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Rule 5122-29-01 | Purpose and applicability.
The purpose of this chapter is to state the requirements for the provision of behavioral health services by providers certified by the Ohio department of mental health and addiction services. The provisions of the rules contained in this chapter are applicable to each provider subject to certification pursuant to rule 5122-25-01 of the Administrative Code. Supplemental Information |
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Rule 5122-29-03 | General services.
(A) "General services" are the assessment activities, medical activities, and counseling and therapy activities as defined in this rule. (B) The general services shall be provided by the professional credentials listed in appendix A of this rule within the scope of practice of those credentialed professionals. (C) Assessment activities: (1) An assessment: (a) Is a clinical evaluation of a person which is: (i) Individualized; and, (ii) Age, gender, and culturally appropriate. (b) Determines diagnosis, treatment needs, and establishes a treatment plan to address the person's mental illness or substance use disorder. (2) When the assessment is to be provided to a client it should started prior to the initiation of other services, except for emergency situations. (3) An initial assessment must, at a minimum, include an evaluation of: (a) The presenting problem; (b) The risk of harm to self and others; (c) The use of alcohol or drugs; (d) The treatment history for mental illness or substance use/abuse; and, (e) A medical history and examination (mental status or physical). (4) A comprehensive assessment shall expand on the initial assessment and obtain additional information that is required to establish and implement a comprehensive treatment plan, and must be completed within thirty days of the initial assessment encounter. (5) A person is not required to have an initial assessment prior to receiving a comprehensive assessment. (6) Initial and comprehensive assessments shall be completed according to prevailing standards of care as defined by: (a) "The Joint Commission"; (b) "The Commission on Accreditation of Rehabilitation Facilities"; (c) "The Council on Accreditation"; or, (d) Other entities as designated by the director. (7) Providers may accept initial or comprehensive assessments from other providers as long as they have been completed within the preceding twelve months. Prior assessments shall be reviewed and updated. (D) Counseling and therapy (1) Counseling and therapy is an interaction with a person or persons where the focus is on achieving treatment objectives related to alcohol and other substances; or the person's mental illness or emotional disturbance. (2) Counseling and therapy involves a face-to-face encounter between a client, group of clients, client and family members, or family members and a behavioral health professional. (3) Group counseling and therapy encounters may not exceed a one-to-twelve behavioral health professional to patient ratio. (E) Medical activities. (1) "Medical activities" are those activities that are performed within professional scope of practice by staff that are licensed or certified by the state medical board of Ohio. the state of Ohio board of nursing, or a pharmacist licensed by the state of Ohio board of pharmacy; and are intended to address the behavioral and other physical health needs of clients receiving treatment for psychiatric symptoms or substance use disorders. (2) Medical activities include, but are not limited to: (a) Performing health care screenings, assessments, and exams; (b) Checking vital signs; (c) Ordering laboratory tests and reviewing the results; and, (d) Medication prescribing, administering, and monitoring. Supplemental Information |
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Rule 5122-29-06 | Mental health day treatment service.
(A) Mental health day treatment is an intensive, structured, goal-oriented, distinct and identifiable treatment service that utilizes multiple mental health interventions that address the individualized mental health needs of the client. Mental health day treatment services are clinically indicated by assessment with clear admission and discharge criteria. The environment at this level of treatment is highly structured, and there should be an appropriate staff-to-client ratio in order to guarantee sufficient therapeutic services and professional monitoring, control, and protection. The purpose and intent of mental health day treatment is to stabilize, increase or sustain the highest level of functioning and promote movement to the least restrictive level of care. The outcome is for the individual to develop the capacity to continue to work towards an improved quality of life with the support of an appropriate level of care. (B) In addition to the definitions found in rule 5122-24-01 of the Administrative Code, the following definition applies to this rule: (1) "Mental health day treatment program day" means the total amount of hours an individual receives mental health day treatment service during a twenty-four hour calendar day. (C) Mental health day treatment must be an intense treatment service that consists of high levels of face-to-face mental health interventions that address the individualized mental health needs of the individual as identified in their individualized treatment plan (ITP). (D) The minimum program length of this service shall be in accordance with the appropriate behavioral health standards of the agency's national accrediting body(ies). Such accrediting bodies are identified in rule 5122-25-02 of the Administrative Code. (E) For purposes of this rule, a mental health day treatment program day shall consist of a minimum of two hours and up to a maximum of seven hours of scheduled intensive activities that may include, but are not limited to, the following: (1) Determination of needed mental health interventions; (2) Skills development (a) Interpersonal and social competency as age, developmentally, and clinically appropriate, such as: (i) Functional relationships with adults; (ii) Functional relationship with peers; (iii) Functional relationship with the community/schools; (iv) Functional relations with employer/family; and (v) Functional relations with authority figures. (b) Problem solving, conflict resolution, and emotions/behavior management. (c) Developing positive coping mechanisms; (3) Managing mental health and behavioral symptoms to enhance vocational/school opportunities and/or independent living; and (4) Psycho-educational interventions including individualized instruction and training of persons served in order to increase their knowledge and understanding of their psychiatric diagnosis(es), prognosis(es), treatment, and rehabilitation in order to enhance their acceptance of these psychiatric disabilities, increase their cooperation and collaboration with treatment and rehabilitation, improve their coping skills, and favorably affect their outcomes. Such education shall be consistent with the individual's ITP and be provided with the knowledge and support of the interdisciplinary/intersystem team providing treatment in coordination with the ITP. (F) Providers of mental health day treatment services shall have a staff development plan based upon identified individual needs of mental health day treatment program staff. Evidence that the plan is being followed shall be maintained. (G) Mental health day treatment service shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-07 | Forensic evaluation service.
(A) "Forensic evaluation service" means an evaluation resulting in a written expert opinion regarding a legal issue for an individual referred by a criminal court, domestic relations court, juvenile court, adult parole authority, or other agency of the criminal justice system or a Ohio department of mental health and addiction services (OhioMHAS) operated regional psychiatric hospital. Forensic evaluation service includes all related case consultation and expert testimony. Forensic evaluation service also assists courts and the adult parole authority to address behavioral health legal issues such as those referenced in paragraph (B) of this rule. (B) Forensic evaluation service addresses behavioral health legal issues, including the following: (1) Competency to stand trial, as defined in division (G)(3) of section 2945.371 of the Revised Code; (2) Mental condition at the time of the offense charged, as defined in division (G)(4) of section 2945.371 of the Revised Code; (3) Post-"NGRI" (not guilty by reason of insanity) examination, as defined in division (A) of section 2945.40 of the Revised Code: (4) Presentence, as defined in section 2951.03 of the Revised Code; (5) Mitigation of penalty, as defined in section 2947.06 of the Revised Code; (6) Mitigation of death penalty, as defined in section 2929.03 of the Revised Code; (7) Domestic violence evaluation, as defined in section 2919.271 of the Revised Code; (8) Competence to be a witness, as defined in section 2317.01 of the Revised Code; (9) Adult parole authority, for parole revocation and other legal questions; (10) Psychological effects of an act upon the victim, as defined in section 2930.13 of the Revised Code; (11) Domestic relations, for custody and visitation; (12) Juvenile dependency, neglect, delinquency (Ohio rules of juvenile procedure, rule 32), or competency as defined in section 2152.53 of the Revised Code; ; or waiver to adult court, as defined in division (C) of section 2152.12 of the Revised Code; (13) Battered woman syndrome, as defined in section 2945.392 of the Revised Code; (14) Violation of anti-stalking protection order, as defined in section 2903.212 of the Revised Code; (15) Intervention in lieu of conviction, as defined in section 2951.041 of the Revised Code; (16) Non-secured status, as defined in section 2945.401 of the Revised Code; (17) Post sentence evaluation-probation or parole for involuntary commitment, as defined in section 2967.22 of the Revised Code; or, (18) Juvenile competency evaluation for serious youthful offenders, as defined in division (C)(2) of section 2152.13 of the Revised Code. (C) No examiner should undertake a forensic evaluation without an appropriate written order from the court ordering the evaluation, or an official written request if the agency requesting the forensic evaluation is a parole or probation department, or OhioMHAS operated regional psychiatric hospital. (D) Forensic evaluation service shall provide the following standards of confidentiality: (1) The relationship between the person being evaluated and the examiner is not confidential in the usual understanding of that term. A written report shall be made to the court or adult parole authority, whether or not the person being evaluated cooperates with the examiner. The relationship between the examiner, evaluee, and court or adult parole authority shall be explained orally and in writing to the person being evaluated. It shall be clearly noted that information gathered and expert opinions reached by the examiners shall be summarized in a written report and/or testimony to the court or adult parole authority or other referring agency. (2) Reports to the criminal courts shall be forwarded only to the court that referred the person or to other court officials, prosecution and defense attorneys, as designated by the referring court. The court may, at its discretion, distribute the report, and bears the responsibility for that distribution. Reports to the adult parole authority shall be forwarded only to that agency, which may, at its discretion, distribute the report, and bears the responsibility for that distribution. Reports may be distributed to other parties only with the written authorization of the court or adult parole authority, or other referring agency. (3) Reports of forensic evaluations shall be stored separately from other types of client records, and shall be considered the property of the court that ordered them or the agency that referred the person. (E) Each forensic evaluation report shall include at least the following: (1) The name and qualifications of the examiner(s); (2) The name of the court or agency that referred the person; (3) The legal or referral question being assessed; (4) Identifying information about the person being evaluated, including relevant clinical, social, and criminal history; (5) The duration and location of the interview(s) with the person being evaluated; (6) A description of collateral information used to develop the report; (7) Psychological and/or psychiatric data that address the legal or referral issue, if applicable; and (8) Opinions and recommendations. (F) The forensic evaluation report shall be presented in non-technical terms and in reasonable detail. The data and recommendations shall be pertinent to the legal or other referral question. Relevant collateral information shall be used in a forensic evaluation to the fullest extent possible. Opinions in a forensic evaluation report shall not be based entirely on self-report of the person being evaluated if collateral information is available. (G) Reports shall contain sufficient information to substantiate the conclusions and recommendations made. Special caution shall be exercised with self-incriminating statements by the person being evaluated, information about others not being evaluated, or other material of a particularly sensitive, personal nature not related to the issue and for which the forensic evaluation was requested. (H) For competence to stand trial and not guilty by reason of insanity forensic evaluations, the qualifications of the examiner(s) are regulated by sections 2945.37 and 2945.371 of the Revised Code. All other examinations for which qualifications are not specified by law shall be conducted by staff who are qualified according to paragraph (K) of this rule. (I) Forensic evaluations shall be completed within the time limits specified by law, unless an extension has been granted by the referral source. Examinations for which no statutory time limit exists shall be completed within a reasonable time, as determined in consultation with the court or agency requesting the service. (J) The agency shall ensure that: (1) All staff who perform forensic evaluation services shall have training and continuing education relating to the legal and behavioral health issues involved in the services they provide; and (2) All persons who perform forensic evaluation services listed in paragraphs (B)(1) to (B)(18) of this rule shall provide written documentation of at least twenty-four hours of training every three calendar years that is specific to the forensic behavioral health area. (K) Forensic evaluation service shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-08 | Behavioral health hotline service.
(A) Behavioral health hotline service means a provider's twenty-four hour per day, seven days per week capability to respond to telephone calls, often anonymous, made to a provider for crisis assistance. The person may or may not be a clientof the provider. (B) Behavioral health hotline service shall: (1) Staff the service so that calls are answered twenty-four hours per day, seven days per week; (2) Provide referrals to crisis intervention service(s); (3) Include, but not be limited to, the following: (a) Provide support, intervention, and crisis management by telephone to persons in crisis; (b) Engage in suicide prevention intervention, including inquiring if the individual has a crisis safety plan and using this information in the intervention; (c) Provide appropriate linkages to all needed services and other community resources, including peer recovery support as applicable; (d) Provide information regarding crisis services, including the local crisis center phone number, additional referral to support services as indicated; and, (e) Provide information and referral to immediate psychiatric and medical services when indicated, such as the crisis center or a hospital emergency room. (4) Ensure that all staff and volunteers receive training in crisis intervention techniques, safety planning, management of risk, and available resources and supports in the county or region where the provider is located; (5) Be provided by staff and volunteers qualified according to paragraph (D) of this rule; and, (6) Document the call in the client medical record if it is known that the person calling is a person served by the provider. (C) The provider service plan for behavioral health hotline services shall include, but not be limited to the requirements that the service: (1) Function as part of an integrated, comprehensive system of health, behavioral health, and other human service providers; (2) Ensure the ability to use and work with case management systems, other involved health care providers, and crisis intervention services on a priority basis; (3) Coordinate with the community's emergency service systems, such as hospital, crisis centers, fire, police, ambulance services, etc.; (4) Maintain a current listing of available residential or housing placements that can be accessed quickly when emergency housing is needed in conjunction with a crisis intervention mental health service; and (5) Is provided as part of the alcohol, drug addiction, and mental health services board's emergency crisis plan for the service district. (D) Behavioral health hotline service shall be provided and supervised by staff and volunteers who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-09 | Residential and withdrawal management substance use disorder services.
This rule is to supersede rule 5122-29-09 of the Administrative Code with the effective date of October 31, 2019. This rule will be effective July 1, 2023. (A) Residential substance use disorder services shall be provided in accordance with the American society of addiction medicine's (ASAM) level of care three and ASAM's level of care three-withdrawal management (WM), and associated sub levels as appropriate to the needs of the individual being served; as published in the ASAM criteria, third edition, 2013. (B) A provider certified to provide this service, may provide ASAM level of care two-withdrawal management. (C) For the purposes of this rule "family" means any individual or caregiver related by blood or affinity whose close association with the person is the equivalent of a family relationship as identified by the person including kinship and foster care. (D) Each provider shall have written policies and procedures to ensure its referral process to other levels of care is appropriately implemented and managed and shall include, at a minimum, the following: (1) Referral decisions made to the appropriate level of care as determined utilizing the American society of addiction medicine criteria protocols for levels of care. Documentation of referral shall appear in the client record. (2) Discharge plan stipulating specific recommendations and referrals for alcohol and drug addiction treatment. The discharge plan shall be documented in the client record. (3) Follow-up communications with client and the service provider to which client is referred. These contacts shall be documented in the client's record. (4) Provisions for the transition of the client to other SUD treatment providers. Provisions for use of transition communications conducted in person to include staff members of the rendering provider organization, the SUD treatment program to which the patient is being referred, the patient, and family, if present. (E) Each provider rendering services pursuant to this rule will be capable of admitting, initiating, and referring clients receiving medication assisted treatment and capable of facilitating the continuity of their pharmacotherapy through care transitions, including but not limited to other levels of care for behavioral health treatment, hospitals, community-based providers, and criminal justice settings. (F) Each provider of this service shall provide, in addition to the required ASAM level of care: (1) Food for clients, to include at least three nutritionally-balanced meals and at least one nutritious snack per day, seven days per week; (2) The opportunity for clients to get eight hours of sleep per night; and, (3) Services in facilities that are clean, safe, and therapeutic. (G) Time for meals, unstructured activities, free time, or time spent in attendance of self-help groups, such as alcoholics anonymous or narcotics anonymous shall not be considered for the purposes of meeting ASAM level of care requirements for services. (H) Providers shall promote interpersonal and group living skills. (1) A service provider may require clients to perform tasks of a housekeeping nature as specified within service provider guidelines. (2) Housekeeping tasks shall not be considered for the purposes of meeting ASAM level of care requirements for services. (I) Providers will offer medication assisted treatment on site or through facilitated access off site. (J) Providers will connect clients to resources for education, job training, job interviews, employment stabilization and obtaining alternative living arrangements. (K) Providers of ASAM level of care 3.1 will: (1) Have a prescriber as part of the interdisciplinary team either through employment or contractual arrangement; however, the prescriber does not provide direct services; and, (2) Offer at least five hours per week of low intensity treatment of substance use disorders. (L) Providers of ASAM level of care 3.3 will: (1) Include, in addition to the ASAM specified interdisciplinary team members, peer supporters certified pursuant to rule 5122-29-15.1 of the Administrative Code as appropriate and available to the range and severity of the residents' problems. (2) Have an appropriately credentialed, licensed addictions clinician manage the program. (3) Have one appropriately certified or licensed addictions clinician on site days and a certified or licensed chemical dependency counselor or similar with telephonic availability during the remaining hours. (4) Offer at least thirty hours per week of a combination of skilled treatment services, clinically managed services and recovery support services focused on individuals where the effects of the substance use or a co-occurring disorder has resulted in cognitive impairment. At least ten of the thirty hours is to include individual, group, or family counseling. (5) Have staff with the knowledge and skills to work with patients with cognitive limitations. (6) Have therapies, for clients with significant cognitive deficits, delivered in a manner to promote engagement and understanding of concepts that is slower paced, more concrete, and more repetitive. (7) Have addiction treatment professionals with sufficient cross-training to recognize the signs and symptoms of co-occurring mental disorders and initiate treatment interventions (treatment within the program or referral to treatment outside the program) to address identified behavioral health needs. (M) Providers of ASAM level of care 3.2-WM and 3.5 will: (1) Include, in addition to the ASAM specified interdisciplinary team members, peer supporters certified pursuant to rule 5122-29-15.1 of the Administrative Code as appropriate and available to the range and severity of the residents' problems. (2) Have an appropriately credentialed, licensed addictions clinician manage the program. (3) Have one appropriately certified or licensed addictions clinician on site days and a certified or licensed practitioner with a declared scope of practice that includes treating people with SUDs in the evenings, with telephonic availability during evenings and nights. A nurse, physician assistant, physician, or emergency services will be available twenty-four hours a day either on site or with telephonic availability. (4) Offer at least thirty hours per week of a combination of skilled treatment services, clinically managed services and recovery and withdrawal (for 3.2-WM programs) support services focused on individuals who have significant social and psychological problems. At least ten of the thirty hours is to include individual, group, or family counseling. (5) Have addiction treatment professionals with sufficient cross-training to recognize thee signs and symptoms of co-occurring mental disorders and initiate treatment interventions (treatment within the program or referral to treatment outside the program) to address identified behavioral health needs. (6) If the provider primarily provides this ASAM level of care to adolescents who have not graduated from high school or who have not passed a general education development (GED) test, offer at least twenty hours per week of a combination of skilled treatment services, clinically managed services and recovery and withdrawal (for 3.5-WM adolescent programs) support services focused on individuals who have significant social and psychological problems. At least ten of the twenty hours is to include individual, group, or family counseling. The provider will also provide year round schooling. (N) Providers of ASAM level of care 3.7-WM and 3.7 will: (1) Include, in addition to the ASAM specified interdisciplinary team members, peer supporters certified pursuant to rule 5122-29-15.1 of the Administrative Code as appropriate and available to the range and severity of the residents' problems. (2) Have one appropriately certified or licensed addictions clinician on site days and evenings, with telephonic availability during the remaining hours. (3) Offer at least thirty hours per week of a combination of skilled treatment services, clinically managed services and recovery and withdrawal (For 3.7 WM programs) support services focused on individuals with subacute biomedical and emotional, behavioral, or cognitive problems. At least ten of the thirty hours is to include individual, group, or family counseling. (4) Have addiction treatment professionals with sufficient cross-training to recognize the signs and symptoms of co-occurring mental disorders and initiate treatment interventions (treatment within the program or referral to treatment outside the program) to address identified behavioral health needs. (O) All component practitioner services must be provided in accordance with Chapter 5122-29 of the Administrative Code. (P) A health history, including food allergies and drug reactions, shall be completed on or before admission to a provider of this service. (Q) Each provider of this service organized to serve individuals under the age of eighteen shall provide services in a manner that is developmentally appropriate, addresses educational needs, and promotes family or significant other involvement. (R) Services provided pursuant to this rule shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Last updated July 27, 2023 at 8:37 AM Supplemental Information |
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Rule 5122-29-09.1 | Substance use disorder qualified residential treatment program (QRTP) for youth.
(A) A provider that provides a level three substance use disorder residential or withdrawal management program that is certified by the Ohio department of mental health and addiction services (OhioMHAS) in accordance with rule 5122-29-09 of the Administrative Code (OhioMHAS) and accepts children or adolescents (youth) for placement is to comply with the standards in this rule. Providers whose initial certification date for this service is on or after October 1, 2020 are to be compliant with this rule in order to become certified. Providers certified prior to October 1, 2020 have until October 1, 2024 to become compliant with the requirements related to meeting QRTP standards; with the exception of paragraph (B)(7) of this rule which must be complied with as of October 1, 2020. In order to maintain title IV-E reimbursability, providers are to meet the standards in this rule by October 1, 2021. (B) Providers are to comply with the following standards: (1) Has a residential program that is accredited by at least one of the following national accrediting bodies and provides ongoing proof of such accreditation status to OhioMHAS: (a) Commission on accreditation of rehabilitation facilities. (b) Joint commission on accreditation of healthcare organizations. (c) Council on accreditation. (2) Implements a trauma-informed approach in which all employees, volunteers, interns, and independent contractors within the location of the level three substance use disorder treatment program are trained in that trauma-informed approach. Trauma-informed training is to occur within the first thirty days after the date of hire and annually thereafter. The required trauma competencies are located at http://jfs.ohio.gov/ofc/Family-First.stm. (3) Utilizes a trauma-informed treatment model that is approved by OhioMHAS for the population the agency serves. A trauma-informed treatment model is a program, organization or system that: (a) Ensures all clinical staff are trained on the trauma model approved by OhioMHAS. The facility (or agency) agency shall describe in writing in its trauma training policies and procedures or elsewhere whether non-clinical staff will be trained on the trauma model or will be trained only on the trauma competencies described in paragraph (B)(2) of this rule. (b) Realizes the widespread impact of trauma and understands potential paths for recovery; (c) Recognizes the signs and symptoms of trauma in clients, families, staff and others involved with the system; (d) Responds by fully integrating information about trauma into policies, procedures and practices; (e) Seeks to actively resist re-traumatization; (f) Includes service of clinical needs and that: (i) Is an approved trauma informed treatment model applicable to the population of youth served located at http://jfs.ohio.gov/ocf/Family-First.stm or, (ii) Meets the ten substance abuse and mental health services administration (SAMHSA) implementation domains and follows the six key principles of the SAMHSA trauma informed approach which are located at http://jfs.ohio.gov/ocf/Family-First.stm; and (iii) Receives approval by the department or designee. (4) Has registered or licensed nursing and clinical staff who operate in accordance with the following: (a) Provide care within the scope of their practice as defined by state law. (b) Are accessible on-site or via interactive videoconferencing based on the youth's clinical or medical needs. Interactive videoconferencing might not be appropriate for a youth in crisis at the agency. (c) Are available twenty-four hours a day and seven days a week. (5) With consideration to the youth's safety and developmental needs, the treatment should be family-driven with both the youth and the family included in all aspects of care, if in the best interest of the youth. The key components of family-centered residential treatment are to be documented in the youth's record and include the following: (a) Facilitation of regular contact between the youth and other members of the family including siblings, (b) Actively involving and supporting families who have a youth placed in the residential facility, (c) Providing outreach, ongoing support and aftercare for the youth and the family. (6) Completes discharge planning that is to include family-based aftercare support. Family-based aftercare support is defined as individualized, community-based, trauma-informed supports that build on treatment gains to promote the safety and well-being of youth and families, with the goal of preserving the youth in a supportive family environment. The discharge plan is to: (a) Include planning for aftercare services for all youth discharged from the agency to family-based settings including: (i) Reunification with family, (ii) Pre-finalized adoptive family, (iii) Kinship care, (iv) Foster care, (v) Independent living. (b) Begin in partnership with the legal custodian or custodial agency no later than the next business day after a youth is admitted to the QRTP. (c) Be reviewed by the QRTP no less than every thirty calendar days and during every individualized treatment plan (ITP) review as described by rule 5122-27-03 of the Administrative Code. An ITP review is to be conducted at least every ninety calendar days. (d) Include at least a six-month period of support after discharge, even if the youth reaches the age of majority. The QRTP is exempt from providing aftercare support if the youth's placement is less than fourteen days. (e) Be provided within the youth or family's community as appropriate to promote the continuity of care for youth. (f) Be individualized and driven by the youth, the caregivers and the family as appropriate, and include the following: (i) Monthly contact with the youth and caregivers to promote and maintain engagement and to regularly evaluate the family's needs. Monthly contact may be in person, through interactive videoconferencing, or via phone or other electronic means. (ii) Coordinate engagement with any applicable community providers serving the youth or family. The QRTP will ensure they make themselves available to the community providers for ongoing consultation, and document the consultation in writing. Documentation should include all resources and supports needed and detail how the resources and supports will be provided. (iii) Written documentation provided to all participants of the discharge plan prior to discharge with information on how to access additional supports from the QRTP and community providers including contact information and steps required to access each provider. (7) Conduct a background check for any employee, volunteer, intern or independent contractor in accordance with rule 5122-30-31 of the Administrative Code prior to hire. No employee, volunteer, intern or independent contractor may be present in the level three substance use disorder treatment program until the provider has reviewed the results of the background check and assured that the individual is eligible to work under rule 5122-30-31 of the Administrative Code. (C) This rule is exempt from paragraph (G) of rule 5122-25-02 of the Administrative Code and deemed status recognition. Regardless of accreditation and deemed status, providers are to maintain compliance with this rule, and the department may conduct surveys or require submission of documentation in order to evaluate compliance. Last updated March 15, 2022 at 12:53 PM Supplemental Information |
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Rule 5122-29-10 | Crisis intervention service.
(A) Crisis intervention is an interaction with a person in response to a crisis or emergency situation they are experiencing. (B) Twenty-three hour observation bed means face-to-face evaluation, for up to twenty-three hours duration under close medical/nursing supervision, of an individual who presents an unpredictable risk of adverse consequences due to intoxication, withdrawal potential and/or co-existing disorders for the purpose of determining the appropriate treatment and plan for the next level of care. (C) Crisis intervention includes: (1) An urgent evaluation of the following elements when clinically indicated: (a) Understanding what happened to initiate the crisis and the individual's response or responses to it; (b) Risk assessment of lethality, propensity of violence, and medical/physical condition including alcohol or drug use; (c) Mental status; (d) Information about the individual's strengths. coping skills, and social support network, including face-to-face contact with family and collateral informants; and, (e) Identification of treatment needs and appropriate setting of care. (2) A crisis plan shall be developed to de-escalate the crisis, stabilize the patient, restore safety, provide referral, and linkages to appropriate services, and coordination with other systems. (D) Providers of crisis intervention shall have current certification in first aid and cardio-pulmonary resuscitation (CPR), and shall be trained in de-escalation techniques. (E) When a patient appears to be medically unstable, the patient shall be referred to a medical facility or emergency medical service shall be called. Supplemental Information |
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Rule 5122-29-11 | Employment service.
(A) The purpose and intent of an employment service is to promote recovery through the implementation of evidence based and best practices which allow individuals to obtain and maintain integrated competitive meaningful employment by providing training, ongoing individualized support, and skill development that honor client choice. The outcome of an employment service is that individuals will obtain and maintain a job of their choosing through rapid job placement which will increase their self-sufficiency and further their recovery. Employment services should be coordinated with mental health services and substance use treatment and services. (B) Consistent with the purpose and intent of paragraph (A) of this rule, employment services shall include at least one of the following evidence based and best practice employment activities, unless prior approval has been given for a non-listed activity as provided by paragraph (D) of this rule: (1) Vocational planning (assessment); (2) Training (work and personal); (3) Job seeking skills training (JSST); (4) Job development and placement; (5) Job coaching; (6) Individualized job supports, which may include regular contact with the employers, family members, guardians, advocates, treatment providers, and other community supports; (7) Benefits planning; (8) General consultation, advocacy, building and maintaining relationships with employers; (9) Individualized placement and support supported employment (IPS SE), in accordance with the requirements for qualified providers set forth in rule 5122-29-30 of the Administrative Code; (10) Rehabilitation guidance and counseling; or, (11) Time unlimited vocational support. (C) Any of the following employment supports may be provided in conjuction with at least one employment activitiy either that is listed in paragraph (B) of this rule or which has received prior approval from OhioMHAS: (1) Facilitation of natural supports; (2) Transportation; or, (3) Peer services. (D) Individualized placement and support supported employment (IPS SE). Providers who chose to offer IPS SE employment service shall meet the following requirements to be OhioMHAS qualified providers: (1) IPS SE is an evidence based practice which is integrated and coordinated with mental health treatment and rehabilitation designed to provide individualized placement and support to assist individuals with a severe and persistent mental illness or co-occurring mental illness and substance use disorder obtain, maintain, and advance within competitive community integrated employment positions. (2) In order to be an IPS SE qualified provider, the provider must: (a) Provide the evidence-based practice of IPS SE; (b) Have periodic fidelity reviews completed by an Ohio department of mental health and addiction services (OhioMHAS) approved fidelity reviewer as required by the developer of the practice, and, (c) Achieve the minimum fidelity score necessary to maintain fidelity, as defined by the developer of the practice. (3) In the event a provider fails to achieve the required minimum fidelity score, the provider will receive technical assistance to address areas recommended for improvement as identified in the fidelity review by an OhioMHAS approved fidelity reviewer. If the subsequent fidelity review results in a score of less than the required minimum, the provider will no longer by designated as a qualified IPS provider until their fidelity score again reaches the minimum. (4) Providers implementing IPS SE may become a provisionally qualified IPS SE provider by participating in a baseline fidelity review. Providers may be provisionally qualified one time only and only between the baseline fidelity review and the next subsequent fidelity review. A provider must meet other requirements of this rule in order to receive provisional qualification. (E) Employment services shall be provided and supervised by staff who: (1) Are qualified according to rule 5122-29-30 of the Administrative Code; or, (2) Have experience working with individuals that have a mental illness or substance use disorder. Last updated January 3, 2022 at 12:10 PM Supplemental Information |
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Rule 5122-29-12 | Driver intervention program.
(A) A driver intervention program is a program of screening, education, and referral for individuals who are arrested or convicted of operation of a vehicle or water craft under the influence of alcohol or a drug of abuse under section 4511.19 or 1547.11 of the Revised Code or a substantially similar municipal ordinance or other alcohol-related traffic statute or ordinance. (B) No entity may operate, or purport to operate, a driver intervention program in Ohio unless it has received driver intervention program certification from the Ohio department of alcohol and drug addiction services. (C) Except as otherwise provided in this rule, the provisions of this rule are applicable to all driver intervention programs in Ohio, public or private. The provisions do not negate the necessity of driver intervention programs to be certified programs in accordance with the provisions of Chapter 5122-25 of the Administrative Code. (D) Each driver intervention program shall have either representatives from law enforcement officers, judges, prosecuting and defense attorneys, and treatment center representatives on its governing authority or establish an advisory board with such representatives. If an advisory board is established, it shall: (1) Meet annually; and, (2) Minutes shall be maintained for advisory board meetings. (E) Program administration: (1) Each driver intervention program shall have a program director that is responsible for the overall day-to-day operation of the driver intervention program. The driver intervention program director shall be responsible to the governing authority of the organization. If the driver intervention program is a component of a larger organization, the driver intervention program director may report to the executive director/chief executive officer of the organization, who would report to the governing authority. A program director hired on or after April 20, 2004 shall meet the following qualifications: (a) The program director shall have a bachelor's degree and two years' experience in alcohol and other drug addiction services or an allied profession to include one year as a supervisor; (b) Three years' experience in alcohol and other drug addiction services or an allied profession to include a minimum of one year as a supervisor; or, (c) Three years' experience in business administration to include a minimum of one year as a supervisor. (2) The position description of the driver intervention program director shall include, at a minimum, the following responsibilities: (a) Overseeing the day-to-day operations of the driver intervention program. (b) Developing and implementing the policies and procedures of the driver intervention program. (c) Developing and revising as necessary, the driver intervention program's education curriculum. (d) Preparing an annual plan for the operation of the driver intervention program. (e) Implementing the driver intervention program's quality assurance and improvement activities and findings. (f) Hiring and terminating driver intervention program staff. (g) Ensuring that the driver intervention program is operating in accordance with the Ohio department of alcohol and drug addiction services' driver intervention program certification standards. (F) Services supervisor: (1) Each driver intervention program shall have a services supervisor. The driver intervention program director can also be the services supervisor of the driver intervention program if he/she meets the qualifications of a services supervisor as stated in this rule. (2) An individual hired as the services supervisor of a driver intervention program on or after April 20, 2004 shall have one or more of the following current licenses and/or certifications issued by a professional regulatory board in Ohio: (a) Licensed physician who is licensed by the state of Ohio medical board. (b) Licensed psychologist who is licensed by the state of Ohio psychology board. (c) Professional clinical counselor who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (d) Licensed independent social worker who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (e) Licensed chemical dependency counselor III who is licensed by the state of Ohio chemical dependency professionals board. (f) Licensed independent chemical dependency counselor licensed by the state of Ohio chemical dependency professionals board. (g) A nurse registered with the Ohio board of nursing. (h) Licensed social worker who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (i) Professional counselor who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (j) Certified prevention specialist I who is certified by the Ohio chemical dependency professionals board. (k) Certified prevention specialist II who is certified by the Ohio chemical dependency professionals board. (l) Licensed marriage and family therapist who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (m) Licensed independent marriage and family therapist who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board. (3) The services supervisor's personnel file shall contain copies or verification of, current licenses, certifications, and registrations issued to the individual from professional regulatory boards in Ohio. (G) Each driver intervention program shall maintain the following: (1) Outline of the current education curriculum of the driver intervention program. (2) Copy of the revenue and expenditure budget for the driver intervention program. (H) Each driver intervention program shall meet, at a minimum, the following handicapped accessibility requirements: (1) Entrances, hallways and spaces where services are provided and office space for employees shall be handicapped accessible. (2) Facility shall have at least one handicapped accessible bathroom. (3) Facility shall have designated handicapped parking space(s) based on the Americans with disabilities act accessibility guidelines. (4) Facility shall have at least one drinking fountain that is handicapped accessible. (5) Facility shall have at least one telephone that is handicapped accessible. (6) Each residential driver intervention programs shall have at least one handicapped accessible shower facility. (I) Emergency medical plan and first aid supplies: (1) Each driver intervention program shall have a written emergency medical plan that includes, at a minimum, the following: (a) Current emergency telephone numbers for fire, emergency squad, police and poison control. (b) Location of first aid supplies at the program site during operation of the driver intervention program. (c) General instructions for medical emergencies including supervision of clients during the emergency. (d) General instructions in case of illness of a client. (e) Procedure for documenting unusual incidents and notifying families. (2) A copy of the emergency medical plan shall be conspicuously posted at the program site during the operation of each driver intervention program. (J) Client records: (1) Each driver intervention program shall have written policies and/or procedures for maintaining a uniform client records system that include, at a minimum, the following: (a) Statement that program staff, contract employees, volunteers and student interns shall not convey to a person outside of the program that an individual attends or receives services from the driver intervention program, or disclose any information identifying a client as an alcohol or other drug services client unless the client consents in writing for the release of information; the disclosure is allowed by a court order; the disclosure is to entities with which the provider has entered into a qualified service organization agreement (QSOA) pursuant to 42 CFR part 2; or the disclosure is made to qualified personnel for a medical emergency, research, audit or program evaluation purposes. The driver intervention program has the authority to deny services if a client refuses consent to the release of information. (b) Statement that the federal laws and regulations do not protect any threat to commit, any information about a crime committed by a client, either at the program or against any person who works for the driver intervention program. (c) Statement that the federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities. (d) Each disclosure made with the client's written consent must be consistent with 42 C.F.R., part 2, by including the following written statement: "This information has been disclosed to you from records protected by federal confidentiality rules. The federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 C.F.R., part 2. A general authorization for the release of medical or other information is not sufficient for this purpose. The federal rules restrict any use of information to criminally investigate or prosecute any alcohol or drug abuse client." (e) Policy on the access of client records by clients, staff, and others. (f) Components of client records and time lines, when applicable, for completing each component. (g) Policy on the storage of client records that requires records be maintained in accordance with 42 C.F.R., part 2, confidentiality of alcohol and drug abuse client records. (h) Policy on the destruction of client records to include the requirement that records be maintained for at least six years after clients have been discharged from the program. Client records shall be destroyed to maintain client confidentiality as required by state and federal law. (2) A record shall be maintained for each client of a driver intervention program. Each record shall include, at a minimum, the following components: (a) Identification of client (name of client and/or client identification number). (b) Client fee agreement. (c) Consent for services. (d) Documentation reflecting receipt of the schedule for the driver intervention program being attended by the client. (e) Documentation reflecting receipt of the driver intervention program rules and/or expectations of clients. (f) Documentation reflecting receipt of the program's policy on client rights that lists the client rights required by this rule. (g) Documentation reflecting receipt of the program's client grievance procedure. (h) Documentation reflecting receipt of a written summary of the federal laws and regulations that indicate the confidentiality of client records are protected as required by 42 CFR, part 2. (i) Intake report. (j) Identification of at least two screening instruments that were administered to the client and documentation of the results of both tests. (k) Results and recommendations of the screening. (l) Recommendations for alcohol and/or drug assessment. (m) Assessment, if completed by the driver intervention program. (n) Any recommendations made to a court or other organization. (o) Date of each group session provided. (p) Length of each group session provided. (q) Topic/content of each group session provided. (r) Client's response/feedback during each group session. (s) Disclosure of client information forms, when applicable. (3) Disclosure of client information forms shall include the following information as required by 42 C.F.R., part 2: (a) Name of program making the disclosure. (b) Name or title of the individual or the name of the organization to which the disclosure is to be made. (c) Name of the client. (d) Purpose of the disclosure. (e) Type and amount of information to be disclosed. (f) Original signature of the client or person authorized to give consent. (g) Date client or other authorized person signed the form. (h) Statement that the consent is subject to revocation at any time except to the extent the program or person who is to make the disclosure has already acted in reliance on it. (i) The date, event, or condition upon which the consent will expire, unless revoked before that specified time. (4) Each client record shall include a program completion report which shall include, at a minimum, the following documentation. A copy of the report shall be sent to the court or organization that referred the client to the driver intervention program. (a) Results and recommendations of the screening. (b) Any recommendations for alcohol and/or drug assessment. (c) Any recommendations made to a court or other organization. (d) Number of hours of driver intervention programming the client attended. (e) Any referrals made to alcohol and drug addiction treatment programs and any referrals made to other organizations. (f) Date, signature, and credentials of the program director, services supervisor or program staff of the driver intervention program who makes the recommendation. (g) Summary of client's participation. (h) Disclosure of client information form that is prepared in accordance with 42 CFR, part 2, confidentiality of alcohol and drug abuse patient records, for information released to courts, organizations and/or individuals and for management information reports to the Ohio department of alcohol and drug addiction services. (5) A policy and procedure, in accordance with 42 CFR, part 2, confidentiality of alcohol and drug abuse patient records, for tracking clients for a reasonable time following program completion. (6) If a program maintains electronic client records, the program must be able to produce hard copies of client records upon legally valid requests and have a written policy and procedure indicating how client original signatures and staff original signatures are obtained and verified for documentation. (7) If a program discontinues operations or is taken over or acquired by another entity, it shall comply with 42 C.F.R., part 2, subsection 2.19 which governs the disposition of records by discontinued programs. (K) Intake report: (1) An intake report shall be completed for each client at the beginning of the first day of the driver intervention program. Documentation shall include, at a minimum, the following: (a) Client identification number and name. (b) Prescription and over-the-counter drugs being taken by the client. (c) Type and amount of any medications brought to the program. (d) Special dietary requirements. (e) Known allergies, including but not limited to food and drug reactions. (f) Pregnancy status of women. (g) Special needs of clients. (h) Name, address, and telephone number of a person who is to be contacted in the event of an emergency. (2) Baggage and materials brought to the driver intervention program shall be inspected to ascertain that they do not contain contraband, which includes, at a minimum, illegal drugs, alcohol, or firearms. Documentation shall appear in the intake report. (3) The intake report shall be dated and signed by the staff member completing the intake report. (L) Screening: (1) Screening means a preliminary gathering and sorting of information used to determine whether a comprehensive assessment is appropriate. (2) Each client of a driver intervention program shall be administered at least two screening instruments. The results shall be recorded in the client's record. (3) Screening interviews shall include, at a minimum, the following: (a) Client identification. (b) Presenting problem and/or precipitating factors leading to the need for screening. (c) Past and present use of alcohol and other drugs. (d) History of treatment for alcohol and other drug abuse. (e) Medical problems. (f) Legal history. (g) Recommendations for referral, if applicable, for a comprehensive assessment to determine the extent and severity of alcohol and other drug abuse problems and need for treatment. (h) Date, signature, and credentials of program staff who completed the screening. (M) Referral for assessment: (1) Each driver intervention program shall have a written procedure for making referrals for assessment which requires that a completed release of information shall be obtained prior to contacting a program. (2) Each driver intervention program shall have a written policy stating that the basis for making a recommendation to a court or other organization for alcohol and drug addiction comprehensive assessment shall include, at a minimum, the following: (a) Results of the two screening instruments and screening interview. (b) Observations of the client during screening, client education on alcohol and drug abuse and addiction and group sessions. (3) Each driver intervention program shall have a written policy for submitting a copy of the report to the court or organization that referred the client to the driver intervention program, as requested by the referral source. (N) A driver intervention program may conduct client assessments. Assessments shall be conducted in accordance with rules set forth by the Ohio department of mental health and addiction services. (O) Dietary services: Each driver intervention program that prepares and/or serves meals as part of its daily scheduled activities shall operate its dietary services in accordance with laws, regulations, or ordinances of the Ohio board of dietetics, Ohio department of health and/or local health department. (P) Pharmaceutical services: (1) Driver intervention programs are prohibited from dispensing and/or administering medications. (2) Clients who take prescription medications and/or over-the-counter medications may "self-medicate" at driver intervention programs. Each driver intervention program that permits clients to self-medicate shall have written policies and/or procedures for client self-medication that include, at a minimum, the following: (a) Policy prohibiting clients from having prescription medication in their possession at the program site or while involved in program activities off site, unless required by a physician for medical necessity. (b) Procedures for obtaining and accounting for controlled substances from clients at the time of admission to or upon entering the program and return of same, as appropriate, at the time of discharge/departure. (c) Procedures for storing medications in a locked cabinet. (d) Procedures for reporting theft or loss of over the-counter medications or prescription medication. (e) Procedures for self-medication. (3) Clients shall not be denied driver intervention services due solely to their use of prescribed psychotropic medication(s). (Q) Non-residential driver intervention programs: (1) Each non-residential driver intervention program shall consist of at least thirteen hours of alcohol and drug addiction programming that includes, at a minimum, the following: (a) One hour of screening and individual contact. (b) Eight hours of client education on alcohol and drug abuse and addiction including traffic safety education. (c) Four hours of small group discussion sessions. (2) Each non-residential driver intervention program is prohibited from delivering more than eight hours of alcohol and drug addiction programming to clients each day. (3) Each client shall be administered at least two screening instruments. (4) An individual screening interview shall be done with each client to discuss the screening findings, recommendations and referrals made to a referring court or other organization. (5) A program completion report shall be prepared for each client. (6) Small group discussion sessions: (a) Small group discussion sessions shall not exceed a staff to client ratio of one to fifteen. (b) The total number of clients in a group session shall not exceed fifteen, regardless of the number of staff. (7) If a non-residential driver intervention program is operated within a residential driver intervention program, its programmatic content must be the same as that of the residential driver intervention program, and shall include the mid-day and evening meals. (8) If a non-residential driver intervention program operates its program for five hours or more on any day, the program shall have provisions for a mid-day meal of at least thirty minutes. This mid-day meal shall be included in the program's schedule that is available to clients upon request. Time for meals may not supplant any of the minimum thirteen-hour alcohol and drug programming. (9) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program. (R) Forty-eight hour residential driver intervention programs: (1) Each forty-eight hour residential driver intervention program shall consist of at least sixteen hours of alcohol and drug addiction programming that includes, at a minimum, the following: (a) One hour of screening and individual contact. (b) Ten hours of client education on alcohol and drug abuse and addiction including traffic safety education. (c) Five hours of small group discussion sessions. (2) Each client shall be administered at least two screening instruments. (3) An individual screening interview session shall be done with each client to discuss the screening findings, recommendations and referrals to a referring court or other organization. (4) A program completion report shall be prepared for each client. (5) Small group discussion: (a) Small group discussion sessions shall not exceed a staff to client ratio of one to fifteen. (b) The total number of clients in a small group discussion session shall not exceed fifteen, regardless of the number of staff. (6) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program. (S) Seventy-two hour residential driver intervention programs: (1) Each seventy-two hour residential driver intervention program shall consist of at least twenty-one hours of alcohol and drug addiction programming that includes, at a minimum, the following: (a) One hour of screening and individual contact. (b) Fifteen hours of client education on alcohol and drug abuse and addiction including traffic safety education. (c) Five hours of small group discussion sessions. (2) Each client shall be administered at least two screening instruments. (3) An individual screening interview shall be conducted with each client to discuss the screening findings, recommendations, referrals, and recommendations made. (4) Small group discussion: (a) Small group discussion sessions staff to client ratio shall not exceed one to fifteen. (b) The total number of clients in a group session shall not exceed fifteen, regardless of the number of staff. (5) A program completion report shall be prepared for each client. (6) The program shall provide morning, mid-day, and evening meals of at least thirty minutes duration. (7) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program. (T) Each driver intervention program shall have a written educational curriculum that includes, at a minimum, the following: (1) Traffic safety education as it relates to alcohol and drug use. (2) Client education on alcohol and drug abuse and addiction. (3) Small group discussion topics. (U) Each program shall prepare an educational curriculum for its driver intervention program that shall be approved by the program's governing authority that includes, but is not limited to, the following: (1) Time table for conducting the program. (2) Instructional outline for each topic/module. (3) Method of instruction, including audio/visual aids. (V) Each program shall have a program schedule that can be given to clients upon request. (W) Traffic safety education: (1) Traffic safety education shall include, at a minimum, the following information on the criminal justice system and relevant law. (a) Blood alcohol content (BAC), drugs and impairment. (b) Levels of license suspension and revocation. (c) Fines and levels of incarceration. (2) The driving task and the specific psychomotor skills required. (3) The physiological and psychological effects of alcohol and other drugs on driving performance. (4) Traffic safety education sessions shall not exceed an instructor to client ratio of one to forty eight. (X) Client education on alcohol and drug abuse and addiction: (1) Client education on alcohol and drug abuse and addiction shall include, at a minimum, the following: (a) Physical and psychological aspects of the use of alcohol and other drugs. (b) Combining the use of alcohol with other drugs. (c) Social consequences of the use of alcohol and other drugs. (d) Signs and symptoms of abuse and dependence of alcohol and other drugs. (e) Dysfunctional behavior resulting from the use of alcohol and other drugs. (f) Progressive nature of alcohol and drug abuse and dependence. (g) Abstinence as a life-style and self-help programs such as alcoholics anonymous and narcotics anonymous. (h) Treatment alternatives and local resources. (2) Programming does not include the following: (a) Individual and/or group counseling. (b) Self-help study sessions. (c) Anger management and stress reduction therapies. (3) Staffing for client education group sessions on alcohol and drug abuse and addiction shall not exceed an instructor to client ratio of one to forty eight. (Y) Indigent clients: (1) A driver intervention program that receives funds that originate and/or pass through the Ohio department of mental health and addiction services shall have a policy and procedure which states that admission to the driver intervention program shall not be denied because an individual is indigent as long as public funds are available to cover the cost of the program. (2) Indigent individuals are persons who have in their possession at the beginning of a driver intervention program a document which indicates the client is a recipient of public assistance, including, but not limited to, supplemental security income, social security disability income, medicaid, temporary assistance for needy families or other category of assistance as defined by the Ohio department of mental health and addiction services. (3) The client record of indigent individuals shall include a photocopy of the documentation that was used to verify indigent status. Supplemental Information |
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Rule 5122-29-13 | SUD Case management services.
Substance use disorder case management services means those activities provided to assist and support individuals in gaining access to needed medical, social, educational and other services essential to meeting basic human needs. Case management services may include interactions with family members, other individuals or entities. (A) Case management services shall include, at a minimum, the following activities: (1) Assessment. (2) Referral. (3) Monitoring and follow-up. (B) Examples of case management activities include: coordinating: client assessments, treatment planning and crisis intervention services; providing training and facilitating linkages for the use of community resources; monitoring service delivery; obtaining or assisting individuals in obtaining necessary services, for example, financial assistance, housing assistance, food, clothing, medical services, educational services, vocational services, recreational services, etc.; assisting individuals in becoming involved with self-help support groups; assisting individuals in increasing social support networks with family members, friends, and/or organizations; assisting individuals in performing daily living activities; and coordinating criminal justice services. (1) Transportation in and of itself does not constitute case management. (2) Waiting with clients for appointments at social service agencies, court hearings and similar activities does not, in and of itself, constitute case management. (C) Case management services do not include the provision of (1) Direct services to which the client has been referred such as medical, educational, or social; or, (2) Internal quality assurance activities, such as clinical supervisory activities and/or case reviews/staffing sessions. Supplemental Information |
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Rule 5122-29-14 | Mobile response and stabilization service.
(A) Mobile response and stabilization service (MRSS) is a structured intervention and support service provided by a mobile response and stabilization service team that is designed to promptly address a crisis situation; with young people who are experiencing emotional symptoms, behaviors, or traumatic circumstances that have compromised or impacted their ability to function within their family, living situation, school, or community. (B) MRSS is provided to people who are under the age of twenty-one. (C) MRSS is intended to be delivered in-person where the young person or family is located, such as their home or a community setting. There are instances where MRSS can be delivered using a telehealth modality. Common times that telehealth would be appropriate are: (1) When the young person or family requests MRSS service delivery using telehealth modalities, (2) There is a contagious medical condition present in the home, or (3) Inclement weather that prevents or makes it dangerous for the MRSS team to travel to the young person or family. (D) The initial mobile response is expected to occur within sixty minutes from the end of the initial call and immediate linkage of the caller to the MRSS provider, with a de-escalation period up to seventy-two hours and a stabilization period for up to six weeks. If the caller requests mobile response later than sixty minutes, the response will occur within forty-eight hours. The de-escalation period begins when the initial mobile response occurs. In instances where the initial mobile response occurs greater than sixty minutes from the time of dispatch, the MRSS team will maintain documentation that supports the extended response time was an appropriate response. (E) In order to be certified for the MRSS service, a community mental health services or addiction services provider will also hold and maintain certification from the Ohio department of mental health and addiction services (OhioMHAS) for all the following: (1) General services as defined in rule 5122-29-03 of the Administrative Code. (2) SUD case management services as defined in rule 5122-29-13 of the Administrative Code. (3) Peer recovery services as defined in rule 5122-29-15 of the Administrative Code. (4) Community psychiatric supportive treatment as defined in rule 5122-29-17 of the Administrative Code. (5) Therapeutic behavioral services and psychosocial rehabilitation as defined in rule 5122-29-18 of the Administrative Code. (F) The community mental health services or addiction services provider will be able to provide all allowable services by telehealth as defined in rule 5122-29-31 of the Administrative Code. (G) Definitions: (1) Crisis means a situation defined by the young person, their family or those responsible for the welfare of the youth that is causing stress or discordance to the person or their family or the community. (2) Family means any individual or caregiver related by blood or affinity whose close association with the person is the equivalent of a family relationship as identified by the person including kinship and foster care. (3) Young person means a child, youth or young adult under the age of twenty-one. (H) MRSS team staff. (1) A MRSS team will consist of at least: (a) A clinician identified in rule 5122-29-30 of the Administrative Code who holds a valid and unrestricted certification or license issued by any of the Ohio professional boards that includes a scope of practice for behavioral health conditions. This provider will also demonstrate and maintain competency in the under twenty-one years of age population. The independently licensed supervising practitioner will also be considered a member of the MRSS team. A qualified behavioral health specialist (QBHS) as defined in rule 5122-29-30 of the Administrative Code does not meet the standards of this paragraph; and (b) One of the following: (i) A family peer or youth peer supporter who holds a valid and unrestricted certification from OhioMHAS issued in accordance with rule 5122-29-15.1 of the Administrative Code. The peer supporter will also demonstrate competency in the care and services of individuals in the under twenty-one years of age population and has scope of practice for persons age twenty-one and under with mental health disorders and substance use disorders. (ii) A QBHS as defined in rule 5122-29-30 of the Administrative Code. This QBHS will also demonstrate competency in the care and services of individuals in the under twenty-one years of age population and has scope of practice for persons age twenty-one and under with mental health disorders and substance use disorders. (2) The MRSS team will have ready access to a psychiatrist or certified nurse practitioner or clinical nurse specialist for consultation purposes as needed, and this person is not necessarily a member of the MRSS team. The psychiatrist or certified nurse practitioner or clinical nurse specialist will hold a valid and unrestricted license to practice in Ohio. (I) MRSS providers will have an initial fidelity review no more than twelve months from the date of initial certification. MRSS providers will have regular repeat fidelity reviews, no more than twelve months from the report date of the previous fidelity review, by an independent validation entity recognized by the department. (J) For continuing certification, each MRSS provider will achieve and maintain a minimum benchmark score of twenty-six as a component of overall fidelity within three years of initial certification as determined by an independent validation entity recognized by the department. The provider will maintain fidelity in all fidelity reviews after the first three years. (K) Providers will participate in MRSS quality improvement activities including data collection and submission. (L) Providers will complete OhioMHAS's approved initial and ongoing MRSS trainings as appropriate to their role. (M) Providers of MRSS will assure the service meets the following: (1) Within one year from the date of initial certification from OhioMHAS, have the MRSS available twenty-four hours a day, seven days a week. (2) Provided on a mobile basis. MRSS is provided where the young person is experiencing the crisis or where the family requests services, not at a static location where the person will present themselves. (3) The initial mobile response occurs in accordance with paragraph (D) of this rule. (4) Provided by eligible providers and supervisors identified in rule 5122-29-30 of the Administrative Code and who are MRSS team members described in paragraph (H)(1) of this rule." (N) MRSS provides immediate de-escalation, delivers rapid community-based assessment, and stabilization services to help the young person remain in their home and community. MRSS consists of three activities: screening/triage, mobile response, and stabilization. Some young people do not need all three MRSS activities but are still considered MRSS participants. MRSS will be initiated through screening/triage and progress in the order listed in this paragraph. (1) Screening/triage MRSS screening/triage includes, at a minimum, the following: The MRSS service may be initiated through direct connection with the MRSS provider or the statewide MRSS call center. When the service is initiated through direct connection with the provider: (a) An initial triage screening is done to gather information on the crisis or crises, identify the parties involved, and determine an appropriate response or responses. The initial triage screening is performed remotely. (b) All calls with a young person or family in crisis where 911 is not indicated, are responded to with a mobile response. (c) If a young person or family is already involved with an intensive home-based service (i.e. IHBT, wraparound) the mobile response team is dispatched to de-escalate the presenting crisis. Once the family is stabilized, the family is re-connected with the existing service. (2) Mobile response (a) The mobile response team will mobilize to arrive at the location of the crisis or a location specified by the young person or family within the designated response time, as determined by the end of the triage assessment. If the initial response is done by a single team member, that team member will meet the standards of paragraph (H)(1)(a) of this rule. (b) The MRSS mobile response team will provide de-escalation services for up to seventy-two hours until the young person and family are stable; de-escalation services will include the following: (i) An urgent assessment of the following elements for de-escalation: understanding what happened to initiate the crisis and the young person's and their family's response or responses to it; risk assessment of lethality, propensity for violence, and medical/physical condition including alcohol or drug use, mental status, and information about the young person's and family's strengths, coping skills, and social support network. (ii) Development of an initial safety plan to be provided to the youth and family at the end of the first face-to-face contact. (iii) Crisis intervention and de-escalation with the young person or family using strategies as appropriate to meet the unique needs of the youth and family. Such strategies may include, but are not limited to: ongoing risk assessment and safety planning, teaching of coping and behavior management skills, mediation, parent support, and psychoeducation. (iv) Telephonic psychiatric consultation initiated when indicated. (v) Administration of the Ohio children's initiative brief child and adolescent needs and strengths (CANS) tool prior to entry into the ongoing stabilization phase of services, and for youth who do not continue into stabilization, complete the CANS when adequate information is known. This will be performed by a provider who is a qualified CANS assessor. (vi) Consult with the young person or family to define goals for preventing future crisis and the need for ongoing stabilization. (vii) Initiate an individualized MRSS plan, prior to the stabilization phase, which is inclusive of the safety plan. An individualized MRSS plan is valid for up to forty-two days or until the end of the MRSS episode of care and should be updated or modified as indicated during this time period. (3) Stabilization (a) Stabilization services are provided by the MRSS team as documented in the individualized MRSS plan. The stabilization services immediately follows the seventy-two hours of mobile response. (b) Continued monitoring, coordination, and implementation of the individualized MRSS plan. (c) The MRSS team provides stabilization services that are defined in the individualized MRSS plan to achieve goals as articulated by the young person or family. Stabilization services are to build skills of the young person and family, to strengthen capacity to prevent future crisis, facilitate an ongoing safe environment, link the young person and family to natural and culturally relevant supports and build or facilitate building the young person and family's resilience. Stabilization activities include but are not limited to: (i) Psychoeducation: young person or family individual coping skills; behavior management skills, problem solving and effective communication skills; (ii) Referral for psychiatric consultation and medication management if indicated; (iii) Advocacy and networking by the provider to establish linkages and referrals to appropriate community-based services and natural supports; (iv) Coordination of services to address the needs of the young person or family. (d) Linkage to the natural and clinical supports and services to maintain engagement and sustain the young person's or their family's stabilization post MRSS involvement. (e) Convene or participate in planning meeting(s) with the young person, family, and cross system partners for the purpose of developing and coordinating linkages to ongoing services and supports when family need indicates. (f) Service transition (i) The MRSS team and the young person or their family will work on moving from stabilization to ongoing support through identified supports, resources, and services, which are consistent with their unique needs and documented in the individualized MRSS plan. (ii) With the young person's or family's permission, the MRSS team will share the most recent individualized MRSS plan and supporting information with other service providers in person, including by video or telephone, and with the young person or family present when possible. (iii) Review with the young person or their family newly formed coping skills and how future crisis can be managed; emphasizing the role of the young person and the family. (iv) Prepare and finalize a transition plan with the young person and their family. The transition plan will include the most recent version of the individualized MRSS plan with safety plan. Last updated March 22, 2024 at 10:36 AM Supplemental Information |
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Rule 5122-29-15 | Peer support services.
(A) Peer support services are services for individuals with a mental illness, intellectual or developmental disabilities, or substance use disorders and their caregivers and families. (B) Peer support services consist of activities that promote resiliency and recovery, self-determination, advocacy, well-being, and skill development. Peer support services are individualized, resiliency and recovery focused, and based on increasing knowledge and skills through a peer relationship that supports an individual's or family's ability to address needs, navigate systems and promote recovery, resiliency, and wellness. They promote family driven, youth guided, trauma informed care and cultural humility, encourage partnership with individuals and families, and advocate for informed choice. (C) For the purposes of this rule, the following definitions apply: (1) "Recovery" means the personal process of change in which an individual strives to improve their health and wellness, resiliency, and reach their full potential through self-directed actions. (2) "Resiliency" means the ability to recover from setbacks, adapt well to change, and keep going in the face of adversity. It is the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress such as family and relationship problems, serious health problems, or workplace and financial stressors. (3) "Wellness " means a broad approach for things individuals can do at their own pace, in their own time, and within their own abilities, that can help them feel better and live longer. (D) Peer support services may include, but are not limited to: (1) Ongoing exploration of recovery, resiliency, and wellness needs; (2) Supporting individuals and their caregivers and families in achieving goals through increased knowledge, skills and connection as identified by the individual or family; (3) Encouraging hope; (4) Supporting the development of life skills; (5) Developing and working toward achievement of individualized recovery, resiliency, and wellness goals; (6) Modeling personal responsibility for resiliency, recovery and wellness; (7) Teaching and coaching skills to effectively navigate systems to effectively and efficiently utilize services; (8) Addressing skills or behaviors, through processes that assist an individual, caregiver, or family in eliminating barriers to achieving or maintaining recovery, resiliency, and wellness; (9) Assisting with accessing and developing natural support systems; (10) Promoting coordination and linkage among providers; (11) Coordinating or assisting in crisis interventions and stabilization; (12) Conducting outreach and community education; (13) Attending and participating in team decision making or specific treatment team; or, (14) Assisting individuals, caregivers, or families in the development of empowerment skills through advocacy and activities that mitigate discrimination and inspire hope. (E) Providing services in a culturally inclusive and competent manner which includes not practicing, condoning, facilitating, or collaborating in any form of discrimination on the basis of ethnicity, race, gender, sexual orientation, age, religion, national origin, marital status, political belief, or mental or physical disability. (F) Peer support services are not site specific but shall be provided in locations that meet the needs of the individual, caregiver, or families. (G) Peer support services may be facilitated to individuals, families, or groups. (H) Peer support services shall be provided a person certified in accordance with in rule 5122-29-15.1 of the Administrative Code. (I) Peer support services providers shall report for any certified peer supporter employed by or volunteering with the provider to the Ohio department of mental health and addiction services any events that would disqualify the certified peer supporter pursuant to rule 5122-29-15.1 of the Administrative Code. Last updated April 7, 2022 at 8:30 AM Supplemental Information |
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Rule 5122-29-15.1 | Adult, family, and youth certified peer supporter.
(A) Certified peer recovery supporter. (1) A "certified peer recovery supporter" (CPRS) is an individual, with a direct lived experience, who has self-identified as being in recovery from a mental health or substance use disorder and has been certified pursuant to this rule. (2) For CPRS certification the individual will be at least eighteen years of age at the time of certification. (B) Certified youth peer supporter. (1) A certified youth peer supporter (CYPS) is an individual who self-identifies as having lived experience with the behavioral health care system and other child or youth serving systems and has been certified by the state pursuant to this rule. (2) For CYPS the individual will be at least eighteen years of age but no older than thirty years of age at the time of certification. (C) Certified family peer supporter. (1) A certified family peer supporter (CFPS) is an individual who has self-identified as the caregiver of a person with behavioral health challenges who has successfully navigated service systems for at least one year on behalf of the person and has been certified pursuant to this rule. (2) For CFPS certification the individual will be at least twenty-one years of age at the time of certification. (D) "Certified peer supporter" as used in this rule means an individual certified as a CPRS, CYPS, or CFPS. (E) Supervision Certified peer supporters will be supervised by an individual who either: (1) ) Has experience delivering peer services in behavioral health over a cumulative period of two years, has completed the sixteen hours of online learning administered or designated by the department, and has completed the four-hour supervising peers training administered or designated by the department; or, (2) Is a clinician with one of the following licenses, and has completed the sixteen hours of online learning administered or designated by the department and has completed the four-hour supervising peers training administered or designated by the department: (a) Licensed social worker; (b) Licensed independent social worker; (c) Licensed professional counselor; (d) Licensed chemical dependency counselor II; (e) Licensed chemical dependency counselor III; (f) Licensed professional clinical counselor; (g) Licensed independent chemical dependency counselor; (h) Licensed marriage and family therapist; (i) Licensed independent marriage and family therapist; (j) Psychologist; or, (k) Psychiatrist. (F) Certification (1) To obtain peer supporter certification individuals will submit a complete and compliant application including the following documentation: (a) Proof of a minimum of forty hours of department approved competency-based peer services training or three equivalent years formal, verifiable experience providing behavioral health peers services pursuant to rule 5122-29-15 of the Administrative Code. (b) Hold a high school diploma, a general educational development certification, or similar secondary education from outside of the United States; (c) Documentation of passing the department peer supporter exam, or an exam administered or designated by the department; (d) Certified peer supporters will attest to having read and understood the code of ethics at initial certification and every certification renewal thereafter; (e) The results of a bureau of criminal investigation and federal bureau of investigation criminal records check conducted within one year of submission. (2) For CPRS and CYPS certification, completion of sixteen hours of online learning administered or designated by the department. (3) Certifications issued by the department expire two years from the date the certification issued or renewed. (G) Renewal of certification (1) Peer supporter certification renewal will include submission of a complete and compliant application, including the following: (a) Documentation of thirty hours of continuing education credits, which will include the following competencies and minimum hours; (i) Ethics (may include HIPAA, confidentiality) - three hours; (ii) Boundaries - three hours; (iii) Diversity and inclusion/cultural sensitivity - two hours; (iv) System navigation and care coordination - one hour; (v) Trauma informed care - two hours; (vi) Human trafficking - one hour; (vii) Behavioral health knowledge (may include recovery and resiliency) - one hour; (viii) Basic principles related to health and wellness - one hour; and, (ix) Principles of coaching as applied to the delivery of peer services - two hours. Continuing education credits will be accepted from a continuing education program that meets the professional needs of the intended clientle, which will include certified peer recovery supporters, certified family peer supporters, certified youth peer supporters, counselors, social workers, marriage and family therapists, psychologists, nurses, chemical dependency counselors, or other human service professionals. The program will have a minimum duration of one clock hour. The program will have written goals and objectives which are responsive to the needs of prospective attendees. (b) Certified peer supporters will attest to having read and understood the code of ethics at initial certification and every certification renewal thereafter. (c) For those certified peer supporters providing supervision, documentation of three hours of supervisor training. (d) Either an attestation that the applicant has not been convicted of any new felony offenses, or a new background check pursuant to paragraph (L) of this rule. (2) Renewal of certified peer supporter status is dependent on all materials being completed, submitted, and approved by the department. Renewal of certification is for two years from the date of the expiration of previous certification or the approval of the renewal certification, whichever is later. (H) Denial of initial or renewal certification (1) An application for initial or renewal certification may be denied and a certification may be revoked for the following: (a) Failure to provide peer supporter services in accordance with the standards set forth in this rule. (b) Failure to submit a complete certification or renewal application. (c) Failure to complete any of the standards for certification or renewal. (d) The department determines that the certified peer supporter code of ethics has been violated. (e) The individual is included in one of the following databases: (i) The sex offender and child-victim offender database established pursuant to division (A)(11) of section 2950.13 of the Revised Code (available at http://www.icrimewatch.net/index.php?AgencyID=55149&disc=); (ii) The database of incarcerated and supervised offenders established pursuant to section 5120.66 of the Revised Code (available at http://www.drc.ohio.gov/OffenderSearch/Search.aspx). (f) A background check that has any of the permanently disqualifying offenses listed in paragraph (O) of this rule. (g) A background check that has any of the five year disqualifying offenses listed in paragraph (O) of this rule, when five years have not elapsed between the release of all sanctions for the offense, and the submission of the certification application. (2) The denial of an application for certification or renewal, or the revocation of certification is subject to appeal under Chapter 119. of the Revised Code. (3) Upon receipt of an application, the department will review the materials to determine if they are complete. If an application is incomplete, the department will notify the applicant of corrections or additions needed. Incomplete materials will not be considered an application for certification, and will not constitute a denial of an application for certification. (4) Any individual who has had their certification revoked or an application denied pursuant to this rule will not be eligible to apply to the department for certification for at least three years from the date of revocation. (I) Inactive-lapsed status. (1) Certifications issued pursuant to this rule are valid for two years from the issue date. If a certification is not renewed it will be placed in an inactive-lapsed status for a period of no more than two years. (2) A certification in an inactive-lapsed status may be renewed by an individual by meeting the renewal standards of paragraph (G) of this rule. (3) Certifications in inactive-lapsed status for more than two years will be considered as expired and any individual seeking certification will apply as new. (J) Voluntary inactive status (1) A person certified pursuant to this rule may submit a request to the department to have the person's certification classified as inactive. If the person's certification is in good standing the department will classify the certification as inactive. The inactive classification will become effective immediately when the inactive request is processed. (2) During the period that a certification is classified as inactive, the person can not engage in the practice of professional peer support, as applicable, in this state or make any representation to the public indicating that the person is actively certified pursuant to this rule. (3) During the period that a certification is classified as inactive, the person will be subject to the code of ethics as defined in paragraph (N) of this rule. (4) A person whose certification has been classified as inactive may apply to the department to have the certification reactivated. The department will reactivate the certification if the person meets the standards for certification or renewal pursuant to paragraph (G) of this rule. (5) During the time a certification is in voluntary inactive status the department may revoke or deny a certification pursuant to paragraph (H) of this rule when a certification is classified as inactive. (6) The certification may stay inactive for no longer than two years from the date the inactive status is issued. After two years of an inactive status, a certification is no longer valid and the person will need to apply for initial certification as set forth in paragraph (F) of this rule. (7) If the certification is past the date on which it would have originally expired, the person will submit documentation of the successful completion of thirty continuing education credits within the inactive status period. (K) Applications for certification and renewal, and all accompanying materials, are subject to public records requests pursuant to Chapter 149. of the Revised Code; however the department will not use the applications for any purpose other than determining certification status and will be kept confidential unless disclosure is mandated by state or federal law. (L) Background check (1) All applicants for an initial certification will submit a request to the bureau of criminal identification and the federal bureau of investigation for a criminal records check of the applicant per sections 4776.02 and 4776.03 of the Revised Code and will include a federal bureau of identification criminal records check request. This applies to all initial applications. The applications for criminal records check will comply with section 109.572 of the Revised Code. (2) Section 4776.02 of the Revised Code states that all fingerprint reports be sent directly to the department from the bureau of criminal identification and investigation. Any fingerprint results mailed to or from some other source will not be accepted. (M) Pardons and certificates. A conviction of, or a plea of guilty to, a disqualifying offense as set forth in paragraph (K) of this rule will not prevent an applicant from certification if any of the following circumstances apply: (1) The applicant has been granted an unconditional pardon for the offense pursuant to Chapter 2967. of the Revised Code; (2) The applicant has been granted an unconditional pardon for the offense pursuant to an existing or former law of the state of Ohio, any other state, or the United States, if the law is substantially equivalent to Chapter 2967. of the Revised Code; (3) The applicant has been granted a conditional pardon for the offense pursuant to Chapter 2967. of the Revised Code, and the condition(s) under which the pardon was granted have been satisfied; (4) The applicant's conviction or guilty plea has been set aside pursuant to law; (5) The applicant was adjudicated delinquent for any of the disqualifying offenses in paragraph (K) of this rule; or, (6) A certificate of qualification for employment has been issued by an Ohio court of common pleas pursuant to section 2953.25 of the Revised Code, or an equivalent certification has been issued by an out of state or federal jurisdiction. Applications that include a certificate of qualification for employment or an equivalent certification associated with a permanent exclusion offense as stated in paragraph (O) of this rule, will be reviewed by the department and a decision will be rendered by the department on a case-by-case basis as to whether an application will be approved or not in accordance with section 2953.25 of the Revised Code. (N) Code of ethics (1) The code of ethical practice and professional conduct constitutes the standards by which the professional conduct of peer supporters will be measured. (2) A violation of the code of ethics unprofessional conduct and is sufficient reason for revocation, or for the denial of the initial certification or renewal. (3) Certified peer supporters will attest to having read and understood the code of ethics at initial certification and every certification renewal thereafter. (4) Certified peer supporters in their various professional roles, relationships, and areas of responsibilities will (a) Use the strength-based model when working with individuals; (b) Respect the rights and dignity of those they work with; (c) Openly share their personal recovery and resiliency stories with colleagues and those they serve; (d) Role-model recovery and resiliency. ; (e) Adhere to privacy and confidentiality of those they serve; (f) Conduct themselves in a professional manner, including: (i) Never intimidating, threatening, or harassing those they serve; (ii) Never using undue influence, physical, force, or verbal abuse with those they serve; (iii) Never making unwarranted promises of benefits to those they serve; and, (iv) Maintaining high standards of personal conduct. (g) Conduct themselves in a culturally competent manner which includes not practicing, condoning, facilitating, or collaborating in any form of discrimination on the basis of ethnicity, race, gender, sexual orientation, age, religion, national origin, marital status, political belief, or mental or physical disability. (h) Conduct themselves in a manner that fosters their own recovery and resiliency, maintaining healthy behaviors. (i) Not enter dual relationships or commitments that conflict with the interests of those they serve; (j) Not engage in sexual or intimate activities with colleagues or those they serve; (k) Not accept or give gifts of significant value from those they serve: (l) Keep current with emerging knowledge relevant to recovery and resiliency, and openly share this knowledge with my colleagues and those they serve; and, (m) Comply with laws and regulations involving mandatory reporting of harm, abuse, or neglect. (O) Disqualifying offenses (1) The following offenses (sections of the Revised Code) are permanently disqualifying as set forth in this rule; any equivalent federal offense or offense from another state will also by permanently disqualifying. (a) 2903.01 (aggravated murder); (b) 2907.02 (rape); (c) 2907.03 (sexual battery); (d) 2907.05 (gross sexual imposition); (e) 2907.32 (pandering obscenity); (f) 2907.322 (pandering sexually-oriented matter involving a minor); (g) 2907.323 (illegal use of minor in nudity-oriented material or performance); (h) 2909.23 (making terrorist threat); (i) 2909.24 (terrorism); (2) The following offenses (sections of the Revised Code) are disqualifying for a period of five years from the end any sanctions as set forth in this rule; any equivalent federal offense or offense from another state will also by disqualifying for a period of five years. (a) 2903.15 (permitting child abuse); (b) 2903.16 (failing to provide for a functionally impaired person); (c) 2903.34 patient abuse and neglect (d) 2903.341 patient endangerment (e) 2905.05 criminal child enticement (felony level) (f) 2905.33 (unlawful conduct with respect to documents); (g) 2905.32 trafficking in persons (h) 2907.04 unlawful sexual conduct with a minor, formerly corruption of a minor (i) 2907.06 sexual imposition (j) 2907.07 importuning (k) 2907.08 voyeurism (l) 2907.12 felonious sexual imposition (m) 2907.31 disseminating matter harmful to juveniles (n) 2907.321 pandering obscenity involving a minor (o) 2909.22 soliciting/providing for act of terrorism (p) 2913.40 (medicaid fraud); (q) 2919.22 endangering children Last updated April 8, 2022 at 10:16 AM Supplemental Information |
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Rule 5122-29-16 | Peer run organization.
(A) "Peer run organization" means any service or activity that is planned, developed, administered, delivered, and evaluated by persons, a majority of whom have a direct lived experience of a mental health or substance use disorder. (B) "Recovery" as used in this rule has the same meaning as defined in paragraph (C) of rule 5122-29-15 of the Administrative Code. (C) Peer run organizations include but are not limited to consumer operated services, recovery community organizations, peer drop-in centers, and club houses. (D) Peer run organizations shall: (1) Have a primary goal of enhancing the quantity and quality of support available to individuals seeking recovery from mental health or substance use disorders; (2) Be grounded in three core principles: a recovery vision, authenticity of voice, and accountability to the recovery community; (3) Promote the strategies of public awareness and education, personal empowerment, and peer based- and other recovery support services and activities which may include: peer recovery support, telephone recovery support services, all-recovery meetings, structured volunteer/work activities, groups, social activities, or wellness activities; (4) Be responsive to the needs of individuals participating in services and be based on local needs as identified by the individuals participating in the service. Supplemental Information |
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Rule 5122-29-17 | Community psychiatric supportive treatment (CPST) service.
(A) Community psychiatric supportive treatment (CPST) service provides an array of services delivered by community based, mobile individuals or multidisciplinary teams of professionals and trained others. Services address the individualized mental health needs of the client. They are directed towards adults, children, adolescents and families and will vary with respect to hours, type and intensity of services, depending on the changing needs of each individual. The purpose/intent of CPST services is to provide specific, measurable, and individualized services to each person served. CPST services should be focused on the individual's ability to succeed in the community; to identify and access needed services; and to show improvement in school, work and family and integration and contributions within the community. (B) Activities of the CPST service shall consist of one or more of the following: (1) Ongoing assessment of needs; (2) Assistance in achieving personal independence in managing basic needs as identified by the individual and/or parent or guardian; (3) Facilitation of further development of daily living skills, if identified by the individual and/or parent or guardian; (4) Coordination of the ISP, including: (a) Services identified in the ISP; (b) Assistance with accessing natural support systems in the community; and (c) Linkages to formal community service/systems; (5) Symptom monitoring; (6) Coordination and/or assistance in crisis management and stabilization as needed; (7) Advocacy and outreach; (8) As appropriate to the care provided to individuals, and when appropriate, to the family, education and training specific to the individual's assessed needs, abilities and readiness to learn; (9) Mental health interventions that address symptoms, behaviors, thought processes, etc., that assist an individual in eliminating barriers to seeking or maintaining education and employment; and (10) Activities that increase the individual's capacity to positively impact his/her own environment. (C) The methods of CPST service delivery shall consist of: (1) Service delivery to the person served and/or any other individual who will assist in the person's mental health treatment. (a) Service delivery may be face-to-face, by telephone, and/or by video conferencing; and (b) Service delivery may be to individuals or groups. (2) CPST services are not site specific. However, they must be provided in locations that meet the needs of the persons served. When a person served is enrolled in a residential treatment or residential support facility setting, CPST services must be provided by staff that are organized and distinct and separate from the residential service as evidenced by staff job descriptions, time allocation or schedules, and development of service rates. (D) There must be one CPST staff who is clearly responsible for case coordination. This staff person must be an employee of an agency that is certified by ODMH to provide CPST services. This person may delegate CPST services to eligible providers internal and/or external to the certified agency as long as the following requirements and/or conditions are met: (1) All delegated CPST activities are consistent with this rule in its entirety; (2) The delegated CPST services may be provided by an entity not certified by ODMH to provide CPST services as long as there is written agreement between the certified agency and the non-certified entity that defines the service expectations, qualifications of staff, program and financial accountability, health and safety requirements, and required documentation; and (3) An entity that is not certified by ODMH for CPST service may only seek reimbursement for CPST services through a certified agency and with a written agreement as required in this paragraph. (E) Providers of CPST service shall have a staff development plan based upon identified individual needs of CPST staff. Evidence that the plan is being followed shall be maintained. The plan shall address, at a minimum, the following: (1) An understanding of systems of care, such as natural support systems, entitlements and benefits, inter- and intra-agency systems of care, crisis response systems and their purpose, and the intent and activities of CPST; (2) Characteristics of the population to be served, such as psychiatric symptoms, medications, culture, and age/gender development; and (3) Knowledge of CPST purpose, intent and activities. (F) Community psychiatric supportive treatment (CPST) service shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-18 | Therapeutic behavioral services and psychosocial rehabilitation.
(A) Therapeutic behavioral services (TBS) and psychosocial rehabilitation (PSR) services are an array of activities intended to provide individualized supports or care coordination of healthcare, behavioral healthcare, and non-healthcare services. TBS and PSR may involve collateral contacts and may be delivered in all settings that meet the needs of the individual. (B) Service activities. (1) TBS service activities include, but are not limited to the following: (a) Consultation with a licensed practitioner or an elgible provider pursuant to paragraph (C) of this rule, to assist with the individual's needs and service planning for individualized supports or care coordination of healthcare, behavioral healthcare, and non-healthcare services and development of a treatment plan; (b) Referral and linkage to other healthcare, behavioral healthcare, and non-healthcare services to avoid more restrictive levels of treatment; (c) Interventions using evidence-based techniques; (d) Identification of strategies or treatment options; (e) Restoration of social skills and daily functioning; and, (f) Crisis prevention and amelioration. (2) PSR service activities include, but are not limited to the following (a) Restoration, rehabilitation and support of daily functioning to improve self-management of the negative effects of psychiatric or emotional symptoms that interfere with a person's daily functioning; (b) Restoration and implementation of daily functioning and daily routines critical to remaining successfully in home, school, work, and community; and, (c) Rehabilitation and support to restore skills to function in a natural community environment. (C) Eligible providers. (1) Eligible providers of TBS are those practitioners who have : (a) A bachelor's or master's degree in social work, psychology, nursing, or in related human services, or (b) A high school diploma with a minimum of three years of relevant experience. (2) Eligible providers for PSR services are those practitioners who have a high school diploma and specific training related to persons with mental health conditions or needs. Supplemental Information |
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Rule 5122-29-19 | Consultation service.
(A) "Consultation service" means a formal and systematic information exchange between a provider and a person other than a client, which is directed towards the development and improvement of individualized service plans and/or techniques involved in the delivery of behavioral health services. (B) Consultation may be focused on the clinical condition of a person served by another system or focused on the functioning and dynamics of another system. Consultation related to the clinical condition of a person served shall be provided by staff qualified according to paragraph (C) of this rule. (1) The provider shall survey periodically other community systems to determine behavioral health consultation needs that may be desired by the systems, persons or families being served by those other systems. (2) The provider shall maintain a record of all consultation services provided, including the name of the person or system to whom the service was provided, the nature of the consultation, and the outcome of the consultation. (C) Consultation service shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-20 | Prevention services.
(A) As used in this rule: (1) "Adverse childhood experiences" or "ACES" mean potentially traumatic events that occur during childhood (ages zero to seventeen years of age). "Adverse childhood experiences" include physical and emotional abuse, neglect, caregiver mental illness, and household violence. (2) "Brief intervention" means a time-limited, structured behavioral health intervention using techniques such as motivational engagement that are personalized to reduce risk and encourage behavior change. (3) "Coalition" means a group of diverse organizations and constituent groups working together, using a comprehensive public health approach and data driven planning process, toward a common goal of reducing the local incidence, prevalence, and consequences of mental, emotional, and behavioral (MEB) disorders. (4) "Culturally relevant" means the service delivery system response to the cultural, linguistic, beliefs, and practices of the community as demonstrated through readiness, resource, and needs assessment activities; capacity development efforts; engaging stakeholders in planning; sound implementation science; and evaluation, quality improvement, and sustainability activities. (5) "Direct services" mean interactive prevention interventions that require personal contact with individuals or groups to influence individual-level change. "Direct services" include classroom-based programming, parent programs, training, and coalition building. (6) "Early intervention" means an integral part of the continuum of prevention services that includes providing early services and supports after serious risk factors have been identified. These interventions are implemented to halt or slow the impact of those risks and indicators of MEB disorders in the earliest stages. (7) "Evidenced-based" means a program, practice, policy, strategy, or intervention that has been identified as effective by a nationally-recognized organization, a federal agency, or agency of this state and has produced a consistent, positive pattern of results on the majority of the intended recipients or target population. (8) "Evidence-informed" means practices, strategies, policies, or interventions that were developed based on the best research available in the field. These activities have a strong scientific basis for their use and there is confidence from recognized institutions that these will have a consistent positive pattern of results or fit within prevention best-practice frameworks. (9) "Indirect services" mean population-based prevention interventions that require sharing resources and collaborating to contribute to community-level change. "Indirect services" include compliance checks, media campaigns, advocacy, and resource development. (10) "Mental, emotional, and behavioral health (MEB) development" or "MEB development" means a product of complex neurobiological processes that interact with characteristics of the physical and social environment, beginning before conception and continuing through and beyond adolescence. (11) "Mental, emotional, and behavioral health disorders" or "MEB disorders" mean a number of conditions that exist on a continuum, including mental and substance use disorders, while including a broader range of concerns associated with problem behaviors in youth. (12) "Mental health promotion" means actions supporting the development of protective factors and healthy behaviors that can help promote healthy MEB development and prevent or reduce risk factors that could lead to the development of a diagnosable MEB disorder. (13) "Prevention services" means a planned sequence of culturally relevant, evidence-based strategies designed to reduce the likelihood of or delay the onset of MEB disorders. "Prevention services" include direct services and indirect services. (14) "Protective factor" means a characteristic at the biological, psychological, family, or community level that is associated with a lower likelihood of problem outcomes or that reduce the negative impact of a risk factor on problem outcomes. (15) "Public health approach" means a model that attempts to prevent or reduce a particular illness or social problem in a population by identifying risk factors and implementing strategies to improve conditions. (16) "Resiliency" means the ability to adapt and grow in response to adversity, stress, or trauma. Building resiliency includes a focus on strategies that mitigate risk and build protections in individuals and communities that prevent adverse childhood experiences and other risks that contribute to MEB disorders. (17) "Risk factor" means a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes. (18) "Screening" means a process that identifies risk factors or early behaviors that make MEB disorders more likely and can be carried out at the individual, group, and community level. Screening segments a portion of those screened who could benefit from additional interventions, including a referral for a diagnostic assessment. (19) "Social determinants of health" mean conditions in places where people live, learn, work, and play that affect a wide range of health risks and outcomes. "Social determinants of health" include economic stability, education, health and healthcare, neighborhood and built environment, and social and community context. (20) "Trauma-informed" means a program, organization, or system that does all of the following: (a) realizes the widespread impact of trauma and understands potential paths for recovery; (b) recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; (c) responds by fully integrating knowledge about trauma into policies, procedures, and practices; and (d) seeks to actively resist re-traumatization. (21) "Workforce development" means learning opportunities designed to increase knowledge, skills, and abilities of the workforce and includes training, conferences, virtual learning webinars, and communities of practice. (B) Prevention services involve a continuum of coordinated efforts developed within a comprehensive public health approach combining the use of the following evidence-based strategies in appropriate proportions. Mental health promotion and early intervention are part of this continuum and use a combination of the approaches and methods described in paragraphs (B)(2) and (B)(3) of this rule. (1) Evidence-based prevention strategies (a) Education: This strategy increases knowledge and skills, as well as influences attitude or behavior. This strategy does not include education provided as a component of treatment services. (b) Environmental: This strategy seeks to establish or change standards or policies that will reduce the incidence and prevalence of behavioral health problems in a population. (c) Community-based process: This strategy focuses on enhancing the ability of the community to provide prevention services through organizing, training, planning, interagency collaboration, coalition building, or networking. This strategy is essential to effectively implementing environmental strategies that will impact social determinants of health. (d) Alternatives: This strategy focuses on providing opportunities for positive behavioral support that reduce risk taking behavior and reinforce protective factors achieved through attachment and bonding to families, schools, communities, and peers. The opportunities are to be provided as part of a larger comprehensive prevention effort. (e) Information dissemination: This strategy builds knowledge and awareness of the nature and extent of risk and protective factors related to MEB disorders and their effects on individuals, families, and communities. (f) Problem identification and referral: This strategy focuses on identifying individuals who exhibit behavior or risk indicators and referring them for prevention interventions, clinical assessment, or services. An example of this strategy is universal screening in a school. (2) Mental health promotion involves the use of one or both of the following approaches: (a) Universal efforts to enhance an individual's ability to achieve developmentally appropriate tasks and a positive sense of self-esteem, mastery, well-being, and social inclusion, as well as strengthening their ability to cope with adversity by targeting skills (such as self-regulation, self-efficacy, goal setting, and building positive relationships) that build resiliency; (b) Actions to strengthen the policy environment and use of strategic communication for network building, stakeholder engagement, enhanced mental health literacy, and behavior change. (3) Early intervention involves the use of both of the following methods: (a) A comprehensive developmental approach that is collaborative, culturally relevant, and geared toward skill development or increasing protective factors; and (b) Services and supports that are provided to individuals and families prior to receiving a clinical diagnosis, are usually included in the indicated category, and most often use education and problem identification and referral strategies, such as screening and brief interventions. (C) Subject to paragraph (D) and except as provided in paragraph (G) of this rule, a provider that seeks to receive the government funds described in division (B) of section 5119.36 of the Revised Code for its prevention services is to have those services certified by the department of mental health and addiction services by meeting all of the following standards: (1) The provider uses at least one of the following evidence-based prevention strategies described in paragraph (B)(1)(a), (B)(1)(b), or (B)(1)(c) of this rule: education, environmental, or community-based process. (2) All prevention interventions used by the provider are evidence-based or evidence-informed by prevention science as demonstrated by one of the following: (a) A theory of change that is documented in a logic or conceptual model; (b) A description of the intervention in a national registry or peer-reviewed journal; (c) Documentation that the intervention has been implemented showing a consistent pattern of positive results; or (d) Documentation that the intervention has been reviewed and found appropriate by a panel of informed prevention experts or key community leaders that includes a description of each reviewer's qualifications. (3) The provider is implementing interventions that are targeted to various populations based on the following levels of risk: (a) Universal: targeted to the general public or a whole population group that has not been identified on the basis of individual risk. (b) Selective: targeted to individuals or a subgroup of the population whose risk of developing mental, emotional, or behavioral disorders is significantly higher than average. (c) Indicated: targeted to high-risk individuals who are identified as having minimal but detectable signs or symptoms that foreshadow an MEB disorder, as well as biological markers that indicate a predisposition in a person for such disorder prior to a clinical diagnosis. (4) Within a targeted population, the provider is implementing interventions by considering all of the following: (a) Conceptual fit addressing identified risk and protective factor priorities; (b) Cultural relevance and support from key prevention stakeholders; (c) Adverse childhood experiences and trauma-informed implications; and (d) Age and gender appropriateness. (5) The provider employs or contracts with either or both of the following to provide prevention interventions: (a) Licensed or certified individuals, consistent with paragraph (B) of rule 5122-29-30 of the Administrative Code, who are able to show (i) prevention competency within the professional scope of practice of the appropriate license, certification, or registration issued by a regulatory board of this state and (ii) compliance with the supervisory and ethical requirements identified by such regulatory board. (b) Prevention specialist assistants, prevention specialists, or prevention consultants certified under Chapter 4758. of the Revised Code who are working within their professional scope of practice and are supervised in accordance with rules 4758-6-08, 4758-6-09, and 4758-6-10 of the Administrative Code. (6) The provider has a process to ensure volunteers assisting with prevention interventions are supervised by one or more individuals who are eligible, in accordance with rule 5122-29-30 of the Administrative Code, to supervise within the applicable professional scope of practice. (7) The provider has a procedure for prevention service providers to document their workforce development and continuing education hours for purposes of staying current with the latest developments in prevention science. (8) The provider has a procedure for referring individuals participating in prevention services to all of the following when a need is identified: (a) Substance use, problem gambling, or other mental health disorder treatment and primary care health services; (b) Social services; and (c) Community resources. (9) The provider has a plan for evaluating the effectiveness of the prevention services it provides and its workforce development approaches. (10) The provider has a plan to maintain, in accordance with paragraph (E)(3) of rule 5122-27-01 of the Administrative Code, documentation for the prevention services it provides. (D) A provider that is a coalition is not subject to the certification requirement in paragraph (C) of this rule until July 1, 2025. The applicability of paragraph (C) on providers that are coalitions, beginning July 1, 2025, does not prohibit a board of alcohol, drug addiction, or mental health services from doing any of the following: (1) Participating as a member or convener of a coalition; (2) Serving as a fiscal or administrative agent for a coalition; (3) Providing staff support for a coalition; (4) Submitting an application for certification on a coalition's behalf, as long as the board indicates the coalition's name in the space designated for the provider's "doing business as" name and all other information the board submits as part of the application is about the coalition as the provider. As provided in section 340.037 of the Revised Code, a board of alcohol, drug addiction, or mental health services is not permitted to provide prevention services except as permitted under that section. (E) A provider that is a coalition, and that is not requesting deemed status according to rule 5122-25-02 of the Administrative Code, is to file an application according to the procedure in rule 5122-25-03 of the Administrative Code except that the coalition is only required to submit as part of the application all of the following: (1) The items specified in paragraphs (A)(1)(a)(i), (A)(1)(a)(iii) to (A)(1)(a)(ix), (A)(1)(a)(xi), (A)(1)(a)(xii), and (A)(1)(a)(xiv) of rule 5122-25-03 of the Administrative Code; (2) The address and telephone number the coalition uses for legal notice and correspondence; (3) A written description of the coalition's governance structure and a written table of organization or organization chart; (4) Upon request of the department and if applicable, the corporate information specified in paragraph (A)(1)(b) of rule 5122-25-03 of the Administrative Code. (F) A provider that is a coalition and that is seeking certification under this rule is exempt from the certification fee for prevention services specified in rule 5122-25-08 of the Administrative Code. (G) All of the following are not subject to the certification requirement in paragraph (C) of this rule, although each may attain certification on a voluntary basis: (1) An educational entity under the jurisdiction of the Ohio department of education or Ohio department of higher education; (2) A board of health of a general or city health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code that has received accreditation from the public health accreditation board; (3) A faith-based organization that is actively working with a provider certified under this rule, as verified in writing by that provider; (4) A county family and children first council established under division (B)(1) of section 121.37 of the Revised Code. (H) A provider whose prevention services have been certified pursuant to this rule is not required to keep records of individuals who receive prevention services. Any records which are kept, however, are to be kept in compliance with the requirements of 42 C.F.R. part 2 and the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, 45 C.F.R. part 160 and subparts A and E of part 164. Last updated October 2, 2023 at 8:34 AM Supplemental Information |
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Rule 5122-29-22 | Referral and information service.
(A) "Referral and information service" means responses, usually by telephone, to inquiries from people about services in the community. Referral may include contacting any agency or a provider in order to secure services for the person requesting assistance. (B) Referral and information service shall be planned and coordinated with other health and human service providers, and shall: (1) Have a mechanism to compile information about services available in the service system and the community; and (2) Have mechanisms to determine whether persons referred were able to access services, were satisfied with the services, or experienced any problems with the referral source. This information shall be used to determine if particular providers shall continue to be used as referrals for persons seeking services. All state and federal confidentiality laws shall be adhered to in this process. (C) The provider shall ensure access and availability of referral and information service including: (1) A referral and information service shall have a published telephone number, including a published telephone number for special telephone services for the hearing impaired; and (2) The provider shall ensure access and availability for persons whose primary means of communication is a language other than english, and for persons with communication impairments such as speech, language or hearing disorders, access to telecommunication relay services (TRS), and for persons with visual impairments. A TRS is a telephone service that allows persons with hearing or speech disabilities to place and receive telephone calls, such services include but are not limited to text to speech relay and signing to speech relay. (D) Each call and contact shall be logged and shall include the date, time and person answering the call or contact. (E) A referral and information service is not hotline service, and is not intended to replace the crisis assistance function of a hotline service. Supplemental Information |
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Rule 5122-29-27 | Supplemental behavioral health services.
(A) "Supplemental behavioral health services" means services other than those specifically listed in this chapter. Supplemental behavioral health services may include representative payeeship, outreach, screening, education, and other supportive behavioral health services and may be offered by a variety of entities, including YMCAs, churches, children's cluster or family and children first. (B) Supplemental behavioral health services approved by the board of alcohol, drug addiction, and mental health services and the department shall: (1) Ensure that the provider or organization providing the service meets the appropriate standards or regulations under which they operate; (2) Ensure that staff providing behavioral health services have participated in orientation or training regarding basic information about mental illness, emotional disturbance, and substance use disorders, and know how to obtain assistance from the behavioral health system if needed; and (3) Develop mechanisms to solicit and receive feedback about the quality of the service from persons served. (C) Providers furnishing supplemental behavioral health services shall receive certification to provide the service(s) according to either paragraph (A)(1)(f) of rule 5122-25-03 of the Administrative Code or paragraph (A)(1)(f) of rule 5122-25-04 of the Administrative Code. Supplemental Information |
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Rule 5122-29-28 | Intensive home based treatment (IHBT) service.
(A) In addition to the definitions in rule 5122-24-01 of the Administrative Code, the following definitions apply to this rule: (1) "Caseload" means the individual cases open or assigned to each full-time equivalent IHBT staff. (2) "Continued stay review" means a review of a child/adolescent's functioning to determine the need for further services to achieve or maintain service goals and objectives. (3) "Crisis response" means the immediate access and availability, as clinically indicated, to the child/adolescent and family, which may include crisis stabilization services in accordance with rule 5122-29-10 of the Administrative Code, safety planning, and the alleviation of the presenting crisis. (4) "Family" means any individual or caregiver related by blood or affinity whose close association with the person is the equivalent of a family relationship as identified by the person; including kinship and foster care. (5) "Home" means any family living arrangement including but not limited to biological, kinship, adoptive, foster home, and non-custodial families who have made a commitment to the child/adolescent. (6) "Out-of-home placement" means any removal of the child/adolescent from his or her home. Planned respite, where the child's main residence remains their home, is not considered out-of-home placement. (B) Intensive home based treatment (IHBT) service is a comprehensive behavioral health service provided to a child/adolescent with serious emotional disturbance (SED) and their family, designed to treat mental health conditions that significantly impair functioning. IHBT may also be utilized for the treatment of children and adolescents that have co-occurring substance use or neurodevelopmental needs, when these needs co-occur with a mental health condition. IHBT is provided for the purpose of preventing out of home placement or facilitating a successful transition back home. IHBT integrates trauma-informed and resilience-focused assessment, crisis response, individual and family psychotherapy, service and resource coordination, and rehabilitative skill development with the goal of either preventing the out-of-home placement or facilitating a successful transition back to home. These intensive, time-limited behavioral health services are provided in the child/adolescent's natural environment with the purpose of stabilizing and improving their behavioral health functioning as documented using the Ohio specific child and adolescent needs and strengths (CANS) tool. The purpose of IHBT is to enable a child/adolescent with SED to function successfully in the least restrictive, most normative environment. IHBT services are culturally, ethnically, racially, developmentally and linguistically appropriate, and respect and build on the strengths of the child/adolescent and family's race, culture, and ethnicity. (C) The following describes the activities and components of IHBT: (1) IHBT is an intensive service that consists of multiple in person contacts per week with the child/adolescent and family, which includes collateral contacts related to the behavioral health needs of the child/adolescent as documented in the individual client record (ICR) as required by Chapter 5122-27 of the Administrative Code. IHBT can be provided via telehealth in accordance with rule 5122-29-31 of the Administrative Code. (2) IHBT is provided in the home, school, and community where the child/adolescent lives and functions; (3) The frequency and modality of contacts may fluctuate based on the assessed needs and unique circumstances of the child, adolescent, and family; (4) IHBT is strength-based and family-driven, with both the child/adolescent and family regarded as equal partners with the IHBT staff in all aspects of developing the service plan and service delivery; (5) Provided by staff with a caseload that averages over any six month period and per full time equivalent staff: (a) Twelve or less when provided by a team of two, or (b) Six or less when provided by an individual staff. (6) Immediate crisis response is available twenty-four hours a day seven days a week by the lead IHBT team member with back-up coverage available from other IHBT team members or the IHBT team supervisor. (7) Each child/adolescent and family receiving IHBT is assessed for risk and safety issues. A jointly written crisis and safety plan shall be developed that is provided to the child/adolescent and family; (8) Collaboration is required to be performed with other child-serving agencies or systems, e.g., school, court, developmental disabilities, child welfare, and health care providers that are providing services to the child/adolescent and family, as well as family and community supports identified by the child/adolescent and family; (9) The service activities and components are individually tailored to meet the needs of the child/adolescent and family. Appointments are made at a time that is convenient to the child/adolescent and family, including evenings and weekends if necessary; (10) The service is time-limited, with length of stay matched to the presenting behavioral health needs of the child/adolescent and the family; and (11) The IHBT team will collaboratively develop a plan to transition with each youth and family. The plan will include a focus on transition to other services, supports and providers for services and supports based on the individualized needs of the youth and family. (D) Eligibility for IHBT will be determined by the IHBT team in collaboration with the youth and family and other cross systems partners by documenting the following criteria: (1) Is clinically determined to meet the "person with serious emotional disturbance" (SED) criteria in rule 5122-24-01 of the Administrative Code and the child or adolescent; (a) Is under twenty-one years of age; (b) Has a mental health need; (c) Has an Ohio specific CANS assessment that indicates marked to severe behavioral/emotional impairment and at least one of the following: (i) Impairment that seriously disrupts life functioning; or (ii) Risk behaviors that are rated as actionable on the CANS. (2) Meets one or more of the following criteria as documented in the ICR: (a) Is at risk for out-of-home placement due to their behavioral health conditions; (b) Has returned within the previous thirty days from an out-of-home placement or is transitioning back to their home within thirty days; or (c) Requires a high intensity of behavioral health interventions to safely remain in or return home. (E) The community mental health services or addiction services provider must demonstrate that the following staff requirements and qualifications are met: (1) A minimum of two full-time equivalent staff provide the service. Services may be provided by a single person, or team of staff clearly sharing various responsibilities for the same child/adolescent and family. Each child/adolescent shall have a staff assigned with lead responsibility. (2) The provider must have a documented plan for clinical supervision of each team member. (3) The IHBT supervisor shall have primary responsibility for providing supervision to the IHBT staff twenty-four hours a day, seven days a week. If the IHBT supervisor is unavailable, then supervision must be provided by staff qualified according to rule 5122-29-30 of the Administrative Code. (F) The provider must demonstrate that each IHBT staff has an individualized training plan based on an assessment of their specific training needs. The following professional training and development criteria must be met: (1) Each staff receives an assessment of initial training needs based on the skills and competencies necessary to provide IHBT service prior to providing IHBT service; and (2) The agency shall have a written description of the skills and competencies required to provide IHBT service, which include, at a minimum, the following: (a) Family systems; (b) Risk assessment, crisis stabilization, and safety planning; (c) Parenting skills and supports for children/adolescents with SED; (d) Cultural competency; (e) Intersystem collaboration with a focus on schools, courts, and child welfare: (i) Knowledge of other systems; (ii) System advocacy; and (iii) Roles, responsibilities, and mandates of other child/adolescent-serving entities; (f) Trauma-informed and resiliency-focused care; (g) Educational and vocational functioning: (i) Assessment and intervention strategies for resolving barriers to successful educational and vocational functioning; (ii) Knowledge of special education laws; and (iii) Strategies for developing positive home-school partnerships and connections; (h) IHBT philosophy, including strength-based assessment and treatment planning; and (i) Understanding the complex and interconnected range of symptoms and needs of children and adolescents, including co-occurring substance use disorders and developmental disabilities. (G) The provider's training plan must include provisions for ongoing training specific to the identified training needs of the staff as it relates to the population served, including attention to cultural competency, changing demographics, new knowledge or research, and other areas identified by the agency. (H) The provider must demonstrate that each IHBT supervisor receives training specific to the clinical and administrative supervision of the service. (I) The provider shall obtain satisfactory fidelity reviews based on the provider's specific program modality every twelve months by an individual or organization external to the provider and designated by the Ohio department of mental health and addiction services (OhioMHAS), utilizing the IHBT individual provider model fidelity rating tool, version March 1, 2022 or the IHBT teamed-model fidelity rating tool, Version March 1, 2022 available at www.medicaid.ohio.gov, or be licensed by an OhioMHAS approved evidence-based practice (EBP). The provider shall incorporate the results of the fidelity review into the provider's performance improvement program, if indicated. (J) Intensive home based treatment service shall be supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. (K) IHBT shall be provided by persons with competency in the provision of mental health interventions through one of the following program configurations: (1) At least one licensed practitioner and at least one other licensed practitioner who is authorized to provide services pursuant to rule 5122-29-30 of the Administrative Code and who are providing an evidence-based practice approved by OhioMHAS and are working in a program licensed by a national accreditation body or their delegate. Each practitioner must have their own caseload of clients. For those providers who are delivering functional family therapy (FFT), the services may be delivered by an individual who is licensed to provide services pursuant to rule 5122-29-30 of the Administrative Code; (2) At least two or more licensed or licensed-eligible practitioners who are eligible to provide services pursuant to rule 5122-29-30 of the Administrative Code and who are providing an evidence-supported practice approved by OhioMHAS. Each practitioner must have their own caseload of clients; or (3) At least two practitioners eligible to provide services pursuant to rule 5122-29-30 of the Administrative Code. One of the practitioners must be licensed and the other either a qualified behavioral health specialist as defined in rule 5122-29-30 of the Administrative Code or a peer supporter who holds a valid and unrestricted certification from OhioMHAS issued in accordance with rule 5122-29-15.1 of the Administrative Code. The peer supporter must be a family peer supporter or a youth peer supporter in accordance with rule 5122-29-15.1 of the Administrative Code. Peer supporters will also demonstrate competency working with children or adolescents with SED and their families. These practitioners must share a caseload of clients. (L) A provider of FFT who provides the service in accordance with the national evidence based model, found at https://www.fftllc.com/about-fft-training/clinical-model.html, does not need to meet requirements of paragraphs (C) and (E) to (H) of this rule. Any provider of FFT without meeting all other requirements of this rule will be certified as "IHBT-FFT Only." Last updated March 1, 2022 at 8:33 AM Supplemental Information |
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Rule 5122-29-29 | Assertive community treatment (ACT).
(A) Assertive community treatment (ACT) services are provided to an individual with a major functional impairment or behavior which present a high risk to the individual due to severe and persistent mental illness and which necessitate high service intensity. ACT services are also provided to the individual's family and other support systems. A client receiving ACT services may also have coexisting substance use disorder, physical health diagnoses, and/or mild intellectual disability. The service is available twenty-four hours a day, seven days a week. (B) The purpose of ACT team services is to provide the necessary services and supports which maximize recovery, and promote success in employment, housing, and the community. (C) ACT service providers shall employ one or more teams of practitioners which meet the minimum fidelity criteria as described in paragraphs (D) and (E) of this rule using the tool for measurement of ACT (TMACT) or dartmouth assertive community treatment scale (DACTS). (D) For initial certification, each ACT team must achieve a minimum average overall fidelity score of 3.0 as determined by an independent validation entity recognized by the department. At its discretion, the Ohio department of mental health and addiction services (OhioMHAS) may lower the minimum score due to the COVID-19 state of emergency declared by the governor. (E) For continuing certification, each ACT team must achieve and maintain a minimum average overall fidelity score of 4.0 within three years of initial certification as determined by an independent validation entity recognized by the department. At its discretion, OhioMHAS may lower the minimum score due to the COVID-19 state of aemergency declared by the governor. (F) ACT teams shall have regular repeat fidelity reviews, no more than twelve months from the report date of the previous fidelity review, by an independent validation entity recognized by the department. (G) At any time after certification of the ACT service, the department may request a new fidelity review based on specific findings of non-compliance with the rules in this chapter. (H) For a minimum of ninety days, or until the client has stated their desire to discontinue ACT services, the ACT team shall attempt at least two contacts per month for a client who has discontinued ACT services unexpectedly. Such attempts and client response, if any, shall be documented in the individual client record. (I) ACT shall be provided and supervised by staff who are qualified according to rule 5122-29-30 of the Administrative Code. Supplemental Information |
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Rule 5122-29-30 | Eligible providers and supervisors.
(A) Individuals are eligible to provide and supervise within their professional scope of practice those services certified by the Ohio department of mental health and addiction services and listed and described in Chapter 5122-29 of the Administrative Code. (B) Licensed, certified or registered individuals shall comply with current, applicable scope of practice, supervisory, and ethical requirements identified by appropriate licensing, certifying or registering bodies. (C) Individuals providing the following services who are not otherwise credentialed by the Ohio chemical dependency professionals board; Ohio counselor, social worker and marriage and family therapist board; state medical board of Ohio; Ohio board of nursing, Ohio board of pharmacy, or Ohio board of psychology shall not provide any service or activity for which a credential by one of these boards is required by the Revised Code or Administrative Code and shall meet the requirements of a qualified behavioral health specialist in paragraph (D) of this rule: (1) Mental health day treatment in accordance with rule 5122-29-06 of the Administrative Code. (2) SUD case management services in accordance with rule 5122-29-13 of the Administrative Code. (3) Mobile response and stabilization service in accordance with rule 5122-29-14 of the Adminstrative Code. (4) Community psychiatric supportive treatment in accordance with rule 5122-19-17 of the Administrative Code. (5) Therapeutic behavioral services and psychosocial rehabilitation in accordance with rule 5122-19-18 of the Administrative Code. (6) Intensive home based treatment (IHBT) service in accordance with rule 5122-29-28 of the Administrative Code. (7) Assertive community treatment (ACT) service in accordance with rule 5122-29-29 of the Administrative Code. (D) Qualified behavioral health specialist. (1) Qualified behavioral health specialist (QBHS) means an individual who has received training for or education in either mental health or substance use disorder competencies; and who has demonstrated, prior to or within ninety days of hire the minimum competencies in basic mental health or substance use disorder and recovery skills listed in this rule. The individual shall not otherwise be required to perform duties covered under the scope of practice according to Ohio professional licensure. (2) Basic competencies for each QBHS shall include, at a minimum, an understanding of: (a) Either mental illness or substance use disorder treatment and recovery; (b) The community behavioral health system, social service systems, the criminal justice system, and other healthcare systems; (c) Psychiatric and substance use disorder symptoms and their impact on functioning and behavior, (d) How to therapeutically engage either with a person with mental illness or a person in substance use disorder treatment and recovery; (e) Crisis response procedures; and, (f) De-escalation techniques and an understanding of how the individual's own behavior can impact the behavior of others. (3) The employing provider shall establish additional competency requirements, as appropriate, for each QBHS based upon the services to be performed, characteristics and needs of the persons to be served, and skills appropriate to the position. (4) A QBHS must be supervised by an individual qualified to supervise the provisions of services within in their scope of practice. (E) QBHS includes both a qualified mental health specialist and a care management specialist. Last updated March 22, 2024 at 10:37 AM Supplemental Information |
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Rule 5122-29-31 | Telehealth.
(A) For purposes of this chapter, telehealth means the use of, real-time audiovisual communications of such quality as to permit accurate and meaningful interaction between at least two persons, one of which is a certified provider of the service being provided pursuant to Chapter 5122-25 of the Administrative Code. Asynchronous modalities that do not have both audio and video elements are considered telehealth. (B) "Originating site" means the site where a client is located at the time the service is furnished. (C) "Distant site" means the site where the eligible provider is located at the time the service is furnished. (D) No initial in person visit is necessary to initiate services using telehealth modalities. The decision of whether or not to provide initial or occasional in-person sessions shall be based upon client choice, appropriate clinical decision-making, and professional responsibility, including the requirements of professional licensing, registration or credentialing boards. (E) The following are the services that may be provided via telehealth: (1) General services as defined in rule 5122-29-03 of the Administrative Code; (2) CPST service as defined in rule 5122-29-17 of the Administrative Code; (3) Therapeutic behavioral services and psychosocial rehabilitation service as defined in rule 5122-29-18 of the Administrative Code; (4) Peer recovery services as defined in rule 5122-29-15 of the Administrative Code; (5) SUD case management service as defined in rule 5122-29-13 of the Administrative Code; (6) Crisis intervention service.as defined in rule 5122-29-10 of the Administrative Code; (7) Assertive community treatment service as defined in rule 5122-29-29 of the Administrative Code; and, (8) Intensive home based treatment service as defined in rule 5122-29-28 of the Administrative Code. (9) Mobile response and stabilization service as defined in rule 5122-29-14 of the Adminstrative Code. (F) Individuals receiving residential and withdrawal management substance use disorder services as defined in rule 5122-29-09 of the Administrative Code or mental health day treatment service as defined in rule 5122-29-06 of the Administrative Code may receive any of the component services listed in paragraph (E) of this rule through telehealth. (G) Progress notes as defined in rule 5122-27-04 of the Administrative Code must include documentation to reflect that the service was provided by telehealth. (H) The provider must have a written policy and procedure describing how they ensure that staff assisting clients with telehealth services or providing telehealth services are adequately trained in equipment usage. (I) Prior to providing services to a client by telehealth, an eligible provider of the service to be provided as listed in rule 5122-29-30 of the Administrative Code shall describe to the client the potential risks associated with receiving telehealth services, telehealth and document that the client was provided with the risks and agreed to assume those risks. (J) The risks to be communicated to the client pursuant to paragraph (H) of this rule must address at a minimum the following: (1) Clinical aspects of receiving telehealth services; (2) Security considerations when receiving telehealth services; and, (3) Confidentiality considerations when receiving telehealth services. (K) It is the responsibility of the provider to assure contractually that any entity or individuals involved in the transmission of the information guarantee that the confidentiality of the information is protected. When the client chooses to receive services by telehealth at a client site that is not arranged for by the provider, e.g., at their home or that of a family or friend, the provider is not responsible for any breach of confidentiality caused by individuals present at the client site. (L) Providers shall have a contingency plan for providing services to clients when technical problems occur during a telehealth session. (M) Providers shall maintain, at a minimum, the following local resource information. For purposes of this rule, local means the area where the client indicates they reside and where they are receiving services as indicated in paragraph (P) of this rule. (1) The local suicide prevention hotline if available or national suicide prevention hotline. (2) Contact information for the local police and fire departments. The provider shall provide the client information on how to access assistance in a crisis, including one caused by equipment malfunction or failure. (N) For the purposes of meeting the requirements of paragraph (L) of this rule, providers shall require that the client provide the street address and city where they are receiving services prior to the first session utilizing interactive videoconferencing and update the address whenever the client site changes. (O) It is the responsibility of the provider to assure that equipment meets standards sufficient to: (1) Assure confidentiality of communication; (2) Provide for interactive videoconferencing communication between the practitioner and the client; and (3) Assure videoconferencing picture and/or audio are sufficient to assure real-time interaction between the client and the provider and to assure the quality of the service provided. (P) All services provided by telehealth shall: (1) Begin with the verification of the client through a name and password or personal identification number when services are being provided with a client (s), and (2) Be provided in accordance all state and federal laws including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and 42 C.F.R. part 2 (January 1, 2020). (Q) Provider must have a physical location in Ohio or have access to a physical location in Ohio where individuals may opt to receive in person services rather than telehealth services. Last updated March 22, 2024 at 10:38 AM Supplemental Information |