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