Or. Admin. R. 309-019-0183

Current through Register Vol. 63, No. 6, June 1, 2024

Section 309-019-0183 - Intensive Outpatient Substance Use Disorder Services ASAM Level 2.1

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(s) and Level(s) of Care listed on their certificate. ASAM Level 2.1 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 2.1 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 in Dimensions 1 and 2, and 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:

(A) A Medical Director or LMP with credentialing, training or experience in addiction medicine be available for complex case consultation; and

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

(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) 9 to 19 hours of weekly treatment contact for adults;

(b) 6 to 19 hours of weekly treatment contact for adolescents;

(c) Services rendered by the program:

(A) Individual, group and family therapy; and

(B) Psychoeducation and motivational strategies.

(d) Services rendered by the program or coordinated through consultation and referral:

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

(B) Psychiatric and medical services;

(C) Medication management;

(D) Occupational or recreational;

(E) Skill-building;

(F) Case management; and

(G) Peer delivered services.

(e) If an adult individual no longer requires 9 or more hours of structured programming per week or adolescent no longer requires 6 or more hours of structured programming per week and is not yet stable enough to transition to ASAM Level 1, the program may lessen the minimum required hours per week for a maximum of two weeks while focusing on stabilization and transition to Level 1.

(7) ASAM Enhanced Service designation(s) are service types that the program may choose to apply to render to either adults or adolescents when it corresponds to an ASAM Level of Care that is certified by the Division. Programs certified to render Outpatient Substance Use Disorder Services ASAM Level 2.1 may choose to also be certified to render any of the following Enhanced Service types:

(a) ASAM Level 2.1 Co-occurring Capable services. Programs certified to render Co-occurring Capable ASAM Level 2.1 services shall render ASAM Level of Care 2.1 services as described in this rule and also, at a minimum:

(A) Ensure individuals admitted have documented co-occurring mental disorders and 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) Be appropriate for individuals with co-occurring disorders when the services are integrated into the program; and

(D) Arrange medical and psychiatric consultation and medication management.

(b) ASAM Level 2.1 Co-occurring Enhanced services. Programs certified to render Co-occurring Enhanced ASAM Level 2.1 services shall render ASAM Level of Care 2.1 services as described in this rule and also, at a minimum:

(A) Render services as described by ASAM Level of Care 2.1 Co-occurring Capable program rules.

(B) Have access to consult with an LMP; and

(C) Render a comprehensive assessment with history and examination by an LMP within a reasonable timeframe given the current risk assessment and immediate needs profile.

Or. Admin. R. 309-019-0183

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