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Oregon Bulletin

March 1, 2012

Oregon Health Authority, Addictions and Mental Health Division: Addiction Services, Chapter 415

Rule Caption: Substance Abuse and Problem Gambling Prevention Programs.

Adm. Order No.: ADS 1-2012

Filed with Sec. of State: 2-9-2012

Certified to be Effective: 2-9-12

Notice Publication Date: 1-1-2012

Rules Adopted: 415-056-0030, 415-056-0035, 415-056-0040, 415-056-0045, 415-056-0050

Rules Repealed: 415-056-0000, 415-056-0005, 415-056-0010, 415-056-0015, 415-056-0020, 415-056-0025

Subject: These rules prescribe standards and procedures for substance abuse and problem gambling prevention providers approved by the Addictions and Mental Health Division (AMH), and provide that a full continuum of services be available to Oregonians either directly or through written agreements or contracts.

Rules Coordinator: Nola Russell—(503) 945-7652

415-056-0030

Purpose and Scope

These rules prescribe standards and procedures for substance abuse and problem gambling prevention providers approved by the Addictions and Mental Health Division (AMH). These rules establish standards for community substance abuse and problem gambling prevention and provide that a full continuum of services be available to Oregonians either directly or through written agreements or contracts.

Stat. Auth.: ORS 409.410 & 413.042
Stats. Implemented: ORS 430.240 - 430.415
Hist.: ADS 1-2012, f. & cert. ef. 2-9-12

415-056-0035

Definitions

(1) “Approval” means the Letter of Approval issued by the Division to indicate that the substance abuse prevention and/or problem gambling program has been found in compliance with all relevant federal and Oregon laws and Oregon Administrative Rules (OAR).

(2) “Community Mental Health Program (CMHP)” means an entity that is responsible for planning and delivery of services for individuals with substance use disorders or a mental health diagnosis, operated in a specific geographic area of the state under an intergovernmental agreement or direct contract with the Division.

(3) “Coordinator” means the designated county or tribal program coordinator hired to oversee prevention services.

(4) “Cultural Competence” means the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, disabilities, religions, genders, sexual orientation and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families and communities and protects and preserves the dignity of each.

(5) “Deputy Director” means the Deputy Director of AMH.

(6) “Division” means the AMH Division of the Oregon Health Authority.

(7) “Evidenced-Based Practices” (EBP) means practices for which there is consistent scientific evidence that produce positive outcomes. An EBP must meet the criteria set forth by the Division.

(8) “Gender-Specific Services” means services which comprehensively address the needs of a gender group and foster positive gender identity development.

(9) “Letter of Approval” means the “Approval” as defined in 415-056-0035.

(10) “Institute of Medicine Model” means the framework that defines the target groups and activities addressed by various prevention efforts and includes the following:

(a) Promotion: Strategies that typically address the entire population. Strategies are aimed to enhance individuals’ ability to achieve developmentally appropriate tasks (competence) and a positive sense of self-esteem, mastery, well-being and social inclusion, and strengthen their ability to cope with adversity;

(b) Universal Prevention: Universal strategies address the entire population with messages and programs aimed at preventing or delaying the substance abuse and/or problem gambling.

(c) Selective Prevention: Selective prevention strategies target subsets of the total population that are deemed to be at-risk for substance abuse or problem gambling by virtue of the membership in a particular population segment; and

(d) Indicated Prevention: Indicated prevention strategies are designed to prevent the onset of substance abuse or problem gambling in individuals who do not meet criteria for addiction but who are showing early danger signs.

(11) “Local Alcohol and Drug Planning Committee” (LADPC), means a committee appointed or designated by a board of county commissioners. The committee identifies needs and establishes priorities for substance abuse prevention, treatment and recovery services in the county. Members of the committee must be representative of the geographic area and include a number of minority members to reasonably reflect the proportion of need for minority services in the community.

(12) “Minority” means a participant whose cultural, ethnic or racial characteristics constitute a distinct demographic population including but not limited to members of differing cultures, languages, classes, races, ethnic backgrounds, disabilities, religions, genders or sexual orientations.

(13) “Minority Program” means a program that is designed to meet the unique prevention needs of a minority group and that provides services to individuals belonging to a minority population as defined in these rules.

(14) “Participant” means an individual who receives services under these rules.

(15) “Prevention Provider” means a governmental entity, an organization or federally recognized tribe that undertakes to establish, operate or contract for prevention services.

(16) “Prevention Service” means an integrated combination of strategies designed to prevent substance abuse and/or problem gambling and associated effects regardless of the age of participants.

(17) “Strategy” means activities targeted to a specific population or the larger community that are designed to be implemented before the onset of problems as a means to prevent substance abuse and problem gambling or detrimental effects from occurring. The Center for Substance Abuse Prevention’s strategies are defined below:

(a) Information Dissemination: This strategy provides knowledge and increases awareness of the nature and extent of alcohol and other drug use, abuse and addiction, as well as their effects on individuals, families and communities. It also provides knowledge and increases awareness of available prevention and treatment programs and services. It is characterized by one-way communication from the source to the audience with limited contact between the two;

(b) Education: This strategy builds skills through structured learning processes. Critical life and social skills include decision making, peer resistance, coping with stress, problem solving, interpersonal communication and systematic and judgmental abilities. There is more interaction between facilitators and participants than in the information dissemination strategy;

(c) Alternatives: This strategy provides participation in activities that exclude alcohol and other drugs and gambling. The purpose is to identify and offer healthy activities and to discourage the use of gambling, alcohol and drugs through these activities;

(d) Problem Identification and Referral: This strategy aims at identification of individuals who have indulged in illegal or age-inappropriate use of tobacco or alcohol or gambling and those individuals who have indulged in the first use of illicit drugs in order to assess if the individual’s behavior can be reversed through education;

(e) Community Based Processes: This strategy provides ongoing networking activities and technical assistance to community groups or agencies. It encompasses neighborhood-based or industry led, grassroots, empowerment models using action planning and collaborative systems planning; and

(f) Environmental: This strategy establishes or changes written and unwritten community standards, codes and attitudes, thereby influencing alcohol and other drug use and gambling by the general population.

(18) “Tribal Authority” means an individual or group identified by the tribe that approves the prevention plan. Examples include a Tribal Council, Health Director or Prevention Supervisor.

Stat. Auth.: ORS 409.410 & 413.042
Stats. Implemented: ORS 430.240 - 430.415
Hist.: ADS 1-2012, f. & cert. ef. 2-9-12

415-056-0040

Administrative Requirements

(1) A prevention provider that contracts directly or indirectly with the Division must comply with all related administrative rules.

(2) Subcontracted agencies must be administered by staff in accordance with standards set forth in OAR 309-014-0000 through 0025 and 309-014-0030(3) through 0040.

(3) A fee schedule may be established that approximates actual cost of service delivery. The fee schedule must assess the cost to the participant for the service in accordance with the participant’s ability to pay.

(4) A prevention provider must establish comprehensive written policies and procedures which describe program operations and compliance with these rules, and shall at minimum address the following:

(a) A mission, vision and values statement;

(b) An organizational management chart;

(c) The prevention framework that guides the program’s prevention efforts;

(d) An anti-discrimination policy;

(e) A cultural competency plan;

(f) Gender specific services;

(g) The use of substances by program participants and staff during program activities;

(h) Gambling by program participants and staff during program activities;

(i) The protection and safety of service recipients and

(j) A process for referring individuals who are not appropriate for prevention services to more applicable resources such as emergency and crisis services, detoxification, mental health treatment and other services within the continuum of care.

(5) A request for certification will be considered by the Division after the CMHP or tribal authority, and the LADPC or other applicable committee has reviewed and commented on the request.

(6) Prevention providers must provide services that incorporate evidence based practices as defined in OAR 415-056-0035.

(7) Printed materials utilized by the program must be:

(a) Written with consideration to the demographic make-up of the program and in cultural competent language;

(b) In the participant’s native language; and

(c) Reflective of current substance abuse and gambling prevention research and practice.

(8) The provider must report to the Division on approved standardized forms. All reporting must be done in accordance with Federal Confidentiality Regulations (42 CFR Part 2).

(9) The provider must ensure the privacy and safety of participants where appropriate and necessary.

(10) Providers must document coordination of activities with related community partners.

Stat. Auth.: ORS 409.410 & 413.042
Stats. Implemented: ORS 430.240 - 430.415
Hist.: ADS 1-2012, f. & cert. ef. 2-9-12

415-056-0045

Staff Requirements

(1) The substance abuse and/or problem gambling prevention program must be administered by staff in accordance with standards set forth in these rules.

(2) The Coordinator is qualified by virtue of knowledge, training, experience and skills. The Coordinator must be certified by the Addiction Counselor Certification Board of Oregon (ACCBO) as a Certified Prevention Specialist (CPS), or must acquire certification within two years from the date of hire.

(3) The Coordinator shall be employed greater than .50 FTE to carry out their responsibilities.

(4) Roles and authorities of the Coordinator include:

(a) Development, monitoring and oversight of the Prevention Implementation Plan, which shall be in compliance with the requirements set forth by the Division.

(b) Implementation of the defined strategies;

(c) Management of the program staff;

(d) Administration of funds;

(e) Accountability for the oversight and quality of prevention services; and

(f) Supervision of other staff related to their skill level with the goal of achieving the objectives of the prevention program and assisting staff to increase their knowledge, skills and abilities.

(5) Program staff providing more than .5 FTE hours of direct prevention services must:

(a) Have a CPS certification, or must acquire the certification within two years of hire;

(b) Have a workforce development plan utilized to assure compliance with these rules and to ensure each staff has opportunities to advance their prevention knowledge and skills; and

(c) Be culturally competent to serve the identified populations. Agencies who contract for the delivery of direct prevention services must assure that the contractors meet the requirements for prevention staff described in these rules.

(6) The number and responsibilities of the prevention staff must be sufficient to provide the services required under these rules, for the number of participants the program intends to serve.

Stat. Auth.: ORS 409.410 & 413.042
Stats. Implemented: ORS 430.240 - 430.415
Hist.: ADS 1-2012, f. & cert. ef. 2-9-12

415-056-0050

Variances

Requirements and standards for requesting and granting variances or exceptions are found in OAR 415-012-0090.

Stat. Auth.: ORS 409.410 & 413.042
Stats. Implemented: ORS 430.240 - 430.415
Hist.: ADS 1-2012, f. & cert. ef. 2-9-12


 

Rule Caption: Health Professionals’ Services Program.

Adm. Order No.: ADS 2-2012

Filed with Sec. of State: 2-9-2012

Certified to be Effective: 2-9-12

Notice Publication Date: 11-1-2011

Rules Amended: 415-065-0010, 415-065-0015, 415-065-0025, 415-065-0030, 415-065-0035, 415-065-0040, 415-065-0045, 415-065-0050, 415-065-0055, 415-065-0060, 415-065-0065

Subject: This rule activity changes the definition of “vendor” to “contractor” and clarifies several existing statements and requirements.

Rules Coordinator: Nola Russell—(503) 945-7652

415-065-0010

Definitions

The following terms mean:

(1) “Admitted to the hospital for mental illness” for purposes of ORS 676.190 means admitted to the hospital for treatment of a mental health disorder that gives rise to concerns about the licensee’s ability or willingness to participate in the program. Admission for evaluation or diagnosis does not constitute being admitted to the hospital for mental illness.

(2) “Assessment or evaluation” means the process an independent third-party evaluator uses to diagnose the licensee and to recommend treatment options for the licensee.

(3) “Authority” means the Oregon Health Authority.

(4) “Board” means a health professional regulatory board as defined in ORS 676.160 or the Oregon Health Licensing Agency for a board, council or program listed in 676.606.

(5) “Business day” means Monday through Friday, 8:00 a.m. to 5:00 p.m. Pacific Time, except legal holidays as defined in ORS 187.010 or 187.020.

(6) “Comply Continuously” means to have been:

(a) Enrolled in the program for at least two uninterrupted years without any reports of substantial noncompliance involving significant violations of the monitoring agreement and

(b) Deemed by the contractor if self-referred, or by the licensee’s board if board referred, to have otherwise successfully complied with all terms of the monitoring agreement.

(7) “Contractor” means the entity that has contracted with the Division to conduct the program.

(8) “Diagnosis” means the principal mental health or substance use diagnosis listed in the DSM. The diagnosis is determined through the assessment and any examinations, tests or consultations suggested by the assessment and is the medically appropriate reason for services.

(9) “Division” means the Oregon Health Authority, Addictions and Mental Health Division.

(10) “DSM” means the Diagnostic and Statistical Manual of Mental Disorders-IV-R, published by the American Psychiatric Association.

(11) “Family” means any natural, formal, or informal support persons identified as important by the licensee.

(12) “Federal regulations” means:

(a) As used in ORS 676.190(1)(f)(D), a “positive toxicology test result as determined by federal regulations pertaining to drug testing” means test results meet or exceed the cutoff concentrations shown in 49 CFR ? 40.87 (2009) for the substances listed there.

(b) As used in ORS 676.190(4)(i), requiring a “licensee to submit to random drug or alcohol testing in accordance with federal regulations” means licensees are selected for random testing by a scientifically valid method, such as a random number table or a computer-based random number generator that is matched with licensees’ unique identification numbers or other comparable identifying numbers. Under the selection process used, each covered licensee shall have an equal chance of being tested each time selections are made, as described in 49 CFR ? 199.105(c)(5)(2009). Random drug tests must be unannounced and the dates for administering random tests must be spread reasonably throughout the calendar year, as described in 49 CFR ? 199.105(c)(7)(2009).

(13) “Fitness to practice evaluation” means the process a qualified, independent third-party evaluator uses to determine if the licensee can safely perform the essential functions of the licensee’s health practice.

(14) “Independent third-party evaluator” means an individual who is approved by a licensee’s board to evaluate, diagnose, and offer treatment options for substance use disorders, mental health disorders, or co-occurring disorders.

(15) “Individual service record” means the official permanent program documentation, written or electronic, for each licensee, which contains all information required by these rules and maintained by the program to demonstrate compliance with these rules

(16) “Licensee” means a health professional who is licensed or certified by or registered with a board and the professional is receiving services in the program under these rules.

(17) “Mental health disorder” means a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom that is identified in the DSM. “Mental health disorder” includes gambling disorders.

(18) “Monitoring agreement” means an individualized agreement between a licensee and the contractor that meets the requirements for a diversion agreement set by ORS 676.190.

(19) “Monitoring Entity” means an independent third-party that monitors licensees’ program enrollment status and monitoring agreement compliance.

(20) “Non-treatment compliance monitoring” means the non-medical, non-therapeutic services employed by the contractor to track and report the licensee’s compliance with the monitoring agreement.

(21) “Peer” means another licensee currently enrolled in the program.

(22) “Provisional enrollment” means temporary enrollment, pending verification that a self-referred licensee meets all program eligibility criteria.

(23) “Self-referred licensee” means a licensee who seeks to participate in the program without a referral from the board.

(24) “Substance Use Disorders” means disorders related to the taking of a drug of abuse including alcohol, to the side effects of a medication, and to a toxin exposure. The disorders include substance use disorders such as substance dependence and substance abuse, and substance-induced disorders, including substance intoxication, withdrawal, delirium, and dementia, as well as substance induced psychotic disorder, mood disorder and other disorders, as defined in DSM criteria.

(25) “Substantial non-compliance” means that a licensee is in violation of the terms of his or her monitoring agreement in a way that gives rise to concerns about the licensee’s ability or willingness to participate in the program. Substantial non-compliance and non-compliance include, but are not limited to, the factors listed in ORS 676.190(1)(f). Conduct that occurred before a licensee entered into a monitoring agreement does not violate the terms of that monitoring agreement.

(26) “Successful completion” means that for the period of service deemed necessary by the contractor or by the licensee’s board by rule, the licensee has complied with the licensee’s monitoring agreement to the satisfaction of the program, and has met the terms of the fee agreement between the program and the licensee.

(27) “Toxicology testing” means urine testing or alternative chemical monitoring including but not limited to blood, saliva, hair or breath.

(28) “Treatment” means the planned, specific, individualized health and behavioral-health procedures, activities, services and supports that a treatment provider uses to remediate symptoms of a substance use disorder, mental health disorder or both types of disorders.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 3-2011, f. & cert. ef. 8-16-11; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0015

Clinical Council

(1) The Division, in collaboration with the boards, may establish a Clinical Council that provides clinical guidance and advice to the contractor, in light of evidenced-based research and data about substance use disorders, mental health disorders or both types of disorders.

(2) The Clinical Council shall consist of eight members. The Division shall appoint one member and the boards, in consultation with the Division, shall appoint seven members.

(3) The Clinical Council shall select a chairperson from among its members.

(4) To be eligible for appointment to the Clinical Council, an individual must be a resident of Oregon and must have expertise in the recognition, intervention, assessment and treatment of persons who have a substance use disorders, mental health disorders or both types of disorders.

(5) In recruiting and selecting members for the Clinical Council, the Division and the boards shall seek members who have expertise with a range of culturally appropriate treatment options for people with substance use disorders, mental health disorders or both types of disorders.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 3-2011, f. & cert. ef. 8-16-11; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0025

Record Maintenance and Disposition

(1) If the contractor discontinues operations, the contractor shall transfer the individual service records and the program service records to the Division.

(2) The Division shall identify a records administrator, who is responsible for:

(a) Assuring compliance with 42 CFR ¦ 2.19 and other applicable state and federal regulations;

(b) Keeping the transferred individual service records consistent with the applicable records retention schedule; and

(c) With a licensee’s written consent, transferring individual service records to another contractor.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0030

Administration Fee

(1) Each board that participates in the program shall pay the Division a fee for participating in the program.

(2) The Division shall calculate the total fee based on all the contractor costs and administration expenses, including but not limited to, Division personnel costs and ancillary expenses, and fees paid to the contractor, the monitoring entity, and the auditor.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0035

Board Referrals

(1) A board that refers a licensee to the program must make the referral in writing. The referral must include:

(a) A copy of a report from an independent third-party evaluator who diagnosed the licensee with a substance use disorder, a mental health disorder or both types of disorder, stating the diagnosis and the applicable diagnostic code from the DSM;

(b) The treatment options developed by the independent third-party evaluator;

(c) A statement that the board has investigated the licensee’s professional practice and has determined whether the licensee’s professional practice, while impaired, presents or has presented a danger to the public;

(d) A description of any restrictions imposed by the board or recommended by the board on the licensee’s professional practice;

(e) A statement that the licensee has agreed to report any arrest for or conviction of a misdemeanor or felony crime to the board within three business days after the licensee is arrested or convicted; and

(f) A written statement from the licensee agreeing to enter the program and agreeing to abide by all terms and conditions established by the contractor.

(2) A board-referred licensee is enrolled in the program effective on the date the contractor receives the licensee’s signed consents and the monitoring agreement including payment of fees as required by ORS 676.190.

(3) Upon the licensee’s enrollment in the program, the contractor shall send to the monitoring entity a copy of the licensee’s monitoring agreement and the consents required by ORS 676.190.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0040

Self-Referrals

(1) Provisional Enrollment. To be provisionally enrolled in the program, a self-referred licensee must:

(a) Sign a written consent allowing disclosure and exchange of information between the contractor, the monitoring entity, the licensee’s employer, independent third-party evaluators, and treatment providers;

(b) Sign a written consent allowing disclosure and exchange of information between the contractor, the board, the monitoring entity, the licensee’s employer, independent third-party evaluators and treatment providers in the event the contractor determines the licensee to be in substantial noncompliance with his or her monitoring agreement. The purpose of the disclosure is to permit the contractor and the monitoring entity to notify the board if the contractor determines the licensee to be in substantial non-compliance with his or her monitoring agreement;

(c) Sign a written statement that the licensee has agreed to report any arrest for or conviction of a misdemeanor or felony crime to the contractor within three business days after the licensee is arrested or convicted;

(d) Attest that the licensee is not, to the best of the licensee’s knowledge, under investigation by his or her board; and

(e) Agree to and sign a monitoring agreement.

(2) Upon provisional enrollment, the contractor shall send to the monitoring entity copies of the signed consents and the monitoring agreement, described in section (1) of this rule.

(3) Enrollment: To move from provisional enrollment to enrollment in the program, a self-referred licensee must:

(a) Obtain at the licensee’s own expense and provide to the contractor, an independent third-party evaluator’s written evaluation containing a DSM diagnosis and diagnostic code and treatment recommendations;

(b) Agree to cooperate with the contractor’s investigation to determine whether the licensee’s practice while impaired presents or has presented a danger to the public; and

(c) Enter into an amended monitoring agreement, if required by the contractor.

(4) Once a contractor provisionally enrolls a self-referred licensee in the program, failure to complete enrollment may constitute substantial non-compliance and may be reported to the board.

(5) Upon enrollment of a self-referred licensee, the contractor shall send to the monitoring entity a copy of the written evaluation by the independent third-party evaluator and a copy of the amended monitoring agreement, if any.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0045

Licensee Responsibilities

(1) Board-referred licensees must:

(a) Comply continuously with his or her monitoring agreement, including any restrictions on his or her practice, for at least two years or longer, as specified by the board by rule or order; and

(b) Be responsible for the cost of evaluations, toxicology testing and treatment.

(2) Self-referred licensees must:

(a) Provide to the contractor a copy of a report of the licensee’s criminal history periodically, as required by the contractor;

(b) Comply continuously with his or her monitoring agreement, including any restrictions on his or her practice, for at least two years or longer, as specified by the board by rule or order; and

(c) Be responsible for the cost of evaluations, toxicology testing and treatment.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0050

Unique Identification Number

(1) The contractor shall assign a unique licensee identification number to each licensee the contractor enrolls in the program:

(a) The contractor, the monitoring entity, and the Division shall use the same number and shall include the number in any communications or data exchanges involving the licensee;

(b) The contractor shall not assign the identification number to any other licensee enrolled in the program;

(c) The contractor shall retire the number when the licensee is no longer enrolled in the program; and

(d) The contractor shall reassign the number to the licensee if the contractor reenrolls the licensee at a later date.

(2) The contractor may not use all or a portion of a licensee’s social security number as the unique identification number.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0055

Program Requirements

The contractor shall:

(1) Inform the licensee about the program services, requirements, benefits, risks, and confidentiality limitations and ensure that the licensee has signed a consent for services. The consent for services explains:

(a) Information the contractor will give to the board or to the monitoring entity and under what circumstances;

(b) Information the monitoring entity will give to the board and under what circumstances; and

(c) That the board may take action to suspend, restrict, modify, or revoke the licensee’s license or end the licensee’s participation in the program based on information from the contractor or the monitoring entity.

(2) Enter into a monitoring agreement with the licensee;

(3) Assess the licensee’s compliance with his or her monitoring agreement;

(4) Assess the ability of the licensee’s employer, when an employer exists to supervise the licensee, and require the employer to establish minimum training requirements for the licensee’s supervisor;

(5) Report the licensee’s substantial noncompliance with his or her monitoring agreement to the monitoring entity within one business day after the contractor learns of any substantial noncompliance; and

(6) At least weekly, submit a list to the monitoring entity of licensees who are enrolled in the program and a list of licensees who successfully completed the program.

(7) Seek a court order authorizing the contractor to release identifying information to a licensee’s board, including a report of substantial noncompliance as is described in OAR 415-065-0060, if a self-referred licensee enrolled in the program, or a provisionally enrolled licensee with a qualifying diagnosis, revokes his or her consent to report substantial noncompliance to the licensee’s board.

(a) The contractor shall file documents with the court seeking a court order as soon as possible but no later than three business days from the date it was notified that the licensee revoked consent to report substantial noncompliance.

(b) The contractor shall comply with 42 USC & 290dd-2(b)(2); 42 CFR Part 2; the Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191, 45 CFR Parts 160, 162 and 164 and ORS 179.505, ORS 192.518–192.524 in seeking such a court order.

(c) The contractor shall disclose to the licensee’s board, within one (1) business day, any information the court authorizes it to disclose.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 1-2011(Temp), f. & cert. ef. 2-11-11 thru 8-5-11; ADS 3-2011, f. & cert. ef. 8-16-11; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0060

Reports of Substantial Noncompliance

(1) Unless otherwise prohibited by law, when the contractor reports a licensee’s substantial noncompliance to the monitoring entity, the report shall include:

(a) A description of the noncompliance;

(b) A copy of the report from the independent third-party evaluator who diagnosed the licensee stating the licensee’s diagnosis;

(c) A copy of the licensee’s monitoring agreement; and

(d) The licensee’s practice or employment status.

(2) In addition to reporting substantial noncompliance to the monitoring entity, the contractor may report substantial noncompliance directly to the licensee’s board.

(3) The contractor and the licensee’s board may also exchange information in the absence of substantial noncompliance, consistent with the licensee’s consent to disclose information.

(4) A positive toxicology result as determined by 49 CFR ¦ 40.87 (2009) must be reported as substantial non-compliance, but positive toxicology results for other drugs and for alcohol may also constitute and may be reported as substantial non-compliance.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

415-065-0065

Program Services

The contractor shall provide the following services:

(1) Safe Practice Investigations of Self-referred Licensees:

(a) The contractor shall conduct a focused safe-practice investigation of a self-referred licensee to determine whether the licensee’s practice while impaired presents or has presented a danger to the public. The investigation may include contractor interviews with the licensee’s employer, supervisor, co-workers, family, or significant others.

(b) The contractor shall complete the safe-practice investigation within 15 business days of the contractor’s receipt of the independent third party’s evaluation with a qualifying diagnosis. The licensee remains provisionally enrolled in the program during this process.

(2) Monitoring Agreements:

(a) The contractor shall develop and the licensee shall sign an individualized, written monitoring agreement that is based on the contractor’s comprehensive review of the independent third-party’s evaluation and treatment recommendations and any other relevant and appropriate information, which may include information from employers, supervisors, co-workers, family, and significant others.

(b) The contractor shall amend the monitoring agreement as necessary to respond to changes in the licensee’s situation, with the goal of protecting the public.

(c) The contractor shall give the licensee and their employer, when an employer exists, a copy of the licensee’s monitoring agreement, including any amendments, and shall immediately place a copy of the monitoring agreement, including any amendments, in the licensee’s individual service record.

(d) The monitoring agreement shall:

(A) Require the licensee to participate in the program for at least two years or longer, as specified by board rule or order;

(B) Require the licensee to participate in a treatment provider’s treatment plan;

(C) Outline the limits on the licensee’s health profession practice by the contractor and the board;

(D) Notify the licensee that the program, in its discretion, may require the licensee to obtain an evaluation of the licensee’s fitness to practice before the program removes limits on the licensee’s health profession practice;

(E) Outline methods for the licensee’s employer to monitor and report on the licensee’s safe practice;

(F) Based on the independent third-party evaluator’s evaluation, require the licensee to abstain from all mind-altering or intoxicating substances or potentially addictive drugs, unless the program approves the licensee to use a particular drug prescribed for the licensee by a person authorized by law to prescribe for the licensee’s documented medical condition;

(G) Require the licensee to report to the program the licensee’s use of mind-altering or intoxicating substances or potentially addictive drugs within 24 hours of the licensee’s use of the substances or drugs;

(H) Require the licensee to submit to random toxicology testing, per an individualized schedule;

(I) Require the licensee to report his or her arrest for or conviction of a misdemeanor or felony crime to the contractor within three business days if the licensee is arrested or convicted;

(J) Require the licensee to report to the contractor any of the licensee’s applications for licensure in other states, changes in employment, changes in practice setting, and changes in residence;

(K) Require the licensee to report at least weekly to the program regarding the licensee’s compliance with the agreement; and

(L) Require the licensee to attend compliance consultation group meetings on an individualized schedule based on the contractor’s assessment of the licensee’s need for additional accountability and structure and based on board’s monitoring requirements.

(e) Boards may provide other requirements by rule, including allowing for practice supervision of sole practice licensees or other licensees not in an employment setting.

(3) Compliance Consultation Group Meetings. If required by a board’s rules, a licensee identified by the board must attend compliance consultation group meetings. Any board-referred or self-referred licensee may elect to attend the meetings. There may be a fee for the meetings.

(a) The contractor shall conduct or arrange for non-treatment compliance consultation group meetings in which a monitoring consultant meets face-to-face, either directly or by tele-video, with licensees identified by a board to determine the licensee’s overall compliance with his or her monitoring agreement and for the licensee to gain peer support for his or her compliance efforts.

(b) A monitoring consultant shall conduct each compliance consultation group meeting.

(c) The monitoring consultants shall assess the licensee’s progress with his or her monitoring agreement and provide holistic progress reports to the contractor regarding the licensee’s status in relation to, but not limited to, his or her: compliance with the monitoring agreement, compliance with the treatment provider’s treatment plan, recovery activities, emotional and physical health, work-place dynamics, and relationship and boundary concerns.

(d) The licensee’s board may elect to pay for the licensee’s participation in the compliance consultation group meetings or the board may require the licensee to pay for the service.

(4) Toxicology Testing. The contractor shall ensure that:

(a) The licensee receives a baseline toxicology test within five business days of the date the contractor enrolls the licensee in the program;

(b) The licensee receives a final toxicology test before the licensee is deemed to successfully complete the program;

(c) All monitoring agreements contain provisions requiring three types of toxicology testing:

(A) Testing customized to the licensee’s circumstances, including where appropriate requiring expanded toxicology testing drug panels and long-acting alcohol consumption toxicology testing;

(B) Random testing; and

(C) Testing that is required when the contractor has reason to believe that the licensee may have used alcohol or other drugs in violation of the licensee’s monitoring agreement.

(d) The contractor’s toxicology testing laboratory is certified by the Substance Abuse and Mental Health Services Administration and accredited through the College of American Pathologists Forensic Drug Testing Accreditation Program.

(e) In addition, the laboratory shall perform testing in compliance with OAR 333-024-0305 through 333-024-0350.

(f) Urinalysis specimens are collected in a way that preserves the integrity of the specimen. Unless otherwise provided by the licensee’s board by rule, the person collecting the sample must be able to see the licensee void.

(g) If the contractor suspects that the licensee has used alcohol or other drugs in violation of the licensee’s monitoring agreement or suspects that the licensee has attempted to provide a false or dilute urine sample, the licensee may be required to provide a directly observed urine specimen under the procedures described in 49 CFR 40.67(g) through (k), including:

(A) A person of the same gender as the licensee must ask the licensee to raise his or her shirt, blouse, or dress/skirt, as appropriate, above the waist, and lower clothing and underpants to demonstrate, by turning around, that the licensee does not have a prosthetic device to dispense urine; and

(B) A person of the same gender as the licensee must watch the urine go from the licensee’s body into the specimen collection container.

Stat. Auth.: ORS 413.042 & 676.190
Stats. Implemented: ORS 676.185 - 676.200
Hist.: ADS 3-2010, f. & cert. ef. 7-1-10; ADS 2-2012, f. & cert. ef. 2-9-12

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2011.

2.) Copyright 2012 Oregon Secretary of State: Terms and Conditions of Use

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