OAR 309-019-0182: Outpatient Substance Use Disorder Services ASAM Level 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 and ASAM Level of Care types listed on their certificate. (5) In addition to any other requirements described in these rules and applicable statutes, programs certified to render adolescent or adult residential ASAM Level 1 services shall, at a minimum, meet and maintain documentation demonstrating ongoing compliance with each of the following standards: (a) ASAM Level of Care 1 programs shall ensure the individual meets ASAM dimensional admission criteria: (A) ASAM dimensional admission criteria in each of the Dimensions; (B) Diagnostic criteria for a substance use, substance-induced or other addictive disorder, per DSM-5-TR, or the probability of such a diagnosis is determined through collateral information; and (C) 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 shall include: (A) Medical Director or LMP who shall 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 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) Less than 9 hours of weekly treatment contact for adults; (b) Less than 6 hours of weekly treatment contact for adolescent; (c) 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; (d) Address lifestyle, thinking, belief, and behavioral patterns that are identified as barriers to the improvement of functioning; (e) Offer education, monitoring and disease management; (f) Offer or coordinate access to medical, psychiatric, including medication management, psychological services in a timeframe that matches the severity of the need; (g) Offer or coordinate access to urinalysis testing and other toxicology and laboratory testing services; and (h) Have direct affiliation or referral relationship with higher levels of care and medication management. (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 1 may choose to also be certified to render any of the following Enhanced Service types: (a) ASAM Level 1 Co-occurring Capable services. Programs certified to render Co-occurring Capable ASAM Level 1 services shall render ASAM Level of Care 1 services as described in this rule and also, at a minimum : (A) Individuals admitted have co-occurring mental disorders that meet the stability criteria for a co-occurring capable program, or experience troublesome but subsyndromal symptomology; and (B) The mental health services are either rendered by community partners and closely coordinated or rendered by program staff who are qualified, credentialed and working within their scope. (b) ASAM Level 1 Co-occurring Enhanced services. Programs certified to render Co-occurring Enhanced ASAM Level 1 services shall render ASAM Level of Care 1 services as described in this rule and also, at a minimum: (A) Be certified to render services in accordance with OAR 309-019-0145 Intensive Co-occurring Disorders Services; (B) Render services as described in ASAM Level 2.5 Co-occurring Capable Program rules; (C) Include individuals whose co-occurring disorders are documented as either: (i) Moderate severity and needing ongoing monitoring; or (ii) High severity and chronic but have stabilized to the extent where these services are potentially beneficial. (D) Offer the following services: (i) Monitor and manage psychotropic medication; (ii) Mental health treatment; and (iii) Services that address the interaction between mental health and substance use disorders.