NH
New Hampshire
RENAMED
He-M 200 ↗
CMHC
IDD_COMMUNITY
PSYCH_FACILITY
The two versions are substantively identical; the only differences are minor formatting and typographical adjustments (e.g., line breaks, spacing, and punctuation styling) with no changes to definitions, timelines, procedural requirements, or staff obligations.
The two versions of He-M 600 are substantively identical; the only differences are minor formatting and punctuation adjustments (e.g., line breaks within sentences), with no changes to definitions, requirements, thresholds, procedures, or any compliance-relevant content.
The two versions are substantively identical in all content visible here — the only differences are minor formatting and whitespace changes (e.g., spacing around "eff" abbreviations in the Source note), with no changes to definitions, requirements, thresholds, or compliance obligations.
OH
Ohio
AMENDED
OAC 5122-26 ↗
CMHC
CRISIS_STABILIZATION
DETOX
MH_IOP
MH_PHP
MH_RESIDENTIAL
OTP
OUTPATIENT
PRTF
SUD_IOP
SUD_PHP
SUD_RESIDENTIAL
• **Scope of applicability expanded and restructured:** The old rule applied to providers funded by Medicaid, ADAMHS boards, or federal/block grants. The new rule applies broadly to any person or government entity providing or seeking to provide "certifiable services or supports" — a wider net that no longer ties applicability solely to funding source.
• **New explicit exemptions added:** Licensed individual practitioners (regardless of practice structure) and individuals working within accredited hospital outpatient clinics are now formally exempt from this chapter — a protection that did not exist in the previous version. Facilities should review whether any contracted or employed staff now fall outside chapter requirements.
• **FQHCs and FQHC look-alikes get a detailed, service-specific framework:** The new rule creates a two-tier system for FQHCs — those providing certain "out of scope" services (e.g., residential SUD, crisis intervention, peer support, ACT) must comply with this chapter, while those providing only "in scope" services (e.g., general services, referral, consultation, including MAT and psychotropic prescribing) are exempt. This is entirely new and requires FQHCs to assess each service line individually.
• **Governing body requirements streamlined for nonprofits:** The board orientation provision for new members no longer requires documenting information about "conflict of interest" policies as a bylaw element; conflict-of-interest language is simplified to a flat "ban." The previous requirement to offer community input opportunities (consumers, families, diverse demographics) in governance is no longer explicitly listed — facilities should verify whether this obligation survives elsewhere in updated rules.
• **Performance improvement plan replaces quality assurance plan:** Quarterly board meetings must now include approval of a "performance improvement plan" rather than a "quality assurance plan" — facilities need to update their board meeting agendas, minutes templates, and internal plan titles to reflect this terminology change.
AMENDED
OAC 5122-27 ↗
CRISIS_STABILIZATION
DETOX
MH_PHP
MH_RESIDENTIAL
OTP
OUTPATIENT
SUD_RESIDENTIAL
• **Applicability rule completely restructured:** The old rule used a funding-based trigger (board/block grant funding) plus service-type lists. The new rule uses a broader "certifiable services or supports" standard — if you provide or seek to provide any certifiable service, these rules apply to you, regardless of funding source. This expands who is covered.
• **Peer support services exemption is now conditional:** Previously, peer recovery services were flatly exempt from this chapter. Under the new rule, peer support services are only exempt if they are NOT part of a clinical treatment team AND NOT included in a client's individualized treatment plan (ITP). If peer support is integrated into clinical care or the ITP, full ICR requirements now apply — a significant operational change for facilities using peer support staff.
• **New FQHC/FQHC look-alike standard added:** The previous rule had no specific provisions for federally-qualified health centers. The new rule creates a detailed two-track system: FQHCs providing services designated "out of scope" must comply with this chapter; FQHCs providing services designated "in scope, other activities" (including general services, MAT, and psychotropic prescribing) are exempt. FQHCs must now determine their service designation status to know which documentation rules apply.
• **Exempted services must still follow their own documentation rules:** The new rule explicitly states (paragraph C) that providers exempt from this chapter must still comply with the documentation requirements in their specific Chapter 5122-29 service rule. Behavioral health hotline and prevention services also now have an additional obligation under new rule 5122-27-02.1.
• **Individual client record rule renumbered and restructured:** Rule 5122-27-02 has been substantially rewritten (effective August 1, 2026 vs. April 1, 2016), and a new companion rule 5122-27-02.1 has been created to handle modified documentation requirements for certain services — review 5122-27-02.1 separately to identify any new documentation obligations.
AMENDED
OAC 5122-25 ↗
CMHC
CRISIS_STABILIZATION
DETOX
MH_IOP
MH_PHP
MH_RESIDENTIAL
OTP
OUTPATIENT
SUD_IOP
SUD_PHP
SUD_RESIDENTIAL
• **Scope of applicability completely restructured:** The old rule applied based on funding source (Medicaid, ADAMH board, block grants) or service type. The new rule applies broadly to any person or government entity providing "certifiable services or supports," regardless of funding source, and explicitly includes opioid treatment programs, Class 1 residential facilities, and ADAMH boards approved to provide certifiable services.
• **New FQHC/FQHC look-alike framework added:** The new rule creates a detailed two-track system for Federally Qualified Health Centers. FQHCs providing services designated "out of scope" (18 specific service types listed, including residential, crisis, CPST, ACT, peer support, etc.) ARE subject to certification requirements. FQHCs providing services designated "in scope" (general services, consultation, referral/information, MAT, and psychotropic prescribing) are NOT subject to certification requirements.
• **Exemptions reorganized and clarified:** The two existing exemptions (licensed health care professionals and hospital outpatient clinic employees/contractors) are retained but moved into a dedicated "Exemptions" section (paragraph B). The reference to the director is updated from "director of mental health and addiction services" to "director of behavioral health," reflecting the agency rename.
• **Voluntary certification and driver intervention program provisions removed:** The old rule explicitly covered providers voluntarily seeking certification (A)(5) and driver intervention programs (A)(3) as standalone applicability categories; these are absorbed into the broader "certifiable services or supports" framework rather than called out separately.
• **Practical impact:** Facilities that are FQHCs or work alongside FQHCs must now carefully determine whether each behavioral health service they provide is classified "in scope" or "out of scope" under their FQHC designation, as this directly determines whether OAC 5122-25 certification requirements apply to those services.
AMENDED
OAC 5122-26 ↗
CMHC
CRISIS_STABILIZATION
DETOX
MH_IOP
MH_PHP
MH_RESIDENTIAL
OTP
OUTPATIENT
PRTF
SUD_IOP
SUD_PHP
SUD_RESIDENTIAL
• **Scope of applicability expanded and restructured:** The old rule applied to providers funded by Medicaid, ADAMHS boards, or federal/block grants. The new rule applies broadly to any person or government entity providing or seeking to provide "certifiable services or supports" — a wider net that no longer hinges solely on funding source.
• **New explicit exemptions added:** Licensed individual practitioners (regardless of practice structure) and individuals working within accredited hospital outpatient clinics are now formally exempt from this chapter — a protection that did not exist in the previous version. Facilities should review whether any contracted or employed staff now fall outside chapter requirements.
• **FQHCs and FQHC look-alikes get a detailed, service-specific framework:** The new rule creates a two-tier system for FQHCs — those providing "out of scope" services (18 specific service types listed, including crisis intervention, peer support, residential SUD, and CPST) are subject to this chapter; those providing only "in scope" services (general services, consultation, referral/information, including MAT and psychotropic prescribing) are exempt. This is entirely new and requires FQHCs to assess each service line individually.
• **Governing body requirements streamlined for nonprofits:** The board orientation requirement for new members no longer requires covering "conflict of interest" as a written bylaw topic (it remains a ban, but the bylaw requirement for orientation on it was removed). The "performance improvement plan" replaces the prior "quality assurance plan" as the document requiring board approval — facilities must update their board meeting agendas and documentation accordingly.
• **Language shift from "mental health and addiction services" to "certifiable services or supports":** This terminology change throughout the rule reflects a broader regulatory framework and may affect how facilities describe and document the services they are certified to provide.
RENAMED
OAC 5122-29 ↗
CMHC
CRISIS_STABILIZATION
DETOX
MH_PHP
OUTPATIENT
PRTF
SUD_RESIDENTIAL
The two versions provided appear to be identical in substantive content — no requirements, definitions, timelines, staff ratios, or other compliance-relevant provisions were changed between the previous and current versions.
AMENDED
OAC 5122-25 ↗
CMHC
CRISIS_STABILIZATION
DETOX
MH_IOP
MH_PHP
MH_RESIDENTIAL
OTP
OUTPATIENT
SUD_IOP
SUD_PHP
SUD_RESIDENTIAL
• **Scope of applicability completely restructured:** The old rule applied based on funding source (Medicaid, ADAMH board, block grants) or service type. The new rule applies broadly to any person or government entity providing "certifiable services or supports," including OTP operators and Class One residential facility operators — funding source is no longer the trigger for coverage.
• **New FQHC/FQHC look-alike framework added:** The updated rule creates a detailed two-track system for FQHCs. Services provided "out of scope" of the FQHC designation (e.g., residential/withdrawal management, crisis intervention, CPST, ACT, peer support) ARE subject to certification requirements. Services provided "in scope" as "other activities" (general services, consultation, referral/information, MAT, psychotropic prescribing) are NOT subject to certification — this is a brand-new compliance distinction that FQHCs must actively manage.
• **Exemptions clarified and expanded:** The old rule buried exemptions within the applicability section. The new rule consolidates exemptions into a dedicated paragraph (B) and adds a third exemption category: any person or entity specifically exempted by another individual rule — giving the department flexibility to carve out additional exemptions rule-by-rule going forward.
• **Voluntary certification removed:** The previous rule explicitly allowed providers to voluntarily seek certification (paragraph A(5)). That provision does not appear in the new rule, which may affect providers who sought certification purely for credentialing or funding purposes without a legal obligation to do so.
• **Rule 5122-25-02 completely replaced:** What was previously the accreditation/deemed status rule is now the initial certification application procedure rule — the accreditation/deemed status content has been moved elsewhere. Facilities relying on deemed status provisions must locate the new rule where that content now lives.
OR
Oregon
• This is a brand-new rule adoption (effective 08/01/2026) — the previous version of Division 37 had no substantive rules under it; OHA has now added three new rule sections (0200, 0210, 0220) establishing a complete compliance framework for behavioral health capital grants.
• Any facility or organization receiving OHA grant funds to acquire, build, or renovate a Behavioral Health Facility or Community-Based Structured Housing must now execute and **record a Declaration of Restrictive Covenants (DRC) against the property before any construction or improvement work begins** — the grantee pays all recording fees.
• The DRC imposes a use restriction tied to funding amount: **5 years** (under $500K), **10 years** ($500K–$1.49M), **15 years** ($1.5M–$3.99M), or **20 years** ($4M+) — meaning the property must continue to be used for its intended behavioral health purpose for that entire period, regardless of ownership changes.
• Grantees must submit **annual reports** for the full duration of the use restriction period and must **notify OHA before any sale, transfer, or refinancing** of the property; the use restriction automatically binds any future owners or buyers.
• **Tribal exemption:** Federally recognized tribes are exempt from the DRC requirement if the capital project is on tribal land or the land/building is tribally owned or being purchased by the tribe.
• This is a brand-new rule adoption (effective 08/01/2026) — the previous version of Division 37 had no substantive rules under this citation; OHA has now added three new rule sections (0200, 0210, 0220) establishing a complete compliance framework for behavioral health capital grants.
• Any facility or organization receiving OHA grant funds for acquiring, constructing, or renovating a Behavioral Health Facility or Community-Based Structured Housing must now execute and **record a Declaration of Restrictive Covenants (DRC) against the property before capital work begins** — failure to do so before breaking ground is a compliance violation.
• The DRC imposes a **use restriction tied to funding amount**: under $500K = 5 years; $500K–$1.49M = 10 years; $1.5M–$3.99M = 15 years; $4M or more = 20 years. Grantees must operate the property for its intended behavioral health purpose for the entire restriction period, and the restriction **runs with the land and binds future owners**.
• Grantees must submit **annual compliance reports** for the full duration of the use restriction period and must **notify OHA before any sale, transfer, or refinancing** of the property — these are ongoing documentation obligations that facilities need to build into their administrative calendars.
• The DRC requirement does **not apply** if the grantee is a federally recognized tribe and the project is on tribal land or involves tribally owned property.