OAR 410-172-0695
Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT)

(1) Before providing services, providers of IIBHT for youth shall meet qualifications, credentialing, or licensing standards and competencies described in OAR 309-019-0125 (Specific Staff Qualifications and Competencies), OAR 309-019-0130 (Personnel Documentation, Training, and Supervision), and OARs 410-180-0300 (Purpose) - 0380 for the following services:
(a) Child Psychiatric Services:
(A) A Board Eligible or Certified Child and Adolescent Psychiatrist; or
(B) A Psychiatric Nurse Practitioner (PNP) under the weekly consultation and quarterly supervision of a Board Eligible of Certified Child and Adolescent Psychiatrist;
(b) Skills Training;
(c) Individual Therapy;
(d) Family Therapy;
(e) In-home Proactive Support and Crisis Response available 24 hours each day;
(f) Case Management; and
(g) Peer Delivered Services
(2) IIBHT services as defined in OAR 309-019-0167 (Intensive In-Home Behavioral Health Treatment (IIBHT) for Children) are intended as an outcome-based, transitional, and episodic period of care to provide service and supports in a natural environment that allows the individual and their family or caregivers to successfully remain or reintegrate into their home, in school and community.
(3) Participation in IIBHT services shall not be contingent upon successful completion of, or participation in, any other behavioral health treatment services.
(4) A Youth and Family shall not be required to participate in other services or supports, including Wraparound, to receive IIBHT.
(5) Youth are eligible for IIBHT services in congregate care settings including Behavioral Rehabilitation Services or Developmental Disability Group Home.
(6) Youth are considered for IIBHT services without regard to race, ethnicity, gender, gender identity, gender presentation, sexual orientation, religion, creed, national origin, age, intellectual and/or developmental disability, IQ score, or physical disability.
(7) To be eligible for IIBHT services, Youth ages zero through 20 years of age shall:
(a) Be determined by the Department of Human Services (Department) to meet Title XIX Medicaid eligibility criteria. The Department shall complete Title XIX Medicaid eligibility determinations according to OAR chapter 461, division 135, division 140, and division 155 rules; and OAR chapter 410 division 200 and division 120 rules.
(b) Receive a mental health assessment, using an OHA approved assessment tool and completed by a licensed provider or a Qualified Mental Health Professional (QMHP) as described in OAR 309-019-0167 (Intensive In-Home Behavioral Health Treatment (IIBHT) for Children);
(c) Display Intensive behavioral health needs, which shall include:
(A) Multiple behavioral health diagnoses; and
(B) Impact on multiple life domains (school, home, community) effected as identified on the OHA approved assessment; and
(C) Significant safety risks or concerns; or
(D) Are at risk of out-of-home treatment or placement; or
(E) Are transitioning home from an out-of-home treatment or placement.

(8) The IIBHT provider shall administer an OHA approved outcome measure tool:

(a) For each youth enrolled in IIBHT services within 14 calendar days of entry; and
(b) Within 14-calendar days prior to discharge from IIBHT services.
(9) IIBHT providers shall enter information from the OHA approved outcome measurement tool into an OHA approved data system within the seven days of completion of the OHA approved outcome measurement tool. Information entered into the OHA approved data system shall be complete and document measurable outcomes, compliant with OAR 3090-019-0167, IIBHT program standards.
(10) IIBHT services require a service plan developed with the Youth and Family or Caregiver.
(11) IIBHT services providers shall document services as described in OAR 410-120-1360 (Requirements for Financial, Clinical and Other Records) Requirements for Financial, Clinical and Other Records and OAR 410-0620 Documentation Standards. The Division may consider incomplete or insufficient documentation as required by OAR 410-172-0620 (Documentation Standards) as non-existent records and recoup payments.
(12) IIBHT services providers shall retain clinical records for seven years and financial and other records for at least five years as described in 410-120-1360 (Requirements for Financial, Clinical and Other Records) Requirements for Financial, Clinical and Other Records. The Division may consider incomplete or insufficient documentation above as non-existent records and recoup payments.
(13) Qualified IIBHT services provider shall work with all providers and the Youth and their family to implement a 30-day transition plan, in accordance with OAR 309-019-0167 (Intensive In-Home Behavioral Health Treatment (IIBHT) for Children), prior to the end of IIBHT services which includes:
(a) Work with the Youth and Family or Caregiver and other service providers to establish criteria for a successful transition;
(b) Development of a post IIBHT crisis and safety plan, which includes:
(A) Prevention strategies;
(B) Action steps to engage prevention strategies;
(C) Specific roles and responsibilities each person will have to manage crisis; and
(D) Communication protocols.
(c) A plan for ongoing maintenance of skills and progress of IIBHT services;
(d) Develop connections to post-IIBHT resources and supports, including a warm handoff, as defined in OAR 309-032-0860 (Definitions), to formal and natural supports; and
(e) Communication about how to access IIBHT services, in the future, as needed.
(14) IIBHT services provider shall work with all providers to develop a 30-day transition plan that is agreed and consented to by the youth and their family and submit to the division or their contractor with the request for prior authorization.
(15) IIBHT intake shall be offered no more than three calendar days after receipt of prior authorization.
(16) The Division shall reimburse authorized IIBHT services that are medically appropriate as described in OAR 410-172-0639 and identified on the behavioral health fee schedule described in OAR 410-172-0640 (Behavioral Health Services Fee Schedule).
(17) To be reimbursed for IIBHT services, providers shall comply with Medicaid billing and payment rules described in OAR 410-120-1280 (Billing) through 1340.

Source: Rule 410-172-0695 — Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT), https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-172-0695.

410–172–0600
Acronyms and Definitions 410–172–0610
Provider Enrollment 410–172–0620
Documentation Standards 410–172–0630
Medically Appropriate 410–172–0640
Behavioral Health Services Fee Schedule 410–172–0650
Prior Authorization 410–172–0660
Rehabilitative Behavioral Health Services 410–172–0670
Substance Use Disorder Treatment Services 410–172–0680
Residential Treatment Services for Children 410–172–0690
Admission Procedure for Residential Treatment Services for Children 410–172–0695
Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT) 410–172–0705
Residential Rate Standardization 410–172–0710
Residential Personal Care 410–172–0720
Prior Authorization and Re-Authorization for Residential Treatment 410–172–0730
Payment Limitations for Behavioral Health Services 410–172–0745
Exception Criteria for Facial Gender Confirmation Surgery (FGCS) 410–172–0760
Applied Behavior Analysis 410–172–0770
Individual Eligibility for Applied Behavioral Analysis Treatment 410–172–0780
Behavioral Health Personal Care Attendant Program 410–172–0790
Eligibility for Behavioral Health Personal Care Attendant Services 410–172–0800
Personal Care Attendant Employer-Employee Relationship 410–172–0810
Personal Care Attendant Qualifications 410–172–0820
Provider Termination 410–172–0830
Personal Care Attendant Service Assessment, Authorization, and Monitoring 410–172–0840
Personal Care Attendant Payment Limitations 410–172–0850
Telemedicine for Behavioral Health 410–172–0860
Billing for Dual Eligible Individuals
Last Updated

Jun. 8, 2021

Rule 410-172-0695’s source at or​.us