience
			 moderate withdrawal symptoms and need 24-hour support to complete withdrawal
			 management and increase the likelihood of continuing treatment or recovery.
			 Clinically managed services are directed by non-physician addiction specialists
			 rather than medical and nursing personnel. This level emphasizes peer and
			 social support and is for patients whose intoxication is sufficient to warrant
			 24-hour support or whose withdrawal symptoms are sufficiently severe to require
			 primary medical nursing care services.
(11) "Adult ASAM Level 3.7-WM Medically
			 Monitored Withdrawal Management (ASAM Level 3.7-WM)" means a medical, inpatient
			 setting as described in The ASAM Criteria, Third Edition that provides 24-hour
			 medically monitored intensive inpatient treatment services for patients
			 assessed at ASAM Level 3.7-WM. Patients who meet criteria for admission to this
			 level of care experience severe withdrawal syndrome and need 24-hour nursing
			 care and LMP visits as needed.
(12)
			 "Assessment" means the process of obtaining sufficient information through one
			 or more face-to-face interview(s) to determine a diagnosis and to plan
			 individualized services and supports.
(13) "Oregon Health Authority (Authority) or
			 (OHA)" means the Oregon Health Authority of the state of Oregon.
(14) "Community Mental Health Program (CMHP)"
			 an entity that is responsible for planning and delivery of safety net services
			 for persons with mental or emotional disturbances, drug abuse problems, and
			 alcoholism and alcohol abuse in a specific geographic area of the state under a
			 contract with the Division or a local mental health authority and pursuant to
			 OAR Chapter 309, Division 014.
(15)
			 "Care Coordination" means a process-oriented activity to facilitate ongoing
			 communication and collaboration to meet multiple needs. Care coordination
			 includes facilitating communication between the family, natural supports,
			 community resources, and involved providers and agencies; organizing,
			 facilitating, and participating in team meetings; and providing for continuity
			 of care by creating linkages to and managing transitions between levels of care
			 or transitions for young adults in transition to adult services.
(16) "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.
(17) "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.
(18) "Collaborative
			 Educational Agreement" means an individualized written arrangement between an
			 accredited college or university and a Division-certified provider pertaining
			 to a student's internship or field placement experience.
(19) "Community Health Worker (CHW)" means
			 personnel who meets qualification criteria adopted by the authority under ORS
			 414.665 and who is certified
			 pursuant to the requirements in OAR 410-180-0310.
(20) "Consistent with ASAM Criteria" means
			 containing information that demonstrates use of and adherence to the
			 description of components contained within The ASAM Criteria, Third
			 Edition.
(21) "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 Oregon Health 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.
(22)
			 "County" means the board of county commissioners or its
			 representatives.
(23) "Criminal
			 Records Check" means documenting the criminal background check results for all
			 employees, contracted staff and interns that render medical or behavioral
			 health services and supports or have access to protected health information
			 such as service records or billing information.
(24) "Critical Incident" means any
			 unanticipated event that threatens health, safety or the structural integrity
			 of the facility and is documented in an Incident Report. Critical Incidents are
			 reported to the Division.
(25)
			 "Cultural Competence" means the process by which people and systems respond
			 respectfully and effectively to people of all cultures, languages, classes,
			 races, ethnic backgrounds, disabilities, religions, genders, sexual
			 orientations, and other diversity factors in a manner that recognizes, affirms,
			 and values the worth of patients, families, and communities and protects and
			 preserves the dignity of each.
(26)
			 "Culturally Responsive" means services that are respectful of and relevant to
			 the beliefs, practices, culture and linguistic needs of diverse consumer/client
			 populations and communities whose members identify as having particular
			 cultural or linguistic affiliations. Cultural responsiveness describes the
			 capacity to respond to the issues of diverse communities. It thus requires
			 knowledge and capacity at different levels of intervention: systemic,
			 organizational, professional, and patient.
(27) "Diagnosis" means the principal
			 substance use disorder diagnosis consistent with 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 is the medically necessary reason for
			 services.
(28) "Division" means the
			 Health Systems Division of the Oregon Health Authority, or its
			 designee.
(29) "Diagnostic and
			 Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5-TR)" means the
			 textbook used to diagnose and classify mental disorders that is published by
			 the American Psychiatric Association.
(30) "Episode of Care" means the period of
			 care that begins at admission and ends at discharge.
(31) "Grievance" means a formal complaint
			 submitted to a provider verbally, or in writing, by a patient, or the patient's
			 chosen representative.
(32) "Face
			 to Face" means a personal interaction where both words can be heard, and facial
			 expressions can be seen in person or through telehealth services where there is
			 a live streaming audio and video.
(33) "Health Insurance Portability and
			 Accountability" (HIPAA) means the federal Health Insurance Portability and
			 Accountability Act of 1996 and the regulations published in Title 45, parts 160
			 and 164, of the Code of Federal Regulations (CFR).
(34) "Incident" means any event involving an
			 individual or child of an individual receiving services occurring on the
			 premises of the program or involving program staff or during a stabilization
			 plan or care coordination plan activity and including but not limited to
			 injury, major illness, accident, act of physical aggression, medication error,
			 suspected abuse or neglect, or any other unusual or critical event that
			 presents a risk to health and safety. Critical incidents are reported to the
			 Division.
(35) "Incident Report"
			 means a written description of any incident.
(36) "Informed Consent for Services" means
			 that the service options, risks and benefits have been explained to the patient
			 and guardian, if applicable, in a manner and language that they comprehend, and
			 the patient and guardian, if applicable, have consented to the services or
			 prior to or on the first date of service.
(37) "Institutions of Mental Disease (IMD)"
			 means a hospital, nursing facility, or other institution of more than 16 beds
			 that is primarily engaged in providing diagnosis, treatment, or care of
			 individuals with mental diseases, which includes substance use disorders
			 (SUDs).
(38) "Level of Care" means
			 the type, frequency, and duration of medically necessary services provided from
			 the most integrated setting to the most restrictive and intensive inpatient
			 setting.
(39) "Licensed Health Care
			 Professional" means a practitioner of the healing arts acting within the scope
			 of their practice under State law who is licensed by a recognized governing
			 board in Oregon.
(40) "Licensed
			 Medical Practitioner (LMP)" means an individual who meets the following minimum
			 qualifications as documented by the Local Mental Health Authority (LMHA) or
			 designee:
(a) Physician licensed to practice
			 in the State of Oregon; or
(b)
			 Nurse practitioner licensed to practice in the State of Oregon; or
(c) Physician's Assistant licensed to
			 practice in the State of Oregon; and
(d) Whose training, experience and competence
			 demonstrate the ability to conduct a medical exam, a mental health assessment
			 and provide medication management.