Chapter 3793:2-1 Alcohol and Drug Addiction Programs

3793:2-1-01 Program certification/licensure process.

(A) The purpose of this rule is to state the procedures for certification and licensure of alcohol and drug addiction programs in Ohio.

(B) The provisions of this rule are applicable to all of the following Ohio alcohol and drug addiction programs, public and private, regardless of whether they receive any public funds that originate and/or pass through the Ohio department of alcohol and drug addiction services in accordance with division (A) of section 3793.06 of the Revised Code:

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Criminal justice therapeutic community programs.

(3) Treatment alternatives to street crime programs.

(4) Driver intervention programs.

(5) Programs located outside the state of Ohio.

(D) Procedure for processing an application for certification/licensure for programs not currently certified and opioid agonist programs.

(1) Any Ohio alcohol and drug addiction outpatient treatment program, residential treatment program, opioid agonist program, or detoxification program subject to or seeking program certification/licensure pursuant to division (A) of section 3793.06 of the Revised Code shall apply to the Ohio department of alcohol and drug addiction services by filing an application that includes, but is not limited to, the following information for each program site to be certified/licensed by the department:

(a) Name, address, telephone number and county of each program site to be certified by the Ohio department of alcohol and drug addiction services. A location which would be considered the client's natural environment (e.g. school, home, job and family services agency) is not considered a site and need not be certified.

(b) Program and business hours of operation for alcohol and drug addiction services.

(c) The alcohol and drug addiction services the program provides.

(d) Copy of an Ohio food services operator's license if required by the Ohio department of health.

(e) Copy of an occupancy and use certificate issued by the division of construction compliance of the Ohio department of commerce or issued by an Ohio certified building department of a municipal corporation, township or county which has been established in conformity with law for the purpose of enforcing the "Ohio Basic Building Code" for the location where the program will be conducted.

(f) Copy of a current annual fire inspection by an Ohio certified fire authority or by the division of the state fire marshal of the Ohio department of commerce for the location where services will be provided.

(g) A copy of the owner's current registration for doing business in Ohio that has been filed with the Ohio secretary of state.

(h) If the owner is an out-of-state corporation, a copy of the license from the Ohio secretary of state for doing business in Ohio.

(i) If the program is a non-profit organization, a copy of the approved statement of continued existence approved by the Ohio secretary of state.

(j) Opioid agonist programs shall submit a copy of the current certification from the substance abuse and mental health services administration to use an opioid agonist in the maintenance treatment of opioid addiction.

(k) List of clinical staff, license number, and licensing body.

(l) Residential, halfway house treatment, detoxification programs shall indicate the number of alcohol and other drug beds for each type of treatment program.

(m) Programs requesting a variance or an extension of a variance for one or more of the program certification/licensure standards shall include a copy of the request with the program certification/licensure application. Each variance request shall be prepared and submitted in accordance with this rule.

(n) The application shall be signed and dated by the executive director, CEO or president of the organization.

(2) Upon receipt of an application, the Ohio department of alcohol and drug addiction services shall:

(a) Notify, in writing, the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board of the application.

(b) Review the application to determine if it is complete.

(i) If an application is incomplete, the department shall notify the applicant of corrections or additions needed and/or may return the materials to the applicant.

(ii) The department's return of the materials to the applicant or failure of the department to take further action to issue a certificate/license shall not constitute denial of an application for program certification or licensure.

(3) Upon acceptance of an application the Ohio department of alcohol and drug addiction services shall contact the program to schedule an on-site inspection of the program.

(a) The department shall send the program a letter confirming the date of the on-site inspection.

(b) The department shall notify, in writing, the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board of the date of the on-site inspection.

(4) The Ohio department of alcohol and drug addiction services shall conduct an on-site inspection at the time of application, with official written notice to the program, or at any other time for cause as determined by the department , with or without official written notice to the program.

(5) The Ohio department of alcohol and drug addiction services shall have access to all program-related records to verify compliance with program certification and/or licensure standards as established by department rules. The department may conduct interviews with members of the program's governing authority, program staff, others in the community and/or clients with the clients' permission.

(6) The Ohio department of alcohol and drug addiction services shall prepare a follow-up inspection report for the on-site inspection of the program.

(a) The inspection report shall cite any standards with which the program was not in compliance at the time of the on-site inspection.

(b) The Ohio department of alcohol and drug addiction services shall provide a copy of the on-site inspection report to the program and to the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board.

(c) Programs shall correct deficiencies identified during a program certification/licensure inspection conducted by the Ohio department of alcohol and drug addiction services and documentation of correction of the deficiencies shall be sent to the department within the time frame specified in the follow-up inspection report.

(7) The Ohio department of alcohol and drug addiction services shall issue a certificate or license to each applicant complying with the program certification or licensure standards.

(a) Certificates for outpatient and residential treatment programs and detoxification programs shall not exceed three years.

(b) Licenses for opioid agonist programs shall be for one year.

(c) The department shall provide the program with the original certificate or license, and provide a copy of the certificate or license to the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board.

(d) The program site shall display the certificate in a prominent location where services are provided.

(E) Conditional program certification/licensure.

(1) Conditional program certification/licensure may be granted by the Ohio department of alcohol and drug addiction services to enable the program to serve clients, to establish and maintain client records, to implement quality improvement activities and/or to correct deficiencies identified during an on-site program certification/licensure inspection.

(2) The Ohio department of alcohol and drug addiction services may issue a conditional program certification/licensure for a maximum period of ninety days.

(F) Relocation of a certified program shall render the certification and/or licensure void. Void certificates/licenses shall be returned to the Ohio department of alcohol and drug addiction services.

(1) A program shall submit an application for program certification and/or licensure of a new site location to the Ohio department of alcohol and drug addiction services at least thirty days prior to relocation to avoid possible non-certified or non-licensure status of the program.

(2) Upon acceptance of an application, the Ohio department of alcohol and drug addiction services may conduct an on-site inspection of the new program site location for compliance with certification/licensure standards for physical plant and safety and any other program certification/licensure standards deemed appropriate by the Ohio department of alcohol and drug addiction services.

(3) Certificates/licenses issued as a result of a relocation of a program site shall have the same expiration date as the certification or licensure of the original program site.

(G) Procedure for renewal of program certification for currently certified programs:

(1) All programs certified by the department of alcohol and drug addiction services as an outpatient treatment program, residential treatment program, or a detoxification program shall be certified for a certification period not to exceed three years and shall renew upon completion of the assurance statement as indicated in paragraph (G)(3) of this rule.

(2) For programs that have obtained deemed certification pursuant to paragraph 3793:2-1- 01.1 of the Administrative Code, the program shall be certified for the period of their national accreditation, not to exceed three years.

(3) The Ohio department of alcohol and drug addiction services will send each owner an assurance statement for each certified site and for programs that have obtained deemed certification with information that the department has on file . Any Ohio alcohol and drug addiction outpatient, residential treatment program or detoxification program seeking renewal of program certification pursuant to division (A) of section 3793.06 of the Revised Code shall submit an assurance statement signed and dated by the executive director, CEO or president of the organization, and president of the governing authority which states that the agency shall comply with the certification standards as established by department rules for each certified program site location for the duration of its three-year certification period. All assurance statements must be received by the department within thirty days of the beginning of the new certification period and must include:

(a) Any changes to the information supplied by the department regarding that program. Changes include but are not limited to name, address, telephone number, email address, each program site location, program business hours of operation, and the number of alcohol and drug addiction beds if applicable.

(b) Programs requesting a variance or an extension of a variance for one or more of the program certification/licensure standards shall include a copy of the request with the program certification/licensure application. Each variance request shall be prepared and submitted in accordance with this rule.

(4) Failure to comply with the requirements of paragraph (G)(3) of this rule within the specified time frame shall result in the program being placed on conditional status.

(5) The Ohio department of alcohol and drug addiction services shall contact the program to schedule an on-site inspection of the program within the three-year certification period. Reviews will be scheduled with a minimum ninety-day notice.

(a) The department shall send the program a letter confirming the date of the on-site inspection.

(b) The department shall notify, in writing, the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board of the date of the on-site inspection.

(6) The Ohio department of alcohol and drug addiction services shall conduct an on-site inspection within the three-year certification period with official written notice to the program, or at any other time for cause as determined by the department, with or without official written notice to the program.

(7) The Ohio department of alcohol and drug addiction services shall have access to all program-related records to verify compliance with program certification and/or licensure standards. The department may conduct interviews with members of the program's governing authority, program staff, others in the community and/or clients with the clients' permission.

(8) The Ohio department of alcohol and drug addiction services shall prepare a follow-up inspection report for the on-site inspection of the program.

(a) The inspection report shall cite any standards with which the program was not in compliance at the time of the on-site inspection.

(b) The Ohio department of alcohol and drug addiction services shall provide a copy of the on-site inspection report to the program and to the applicable alcohol and drug addiction services board or the alcohol, drug addiction and mental health services board.

(c) Programs shall correct deficiencies identified during a program certification inspection conducted by the Ohio department of alcohol and drug addiction services. Documentation of correction of the deficiencies shall be sent to the department within the time frame specified from the date in the follow-up inspection report.

(H) The Ohio department of alcohol and drug addiction services certifies and licenses program sites. Each program certification or license issued by the department is for a specific address. Certificates and licenses are not transferable to any other program entity or to other program site locations.

(I) Variances.

(1) The Ohio department of alcohol and drug addiction services may grant a variance from any certification or licensure standard, or portion thereof, for the period during which the certification or licensure is in effect.

(2) "Variance" means written permission granted by the Ohio department of alcohol and drug addiction services to a program to be exempted from or meet a modified requirement of a rule or specific provision of a rule of the Administrative Code or other program certification/licensure standard.

(3) Requests for variances of certification or licensure standards shall be in writing to the Ohio department of alcohol and drug addiction services and shall include:

(a) The administrative rule number and standard for which a variance is sought.

(b) The rationale for requesting the variance.

(c) Documentation by the program that assures the Ohio department of alcohol and drug addiction services that the quality of services and client safety shall not be jeopardized if the variance is granted.

(d) The consequences of not receiving approval of the requested variance.

(4) The Ohio department of alcohol and drug addiction services shall issue a written statement to the program granting or denying a request for variance of program certification and/or licensure standards. A copy of the written statement shall be provided to the applicable alcohol and drug addiction services board or alcohol, drug addiction and mental health services board.

(5) The program shall maintain a file copy of all requests for variances and the approval or denial of the requests for the period during which the certification or licensure is in effect.

(J) The Ohio department of alcohol and drug addiction services may deny or revoke certification or licensure for one or more of the following reasons:

(1) The program fails to comply with any program certification/licensure standard;

(2) The program misuses or fails to properly account for the disbursement of state or federal funds;

(3) The program knowingly provides false information to: the Ohio department of alcohol and drug addiction services, an alcohol and drug addiction services board or an alcohol, drug addiction and mental health services board or other entity;

(4) The program knowingly permits an employee to falsify information on client records;

(5) The program is aware of an employee who has abused or neglected a client and has failed to take appropriate disciplinary action to correct the situation;

(6) The program fails to provide access to its records as requested by the Ohio department of alcohol and drug addiction services.

(7) Denial, revocation or termination would be in the best interest of the citizens of Ohio.

(K) The Ohio department of alcohol and drug addiction services shall give the program written notice by certified mail, return receipt requested, if it intends to deny or revoke certification/licensure. The notice shall include:

(1) The standard(s) with which the program was found to be in non-compliance and/or other reason(s) for the action.

(2) The section(s) of the law or rule(s) involved.

(3) A statement informing the program that it is entitled to a hearing if it requests it within thirty days of the time of the mailing of the notice.

(4) A statement that at the hearing, the program's representative may appear in person and/or be represented by its attorney or may present its position, arguments or comments in writing and at the hearing it may present evidence and examine witnesses appearing for and against it. A copy of the notice shall be mailed to the attorney or other representative of record representing the program.

(L) If a program requests a hearing, the Ohio department of alcohol and drug addiction services shall set the date, time and place for the hearing within fifteen days, but not earlier than seven days, after the program has requested a hearing unless otherwise agreed upon by both the department and the program. A copy of the hearing notice shall be mailed to the program's representative or its attorney.

(1) The Ohio department of alcohol and drug addiction services shall conduct the adjudication hearing following the procedures in section 119.09 of the Revised Code and among other things may appoint a referee or hearing examiner to conduct the proceedings and make recommendations as appropriate.

(2) The Ohio department of alcohol and drug addiction services shall provide the program a certified copy of its decision by certified mail, return receipt requested.

(3) If the Ohio department of alcohol and drug addiction services' decision after the hearing is to deny or revoke certification or licensure, the program shall be informed of its right to appeal and file its notice of appeal of the decision within fifteen days of the mailing of the notice of the department's order.

(4) If the program decides to appeal the Ohio department of alcohol and drug addiction services' decision, the program shall appeal the order of the department to the court of common pleas of the county in which it the program's place of business is located. The program's notice of appeal is to be filed with the department and must state the order appealed from and the grounds of the appeal. A copy of the program's appeal must be filed with the court of common pleas in the county in which the appeal is being filed.

(5) Within thirty days after receipt of a notice of appeal, the Ohio department of alcohol and drug addiction services shall send to the common pleas court a complete record of the proceedings in the case by certified mail, return receipt requested.

(M) Any person who violates the provisions of these rules shall be subject to the penalties provided in section 3793.99 of the Revised Code.

(N) Sanction:

(1) Any program which has had its certification/licensure revoked pursuant to this rule shall not be eligible to apply to the Ohio department of alcohol and drug addiction services for program certification/licensure for at least five years from the date of revocation without the written consent of the department.

(2) Any program which has been denied certification/licensure pursuant to this rule shall not be eligible to apply to the Ohio department of alcohol and drug addiction services for program certification/licensure for at least three years from the date of denial without the written consent of the department.

(O) Program certification or licensure shall be considered void and invalid if a program: fails to follow the procedures for renewal of program certification, voluntarily relinquishes the certificate for certification or licensure, moves to another location, goes out of business or is sold or otherwise conveyed to another entity.

(P) The program shall immediately notify the Ohio department of alcohol and drug addiction services in writing of any changes in its operations that affect the program's continued compliance with the department's program certification and licensure requirements.

(Q) All programs shall be in compliance with all applicable federal, state and local laws and regulations.

(R) Alcohol and drug addiction programs currently certified or licensed by the Ohio department of alcohol and drug addiction services at the time of the effective date of agency 3793 of the Administrative Code shall remain certified/licensed until the expiration of their current certification or licensure unless their certification or licensure were to be revoked or terminated in accordance with this rule.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06 , 3793.11
Rule Amplifies: 3793.06 , 3793.11
Prior Effective Dates: 7/1/91, 7/1/01, 6/1/05, 11/17/05

3793:2-1-01.1 Deemed Certification.

(A) The department shall accept, as evidence of compliance with rules 3793:2-1-01 to 3793:2-1-08 and 3793:5-1-01 to 3793:5-1-07 of the Administrative Code, the agency's appropriate behavioral health accreditation by any of the following accrediting bodies: "The Joint Commission "; "The Commission on Accreditation of Rehabilitation Facilities;" and/or "The Council on Accreditation".

(1) The following certification standards are exempted from the statement in paragraph (A) of this rule:

(a) Paragraph (G) of rule 3793:2-1-04 of the Administrative Code (major unusual incident notification);

(b) Rule 3793:2-1-09 of the Administrative Code (uniform cost reporting); and

(c) Rule 3793:2-1-10 of the Administrative Code (actual uniform cost report (AUCR) agreed-upon procedures and report submission requirement).

(B) An agency applying for deemed status by the department must submit the following:

(1) A copy of the certificate or license awarded by the accrediting body;

(2) A copy of the accreditation award notification letter; and

(3) A copy of each of the accrediting body's survey reports and any modifications made to the survey report.

(C) The department may also accept as documentation of the agency's compliance with certification standards, in whole or in part, official report(s) that the agency complies with comparable licensure and/or certification requirements of another state department.

(D) An agency must notify the department within ten days of any change to its accreditation, licensure and/or certification status, by providing a copy of the accreditation status change notification.

(1) Should an agency's accreditation, licensure and/or certification status be granted as or modified to probation, stipulations, conditional, provisional, deferral, preliminary denial or other similar status, the department may ask for additional documentation until such time as full accreditation status is restored. Full accreditation status means the accrediting body has issued an accreditation decision of "accredited" or "accreditation" without additional conditions or modifiers other than three-year or one-year accreditation.

(2) Should an agency's accreditation, licensure and/or certification status be denied, suspended or revoked by the accrediting and/or licensing/certifying body, the department shall withdraw deemed status and the agency shall be subject to a full certification survey and/or proposal to revoke certification in accordance with Chapter 119. of the Revised Code.

(E) The department may conduct surveys and/or review documentation of a sample of agencies having achieved appropriate behavioral health accreditation in order to evaluate whether the accreditation processes used by the organizations are consistent with service delivery models the director considers appropriate for alcohol and drug addiction services. The department will communicate to an accrediting organization any identified concerns, trends, needs, and recommendations. The department shall have access to all records necessary to evaluate the accrediting body processes, but may not conduct a survey or request documentation under this paragraph for the purpose of determining compliance with certifications standards.

Replaces: 3793:2-1- 01.1

Effective: 09/30/2013
R.C. 119.032 review dates: 09/30/2018
Promulgated Under: 119.03
Statutory Authority: 3793.02 , 3793.06 , 3793.061
Rule Amplifies: 3793.02 , 3793.06 , 3793.061
Prior Effective Dates: 8/26/2010

3793:2-1-02 Governing authority.

(A) The purpose of this rule is to state the minimum governing authority requirements that a program must meet in order to be certified or licensed by the Ohio department of alcohol and drug addiction services as an alcohol and drug addiction outpatient treatment program, residential treatment program or methadone program.

(B) The provisions of this rule are applicable to all of the following alcohol and drug addiction programs, public and private, regardless of whether they receive any public funds that originate from and/or pass through the Ohio department of alcohol and drug addiction services, in accordance with division (A) of section 3793.06 of the Revised Code.

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opiod agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(D) Deemed status shall be granted to waive paragraphs of the Administrative Code if the program:

(1) Is certified/licensed by the Ohio department of mental health. Deemed provisions include paragraphs (F),(G),(H),(I),(J),(K),(L), and (M) of this rule.

(2) Is licensed by the Ohio department of jobs and family services. Deemed provision includes paragraph (I) of this rule.

(E) Each program, except government owned programs, shall be registered to do business in Ohio with the Ohio secretary of state and shall have on file a copy of this registration.

(1) If the program is a non-profit organization, the program shall submit an application for continued existence to the Ohio secretary of state as required by statute. The program shall have on file a copy of the approved statement of continued existence for the corporation approved by the Ohio secretary of state.

(2) If the program is owned by an out-of-state corporation, the program shall have on file a copy of the license to do business in Ohio which is issued by the Ohio secretary of state.

(F) Each program, including government-owned organizations, shall have a governing authority that has overall responsibility for the operation of its alcohol and drug addiction program(s).

(1) The governing authority for a corporation shall be a board of directors/trustees.

(2) The governing authority for a partnership shall be the partners as specified in their registration with the Ohio secretary of state.

(3) The governing authority for a limited liability company shall be the members as specified in their registration with the Ohio secretary of state.

(4) The governing authority for a government organization shall be the appointing authority of a department, division, bureau or other government office.

(G) Each program whose governing authority is a board of directors, shall have written policies, code of regulations and/or by-laws that include, but are not limited to the following:

(1) Procedure for selecting members of the governing authority.

(2) Statement of the number of members of the board of directors needed for a quorum at meetings of the board of directors.

(3) Provisions for guarding against the development of, and prohibiting the existence of, a conflict of interest between a member of the board of directors and the program.

(4) Provisions for orienting new members of the board of directors.

(H) Each program (corporation, partnership, limited liability company, sole proprietorship and/or government organization) shall have written policies, code of regulations, articles of incorporation and/or by-laws stating the responsibilities of the governing authority and shall maintain documentation that includes, at a minimum, the following:

(1) Establishing the duties and responsibilities of the alcohol and drug addiction program director.

(2) Selecting a program director to manage the day-to-day activities of the alcohol and drug addiction program.

(3) Conducting meetings of the governing authority at least quarterly and maintaining minutes of these meetings.

(4) Approving the alcohol and drug addiction services that the program will provide.

(5) Approving the program's policies for operating the alcohol and drug addiction program(s).

(6) Approving an annual budget for each alcohol and drug addiction program certified by the Ohio department of alcohol and drug addiction services.

(7) Reviewing the annual audit report of the agency conducted in accordance with this rule.

(I) The agency shall maintain a roster of the members of the board of directors and their professional affiliations.

(J) Each alcohol and drug addiction program shall have a current table of organization that:

(1) Reflects the relationship of the alcohol and drug addiction program to the governing authority.

(2) Reflects each position, including employees, contract staff, student interns and volunteers of the alcohol and drug addiction program(s).

(3) Includes the date and original signature of the alcohol and drug addiction program director.

(K) Each program shall establish and implement a written quality improvement plan updated annually and approved by the governing authority that includes, at a minimum, the following:

(1) Designation of a committee or staff member for coordinating the program's quality assurance and improvement activities.

(2) Provisions for informing the program's governing authority of the findings of quality assurance and improvement activities.

(3) Provisions for monitoring corrective actions directed by the governing authority.

(4) Provisions for conducting quality improvement activities in accordance with rule 3793:2-1-04 of the Administrative Code.

(5) A description of how quality improvement activities are integrated into the entity's overall management.

(L) The governing authority is responsible for ensuring that the alcohol and drug addiction program is operated in accordance with the following:

(1) All applicable federal and state laws, regulations and rules, to include non-discrimination provisions for employment and services provided.

(2) Local ordinances and regulations.

(3) Local zoning regulations.

(4) Program policies and procedures as required by this rule.

(M) The governing authority shall be responsible for ensuring that there is protection through liability insurance, malpractice insurance and/or other insurance for the governing authority, the program's staff and the alcohol and drug addiction program.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06 , 3793.11
Rule Amplifies: 3793.06 , 3793.11
Prior Effective Dates: 7/1/91, 7/1/01, 11/17/05

3793:2-1-03 Program administration.

(A) The purpose of this rule is to state the minimum program administration requirements that a program must meet in order to be certified or licensed by the Ohio department of alcohol and drug addiction services as an alcohol and drug addiction outpatient treatment program, residential treatment program, ambulatory or sub-acute detoxification program or licensed as an opioid agonist program.

(B) The provisions of this rule are applicable to all of the following Ohio alcohol and drug addiction programs, public and private, regardless of whether they receive any public funds that originate from and/or pass through the Ohio department of alcohol and drug addiction services, in accordance with division (A) of section 3793.06 of the Revised Code:

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) Deemed status shall be granted to waive paragraphs of the Administrative Code if the program:

(1) Is certified/licensed by the Ohio department of mental health. Deemed provisions include paragraphs (M), (N), (Q), (U) and (Y) of this rule.

(2) Is licensed by the Ohio department of jobs and family services. Deemed provisions include paragraphs (L) and (R) of this rule.

(D) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and other drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(E) Each program shall have a program director (or other similar title) who is responsible for the overall day-to-day operation of the alcohol and drug addiction program.

(F) The qualifications for an alcohol and drug addiction program director shall include at least the following knowledge and skills requirements:

(1) Bachelor's degree and a minimum of five years' experience in alcohol and other drug addiction services or an allied profession to include a minimum of two years as a supervisor or

(2) Minimum of six years' experience in alcohol and other drug addiction services or an allied profession to include a minimum of three years as a supervisor or

(3) Minimum of five years business administration experience to include a minimum of two years as a supervisor.

(G) The program shall have an annual revenue and expenditure budget that has been approved by the governing authority before the beginning of the program's fiscal year. Minutes of the governing authority shall reflect that approval.

(H) The program shall prepare monthly financial statements reflecting the financial position of the program. These statements shall be brought to the attention of the governing authority. Minutes of the governing authority shall reflect that the monthly financial statements have been brought to the attention of the governing authority.

(I) Each program shall account for funds in compliance with rules and regulations required by applicable funding sources.

(J) Where applicable, each program shall ensure that federal, state and local funds are spent in accordance with grant agreements, assurances, contracts and federal cost principles as each requirement relates to the source of funds and the funding agency.

(K) Programs that receive funds that originate from and/or pass through the alcohol, drug addiction and mental health services board, the alcohol and drug addiction services board and/or the Ohio department of alcohol and drug addiction services shall have an audit/review conducted in accordance with the department's financial and compliance audit guidelines for alcohol and other drug addiction programs and agencies receiving state and other funding.

(L) Programs that do not receive funds that originate from and/or pass through the alcohol, drug addiction and mental health services board, the alcohol and drug addiction services board and/or the Ohio department of alcohol and drug addiction services shall, at a minimum, have an audit/review conducted in accordance with generally accepted auditing standards. Programs may utilize additional standards as designated by their funding entities as long as the required audits meet these minimum standards.

(M) Each program shall have policies and procedures regarding communication assistance for limited-English proficient clients, family members or significant others as required by state and federal law.

(N) Each program shall have policies and procedures regarding auxiliary aids for sensory-impaired clients, family members or significant others, including the sight and hearing impaired as required by state and federal law.

(O) Each program shall establish and maintain written personnel policies and procedures that comply with relevant federal, state and local statutes and regulations including, at a minimum, the following:

(1) Assurance of non-discrimination against any person or group of persons on the basis of race, ethnicity, age, color, religion, sex, national origin, sexual orientation or disability in the recruitment, selection, promotion, evaluation or retention of employees or volunteers.

(2) Provisions for providing cultural sensitivity training to staff.

(3) Policy prohibiting sexual harassment.

(4) Employment recruitment and selection process.

(5) Provisions for promotion, discipline and termination of employment.

(6) Annual performance evaluation of each employee.

(7) Program employee grievance procedure.

(8) Staff development.

(9) Employee benefits (e.g. retirement plans, annuities, insurance, sick leave, vacation leave and other leave).

(10) Standards of acceptable behavior for all program employees.

(11) Overtime and compensatory time policies and/or procedures.

(12) Policy ensuring that a copy of the program's personnel policies and procedures is available to each employee.

(13) Procedure for notifying employees of changes in personnel polices and procedures.

(14) Policy permitting each employee the right to review his/her own personnel file and procedures for doing this.

(15) Procedure that states that employment applicants shall be informed that the program follows the rules and regulations governing fair employment practices, that the applicant's right to privacy shall be respected, and that the results of inquiries shall be treated in confidence by the program.

(16) Policy prohibiting an individual from supervising any person closely related by blood, marriage or other significant relationship including business associate.

(a) "Closely related by blood or marriage" is defined to include, but is not limited to, spouse, children (whether dependent or independent), parents, grandparents, siblings, aunts, uncles, in-laws, steps and other persons related by blood or marriage who reside in the same household.

(b) "Significant relationship" means persons living together as a spousal or family unit when not legally married or related where the nature of the relationship may impair the objectivity or independence of judgment of one individual working with the other.

(c) "Business associates" are defined as parties who are joined together in a relationship for business purposes or acting together to pursue a common business purpose or enterprise.

(d) "Supervision" means the direct ability or power to effectively recommend the hire, suspension, layoff, promotion, discharge, reward or discipline of a person.

(P) A personnel file shall be maintained for each employee, contract staff, volunteer and student intern conducting program activities. Personnel files shall contain, at a minimum, the following when applicable:

(1) Employment application and/or resume.

(2) Copy of notification of hiring, to include starting date, position and starting salary or wage for those employees hired after the effective date of this rule.

(3) Verification or copies of current professional licenses and/or certifications and/or registration from professional regulatory boards in Ohio of each alcohol and drug addiction service provider. If verification by a staff member of the organization is used in lieu of a copy of the credential, each verification must include the employee's name, social security number, name of regulatory board in Ohio which issued the certification/license, certification/license number and expiration date of the license. The staff member verifying the credential must date and sign the verification document.

(4) The personnel file of each alcohol and drug services provider and supervisor shall include documentation of education, training and experience to demonstrate competency in providing and/or supervising alcohol and drug addiction services.

(5) Position description.

(6) Annual performance evaluation.

(7) Documentation that the employee has reviewed and agreed to abide by the federal regulations on the confidentiality of alcohol and drug abuse patient records (Title 42, Code of Federal Regulations, part 2).

(8) Documentation to reflect that the employee has received a copy of the following and has agreed to abide by each of them:

(a) Program's personnel policies and procedures.

(b) Program's client abuse/neglect policy.

(c) Program's client rights policy.

(d) Program's client grievance procedure.

(9) For contract staff, a signed copy of his/her contract with the program.

(Q) A position description shall be established for each employee of the program. Each position description shall include, at a minimum, the following:

(1) Job title.

(2) Supervisor to whom the person holding this position is responsible.

(3) Duties/responsibilities.

(4) Minimum qualifications for the position (knowledge/skills).

(5) Credentials and academic requirements, if applicable.

(6) Subordinates (positions supervised by person holding this position).

(R) Each alcohol and drug addiction program serving children and/or adolescents shall have a policy which states the following:

(1) Each employee and/or contract staff hired after June 13, 2004 and/or volunteer and student intern utilized in positions which are responsible for the direct care or supervision of children and/or adolescents shall:

(a) Be at least twenty-one years of age.

(b) Possess a high school diploma or equivalency certificate.

(c) Meet the policies set forth in paragraphs (R)(2) and (R)(3) of rule 3793:2-1-03 of the Administrative Code.

(2) The policy shall state that a prospective employee, volunteer or student intern has not pled guilty to nor been convicted of any of the offenses listed in paragraph (I) of rule 5101:2-5-09 of the Administrative Code. A prospective employee, adult volunteer or student intern convicted of or who has pleaded guilty to an offense listed in paragraph (I) of rule 5101:2-5-09 of the Administrative Code may be hired by an agency if the conditionsas provided in paragraph (H) of rule 5102:2-5-09 of the Administrative Codehave been met.

(3) The policy shall state that the agency shall require that criminal records checks on employees, volunteers and student interns be conducted by the bureau of criminal identification and investigation (BCII) and, if the prospective employee does not demonstrate that he/she has been a resident of Ohio for the preceding five years, by the federal bureau of investigation (FBI).

(S) Each alcohol and drug addiction residential or halfway house program for adults that includes child care shall have a policy which states that:

(1) Each employee, contract staff, volunteer or student intern which is responsible for the direct care of children shall:

(a) Be at least eighteen years of age and

(b) Possess a high school diploma or equivalency certificate.

(2) The policy shall state that a prospective employee, adult volunteer or student intern has not pled guilty to nor been convicted of any of the offenses listed in paragraph (I) of rule 5101:2-5-09 of the Administrative Code. A prospective employee, adult volunteer or student intern convicted of or who has pleaded guilty to an offense listed in paragraph (I) of rule 5101:2-5-09 of the Administrative Code may be hired by an agency if the conditionsas provided in paragraph (H) of rule 5101:2-5-09 of the Administrative Code have been met.

(3) The policy shall state that the agency shall require that criminal records checks on prospective employees, adult volunteers and student interns be conducted by the bureau of criminal identification and investigation (BCII) and, if the prospective employee does not demonstrate that he/she has been a resident of Ohio for the preceding five years, by the federal bureau of investigation (FBI).

(T) Each program shall have an affirmative action plan that includes the stated goal that the program will attempt to have staff who reflect, as nearly as possible, the racial composition of its service area.

(U) Each program shall have a plan that includes the stated goal that the program will address the need for culturally specific and relevant programming for ethnic minorities, deaf or hearing impaired and others:

(V) Each program shall have a written policy or procedure for handling cases of client abuse and/or neglect by employees, contract staff, student interns and volunteers that includes notifying appropriate professional regulatory boards and law enforcement authorities when applicable.

(W) Each alcohol and drug addiction treatment program shall:

(1) Maintain a client information system which meets specifications established by the Ohio department of alcohol and drug addiction services for collecting socio-demographic information and data on alcohol/drug addiction services provided by the program.

(2) Maintain a financial management information system which meets specifications established by the department for collecting financial information related to alcohol/drug addiction services provided by the program.

(3) Participate in information surveys conducted or sponsored by the Ohio department of alcohol and drug addiction services.

(X) Each program shall identify a location (street address, city and county) as a primary place for conducting business. This standard does not prohibit alcohol and drug addiction services from being provided in the natural environment of a client, for example, place of residence, work place or school.

(1) Each agency shall designate a safety officer who will be responsible for ensuring that each program site is in compliance with the physical plant and safety requirements of this rule.

(2) The program shall have on file a copy of a "certificate of use and occupancy" for each program site where alcohol and drug addiction services are provided in accordance with the Ohio basic building code and rule 4101:2-1-27 of the Administrative Code.

(3) The program shall have on file a copy of the report of an annual fire inspection by a certified fire authority, or where none is available, by the division of the state fire marshal of the Ohio department of commerce, for each program site where alcohol and drug addiction services are provided.

(4) The program shall have a fire and evacuation plan for each program site where alcohol and drug addiction services are provided.

(5) If a program has a swimming pool, the program shall maintain documentation to reflect that the swimming pool is being maintained in compliance with the requirements of section 3749.04 of the Revised Code.

(6) A program is prohibited from using freestanding wood burning stoves or unvented kerosene, gas or oil heaters at its site.

(7) The program shall have sufficient office space to allow privacy between a counselor and a client.

(8) Each program site shall meet, at a minimum, the following handicapped accessibility requirements, or have on file a copy of a plan for meeting these requirements that has been approved by the Ohio department of alcohol and drug addiction services' equal employment opportunity regional program administrator.

(a) Entrances, hallways, spaces where services are provided and office space for employees shall be handicapped accessible.

(b) The programs shall have at least one handicapped accessible bathroom.

(c) Residential treatment programs shall have handicapped accessible shower facilities.

(d) The program shall have designated handicapped parking space(s) based on the Americans with Disabilities Act accessibility guidelines.

(e) At least one drinking fountain that is handicapped accessible shall be available.

(f) At least one telephone that is handicapped accessible shall be available.

(Y) Each program shall have written policies and/or procedures for universal infection control for each program site.

(1) Each program shall provide training and education on infection control to all employees, contract staff, student interns and volunteers.

(2) Each program shall have a written policy and/or procedure for the reporting of communicable diseases in accordance with Chapter 3701-3 of the Administrative Code.

(Z) Each program shall be in compliance with the Federal Department of Transportation Omnibus Transportation Testing Act of 1991 and the Drug-Free Workplace Act of 1988 regarding federal drug-free workplace regulations, when applicable.

(AA) Closing a program:

(1) If a program certified/licensed by the Ohio department of alcohol and drug addiction services voluntarily closes its alcohol and drug addiction program, it shall give a thirty-day advance written notice to each of its current clients which specifies the date that the program will close.

(a) A copy of this notice shall be placed in each client's clinical record.

(b) A copy of this notice shall be sent to the:

(i) Unit of the Ohio department of alcohol and drug addiction services responsible for compliance and certification/licensure of programs.

(ii) Applicable alcohol and drug addiction services board or alcohol, drug addiction and mental health services board.

(c) A program close-out audit shall be conducted which shall meet the Ohio department of alcohol and drug addiction services' guidelines and federal office of management and budget circulars.

(2) If it appears that a client will require ongoing alcohol and drug addiction services after the projected closing date of the program, the program shall:

(a) Refer the client to another program certified by the Ohio department of alcohol and drug addiction services for alcohol and drug addiction services or to an individual in private practice who is qualified to provide the services needed.

(b) Have documentation to ascertain that the program has accepted the client for admission. (A progress note by a case manager or clinician stating the date, time and place that the client is scheduled for an intake interview will meet the requirements of this standard).

(3) If a client is a minor, the program shall:

(a) Send a thirty-day advance notice, which specifies the date that the program will close to the minor client's parent or legal guardian and to the minor in accordance with section 3719.012 of the Revised Code.

(b) Refer the client to another program which offers the appropriate level of care and is certified by the Ohio department of alcohol and drug addiction services for alcohol and drug addiction services, or to an individual in private practice who is qualified to provide the services needed.

(c) Have documentation to ascertain that the program has accepted the client for admission. (A progress note by a case manager or clinician stating the date, time and place that the client is scheduled for an intake interview will meet the requirements of this standard).

(BB) Each organization that owns and/or operates an alcohol and drug addiction program shall be in compliance with all applicable federal, state and local laws and regulations in addition to the requirements of agency-level 3793 of the Administrative Code.

(CC) A program certified as an alcohol and drug addiction outpatient or residential treatment program or detoxification program by the Ohio department of alcohol and drug addiction services or licensed as a opioid agonist program at the time of the effective date of this rule shall remain certified/licensed until the expiration of its current certification/licensure. If it wants to continue to operate as an alcohol and drug addiction outpatient, residential treatment, detoxification program or opioid agonist program, it is required to apply to the department for program certification/licensure in accordance with this rule and rule 3793:2-1-01 of the Administrative Code.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06
Rule Amplifies: 3793.06
Prior Effective Dates: 7/1/91, 7/1/2001, 11/17/2005, 7/1/2006

3793:2-1-04 Quality assurance and improvement.

(A) The purpose of this rule is to state the minimum quality assurance and improvement requirements that a program must meet in order to be certified or licensed by the Ohio department of alcohol and drug addiction services to provide alcohol and drug addiction services.

(B) The provisions of this rule are applicable to all of the following alcohol and drug addiction programs, public and private, regardless of whether they receive any public funds that originate from and/or pass through the Ohio department of alcohol and drug addiction services in accordance with division (A) of section 3793.06 of the Revised Code:

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opiod agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(D) Deemed status shall be granted to waive paragraphs of the Administrative Code if the program

is certified/licensed by the Ohio department of mental health. Deemed provision includes paragraph (F) of this rule.

(E) Each program shall establish and implement a written quality improvement plan updated annually and approved by the governing authority that includes, at a minimum, the following:

(1) Designation of a committee or staff member for coordinating the program's quality assurance and improvement activities.

(2) Provisions for informing the program's governing authority of the findings of quality assurance and improvement activities.

(3) Provisions for monitoring corrective actions directed by the governing authority.

(4) Provisions for conducting completeness of client records review at least quarterly.

(5) Provisions for conducting peer review. Peer review means an evaluation of the clinical pertinence and appropriateness of services delivered. Peer review shall be conducted by staff who are qualified to provide the same alcohol and drug addiction services under review. Peer review shall occur at least quarterly and shall determine the following:

(a) Assessments were thorough, complete and timely.

(b) Treatment plan problems, goals and objectives were based on the results of the assessment.

(c) Services were related to the treatment plan goals and objectives.

(d) Documentation accurately reflects the services that were provided.

(6) Assurance that any service provider cannot review his/her own client records for quality assurance and improvement activities.

(7) Provisions for conducting activities to determine that the client's admission to, continued stay and discharge from the program is appropriate based on the Ohio department of alcohol and drug addiction services' protocols for levels of care (youth and adult) for publicly funded clients, including, at a minimum, the methodology, frequency and content of these activities.

(8) Procedures for conducting waiting list management activities, including: identification of pregnant women, intravenous drug users, non-emergency status clients and clients with medical and/or psychiatric emergencies, maintaining contact with clients, policy and procedures for removing clients from the waiting list and procedures for notifying referral sources of the client's waiting list status.

(9) Provisions for conducting client satisfaction surveys to include, at a minimum, the following:

(a) Survey to be conducted on an annual basis.

(b) Satisfaction protocols, including provisions for the opportunity for all clients to participate and provisions for anonymity in survey participation, data collection, analysis and reporting of findings.

(c) Satisfactions measures, including accessibility (timeliness of appointments), appropriateness (responsiveness to client needs), cultural competency (of staff providing services), recommendation of services to others and overall satisfaction.

(d) Use of findings for improvement of the services provided by the program.

(10) Provisions for conducting referral source satisfaction surveys which shall include, at a minimum, the following:

(a) Survey to be conducted on an annual basis.

(b) Satisfaction protocols, including reasonable attempts to contact a sample of referral sources, data collection, analysis and reporting of findings.

(c) Satisfaction measures, including access (ease of referral), program information (general information about the program), client information (feedback about client) and overall satisfaction.

(d) Use of findings for improvement of the services provided by the program.

(11) A description of how quality improvement activities are integrated into the entity's overall management.

(F) Each program shall have a written risk management plan for conducting risk management activities. Risk management means a planned approach for the purpose of safeguarding potential risks in terms of hazardous working conditions, fire and safety conditions, major and unusual incidents and financial risk. The plan shall include, at a minimum, the following:

(1) Plan objectives.

(2) Structure and process for implementing the risk management plan:

(a) Identification of staff responsible for implementing and coordinating risk management activities.

(b) Functional duties and responsibilities of the staff designated; staff may also assume other organizational functions.

(3) Scope and content of the risk management activities that include, at a minimum, the following:

(a) A policy to safeguard against potential hazardous working conditions for staff, clients and visitors to the program, including physical plant conditions and fire safety considerations.

(b) Provisions for conducting routine risk management activities shall be developed, to include, at a minimum, the following:

(i) Reporting, reviewing and monitoring of all major and unusual incidents such as death or injury to a client or staff, sexual/physical abuse of a client by staff or significant disruption of services.

(ii) Reporting, reviewing and monitoring of significant financial loss to the program, as determined in the risk management plan.

(iii) Linkage of risk management activities to quality assurance activities, including, at a minimum, ongoing formal communication between staff responsible for both activities, joint reporting to the governing authority and accountability for corrective action(s).

(c) An emergency medical plan posted in an area accessible to staff at all times.

(G) All major unusual incidents shall be reported in writing to the Ohio department of alcohol and drug addiction services and to the applicable alcohol and drug addiction services board or alcohol, drug addiction and mental health services board within seventy-two hours of the reported incident or such other time as agreed upon between the parties. Each program shall have written criteria for conducting reviews of major unusual incidents that include, but are not limited to, the following:

(1) Death or serious injury of a client, employee, contract staff member, volunteer or student intern when the person is on the program's premises, performing tasks for the program or participating in program activities.

(2) Any allegation of physical, sexual or verbal abuse of a client.

(3) Any allegation of staff neglect of a client.

(H) Each program shall maintain documentation for the quality assurance, risk management and quality improvement activities that it conducts.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02 , (D), 3793.06 , 3793.11
Rule Amplifies: 3793.06
Prior Effective Dates: 7/1/91, 7/1/01, 11/17/05

3793:2-1-05 Clinical management.

(A) The purpose of this rule is to state the minimum clinical management requirements that a program must meet in order to be certified by the Ohio department of alcohol and drug addiction services as an alcohol and drug addiction outpatient treatment program, residential treatment program, ambulatory or sub-acute detoxification program or licensed as an opioid agonist program.

(B) The provisions of this rule are applicable to all of the following Ohio alcohol and drug treatment programs, public and private, regardless of whether they receive any public funds or funds that originate and/or pass through the Ohio department of alcohol and drug addiction services in accordance with division (A) of section 3793.06 of the Revised Code.

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(D) Each program shall be abstinence-based.

(E) Clinical organization:

The admission, continued stay and discharge/referral to each level of care based on the Ohio department of alcohol and drug addiction services' protocols for levels of care (youth and adult) for publicly-funded clients shall be predicated upon the following factors:

(1) A substance related disorder diagnosis based on the current "Diagnostic and Statistical Manual of Mental Disorders" for adult clients admitted to levels I-IV and levels I-III for youth.

(2) The degree of severity for the following dimensions:

(a) Intoxication or withdrawal potential.

(b) Biomedical conditions and complications.

(c) Emotional/behavioral/cognitive conditions and complications.

(d) Treatment acceptance/resistance.

(e) Relapse potential.

(f) Recovery environment.

(g) Family or care giver functioning (for youth).

(F) The admission, continued stay and discharge/referral to each level of care for non-publicly-funded clients shall be based on the Ohio department of alcohol and drug addiction services' protocol or other objective placement criteria.

(G) Each alcohol and drug treatment program shall have written policies and/or procedures that include, but are not limited to:

(1) Admission criteria including criteria for financial eligibility and for determining appropriateness of services.

(2) Admission procedures.

(3) Procedures to follow when an individual has been determined to be inappropriate for admission to the program.

(4) Procedures for transferring clients to a different treatment program within the same agency.

(5) Identification and description of the alcohol and drug addiction services provided under each level of care.

(6) Procedures for making a referral to other organizations, including a determination of the appropriateness of the referral, referral when the appropriate level of care is not provided by the program and provisions for obtaining a properly completed release form.

(7) Procedures for transporting clients to other organizations, when necessary that include, but are not limited to:

(a) A hospital.

(b) A mental health facility for individuals who present a danger to self and/or others.

(8) Procedures for terminating client services, including terminating against the advice of the program.

(9) Procedures for the release of client information.

(10) Procedures for obtaining an assessment for each client admitted or re-admitted to the program, including acceptance of an assessment performed by another program certified by the department or an assessment containing comparable elements of assessment per rule 3793:2-1-08 of the Administrative Code that has been performed within one year of the admission or re-admission date of a client. A copy of the assessment shall be filed in the client's record and updated, signed and dated by a staff member of the admitting program authorized to conduct an assessment pursuant to agency 3793 of the Administrative Code.

(11) Procedures for developing an individualized treatment plan that addresses problems identified in the client's assessment.

(12) Procedures for reporting suspected child abuse and/or neglect, consistent with sections 2151.42.1 and 2151.421 of the Revised Code, rule 5101:2-34-06 of the Administrative Code and rule 3793:2-1-03 of the Administrative Code.

(13) All programs certified by the Ohio department of alcohol and drug addiction services shall have a policy on client behavioral interventions that includes, but is not limited to, the following:

(a) A statement that the use of all cruel and unusual punishments and practices including, but not limited to physical or verbal abuse is prohibited:

(b) Statement indicating what types of interventions shall be employed.

(c) Statement that isolation in a locked, unmonitored room shall not occur.

(d) Statement that behavioral intervention shall only be administered by the program director, clinical director or program employees with direct care responsibilities who have been trained in the program's approved behavioral interventions policy and procedures.

(14) Policy/procedure for referring or providing client education on exposure to, and the transmission of, tuberculosis, hepatitis type B and C, and HIV disease for each client admitted to the program. Documentation shall appear in the client record.

(H) Dietary services:

(1) Each program shall operate its dietary services in accordance with laws, regulations and/or ordinances of the Ohio board of dietetics, Ohio department of health and/or local health department.

(a) Each program shall have policies and procedures for planning menus, preparing and serving food, procurement and storage of food, sanitation and waste disposal.

(b) Halfway house treatment programs and residential treatment programs shall make provisions for three nutritionally balanced meals daily for each client.

(2) Each program that prepares and/or serves meals as part of its daily scheduled activities, shall follow written dietary policies and/or procedures that include, but are not limited to, the following:

(a) Planning menus that meet the nutritional needs of clients in accordance with the current recommended daily allowance established by the national academy of science.

(b) Provisions for preparing and serving meals for persons with special dietary needs.

(c) Procurement, storage, preparation and serving of food.

(d) Maintaining the food service areas and storage areas in a sanitary condition.

(e) Waste disposal.

(3) Each program that prepares and/or serves food shall have documentation to reflect that a dietician, who is licensed by the Ohio board of dietetics, has reviewed, signed, dated and approved:

(a) The program's dietary policies and procedures.

(b) The program's menus.

(c) Special diets.

(I) Pharmaceutical services:

(1) Each program that dispenses, administers and/or prescribes medications, shall have a license for the terminal distribution of dangerous drugs from the Ohio board of pharmacy.

(a) "Administer" means the direct application of a drug to a person, whether by injection, ingestion or any other means.

(b) "Dispense" means the final association of a drug with a particular client pursuant to the prescription, drug order or other lawful order of a prescriber and the professional judgment of and the responsibility for: interpreting, preparing, compounding, labeling and packaging a specific drug.

(2) Each program that dispenses, prescribes and/or administers medications shall have written policies and/or procedures for pharmaceutical services, that include, at a minimum, the following in accordance with 21 C.F.R. 1305m, 21 C.F.R. 1307 and Chapter 4729. of the Revised Code:

(a) Individuals who can dispense, prescribe and/or administer over-the-counter and prescription medications for the program.

(b) Ordering, receiving and storing prescription and over-the-counter medications.

(c) Administering medications.

(d) Dispensing and labeling medications.

(e) Procedures for disposal of all medications.

(f) Procedures for reporting theft or loss of prescription or over-the counter medications..

(3) Each program that permits clients to medicate themselves shall have written policies and/or procedures that include, but are not limited to, the following:

(a) Procedures for storing medications in a locked cabinet.

(b) Procedures for self-medication.

(c) Procedures for accounting for medications that are kept for the client while she/he is at the program site.

(d) Policy prohibiting clients from having unsecured prescription medications in their possession at the alcohol/drug program site or while involved in program activities off site unless required for medical necessity.

(e) Procedures for obtaining and for accounting for medications (prescription and over-the-counter) from clients at the time of admission to or upon entering the program site and return of same, as appropriate, at the time of the discharge/departure.

(4) Clients shall not be denied admission to a program due solely to their use of prescribed psychotropic medication(s).

(J) Each program certified by the Ohio department of alcohol and drug addiction services shall have a clinical director (this title may be referred to as clinical coordinator, etc.) who has demonstrated experience and/or education in substance abuse treatment and holds one or more of the following credentials from a professional regulatory board in Ohio:

(1) Physician who is licensed to practice medicine in Ohio by the Ohio state medical board.

(2) Psychologist who is licensed by the Ohio state board of psychology.

(3) Professional clinical counselor who is licensed by the state of Ohio counselor, a social worker and marriage and family therapist board and whose declaration statement includes substance abuse assessment and counseling and supervision.

(4) Licensed independent social worker who is licensed by the state of Ohio counselor, social worker and marriage and family therapist board and whose declaration statement includes substance abuse assessment and counseling.

(5) Registered nurse with the Ohio board of nursing who has demonstrated experience and/or education in substance use disorder treatment.

(6) Certified chemical dependency counselor III-E, or licensed independent chemical dependency counselor, who is licensed by the chemical dependency professionals board.

(7) Licensed independent marriage and family therapist who is licensed by the state of Ohio counselor, social worker & marriage and family therapist board and whose declaration statement includes substance abuse assessment and counseling and supervision.

(K) Individuals qualified to be alcohol and drug treatment services supervisors pursuant to rule 3793:2-1-08 of the Administrative Code shall:

(1) Conduct regularly scheduled individual and/or group supervision sessions.

(2) Develop written goals and methods for supervision that are agreed upon with the supervisee.

(3) Document what occurred during supervision sessions and progress with supervision goals.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06 , 3793.11
Rule Amplifies: 3793.06 . 3793.11
Prior Effective Dates: 7/1/91, 7/1/01, 6/13/04, 11/17/05

3793:2-1-06 Client records.

(A) The purpose of this rule is to state the minimum client records requirements for certification/licensure as an alcohol and drug addiction treatment program.

(B) The provisions of this rule are applicable to all of the following Ohio alcohol and drug addiction treatment programs, public and private, regardless of whether they receive any public funds that originate and/or pass through the Ohio department of alcohol and drug addiction services, in accordance with division (A) of section 3793.06 of the Revised Code.

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(D) Each program shall have written policies and/or procedures for maintaining a uniform client records system that include, at a minimum, the following:

(1) Confidentiality of client records that includes, at a minimum, the following statements:

(a) Program staff shall not convey to a person outside of the program that a client attends or receives services from the 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, or the disclosure is made to a qualified personnel for a medical emergency, research, audit or program evaluation purposes.

(b) Federal laws and regulations do not protect any threat to commit a crime, any information about a crime committed by a client either at the program or against any person who works for the program.

(c) 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.

(2) Access to client records:

(a) By clients.

(b) By staff.

(c) By individuals other than clients or staff.

(3) Release of client information.

(4) Components of client records and time lines, when applicable, for completing each component.

(5) Storage of client records that requires client records be maintained in accordance with 42 C.F.R. part 2, confidentiality of alcohol and drug abuse client records.

(6) Destruction of client records to include the requirement that records be maintained for at least seven 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.

(E) Programs shall maintain documentation for services provided.

(F) Components of client records shall include, but not be limited to, the following:

(1) Identification of client (name of client and/or client identification number).

(2) Assessment.

(3) Consent for alcohol and other drug treatment services.

(4) Client fee agreement.

(5) Documentation to reflect that the client was given a copy of the following:

(a) Program rules or expectations of clients.

(b) Client rights and grievance procedures.

(c) Written summary of the federal laws and regulations that indicate the confidentiality of client records is protected as required by 42 CFR Part B, paragraph 2.22.

(6) Diagnosis.

(7) Treatment plans.

(8) Case management plans of care.

(9) Progress notes.

(10) Disclosure of client information forms, when applicable.

(11) Termination summary/discharge plan.

(G) Disclosure of client information forms shall include the following information as required by 42 C.F.R. part 2:

(1) Name of the program making the disclosure.

(2) Name or title of the individual or the name of the organization to which the disclosure is to be made.

(3) Name of the client.

(4) Purpose of the disclosure.

(5) Type and amount of information to be disclosed.

(6) Signature of the client or person authorized to give consent.

(7) Date client or other authorized person signed the form.

(8) 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.

(9) The date, event or condition upon which the consent will expire, unless revoked before that specified time.

(H) 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."

(I) A diagnosis shall be made by a clinician who can diagnose substance-related disorders as authorized by the Ohio Revised Code, and shall be recorded in each client's record upon completion of assessment. Supporting documentation in the client record shall include:

(1) Identification of the client.

(2) Diagnosis .

(3) Signs and symptoms justifying the diagnosis.

(4) Date the diagnosis was made.

(5) Original signature and credentials of the clinician making the diagnosis.

(J) A program may accept a diagnosis made within ninety days of the admission date of a client by a clinician who can diagnose substance-related disorders as authorized by the Ohio Revised Code.

(K) The individualized treatment plan and case management plan of care may be integrated into a single plan as long as the single plan meets the criteria of paragraphs (L) and (M) of this rule.

(L) An individualized treatment plan (ITP) shall be written for each client within seven days of completion of the assessment or at the time of the first face-to-face contact following assessment. Individualized treatment plans shall be based on assessment and include, at a minimum, the following:

(1) Client identification (name and/or identification number).

(2) Level of care to which client is admitted.

(3) Problem(s) to be addressed including but not limited to diagnosis or diagnoses and other primary problems based upon clinician recommendations.

(4) Measurable goals that address client's needs.

(5) Measurable treatment objectives with time frame for achievement of each objective.

(6) Frequency, duration and types of treatment services as described in rule 3793:2-1-08 of the Administrative Code.

(7) Original signature of the client.

(8) Date, original signature and credentials of the person who completed the plan and is qualified to provide alcohol and drug addiction services in accordance with rule 3793:2-1-08 of the Administrative Code.

(M) A case management plan of care (CMP) shall be written for each client that receives case management services. The CMP shall be completed prior to a client receiving case management services and shall include, at a minimum:

(1) Comprehensive assessment and periodic reassessment of individual needs. The case management assessment, which can be the same as or derived from the assessment service defined in rule 3793:2-1-08 of the Administrative Code as long as the components described in this rule are also met, shall include:

(a) Taking or reviewing a client's history.

(b) Identification of the needs of the individual.

(c) As necessary, gathering information from other sources. Other sources may include, but are not limited to, family members, medical providers, other behavioral health providers, the criminal or juvenile justice systems, child welfare, social workers and educators.

(d) The first CMP reassessment, whether it is stand alone or integrated with the ITP, shall be conducted at least ninety days from the completion of the initial CMP and at least once every ninety days following each reassessment.

(2) Development and periodic revision of the CMP shall be based on the case management assessment that includes the following:

(a) Goals and actions to address the medical, social, educational and other services needed by the client.

(b) Activities that ensure active participation by the client in developing case management goals.

(c) Course of action to respond to the assessed case management needs of the client.

(3) Referral and related activities to assist the client to obtain needed services, including but not limited to, activities that help link the client with medical, social and educational providers or other programs and services in order to meet identified needs and goals in the CMP.

(4) Monitoring and follow-up activities in order to determine if the following conditions have been met:

(a) Services are being furnished in accordance with the CMP.

(b) Services in the CMP are adequate.

(c) Changes in the needs and status of the client.

(N) Programs shall have written policies and procedures that specify criteria and time frames for reviewing and updating an ITP, which take into account the client's changing clinical needs and response to treatment. If the ITP and CMP are integrated, then the integrated plan must be reviewed and updated in accordance with paragraph (M)(1)(d) of this rule.

(O) Progress notes shall be written to reflect the implementation and evaluation of ITPs for clients admitted to programs. Progress notes are required to include sufficient content to justify the client's continuing need for services. Each service listed in rule 3793:2-1-08 of the Administrative Code delivered to the client, with the exception of urinalysis, shall be documented as defined is this rule in the client's record with either a service level, daily or weekly progress note. Results of urinalysis testing shall be placed in the client's file per paragraph (R)(1)(g) of rule 3793:2-1-08 of the Administrative Code.

(1) Progress notes shall indicate progress the client is making towards achieving the goals and objectives that are identified in the individualized treatment plan.

(P) Service level progress notes shall include, at a minimum, the following:

(1) Client identification (name and/or identification number).

(2) Date of service contact or service delivery.

(3) Length of time of service contact or service delivery (calculated by the number of hours, minutes and/or start and ending time of service delivery).

(4) Type of service (for example, case management, individual counseling, group counseling, crisis intervention, etc.).

(5) Summary of what occurred during the service contact or service delivery.

(6) Date, original signature and credentials (registration, certification and/or license) of the staff member providing the service.

(Q) If provided, the following modalities and/or activities shall be documented in each client's record: occupational therapy, recreational therapy, activity therapies, parenting skills training, alcoholism and drug addiction client education, expressive therapies (art, drama, poetry, music, movement) and nutrition education.

(1) If provided, a progress note is not required for parenting skills training, alcoholism and drug addiction client-education, urinalysis and nutrition education; however, documentation verifying the client's attendance is necessary.

(2) If provided, a progress note is required for occupational therapy, recreational therapy, activity therapy, expressive therapy and nutrition counseling.

(R) Daily or weekly progress notes shall include, at a minimum, the following and may include checklists:

(1) Client identification (name and/or identification number;

(2) For daily progress notes, the calendar day the progress note is applicable to;

(3) For weekly progress notes, the weekly period the progress note is applicable to. (must be a continuous 7 day period);

(4) An overall summary of the client's treatment progress during the note period.

(5) Date, original signature and credential (registration, certification and/or license) of the staff member writing the daily or weekly progress note. The staff member must be qualified, in accordance with rule 3793:2-1-08 of the Administrative Code, to provide all of the services documented in the daily or weekly service log.

(S) Client records utilizing daily or weekly progress notes pursuant to paragraph (P) of this rule must contain a service log that includes, at a minimum, the following which may include checklists:

(1) Date of service for each service provided during the day or week.

(2) Type of services (for example, case management, individual counseling, group counseling, crisis intervention, etc.) provided during the day or week.

(3) Length of time of each service contact or service delivery (calculated by the number of hours, minutes and/or start and ending time of each service delivery.

(4) The signature and license of each clinician who provided services during the day or week.

(T) A termination summary shall be prepared within thirty calendar days after treatment has been terminated in accordance with the client's individualized treatment plan. For purposes of this rule, treatment has been terminated when no treatment services have been provided or upon documentation of last communication or attempted communication with the client. Services must be documented in the client's chart in order to establish the timeline governing the preparation of the termination summary. Termination summaries/discharges summaries shall include, at a minimum, the following:

(1) Client identification (name and/or identification number).

(2) Date of admission.

(3) Date of discharge.

(4) Diagnosis.

(5) The degree of severity at admission and at discharge for the following dimensions shall be based on the Ohio department of alcohol and drug addiction services' protocols for levels of care (youth and adult) for publicly-funded clients. For non-publicly-funded clients, the degree of severity at admission and discharge shall be based on the Ohio department of alcohol and drug addiction services' protocols for levels of care or other objective placement criteria:

(a) Intoxication and withdrawal.

(b) Biomedical conditions and complications.

(c) Emotional/behavioral/cognitive conditions and complications.

(d) Treatment acceptance/resistance.

(e) Relapse potential.

(f) Recovery environment.

(g) Family or care giver functioning (for youth).

(6) Level of care and service(s) provided during course of treatment.

(7) Client's response to treatment.

(8) Recommendations and/or referrals for additional alcohol and drug addiction treatment or other services.

(9) Date, original signature and credentials of a person qualified to provide counseling services in accordance with rule 3793:2-1-08 of the Administrative Code.

(U) If a program maintains electronic health records (EHRs) it must be a system or module that is certified in accordance with the Public Health Service Act (PHSA) Title XXX and also comply with section 3701.75 of the Revised Code.

(V) 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.

Effective: 07/01/2012
R.C. 119.032 review dates: 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.06 , 3793.02 , 3793.11
Rule Amplifies: 3793.06 , 3793.11
Prior Effective Dates: 7/1/01, 6/13/04, 11/17/05, 2/14/11

3793:2-1-07 Client rights and grievances.

(A) The purpose of this rule is to state the minimum client rights and grievances requirements for certification by the Ohio department of alcohol and drug addiction services as an alcohol and drug addiction treatment program.

(B) The provisions of this rule are applicable to all of the following programs, public or private, regardless of whether they receive any public funds or funds that originate and/or pass through the Ohio department of alcohol and drug addiction services in accordance with division (A) of section 3793.06 of the Revised Code.

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternatives to street crime programs.

(5) Driver intervention programs.

(D) Deemed status shall be granted to waive sections of the administrative code if the program if the program is certified/licensed by the Ohio department of mental health. Deemed provisions include paragraphs (E), (F), (G), (H) and (I)(1) to (I)(6) and (I)(8) of this rule.

(E) Each program shall have the following:

(1) Client rights policy that lists all of the client rights identified in this rule.

(2) Client grievance procedure.

(3) Policy for maintaining for at least two years from resolution, records of client grievances that include, at a minimum, the following:

(a) Copy of the grievance.

(b) Documentation reflecting process used and resolution/remedy of the grievance.

(c) Documentation, if applicable, of extenuating circumstances for extending the time period for resolving the grievance beyond twenty-one calendar days.

(F) The rights of clients for each program shall include, but not be limited to, the following:

(1) The right to be treated with consideration and respect for personal dignity, autonomy and privacy.

(2) The right to receive services in the least restrictive, feasible environment.

(3) The right to be informed of one's own condition.

(4) The right to be informed of available program services.

(5) The right to give consent or to refuse any service, treatment or therapy.

(6) The right to participate in the development, review and revision of one's own individualized treatment plan and receive a copy of it.

(7) The right or freedom from unnecessary or excessive medication, unnecessary physical restraint or seclusion.

(8) The right to be informed and the right to refuse any unusual or hazardous treatment procedures.

(9) The right to be advised and the right to refuse observation by others and by techniques such as one-way vision mirrors, tape recorders, video recorders, television, movies or photographs.

(10) The right to consult with an independent treatment specialist or legal counsel at one's own expense.

(11) The right to confidentiality of communications and personal identifying information within the limitations and requirements for disclosure of client information under state and federal laws and regulations.

(12) The right to have access to one's own client record in accordance with program procedures.

(13) The right to be informed of the reason(s) for terminating participation in a program.

(14) The right to be informed of the reason(s) for denial of a service.

(15) The right not to be discriminated against for receiving services on the basis of race, ethnicity, age, color, religion, sex, national origin, disability or HIV infection, whether asymptomatic or symptomatic, or AIDS.

(16) The right to know the cost of services.

(17) The right to be informed of all client rights.

(18) The right to exercise one's own rights without reprisal.

(19) The right to file a grievance in accordance with program procedures.

(20) The right to have oral and written instructions concerning the procedure for filing a grievance.

(G) the program's client rights policy and the program's client grievance procedure shall:

(1) Be posted in a place accessible by clients at each program site.

(2) Be given to each client at admission, with documentation of same included in the client record.

(H) All staff involved with the operation of an alcohol and drug addiction program shall be familiar with the program's client rights policy and client grievance procedure. There shall be documentation in each employee's personnel file, including contract staff, volunteers and student interns that she/he has received a copy of the client rights policy and the client grievance procedure and has agreed to abide by them.

(I) Each alcohol and drug addiction treatment program shall have a client grievance procedure that has provisions for, but is not limited to, the following:

(1) Requirement that the grievance must be in writing.

(2) Requirement that the grievance must be dated and signed by the client or the individual filing the grievance on behalf of the client.

(3) Requirement that the grievance include the date, approximate time, description of the incident and names of individuals involved in the incident/situation being grieved.

(4) Statement to whom the client is to give the grievance.

(5) Statement that the program will make a resolution decision on the grievance within twenty-one calendar days of receipt of the grievance. Any extenuating circumstances indicating that this time period will need to be extended must be documented in the grievance file and written notification given to the client.

(6) Designation of staff who will be available to assist a client in filing of a grievance.

(7) Statement that a client has the option to file a grievance with outside organizations, that include, but are not limited to, the following, with the mailing address and telephone numbers for each stated:

(a) Applicable alcohol and drug addiction services board or alcohol, drug addiction and mental health services board.

(b) Ohio department of alcohol and drug addiction services.

(c) Ohio legal rights services.

(d) U.S. department of health and human services, civil rights regional office in Chicago.

(8) Requirement that a written acknowledgment of receipt of the grievance be provided to each grievant. Such acknowledgment shall be provided within three working days from receipt of the grievance. The written acknowledgment shall include, but not be limited to, the following:

(a) Date grievance was received.

(b) Summary of grievance.

(c) Overview of grievance investigation process.

(d) Timetable for completion of investigation and notification of resolution.

(e) Treatment provider contact name, address and telephone number.

Effective: 02/14/2011
R.C. 119.032 review dates: 11/10/2010 and 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06
Rule Amplifies: 3793.06
Prior Effective Dates: 7/1/91, 7/1/01, 11/17/05, 7/1/06

3793:2-1-08 Treatment services.

(A) The purpose of this rule is to define alcohol and drug addiction treatment services, and identify who can deliver and supervise treatment services.

(B) The provisions of this rule are applicable to all of the following Ohio alcohol and drug addiction programs public or private, regardless of whether they receive any public funds that originate and/or pass through the Ohio department of alcohol and drug addiction services, in accordance with division (A) of section 3793.06 of the Revised Code:

(1) Alcohol and drug addiction outpatient treatment programs.

(2) Alcohol and drug addiction residential treatment programs.

(3) Opioid agonist programs.

(4) Alcohol and drug addiction ambulatory detoxification programs.

(C) The provisions of this rule are not applicable to the following programs:

(1) Alcohol and drug prevention programs.

(2) Alcohol and drug addiction sub-acute detoxification and acute hospital detoxification programs.

(3) Criminal justice therapeutic community programs.

(4) Treatment alternative to street crime programs.

(5) Driver intervention programs.

(6) Programs located outside the state of Ohio.

(D) The Ohio department of alcohol and drug addiction services recognizes the following services that may be used in the treatment of alcohol and other drug addiction:

(1) Consultation.

(2) Referral and information.

(3) Intervention.

(4) Hotline.

(5) Training.

(6) Outreach.

(7) Assessment.

(8) Crisis intervention.

(9) Case management.

(10) Individual counseling.

(11) Group counseling.

(12) Family counseling.

(13) Intensive outpatient.

(14) Urinalysis.

(15) Medical/somatic.

(16) Opioid agonist administration.

(17) Medical community residential.

(18) Non-medical community residential.

(19) Twenty-three-hour observation bed.

(20) Ambulatory detoxification.

(21) Sub-acute detoxification.

(22) Adjunctive alcohol and/or drug services.

(23) Acute hospital detoxification.

(24) Medication assisted treatment.

(E) Consultation means assisting an individual in accessing alcohol and other drug services or other necessary services generally occurring prior to admission. Consultation is a cross-system or within-system collaboration on behalf of an individual to assist in assessment and triage decisions. This process may include family members or other significant persons. Within-system does not include consultation within a treatment agency.

(F) Referral and information service means responding to inquiries from people, usually by telephone, about services provided by the program or services provided by other health care organizations and contacting another health care organization provider in order to obtain services for an individual. This service does not include "hotline services".

(G) Intervention service means those activities that seek to detect alcohol and/or other drug problems and addiction and to intervene in such a way as to arrest the progression of such problems. It includes early intervention services.

(H) Hotline service means a program's twenty-four hour per day, seven days per week capability to respond to telephone calls often anonymous, made to a program for crisis assistance. The caller may or may not become a client of the program.

(I) Training service (non-prevention) means developing alcohol and/or drug service skills of staff and personnel not employed by the agency (e.g. counselors'/clinicians' training on counseling techniques and approaches; sessions for clinicians on the effect of various types of drugs).

(J) Outreach service means a planned approach to reach a target population within their environment. The purpose of this approach is to prevent and/or address issues and problems as they relate to the use/abuse of alcohol or drugs.

(K) Assessment service means the evaluation of an individual to determine the nature and extent of his/her abuse, misuse and/or addiction to alcohol and/or other drugs. Assessment services shall consist of time limited, structured, face-to-face sessions.

(1) Face-to-face assessment sessions can include family members, legal guardians and/or significant others when the intended outcome of sessions is to ascertain the nature and extent of a client's alcohol and/or drug problem.

(2) Assessment services may be provided at an alcohol and drug addiction program site certified by the Ohio department of alcohol and drug addiction services or in the natural environment of the client being served.

(3) Assessment includes at a minimum, the following information:

(a) Presenting problem(s) and/or precipitating factors leading to the need for an assessment;

(b) History of alcohol and other drug use by client and family members and/or significant others;

(c) Current over-the-counter and prescription medications being used;

(d) History of treatment for alcohol and other drug abuse;

(e) Medical history;

(f) Allergies to include food and drug reactions;

(g) Employment history;

(h) Educational history;

(i) Legal history to include pending charges and parole/probation status;

(j) Mental status screen including but not limited to, appearance, attitude, motor activity, affect, mood, speech and thought content;

(k) Psychiatric history;

(l) Family history;

(m) Sexual history;

(n) Religion/spiritual orientation;

(o) Strengths/assets;

(p) Weaknesses/limitations;

(q) Degree of severity for the following dimensions: intoxication and withdrawal potential, biomedical conditions and complications, emotional/behavioral/cognitive conditions and complications, treatment acceptance/resistance, relapse potential, recovery environment and family or care giver functioning (youth only);

(r) Recommendations for treatment.

(4) A program may accept an assessment from a program certified by the department or an assessment containing comparable elements of assessment required by this rule that has been completed within one year of the admission date of a client; however, a copy of the assessment shall be filed in the client's record and updated, signed and dated by a staff member of the admitting program authorized to conduct an assessment pursuant to agency-level 3793 of the Administrative Code.

(L) A crisis intervention service is a face-to-face interaction with a client that is in response to a crisis or emergency situation experienced by themselves, a family member and/or significant other. It begins with an evaluation of what happened during the crisis and the individual's response or responses to it. An individual's reaction to a crisis can include emotional reactions (such as fear, anger, guilt, anxiety, grief), mental reactions (such as difficulty concentrating, confusion, nightmares), physical reactions (such as headaches, dizziness, fatigue, stomach problems), and behavioral reactions (sleep and appetite problems, isolation, restlessness). Information about the individual's strengths, coping skills, and social support networks is also obtained.

(1) Crisis intervention services can be provided at a program site certified by the Ohio department of alcohol and drug addiction services or in the client's natural environment.

(a) Individuals who have unstable medical problems shall be referred to a medical facility.

(b) Individuals who have unstable psychiatric problems shall be referred to a psychiatric facility.

(c) Individuals who are experiencing withdrawal symptoms from use of alcohol and/or other drugs shall be referred to a person and/or entity that can provide the appropriate level of detoxification services.

(2) Individual service providers of crisis intervention services shall have current training and/or certification, with documentation of same in their personnel files, in the following:

(a) Cardio-pulmonary resuscitation techniques.

(b) First aid.

(c) De-escalation techniques.

(M) 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.

(1) Case management services shall include, at a minimum, the following activities:

(a) Assessment.

(b) Development of a case management plan of care as defined in rule 3793:2-1-06 of the Administrative Code.

(c) Referral.

(d) Monitoring and follow-up.

(2) 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.

(a) Transportation in and of itself does not constitute case management.

(b) Waiting with clients for appointments at social service agencies, court hearings and similar activities does not, in and of itself, constitute case management.

(3) Case management services can be provided at a program site certified by the Ohio department of alcohol and drug addiction services, in the natural environment of the client or by telephone.

(4) Case management services do not include the provision of direct services (medical, educational, or social) to which the client has been referred nor does it include internal quality assurance activities, such as clinical supervisory activities and/or case reviews/staffing sessions.

(N) Individual counseling involves a face-to-face encounter between a client or client and family member and a counselor. Individual counseling means the utilization of special skills to assist an individual in achieving treatment objectives through the exploration of alcohol and other drug problems and/or addiction and their ramifications, including an examination of attitudes and feelings, consideration of alternative solutions and decision making and/or discussing didactic materials with regard to alcohol and other drug related problems. Individual counseling services can be provided at a program site certified by the Ohio department of alcohol and drug addiction services or in the client's natural environment.

(O) Group counseling means the utilization of special skills to assist two or more individuals in achieving treatment objectives. This occurs through the exploration of alcohol and other drug problems and/or addiction and their ramifications, including an examination of attitudes and feelings, consideration of alternative solutions and decision making and/or discussing information related to alcohol and other drug related problems. Group counseling services shall be provided at a program site certified by the Ohio department of alcohol and drug addiction services or in the client's natural environment. The client to counselor ratio for group counseling shall not be greater than twelve to one. Group counseling shall be documented per paragraphs (M) and (N) of rule 3793:2-1-06 of the Administrative Code. Group sessions, which focus on helping individuals increase awareness and knowledge of the nature, extent and harm of their alcohol and drug addiction do not have a client to counselor ratio requirement. Such group sessions can consist of lecture, viewing a video or a structured discussion session and shall be documented per paragraph (O)(1) of rule 3793:2-1-06 of the Administrative Code. The provision of this type of group session shall not eliminate the requirement for group counseling in outpatient and residential treatment.

(P) Family counseling means the utilization of special skills in sessions with individuals and their family members and/or significant others under the guidance of a counselor to address family and relationship issues related to alcohol and other drug abuse and/or dependence for the purpose of promoting recovery from addiction. Family counseling services can be provided at a program certified by the Ohio department of alcohol and drug addiction services or in the natural environment of the client.

(Q) Intensive outpatient service means structured individual and group alcohol and drug addiction activities and services that are provided at a certified treatment program site for a minimum of eight hours per week with services provided at least three days per week.

(1) Intensive outpatient services shall be provided at a treatment program site certified by the department of alcohol and drug addiction services.

(2) Intensive outpatient services shall include the following services:

(a) Assessment.

(b) Individual counseling.

(c) Group counseling.

(d) Crisis intervention as needed.

(3) Group counseling shall be provided each day intensive outpatient services are offered.

(R) Urinalysis means the testing of an individual's urine specimen to detect the presence of alcohol and other drugs. Urinalysis includes laboratory testing and/or urine dip screen.

(1) Laboratory testing procedures include:

(a) Urine specimens for urinalysis/lab analysis can be collected at a program site certified by the Ohio department of alcohol and drug addiction services, in the client's natural environment or at a laboratory.

(b) Programs that perform urinalysis/lab analysis shall have a standing physician's, clinical nurse specialist's or certified nurse practitioner's order for each client needing this service.

(c) Programs that perform urinalysis/lab analysis shall have a written procedure for a chain of custody of urine specimens.

(d) Urine specimens shall be collected in a manner to minimize falsification.

(e) Containers for urine specimens shall be labeled to reflect:

(i) The identification of the person from whom the specimen was obtained.

(ii) Date that the specimen was obtained.

(f) Urinalysis/lab analysis shall be performed by a laboratory that is in compliance with all applicable federal proficiency testing and licensing standards.

(g) Results of urinalysis/lab analysis testing shall be reviewed by the program staff and a copy of the results placed in the client's file. Positive results shall be shared with the client.

(2) Urine dip screen procedures include:

(a) Urine specimens shall be collected in a manner to minimize falsification.

(b) Programs that perform urine dip screens do not need a standing physician's clinical nurse specialist's or certified nurse practitioner's order for each client needing this service.

(c) Containers for urine specimens shall be labeled to reflect:

(i) The identification of the person from whom the specimen was obtained.

(ii) Date that the specimen was obtained.

(d) Results of the urine dip screen shall be reviewed by the program staff and a copy of the results placed in the client's file. Positive results shall be shared with the client.

(S) Medical/somatic services means medical services, medication administration services, medication assisted treatment, and the dispensing of medications in an alcohol and other drug treatment program.

(1) Medical/somatic services shall be delivered at a program site certified by the Ohio department of alcohol and drug addiction services.

(2) Medical services means those activities performed by a physician, registered nurse or licensed practical nurse to address the physical needs of clients. Medical services include, but are not limited to: health care examinations, health assessments, taking vital signs and reviewing laboratory findings.

(a) Medical services shall be delivered by staff who are credentialed by the Ohio board of nursing or by the Ohio state medical board.

(b) Providers of medical services shall be supervised by a registered nurse who is registered with the Ohio nursing board or by a physician who is licensed by the Ohio state medical board.

(3) Medication administration services means the administration or dispensing of medications to clients. This service does not include detoxification, rehabilitation, opioid agonist administration or urinalysis. Only physicians and pharmacists are authorized to dispense medications.

(4) Medication assisted treatment means the services of a medical professional directly related to the use of medications to provide a whole patient approach to the treatment of substance abuse disorders. This includes, but is not limited to, services associated with prescribing medications, the direct administration of medications and follow-up monitoring of patient health related to the use of medications. Medications utilized must be approved by the U.S. food and drug administration specifically for the treatment of alcohol and/or drug abuse or dependence. Medication assisted treatment does not include services as defined in paragraphs (T) and (X) of this rule. Medication assisted treatment shall be administered in the following manner:

(a) At an outpatient or residential program certified by the department of alcohol and drug addiction services or in the natural environment of the client.

(b) By a physician who is licensed by the state of Ohio medical board and is in compliance with any applicable waiver requirement related to the Drug Addiction Treatment Act (DATA) of 2000. The physician is the only medical professional who may provide medication assisted treatment in the natural environment of the client.

(c) Services of a non physician medical professional must be directed by the treating physician and shall be considered a component of the medication assisted treatment service.

(d) The treating physician must be immediately available to assist the non-physician.

(e) Comply with all state and federal laws and regulations related to the administration, dispensing and prescribing of medication assisted treatment.

(T) Opioid agonist administration means the administration or dispensing of opioid agonist to an individual only for the treatment of narcotic addiction by an alcohol and other drug treatment program licensed by the department of alcohol and drug addiction services as a opioid agonist program in accordance with section 3793.11 of the Revised Code. Opioid agonist shall be administered and/or dispensed at a program site which is certified as a treatment program by the department of alcohol and drug addiction services and is approved by the U.S. food and drug administration for the use of opioid agonist in the treatment of narcotic addiction.

(U) Medical community residential treatment means a twenty-four-hour rehabilitation facility, with twenty-four-hour-a-day medical/nursing monitoring, where a planned program of professionally directed evaluation, care and treatment for the restoration of functioning for persons with alcohol and other drug problems and/or addiction occurs. It may be affiliated with or located within a hospital, as part of the inpatient/residential continuum or may be in a freestanding facility.

(V) Non-medical community residential treatment means a twenty-four-hour rehabilitation facility, without twenty-four-hour-per-day medical/nursing monitoring, where a planned program of professionally directed evaluation, care and treatment for the restoration of functioning for persons with alcohol and other drug problems and/or addiction occurs.

(W) 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.

(X) Ambulatory detoxification services means face-to-face interactions with an individual who is suffering mild to moderate symptoms of withdrawal, for the purpose of alcohol and/or drug detoxification. This service shall be supervised by a physician, under a defined set of policies and procedures, who is licensed by the state of Ohio medical board. Ambulatory detoxification services shall be provided by an outpatient program that is certified by the department of alcohol and drug addiction services. Department certified halfway house and residential treatment programs that want to provide ambulatory detoxification services need not obtain outpatient certification from the department.

(Y) Sub-acute detoxification refers to detoxification services provided with twenty-four-hour medical monitoring. Services are of brief duration and linkage to other formal and informal services shall be made. Sub-acute detoxification may be provided in a hospital setting as a step-down service from acute detoxification, or may be provided in a free-standing setting with medical monitoring. This service shall be supervised by a physician, under a defined set of policies and procedures, who is licensed by the state of Ohio medical board.

(Z) Acute hospital detoxification services are delivered based on treatment protocols for detoxification in a hospital setting and are delivered by medical and nursing professionals who provide twenty-four hour medically-directed assessment and withdrawal management. Acute hospital detoxification services are indicated for individuals whose intoxication/withdrawal signs and symptoms are sufficiently severe to require primary medical and nursing care service and medical management. Acute hospital detoxification services are to be delivered under a defined set of physician approved policies and physician managed procedures and medical protocols.

(AA) Adjunctive alcohol and/or drug services means services other than those listed as specific alcohol and/or drug treatment services provided to individuals enrolled in an alcohol and other drug program or their family members, which are supportive of alcohol and/or drug addiction treatment services.

(BB) A physician, clinical nurse specialist or certified nurse practitioner who is licensed by the state of Ohio medical board and has demonstrated experience and/or training in substance use disorder treatment can supervise and provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Ordering urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Medical/somatic services.

(12) Opioid agonist administration.

(13) Twenty-three-hour observation bed services.

(14) Ambulatory detoxification services.

(15) Sub-acute detoxification services.

(16) Acute hospital detoxification services.

(17) Consultation.

(18) Referral and information.

(19) Intervention.

(20) Hotline.

(21) Training.

(22) Outreach.

(23) Adjunctive alcohol and drug services.

(24) Medication assisted treatment as defined in paragraph (BB) of this rule.

(CC) A psychologist who is licensed by the state of Ohio board of psychology and has demonstrated competence in substance use disorder treatment can supervise (except twenty-three hour observation bed) and provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three-hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(DD) A psychology assistant who is practicing under the supervision of a psychologist licensed by the state of Ohio board of psychology and has demonstrated competence in substance use disorder treatment can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(EE) A professional clinical counselor licensed by the state of Ohio counselor, social worker, and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can supervise (except twenty-three hour observation bed) and provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(FF) A professional counselor licensed by the state of Ohio counselor, social worker, and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis with supervision pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(GG) A licensed independent social worker licensed by the state of Ohio counselor, social worker, and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can supervise (except twenty-three hour observation bed) and provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(HH) A licensed social worker licensed by the state of Ohio counselor, social worker, and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis with supervision pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(II) A licensed marriage and family therapist by the state of Ohio counselor, social worker and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can provide the following treatment services:

(1) Crisis intervention

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis

(9) Non-medical community residential services

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(JJ) A licensed independent marriage and family therapist licensed by the state of Ohio counselor, social worker, and marriage and family therapist board and whose professional disclosure statement includes substance abuse assessment and counseling can supervise (except twenty-three hour observation bed) and provide the following treatment services:.

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(KK) A chemical dependency counselor assistant may do the following as they relate to abuse of or dependency on alcohol and other drugs. These tasks may only be performed while under the supervision of one of those individuals designated in paragraph (K) of rule 3793:2-1-05 of the Administrative Code.

(1) Crisis intervention.

(2) Case management

(3) Assessment, excluding diagnosis pursuant to section 4758.59 of the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(LL) A certified chemical dependency counselor II or licensed chemical dependency counselor II credentialed by the Ohio chemical dependency professionals board can provide the following treatment services as they relate to abuse of and dependency on alcohol and other drugs:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to section 4758.57 of the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(MM) A licensed chemical dependency counselor III licensed by the Ohio chemical dependency professionals board can provide, and may supervise (except for diagnosis and twenty-three hour observation bed), while under the supervision of one of the individuals in paragraph (K) of rule 3793:2-1-05 of the Administrative Code, the following treatment services as they relate to abuse of and dependency on alcohol and other drugs:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to section 4758.56 of the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(NN) A licensed independent chemical dependency counselor licensed by the Ohio chemical dependency professionals board can supervise (except for twenty-three hour observation bed) and provide the following treatment services as they relate to abuse of and dependency on alcohol and other drugs:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis pursuant to section 4758.55 of the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three-hour observation bed services (may provide but not supervise).

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(OO) A nurse registered with the Ohio board of nursing who has demonstrated experience and/or education in substance use disorder treatment can supervise and provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Medical/somatic services.

(12) Opioid agonist administration.

(13) Twenty-three-hour observation bed services.

(14) Ambulatory detoxification services.

(15) Sub-acute detoxification services.

(16) Acute hospital detoxification services.

(17) Consultation.

(18) Referral and information.

(19) Intervention.

(20) Hotline.

(21) Training.

(22) Outreach.

(23) Adjunctive alcohol and drug services.

(24) Medication assisted treatment as defined in paragraph (BB) of this rule.

(PP) A licensed practical nurse licensed by the Ohio board of nursing in accordance with Chapter 4723. of the Revised Code to practice as a licensed practical nurse in Ohio who has demonstrated experience and/or education in substance use disorder treatment can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Medical/somatic services at the direction of a licensed physician or registered nurse.

(12) Opioid agonist administration in accordance with rule 3793:2-3-01 of the Administrative Code.

(13) Twenty-three-hour observation bed services.

(14) Ambulatory detoxification services at the direction of a licensed physician or registered nurse.

(15) Sub-acute detoxification services at the direction of a licensed physician or registered nurse.

(16) Acute hospital detoxification services at the direction of a licensed physician or registered nurse.

(17) Consultation.

(18) Referral and information.

(19) Intervention.

(20) Hotline.

(21) Training.

(22) Outreach.

(23) Adjunctive alcohol and drug services.

(24) Medication assisted treatment as defined in paragraph (BB) of this rule.

(QQ) A school psychologist licensed to practice school psychology in accordance with Chapter 4732. of the Revised Code who has demonstrated competence in substance use disorder treatment can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(RR) A school psychologist who is certified in accordance with division (O) of section 3301.07 of the Revised Code and has demonstrated competence in substance use disorder treatment can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(SS) A social work assistant who is registered with the state of Ohio counselor and social worker board and is supervised by an individual who is both qualified to supervise pursuant to rule 4757-21-01 of the Administrative Code, and to be an alcohol and drug treatment services supervisor pursuant to this rule and has demonstrated experience and/or education in substance use disorder treatment can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Intensive outpatient services excluding counseling.

(5) Requesting urinalysis/lab analysis.

(6) Medical community residential services excluding counseling.

(7) Non-medical community residential services excluding counseling.

(8) Twenty-three-hour observation bed services excluding counseling.

(9) Consultation.

(10) Referral and information.

(11) Intervention.

(12) Hotline.

(13) Training.

(14) Outreach.

(15) Adjunctive alcohol and drug services.

(TT) A counselor trainee who is registered with the state of Ohio counselor, social worker, and marriage and family therapist board and is supervised by an individual who is both qualified to supervise pursuant to rule 4757-17-01 of the Administrative Code, and to be an alcohol and drug treatment services supervisor pursuant to this rule and has demonstrated experience and/or education in substance use disorder treatment can provide the following services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, including diagnosis under the supervision of a professional clinical counselor.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Non-medical community residential services.

(10) Medical community residential services.

(11) Twenty-three hour observation bed.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(UU) Students enrolled in an accredited educational institution in Ohio performing an internship or field placement and supervised by an individual qualified to be an alcohol and drug treatment services supervisor pursuant to paragraph (J) of rule 3793:2-1-05 of the Administrative Code can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(VV) Individuals who are licensed with the state of Ohio counselor, social worker, and marriage and family therapist board, or nurses registered with the Ohio board of nursing who are supervised by an individual qualified to be an alcohol and drug treatment services supervisor pursuant to this rule, can provide the following treatment services:

(1) Crisis intervention.

(2) Case management.

(3) Assessment, excluding diagnosis pursuant to the Revised Code.

(4) Individual counseling.

(5) Group counseling.

(6) Family counseling.

(7) Intensive outpatient services.

(8) Requesting urinalysis/lab analysis.

(9) Medical community residential services.

(10) Non-medical community residential services.

(11) Twenty-three-hour observation bed services.

(12) Consultation.

(13) Referral and information.

(14) Intervention.

(15) Hotline.

(16) Training.

(17) Outreach.

(18) Adjunctive alcohol and drug services.

(WW) Individuals who possess one or more of the following credentials can dispense opioid agonist and other medications:

(1) Physician who is licensed by the state of Ohio medical board.

(2) Pharmacist who is registered with the state of Ohio board of pharmacy.

(XX) Providers of medical/somatic, twenty-three-hour observation bed, ambulatory detoxification, sub-acute detoxification and acute hospital detoxification shall be supervised by individuals who have one of the following credentials:

(1) Physician who is licensed by the state of Ohio medical board.

(2) Nurse who is registered with the Ohio board of nursing.

(YY) A care management specialist (CMS) is an individual who has received training for or education in alcohol and other drug addiction, abuse, and recovery and who has demonstrated, prior to or within ninety days of hire, competencies in fundamental alcohol and other drug addiction, abuse, and recovery. Fundamental competencies shall include, at a minimum, an understanding of alcohol and other drug treatment and recovery, how to engage a person in treatment and recovery and an understanding of other healthcare systems, social service systems and the criminal justice system. A CMS is an individual who is not otherwise designated as a provider or supervisor under this rule, and who is not required to perform duties covered under the scope of practice according to Ohio professional licensure. A CMS must be supervised by an individual qualified to be an alcohol and drug treatment services supervisor pursuant to this rule. A CMS may provide the following treatment services:

Case management.

Effective: 07/01/2012
R.C. 119.032 review dates: 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.06 , 3793.02
Rule Amplifies: 3793.06 , 3793.02
Prior Effective Dates: 7/1/91, 7/1/01, 7/1/05, 7/1/06, 7/2/07, 10/4/10, 5/19/11

3793:2-1-09 Uniform cost reporting.

(A) Definitions

(1) ADAMHS board means an alcohol, drug addiction and mental health services board as defined in section 340.02 of the Revised Code.

(2) ADAS board means an alcohol and drug addiction services board as defined in section 340.021 of the Revised Code.

(3) AOD means alcohol and other drug.

(4) AOD program means any alcohol and drug addiction program (as defined in section 3793.01 of the Revised Code) which has been issued a certificate from the Ohio department of alcohol and drug addiction services in accordance with the requirements of section 3793.06 of the Revised Code or has been issued a license from the Ohio department of alcohol and drug addiction services in accordance with the requirements of section 3793.11 of the Revised Code.

(5) CMS means the "Centers for Medicare and Medicaid" services.

(6) MACSIS means the multi-agency community services information system.

(7) ODADAS means the Ohio department of alcohol and drug addiction services as defined in sections 3793.02 and 3793.03 of the Revised Code.

(8) OMB A-122 means the most current version of the office of management and budget circular A-122 "Cost Principles for Non-Profit Organizations." This can be found at the following internet site: http://www.whitehouse.gov/omb/circulars/index.html.

(9) OMB A-87 means the most current version of the office and budget circular A-87 "Cost Principles for State, Local, and Indian Tribal Governments." This can be found at the following internet site: http://www.whitehouse.gov/omb/circulars/index.html.

(10) PRM, part 1 means the most current version of the provider reimbursement manual (PRM)-part 1 as published by CMS. This can be found at the following internet site: http://www.cms.hhs.gov/manuals/PBM/list.asp.

(11) SFY means state fiscal year. This is the time period commencing on July first of any given calendar year and completing on June thirtieth of the following calendar year.

(12) UCR means uniform cost report. The form designated as ODADAS-FIS-047 in appendix A to this rule. When completed on a prospective basis using budget cost information for a SFY, it is considered a budgeted UCR. When completed on a retrospective basis using actual cost information for a SFY, it is considered an actual UCR.

(13) UFMS means uniform financial management system. Appendix A to this rule in its entirety, including the UCR.

(14) UPI means unique provider identification number. This number, assigned for MACSIS use, represents an ODADAS certified/licensed AOD program and owner (indicated by a single federal tax identification number) operating at a discrete physical location.

(B) Beginning with SFY 2011 cost reporting, the principles set forth in this rule are applicable to all UCRs filed with ODADAS for the purpose of reporting costs associated with providing AOD services as defined in agency 3793 of the Administrative Code. All UCRs must be completed by utilizing generally accepted accounting principles and all costs must be allocated, either directly or indirectly, to the services that benefit from the cost.

(C) All AOD programs must use the UCR to report all costs associated with providing AOD services regardless of anticipated or actual payor source(s). There are three options for completion and filing of UCRs.

(1) By discrete UPIs.

(2) By bundling costs from multiple physical locations and reporting these under a single UPI or

(3) At the corporate level, by reporting all service costs associated with multiple physical locations under a single UPI and federal tax identification number combination at the corporate level.

(D) Any AOD program not receiving funding from an ADAMHS board, an ADAS board or directly from ODADAS may file the following statement in lieu of an actual UCR:

(1) This statement must be submitted on program letterhead and signed by the program director.

I do hereby certify that my program has not received any funding from an ADAMHS board, an ADAS board or directly from ODADAS in the past SFY and am filing this statement in lieu of an actual UCR.

(E) All AoD programs must file an actual UCR or the statement in lieu of an actual UCR with ODADAS within one hundred eighty days after the close of a SFY. Any AOD program failing to file an actual UCR or the statement in lieu of an actual UCR with ODADAS, and sending a copy to the local ADAMHS/ADAS board in which the AOD program owner's primary place of business is located, within one hundred eighty days after the close of a SFY may have its ODADAS certification/license revoked for violation of paragraph (I)(2) of rule 3793:2-1-01 of the Administrative Code. ODADAS will follow paragraphs (J) and (K) of rule 3793:2-1-01 of the Administrative Code when proposing revocation of ODADAS certification/licensure.

(F) When an incomplete or inadequate actual UCR is filed with ODADAS within the prescribed time period, ODADAS will notify the AOD program of the discrepancy(ies) and send a copy of the notification to the local ADAMHS/ADAS board in which the AOD program owner's primary place of business is located. The AOD program has forty-five days from the date of the notification of the discrepancy(ies) to refile and complete and adequate UCR with ODADAS, including sending a copy to the local ADAMHS/ADAS board in which the AOD program owner's primary place of business is located. Failure to refile a complete and adequate UCR may result in ODADAS proposing revocation of the AOD program's ODADAS certification/licensure for violation of paragraph (I)(2) of rule 3793:2-1-01 of the Administrative Code. ODADAS will follow paragraphs (J) and (K) of rule 3793:2-1-01 of the Administrative Code when proposing revocation of ODADAS certification/licensure.

(G) All cost data must be reported using the accrual basis of accounting.

(H) Cost categories

(1) Allowable costs - for privately owned and/or operated not-for-profit programs, allowable costs shall be determined in accordance with 42 CFR 413 and OMB A-122. For governmentally owned and/or operated programs, allowable costs shall be determined in accordance with 42 CFR 413 and OMB A-87. For privately owned and/or operated for-profit programs, allowable costs shall be determined in accordance with 42 CFR 413 and the PRM, Part 1.

(2) Unallowable costs - for privately owned and/or operated not-for-profit programs, unallowable costs shall be determined in accordance with 42 CFR 413 and OMB A-122 part 1. For governmentally owned and/or operated programs, unallowable costs shall be determined in accordance with 42 CFR 413 and OMB A-87. For privately owned and/or operated for-profit programs, unallowable costs shall be determined in accordance with 42 CFR 413 and the PRM, part 1.

(3) Direct service personnel costs - direct service personnel costs shall represent the full salary and benefit costs of those personnel who provide direct services to the clients.

(4) Support service personnel costs - support service personnel costs shall represent the full salary and benefit costs of those personnel who directly support a specific AOD service or services.

(5) Non-personnel costs - Are those costs necessary for, and allocated to, specific direct services.

(6) Administrative overhead costs - Administrative overhead costs are those personnel and non-personnel costs that benefit the agency as whole and cannot be allocated to a specific service or services.

(I) An actual UCR must be audited in accordance with the UCR audit requirements and procedures as set forth in agency 3793 of the Administrative Code.

(J) All AOD programs must keep all actual UCRs and the supporting documentation necessary to fully disclose the extent of services provided and costs associated with providing those services for a period of seven SFYs from the date a service is rendered or until all financial reporting obligations which include or rely upon data contained in the UCR and/or the supporting documentation have been completed, whichever is longer.

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Effective: 07/11/2011
R.C. 119.032 review dates: 01/19/2010 and 07/15/2014
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06 , 3793.11
Rule Amplifies: 3793.06 , 3793.11
Prior Effective Dates: 7/23/04, 3/7/05, 7/10/05

3793:2-1-10 Actual uniform cost report agreed upon procedures and report submission requirement.

(A) This rule establishes the requirement for all Ohio department of alcohol and drug addiction services (ODADAS)-certified programs required to submit an actual uniform cost report (AUCR) in accordance with rule 3793:2-1-09 of the Administrative Code to have the AUCR examined by an independent public accounting(IPA) firm using the agreed upon procedures (AUP) contained in appendix A to this rule prior to submission to ODADAS. The ODADAS-certified program owner shall assure any recommendations contained in the agreed upon procedures report are made and a new original AUCR is completed.

(B) Beginning with the AUCR period of July 1, 2005 through June 30, 2006 and for each subsequent state fiscal year (SFY) AUCR reporting period thereafter, the ODADAS-certified program shall submit the following to ODADAS within one hundered eighty days after the end of a SFY:

(1) The originally prepared AUCR which was completed prior to the agreed upon procedures review and in accordance with rule 3793:2-1-09 of the Administrative Code,

(2) A copy of the agreed upon procedures AUCR report completed in accordance with appendix A to othis rule and issued by the IPA firm, and

(3) If appropriate, a new original AUCR adjusted based upon the recommendations of the IPA firm as documented in the AUCR AUP report.

(C) An ODADAS-certified program reporting costs on the AUCR "Mental Health Services" line will also need to submit a copy of their information required under rule 5122-26-191 of the Administrative Code.

(D) An ODADAS-certified program which is also subject to rule 5101:2-47-26.2 of the Administrative Rule may submit the information required in rule 5101:2-47-26.2 of the Administrative Code in place of the information required by paragraph (B) of this rule with the following exception: the ODADAS-certified program is responsible for making all recommended adjustments to the AUCR and, if appropriate, completing and submitting a new original UCR.

(E) The ODADAS-certified program owner shall send the AUCR AUP reprort and, if applicable, the new original AUCR to the ODADAS' fiscal services division. A copy of the AUCR AUP report and, if applicable, a copy of the new AUCR shall be sent to the local alcohol, drug addiction and mental health service or alcohol and drug addiction services board where the program owner's primary place of business is locate.

APPENDIX Actual Uniform Cost Report Agreed Upon Procedures and Report Submission Requirement - Appendix A.

(A) An independent public accounting (IPA) firm shall use the following procedures in order to:

(1) report on the accuracy of the data reported on the actual uniform cost report (AUCR),

(2) report on the appropriateness of the allocation methods used for actual cost reporting,

(3) report on the allowability and unallowability of the cost data reported on the ACUR, and

(4) determine if the data reported on the AUCR is in accordance with the applicable federal and state resources as stated in Ohio Administrative Code 3793:2-1-09 as in effect for the State Fiscal Year (SFY) being reported.

(5) report on the consistency between the first budget uniform cost report (BUCR) and the AUCR.

(B) Work completed in other areas or during other agreed upon procedures (AUP) reviews may be used to satisfy these procedures as long as it is documented by the IPA firm how the work satisfies these procedures. Work completed during an Ohio Administrative Code 5101:2-47- 26.2 required review may be used for completing the review required by this rule. If reliance is placed on work completed by an IPA firm from another engagement, such as an Office of Management and Budget (OMB) circular A-133 audit, a financial statement audit, or other such audit or review or some other auditor's work, it must be documented in the AUP report required by this rule, how the work being relied upon meets the requirements contained in these procedures.

(C) If it is available, the previous SFY AUCR, AUCR report, and independent financial audit report are to be reviewed to determine if any management comments and/or findings will impact the current actual uniform cost report data.

(D) Obtain and inspect the program's chart of accounts, including all revenue and expense accounts.

(E) Obtain and inspect a copy of Ohio Administrative Code 3793:2-1-09 as in effect for the SFY AUCR being reviewed.

(F) obtain and inspect the first BUCR and all supporting documentation.

(G) Agreed Upon Procedures.

(1) Procedure One - Mathematical Accuracy Testing.

(a) Obtain a reconciliation of the total costs reported on the AUCR to the general ledger and/or the independently audited financial statements for the SFY being verified. Compare the amounts listed on the reconciliation to the amounts listed on the general ledger and/or independently audited financial statements for the SFY being verified. Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(b) For and by each service with costs being reported on the AUCR:

(i) sum the values reported in columns 4 and 5 and verify the result is equal to the value reported in the corresponding column 6.

(ii) sum the values reported in columns 6 and 7 and verify the result is equal to the value reported in the corresponding column 8.

(iii) verify the value reported in column 9 is equal to the result of dividing the value in column 8 by the value in column 2.

(iv) verify the valued reported in column 11 is equal to the result of subtracting the value in column 10 from the value in column 8.

(v) verify the value reported in column 12 is equal to the result of dividing the value in column 11 by the value in column 2.

(vi) verify the values reported in the "TOTALS FOR AOD SERVICES" are equal to the sum of the values reported in the corresponding column.

(vii) verify the values reported in the "TOTALS FOR AGENCY" are equal to the sum of the values reported in the corresponding column.

(2) Procedure Two - Personnel Costs Verification.

(a) Compare the personnel costs reported in column 4 of the AUCR to the salaries, wages and fringe benefits reported on the independently audited financial statements or Federal Internal Revenue Service Employer Form 941. Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(b) From the personne l costs reported in column 4 of the AUCR, select ten employees whose personnel costs roll- up to those costs. Either for one pay period or on the year end totals, perform the following procedures on the sample by inspecting the following supporting documentation:

(i) Compare the costs for allowability and unallowability as defined in Ohio Administrative Code 3793:2-1-09 paragraphs (H)(1) and (H)(2).

(ii) Compare the allocation methods used to determine whether the costs are documented as direct service (column 4a) or support service (column 4b) costs.

(iii) Compare the allocation method or methods used to determine which service personnel costs have been allocated to.

(iv) Verify any unallowable costs are allocated in the same manner they were originally allocated and are documented in the appropriate service row of column 10 of the AUCR

(v) Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(3) Procedure Three - Non-Personnel Costs Verification

(a) From the non-personnel costs reported in column 5 of the AUCR, select a haphazard sample (as defined in the American Institute of Certified Public Accountants audit sampling guide) of checks and/or electronic funds transfer (EFT) disbursements, equal to 20 percent or 40 checks and/or EFT disbursements, whichever is less. Perform the following procedures on each selected check or EFT disbursement:

(i) Compare the costs the check or EFT disbursement is for to the appropriate allowability or unallowability criteria listed in Ohio Administrative Code 3793:2-1-09 paragraphs (H)(1) and (H)(2).

(ii) Verify the allocation method or methods used for the sampled nonpersonnel costs have been made in accordance with Ohio Administrative Code 3793:2-1-09, Appendix A.

(iii) Verify any unallowable costs are allocated in the same manner they were originally allocated and are documented in the appropriate service row of column 10 of the AUCR.

(iv) Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(4) Procedure Four - Administrative Overhead Costs Verification

(a) From the administrative overhead costs reported in column 7 of the AUCR, select a haphazard sample (as defined in the American Institute of Certified Public Accountants audit sampling guide) of checks and/or electronic funds transfer (EFT) disbursements, equal to 10 percent or 20 checks and/or EFT disbursements, whichever is less. Perform the following procedures on each selected check or EFT disbursement:

(i) Compare the costs the check or EFT disbursement is for to the appropriate allowability or unallowability criteria listed in Ohio Administrative Code 3793:2-1-09 paragraphs (H)(1) and (H)(2).

(ii) Determine if the administrative overhead costs were allocated using only one of the allowable methods described in Ohio Administrative Code 3793:2-1-09, Appendix A.

(iii) Verify any unallowable costs are allocated in the same manner they were originally allocated and are documented in the appropriate service row of column 10 of the AUCR.

(iv) Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(5) Procedure Five - Units of Service Verification.

(a) From and by each service with costs reported on the AUCR, select a haphazard sample (as defined in the American Institute of Certified Public Accountants audit sampling guide) of the reported units of service, equal to 20 percent or 40 total units, whichever is less. Perform the following procedures on the selected units:

(i) Verify documentation exists in client records to support the number of units selected.

(ii) Compare the type of service selected to determine it is reported in the appropriate service line of column 2.

(iii) Identify and document any material variances (variances greater than plus or minus two percent) and obtain management's explanation of the material variance(s) for inclusion in the AUCR AUP report.

(6) Procedure Six - First BUCR to AUCR comparison.

(a) Compare the first BUCR to the AUCR and verify the methods of cost reporting selected are the same as the methods used when completing the AUCR.

(H) Actual Uniform Cost Report Agreed Upon Procedures Report

(1) A written report on the results of these AUP shall be completed by the IPA firm for the Ohio Department of Alcohol and Drug Addiction Services (ODADAS)-certified program to submit to ODADAS. The report shall be completed in accordance with the American Institute of Certified Public Accountants Statement on Standards for Attestation Engagements Statement number 11, 12 or its successors and the workpapers shall be completed in accordance with Government Auditing Standards. At a minimum, the report shall include the following:

(a) a summary of the procedures performed and the findings,

(b) a schedule listing the number of variances, if any, per procedure and a list of unallowable costs noted during the AUP,

(c) the completed copy of the AUCR, including an original signature,

(d) any other observations and/or comments of note the auditor, using their professional judgment, deems relevant.

(I) The AUCR AUP report shall be given to the ODADAS-certified program owner.

Effective: 06/29/2006
R.C. 119.032 review dates: 06/28/2011
Promulgated Under: 119.03
Statutory Authority: 3793.02(D) , 3793.06 , 3793.11
Rule Amplifies: 3793.06 , 3793.11

3793:2-1-11 Alcohol and drug treatment services provided by interactive videoconferencing.

(A) For purposes of this rule, interactive videoconferencing means the use of secure, real-time audiovisual communications of such quality as to permit accurate and meaningful interaction between at least two persons, one of which is a treatment professional listed in rule 3793:2-1-08 of the Administrative Code. This expressly excludes telephone calls, images transmitted via facsimile machine, and text messages without visualization of the other person, i.e., electronic mail. Telephone calls are permitted when made for the purpose of case management as defined in paragraph (M) of rule 3793:2-1-08 of the Administrative Code.

(B) An outpatient treatment program certified by the department of alcohol and drug addiction services may provide treatment service via interactive videoconferencing provided the criteria outlined in the rule are met.

(C) The following are the treatment services that may be provided via interactive videoconferencing and are considered to be provided on a face-to-face basis in accordance with rule 3793:2-1-08 of the Administrative Code.

(1) Case management as defined in paragraph (M) of rule 3793:2-1-08 of the Administrative Code including the provision of this service to authorized individuals other than the client.

(2) Group counseling as defined in paragraph (O) of rule 3793:2-1-08 of the Administrative Code. Group counseling utilizing interactive videoconferencing shall be conducted in the following manner:

(a) Client to counselor ratio shall not be greater than six to one; and,

(b) Participants in the group counseling session must be able to view all other participants in the group counseling session, including the clinician at all time.

(3) Individual counseling as defined in paragraph (N) of rule 3793:2-1-08 of the Administrative Code.

(D) Progress notes as defined in paragraph (M) of rule 3793:2-1-06 of the Administrative Code must include documentation to reflect that the service was conducted via interactive videoconferencing.

(E) The treatment program must have a written policy and procedure describing how they ensure that staff assisting clients with interactive videoconferencing services or providing treatment services via interactive videoconferencing are fully trained in equipment usage.

(F) All treatment services provided by interactive videoconferencing shall:

(1) Begin with the verification of the client through a name and password or personal identification number when treatment service are being provided with a client (s), and

(2) Be provided in accordance with the Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules and 42 C.F.R. Part 2.

(G) All data, including audio, video, text and presentation material shall be transferred using a minimum of one hundred twenty-eight bit-encryption.

(H) All treatment services rendered by interactive videoconferencing using the public internet must maintain at a minimum the advanced encryption standard (AES) algorithm or be rendered through the use of a virtual private network (VPN) to ensure the transmission is secure.

(I) All audio and video must be real time and not store forward.

(J) Treatment programs shall have a contingency plan for providing treatment services to clients when technical problems occur during the provision of treatment services via interactive videoconferencing.

(K) Prior to providing treatment services to a client via interactive videoconferencing, a professional listed in rule 3793:2-1-08 of the Administrative Code shall describe to the client the potential risks associated with receiving treatment services via interactive videoconferencing, provide the client with a written document that describes the potential risks associated with receiving treatment services via interactive videoconferencing and obtain a written acknowledgement, indicated by the client's signature that the client consents to receiving treatment services via interactive videoconferencing. The review must be conducted in person.

(L) The risks to be communicated to the client pursuant to paragraph (L) of this rule must address at a minimum the following:

(1) Clinical aspects of receiving treatment services via interactive videoconferencing.

(2) Security considerations when receiving treatment services via interactive videoconferencing; and

(3) Confidentiality for individual and group counseling.

(M) Programs 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 (O) 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.

(N) Programs shall provide local emergency contact information to each client that consents to receiving treatment services via interactive videoconferencing.

(O) Programs shall require that the client provide the street address and city where they are receiving services for each counseling session utilizing interactive videoconferencing.

(P) Programs must be located in Ohio and perform services to individuals who are residents of and are physically in Ohio.

Effective: 04/04/2011
R.C. 119.032 review dates: 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.06 , 3793.02
Rule Amplifies: 3793.02 , 3793.06

3793:2-1-12 Alcohol and drug treatment services provided by interactive videoconferencing for clients that are deaf or hearing impaired.

(A) The purpose of this rule is to expand interactive videoconferencing as defined in rule 3793:2-1-11 of the Administrative Code for clients that are deaf or hearing impaired as defined in the Americans with Disabilities Act. Unless otherwise specified in this rule, the requirement for interactive videoconferencing in rule 3793:2-1-11 of the Administrative Code are applicable.

(B) Videophone utilized for communication which allow visual interaction with a deaf or hard of hearing person are permitted under interactive videoconferencing.

(C) Assessment as defined in paragraph (K) of rule 3793:2-1-08 of the Administrative Code may be conducted using interactive videoconferencing when it is documented in the case note that an in-person assessment was not feasible for the client.

(D) The requirements in paragraph (K) of rule 3793:2-1-11 of the Administrative Code may be conducted using interactive videoconferencing when it is demonstrated in the client record that an in-person assessment was not feasible for the client.

Effective: 04/04/2011
R.C. 119.032 review dates: 07/15/2015
Promulgated Under: 119.03
Statutory Authority: 3793.02 , 3793.06
Rule Amplifies: 3793.06