Or. Admin. R. 309-019-0184

Current through Register Vol. 63, No. 8, August 1, 2024

Section 309-019-0184 - Partial Hospitalization Substance Use Disorder Services ASAM Level 2.5

Programs shall be certified by the Division in accordance with OAR 309 Division 008 in order to render outpatient substance use disorder treatment and recovery services. A certificate issued to a program shall be effective for a duration not to exceed three years from the date of issue and may be renewed, conditioned, denied, suspended, or revoked by the Division in the manner set forth in OAR 309-008. Certified programs shall meet the standards set forth in these rules and all applicable statutes.

(1) Currently certified providers shall submit complete outpatient substance use disorder treatment and recovery services applications to render each selected ASAM Level(s) of Care and any optional Enhanced ASAM Service Designation(s) no later than October 1, 2023.

(2) Division approved ASAM level(s) of Care and optional Enhanced ASAM Service designation(s), if any, shall be added to the outpatient substance use disorder treatment and recovery services certificate starting January 1, 2024.

(3) Effective April 1, 2024, all outpatient substance use disorder treatment programs must have a valid certificate designating each the following ASAM Level(s) of Care and any optional Enhanced ASAM Service designation(s) that they are certified by the Division to provide.

(4) Each program shall operate within the scope of the service and Level of Care types listed on their certificate. ASAM Level 2.5 services and supports may be rendered within an ASAM Level 3.1 service setting that is owned and operated by the same provider.

(5) In addition to any other requirements described in these rules and applicable statutes, programs certified to render adolescent or adult residential ASAM Level 2.1 services shall, at a minimum, meet and maintain documentation demonstrating ongoing compliance with each of the following standards:

(a) The individual meets ASAM dimensional admission criteria for ASAM Level 2.5 when:

(A) Adult ASAM dimensional admission criteria is met in Dimensions 2, 3 and one of 4, 5, or 6;

(B) Adolescent ASAM dimensional admission criteria is met when:

(i) Stability specifications are met in Dimensions 1 and 2; and

(ii) The severity specifications in at least one of Dimensions 3, 4, 5, or 6.

(C) Diagnostic criteria for a substance use or other addictive disorder, per DSM-5-TR, or the probability of such a diagnosis is determined through collateral information; and

(D) When the ASAM Level of Care placement is not the same as the ASAM Level of Care assessed, the documentation shall include a rationale for this discrepancy.

(b) Program staff include those who are qualified and, when applicable, credentialed according to these rules and working within their scope, and shall include:

(A) A Medical Director or LMP with credentialing, training or experience in addiction medicine or addiction psychiatry. The Medical Director or an LMP addiction specialist is available for complex case consultation; and

(B) Adolescent programs shall have program staff knowledgeable about adolescent development and experienced in engaging and working with adolescent.

(c) Arrange transfer of individuals to all other ASAM Levels of Care as indicated; and

(d) Provide instruction on accessing emergency services by telephone 24 hours per day, 7 days per week.

(6) Programs shall provide an array of weekly services and supports that are designed to meet the needs of the individual and their clinical severity through the number of planned hours per week and the type of planned services and supports. Programs shall ensure the following minimum standards:

(a) 20 or more hours of weekly contact for adults;

(b) 20 or more hours of weekly contact hours for adolescents;

(c) ASAM Level 2.5 program includes an array of structured service and support treatment contacts per week, offered in a planned format, that are adapted to the individual's developmental stage and comprehension level. Services and supports offered by the program shall include:

(A) Individual, Group and Family therapy;

(B) Psychoeducation and Motivational strategies;

(C) Skill-building; and

(D) Case management.

(d) Services either offered by the program or coordinated through consultation and referral, which shall include:

(A) Offer or coordinate access to urinalysis testing and other toxicology and laboratory testing services;

(B) Medical consultation and examination, laboratory and toxicology services;

(C) Occupational therapy;

(D) Recreational therapy;

(E) Peer delivered services; and

(F) Psychiatric services that are available within a timeframe reflective of the urgency of the symptoms.

(7) ASAM Level 2.5 Co-occurring Capable Programs provide an additional and optional version of the services provided in Partial Hospitalization Substance Use Disorder Services ASAM Level of Care 2.5. Programs certified to render Partial Hospitalization Substance Use Disorder Services ASAM Level 2.5 may choose to also be certified to render ASAM Level 2.5 Co-occurring Capable services. All certified service types are listed on one certificate for the program.

(8) ASAM Level 2.5 Co-occurring Capable services. Programs certified to render Co-occurring Capable ASAM Level 2.5 services shall render ASAM Level of Care 2.5 services as described in this rule and also, at a minimum:

(a) Ensure individuals admitted have documented co-occurring mental disorders who are able to tolerate and benefit from a co-occurring capable program, or experience troublesome but subsyndromal symptomology;

(b) Be certified to render services in accordance with OAR 309-019-0145 Intensive Co-occurring Disorders Services;

(c) Include program staff working within their scope to document the mental health conditions, the relationship between the mental and substance use disorders, and the individual's current level of functioning;

(d) Offer intensive case management; and

(e) Offer medication management and psychotherapy either by the program or through consultation and referral.

(9) ASAM Level 2.5 Co-occurring Enhanced Programs provide an additional and optional version of the services provided in Partial Hospitalization Substance Use Disorder Services ASAM Level of Care 2.5. Programs certified to render Partial Hospitalization Substance Use Disorder Services ASAM Level 2.5 may choose to also be certified to render ASAM Level 2.5 Co-occurring Enhanced services. All certified service types are listed on one certificate for the program.

(10) ASAM Level 2.5 Co-occurring Enhanced services. Programs certified to render Co-occurring Enhanced Programs ASAM Level 2.5 shall render ASAM Level of Care 2.5 services as described in this rule and also, at a minimum:

(a) Render services as described by ASAM Level 2.5 Co-occurring Capable Program rules;

(b) Have the capacity to effectively treat individuals who have complex co-occurring conditions. These programs shall provide:

(A) Psychiatric services;

(B) Medication management;

(C) A review of the recent psychiatric history;

(D) A mental status examination; and

(E) A comprehensive psychiatric history examination and assessment performed within a timeframe determined by the individual's psychiatric condition.

Or. Admin. R. 309-019-0184

BHS 11-2023, adopt filed 04/07/2023, effective 4/7/2023

Statutory/Other Authority: ORS 161.390, 413.042, 430.256 & 430.640

Statutes/Other Implemented: ORS 161.390-161.400, 428.205-428.270, 430.010, 430.205-430.210, 430.254-430.640, 430.850-430.955 & 743A.168