Oregon Health Authority
Health Systems Division: Behavioral Health Services - Chapter 309
Division 18
RESIDENTIAL SUBSTANCE USE DISORDERS AND PROBLEM GAMBLING TREATMENT AND RECOVERY SERVICES
309-018-0125
Specific Staff Qualifications and Competencies
Provider must assure that staff in the following positions meet applicable qualifications, credentialing or licensing standards and competencies, including those set forth in these rules:
(1) Program staff providing treatment services or Peer-Delivered Services in substance use disorders or problem gambling treatment programs shall be trained in and familiar with strategies for the delivery of trauma informed and culturally responsive treatment services. All treatment services shall be provided in a trauma informed and culturally responsive manner. (2) Medical Directors shall be licensed under ORS 677 or 685 and may perform health maintenance and restoration measures consistent with generally recognized and accepted principles of medicine, including but not limited to:
(a) Administering, dispensing, or writing prescriptions for medications;
(b) Recommending the use of specific and appropriate over-the-counter pharmaceuticals;
(c) Ordering diagnostic tests; and
(d) Perform tasks required by OAR 309-019-0200.
(3) Clinical supervisors in all programs shall demonstrate competence in leadership, wellness, oversight and evaluation of services, staff development, service planning, case management and coordination, utilization of community resources, group, family and individual therapy or counseling, documentation, and rationale for services to promote intended outcomes and implementation of all provider policies.
(4) Clinical supervisors in substance use disorders treatment and recovery programs shall be certified or licensed by a health or allied provider agency as follows:
(a) For supervisors holding a certification or license in substance use counseling, qualifications for the certificate or license shall have included at least:
(A) 4000 hours of supervised experience in substance use counseling;
(B) 300 contact hours of education and training in substance use related subjects; and
(C) Successful completion of a written objective examination or portfolio review by the certifying body.
(b) For supervisors holding a health or allied provider license, the license or registration shall have been issued by one of the following state bodies, and the supervisor shall possess documentation of at least 120 contact hours of academic or continuing professional education in the treatment of substance use disorders:
(A) Oregon Medical Board;
(B) Board of Psychologist Examiners;
(C) Board of Licensed Social Workers;
(D) Board of Licensed Professional Counselors and Therapists; or
(E) Oregon State Board of Nursing.
(c) Additionally, clinical supervisors in substance use disorders programs shall have one of the following qualifications:
(A) Five years of paid full-time experience in the field of substance use disorders counseling; or
(B) A Bachelor's degree and four years of paid full-time experience in the social services field with a minimum of two years of direct substance use disorders counseling experience; or
(C) A Master's degree and three years of paid full-time experience in the social services field with a minimum of two years of direct substance use disorders counseling experience.
(5) Clinical supervisors in problem gambling treatment and recovery programs shall meet the requirements for clinical supervisors in either mental health or substance use disorders treatment and recovery programs and have completed twelve hours of gambling specific training within two years of designation as a problem gambling services supervisor.
(6) Clinical supervisors of mental health services shall meet Qualified Mental Health Professional (QMHP) requirements and have completed two years equivalent of post-graduate clinical experience in a mental health treatment setting.
(7) Peer Delivered Services Supervisors shall be a certified Peer Support Specialist (PSS) or Peer Wellness Specialist (PWS) with at least one year experience as a PSS or PWS in behavioral health treatment services.
(8) Substance use disorders treatment staff shall:
(a) Demonstrate competence in the use of The ASAM Criteria, Third Edition, in treatment of substance-use disorders including individual assessment to include identification of health and safety risks to self or others; individual, group, family and other counseling techniques; program policies and procedures for service delivery and documentation and identification; development of a safety plan; implementation and coordination of services identified to facilitate intended outcomes; and
(b) Receive clinical supervision that documents progress towards certification and recertification; or
(c) At the date of first hire to provide substance use disorder treatment, if the program staff is not certified to provide substance use disorder treatment, they shall register with the Division recognized credentialing body within 30 days of hire and obtain professional substance use disorder treatment certification within two years from the date of first hire unless they obtain a variance from the Division before that time has elapsed;
(d) For program staff holding certification in substance use disorder counseling, qualifications for the certificate shall have included at least:
(A) 1000 hours of supervised experience in substance use counseling;
(B) 150 contact hours of education and training in substance use related subjects; and
(C) Successful completion of a professional psychometric examination by a Division recognized credentialing body. A substantively equivalent portfolio evaluation by Division recognized credentialing body may be accepted in lieu of a professional psychometric examination using procedures approved by the Division.
(e) Substance use disorder treatment staff not holding certification from a Division recognized credentialing body in substance use disorder counseling shall have a license or registration from a Division recognized credentialing body and at least 60 contact hours of academic or continuing professional education in the treatment of substance use disorders. The license or registration shall have been issued by one of the following state bodies:
(A) Oregon Medical Board;
(B) Board of Psychologist Examiners;
(C) Board of Licensed Social Workers;
(D) Board of Licensed Professional Counselors and Therapists; or
(E) Oregon State Board of Nursing.
(9) Problem gambling treatment staff shall:
(a) Demonstrate competence in treatment of problem gambling including individual assessment to include identification of health and safety risks to self or others; individual, group, family and other counseling techniques; program policies and procedures for service delivery and documentation, implementation and coordination of services identified to facilitate intended outcomes and cultural responsiveness;
(b) Receive clinical supervision that documents progress towards certification and recertification;
(c) At the date of first hire to provide substance use disorder treatment, if the program staff is not certified to provide substance use disorder treatment, they shall register with the Division recognized credentialing body within 30 days of hire and obtain professional substance use disorder treatment certification within two years from the date of first hire unless they obtain a variance from the Division before that time has elapsed;
(d) For program staff holding certification in problem gambling counseling, qualifications for the certificate shall have included at least:
(A) 500 hours of supervised experience in problem gambling counseling;
(B) 60 contact hours of education and training in problem gambling related subjects; and
(C) 24 hours of face-to-face, telephone, email or other electronic communication, of certification consultation from a problem gambling approved certification consultant; and
(D) Successful completion of a professional psychometric examination by a Division recognized credentialing body or a substantively equivalent portfolio evaluation by a Division recognized credentialing body may be accepted in lieu of a professional psychometric examination using procedures approved by the Division.
(e) Program staff not holding certification in gambling addiction counseling by a Division recognized credentialing body shall have at least 60 contact hours of academic or continuing professional education in the treatment of gambling addiction. The license or registration shall have been issued by one of the following state bodies:
(A) Oregon Medical Board;
(B) Board of Psychologist Examiners;
(C) Board of Licensed Social Workers;
(D) Board of Licensed Professional Counselors and Therapists; or
(E) Oregon State Board of Nursing.
(10) Rehabilitative Behavioral Health Service Providers, including medical treatment staff, shall demonstrate cultural responsiveness and meet the requirements and qualifications in OAR 410-172-0660.
(11) Behavioral health clinicians shall meet one of the following qualifications and maintain the corresponding credential in the State of Oregon:
(a) A licensed psychiatrist;
(b) A licensed psychologist;
(c) A licensed nurse practitioner with a specialty in psychiatric mental health;
(d) A licensed clinical social worker;
(e) A licensed professional counselor or licensed marriage and family therapist;
(f) A certified clinical social work associate;
(g) A Mental Health Intern or resident who is working under a board-approved supervisory contract in a clinical mental health field;
(h) A Qualified Mental Health Practitioner (QMHP); or
(i) Any other clinician whose authorized scope of practice includes mental health diagnosis and treatment.
(12) Qualified Mental Health Associates (QMHA) program staff shall:
(a) Demonstrate the following minimum competencies: cultural responsiveness, effective communication, care coordination, inter- and intra-agency collaboration, working alliances with individuals, assist in the gathering and compiling of information to be included in the assessment, screen for suicide and other risks, and implement timely interventions, teach skill development strategies, case management, and transition planning;
(b) Render services and supports within their scope to individuals engaged in a Division approved behavioral health services provider; and
(c) Shall meet the following minimum qualifications:
(A) Bachelor's degree in psychology, social work, or behavioral science field;
(B) An equivalent degree as evidenced by providing transcripts indicating applicable coursework meeting the required competencies and approved by a Division certified behavioral health provider; or
(C) A combination of at least three years of relevant work, education, training, or experience.
(d) Receive clinical supervision that documents progress towards certification and recertification.
(13) Qualified Mental Health Professional (QMHP) program staff shall:
(a) Demonstrate the following minimum competencies: cultural responsiveness, effective communication, care coordination, inter- and intra-agency collaboration, working alliances with individuals, suicide and other risk assessments and interventions, creating and monitoring safety plans, completion of bio-psycho-social assessments and additional assessments, updating assessments when clinical circumstances change, generating a differential DSM-5-TR diagnosis, prioritizing health, wellness and recovery needs, writing measurable service objectives, creating, monitoring and revising service plans, delivery of mental health and recovery treatment services in individual, group and family formats within their scope, gathering and recording data that measures progress toward the service objectives and documenting services, supports and other information supportive of the service plan.
(b) Render services and supports within their scope to individuals engaged in a Division approved behavioral health services program;
(c) Meet the following minimum qualifications:
(A) Bachelor’s degree in nursing and licensed by the State of Oregon. Nurses are accountable to abide by the Oregon Nurse Practice Act to determine if job descriptions are compliant with the competencies listed above;
(B) Bachelor’s degree in occupational therapy and licensed by the State of Oregon;
(C) Graduate degree in psychology, social work, recreational art or music therapy, or behavioral science field;
(D) An equivalent degree as evidenced by providing transcripts indicating applicable coursework meeting the required competencies and approved by a Division certified behavioral health provider; or
(E) Qualify as a Mental Health Intern, as described in these rules.
(d) Receive clinical supervision that documents progress towards certification and recertification.
(14) Mental Health Intern (MHI) program staff shall:
(a) Be currently enrolled in a graduate program for a master’s degree in psychology, social work, or related field of behavioral science;
(b) Have a collaborative educational agreement between the Division certified provider and the graduate program for the student;
(c) Demonstrate cultural responsiveness, effective communication and competence in care coordination, development of working alliances with individuals, inter- and intra-agency collaboration, and the rendering of services and supports within their scope and in accordance with the service plan, including transition planning; and
(d) Work within the scope of practice and competencies identified by collaborative educational agreement and the policies and procedures for the credentialing of clinical staff as established by the provider and the graduate program;
(15) Student Intern program staff shall:
(a) Be currently enrolled in an educational program for an undergraduate degree in a behavioral health field;
(b) Have a collaborative education agreement between the Division certified provider and the educational institute for the student;
(c) Demonstrate cultural responsiveness, effective communication and competence in care coordination, development of working alliances with individuals, inter- and intra-agency collaboration, and the rendering of services and supports within their scope and in accordance with the service plan, including transition planning;
(d) Work within the scope of practice and competencies identified by the collaborative educational agreement and the policies and procedures for the credentialing of clinical staff as established by the provider; and
(e) Receive, at a minimum, weekly individual supervision by a qualified clinical supervisor employed by the provider of services.
(f) Render services and supports under the direct supervision of a qualified supervisor employed by the provider of services, within the scope of practice and competencies identified by the collaborative educational agreement, and within the policies and procedures for the credentialing of program staff as established by the provider.
(16) Intern program staff shall:
(a) Be working towards obtaining a behavioral health credential;
(b) Demonstrate cultural responsiveness, effective communication and competence in care coordination, development of working alliances with individuals, inter-and intra-agency collaboration, and the rendering of services and supports within their scope and in accordance with the service plan, including transition planning;
(c) Work within the scope of practice and competencies identified by the applicable Division recognized credentialing body and the policies and procedures for the credentialing of clinical staff as established by the provider; and
(d) Render services and supports under the direct supervision of a qualified supervisor employed by the provider of services, within the scope of practice and competencies identified by the applicable Division recognized credentialing body, and within the policies and procedures for the credentialing of program staff as established by the provider.
(17) Community Health Workers working in substance use disorders treatment and recovery programs shall be certified as described in OAR 410-180-0310 and who:
(a) Has expertise or experience in behavioral health;
(b) Works in an urban or rural community, either for pay or as a volunteer in association with a local health care system;
(c) To the extent practicable, shares ethnicity, language, socioeconomic status and life experiences with the members of the community where the worker serves;
(d) Assists members of the community to improve their health and increases the capacity of the community to meet the health care needs of its residents and achieve wellness;
(e) Provides health education and information that is culturally appropriate to the individuals being served;
(f) Assists community members in receiving the care they need;
(g) CHW staff may:
(A) Give peer assistance and guidance on health including behavioral health behaviors; and
(B) Provide skills restoration services.
(18) Peer Support Specialists and Peer Wellness Specialists, including family and youth support and wellness specialists, shall meet the requirements in OAR 410-180-0300 to 0380 for certification and continuing education, and:
(a) A Peer Support Specialist and Peer Wellness Specialist shall be:
(A) Someone self-identified as currently or formerly receiving mental health, problem gambling or substance use services;
(B) Someone self-identified as in recovery from a substance use disorder;
(C) Someone self-identified as in recovery from problem gambling; or
(D) Someone who has experience parenting a child who:
(i) Is a current or former recipient of mental health or substance use treatment; or
(ii) Is facing or has faced difficulties in accessing education and health and wellness services due to a mental health or other behavioral health barrier.
(b) A Peer Support Specialist and Peer Wellness Specialist shall demonstrate:
(A) The ability to support others in their recovery or resiliency;
(B) Personal life experience and tools of self-directed recovery and resiliency; and
(C) Demonstrate cultural responsiveness and effective communication.
(19) “Youth support specialist” means an individual who meets qualification criteria adopted by the authority under ORS 414.665 and who, based on a similar life experience, provides supportive services to an individual who:
(a) Is not older than 30 years of age; and
(b) Is a current or former consumer of mental health or addiction treatment; or
(c) Is facing or has faced difficulties in accessing education, health and wellness services due to a mental health or behavioral health barrier.
(d) A “youth support specialist” may be a peer wellness specialist or a peer support specialist.
(20) Program staff include:
(a) Oregon Licensed Medical Professional (LMP) licensed by the Oregon Medical Board;
(b) Oregon Licensed Practical Nurse (LNP) licensed by the Oregon Board of Nursing;
(c) Oregon Registered Nurse (RN) licensed by the Oregon Board of Nursing;
(d) Advanced Practice Nurse including Clinical Nurse Specialist and Certified Nurse Practitioner licensed by the Oregon Board of Nursing;
(e) Psychologist licensed by the Oregon Board of Psychology;
(f) Professional Counselor (LPC) or Marriage and Family Therapist (LMFT) licensed by the Oregon Board of Licensed Professional Counselors and Therapists;
(g) Clinical Social Worker (CSW) licensed by the Oregon Board of Licensed Social Workers;
(h) Licensed Master Social Worker (LCSW) licensed by the Oregon Board of Licensed Social Workers as described in OAR 877-015-0105;
(i) Licensed Psychologist Associate granted independent status as described in OAR 858-010-0039;
(j) Licensed Occupational Therapist licensed by the Oregon Occupational Therapy Licensing Board;
(k) Board registered interns, including:
(A) Psychologist Associate Residents as described in OAR 858-010-0037;
(B) Licensed Psychologist Associate under continued supervision as described in OAR 858-010-0038;
(C) Licensed Professional Counselor Associate or Marriage and Family Therapist Associate registered with the Oregon Board of Licensed Professional Counselors and Therapists as described in OAR 833-050-0011;
(D) Certificate of Clinical Social Work Associate issued by the Oregon Board of Licensed Social Workers as described in OAR 877-020-0009;
(E) Registered Bachelor of Social Work issued by the Oregon Board of Licensed Social Workers as described in OAR 877-015-0105.
(l) Qualified Mental Health Professional (QMHP) as defined in OAR 309-019-0125(8);
(m) Qualified Mental Health Associate (QMHA) as defined in OAR 309-019-0125(7);
(n) Mental health intern as defined in OAR 309-019-0105;
(o) Problem Gambling treatment staff registered with the Mental Health and Addiction Certification Board of Oregon (MHACBO), which includes:
(A) Certified Gambling Addiction Counselor-Registered (CGAC-R);
(B) Certified Gambling Addiction Counselor-I (CGAC-I); or
(C) Certified Gambling Addiction Counselor-II (CADC-II).
(p) Substance Use Disorders (SUD) Treatment Staff, which includes:
(A) Certified Alcohol and Drug Counselor-Registered (CADC-R);
(B) Certified Alcohol and Drug Counselor-I (CADC-I);
(C) Certified Alcohol and Drug Counselor-II (CADC-II); and
(D) Certified Alcohol and Drug Counselor-III (CADC-III).
(q) Peer-Support Specialist (PSS) as defined in OAR 410-180-0305;
(r) Peer Wellness Specialist;
(s) Peer Delivered Services Supervisor;
(t) Tribal Traditional Health Worker; and
(u) Youth Support Specialist.
(21) Milieu staff are not required to have credentials. Milieu staff shall have or obtain training and education in de-escalation, mental health symptoms, substance use disorder symptoms, and suicide ideation identification to maintain a safe, supportive and effective treatment environment, and shall demonstrate effective:
(a) Knowledge of substance use disorders, including the ability to identify drugs and paraphernalia, post-acute withdrawal symptoms, triggers and relapse warning signs;
(b) Interpersonal boundaries, communication and coordination within the interdisciplinary team;
(c) Application of the program’s Code of Conduct, philosophy, guidelines, policies, procedures, standards and expectations;
(d) Safe, trauma informed and respectful interpersonal communications and behaviors; and
(e) Identification of symptoms, behaviors and circumstances that require notification of or consultation with a program or medical treatment staff.
Statutory/Other Authority: ORS 413.042, 430.640 & 443.450
Statutes/Other Implemented: ORS 430.010, 430.205 - 430.210, 430.254 - 430.640, 430.850 - 430.955, 443.400 - 443.460, 443.991, 461.549 & 743A.168
History:
BHS 10-2023, amend filed 04/07/2023, effective 04/07/2023
BHS 1-2022, amend filed 01/05/2022, effective 01/05/2022
BHS 20-2019, amend filed 12/24/2019, effective 01/01/2020
MHS 4-2018, amend filed 02/27/2018, effective 03/01/2018
MHS 10-2017(Temp), f. 9-15-17, cert. ef. 9-15-17 thru 3-13-18
MHS 3-2014, f. & cert. ef. 2-3-14
MHS 10-2013(Temp), f. 8-8-13, cert. ef. 8-9-13 thru 2-5-14