OAC 5122-29

OAC 5122-29 Requirements and Procedures for Behavioral Health Services

This chapter establishes requirements for behavioral health service providers certified by OhioMHAS, covering a broad range of services including general clinical services (assessment, counseling, medical activities), mental health day treatment, forensic evaluation, behavioral health hotline, crisis intervention, residential and withdrawal management substance use disorder services (ASAM levels 3.1, 3.3, 3.5, 3.7, and associated withdrawal management sub-levels), and a qualified residential treatment program (QRTP) for youth in SUD residential settings. Providers must follow staffing qualifications, documentation standards, referral procedures, and service-specific operational requirements as outlined in each rule. The chapter applies to all OhioMHAS-certified providers subject to certification under OAC 5122-25-01.

This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and
 universities.

Chapter 5122-29 
|
 Requirements and Procedures for Behavioral Health Services

Ohio Administrative Code

/

5122 

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Rule

Rule 5122-29-01 
|
 Purpose and applicability.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

The purpose of this chapter is to state the
 requirements for the provision of behavioral health services by providers
 certified by the Ohio department of mental health and addiction
 services.
The provisions of the rules contained in this
 chapter are applicable to each provider subject to certification pursuant to
 rule 
5122-25-01
 of the Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

1/1/1991

Rule 5122-29-03 
|
 General services.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) "General services" are the
 assessment activities, medical activities, and counseling and therapy
 activities as defined in this rule.
(B) The general services shall be
 provided by the professional credentials listed in appendix A of this rule
 within the scope of practice of those credentialed professionals.
(C) Assessment activities:
(1) An assessment:
 
(a) Is a clinical evaluation of a person which
 is:
(i) Individualized; and,
 
(ii) Age, gender, and
 culturally appropriate.
(b) Determines diagnosis, treatment needs, and establishes
 a treatment plan to address the person's mental illness or substance use
 disorder.
(2) When the assessment
 is to be provided to a client it should started prior to the initiation of
 other services, except for emergency situations.
(3) An initial assessment
 must, at a minimum, include an evaluation of:
(a) The presenting problem;
(b) The risk of harm to self and others;
(c) The use of alcohol or drugs;
(d) The treatment history for mental illness or substance
 use/abuse; and,
(e) A medical history and examination (mental status or
 physical).
(4) A comprehensive
 assessment shall expand on the initial assessment and obtain additional
 information that is required to establish and implement a comprehensive
 treatment plan, and must be completed within thirty days of the initial
 assessment encounter.
(5) A person is not
 required to have an initial assessment prior to receiving a comprehensive
 assessment.
(6) Initial and
 comprehensive assessments shall be completed according to prevailing standards
 of care as defined by:
(a) "The Joint Commission";
(b) "The Commission on Accreditation of
 Rehabilitation Facilities";
(c) "The Council on Accreditation";
 or,
(d) Other entities as designated by the
 director.
(7) Providers may accept
 initial or comprehensive assessments from other providers as long as they have
 been completed within the preceding twelve months. Prior assessments shall be
 reviewed and updated.
(D) Counseling and therapy
(1) Counseling and
 therapy is an interaction with a person or persons where the focus is on
 achieving treatment objectives related to alcohol and other substances; or the
 person's mental illness or emotional disturbance.
(2) Counseling and
 therapy involves a face-to-face encounter between a client, group of clients,
 client and family members, or family members and a behavioral health
 professional. 
(3) Group counseling and
 therapy encounters may not exceed a one-to-twelve behavioral health
 professional to patient ratio.
(E) Medical activities.
(1) "Medical
 activities" are those activities that are performed within professional
 scope of practice by staff that are licensed or certified by the state medical
 board of Ohio. the state of Ohio board of nursing, or a pharmacist licensed by
 the state of Ohio board of pharmacy; and are intended to address the behavioral
 and other physical health needs of clients receiving treatment for psychiatric
 symptoms or substance use disorders.
(2) Medical activities
 include, but are not limited to:
(a) Performing health care screenings, assessments, and
 exams;
(b) Checking vital signs;
(c) Ordering laboratory tests and reviewing the results;
 and,
(d) Medication prescribing, administering, and
 monitoring.

View Appendix

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

1/22/1979, 1/1/1991, 4/18/1991, 10/1/1993, 11/17/2005, 12/15/2005, 7/1/2006, 7/2/2007, 8/23/2007, 7/1/2008, 7/1/2009

Rule 5122-29-06 
|
 Mental health day treatment service.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Mental health day treatment is an
 intensive, structured, goal-oriented, distinct and identifiable treatment
 service that utilizes multiple mental health interventions that address the
 individualized mental health needs of the client. Mental health day treatment
 services are clinically indicated by assessment with clear admission and
 discharge criteria. The environment at this level of treatment is highly
 structured, and there should be an appropriate staff-to-client ratio in order
 to guarantee sufficient therapeutic services and professional monitoring,
 control, and protection.
The purpose and intent of mental health day
 treatment is to stabilize, increase or sustain the highest level of functioning
 and promote movement to the least restrictive level of care.
The outcome is for the individual to develop the
 capacity to continue to work towards an improved quality of life with the
 support of an appropriate level of care.
(B) In addition to the definitions found
 in rule 
5122-24-01
 of the Administrative Code, the following definition applies
 to this rule:
(1) "Mental health
 day treatment program day" means the total amount of hours an individual
 receives mental health day treatment service during a twenty-four hour calendar
 day.
(C) Mental health day treatment must be an intense treatment
 service that consists of high levels of face-to-face mental health
 interventions that address the individualized mental health needs of the
 individual as identified in their individualized treatment plan
 (ITP).
(D) The minimum program length of this
 service shall be in accordance with the appropriate behavioral health standards
 of the agency's national accrediting body(ies). Such accrediting bodies
 are identified in rule 
5122-25-02
 of the Administrative Code.
(E) For purposes of this rule, a mental health day treatment
 program day shall consist of a minimum of two hours and up to a maximum of
 seven hours of scheduled intensive activities that may include, but are not
 limited to, the following:
(1) Determination of
 needed mental health interventions;
(2) Skills
 development
(a) Interpersonal and social competency as age, developmentally,
 and clinically appropriate, such as:
(i) Functional
 relationships with adults;
(ii) Functional
 relationship with peers;
(iii) Functional
 relationship with the community/schools;
(iv) Functional relations
 with employer/family; and
(v) Functional relations
 with authority figures.
(b) Problem solving, conflict resolution, and emotions/behavior
 management.
(c) Developing positive coping mechanisms;
(3) Managing mental
 health and behavioral symptoms to enhance vocational/school opportunities
 and/or independent living; and
(4) Psycho-educational
 interventions including individualized instruction and training of persons
 served in order to increase their knowledge and understanding of their
 psychiatric diagnosis(es), prognosis(es), treatment, and rehabilitation in
 order to enhance their acceptance of these psychiatric disabilities, increase
 their cooperation and collaboration with treatment and rehabilitation, improve
 their coping skills, and favorably affect their outcomes. Such education shall
 be consistent with the individual's ITP and be provided with the knowledge
 and support of the interdisciplinary/intersystem team providing treatment in
 coordination with the ITP. 
(F) Providers of mental health day treatment services shall
 have a staff development plan based upon identified individual needs of mental
 health day treatment program staff. Evidence that the plan is being followed
 shall be maintained.
(G) Mental health day treatment service shall be provided
 and supervised by staff who are qualified according to rule 
5122-29-30
 of the
 Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

7/15/2001

Rule 5122-29-07 
|
 Forensic evaluation service.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

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(A) "Forensic evaluation
 service" means an evaluation resulting in a written expert opinion
 regarding a legal issue for an individual referred by a criminal court,
 domestic relations court, juvenile court, adult parole authority, or other
 agency of the criminal justice system or a Ohio department of mental health and
 addiction services (OhioMHAS) operated regional psychiatric hospital. Forensic
 evaluation service includes all related case consultation and expert testimony.
 Forensic evaluation service also assists courts and the adult parole authority
 to address behavioral health legal issues such as those referenced in paragraph
 (B) of this rule.
(B) Forensic evaluation service addresses
 behavioral health legal issues, including the following:
(1) Competency to stand
 trial, as defined in division (G)(3) of section 
2945.371
 of the Revised
 Code;
(2) Mental condition at
 the time of the offense charged, as defined in division (G)(4) of section
 
2945.371
 of the Revised Code;
(3) Post-"NGRI"
 (not guilty by reason of insanity) examination, as defined in division (A) of
 section 
2945.40
 of the Revised Code:
(4) Presentence, as
 defined in section 
2951.03
 of the Revised Code;
(5) Mitigation of
 penalty, as defined in section 
2947.06
 of the Revised Code;
(6) Mitigation of death
 penalty, as defined in section 
2929.03
 of the Revised Code;
(7) Domestic violence
 evaluation, as defined in section 
2919.271
 of the Revised Code;
(8) Competence to be a
 witness, as defined in section 
2317.01
 of the Revised Code;
(9) Adult parole
 authority, for parole revocation and other legal questions;
(10) Psychological
 effects of an act upon the victim, as defined in section 
2930.13
 of the Revised
 Code;
(11) Domestic relations,
 for custody and visitation;
(12) Juvenile dependency,
 neglect, delinquency (Ohio rules of juvenile procedure, rule 32), or competency
 as defined in section 
2152.53
 of the Revised Code; ; or waiver to adult court,
 as defined in division (C) of section 
2152.12
 of the Revised Code;
(13) Battered woman
 syndrome, as defined in section 
2945.392
 of the Revised Code;
(14) Violation of
 anti-stalking protection order, as defined in section 
2903.212
 of the Revised
 Code;
(15) Intervention in lieu
 of conviction, as defined in section 
2951.041
 of the Revised Code;
(16) Non-secured status, as defined in
 section 
2945.401
 of the Revised Code;
(17) Post sentence evaluation-probation or
 parole for involuntary commitment, as defined in section 
2967.22
 of the Revised
 Code; or,
(18) Juvenile competency evaluation for
 serious youthful offenders, as defined in division (C)(2) of section 
2152.13
 of
 the Revised Code.
(C) No examiner should undertake a
 forensic evaluation without an appropriate written order from the court
 ordering the evaluation, or an official written request if the agency
 requesting the forensic evaluation is a parole or probation department, or
 OhioMHAS operated regional psychiatric hospital.
(D) Forensic evaluation service shall
 provide the following standards of confidentiality:
(1) The relationship
 between the person being evaluated and the examiner is not confidential in the
 usual understanding of that term. A written report shall be made to the court
 or adult parole authority, whether or not the person being evaluated cooperates
 with the examiner. The relationship between the examiner, evaluee, and court or
 adult parole authority shall be explained orally and in writing to the person
 being evaluated. It shall be clearly noted that information gathered and expert
 opinions reached by the examiners shall be summarized in a written report
 and/or testimony to the court or adult parole authority or other referring
 agency.
(2) Reports to the
 criminal courts shall be forwarded only to the court that referred the person
 or to other court officials, prosecution and defense attorneys, as designated
 by the referring court. The court may, at its discretion, distribute the
 report, and bears the responsibility for that distribution. Reports to the
 adult parole authority shall be forwarded only to that agency, which may, at
 its discretion, distribute the report, and bears the responsibility for that
 distribution. Reports may be distributed to other parties only with the written
 authorization of the court or adult parole authority, or other referring
 agency.
(3) Reports of forensic
 evaluations shall be stored separately from other types of client records, and
 shall be considered the property of the court that ordered them or the agency
 that referred the person.
(E) Each forensic evaluation report shall
 include at least the following:
(1) The name and
 qualifications of the examiner(s);
(2) The name of the court
 or agency that referred the person;
(3) The legal or referral question being
 assessed;
(4) Identifying information about the
 person being evaluated, including relevant clinical, social, and criminal
 history;
(5) The duration and location of the
 interview(s) with the person being evaluated;
(6) A description of collateral
 information used to develop the report;
(7) Psychological and/or psychiatric data
 that address the legal or referral issue, if applicable; and
(8) Opinions and
 recommendations.
(F) The forensic evaluation report shall
 be presented in non-technical terms and in reasonable detail. The data and
 recommendations shall be pertinent to the legal or other referral question.
 Relevant collateral information shall be used in a forensic evaluation to the
 fullest extent possible. Opinions in a forensic evaluation report shall not be
 based entirely on self-report of the person being evaluated if collateral
 information is available.
(G) Reports shall contain sufficient
 information to substantiate the conclusions and recommendations made. Special
 caution shall be exercised with self-incriminating statements by the person
 being evaluated, information about others not being evaluated, or other
 material of a particularly sensitive, personal nature not related to the issue
 and for which the forensic evaluation was requested.
(H) For competence to stand trial and not
 guilty by reason of insanity forensic evaluations, the qualifications of the
 examiner(s) are regulated by sections 
2945.37
 and 
2945.371
 of the Revised Code.
 All other examinations for which qualifications are not specified by law shall
 be conducted by staff who are qualified according to paragraph (K) of this
 rule.
(I) Forensic evaluations shall be
 completed within the time limits specified by law, unless an extension has been
 granted by the referral source. Examinations for which no statutory time limit
 exists shall be completed within a reasonable time, as determined in
 consultation with the court or agency requesting the service.
(J) The agency shall ensure
 that:
(1) All staff who perform
 forensic evaluation services shall have training and continuing education
 relating to the legal and behavioral health issues involved in the services
 they provide; and
(2) All persons who
 perform forensic evaluation services listed in paragraphs (B)(1) to (B)(18) of
 this rule shall provide written documentation of at least twenty-four hours of
 training every three calendar years that is specific to the forensic behavioral
 health area.
(K) Forensic evaluation service shall be
 provided and supervised by staff who are qualified according to rule 
5122-29-30

 of the Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

1/9/2011

Rule 5122-29-08 
|
 Behavioral health hotline service.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Behavioral health hotline service
 means a provider's twenty-four hour per day, seven days per week
 capability to respond to telephone calls, often anonymous, made to a provider
 for crisis assistance. The person may or may not be a clientof the
 provider.
(B) Behavioral health hotline service
 shall:
(1) Staff the service so
 that calls are answered twenty-four hours per day, seven days per
 week;
(2) Provide referrals to
 crisis intervention service(s);
(3) Include, but not be
 limited to, the following:
(a) Provide support, intervention, and crisis management by
 telephone to persons in crisis;
(b) Engage in suicide prevention intervention, including
 inquiring if the individual has a crisis safety plan and using this information
 in the intervention;
(c) Provide appropriate linkages to all needed services and other
 community resources, including peer recovery support as
 applicable;
(d) Provide information regarding crisis services, including the
 local crisis center phone number, additional referral to support services as
 indicated; and,
(e) Provide information and referral to immediate psychiatric and
 medical services when indicated, such as the crisis center or a hospital
 emergency room.
(4) Ensure that all staff
 and volunteers receive training in crisis intervention techniques, safety
 planning, management of risk, and available resources and supports in the
 county or region where the provider is located;
(5) Be provided by staff
 and volunteers qualified according to paragraph (D) of this rule;
 and,
(6) Document the call in
 the client medical record if it is known that the person calling is a person
 served by the provider.
(C) The provider service plan for
 behavioral health hotline services shall include, but not be limited to the
 requirements that the service:
(1) Function as part of
 an integrated, comprehensive system of health, behavioral health, and other
 human service providers;
(2) Ensure the ability to
 use and work with case management systems, other involved health care
 providers, and crisis intervention services on a priority basis;
(3) Coordinate with the
 community's emergency service systems, such as hospital, crisis centers,
 fire, police, ambulance services, etc.;
(4) Maintain a current
 listing of available residential or housing placements that can be accessed
 quickly when emergency housing is needed in conjunction with a crisis
 intervention mental health service; and
(5) Is provided as part
 of the alcohol, drug addiction, and mental health services board's
 emergency crisis plan for the service district.
(D) Behavioral health hotline service
 shall be provided and supervised by staff and volunteers who are qualified
 according to rule 
5122-29-30
 of the Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

7/1/2012

Rule 5122-29-09 
|
 Residential and withdrawal management substance use disorder services.

Effective:

July 1, 2023

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

This rule is to supersede rule 
5122-29-09
 of the
 Administrative Code with the effective date of October 31, 2019. This rule will
 be effective July 1, 2023.
(A) Residential substance use disorder
 services shall be provided in accordance with the American society of addiction
 medicine's (ASAM) level of care three and ASAM's level of care
 three-withdrawal management (WM), and associated sub levels as appropriate to
 the needs of the individual being served; as published in the ASAM criteria,
 third edition, 2013.
(B) A provider certified to provide this
 service, may provide ASAM level of care two-withdrawal management.
(C) For the purposes of this rule
 "family" means any individual or caregiver related by blood or
 affinity whose close association with the person is the equivalent of a family
 relationship as identified by the person including kinship and foster care.
 
(D) Each provider shall have written policies and
 procedures to ensure its referral process to other levels of care is
 appropriately implemented and managed and shall include, at a minimum, the
 following:
(1) Referral decisions
 made to the appropriate level of care as determined utilizing the American
 society of addiction medicine criteria protocols for levels of care.
 Documentation of referral shall appear in the client record.
(2) Discharge plan
 stipulating specific recommendations and referrals for alcohol and drug
 addiction treatment. The discharge plan shall be documented in the client
 record.
(3) Follow-up
 communications with client and the service provider to which client is
 referred. These contacts shall be documented in the client's
 record.
(4) Provisions for the
 transition of the client to other SUD treatment providers. Provisions for use
 of transition communications conducted in person to include staff members of
 the rendering provider organization, the SUD treatment program to which the
 patient is being referred, the patient, and family, if present.
(E) Each provider rendering services
 pursuant to this rule will be capable of admitting, initiating, and referring
 clients receiving medication assisted treatment and capable of facilitating the
 continuity of their pharmacotherapy through care transitions, including but not
 limited to other levels of care for behavioral health treatment, hospitals,
 community-based providers, and criminal justice settings.
(F) Each provider of this service shall provide, in
 addition to the required ASAM level of care:
(1) Food for clients, to
 include at least three nutritionally-balanced meals and at least one nutritious
 snack per day, seven days per week;
(2) The opportunity for
 clients to get eight hours of sleep per night; and,
(3) Services in
 facilities that are clean, safe, and therapeutic.
(G) Time for meals, unstructured activities, free time, or
 time spent in attendance of self-help groups, such as alcoholics anonymous or
 narcotics anonymous shall not be considered for the purposes of meeting ASAM
 level of care requirements for services.
(H) Providers shall promote interpersonal and group living
 skills. 
(1) A service provider
 may require clients to perform tasks of a housekeeping nature as specified
 within service provider guidelines.
(2) Housekeeping tasks
 shall not be considered for the purposes of meeting ASAM level of care
 requirements for services.
(I) Providers will offer medication assisted treatment on
 site or through facilitated access off site.
(J) Providers will connect clients to resources for
 education, job training, job interviews, employment stabilization and obtaining
 alternative living arrangements.
(K) Providers of ASAM level of care 3.1 will:
(1) Have a prescriber as
 part of the interdisciplinary team either through employment or contractual
 arrangement; however, the prescriber does not provide direct services;
 and,
(2) Offer at least five
 hours per week of low intensity treatment of substance use
 disorders.
(L) Providers of ASAM level of care 3.3 will:
(1) Include, in addition
 to the ASAM specified interdisciplinary team members, peer supporters certified
 pursuant to rule 
5122-29-15.1
 of the Administrative Code as appropriate and
 available to the range and severity of the residents'
 problems.
(2) Have an appropriately
 credentialed, licensed addictions clinician manage the program.
(3) Have one
 appropriately certified or licensed addictions clinician on site days and a
 certified or licensed chemical dependency counselor or similar with telephonic
 availability during the remaining hours.
(4) Offer at least thirty
 hours per week of a combination of skilled treatment services, clinically
 managed services and recovery support services focused on individuals where the
 effects of the substance use or a co-occurring disorder has resulted in
 cognitive impairment. At least ten of the thirty hours is to include
 individual, group, or family counseling.
(5) Have staff with the
 knowledge and skills to work with patients with cognitive
 limitations.
(6) Have therapies, for
 clients with significant cognitive deficits, delivered in a manner to promote
 engagement and understanding of concepts that is slower paced, more concrete,
 and more repetitive.
(7) Have addiction
 treatment professionals with sufficient cross-training to recognize the signs
 and symptoms of co-occurring mental disorders and initiate treatment
 interventions (treatment within the program or referral to treatment outside
 the program) to address identified behavioral health needs.
(M) Providers of ASAM level of care 3.2-WM and 3.5
 will:
(1) Include, in addition
 to the ASAM specified interdisciplinary team members, peer supporters certified
 pursuant to rule 
5122-29-15.1
 of the Administrative Code as appropriate and
 available to the range and severity of the residents'
 problems.
(2) Have an appropriately
 credentialed, licensed addictions clinician manage the program.
(3) Have one
 appropriately certified or licensed addictions clinician on site days and a
 certified or licensed practitioner with a declared scope of practice that
 includes treating people with SUDs in the evenings, with telephonic
 availability during evenings and nights. A nurse, physician assistant,
 physician, or emergency services will be available twenty-four hours a day
 either on site or with telephonic availability.
(4) Offer at least thirty
 hours per week of a combination of skilled treatment services, clinically
 managed services and recovery and withdrawal (for 3.2-WM programs) support
 services focused on individuals who have significant social and psychological
 problems. At least ten of the thirty hours is to include individual, group, or
 family counseling.
(5) Have addiction
 treatment professionals with sufficient cross-training to recognize thee signs
 and symptoms of co-occurring mental disorders and initiate treatment
 interventions (treatment within the program or referral to treatment outside
 the program) to address identified behavioral health needs.
(6) If the provider
 primarily provides this ASAM level of care to adolescents who have not
 graduated from high school or who have not passed a general education
 development (GED) test, offer at least twenty hours per week of a combination
 of skilled treatment services, clinically managed services and recovery and
 withdrawal (for 3.5-WM adolescent programs) support services focused on
 individuals who have significant social and psychological problems. At least
 ten of the twenty hours is to include individual, group, or family counseling.
 The provider will also provide year round schooling.
(N) Providers of ASAM level of care 3.7-WM and 3.7
 will:
(1) Include, in addition
 to the ASAM specified interdisciplinary team members, peer supporters certified
 pursuant to rule 
5122-29-15.1
 of the Administrative Code as appropriate and
 available to the range and severity of the residents'
 problems.
(2) Have one
 appropriately certified or licensed addictions clinician on site days and
 evenings, with telephonic availability during the remaining hours.
(3) Offer at least thirty
 hours per week of a combination of skilled treatment services, clinically
 managed services and recovery and withdrawal (For 3.7 WM programs) support
 services focused on individuals with subacute biomedical and emotional,
 behavioral, or cognitive problems. At least ten of the thirty hours is to
 include individual, group, or family counseling.
(4) Have addiction
 treatment professionals with sufficient cross-training to recognize the signs
 and symptoms of co-occurring mental disorders and initiate treatment
 interventions (treatment within the program or referral to treatment outside
 the program) to address identified behavioral health needs.
(O) All component practitioner services must be provided in
 accordance with Chapter 5122-29 of the Administrative Code.
(P) A health history, including food allergies and drug
 reactions, shall be completed on or before admission to a provider of this
 service.
(Q) Each provider of this service organized to serve
 individuals under the age of eighteen shall provide services in a manner that
 is developmentally appropriate, addresses educational needs, and promotes
 family or significant other involvement.
(R) Services provided pursuant to this rule shall be
 provided and supervised by staff who are qualified according to rule 
5122-29-30

 of the Administrative Code.

Last updated July 27, 2023 at 8:37 AM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

7/1/2028

Prior Effective Dates:

7/1/2006, 7/2/2007, 7/1/2012, 1/1/2018

Rule 5122-29-09.1 
|
 Substance use disorder qualified residential treatment program (QRTP) for youth.

Effective:

October 1, 2020

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) A provider that provides a level
 three substance use disorder residential or withdrawal management program that
 is certified by the Ohio department of mental health and addiction services
 (OhioMHAS) in accordance with rule 
5122-29-09
 of the Administrative Code
 (OhioMHAS) and accepts children or adolescents (youth) for placement is to
 comply with the standards in this rule. Providers whose initial certification
 date for this service is on or after October 1, 2020 are to be compliant with
 this rule in order to become certified. Providers certified prior to October 1,
 2020 have until October 1, 2024 to become compliant with the requirements
 related to meeting QRTP standards; with the exception of paragraph (B)(7) of
 this rule which must be complied with as of October 1, 2020. In order to
 maintain title IV-E reimbursability, providers are to meet the standards in
 this rule by October 1, 2021.
(B) Providers are to comply with the
 following standards:
(1) Has a residential
 program that is accredited by at least one of the following national
 accrediting bodies and provides ongoing proof of such accreditation status to
 OhioMHAS:
(a) Commission on accreditation of rehabilitation
 facilities.
(b) Joint commission on accreditation of healthcare
 organizations.
(c) Council on accreditation.
(2) Implements a
 trauma-informed approach in which all employees, volunteers, interns, and
 independent contractors within the location of the level three substance use
 disorder treatment program are trained in that trauma-informed approach.
 Trauma-informed training is to occur within the first thirty days after the
 date of hire and annually thereafter. The required trauma competencies are
 located at http://jfs.ohio.gov/ofc/Family-First.stm.
(3) Utilizes a trauma-informed treatment
 model that is approved by OhioMHAS for the population the agency serves. A
 trauma-informed treatment model is a program, organization or system that:
 
(a) Ensures all clinical staff are trained on the trauma
 model approved by OhioMHAS. The facility (or agency) agency shall describe in
 writing in its trauma training policies and procedures or elsewhere whether
 non-clinical staff will be trained on the trauma model or will be trained only
 on the trauma competencies described in paragraph (B)(2) of this
 rule.
(b) Realizes the widespread impact of trauma and
 understands potential paths for recovery;
(c) Recognizes the signs and symptoms of trauma in clients,
 families, staff and others involved with the system;
(d) Responds by fully integrating information about trauma
 into policies, procedures and practices;
(e) Seeks to actively resist
 re-traumatization;
(f) Includes service of clinical needs and
 that:
(i) Is an approved trauma
 informed treatment model applicable to the population of youth served located
 at http://jfs.ohio.gov/ocf/Family-First.stm or,
(ii) Meets the ten
 substance abuse and mental health services administration (SAMHSA)
 implementation domains and follows the six key principles of the SAMHSA trauma
 informed approach which are located at
 http://jfs.ohio.gov/ocf/Family-First.stm; and
(iii) Receives approval
 by the department or designee.
(4) Has registered or licensed nursing
 and clinical staff who operate in accordance with the following:
(a) Provide care within the scope of their practice as
 defined by state law.
(b) Are accessible on-site or via interactive
 videoconferencing based on the youth's clinical or medical needs.
 Interactive videoconferencing might not be appropriate for a youth in crisis at
 the agency.
(c) Are available twenty-four hours a day and seven days a
 week.
(5) With consideration to the
 youth's safety and developmental needs, the treatment should be
 family-driven with both the youth and the family included in all aspects of
 care, if in the best interest of the youth. The key components of
 family-centered residential treatment are to be documented in the youth's
 record and include the following:
(a) Facilitation of regular contact between the youth and
 other members of the family including siblings,
(b) Actively involving and supporting families who have a
 youth placed in the residential facility,
(c) Providing outreach, ongoing support and aftercare for
 the youth and the family.
(6) Completes discharge planning that is
 to include family-based aftercare support. Family-based aftercare support is
 defined as individualized, community-based, trauma-informed supports that build
 on treatment gains to promote the safety and well-being of youth and families,
 with the goal of preserving the youth in a supportive family environment. The
 discharge plan is to:
(a) Include planning for aftercare services for all youth
 discharged from the agency to family-based settings including: 
(i) Reunification with
 family, 
(ii) Pre-finalized
 adoptive family,
(iii) Kinship care, 
(iv) Foster care, 
(v) Independent living. 
(b) Begin in partnership with the legal custodian or
 custodial agency no later than the next business day after a youth is admitted
 to the QRTP. 
(c) Be reviewed by the QRTP no less than every thirty
 calendar days and during every individualized treatment plan (ITP) review as
 described by rule 
5122-27-03
 of the Administrative Code. An ITP review is to be
 conducted at least every ninety calendar days. 
(d) Include at least a six-month period of support after
 discharge, even if the youth reaches the age of majority. The QRTP is exempt
 from providing aftercare support if the youth's placement is less than
 fourteen days.
(e) Be provided within the youth or family's community
 as appropriate to promote the continuity of care for youth. 
(f) Be individualized and driven by the youth, the
 caregivers and the family as appropriate, and include the following:
 
(i) Monthly contact with
 the youth and caregivers to promote and maintain engagement and to regularly
 evaluate the family's needs. Monthly contact may be in person, through
 interactive videoconferencing, or via phone or other electronic means.
 
(ii) Coordinate
 engagement with any applicable community providers serving the youth or family.
 The QRTP will ensure they make themselves available to the community providers
 for ongoing consultation, and document the consultation in writing.
 Documentation should include all resources and supports needed and detail how
 the resources and supports will be provided.
(iii) Written
 documentation provided to all participants of the discharge plan prior to
 discharge with information on how to access additional supports from the QRTP
 and community providers including contact information and steps required to
 access each provider.
(7) Conduct a background check for any
 employee, volunteer, intern or independent contractor in accordance with rule
 
5122-30-31
 of the Administrative Code prior to hire. No employee, volunteer,
 intern or independent contractor may be present in the level three substance
 use disorder treatment program until the provider has reviewed the results of
 the background check and assured that the individual is eligible to work under
 rule 
5122-30-31
 of the Administrative Code.
(C) This rule is exempt from paragraph
 (G) of rule 
5122-25-02
 of the Administrative Code and deemed status
 recognition. Regardless of accreditation and deemed status, providers are to
 maintain compliance with this rule, and the department may conduct surveys or
 require submission of documentation in order to evaluate
 compliance.

Last updated March 15, 2022 at 12:53 PM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

10/1/2025

Rule 5122-29-10 
|
 Crisis intervention service.

Effective:

November 21, 2020

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Crisis intervention is an interaction
 with a person in response to a crisis or emergency situation they are
 experiencing.
(B) Twenty-three hour observation bed
 means face-to-face evaluation, for up to twenty-three hours duration under
 close medical/nursing supervision, of an individual who presents an
 unpredictable risk of adverse consequences due to intoxication, withdrawal
 potential and/or co-existing disorders for the purpose of determining the
 appropriate treatment and plan for the next level of care.
(C) Crisis intervention includes:
(1) An urgent evaluation
 of the following elements when clinically indicated:
(a) Understanding what happened to initiate the crisis and the
 individual's response or responses to it;
(b) Risk assessment of lethality, propensity of violence, and
 medical/physical condition including alcohol or drug use;
(c) Mental status;
(d) Information about the individual's strengths. coping
 skills, and social support network, including face-to-face contact with family
 and collateral informants; and,
(e) Identification of treatment needs and appropriate setting of
 care.
(2) A crisis plan shall
 be developed to de-escalate the crisis, stabilize the patient, restore safety,
 provide referral, and linkages to appropriate services, and coordination with
 other systems.
(D) Providers of crisis intervention
 shall have current certification in first aid and cardio-pulmonary
 resuscitation (CPR), and shall be trained in de-escalation
 techniques.
(E) When a patient appears to be
 medically unstable, the patient shall be referred to a medical facility or
 emergency medical service shall be called.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

1/1/1991, 7/1/2006, 5/19/2011, 7/1/2012, 6/11/2020 (Emer.)

Rule 5122-29-11 
|
 Employment service.

Effective:

December 18, 2014

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) The purpose and intent of an employment service is to promote recovery through the implementation of evidence based and best practices which allow individuals to obtain and maintain integrated competitive meaningful employment by providing training, ongoing individualized support, and skill development that honor client choice. The outcome of an employment service is that individuals will obtain and maintain a job of their choosing through rapid job placement which will increase their self-sufficiency and further their recovery. Employment services should be coordinated with mental health services and substance use treatment and services.
(B) Consistent with the purpose and intent of paragraph (A) of this rule, employment services shall include at least one of the following evidence based and best practice employment activities, unless prior approval has been given for a non-listed activity as provided by paragraph (D) of this rule:
(1) Vocational planning (assessment);
(2) Training (work and personal);
(3) Job seeking skills training (JSST);
(4) Job development and placement;
(5) Job coaching;
(6) Individualized job supports, which may include regular contact with the employers, family members, guardians, advocates, treatment providers, and other community supports;
(7) Benefits planning;
(8) General consultation, advocacy, building and maintaining relationships with employers;
(9) Individualized placement and support supported employment (IPS SE), in accordance with the requirements for qualified providers set forth in rule 
5122-29-30
 of the Administrative Code;
(10) Rehabilitation guidance and counseling; or,
(11) Time unlimited vocational support.
(C) Any of the following employment supports may be provided in conjuction with at least one employment activitiy either that is listed in paragraph (B) of this rule or which has received prior approval from OhioMHAS:
(1) Facilitation of natural supports;
(2) Transportation; or,
(3) Peer services.
(D) Individualized placement and support supported employment (IPS SE).
Providers who chose to offer IPS SE employment service shall meet the following requirements to be OhioMHAS qualified providers:
(1) IPS SE is an evidence based practice which is integrated and coordinated with mental health treatment and rehabilitation designed to provide individualized placement and support to assist individuals with a severe and persistent mental illness or co-occurring mental illness and substance use disorder obtain, maintain, and advance within competitive community integrated employment positions.
(2) In order to be an IPS SE qualified provider, the provider must:
(a) Provide the evidence-based practice of IPS SE;
(b) Have periodic fidelity reviews completed by an Ohio department of mental health and addiction services (OhioMHAS) approved fidelity reviewer as required by the developer of the practice, and,
(c) Achieve the minimum fidelity score necessary to maintain fidelity, as defined by the developer of the practice.
(3) In the event a provider fails to achieve the required minimum fidelity score, the provider will receive technical assistance to address areas recommended for improvement as identified in the fidelity review by an OhioMHAS approved fidelity reviewer. If the subsequent fidelity review results in a score of less than the required minimum, the provider will no longer by designated as a qualified IPS provider until their fidelity score again reaches the minimum.
(4) Providers implementing IPS SE may become a provisionally qualified IPS SE provider by participating in a baseline fidelity review. Providers may be provisionally qualified one time only and only between the baseline fidelity review and the next subsequent fidelity review. A provider must meet other requirements of this rule in order to receive provisional qualification.
(E) Employment services shall be provided and supervised by staff who:
(1) Are qualified according to rule 
5122-29-30
 of the Administrative Code; or,
(2) Have experience working with individuals that have a mental illness or substance use disorder.

Last updated January 3, 2022 at 12:10 PM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

1/3/2027

Prior Effective Dates:

1/1/1991, 7/1/2009

Rule 5122-29-12 
|
 Driver intervention program.

Effective:

April 1, 2016

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) A driver intervention program is a program of screening, education, and referral for individuals who are arrested or convicted of operation of a vehicle or water craft under the influence of alcohol or a drug of abuse under section 
4511.19
 or 
1547.11
 of the Revised Code or a substantially similar municipal ordinance or other alcohol-related traffic statute or ordinance.
(B) No entity may operate, or purport to operate, a driver intervention program in Ohio unless it has received driver intervention program certification from the Ohio department of alcohol and drug addiction services.
(C) Except as otherwise provided in this rule, the provisions of this rule are applicable to all driver intervention programs in Ohio, public or private.
The provisions do not negate the necessity of driver intervention programs to be certified programs in accordance with the provisions of Chapter 5122-25 of the Administrative Code.
(D) Each driver intervention program shall have either representatives from law enforcement officers, judges, prosecuting and defense attorneys, and treatment center representatives on its governing authority or establish an advisory board with such representatives.
If an advisory board is established, it shall:
(1) Meet annually; and,
(2) Minutes shall be maintained for advisory board meetings.
(E) Program administration:
(1) Each driver intervention program shall have a program director that is responsible for the overall day-to-day operation of the driver intervention program. The driver intervention program director shall be responsible to the governing authority of the organization. If the driver intervention program is a component of a larger organization, the driver intervention program director may report to the executive director/chief executive officer of the organization, who would report to the governing authority. A program director hired on or after April 20, 2004 shall meet the following qualifications:
(a) The program director shall have a bachelor's degree and two years' experience in alcohol and other drug addiction services or an allied profession to include one year as a supervisor;
(b) Three years' experience in alcohol and other drug addiction services or an allied profession to include a minimum of one year as a supervisor; or,
(c) Three years' experience in business administration to include a minimum of one year as a supervisor.
(2) The position description of the driver intervention program director shall include, at a minimum, the following responsibilities:
(a) Overseeing the day-to-day operations of the driver intervention program.
(b) Developing and implementing the policies and procedures of the driver intervention program.
(c) Developing and revising as necessary, the driver intervention program's education curriculum.
(d) Preparing an annual plan for the operation of the driver intervention program.
(e) Implementing the driver intervention program's quality assurance and improvement activities and findings.
(f) Hiring and terminating driver intervention program staff.
(g) Ensuring that the driver intervention program is operating in accordance with the Ohio department of alcohol and drug addiction services' driver intervention program certification standards.
(F) Services supervisor:
(1) Each driver intervention program shall have a services supervisor. The driver intervention program director can also be the services supervisor of the driver intervention program if he/she meets the qualifications of a services supervisor as stated in this rule.
(2) An individual hired as the services supervisor of a driver intervention program on or after April 20, 2004 shall have one or more of the following current licenses and/or certifications issued by a professional regulatory board in Ohio:
(a) Licensed physician who is licensed by the state of Ohio medical board.
(b) Licensed psychologist who is licensed by the state of Ohio psychology board.
(c) Professional clinical counselor who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(d) Licensed independent social worker who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(e) Licensed chemical dependency counselor III who is licensed by the state of Ohio chemical dependency professionals board.
(f) Licensed independent chemical dependency counselor licensed by the state of Ohio chemical dependency professionals board.
(g) A nurse registered with the Ohio board of nursing.
(h) Licensed social worker who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(i) Professional counselor who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(j) Certified prevention specialist I who is certified by the Ohio chemical dependency professionals board.
(k) Certified prevention specialist II who is certified by the Ohio chemical dependency professionals board.
(l) Licensed marriage and family therapist who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(m) Licensed independent marriage and family therapist who is licensed by the state of Ohio counselor, social worker, and marriage and family therapist board.
(3) The services supervisor's personnel file shall contain copies or verification of, current licenses, certifications, and registrations issued to the individual from professional regulatory boards in Ohio.
(G) Each driver intervention program shall maintain the following:
(1) Outline of the current education curriculum of the driver intervention program.
(2) Copy of the revenue and expenditure budget for the driver intervention program.
(H) Each driver intervention program shall meet, at a minimum, the following handicapped accessibility requirements:
(1) Entrances, hallways and spaces where services are provided and office space for employees shall be handicapped accessible.
(2) Facility shall have at least one handicapped accessible bathroom.
(3) Facility shall have designated handicapped parking space(s) based on the Americans with disabilities act accessibility guidelines.
(4) Facility shall have at least one drinking fountain that is handicapped accessible.
(5) Facility shall have at least one telephone that is handicapped accessible.
(6) Each residential driver intervention programs shall have at least one handicapped accessible shower facility.
(I) Emergency medical plan and first aid supplies:
(1) Each driver intervention program shall have a written emergency medical plan that includes, at a minimum, the following:
(a) Current emergency telephone numbers for fire, emergency squad, police and poison control.
(b) Location of first aid supplies at the program site during operation of the driver intervention program.
(c) General instructions for medical emergencies including supervision of clients during the emergency.
(d) General instructions in case of illness of a client.
(e) Procedure for documenting unusual incidents and notifying families.
(2) A copy of the emergency medical plan shall be conspicuously posted at the program site during the operation of each driver intervention program.
(J) Client records:
(1) Each driver intervention program shall have written policies and/or procedures for maintaining a uniform client records system that include, at a minimum, the following:
(a) Statement that program staff, contract employees, volunteers and student interns shall not convey to a person outside of the program that an individual attends or receives services from the driver intervention program, or disclose any information identifying a client as an alcohol or other drug services client unless the client consents in writing for the release of information; the disclosure is allowed by a court order; the disclosure is to entities with which the provider has entered into a qualified service organization agreement (QSOA) pursuant to 42 CFR part 2; or the disclosure is made to qualified personnel for a medical emergency, research, audit or program evaluation purposes. The driver intervention program has the authority to deny services if a client refuses consent to the release of information.
(b) Statement that the federal laws and regulations do not protect any threat to commit, any information about a crime committed by a client, either at the program or against any person who works for the driver intervention program.
(c) Statement that the federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities.
(d) Each disclosure made with the client's written consent must be consistent with 42 C.F.R., part 2, by including the following written statement: "This information has been disclosed to you from records protected by federal confidentiality rules. The federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 C.F.R., part 2. A general authorization for the release of medical or other information is not sufficient for this purpose. The federal rules restrict any use of information to criminally investigate or prosecute any alcohol or drug abuse client."
(e) Policy on the access of client records by clients, staff, and others.
(f) Components of client records and time lines, when applicable, for completing each component.
(g) Policy on the storage of client records that requires records be maintained in accordance with 42 C.F.R., part 2, confidentiality of alcohol and drug abuse client records.
(h) Policy on the destruction of client records to include the requirement that records be maintained for at least six years after clients have been discharged from the program. Client records shall be destroyed to maintain client confidentiality as required by state and federal law.
(2) A record shall be maintained for each client of a driver intervention program. Each record shall include, at a minimum, the following components:
(a) Identification of client (name of client and/or client identification number).
(b) Client fee agreement.
(c) Consent for services.
(d) Documentation reflecting receipt of the schedule for the driver intervention program being attended by the client.
(e) Documentation reflecting receipt of the driver intervention program rules and/or expectations of clients.
(f) Documentation reflecting receipt of the program's policy on client rights that lists the client rights required by this rule.
(g) Documentation reflecting receipt of the program's client grievance procedure.
(h) Documentation reflecting receipt of a written summary of the federal laws and regulations that indicate the confidentiality of client records are protected as required by 42 CFR, part 2.
(i) Intake report.
(j) Identification of at least two screening instruments that were administered to the client and documentation of the results of both tests.
(k) Results and recommendations of the screening.
(l) Recommendations for alcohol and/or drug assessment.
(m) Assessment, if completed by the driver intervention program.
(n) Any recommendations made to a court or other organization.
(o) Date of each group session provided.
(p) Length of each group session provided.
(q) Topic/content of each group session provided.
(r) Client's response/feedback during each group session.
(s) Disclosure of client information forms, when applicable.
(3) Disclosure of client information forms shall include the following information as required by 42 C.F.R., part 2:
(a) Name of program making the disclosure.
(b) Name or title of the individual or the name of the organization to which the disclosure is to be made.
(c) Name of the client.
(d) Purpose of the disclosure.
(e) Type and amount of information to be disclosed.
(f) Original signature of the client or person authorized to give consent.
(g) Date client or other authorized person signed the form.
(h) Statement that the consent is subject to revocation at any time except to the extent the program or person who is to make the disclosure has already acted in reliance on it.
(i) The date, event, or condition upon which the consent will expire, unless revoked before that specified time.
(4) Each client record shall include a program completion report which shall include, at a minimum, the following documentation. A copy of the report shall be sent to the court or organization that referred the client to the driver intervention program.
(a) Results and recommendations of the screening.
(b) Any recommendations for alcohol and/or drug assessment.
(c) Any recommendations made to a court or other organization.
(d) Number of hours of driver intervention programming the client attended.
(e) Any referrals made to alcohol and drug addiction treatment programs and any referrals made to other organizations.
(f) Date, signature, and credentials of the program director, services supervisor or program staff of the driver intervention program who makes the recommendation.
(g) Summary of client's participation.
(h) Disclosure of client information form that is prepared in accordance with 42 CFR, part 2, confidentiality of alcohol and drug abuse patient records, for information released to courts, organizations and/or individuals and for management information reports to the Ohio department of alcohol and drug addiction services.
(5) A policy and procedure, in accordance with 42 CFR, part 2, confidentiality of alcohol and drug abuse patient records, for tracking clients for a reasonable time following program completion.
(6) If a program maintains electronic client records, the program must be able to produce hard copies of client records upon legally valid requests and have a written policy and procedure indicating how client original signatures and staff original signatures are obtained and verified for documentation.
(7) If a program discontinues operations or is taken over or acquired by another entity, it shall comply with 42 C.F.R., part 2, subsection 
2.19
 which governs the disposition of records by discontinued programs.
(K) Intake report:
(1) An intake report shall be completed for each client at the beginning of the first day of the driver intervention program. Documentation shall include, at a minimum, the following:
(a) Client identification number and name.
(b) Prescription and over-the-counter drugs being taken by the client.
(c) Type and amount of any medications brought to the program.
(d) Special dietary requirements.
(e) Known allergies, including but not limited to food and drug reactions.
(f) Pregnancy status of women.
(g) Special needs of clients.
(h) Name, address, and telephone number of a person who is to be contacted in the event of an emergency.
(2) Baggage and materials brought to the driver intervention program shall be inspected to ascertain that they do not contain contraband, which includes, at a minimum, illegal drugs, alcohol, or firearms. Documentation shall appear in the intake report.
(3) The intake report shall be dated and signed by the staff member completing the intake report.
(L) Screening:
(1) Screening means a preliminary gathering and sorting of information used to determine whether a comprehensive assessment is appropriate.
(2) Each client of a driver intervention program shall be administered at least two screening instruments. The results shall be recorded in the client's record.
(3) Screening interviews shall include, at a minimum, the following:
(a) Client identification.
(b) Presenting problem and/or precipitating factors leading to the need for screening.
(c) Past and present use of alcohol and other drugs.
(d) History of treatment for alcohol and other drug abuse.
(e) Medical problems.
(f) Legal history.
(g) Recommendations for referral, if applicable, for a comprehensive assessment to determine the extent and severity of alcohol and other drug abuse problems and need for treatment.
(h) Date, signature, and credentials of program staff who completed the screening.
(M) Referral for assessment:
(1) Each driver intervention program shall have a written procedure for making referrals for assessment which requires that a completed release of information shall be obtained prior to contacting a program.
(2) Each driver intervention program shall have a written policy stating that the basis for making a recommendation to a court or other organization for alcohol and drug addiction comprehensive assessment shall include, at a minimum, the following:
(a) Results of the two screening instruments and screening interview.
(b) Observations of the client during screening, client education on alcohol and drug abuse and addiction and group sessions.
(3) Each driver intervention program shall have a written policy for submitting a copy of the report to the court or organization that referred the client to the driver intervention program, as requested by the referral source.
(N) A driver intervention program may conduct client assessments. Assessments shall be conducted in accordance with rules set forth by the Ohio department of mental health and addiction services.
(O) Dietary services:
Each driver intervention program that prepares and/or serves meals as part of its daily scheduled activities shall operate its dietary services in accordance with laws, regulations, or ordinances of the Ohio board of dietetics, Ohio department of health and/or local health department.
(P) Pharmaceutical services:
(1) Driver intervention programs are prohibited from dispensing and/or administering medications.
(2) Clients who take prescription medications and/or over-the-counter medications may "self-medicate" at driver intervention programs. Each driver intervention program that permits clients to self-medicate shall have written policies and/or procedures for client self-medication that include, at a minimum, the following:
(a) Policy prohibiting clients from having prescription medication in their possession at the program site or while involved in program activities off site, unless required by a physician for medical necessity.
(b) Procedures for obtaining and accounting for controlled substances from clients at the time of admission to or upon entering the program and return of same, as appropriate, at the time of discharge/departure.
(c) Procedures for storing medications in a locked cabinet.
(d) Procedures for reporting theft or loss of over the-counter medications or prescription medication.
(e) Procedures for self-medication.
(3) Clients shall not be denied driver intervention services due solely to their use of prescribed psychotropic medication(s).
(Q) Non-residential driver intervention programs:
(1) Each non-residential driver intervention program shall consist of at least thirteen hours of alcohol and drug addiction programming that includes, at a minimum, the following:
(a) One hour of screening and individual contact.
(b) Eight hours of client education on alcohol and drug abuse and addiction including traffic safety education.
(c) Four hours of small group discussion sessions.
(2) Each non-residential driver intervention program is prohibited from delivering more than eight hours of alcohol and drug addiction programming to clients each day.
(3) Each client shall be administered at least two screening instruments.
(4) An individual screening interview shall be done with each client to discuss the screening findings, recommendations and referrals made to a referring court or other organization.
(5) A program completion report shall be prepared for each client.
(6) Small group discussion sessions:
(a) Small group discussion sessions shall not exceed a staff to client ratio of one to fifteen.
(b) The total number of clients in a group session shall not exceed fifteen, regardless of the number of staff.
(7) If a non-residential driver intervention program is operated within a residential driver intervention program, its programmatic content must be the same as that of the residential driver intervention program, and shall include the mid-day and evening meals.
(8) If a non-residential driver intervention program operates its program for five hours or more on any day, the program shall have provisions for a mid-day meal of at least thirty minutes. This mid-day meal shall be included in the program's schedule that is available to clients upon request. Time for meals may not supplant any of the minimum thirteen-hour alcohol and drug programming.
(9) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program.
(R) Forty-eight hour residential driver intervention programs:
(1) Each forty-eight hour residential driver intervention program shall consist of at least sixteen hours of alcohol and drug addiction programming that includes, at a minimum, the following:
(a) One hour of screening and individual contact.
(b) Ten hours of client education on alcohol and drug abuse and addiction including traffic safety education.
(c) Five hours of small group discussion sessions.
(2) Each client shall be administered at least two screening instruments.
(3) An individual screening interview session shall be done with each client to discuss the screening findings, recommendations and referrals to a referring court or other organization.
(4) A program completion report shall be prepared for each client.
(5) Small group discussion:
(a) Small group discussion sessions shall not exceed a staff to client ratio of one to fifteen.
(b) The total number of clients in a small group discussion session shall not exceed fifteen, regardless of the number of staff.
(6) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program.
(S) Seventy-two hour residential driver intervention programs:
(1) Each seventy-two hour residential driver intervention program shall consist of at least twenty-one hours of alcohol and drug addiction programming that includes, at a minimum, the following:
(a) One hour of screening and individual contact.
(b) Fifteen hours of client education on alcohol and drug abuse and addiction including traffic safety education.
(c) Five hours of small group discussion sessions.
(2) Each client shall be administered at least two screening instruments.
(3) An individual screening interview shall be conducted with each client to discuss the screening findings, recommendations, referrals, and recommendations made.
(4) Small group discussion:
(a) Small group discussion sessions staff to client ratio shall not exceed one to fifteen.
(b) The total number of clients in a group session shall not exceed fifteen, regardless of the number of staff.
(5) A program completion report shall be prepared for each client.
(6) The program shall provide morning, mid-day, and evening meals of at least thirty minutes duration.
(7) The program shall have at least one staff member who is on-site and actively supervising and/or monitoring clients at all times during the program.
(T) Each driver intervention program shall have a written educational curriculum that includes, at a minimum, the following:
(1) Traffic safety education as it relates to alcohol and drug use.
(2) Client education on alcohol and drug abuse and addiction.
(3) Small group discussion topics.
(U) Each program shall prepare an educational curriculum for its driver intervention program that shall be approved by the program's governing authority that includes, but is not limited to, the following:
(1) Time table for conducting the program.
(2) Instructional outline for each topic/module.
(3) Method of instruction, including audio/visual aids.
(V) Each program shall have a program schedule that can be given to clients upon request.
(W) Traffic safety education:
(1) Traffic safety education shall include, at a minimum, the following information on the criminal justice system and relevant law.
(a) Blood alcohol content (BAC), drugs and impairment.
(b) Levels of license suspension and revocation.
(c) Fines and levels of incarceration.
(2) The driving task and the specific psychomotor skills required.
(3) The physiological and psychological effects of alcohol and other drugs on driving performance.
(4) Traffic safety education sessions shall not exceed an instructor to client ratio of one to forty eight.
(X) Client education on alcohol and drug abuse and addiction:
(1) Client education on alcohol and drug abuse and addiction shall include, at a minimum, the following:
(a) Physical and psychological aspects of the use of alcohol and other drugs.
(b) Combining the use of alcohol with other drugs.
(c) Social consequences of the use of alcohol and other drugs.
(d) Signs and symptoms of abuse and dependence of alcohol and other drugs.
(e) Dysfunctional behavior resulting from the use of alcohol and other drugs.
(f) Progressive nature of alcohol and drug abuse and dependence.
(g) Abstinence as a life-style and self-help programs such as alcoholics anonymous and narcotics anonymous.
(h) Treatment alternatives and local resources.
(2) Programming does not include the following:
(a) Individual and/or group counseling.
(b) Self-help study sessions.
(c) Anger management and stress reduction therapies.
(3) Staffing for client education group sessions on alcohol and drug abuse and addiction shall not exceed an instructor to client ratio of one to forty eight.
(Y) Indigent clients:
(1) A driver intervention program that receives funds that originate and/or pass through the Ohio department of mental health and addiction services shall have a policy and procedure which states that admission to the driver intervention program shall not be denied because an individual is indigent as long as public funds are available to cover the cost of the program.
(2) Indigent individuals are persons who have in their possession at the beginning of a driver intervention program a document which indicates the client is a recipient of public assistance, including, but not limited to, supplemental security income, social security disability income, medicaid, temporary assistance for needy families or other category of assistance as defined by the Ohio department of mental health and addiction services.
(3) The client record of indigent individuals shall include a photocopy of the documentation that was used to verify indigent status.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

3/27/2022

Rule 5122-29-13 
|
 SUD Case management services.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

Substance use disorder case management services means those
 activities provided to assist and support individuals in gaining access to
 needed medical, social, educational and other services essential to meeting
 basic human needs. Case management services may include interactions with
 family members, other individuals or entities.
(A) Case management services shall
 include, at a minimum, the following activities:
(1) 
 Assessment.
(2) Referral.
(3) Monitoring and
 follow-up.
(B) Examples of case management activities
 include: coordinating: client assessments, treatment planning and crisis
 intervention services; providing training and facilitating linkages for the use
 of community resources; monitoring service delivery; obtaining or assisting
 individuals in obtaining necessary services, for example, financial assistance,
 housing assistance, food, clothing, medical services, educational services,
 vocational services, recreational services, etc.; assisting individuals in
 becoming involved with self-help support groups; assisting individuals in
 increasing social support networks with family members, friends, and/or
 organizations; assisting individuals in performing daily living activities; and
 coordinating criminal justice services.
(1) Transportation in
 and of itself does not constitute case management.
(2) Waiting with
 clients for appointments at social service agencies, court hearings and similar
 activities does not, in and of itself, constitute case management.
(C) Case management services do not include
 the provision of
(1) Direct services
 to which the client has been referred such as medical, educational, or social;
 or,
(2) Internal quality
 assurance activities, such as clinical supervisory activities and/or case
 reviews/staffing sessions.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

6/13/2004, 10/4/2010, 5/19/2011

Rule 5122-29-14 
|
 Mobile response and stabilization service.

Effective:

April 1, 2025

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) As used in this rule:
(1) "Certified
 family peer supporter," "certified youth peer supporter," and
 "certified peer supporter" have the same meanings as in rule
 
5122-29-15.1
 of the Administrative Code.
(2) "Child and
 adolescent needs and strengths (CANS) assessment" has the same meaning as
 in rule 
5160-59-01
 of the Administrative Code.
(3) "Clinician"
 means any of the following:
(a) A licensed professional counselor, licensed
 professional clinical counselor, licensed professional clinical counselor -
 supervisor, master's level counselor trainee, independent social worker,
 independent social worker - supervisor, social worker, social worker trainee,
 independent marriage and family therapist, marriage and family therapist, or
 marriage and family therapist trainee licensed or registered under Chapter
 4757. of the Revised Code;
(b) A licensed psychologist as defined in section 
4732.01

 of the Revised Code;
(c) A psychology trainee, psychology assistant, or
 psychology intern who is working under the supervision of a licensed
 psychologist as defined in section 
4732.01
 of the Revised Code and is
 registered by the supervising licensed psychologist as described in division
 (B) of section 
4732.22
 of the Revised Code.
(4) "Community
 behavioral health services provider" means a community addiction services
 provider or community mental health services provider, or both, as defined in
 section 
5119.01
 of the Revised Code.
(5) "Crisis"
 means a situation defined by a young person, the young person's family, or
 a person responsible for the welfare of the young person that is causing stress
 or discordance to the young person, the young person's family, or the
 community.
(6) "De-escalation" means reducing the intensity
 of behaviors or emotional distress for a young person and/or their family to
 minimize effects that might otherwise prompt the use of more restrictive
 interventions.
(7) "Family"
 means an individual related by blood or affinity to a young person or an
 individual whose close association with a young person is the equivalent of a
 family relationship as identified by the young person, including kinship and
 foster care.
(8) "Minor"
 means an individual under eighteen years of age who is not
 emancipated.
(9) "MRSS
 provider" means a community behavioral health services provider that is
 certified under this rule to provide MRSS.
(10) "MRSS
 team" means the team of individuals described in paragraph (G) of this
 rule that is employed by, or under contract with, an MRSS provider to provide
 MRSS.
(11) "MRSS team
 member" means an individual member of an MRSS team.
(12) "Qualified
 behavioral health specialist" or "QBHS" has the same meaning as
 in agency 5122 of the Administrative Code pertaining to qualified behavioral
 health specialists.
(13) "Young
 person" means a child, youth, or young adult under twenty-one years of
 age.
(B) Mobile response and stabilization
 service (MRSS) is a structured intervention and support service provided by an
 MRSS team that is designed to promptly address a crisis situation with a young
 person who is experiencing emotional or behavioral symptoms, traumatic
 circumstances, or any distressing situation as identified by the young person,
 the young person's family, or another person responsible for the welfare
 of the young person that has compromised or impacted the young person's
 ability to function within their family, living situation, school, or
 community.
(C) MRSS is intended to be delivered
 in-person where the young person or the young person's family is located,
 such as their home or a community setting. There are instances where MRSS may
 be delivered using a telehealth modality when clinically appropriate. Common
 times that telehealth would be appropriate include, but are not limited
 to:
(1) When the young person
 or their family requests MRSS delivery using telehealth
 modalities;
(2) When there is a
 contagious medical condition present in the home;
(3) When there is
 inclement weather that prevents or makes it dangerous for the MRSS team to
 travel to the young person or their family; or
(4) When a mobile
 response has been requested but a clinician is not available to respond, in
 person, as part of the MRSS team.
(D) The initial mobile response by an
 MRSS provider is expected to occur within sixty minutes from the end of the
 initial call and immediate linkage of the caller to the MRSS provider, with a
 de-escalation phase up to seventy-two hours and then a stabilization phase.
 From the initial mobile response to the end of the stabilization phase, MRSS
 may be provided for up to six weeks or forty-two days. If the caller requests
 mobile response later than sixty minutes, the response will occur within
 forty-eight hours or the next business day, whichever occurs first. In
 instances where the initial mobile response occurs later than sixty minutes
 from the time of dispatch, the MRSS team will maintain documentation that
 supports the extended response time as being appropriate.
(E) To be certified for MRSS, a community
 behavioral health services provider will also maintain certification from the
 department for all of the following:
(1) General services as
 defined in rule 
5122-29-03
 of the Administrative Code;
(2) SUD case management
 services as defined in rule 
5122-29-13
 of the Administrative Code;
(3) Peer recovery
 services as defined in rule 
5122-29-15
 of the Administrative Code;
(4) Community psychiatric
 supportive treatment as defined in rule 
5122-29-17
 of the Administrative Code;
 and
(5) Therapeutic
 behavioral services and psychosocial rehabilitation as defined in rule
 
5122-29-18
 of the Administrative Code.
(F) The community behavioral health
 services provider is to be able to provide all allowable services by telehealth
 as defined in agency 5122 of the Administrative Code pertaining to
 telehealth.
(G) MRSS team
(1) Subject to paragraph
 (G)(2) of this rule, an MRSS team will consist of both of the
 following:
(a) A clinician who demonstrates and maintains competency
 in the care and provision of services to young people.
(b) One of the following:
(i) A certified family
 peer supporter or certified youth peer supporter. The certified family peer
 supporter or certified youth peer supporter will also demonstrate competency in
 the care and provision of services to young people and have a scope of practice
 that includes young people with mental health disorders and substance use
 disorders.
(ii) A QBHS. The QBHS
 will also demonstrate competency in the care and provision of services to young
 people and have a scope of practice that includes young people with mental
 health disorders and substance use disorders.
A QBHS, certified family peer supporter, or
 certified youth peer supporter is to receive at least one hour of supervision
 each week from a clinician regardless of whether the QBHS, certified family
 peer supporter, or certified youth peer supporter is working in an individual
 or group setting.
(2) If the clinician on
 the team, described in paragraph (G)(1)(a) of this rule, requires clinical or
 work supervision pursuant to rule 
4757-17-01
, 
4757-23-01
, or 
4757-29-01
 of the
 Administrative Code, any other rule adopted by the Ohio counselor, social
 worker, and marriage and family therapist board, or any rule adopted by the
 Ohio board of psychology, the team is also to include an independently licensed
 professional to supervise the MRSS team. The independently licensed
 professional will hold a valid and unrestricted license to practice in
 Ohio.
(3) Although not
 necessarily a member of the MRSS team, the team will have ready access to a
 psychiatrist, certified nurse practitioner, or clinical nurse specialist for
 consultation purposes as needed. The psychiatrist, certified nurse
 practitioner, or clinical nurse specialist will hold a valid and unrestricted
 license to practice in Ohio.
(H) An MRSS provider is to undergo a
 fidelity review once every twelve months conducted by an individual or
 organization external to the provider and designated by the department. The
 individual or organization conducting the fidelity review is to utilize the
 MRSS provider fidelity rating tool indicated by the department on the
 department's MRSS web site.
(I) An MRSS provider will participate in
 ongoing MRSS quality improvement activities that include the provider
 collecting required data and submitting all of that data to the department
 through the data management system designated by the department.
(J) Each MRSS team member and after-hours
 telephonic crisis de-escalation support staff person will complete the
 department's approved initial and ongoing MRSS trainings as appropriate to
 their role.
(K) An MRSS provider will ensure the
 service meets all of the following standards:
(1) Except as provided in
 paragraph (K)(2) of this rule, the service is to be available, at a minimum,
 between the hours of eight a.m. and eight p.m., Monday through Friday,
 including holidays. A caller that contacts the MRSS provider outside of the
 provider's operational hours will be provided with after-hours telephonic
 crisis de-escalation support and be scheduled for a mobile response the next
 business day. The after-hours telephonic crisis de-escalation support is to be
 provided by a community behavioral health services provider that is certified
 under this rule as an MRSS provider or is certified for behavioral health
 hotline service as defined in rule 
5122-29-08
 of the Administrative
 Code.
(2) Not later than the
 date that is three years from the effective date of this rule, the MRSS
 provider is to provide the service twenty-four hours a day, seven days a week,
 including holidays.
(3) The service is to be
 provided on a mobile basis, except under the limited circumstances where the
 service may be provided using a telehealth modality as described in paragraph
 (C) of this rule. MRSS is provided where the young person is experiencing the
 crisis or where the family or other individual responsible for the welfare of
 the young person requests services, not at a static location where the young
 person will present themselves.
(4) The initial mobile
 response of the service is to occur in accordance with paragraph (D) of this
 rule.
(5) The service is to be
 provided by MRSS team members who are eligible to provide the service as
 described in agency 5122 of the Administrative Code pertaining to eligible
 providers and supervisors.
(L) MRSS provides immediate
 de-escalation, rapid community-based assessment, and stabilization services to
 help the young person remain with their family in their home and/or community.
 MRSS consists of three phases: screening/triage, mobile response, and
 stabilization. Some young people do not need all three MRSS phases but are
 still considered MRSS participants.
MRSS will be initiated through screening/triage
 and progress in the order listed in this paragraph.
(1) Screening/triage
MRSS screening/triage includes, at a minimum,
 the following:
MRSS may be initiated through direct connection
 with the MRSS provider or call center designated by the department. When the
 service is initiated through direct connection with the provider, all of the
 following are to be the case:
(a) An initial triage screening is done to gather
 information on the crisis or crises, identify the parties involved, and
 determine an appropriate response or responses. The initial triage screening is
 performed remotely.
(b) All calls with a young person or young person's
 family in crisis, where 911 is not indicated, are responded to with a mobile
 response.
(c) If a young person or their family is already involved
 with an intensive home-based service (IHBT), the mobile response team is
 dispatched to de-escalate the presenting crisis. Once the crisis situation has
 been de-escalated, the young person or family is re-connected with the existing
 service.
(2) Mobile
 response
(a) The mobile response team will mobilize to arrive at the
 location of the crisis or a location specified by the young person, their
 family, or the other individual responsible for the welfare of the young person
 within the designated response time, as determined by the end of the triage
 assessment. The initial response may be scheduled outside of the designated
 response time if requested by the caller. If a call for mobile response is made
 after the MRSS provider's operational hours, the mobile response is to
 occur within forty-eight hours of the call or the next business day, whichever
 occurs first.
(b) The initial response will be conducted by:
(i) A
 clinician;
(ii) A clinician and
 either a QBHS, certified family peer supporter, or certified youth peer
 supporter as described in paragraph (G)(1)(b) of this rule; or
(iii) A combination of at
 least one QBHS and either another QBHS or a certified family peer supporter or
 certified youth peer supporter as described in paragraph (G)(1)(b) of this
 rule.
(c) If a clinician is unable to be present in person at the
 location described in paragraph (L)(2)(a) of this rule, the QBHS, certified
 family peer supporter, or certified youth peer supporter is to contact the MRSS
 team's clinician before leaving the premises of the site of the response
 so that the clinician can participate in the initial response by telehealth. If
 a telehealth connection cannot be made and sustained at the site of the
 response, the clinician is to be available for telephone consultation or is to
 go to the site of the response.
(d) The MRSS team will provide de-escalation services for
 up to seventy-two hours until the young person and their family are stable;
 de-escalation services will include all of the following:
(i) An urgent assessment
 of the following elements for de-escalation: understanding what happened to
 initiate the crisis and the young person's and their family's
 response or responses to it and a risk assessment of lethality, propensity for
 violence, and medical/physical condition including alcohol or drug use, mental
 status, and information about the young person's and family's
 strengths, coping skills, and social support network.
(ii) An initial safety
 plan to be developed with and provided to the young person and their family at
 the end of the first face-to-face contact.
(iii) Crisis intervention
 and de-escalation with the young person or their family using strategies as
 appropriate to meet the unique needs of the young person and family. Such
 strategies include, but are not limited to, ongoing risk assessment and safety
 planning, teaching of coping and behavior management skills, medication, family
 support, and psychoeducation.
(iv) Telephonic
 psychiatric consultation initiated when indicated.
(v) Administration of the
 Ohio children's initiative brief child and adolescent needs and strengths
 (CANS) assessment performed by an MRSS team member who is a certified CANS
 assessor if one of the following is the case:
(a) The young person is
 not enrolled in the Ohio resilience through integrated systems and excellence
 (OhioRISE) program for children and youth involved in multiple state systems or
 children and youth with other complex behavioral health needs;
(b) A CANS assessment has
 not been administered to the young person in the ninety days prior to the MRSS
 team providing de-escalation to that young person; or
(c) There has been a
 significant change in the young person's circumstances as determined by
 the clinician.
(vi) Consultation with
 the young person or their family to define goals for preventing future crisis
 and discuss the benefits of the ongoing stabilization phase of
 MRSS.
(vii) Initiation of an
 individualized MRSS plan, prior to the stabilization phase, which is inclusive
 of the safety plan. An individualized MRSS plan is valid for up to forty-two
 days or until the end of the MRSS episode of care and should be updated or
 modified as indicated during this time period.
(viii) Identification of
 the young person's established behavioral health providers, notifying such
 providers of the crisis response and assisting with coordination of
 services.
(3) Stabilization
(a) Stabilization services are provided by the MRSS team as
 documented in the individualized MRSS plan. The stabilization services
 immediately follow the seventy-two hours of mobile response.
(b) There is to be continued monitoring, coordination, and
 implementation of the individualized MRSS plan.
(c) The MRSS team provides stabilization services that are
 defined in the individualized MRSS plan to achieve goals as articulated by the
 young person and/or their family. Stabilization services are to build skills of
 the young person and their family, strengthen capacity to prevent future
 crisis, facilitate an ongoing safe environment, link the young person and their
 family to natural and culturally relevant supports, and build or facilitate
 building the young person and family's resilience. Stabilization
 activities include, but are not limited to:
(i) Psychoeducation:
 young person or family coping skills, behavior management skills, problem
 solving, and effective communication skills;
(ii) Referral for
 psychiatric consultation and medication management if indicated;
(iii) Advocacy and
 networking by the MRSS team members to establish linkages and referrals to
 appropriate community-based services and natural supports; and
(iv) Coordination of
 services to address the needs of the young person or their family.
(d) There is to be linkage to the natural and clinical
 supports and services to maintain engagement and sustain the young
 person's or their family's stabilization post MRSS
 involvement.
(e) There is to be the convening of or participation in one
 or more planning meetings with the young person, the young person's
 family, and cross system partners for the purpose of developing and
 coordinating linkages to ongoing services and supports when family needs
 indicate that such activities are appropriate.
(f) Service Transition
(i) The MRSS team and the
 young person and/or their family will work on moving from stabilization to
 ongoing support through identified supports, resources, and services that are
 consistent with their unique needs and documented in the individualized MRSS
 plan.
(ii) With the permission
 of the young person or their family, the MRSS team will share the most recent
 individualized MRSS plan and supporting information with other service
 providers and/or family-identified natural supports in person, including by
 video or telephone, and with the young person or their family present when
 possible.
(iii) The MRSS team will
 review with the young person or their family newly formed coping skills and how
 future crises can be managed, emphasizing the role of the young person and
 family.
(iv) The MRSS team will
 prepare and finalize a transition plan with the young person and their family.
 The transition plan will include the most recent version of the individualized
 MRSS plan with safety plan. With the permission of the young person or their
 family, the transition plan will be shared with the other service providers
 and/or family-identified natural supports.
(M) Consent for MRSS
A young person who is at least eighteen years of
 age or an emancipated minor is to consent to their receipt of MRSS. A young
 person who is at least fourteen but less than eighteen years of age may consent
 to their receipt of MRSS in accordance with and subject to the limitations in
 section 
5122.04
 of the Revised Code. Consent to the receipt of MRSS by a young
 person under fourteen years of age is to be given by the minor's parent,
 guardian, or custodian.
(N) Emergency care when consent is not
 required
Under the emergency care doctrine recognized in
 Ohio, a minor of any age may receive emergency medical treatment to preserve
 life and prevent serious impairment without the consent of a parent, custodian,
 or guardian. Because the department recognizes that it could be difficult to
 determine whether such an emergency situation exists until the assessment
 described in paragraph (L)(2)(d)(i) of this rule is completed, the MRSS phases
 of screening/triage and mobile response are not to be delayed or denied to a
 minor under fourteen years of age due to inability to receive parental,
 guardian, or custodian consent. In instances in which an MRSS team is unable to
 contact the parent, guardian, or custodian to obtain consent for providing
 screening/triage and mobile response, the MRSS team is responsible for
 communicating any pertinent follow-up safety planning and/or safety-related
 information to the parent, guardian, or custodian post intervention.

Last updated April 1, 2025 at 8:00 AM

Supplemental Information

Authorized By:

R.C. 
5119.36

Amplifies:

R.C. 
5119.36

Five Year Review Date:

4/1/2030

Prior Effective Dates:

7/1/2022

Rule 5122-29-15 
|
 Peer support services.

Effective:

April 7, 2022

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Peer support services are services
 for individuals with a mental illness, intellectual or developmental
 disabilities, or substance use disorders and their caregivers and families.
 
(B) Peer support services consist of
 activities that promote resiliency and recovery, self-determination, advocacy,
 well-being, and skill development. Peer support services are individualized,
 resiliency and recovery focused, and based on increasing knowledge and skills
 through a peer relationship that supports an individual's or
 family's ability to address needs, navigate systems and promote recovery,
 resiliency, and wellness. They promote family driven, youth guided, trauma
 informed care and cultural humility, encourage partnership with individuals and
 families, and advocate for informed choice. 
(C) For the purposes of this rule, the
 following definitions apply:
(1) "Recovery"
 means the personal process of change in which an individual strives to improve
 their health and wellness, resiliency, and reach their full potential through
 self-directed actions.
(2) "Resiliency" means the ability to recover
 from setbacks, adapt well to change, and keep going in the face of adversity.
 It is the process of adapting well in the face of adversity, trauma, tragedy,
 threats, or significant sources of stress such as family and relationship
 problems, serious health problems, or workplace and financial stressors.
 
(3) "Wellness
 " means a broad approach for things individuals can do at their own pace,
 in their own time, and within their own abilities, that can help them feel
 better and live longer.
(D) Peer support services may include, but are not limited
 to:
(1) Ongoing exploration
 of recovery, resiliency, and wellness needs;
(2) Supporting
 individuals and their caregivers and families in achieving goals through
 increased knowledge, skills and connection as identified by the individual or
 family;
(3) Encouraging
 hope;
(4) Supporting the
 development of life skills;
(5) Developing and
 working toward achievement of individualized recovery, resiliency, and wellness
 goals;
(6) Modeling personal
 responsibility for resiliency, recovery and wellness;
(7) Teaching and coaching
 skills to effectively navigate systems to effectively and efficiently utilize
 services;
(8) Addressing skills or
 behaviors, through processes that assist an individual, caregiver, or family in
 eliminating barriers to achieving or maintaining recovery, resiliency, and
 wellness;
(9) Assisting with
 accessing and developing natural support systems;
(10) Promoting
 coordination and linkage among providers;
(11) Coordinating or
 assisting in crisis interventions and stabilization;
(12) Conducting outreach
 and community education;
(13) Attending and
 participating in team decision making or specific treatment team;
 or,
(14) Assisting
 individuals, caregivers, or families in the development of empowerment skills
 through advocacy and activities that mitigate discrimination and inspire hope.
 
(E) Providing services in a culturally inclusive and
 competent manner which includes not practicing, condoning, facilitating, or
 collaborating in any form of discrimination on the basis of ethnicity, race,
 gender, sexual orientation, age, religion, national origin, marital status,
 political belief, or mental or physical disability. 
(F) Peer support services are not site specific but shall
 be provided in locations that meet the needs of the individual, caregiver, or
 families.
(G) Peer support services may be facilitated to
 individuals, families, or groups.
(H) Peer support services shall be provided a person
 certified in accordance with in rule 
5122-29-15.1
 of the Administrative
 Code.
(I) Peer support services providers shall report for any
 certified peer supporter employed by or volunteering with the provider to the
 Ohio department of mental health and addiction services any events that would
 disqualify the certified peer supporter pursuant to rule 
5122-29-15.1
 of the
 Administrative Code.

Last updated April 7, 2022 at 8:30 AM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

4/7/2027

Prior Effective Dates:

1/1/1991, 10/5/2018

Rule 5122-29-15.1 
|
 Adult, family, and youth certified peer supporter.

Effective:

April 7, 2022

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Certified peer recovery
 supporter.
(1) A "certified
 peer recovery supporter" (CPRS) is an individual, with a direct lived
 experience, who has self-identified as being in recovery from a mental health
 or substance use disorder and has been certified pursuant to this
 rule.
(2) For CPRS certification the individual
 will be at least eighteen years of age at the time of
 certification.
(B) Certified youth peer
 supporter.
(1) A certified youth
 peer supporter (CYPS) is an individual who self-identifies as having lived
 experience with the behavioral health care system and other child or youth
 serving systems and has been certified by the state pursuant to this rule.
 
(2) For CYPS the
 individual will be at least eighteen years of age but no older than thirty
 years of age at the time of certification.
(C) Certified family peer
 supporter.
(1) A certified family
 peer supporter (CFPS) is an individual who has self-identified as the caregiver
 of a person with behavioral health challenges who has successfully navigated
 service systems for at least one year on behalf of the person and has been
 certified pursuant to this rule.
(2) For CFPS
 certification the individual will be at least twenty-one years of age at the
 time of certification.
(D) "Certified peer supporter"
 as used in this rule means an individual certified as a CPRS, CYPS, or
 CFPS.
(E) Supervision 
Certified peer supporters will be supervised by
 an individual who either:
(1) ) Has experience
 delivering peer services in behavioral health over a cumulative period of two
 years, has completed the sixteen hours of online learning administered or
 designated by the department, and has completed the four-hour supervising peers
 training administered or designated by the department; or, 
(2) Is a clinician with
 one of the following licenses, and has completed the sixteen hours of online
 learning administered or designated by the department and has completed the
 four-hour supervising peers training administered or designated by the
 department: 
(a) Licensed social worker; 
(b) Licensed independent social worker; 
(c) Licensed professional counselor; 
(d) Licensed chemical dependency counselor II;
 
(e) Licensed chemical dependency counselor III;
 
(f) Licensed professional clinical counselor; 
(g) Licensed independent chemical dependency counselor;
 
(h) Licensed marriage and family therapist; 
(i) Licensed independent marriage and family
 therapist;
(j) Psychologist; or, 
(k) Psychiatrist. 
(F) Certification
(1) To obtain peer
 supporter certification individuals will submit a complete and compliant
 application including the following documentation: 
(a) Proof of a minimum of forty hours of department
 approved competency-based peer services training or three equivalent years
 formal, verifiable experience providing behavioral health peers services
 pursuant to rule 
5122-29-15
 of the Administrative Code. 
(b) Hold a high school diploma, a general educational
 development certification, or similar secondary education from outside of the
 United States;
(c) Documentation of passing the department peer supporter
 exam, or an exam administered or designated by the department; 
(d) Certified peer supporters will attest to having read
 and understood the code of ethics at initial certification and every
 certification renewal thereafter;
(e) The results of a bureau of criminal investigation and
 federal bureau of investigation criminal records check conducted within one
 year of submission.
(2) For CPRS and CYPS
 certification, completion of sixteen hours of online learning administered or
 designated by the department.
(3) Certifications issued by the
 department expire two years from the date the certification issued or renewed.
 
(G) Renewal of certification
(1) Peer supporter
 certification renewal will include submission of a complete and compliant
 application, including the following:
(a) Documentation of thirty hours of continuing education
 credits, which will include the following competencies and minimum
 hours;
(i) Ethics (may include
 HIPAA, confidentiality) - three hours;
(ii) Boundaries - three
 hours;
(iii) Diversity and
 inclusion/cultural sensitivity - two hours;
(iv) System navigation
 and care coordination - one hour;
(v) Trauma informed care
 - two hours;
(vi) Human trafficking -
 one hour;
(vii) Behavioral health
 knowledge (may include recovery and resiliency) - one hour;
(viii) Basic principles
 related to health and wellness - one hour; and, 
(ix) Principles of
 coaching as applied to the delivery of peer services - two hours.
Continuing education credits will be accepted
 from a continuing education program that meets the professional needs of the
 intended clientle, which will include certified peer recovery
 supporters, certified family peer supporters, certified youth peer supporters,
 counselors, social workers, marriage and family therapists, psychologists,
 nurses, chemical dependency counselors, or other human service
 professionals.
The program will have a minimum duration of
 one clock hour.
The program will have written goals and
 objectives which are responsive to the needs of prospective attendees. 
(b) Certified peer supporters will attest to having read
 and understood the code of ethics at initial certification and every
 certification renewal thereafter.
(c) For those certified peer supporters providing
 supervision, documentation of three hours of supervisor training.
(d) Either an attestation that the applicant has not been
 convicted of any new felony offenses, or a new background check pursuant to
 paragraph (L) of this rule.
(2) Renewal of certified
 peer supporter status is dependent on all materials being completed, submitted,
 and approved by the department. Renewal of certification is for two years from
 the date of the expiration of previous certification or the approval of the
 renewal certification, whichever is later.
(H) Denial of initial or renewal certification
(1) An application for
 initial or renewal certification may be denied and a certification may be
 revoked for the following:
(a) Failure to provide peer supporter services in
 accordance with the standards set forth in this rule.
(b) Failure to submit a complete certification or renewal
 application.
(c) Failure to complete any of the standards for
 certification or renewal.
(d) The department determines that the certified peer
 supporter code of ethics has been violated. 
(e) The individual is included in one of the following
 databases: 
(i) The sex offender and
 child-victim offender database established pursuant to division (A)(11) of
 section 
2950.13
 of the Revised Code (available at
 http://www.icrimewatch.net/index.php?AgencyID=55149&disc=); 
(ii) The database of
 incarcerated and supervised offenders established pursuant to section 
5120.66

 of the Revised Code (available at
 http://www.drc.ohio.gov/OffenderSearch/Search.aspx). 
(f) A background check that has any of the permanently
 disqualifying offenses listed in paragraph (O) of this rule.
(g) A background check that has any of the five year
 disqualifying offenses listed in paragraph (O) of this rule, when five years
 have not elapsed between the release of all sanctions for the offense, and the
 submission of the certification application.
(2) The denial of an
 application for certification or renewal, or the revocation of certification is
 subject to appeal under Chapter 119. of the Revised Code. 
(3) Upon receipt of an
 application, the department will review the materials to determine if they are
 complete. If an application is incomplete, the department will notify the
 applicant of corrections or additions needed.
Incomplete materials will not be considered an
 application for certification, and will not constitute a denial of an
 application for certification.
(4) Any individual who has had their
 certification revoked or an application denied pursuant to this rule will not
 be eligible to apply to the department for certification for at least three
 years from the date of revocation.
(I) Inactive-lapsed status. 
(1) Certifications issued
 pursuant to this rule are valid for two years from the issue date. If a
 certification is not renewed it will be placed in an inactive-lapsed status for
 a period of no more than two years.
(2) A certification in an
 inactive-lapsed status may be renewed by an individual by meeting the renewal
 standards of paragraph (G) of this rule.
(3) Certifications in
 inactive-lapsed status for more than two years will be considered as expired
 and any individual seeking certification will apply as new.
(J) Voluntary inactive status 
(1) A person certified
 pursuant to this rule may submit a request to the department to have the
 person's certification classified as inactive. If the person's
 certification is in good standing the department will classify the
 certification as inactive. The inactive classification will become effective
 immediately when the inactive request is processed.
(2) During the period
 that a certification is classified as inactive, the person can not engage in
 the practice of professional peer support, as applicable, in this state or make
 any representation to the public indicating that the person is actively
 certified pursuant to this rule.
(3) During the period
 that a certification is classified as inactive, the person will be subject to
 the code of ethics as defined in paragraph (N) of this rule. 
(4) A person whose
 certification has been classified as inactive may apply to the department to
 have the certification reactivated. The department will reactivate the
 certification if the person meets the standards for certification or renewal
 pursuant to paragraph (G) of this rule.
(5) During the time a
 certification is in voluntary inactive status the department may revoke or deny
 a certification pursuant to paragraph (H) of this rule when a certification is
 classified as inactive.
(6) The certification may
 stay inactive for no longer than two years from the date the inactive status is
 issued. After two years of an inactive status, a certification is no longer
 valid and the person will need to apply for initial certification as set forth
 in paragraph (F) of this rule. 
(7) If the certification
 is past the date on which it would have originally expired, the person will
 submit documentation of the successful completion of thirty continuing
 education credits within the inactive status period.
(K) Applications for certification and renewal, and all
 accompanying materials, are subject to public records requests pursuant to
 Chapter 149. of the Revised Code; however the department will not use the
 applications for any purpose other than determining certification status and
 will be kept confidential unless disclosure is mandated by state or federal
 law. 
(L) Background check
(1) All applicants for an
 initial certification will submit a request to the bureau of criminal
 identification and the federal bureau of investigation for a criminal records
 check of the applicant per sections 
4776.02
 and 
4776.03
 of the Revised Code and
 will include a federal bureau of identification criminal records check request.
 This applies to all initial applications. The applications for criminal records
 check will comply with section 
109.572
 of the Revised Code. 
(2) Section 
4776.02
 of the Revised Code
 states that all fingerprint reports be sent directly to the department from the
 bureau of criminal identification and investigation. Any fingerprint results
 mailed to or from some other source will not be accepted.
(M) Pardons and certificates. 
A conviction of, or a plea of guilty to, a
 disqualifying offense as set forth in paragraph (K) of this rule will not
 prevent an applicant from certification if any of the following circumstances
 apply: 
(1) The applicant has
 been granted an unconditional pardon for the offense pursuant to Chapter 2967.
 of the Revised Code; 
(2) The applicant has
 been granted an unconditional pardon for the offense pursuant to an existing or
 former law of the state of Ohio, any other state, or the United States, if the
 law is substantially equivalent to Chapter 2967. of the Revised Code;
 
(3) The applicant has
 been granted a conditional pardon for the offense pursuant to Chapter 2967. of
 the Revised Code, and the condition(s) under which the pardon was granted have
 been satisfied; 
(4) The applicant's
 conviction or guilty plea has been set aside pursuant to law;
(5) The applicant was
 adjudicated delinquent for any of the disqualifying offenses in paragraph (K)
 of this rule; or,
(6) A certificate of qualification for
 employment has been issued by an Ohio court of common pleas pursuant to section
 
2953.25
 of the Revised Code, or an equivalent certification has been issued by
 an out of state or federal jurisdiction. 
Applications that include a certificate of
 qualification for employment or an equivalent certification associated with a
 permanent exclusion offense as stated in paragraph (O) of this rule, will be
 reviewed by the department and a decision will be rendered by the department on
 a case-by-case basis as to whether an application will be approved or not in
 accordance with section 
2953.25
 of the Revised Code. 
(N) Code of ethics
(1) The code of ethical
 practice and professional conduct constitutes the standards by which the
 professional conduct of peer supporters will be measured.
(2) A violation of the
 code of ethics unprofessional conduct and is sufficient reason for revocation,
 or for the denial of the initial certification or renewal.
(3) Certified peer
 supporters will attest to having read and understood the code of ethics at
 initial certification and every certification renewal thereafter.
(4) Certified peer
 supporters in their various professional roles, relationships, and areas of
 responsibilities will
(a) Use the strength-based model when working with
 individuals;
(b) Respect the rights and dignity of those they work
 with;
(c) Openly share their personal recovery and resiliency
 stories with colleagues and those they serve;
(d) Role-model recovery and resiliency. ;
(e) Adhere to privacy and confidentiality of those they
 serve;
(f) Conduct themselves in a professional manner,
 including:
(i) Never intimidating,
 threatening, or harassing those they serve; 
(ii) Never using undue
 influence, physical, force, or verbal abuse with those they serve;
(iii) Never making
 unwarranted promises of benefits to those they serve; and,
(iv) Maintaining high
 standards of personal conduct.
(g) Conduct themselves in a culturally competent manner
 which includes not practicing, condoning, facilitating, or collaborating in any
 form of discrimination on the basis of ethnicity, race, gender, sexual
 orientation, age, religion, national origin, marital status, political belief,
 or mental or physical disability.
(h) Conduct themselves in a manner that fosters their own
 recovery and resiliency, maintaining healthy behaviors.
(i) Not enter dual relationships or commitments that
 conflict with the interests of those they serve;
(j) Not engage in sexual or intimate activities with
 colleagues or those they serve;
(k) Not accept or give gifts of significant value from
 those they serve:
(l) Keep current with emerging knowledge relevant to
 recovery and resiliency, and openly share this knowledge with my colleagues and
 those they serve; and, 
(m) Comply with laws and regulations involving mandatory
 reporting of harm, abuse, or neglect.
(O) Disqualifying offenses
(1) The following
 offenses (sections of the Revised Code) are permanently disqualifying as set
 forth in this rule; any equivalent federal offense or offense from another
 state will also by permanently disqualifying. 
(a) 2903.01 (aggravated murder); 
(b) 2907.02 (rape); 
(c) 2907.03 (sexual battery); 
(d) 2907.05 (gross sexual imposition); 
(e) 2907.32 (pandering obscenity); 
(f) 2907.322 (pandering sexually-oriented matter involving
 a minor); 
(g) 2907.323 (illegal use of minor in nudity-oriented
 material or performance); 
(h) 2909.23 (making terrorist threat); 
(i) 2909.24 (terrorism); 
(2) The following
 offenses (sections of the Revised Code) are disqualifying for a period of five
 years from the end any sanctions as set forth in this rule; any equivalent
 federal offense or offense from another state will also by disqualifying for a
 period of five years.
(a) 2903.15 (permitting child abuse); 
(b) 2903.16 (failing to provide for a functionally impaired
 person); 
(c) 2903.34 patient abuse and neglect 
(d) 2903.341 patient endangerment 
(e) 2905.05 criminal child enticement (felony level)
 
(f) 2905.33 (unlawful conduct with respect to documents);
 
(g) 2905.32 trafficking in persons 
(h) 2907.04 unlawful sexual conduct with a minor, formerly
 corruption of a minor 
(i) 2907.06 sexual imposition 
(j) 2907.07 importuning 
(k) 2907.08 voyeurism 
(l) 2907.12 felonious sexual imposition 
(m) 2907.31 disseminating matter harmful to juveniles
 
(n) 2907.321 pandering obscenity involving a minor
 
(o) 2909.22 soliciting/providing for act of terrorism
 
(p) 2913.40 (medicaid fraud); 
(q) 2919.22 endangering children 

Last updated April 8, 2022 at 10:16 AM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

4/7/2027

Rule 5122-29-16 
|
 Peer run organization.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) "Peer run organization"
 means any service or activity that is planned, developed, administered,
 delivered, and evaluated by persons, a majority of whom have a direct lived
 experience of a mental health or substance use disorder.
(B) "Recovery" as used in this
 rule has the same meaning as defined in paragraph (C) of rule 
5122-29-15
 of the
 Administrative Code.
(C) Peer run organizations include but
 are not limited to consumer operated services, recovery community
 organizations, peer drop-in centers, and club houses.
(D) Peer run organizations shall:
(1) Have a primary goal
 of enhancing the quantity and quality of support available to individuals
 seeking recovery from mental health or substance use disorders;
(2) Be grounded in three
 core principles: a recovery vision, authenticity of voice, and accountability
 to the recovery community;
(3) Promote the
 strategies of public awareness and education, personal empowerment, and peer
 based- and other recovery support services and activities which may include:
 peer recovery support, telephone recovery support services, all-recovery
 meetings, structured volunteer/work activities, groups, social activities, or
 wellness activities;
(4) Be responsive to the
 needs of individuals participating in services and be based on local needs as
 identified by the individuals participating in the service.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

7/15/2001

Rule 5122-29-17 
|
 Community psychiatric supportive treatment (CPST) service.

Effective:

September 16, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Community psychiatric supportive
 treatment (CPST) service provides an array of services delivered by community
 based, mobile individuals or multidisciplinary teams of professionals and
 trained others. Services address the individualized mental health needs of the
 client. They are directed towards adults, children, adolescents and families
 and will vary with respect to hours, type and intensity of services, depending
 on the changing needs of each individual. The purpose/intent of CPST services
 is to provide specific, measurable, and individualized services to each person
 served. CPST services should be focused on the individual's ability to
 succeed in the community; to identify and access needed services; and to show
 improvement in school, work and family and integration and contributions within
 the community.
(B) Activities of the CPST service shall
 consist of one or more of the following:
(1) Ongoing assessment of
 needs;
(2) Assistance in
 achieving personal independence in managing basic needs as identified by the
 individual and/or parent or guardian;
(3) Facilitation of
 further development of daily living skills, if identified by the individual
 and/or parent or guardian;
(4) Coordination of the
 ISP, including:
(a) Services identified in the ISP;
(b) Assistance with accessing natural support systems in the
 community; and 
(c) Linkages to formal community service/systems;
(5) Symptom
 monitoring;
(6) Coordination and/or
 assistance in crisis management and stabilization as needed;
(7) Advocacy and
 outreach;
(8) As appropriate to the
 care provided to individuals, and when appropriate, to the family, education
 and training specific to the individual's assessed needs, abilities and
 readiness to learn;
(9) Mental health
 interventions that address symptoms, behaviors, thought processes, etc., that
 assist an individual in eliminating barriers to seeking or maintaining
 education and employment; and 
(10) Activities that
 increase the individual's capacity to positively impact his/her own
 environment.
(C) The methods of CPST service delivery
 shall consist of:
(1) Service delivery to
 the person served and/or any other individual who will assist in the
 person's mental health treatment.
(a) Service delivery may be face-to-face, by telephone, and/or by
 video conferencing; and
(b) Service delivery may be to individuals or
 groups.
(2) CPST services are not
 site specific. However, they must be provided in locations that meet the needs
 of the persons served. When a person served is enrolled in a residential
 treatment or residential support facility setting, CPST services must be
 provided by staff that are organized and distinct and separate from the
 residential service as evidenced by staff job descriptions, time allocation or
 schedules, and development of service rates.
(D) There must be one CPST staff who is
 clearly responsible for case coordination. This staff person must be an
 employee of an agency that is certified by ODMH to provide CPST services. This
 person may delegate CPST services to eligible providers internal and/or
 external to the certified agency as long as the following requirements and/or
 conditions are met:
(1) All delegated CPST
 activities are consistent with this rule in its entirety;
(2) The delegated CPST
 services may be provided by an entity not certified by ODMH to provide CPST
 services as long as there is written agreement between the certified agency and
 the non-certified entity that defines the service expectations, qualifications
 of staff, program and financial accountability, health and safety requirements,
 and required documentation; and
(3) An entity that is not
 certified by ODMH for CPST service may only seek reimbursement for CPST
 services through a certified agency and with a written agreement as required in
 this paragraph.
(E) Providers of CPST service shall have
 a staff development plan based upon identified individual needs of CPST staff.
 Evidence that the plan is being followed shall be maintained. The plan shall
 address, at a minimum, the following:
(1) An understanding of
 systems of care, such as natural support systems, entitlements and benefits,
 inter- and intra-agency systems of care, crisis response systems and their
 purpose, and the intent and activities of CPST;
(2) Characteristics of
 the population to be served, such as psychiatric symptoms, medications,
 culture, and age/gender development; and
(3) Knowledge of CPST
 purpose, intent and activities.
(F) Community psychiatric supportive treatment (CPST)
 service shall be provided and supervised by staff who are qualified according
 to rule 
5122-29-30
 of the Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

9/16/2023

Prior Effective Dates:

8/1/2013

Rule 5122-29-18 
|
 Therapeutic behavioral services and psychosocial rehabilitation.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Therapeutic behavioral services (TBS)
 and psychosocial rehabilitation (PSR) services are an array of activities
 intended to provide individualized supports or care coordination of healthcare,
 behavioral healthcare, and non-healthcare services. TBS and PSR may involve
 collateral contacts and may be delivered in all settings that meet the needs of
 the individual.
(B) Service activities.
(1) TBS service
 activities include, but are not limited to the following:
(a) Consultation with a licensed practitioner or an elgible
 provider pursuant to paragraph (C) of this rule, to assist with the
 individual's needs and service planning for individualized supports or
 care coordination of healthcare, behavioral healthcare, and non-healthcare
 services and development of a treatment plan;
(b) Referral and linkage to other healthcare, behavioral
 healthcare, and non-healthcare services to avoid more restrictive levels of
 treatment;
(c) Interventions using evidence-based
 techniques;
(d) Identification of strategies or treatment
 options;
(e) Restoration of social skills and daily functioning;
 and,
(f) Crisis prevention and amelioration.
(2) PSR service
 activities include, but are not limited to the following
(a) Restoration, rehabilitation and support of daily
 functioning to improve self-management of the negative effects of psychiatric
 or emotional symptoms that interfere with a person's daily
 functioning;
(b) Restoration and implementation of daily functioning and
 daily routines critical to remaining successfully in home, school, work, and
 community; and,
(c) Rehabilitation and support to restore skills to
 function in a natural community environment. 
(C) Eligible providers.
(1) Eligible providers of
 TBS are those practitioners who have :
(a) A bachelor's or master's degree in social
 work, psychology, nursing, or in related human services, or
(b) A high school diploma with a minimum of three years of
 relevant experience.
(2) Eligible providers
 for PSR services are those practitioners who have a high school diploma and
 specific training related to persons with mental health conditions or
 needs.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Rule 5122-29-19 
|
 Consultation service.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) "Consultation service"
 means a formal and systematic information exchange between a provider and a
 person other than a client, which is directed towards the development and
 improvement of individualized service plans and/or techniques involved in the
 delivery of behavioral health services.
(B) Consultation may be focused on the clinical condition
 of a person served by another system or focused on the functioning and dynamics
 of another system. Consultation related to the clinical condition of a person
 served shall be provided by staff qualified according to paragraph (C) of this
 rule.
(1) The provider shall
 survey periodically other community systems to determine behavioral health
 consultation needs that may be desired by the systems, persons or families
 being served by those other systems.
(2) The provider shall
 maintain a record of all consultation services provided, including the name of
 the person or system to whom the service was provided, the nature of the
 consultation, and the outcome of the consultation.
(C) Consultation service shall be provided and supervised
 by staff who are qualified according to rule 
5122-29-30
 of the Administrative
 Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

7/1/2009

Rule 5122-29-20 
|
 Prevention services.

Effective:

July 24, 2026

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) As used in this rule:
(1) "Adverse childhood experiences" or "ACES" mean potentially traumatic events that occur during childhood (newborns to seventeen years of age). "Adverse childhood experiences" include physical and emotional abuse, neglect, caregiver mental illness, and household violence.
(2) "Brief intervention" means a time-limited, structured behavioral health intervention using techniques such as motivational interviewing that are personalized to reduce risk and encourage behavior change.
(3) "Coalition" means a group of diverse organizations and constituent groups working together, using a comprehensive public health approach and data driven planning process, toward a common goal of reducing the local incidence, prevalence, and consequences of adverse public health events such as suicide, substance use, and problem gambling.
(4) "Culturally relevant" means the service delivery system that utilizes population health data to respond to the cultural, linguistic, beliefs, and practices of the community as demonstrated through readiness, resource, and needs assessment activities; capacity development efforts; engaging stakeholders in planning; sound implementation science; and evaluation, quality improvement, and sustainability activities.
(5) "Direct services" mean interactive prevention interventions that necessitate personal contact with individuals or groups to influence individual-level change. "Direct services" include classroom-based programming, parent programs, training, and coalition building.
(6) "Early intervention" means an integral part of the continuum of prevention services that includes providing early services and supports after serious risk factors have been identified. These interventions are implemented to halt or slow the impact of those risks and indicators of MEB disorders in the earliest stages.
(7) "Evidence-based" means a program, practice, policy, strategy, or intervention that has been identified as effective by a nationally-recognized organization, a federal agency, or agency of this state and has produced a consistent, positive pattern of results on the majority of the intended recipients or target population.
(8) "Evidence-informed" means practices, strategies, policies, or interventions that were developed based on the best research available in the field. These activities have a strong scientific basis for their use and there is confidence from recognized institutions that these will have a consistent positive pattern of results or fit within prevention best-practice frameworks.
(9) "Indirect services" means population-based prevention interventions that necessitate sharing resources and collaborating to contribute to community-level change. "Indirect services" include compliance checks, media campaigns, advocacy, resource development, and strategic planning.
(10) "Mental, emotional, and behavioral health disorders" or "MEB disorders" means a number of conditions that exist on a continuum, including mental health and substance use disorders, while including a broader range of concerns associated with problem behaviors in populations.
(11) "Mental health promotion" means actions supporting the development of protective factors, resiliency, and health behaviors that can help promote healthy MEB development and prevent or reduce risk factors that could lead to the development of a diagnosable MEB disorder.
(12) "Prevention services" means a planned sequence of culturally relevant, evidence-based strategies designed to reduce the likelihood of or delay the onset of adverse individual or population outcomes and/or diagnosable disorders. "Prevention services" include direct services and indirect services.
(13) "Protective factor" means a characteristic at the biological, psychological, family, or community level that is associated with a lower likelihood of adverse outcomes or that reduce the negative impact of a risk factor on problem outcomes.
(14) "Public health approach" means a model that attempts to prevent or reduce a particular illness or social problem in a population by identifying risk factors and implementing strategies to improve conditions.
(15) "Resiliency" means the ability to adapt and grow in response to adversity, stress, or trauma. Building resiliency includes a focus on strategies that mitigate risk and build protective factors in individuals and communities that prevent adverse childhood experiences and other risks that contribute to MEB disorders.
(16) "Risk factor" means a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of adverse outcomes.
(17) "Screening" means a process that identifies risk factors or early behaviors that make MEB disorders or population level outcomes more likely and can be carried out at the individual, group, and community level. Screening segments a portion of those screened who could benefit from additional interventions, including a referral for a diagnostic assessment.
(18) "Social determinants of health" means conditions in places where people live, learn, work, and play that affect a wide range of health risks and outcomes. "Social determinants of health" include economic stability, education, health and healthcare, neighborhood and environment, and social and community context.
(19) "Trauma-informed" means a program, organization, or system that does all of the following: (a) realizes the widespread impact of trauma and understands potential paths for recovery; (b) recognizes the signs and symptoms of trauma in clients, families, staff, community, and populations involved with the system; (c) responds by fully integrating knowledge about trauma into policies, procedures, and practices; and (d) seeks to actively resist re-traumatization.
(20) "Workforce development" means learning opportunities designed to increase knowledge, skills, and abilities of the workforce and includes training, conferences, virtual learning webinars, and communities of practice.
(B) Prevention services involve a continuum of coordinated efforts developed within a comprehensive public health approach combining the use of the following evidence-based strategies in appropriate proportions. Mental health promotion and early intervention are part of this continuum and use a combination of the approaches and methods described in paragraphs (B)(2) and (B)(3) of this rule.
(1) Evidence-based prevention strategies
(a) Education: This strategy increases knowledge and skills, as well as influences attitude or behavior. This strategy does not include education provided as a component of treatment services.
(b) Environmental: This strategy seeks to establish or change standards or policies that will reduce the incidence and prevalence of behavioral health problems in a population.
(c) Community-based process: This strategy focuses on enhancing the ability of the community to provide prevention services through organizing, training, planning, interagency collaboration, coalition building, and networking. This strategy is essential to effectively implementing environmental strategies that will positively impact social determinants of health.
(d) Alternatives: This strategy focuses on providing opportunities for positive behavioral support that reduce risk taking behavior, increase resiliency, and reinforce protective factors achieved through attachment and bonding to families, schools, communities, and peers. The opportunities are to be provided as part of a larger comprehensive prevention effort.
(e) Information dissemination: This strategy builds knowledge and awareness of the nature and extent of risk and protective factors related to MEB disorders and their effects on individuals, families, and communities.
(f) Problem identification and referral: This strategy focuses on identifying individuals who exhibit behavior or risk indicators and referring them for prevention interventions, clinical assessment, or services. An example of this strategy is universal screening in a school.
(2) Mental health promotion involves the use of one or both of the following approaches:
(a) Universal efforts to enhance an individual's ability to achieve developmentally appropriate tasks and a positive sense of self-esteem, mastery, well-being, and social inclusion, as well as strengthening their ability to cope with adversity by targeting skills (such as self-regulation, self-efficacy, goal setting, and building positive relationships) that build resiliency;
(b) Actions to strengthen the policy environment and use of strategic communication for network building, stakeholder engagement, enhanced mental health literacy, and behavior change.
(3) Early intervention involves the use of both of the following methods:
(a) A comprehensive developmental approach that is collaborative, culturally relevant, and geared toward skill development or increasing protective factors; and
(b) Services and supports that are provided to individuals and families prior to receiving a clinical diagnosis, are usually included in the indicated category, and most often use education and problem identification and referral strategies, such as screening and brief interventions.
(C) Except as provided in paragraph (D) of this rule, a provider that seeks certification for prevention services is to meet all of the following standards:
(1) Use at least one of the following evidence-based prevention strategies described in paragraph (B)(1)(a), (B)(1)(b), or (B)(1)(c) of this rule: education, environmental, or community-based process.
(2) Use prevention interventions that are evidence-based or evidence-informed by prevention science as demonstrated by one of the following:
(a) A theory of change that is documented in a logic or conceptual model;
(b) A description of the intervention in a national registry or peer-reviewed journal;
(c) Documentation that the intervention has been implemented showing a consistent pattern of positive results; or
(d) Documentation that the intervention has been reviewed and found appropriate by a panel of informed prevention experts or key community leaders that includes a description of each reviewer's qualifications.
(3) Implement interventions that are targeted to various populations based on the following levels of risk:
(a) Universal: targeted to the general public or a whole population group that has not been identified on the basis of individual risk.
(b) Selective: targeted to individuals or a subgroup of the population whose risk of developing mental, emotional, or behavioral disorders is significantly higher than average.
(c) Indicated: targeted to high-risk individuals who are identified as having minimal but detectable signs or symptoms that foreshadow an MEB disorder, as well as biological markers that indicate a predisposition in a person for such disorder prior to a clinical diagnosis.
(4) Within a targeted population, implement interventions by considering all of the following:
(a) Conceptual fit addressing identified risk and protective factor priorities;
(b) Cultural relevance and support from key prevention stakeholders;
(c) Adverse childhood experiences and trauma-informed implications; and
(d) Age and gender appropriateness.
(5) Employ or contract with either or both of the following to provide prevention interventions:
(a) Licensed, certified, or registered individuals, consistent with agency 5122 of the Administrative Code regarding eligible providers and supervisors, who are able to show (i) prevention competency within the professional scope of practice of the appropriate license, certification, or registration issued by a regulatory board of this state and (ii) compliance with the supervisory and ethical mandates identified by such regulatory board.
(b) Prevention specialist assistants, prevention specialists, or prevention consultants certified under Chapter 4758. of the Revised Code who are working within their professional scope of practice and are supervised in accordance with rules 
4758-6-08
, 
4758-6-09
, and 
4758-6-10
 of the Administrative Code.
(6) Have a process to ensure volunteers assisting with prevention interventions are supervised by one or more individuals who are eligible, in accordance with agency 5122 of the Administrative Code regarding eligible providers and supervisors, to supervise within the applicable professional scope of practice.
(7) Have a procedure for prevention service providers to document their workforce development and continuing education hours for purposes of staying current with the latest developments in prevention science.
(8) Have a procedure for referring individuals participating in prevention services to all of the following when a need is identified:
(a) Substance use, problem gambling, or other mental health disorder treatment and primary care health services;
(b) Social services; and
(c) Community resources.
(9) Have a plan for evaluating the effectiveness of the prevention services it provides.
(10) Have a plan to maintain, in accordance rule 
5122-27-02.1
 of the Administrative Code, documentation for the prevention services it provides.
(D) All of the following are not subject to the certification mandate in paragraph (C) of this rule, although each may attain certification on a voluntary basis:
(1) An educational entity under the jurisdiction of the Ohio department of education and workforce or Ohio department of higher education;
(2) A board of health of a general or city health district or the authority having the duties of a board of health under section 
3709.05
 of the Revised Code that has received accreditation from the public health accreditation board;
(3) A faith-based organization that is actively working with a provider certified under this rule, as verified in writing by that provider;
(4) A county family and children first council established under division (B)(1) of section 
121.37
 of the Revised Code;
(5) A coalition.
(E) A provider whose prevention services have been certified pursuant to this rule is not mandated to keep records of individuals who receive prevention services. Any records which are kept, however, are to be kept in compliance with the mandates of 42 C.F.R. part 2 and the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, 45 C.F.R. part 160 and subparts A and E of part 164.

Last updated July 27, 2026 at 7:28 AM

Supplemental Information

Authorized By:

R.C. 
5119.36

Amplifies:

R.C. 
5119.36

Five Year Review Date:

7/24/2031

Prior Effective Dates:

7/15/2001

Rule 5122-29-22 
|
 Referral and information service.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) "Referral and information
 service" means responses, usually by telephone, to inquiries from people
 about services in the community. Referral may include contacting any agency or
 a provider in order to secure services for the person requesting
 assistance.
(B) Referral and information service
 shall be planned and coordinated with other health and human service providers,
 and shall:
(1) Have a mechanism to
 compile information about services available in the service system and the
 community; and
(2) Have mechanisms to
 determine whether persons referred were able to access services, were satisfied
 with the services, or experienced any problems with the referral source. This
 information shall be used to determine if particular providers shall continue
 to be used as referrals for persons seeking services. All state and federal
 confidentiality laws shall be adhered to in this process.
(C) The provider shall ensure access and
 availability of referral and information service including:
(1) A referral and
 information service shall have a published telephone number, including a
 published telephone number for special telephone services for the hearing
 impaired; and
(2) The provider shall
 ensure access and availability for persons whose primary means of communication
 is a language other than english, and for persons with communication
 impairments such as speech, language or hearing disorders, access to
 telecommunication relay services (TRS), and for persons with visual
 impairments.
A TRS is a telephone service that allows
 persons with hearing or speech disabilities to place and receive telephone
 calls, such services include but are not limited to text to speech relay and
 signing to speech relay.
(D) Each call and contact shall be logged
 and shall include the date, time and person answering the call or
 contact.
(E) A referral and information service is
 not hotline service, and is not intended to replace the crisis assistance
 function of a hotline service.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

7/1/2001, 7/1/2006, 5/19/2011

Rule 5122-29-27 
|
 Supplemental behavioral health services.

Effective:

January 1, 2018

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) "Supplemental behavioral health
 services" means services other than those specifically listed in this
 chapter. Supplemental behavioral health services may include representative
 payeeship, outreach, screening, education, and other supportive behavioral
 health services and may be offered by a variety of entities, including YMCAs,
 churches, children's cluster or family and children first.
(B) Supplemental behavioral health
 services approved by the board of alcohol, drug addiction, and mental health
 services and the department shall:
(1) Ensure that the
 provider or organization providing the service meets the appropriate standards
 or regulations under which they operate;
(2) Ensure that staff
 providing behavioral health services have participated in orientation or
 training regarding basic information about mental illness, emotional
 disturbance, and substance use disorders, and know how to obtain assistance
 from the behavioral health system if needed; and
(3) Develop mechanisms to
 solicit and receive feedback about the quality of the service from persons
 served.
(C) Providers furnishing supplemental
 behavioral health services shall receive certification to provide the
 service(s) according to either paragraph (A)(1)(f) of rule 
5122-25-03
 of the
 Administrative Code or paragraph (A)(1)(f) of rule 
5122-25-04
 of the
 Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

1/1/1991, 7/1/2009

Rule 5122-29-28 
|
 Intensive home based treatment (IHBT) service.

Effective:

March 1, 2022

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) In addition to the definitions in rule 
5122-24-01
 of the
 Administrative Code, the following definitions apply to this rule:
(1) "Caseload"
 means the individual cases open or assigned to each full-time equivalent IHBT
 staff.
(2) "Continued stay
 review" means a review of a child/adolescent's functioning to
 determine the need for further services to achieve or maintain service goals
 and objectives.
(3) "Crisis
 response" means the immediate access and availability, as clinically
 indicated, to the child/adolescent and family, which may include crisis
 stabilization services in accordance with rule 
5122-29-10
 of the Administrative
 Code, safety planning, and the alleviation of the presenting
 crisis.
(4) "Family" means any
 individual or caregiver related by blood or affinity whose close association
 with the person is the equivalent of a family relationship as identified by the
 person; including kinship and foster care. 
(5) "Home"
 means any family living arrangement including but not limited to biological,
 kinship, adoptive, foster home, and non-custodial families who have made a
 commitment to the child/adolescent.
(6) "Out-of-home
 placement" means any removal of the child/adolescent from his or her home.
 Planned respite, where the child's main residence remains their home, is
 not considered out-of-home placement.
(B) Intensive home based treatment
 (IHBT) service is a comprehensive behavioral health service provided to a
 child/adolescent with serious emotional disturbance (SED) and their family,
 designed to treat mental health conditions that significantly impair
 functioning. IHBT may also be utilized for the treatment of children and
 adolescents that have co-occurring substance use or neurodevelopmental needs,
 when these needs co-occur with a mental health condition. IHBT is provided for
 the purpose of preventing out of home placement or facilitating a successful
 transition back home. IHBT integrates trauma-informed and resilience-focused
 assessment, crisis response, individual and family psychotherapy, service and
 resource coordination, and rehabilitative skill development with the goal of
 either preventing the out-of-home placement or facilitating a successful
 transition back to home. These intensive, time-limited behavioral health
 services are provided in the child/adolescent's natural environment with
 the purpose of stabilizing and improving their behavioral health functioning as
 documented using the Ohio specific child and adolescent needs and strengths
 (CANS) tool.
The purpose of IHBT is to enable a
 child/adolescent with SED to function successfully in the least restrictive,
 most normative environment. IHBT services are culturally, ethnically, racially,
 developmentally and linguistically appropriate, and respect and build on the
 strengths of the child/adolescent and family's race, culture, and
 ethnicity.
(C) The following describes the activities and components of
 IHBT:
(1) IHBT is an intensive
 service that consists of multiple in person contacts per week with the
 child/adolescent and family, which includes collateral contacts related to the
 behavioral health needs of the child/adolescent as documented in the individual
 client record (ICR) as required by Chapter 5122-27 of the Administrative Code.
 IHBT can be provided via telehealth in accordance with rule 
5122-29-31
 of the
 Administrative Code. 
(2) IHBT is provided in
 the home, school, and community where the child/adolescent lives and
 functions;
(3) The frequency and
 modality of contacts may fluctuate based on the assessed needs and unique
 circumstances of the child, adolescent, and family;
(4) IHBT is strength-based and
 family-driven, with both the child/adolescent and family regarded as equal
 partners with the IHBT staff in all aspects of developing the service plan and
 service delivery;
(5) Provided by staff with a caseload
 that averages over any six month period and per full time equivalent
 staff:
(a) Twelve or less when provided by a team of two,
 or
(b) Six or less when provided by an individual
 staff.
(6) Immediate crisis response is
 available twenty-four hours a day seven days a week by the lead IHBT team
 member with back-up coverage available from other IHBT team members or the IHBT
 team supervisor. 
(7) Each child/adolescent and family
 receiving IHBT is assessed for risk and safety issues. A jointly written crisis
 and safety plan shall be developed that is provided to the child/adolescent and
 family;
(8) Collaboration is required to be
 performed with other child-serving agencies or systems, e.g., school, court,
 developmental disabilities, child welfare, and health care providers that are
 providing services to the child/adolescent and family, as well as family and
 community supports identified by the child/adolescent and family;
(9) The service activities and components
 are individually tailored to meet the needs of the child/adolescent and family.
 Appointments are made at a time that is convenient to the child/adolescent and
 family, including evenings and weekends if necessary;
(10) The service is time-limited, with
 length of stay matched to the presenting behavioral health needs of the
 child/adolescent and the family; and
(11) The IHBT team will collaboratively
 develop a plan to transition with each youth and family. The plan will include
 a focus on transition to other services, supports and providers for services
 and supports based on the individualized needs of the youth and family.
 
(D) Eligibility for IHBT will be determined by the IHBT
 team in collaboration with the youth and family and other cross systems
 partners by documenting the following criteria: 
(1) Is clinically
 determined to meet the "person with serious emotional disturbance"
 (SED) criteria in rule 
5122-24-01
 of the Administrative Code and the child or
 adolescent;
(a) Is under twenty-one years of age;
(b) Has a mental health need;
(c) Has an Ohio specific CANS assessment that indicates
 marked to severe behavioral/emotional impairment and at least one of the
 following:
(i) Impairment that seriously disrupts life functioning; or
 
(ii) Risk behaviors that are rated as actionable on the
 CANS.
(2) Meets one or more of
 the following criteria as documented in the ICR:
(a) Is at risk for out-of-home placement due to their behavioral
 health conditions;
(b) Has returned within the previous thirty days from an
 out-of-home placement or is transitioning back to their home within thirty
 days; or
(c) Requires a high intensity of behavioral health interventions
 to safely remain in or return home.
(E) The community mental health services or addiction
 services provider must demonstrate that the following staff requirements and
 qualifications are met:
(1) A minimum of two
 full-time equivalent staff provide the service. Services may be provided by a
 single person, or team of staff clearly sharing various responsibilities for
 the same child/adolescent and family. Each child/adolescent shall have a staff
 assigned with lead responsibility. 
(2) The provider must have a documented
 plan for clinical supervision of each team member.
(3) The IHBT supervisor
 shall have primary responsibility for providing supervision to the IHBT staff
 twenty-four hours a day, seven days a week. If the IHBT supervisor is
 unavailable, then supervision must be provided by staff qualified according to
 rule 
5122-29-30
 of the Administrative Code.
(F) The provider must demonstrate that each IHBT staff has
 an individualized training plan based on an assessment of their specific
 training needs. The following professional training and development criteria
 must be met:
(1) Each staff receives
 an assessment of initial training needs based on the skills and competencies
 necessary to provide IHBT service prior to providing IHBT service;
 and
(2) The agency shall have
 a written description of the skills and competencies required to provide IHBT
 service, which include, at a minimum, the following:
(a) Family systems;
(b) Risk assessment, crisis stabilization, and safety
 planning;
(c) Parenting skills and supports for children/adolescents with
 SED;
(d) Cultural competency;
(e) Intersystem collaboration with a focus on schools, courts,
 and child welfare:
(i) Knowledge of other
 systems;
(ii) System advocacy;
 and
(iii) Roles,
 responsibilities, and mandates of other child/adolescent-serving
 entities;
(f) Trauma-informed and resiliency-focused care;
(g) Educational and vocational functioning:
(i) Assessment and
 intervention strategies for resolving barriers to successful educational and
 vocational functioning;
(ii) Knowledge of special
 education laws; and
(iii) Strategies for
 developing positive home-school partnerships and connections;
(h) IHBT philosophy, including strength-based assessment and
 treatment planning; and
(i) Understanding the complex and interconnected range of
 symptoms and needs of children and adolescents, including co-occurring
 substance use disorders and developmental disabilities.
(G) The provider's training plan must include
 provisions for ongoing training specific to the identified training needs of
 the staff as it relates to the population served, including attention to
 cultural competency, changing demographics, new knowledge or research, and
 other areas identified by the agency.
(H) The provider must demonstrate that each IHBT supervisor
 receives training specific to the clinical and administrative supervision of
 the service.
(I) The provider shall obtain satisfactory fidelity
 reviews based on the provider's specific program modality every twelve
 months by an individual or organization external to the provider and designated
 by the Ohio department of mental health and addiction services (OhioMHAS),
 utilizing the IHBT individual provider model fidelity rating tool, version
 March 1, 2022 or the IHBT teamed-model fidelity rating tool, Version March 1,
 2022 available at www.medicaid.ohio.gov, or be licensed by an OhioMHAS approved
 evidence-based practice (EBP). The provider shall incorporate the results of
 the fidelity review into the provider's performance improvement program,
 if indicated.
(J) Intensive home based treatment service shall be
 supervised by staff who are qualified according to rule 
5122-29-30
 of the
 Administrative Code.
(K) IHBT shall be provided by persons with competency in
 the provision of mental health interventions through one of the following
 program configurations:
(1) At least one licensed
 practitioner and at least one other licensed practitioner who is authorized to
 provide services pursuant to rule 
5122-29-30
 of the Administrative Code and who
 are providing an evidence-based practice approved by OhioMHAS and are working
 in a program licensed by a national accreditation body or their delegate. Each
 practitioner must have their own caseload of clients.
For those providers who are delivering
 functional family therapy (FFT), the services may be delivered by an individual
 who is licensed to provide services pursuant to rule 
5122-29-30
 of the
 Administrative Code;
(2) At least two or more
 licensed or licensed-eligible practitioners who are eligible to provide
 services pursuant to rule 
5122-29-30
 of the Administrative Code and who are
 providing an evidence-supported practice approved by OhioMHAS. Each
 practitioner must have their own caseload of clients; or
(3) At least two
 practitioners eligible to provide services pursuant to rule 
5122-29-30
 of the
 Administrative Code. One of the practitioners must be licensed and the other
 either a qualified behavioral health specialist as defined in rule 
5122-29-30

 of the Administrative Code or a peer supporter who holds a valid and
 unrestricted certification from OhioMHAS issued in accordance with rule
 
5122-29-15.1
 of the Administrative Code. The peer supporter must be a family
 peer supporter or a youth peer supporter in accordance with rule 
5122-29-15.1

 of the Administrative Code. Peer supporters will also demonstrate competency
 working with children or adolescents with SED and their families. These
 practitioners must share a caseload of clients. 
(L) A
 provider of FFT who provides the service in accordance with the national
 evidence based model, found at
 https://www.fftllc.com/about-fft-training/clinical-model.html, does not need to
 meet requirements of paragraphs (C) and (E) to (H) of this rule. Any provider
 of FFT without meeting all other requirements of this rule will be certified as
 "IHBT-FFT Only."

Last updated March 1, 2022 at 8:33 AM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

1/1/2023

Rule 5122-29-29 
|
 Assertive community treatment (ACT).

Effective:

November 21, 2020

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Assertive community treatment (ACT)
 services are provided to an individual with a major functional impairment or
 behavior which present a high risk to the individual due to severe and
 persistent mental illness and which necessitate high service intensity. ACT
 services are also provided to the individual's family and other support
 systems. A client receiving ACT services may also have coexisting substance use
 disorder, physical health diagnoses, and/or mild intellectual disability. The
 service is available twenty-four hours a day, seven days a week.
(B) The purpose of ACT team services is
 to provide the necessary services and supports which maximize recovery, and
 promote success in employment, housing, and the community.
(C) ACT service providers shall employ
 one or more teams of practitioners which meet the minimum fidelity criteria as
 described in paragraphs (D) and (E) of this rule using the tool for measurement
 of ACT (TMACT) or dartmouth assertive community treatment scale
 (DACTS).
(D) For initial certification, each ACT
 team must achieve a minimum average overall fidelity score of 3.0 as determined
 by an independent validation entity recognized by the department. At its
 discretion, the Ohio department of mental health and addiction services
 (OhioMHAS) may lower the minimum score due to the COVID-19 state of emergency
 declared by the governor.
(E) For continuing certification, each ACT team must achieve and
 maintain a minimum average overall fidelity score of 4.0 within three years of
 initial certification as determined by an independent validation entity
 recognized by the department. At its discretion, OhioMHAS may lower the minimum
 score due to the COVID-19 state of aemergency declared by the
 governor.
(F) ACT teams shall have regular repeat fidelity reviews, no more
 than twelve months from the report date of the previous fidelity review, by an
 independent validation entity recognized by the department.
(G) At any time after certification of the ACT service, the
 department may request a new fidelity review based on specific findings of
 non-compliance with the rules in this chapter.
(H) For a minimum of ninety days, or until the client has stated
 their desire to discontinue ACT services, the ACT team shall attempt at least
 two contacts per month for a client who has discontinued ACT services
 unexpectedly. Such attempts and client response, if any, shall be documented in
 the individual client record.
(I) ACT shall be provided and supervised by staff who are
 qualified according to rule 
5122-29-30
 of the Administrative Code.

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

6/30/2023

Prior Effective Dates:

8/23/2007, 12/13/2007

Rule 5122-29-30 
|
 Eligible providers and supervisors.

Effective:

July 1, 2022

Promulgated Under:

119.03

PDF:

Download Authenticated PDF

(A) Individuals are eligible to provide
 and supervise within their professional scope of practice those services
 certified by the Ohio department of mental health and addiction services and
 listed and described in Chapter 5122-29 of the Administrative
 Code.
(B) Licensed, certified or registered
 individuals shall comply with current, applicable scope of practice,
 supervisory, and ethical requirements identified by appropriate licensing,
 certifying or registering bodies.
(C) Individuals providing the following
 services who are not otherwise credentialed by the Ohio chemical dependency
 professionals board; Ohio counselor, social worker and marriage and family
 therapist board; state medical board of Ohio; Ohio board of nursing, Ohio board
 of pharmacy, or Ohio board of psychology shall not provide any service or
 activity for which a credential by one of these boards is required by the
 Revised Code or Administrative Code and shall meet the requirements of a
 qualified behavioral health specialist in paragraph (D) of this
 rule:
(1) Mental health day
 treatment in accordance with rule 
5122-29-06
 of the Administrative
 Code.
(2) SUD case management
 services in accordance with rule 
5122-29-13
 of the Administrative
 Code.
(3) Mobile response and stabilization service in accordance
 with rule 
5122-29-14
 of the Adminstrative Code.
(4) Community psychiatric supportive
 treatment in accordance with rule 
5122-19-17
 of the Administrative
 Code.
(5) Therapeutic behavioral services and
 psychosocial rehabilitation in accordance with rule 
5122-19-18
 of the
 Administrative Code.
(6) Intensive home based treatment (IHBT)
 service in accordance with rule 
5122-29-28
 of the Administrative
 Code.
(7) Assertive community treatment (ACT)
 service in accordance with rule 
5122-29-29
 of the Administrative
 Code.
(D) Qualified behavioral health specialist.
(1) Qualified behavioral
 health specialist (QBHS) means an individual who has received training for or
 education in either mental health or substance use disorder competencies; and
 who has demonstrated, prior to or within ninety days of hire the minimum
 competencies in basic mental health or substance use disorder and recovery
 skills listed in this rule. The individual shall not otherwise be required to
 perform duties covered under the scope of practice according to Ohio
 professional licensure.
(2) Basic competencies
 for each QBHS shall include, at a minimum, an understanding of:
(a) Either mental illness or substance use disorder treatment
 and recovery;
(b) The community behavioral health system, social service
 systems, the criminal justice system, and other healthcare
 systems;
(c) Psychiatric and substance use disorder symptoms and their
 impact on functioning and behavior,
(d) How to therapeutically engage either with a person with
 mental illness or a person in substance use disorder treatment and
 recovery;
(e) Crisis response procedures; and,
(f) De-escalation techniques and an understanding of how the
 individual's own behavior can impact the behavior of others.
(3) The employing
 provider shall establish additional competency requirements, as appropriate,
 for each QBHS based upon the services to be performed, characteristics and
 needs of the persons to be served, and skills appropriate to the
 position.
(4) A QBHS must be
 supervised by an individual qualified to supervise the provisions of services
 within in their scope of practice.
(E) QBHS includes both a qualified mental health specialist and a
 care management specialist.

Last updated March 22, 2024 at 10:37 AM

Supplemental Information

Authorized By:

5119.36

Amplifies:

5119.36

Five Year Review Date:

7/1/2027

Prior Effective Dates:

7/1/2001, 3/4/2010, 7/1/2012, 8/1/2013