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OREGON HEALTH AUTHORITY,

ADDICTIONS AND MENTAL HEALTH DIVISION: MENTAL HEALTH SERVICES

 

DIVISION 35
RESIDENTIAL CARE FACILITIES FOR MENTALLY OR EMOTIONALLY DISTURBED PERSONS

309-035-0100
Purpose and Scope
(1) Purpose. These rules prescribe
standards by which the Addictions and Mental Health Division of the Oregon Health
Authority approves residential treatment facilities for adults with mental or emotional
disorders. The standards promote the well-being, health and recovery of adults with
mental or emotional disorders through the availability of a wide range of residential
service options. They prescribe how services will be provided in safe, secure and
homelike environments that recognize the dignity, individuality and right to self-determination
of each resident.
(2) Scope. These rules apply
to residential treatment facilities for six to 15 residents and to residential treatment
facilities serving 16 or more residents. Where standards differ based on the number
of residents in a facility, the rules prescribe different requirements.
Stat. Auth.: ORS 413.042 &
443.450

Stats. Implemented: ORS 443.400
- 443.465 & 443.991

Hist.: MHD 9-1984(Temp), f.
& ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert.
ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef.
6-12-08; MHS 10-2011(Temp), f. & cert. ef. 12-5-11 thru 5-31-12; MHS 5-2012,
f. 5-3-12, cert. ef. 5-4-12
309-035-0105
Definitions
As used in these rules the following
definitions apply:
(1) "Abuse" includes but is
not limited to:
(a) Any death caused by other
than accidental or natural means or occurring in unusual circumstances;
(b) Any physical injury caused
by other than accidental means, or that appears to be at variance with the explanation
given of the injury;
(c) Willful infliction of physical
pain or injury;
(d) Sexual harassment or exploitation
including, but not limited to, any sexual contact between an employee of a community
facility or community program, or provider, or other caregiver and the adult. For
situations other than those involving an employee, provider, or other caregiver
and an adult, sexual harassment or exploitation means unwelcome verbal or physical
sexual contact including requests for sexual favors and other verbal or physical
conduct directed toward the adult;
(e) Neglect that leads to physical
harm through withholding of services necessary to maintain health and well being;
(f) Abuse does not include spiritual
treatments by a duly accredited practitioner of a recognized church or religious
denomination when voluntarily consented to by the individual.
(2) "Administrator" means the
person designated by the licensee as responsible for the daily operation and maintenance
of the facility.
(3) "Adult" means an individual
18 years of age or older.
(4) "Aid to Physical Functioning"
means any special equipment ordered for a resident by a Licensed Medical Professional
(LMP) or other qualified health care professional which maintains or enhances the
resident's physical functioning.
(5) "Applicant" means the person(s)
or entity, including the Division, who owns or maintains and operates the facility
and is applying for the license.
(6) "Approved" means authorized
or allowed by the Division.
(7) “Authority”
means the Oregon Health Authority.
(8) "Building Code" means the
Oregon Structural Specialty Code adopted by the Building Codes Division of the Oregon
Department of Consumer and Business Services.
(9) "Care" means services such
as supervision; protection; assistance with activities of daily living such as bathing,
dressing, grooming or eating; management of money; transportation; recreation; and
the providing of room and board.
(10) “Caregiver”
means an employee, program staff, provider or volunteer of a licensed Residential
Treatment Facility (RTF).
(11) "Community Mental Health
Program (CMHP)" means the organization of all or a portion of services for persons
with mental or emotional disorders, operated by, or contractually affiliated with,
a local mental health authority, operated in a specific geographic area of the state
under an intergovernmental agreement or direct contract with the Division.
(12) "Contract" means a formal
written agreement between the community mental health program, Oregon Health Plan
contractor or the Division and a Residential Treatment Facility (RTF) owner. (13)
"Crisis-Respite Services" means the provision of services to individuals for up
to 30 days. Individuals receiving crisis-respite services are RTF residents.
(14) "DSM" means the "Diagnostic
and Statistical Manual of Mental Disorders (DSM-IV)," published by the American
Psychiatric Association.
(15) “Deputy Director”
means the Deputy Director of the Addictions and Mental Health Division of the Oregon
Health Authority.
(16) "Division" means the Addictions
and Mental Health Division of the Oregon Health Authority.
(17) "Direct Care Staff Person"
means an employee responsible for providing services to residents.
(18) "Emergency Admission" means
an admission to an RTF made on an urgent basis due to the pressing service needs
of the individual.
(19) “Employee”
means a person who is employed by a licensed Residential Treatment Facility (RTF),
who receives wages, a salary, or is otherwise paid by the RTF for providing the
service. The term also includes employees of other providers delivering direct
services to clients of RTFs.
(20) "Evacuation Capability"
means the ability of occupants, including residents and staff as a group, to either
evacuate the building or relocate from a point of occupancy to a point of safety
as defined in the Oregon Structural Specialty Code. The category of evacuation capability
is determined by documented evacuation drill times or scores on National Fire Protective
Association (NFPA) 101A 2000 edition worksheets. There are three categories of evacuation
capability:
(a) Impractical (SR-2): A group,
even with staff assistance, that cannot reliably move to a point of safety in a
timely manner, determined by an evacuation capability score of five or greater or
with evacuation drill times in excess of 13 minutes.
(b) Slow (SR-1): A group that
can move to a point of safety in a timely manner, determined by an evacuation capability
score greater than 1.5 and less than five or with evacuation drill times over three
minutes but not in excess of 13 minutes.
(c) Prompt: A group with an
evacuation capability score of 1.5 or less or equivalent to that of the general
population or with evacuation drill times of three minutes or less. The Division
is authorized to determine evacuation
capability for RTFs in accordance with the NFPA 101A 2000 edition. Facilities that
are determined to be "Prompt" may be used in Group R occupancies classified by the
building official, in accordance with the building code.
(21) "Facility" means one or more buildings
and adjacent grounds on contiguous properties that are used in the operation of
a Residential Treatment Facility.
(22) "Fire Code" means the Oregon
Fire Code as adopted by the State of Oregon Fire Marshal.
(23) “Individual”
means any person being considered for or receiving residential and other services
regulated by these rules.
(24) "Licensed Medical Professional
(LMP)" means a person who meets the following minimum qualifications as documented
by the Local Mental Health Authority (LMHA) or designee:
(a) Holds at least one of the
following educational degrees and valid licensures:
(A) Physician licensed to practice
in the State of Oregon;
(B) Nurse Practitioner licensed
to practice in the State of Oregon; or
(C) Physician's Assistant licensed
to practice in the State of Oregon; and
(b) Whose training, experience
and competence demonstrate the ability to conduct a Comprehensive Mental Health
Assessment and provide medication management.
(25) "Licensee" means the person(s)
or entity legally responsible for the operation of the facility to which the Division
has issued a license.
(26) "Local Mental Health Authority
(LMHA)" means the county court or board of county commissioners of one or more counties
who choose to operate a CMHP or MHO; or, if the county declines to operate or contract
for all or part of a CMHP or MHO, the board of directors of a public or private
corporation which contracts with the Division to operate a CMHP or MHO for that
county.
(27) "Medication" means any
drug, chemical, compound, suspension, or preparation in suitable form for use as
a curative or remedial substance either internally or externally by any person.
(28) "Mental or Emotional Disorder"
means a primary Axis I or Axis II DSM diagnosis, other than mental retardation or
a substance abuse disorder that limits an individual's ability to perform activities
of daily living.
(29) "Mental Health Assessment"
means a determination by a Qualified Mental Health Professional (QMHP) of the client's
need for mental health services. It involves collection and assessment of data pertinent
to the client's mental health history and current mental health status obtained
through interview, observation, testing, and review of previous treatment records.
It concludes with determination of a DSM diagnosis or other justification of priority
for mental health services, or a written statement that the person is not in need
of community mental health services.
(30) "Mental Health Organization
(MHO)" means an approved organization that provides most mental health services
through a capitated payment mechanism under the Oregon Health Plan. MHOs may be
fully capitated health plans, community mental health programs, private mental health
organizations or combinations thereof.
(31) “Mistreatment”
means the following behaviors, displayed by an employee, program staff, provider
or volunteer of an RTF when directed toward an individual:
(a) “Abandonment”
means desertion or willful forsaking when the desertion or forsaking results in
harm or places the individual at a risk of serious harm.
(b) “Financial Exploitation”
means:
(A) Wrongfully taking the assets,
funds, or property belonging to or intended for the use of an individual.
(B) Alarming an individual by
conveying a threat to wrongfully take or appropriate money or property of the individual
if the individual would reasonably believe that the threat conveyed would be carried
out.
(C) Misappropriating, misusing,
or transferring without authorization any money from any account held jointly or
singly by an individual.
(D) Failing to use the income
or assets of an individual effectively for the support and maintenance of the individual.
“Effectively” means use of income or assets for the benefit of the
individual.
(c) “Involuntary Restriction”
means the involuntary restriction of an individual for the convenience of a caregiver
or to discipline the individual. Involuntary restriction may include but is not
limited to placing restrictions on an individual’s freedom of movement by
restriction to his or her room or a specific area, or restriction from access to
ordinarily accessible areas of the facility, residence or program, unless agreed
to by the treatment plan. Restriction may be permitted on an emergency or short
term basis when an individual’s presence would pose a risk to health or safety
to the individual or others.
(d) “Neglect” means
active or passive failure to provide the care, supervision, or services necessary
to maintain the physical and mental health of an individual that creates a significant
risk of harm to an individual or results in significant mental injury to an individual.
Services include but are not limited to the provision of food, clothing, medicine,
housing, medical services, assistance with bathing or personal hygiene, or any other
services essential to the well-being of the individual.
(e) “Verbal Mistreatment”
means threatening significant physical harm or emotional harm to an individual through
the use of:
(A) Derogatory in inappropriate
names, insults, verbal assaults, profanity or ridicule.
(B) Harassment, coercion, punishment,
deprivation, threats, implied threats, intimidation, humiliation, mental cruelty,
or inappropriate sexual comments.
(C) A threat to withhold services
or supports, including an implied or direct threat of termination of services.
“Services” include but are not limited to the provision of food, clothing,
medicine, housing, medical services, assistance with bathing or personal hygiene,
or any other services essential to the well-being of an individual.
(D) For purposes of this definition,
verbal conduct includes but is not limited to the use of oral, written, or gestured
communication that is directed to an individual or within their hearing distance
of sight, regardless of their ability to comprehend. In this circumstance the assessment
of the conduct is based on a reasonable person standard.
(E) The emotional harm that
can result from verbal abuse may include but is not limited to anguish, distress
or fear.
(f) “Wrongful Restraint”
means:
(A) A wrongful use of a physical
or chemical restraint excluding an act of restraint prescribed by a licensed physician
pursuant to OAR 309-033-0730.
(B) Wrongful restraint does
not include physical emergency restraint to prevent immediate injury to an individual
who is in danger of physically harming himself or herself or others, provided that
only the degree of force reasonably necessary for protection is used for the least
amount of time necessary.
(32) "Nursing Care" means the
practice of nursing by a licensed nurse, including tasks and functions that are
delegated by a registered nurse to a person other than a licensed nurse, which are
governed by ORS Chapter 678 and rules adopted by the Oregon State Board of Nursing
in OAR Chapter 851.
(33) "Owner" means the person(s)
or entity, including the Division, that is legally responsible for the operation
of the facility.
(34) "P.R.N. (pro re nata) Medications
and Treatments" means those medications and treatments which have been ordered to
be given as needed.
(35) "Program" means the Residential
Treatment Facility and may refer to the owner, staff and/or services as applicable
to the context.
(36) “Program
Staff” means an employee or person who, by contract with an RTF, provides
a service and who has the applicable competencies, qualifications, and certification,
required by the Integrated Services and Supports Rule (ISSR), OAR 309-032-1500 through
309-032-1565 to provide the service.
(37) "Progress Notes" means the notations
in the resident record documenting significant information concerning the resident
and summarizing progress made relevant to the objectives outlined in the residential
service plan.
(38) "Protection" means the
necessary actions taken by the program to prevent abuse, mistreatment, or exploitation
of the residents, to prevent self-destructive acts, and to safeguard residents,
property and funds.
(39) “Provider”
means a qualified individual or an organizational entity operated by or contractually
affiliated with a community mental health program, or contracted directly with the
Division for the direct delivery of mental health services and supports to adults
receiving residential and supportive services in an RTF.
(40) "Resident" means any adult
residing in a facility who receives services on a 24-hour basis, except as excluded
under ORS 443.400.
(41) "Residential Service Plan"
means an individualized, written plan outlining the care and treatment to be provided
to a resident in or through the facility based upon an individual assessment of
care and treatment needs. The residential service plan may be a section or subcomponent
of the individual's overall mental health treatment plan when the RTF is operated
by a mental health service agency that provides other services to the resident.
(42) "Residential Treatment
Facility (RTF)" means a facility that is operated to provide services on a 24-hour
basis for six or more residents.
(43) "Restraints" means any
chemical or physical methods or devices that are intended to restrict or inhibit
the movement, functioning, or behavior of a resident.
(45) "Seclusion" means placing
an individual in a locked room. A locked room includes a room with any type of door
locking device, such as a key lock, spring lock, bolt lock, foot pressure lock,
or physically holding the door shut.
(46) "Secure Residential Treatment
Facility (SRTF)" means any Residential Treatment Facility, or portion thereof, that
restricts a resident's exit from the facility or its grounds through the use of
approved locking devices on resident exit doors, gates or other closures. Such locking
locking devices will be installed in accordance with Building Code requirements.
(47) "Services" means the care
and treatment provided to residents as part of the Residential Treatment Facility
plan.
(48) "Supervision" means the
daily observation, and monitoring of residents by direct care staff or oversight
of staff by the administrator or administrator's designee, as applicable to the
context.
(49) "Termination of Residency"
means the time at which the resident ceases to live in the RTF, and includes the
transfer of the resident to another facility, but does not include absences from
the facility for the purpose of taking a planned vacation, visiting family or friends,
or receiving time-limited medical or psychiatric treatment.
(50) "Treatment" means a planned,
individualized program of medical, psychological or rehabilitative procedures, experiences
and activities consistent with ORS 443.400(12).
(51) “Volunteer”
means a person who provides a service or who takes part in a service provided to
individuals receiving supportive services in an RTF or other provider, and who is
not a paid employee of the RTF or other provider. The services must be non-clinical
unless the person has the required credentials to provide a clinical service.
Stat. Auth.: ORS 413.042 &
443.450

Stats. Implemented: ORS 443.400
- 443.465 & 443.991

Hist.: MHD 9-1984(Temp), f.
& ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert.
ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 6-2007(Temp), f. & cert.
ef. 5-25-07 thru 11-21-07; MHS 13-2007, f. & cert. ef. 8-31-07; MHS 4-2008,
f. & cert. ef. 6-12-08; MHS 10-2011(Temp), f. & cert. ef. 12-5-11 thru 5-31-12;
MHS 5-2012, f. 5-3-12, cert. ef. 5-4-12
309-035-0110
Licensing
(1) License Required. The Division will license any facility that meets the definition of a Residential Treatment Facility and serves adults with a mental or emotional disorder. In the case of a facility serving another category of residents in addition to adults with a mental or emotional disorder, the Department responsible for licensure will be determined by the Assistant Director. No person or governmental unit acting individually or jointly with any other person or governmental unit will establish, maintain, manage, or operate a Residential Treatment Facility without a license issued by the Division.
(2) Initial Application. An application for a license will be accompanied by the required fee and submitted to the Division using the forms or format required by the Division. The following information will be required in the application:
(a) Full and complete information as to the identity and financial interest of each person, including stockholders, having a direct or indirect ownership interest of five percent or more in the facility and all officers and directors in the case of facilities operated or owned by a corporation.
(b) Name and resume of the administrator of the facility;
(c) Location (street address) of the facility and mailing address;
(d) Maximum number of residents to be served at any one time, their age range and evacuation capability;
(e) Proposed annual budget identifying sources of revenue and expenses;
(f) Signed criminal record authorizations for all persons involved in the operation of the RTF who will have contact with the residents;
(g) A complete set of policies and procedures;
(h) Facility plans and specifications; and
(i) Such other information as the Division may reasonably require.
(3) Plans and Design Approval. A complete set of plans and specifications will be submitted to the Division at the time of initial application, whenever a new structure or addition to an existing structure is proposed, or when significant alterations to an existing facility are proposed. Plans will meet the following criteria:
(a) Plans will be prepared in accordance with the Building Code and requirements of OAR 309-035-0125;
(b) Plans will be to scale and sufficiently complete to allow full review for compliance with these rules; and
(c) Plans will bear the stamp of an Oregon licensed architect or engineer when required by the Building Code.
(4) Necessary Approvals. Prior to approval of a license for a new or renovated facility, the applicant will submit the following to the Division:
(a) One copy of written approval to occupy the facility issued by the city or county building codes authority having jurisdiction;
(b) One copy of the fire inspection report from the State Fire Marshal or local jurisdiction indicating that the facility complies with the Fire Code;
(c) When the facility is not served by an approved municipal water system, one copy of the documentation indicating that the state or county health agency having jurisdiction has approved the water supply in accordance with OAR chapter 333, Health Services rules to public water systems.
(d) When the facility is not connected to an approved municipal sewer system, one copy of the sewer or septic system approval from the Department of Environmental Quality or local jurisdiction.
(5) Required Fees. The fee for each Residential Treatment Facility license application is $60. No fee is required in the case of a governmentally operated Residential Treatment Facility.
(6) Renewal Application. A license is renewable upon submission of a renewal application in the form or format required by the Division and a non-refundable fee of $60, except that no fee will be required of a governmentally operated facility.
(a) Filing of an application for renewal before the date of expiration extends the effective date of the current license until the Division takes action upon the renewal application.
(b) The Division will refuse to renew a license if the facility is not in substantial compliance with these rules, or if the State Fire Marshal or authorized representative has given notice of noncompliance.
(7) Review Process. Upon receipt of an application and fee, the Division will conduct an application review. Initial action by the Division on the application will begin within 30 days of receipt of all application materials. The review will:
(a) Include a complete review of application materials;
(b) Determine whether the applicant meets the qualifications outlined in ORS 443.420 including:
(A) Demonstrates an understanding and acceptance of these rules;
(B) Is mentally and physically capable of providing services for residents;
(C) Employs or utilizes only individuals whose presence does not jeopardize the health, safety, or welfare of residents; and
(D) Provides evidence satisfactory to the Division of financial ability to comply with these rules.
(c) Include a site inspection; and
(d) Conclude with a report stating findings and a decision on licensing of the facility.
(8) Findings of Noncompliance. The Division will require an owner to submit and complete a plan of correction for each finding of noncompliance with these rules.
(a) If the finding(s) of noncompliance substantially impact the welfare, health and/or safety of residents, the plan of correction will be submitted and completed prior to issuance of a license. In the case of a currently operating RTF, such findings may result in suspension or revocation of a license.
(b) If it is determined that the finding(s) of noncompliance do not threaten the welfare, health or safety of residents and the facility meets other requirements of licensing, a license may be issued or renewed, and the plan of correction will be submitted and completed as a condition of licensing.
(c) The Division will specify required documentation and set the time lines for the submission and completion of plans of correction in accordance with the severity of the finding(s).
(d) The Division will review and approve each plan of correction. If the plan of correction does not adequately remedy the finding of noncompliance, the Division will require a revised plan of correction, and/or take action to apply civil penalties or deny, revoke or suspend the license.
(e) The RTF owner may appeal the finding of noncompliance or the disapproval of a plan of correction by submitting a request for reconsideration in writing to the Administrator of the Division. The Administrator of the Division or designee will make a decision on the appeal within 30 days of receipt of the appeal. The decision of the Administrator of the Division will be final.
(9) Variance. The Division may grant a variance to these rules based upon a demonstration by the applicant that an alternative method or different approach provides equal or greater program effectiveness and does not adversely impact the welfare, health or safety of residents.
(a) Variance Application. The RTF owner requesting a variance will submit, in writing, an application to the Division which identifies the section of the rules from which the variance is sought, the reason for the proposed variance, the proposed alternative method or different approach, and signed documentation from the CMHP indicating approval of the proposed variance.
(b) Division Review. The Deputy Assistant Director or designee, will review and approve or deny the request for a variance.
(c) Notification of Decision. The Division will notify the RTF owner of the decision in writing within 30 days after receipt of the application. A variance may be implemented only after receipt of written approval from the Division.
(d) Appeal of Decision. The RTF owner may appeal the denial of a variance request by submitting a request for reconsideration in writing to the Assistant Director of the Division. The Assistant Director of the Division will make a decision on the appeal within 30 days of receipt of the appeal. The decision of the Assistant Director of the Division will be final.
(e) Duration of the Variance. A variance will be reviewed by the Division at least every two years and may be revoked or suspended based upon a finding that the variance adversely impacts the welfare, health or safety of the RTF residents.
(10) Issuance of License. Upon finding that the applicant is in substantial compliance with these rules, the Division will issue a license.
(a) The license issued will state the name of the owner of the facility, the name of the administrator, the address of the facility to which the license applies, the maximum number of residents to be served at any one time and their evacuation capability, the type of facility, and such other information as the Division deems necessary.
(b) A Residential Treatment Facility license will be effective for two years from the date issued unless sooner revoked or suspended.
(c) The Residential Treatment Facility license is not transferable or applicable to any location, facility, or management other than that indicated on the application and license.
(11) Conditions of License. The license will be valid under the following conditions:
(a) The Residential Treatment Facility will not be operated or maintained in combination with a nursing facility, hospital, retirement facility, or other occupancy unless licensed, maintained, and operated as a separate and distinct part. Each Residential Treatment Facility will have sleeping, dining and living areas for use only by its own residents, employees and invited guests.
(b) The license will be retained in the facility and available for inspection at all times.
(c) Each license will be considered void immediately upon suspension or revocation of the license by the Division, or if the operation is discontinued by voluntary action of the licensee, or if there is a change of ownership.
(12) Site Inspections. Division staff will visit and inspect every Residential Treatment Facility at least, but not limited to, once every two years to determine whether it is maintained and operated in accordance with these rules. The RTF owner/applicant will allow Division staff entry and access to the facility and residents for the purpose of conducting the inspections.
(a) Division staff will review methods of resident care and treatment, records, the condition of the facility and equipment, and other areas of operation.
(b) All records, unless specifically excluded by law, will be available to the Division for review.
(c) The State Fire Marshal or authorized representative(s) will, upon request, be permitted access to the facility, fire safety equipment within the facility, safety policies and procedures, maintenance records of fire protection equipment and systems, and records demonstrating the evacuation capability of facility occupants.
(13) Investigation of Complaints and Alleged Abuse. Incidents of alleged abuse covered by ORS 430.735 through 430.765 will be reported and investigated in accordance with OAR 410-009-0050 through 410-009-0160. Division staff will investigate complaints and other alleged abuse made regarding residential treatment facilities, will cause a report to be filed, and will take appropriate action under these rules. The Division may delegate the investigation to a CMHP or other appropriate entity.
(14) Denial, Suspension or Revocation of License. The Division will deny, suspend or revoke a license where it finds there has been substantial failure to comply with these rules; or where the State Fire Marshal or authorized representative certifies that there is failure to comply with the Fire Code.
(a) In cases where there exists an imminent danger to the health or safety of residents, a license may be suspended immediately.
(b) Such revocation, suspension, or denial will be done in accordance with OAR 309-035-0157.
(15) Reporting Changes. Each licensee will report promptly to the Division any significant changes to information supplied in the application or subsequent correspondence. Such changes include, but are not limited to, changes in the facility name, owner entity, administrator, telephone number and mailing address. Such changes also include, but are not limited to, changes in the facility's physical plant, policies and procedures or staffing pattern when such changes are significant or impact the health, safety or well-being of residents.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0113
Contracts and Rates
(1) Contracts. Residential Treatment Facility operators providing services funded with state service payments will enter into a contract with the local CMHP, the Division or other Division-approved party. The contract does not guarantee that any number of persons eligible for Division funded services will be referred to or maintained in the facility.
(2) Rates. Rates for all services and the procedures for collecting payments from residents and/or payees will be specified in a fee policy and procedures. The fee policy and procedures will describe the schedule of rates, conditions under which rates may be changed, acceptable methods of payment, and the policy on refunds at the time of termination of residency.
(a) For residents whose services are funded by the Division, reimbursement for services will be made according to the rate schedule outlined in the contract. Room and board payments for residents receiving Social Security benefits or public assistance will be in accordance with rates determined by the Division.
(b) For private paying residents, the program will enter into a signed agreement with the resident, and/or if applicable, resident's guardian, payee or conservator. This agreement will include but not be limited to a description of the services to be provided; the schedule of rates; conditions under which the rates may be changed; and policy on refunds at the time of termination of residency.
(c) Before increasing rates or modifying payment procedures, the program will provide 30 days advance notice of the change to all residents, payees, guardians or conservators, as applicable.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0115
Administrative Management
(1) Licensee. The licensee will be responsible for insuring that the facility is operated in compliance with these rules and all other applicable federal, state and local laws and regulations.
(2) Administrator. The licensee will employ an administrator who:
(a) Has background including special training, experience, and other demonstrated ability in providing care and treatment appropriate to the residents served in the facility;
(b) Has a documented criminal record clearance and no history of abusive behavior;
(c) Will insure that the RTF operates in accordance with the standards outlined in these rules;
(d) Will oversee the daily operation and maintenance of the RTF and will be available to perform administrative duties at the facility at least 20 hours per week;
(e) Will develop and administer written policies and procedures to direct the operation of the RTF and the provision of services to residents;
(f) Will insure that qualified staff are available, in accordance with the staffing requirements specified in these rules;
(g) Will supervise or provide for the supervision of staff and others involved in the operation of the program;
(h) Will maintain facility, personnel and resident records;
(i) Will report regularly to the licensee on the operation of the RTF; and
(j) Will delegate authority and responsibility for the operation and maintenance of the facility to a responsible staff person whenever the Administrator is absent from the RTF. This authority and responsibility will not be delegated to a resident.
(3) Policies and Procedures. Policies and procedures will be developed, updated as necessary, maintained in a location easily accessible for staff reference, and made available to others upon reasonable request. They will be consistent with requirements of these rules, and address, but not be limited to:
(a) Personnel practices and staff training;
(b) Resident selection, admission and termination;
(c) Fire drills, emergency procedures, resident safety and abuse reporting;
(d) Health and sanitation;
(e) Records;
(f) Residential service plan, services and activities;
(g) Behavior management, including the use of seclusion or restraints;
(h) Food Service;
(i) Medication administration and storage;
(j) Resident belongings, storage and funds;
(k) Resident rights and advance directives;
(l) Complaints and grievances;
(m) Facility maintenance;
(n) Evacuation capability determination; and
(o) Fees and money management.
(4) House Rules. The RTF will develop reasonable house rules outlining operating protocols concerning, but not limited to, meal times, night-time quiet hours, guest policies and smoking. The house rules will be consistent with resident rights as delineated in OAR 309-035-0155. House rules will be posted in an area readily accessible to residents. House rules will be reviewed and updated, as necessary. Residents will be provided an opportunity to review and provide input into any proposed changes to house rules before the revisions become effective.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984 (Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; ; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0117
Records
(1) General Requirements. Records will be maintained to document the legal operation of the program, personnel practices and resident services. All records will be properly obtained, accurately prepared, safely stored and readily available within the facility. All entries in records required by these rules will be in ink, indelible pencil, or approved electronic equivalent prepared at the time, or immediately following, the occurrence of the event being recorded; be legible; and be dated and signed by the person making the entry. In the case of electronic records, signatures may be replaced by an approved, uniquely identifiable electronic equivalent.
(2) Program Records. Records documenting the legal operation of the RTF will include, but not be limited to:
(a) Written approval for occupancy of the building by the county or city having jurisdiction, any building inspection reports, zoning verifications, fire inspection reports or other documentation pertaining to the safe and sanitary operation of the facility issued during the development or operation of the facility;
(b) Application for license, related correspondence and site inspection reports;
(c) Program operating budget and related financial records;
(d) Payroll records, employee schedules and time sheets;
(e) Materials Safety and Data Sheets;
(f) Fire drill documentation;
(g) Fire alarm and sprinkler system maintenance and testing records;
(h) Incident reports; and
(i) Policy and procedure manual.
(3) Personnel Records. Records documenting personnel actions will include:
(a) Job descriptions for all positions; and
(b) Individual employee records including, but not limited to, written documentation of employee identifying information and qualifications, criminal record clearance, T.B. test results, Hepatitis B status, performance appraisals, and documentation of pre-service orientation and other training.
(4) Resident Records. An individual resident record will be maintained for each resident and include:
(a) An easily accessible summary sheet which includes, but is not limited to the resident's name, previous address, date of admission to the facility, sex, date of birth, marital status, legal status, religious preference, Social Security number, health provider information, evacuation capability, diagnosis(es), major health concerns, medication allergies, information indicating whether advance mental health and health directives and/or burial plan have been executed, and the name of person(s) to contact in case of emergency;
(b) The names, addresses and telephone numbers of the resident's legal guardian or conservator, parent(s), next of kin, or other significant person(s); physician(s) or other medical practitioner(s); dentist; CMHP case manager or therapist; day program, school or employer; and any governmental or other agency representative(s) providing services to the resident;
(c) A mental health assessment and background information identifying the resident's residential service needs;
(d) Advance mental health and health directives, burial plans or location of these (as available);
(e) A Residential Service Plan and copy(ies) of plan(s) from other service provider(s).
(f) Documentation of the resident's progress and any other significant information including, but not limited to, progress notes, progress summaries, any use of seclusion or restraints, and correspondence concerning the resident; and
(g) Health-related information and up-to-date information on medications in accordance with OAR 309-035-0175.
(5) Records for Crisis-respite Residents. For residents receiving crisis-respite services, an attempt will be made to obtain and maintain records as outlined in OAR 309-035-0117(4). Because it may not be possible to assemble complete records during the crisis-respite resident's short stay, the program will, at a minimum, maintain records in accordance with requirements outlined in OAR 309-035-0145, 309-035-0150, 309-035-0159, and 309-035-0175.
(6) Storage. All resident records will be stored in a weatherproof and secure location. Access to records will be limited to the Administrator and direct care staff unless otherwise allowed in these rules.
(7) Confidentiality. All resident records will be kept confidential. A signed release of information will be obtained for any disclosure from resident records in accordance with all applicable laws and rules.
(8) Resident Access to His/Her Record. A resident, or guardian (as applicable), will be allowed to review and obtain a copy of his/her resident record as allowed in ORS 179.505(9).
(9) Transfer of Records. Pertinent information from records of residents who are being transferred to another facility will be transferred with the resident. A signed release of information will be obtained in accordance with applicable laws and rules.
(10) Maintenance of Records. The facility will keep all records, except those transferred with a resident, for a period of three years.
(11) Administrative Changes. If an RTF changes ownership or Administrator, all resident and personnel records will remain in the facility. Prior to the dissolution of any RTF, the Administrator will notify the Division in writing as to the location and storage of resident records or those records will be transferred with the residents.
(12) Resident Contributions to Record. If a resident or guardian (as applicable) disagrees with the content of the resident record, or otherwise desires to provide documentation for the record, the resident or guardian (as applicable) may provide material in writing that then will become part of the resident record.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0120
Staffing
(1) Staff Qualifications. A job description will be available for each staff position and specify qualifications and job duties.
(a) Any staff person hired to provide direct care to residents will be at least 18 years of age, be capable of implementing the facility's emergency procedures and disaster plan, and be capable of performing other duties of the job as described in the job description.
(b) All staff who will have contact with residents will provide evidence of a criminal record clearance, in accordance with OAR 943-007-0001 through943-007-0501.
(c) In accordance with OAR 333-071-0057 and 437, Division 2, Subdivision Z, 4f (1)(2), all RTF staff who have contact with residents will be tested for tuberculosis and Hepatitis B within two weeks of first employment, additional testing will take place as deemed necessary; and the employment of staff who test positive for tuberculosis will be restricted if necessary.
(d) All staff will meet other qualifications when required by a contract or financing arrangement approved by the Division.
(2) Personnel Policies. Personnel policies will be made available to all staff and will describe hiring, leave, promotion and disciplinary practices.
(3) Staff Training. The administrator will provide or arrange a minimum of 16 hours pre-service orientation and 8 hours in-service training annually for each employee.
(a) Pre-service training for direct care staff will include, but not be limited to, a comprehensive tour of the facility; a review of emergency procedures developed in accordance with OAR 309-035-0130; a review of facility house rules, policies and procedures; background on mental and emotional disorders; an overview of resident rights; medication management procedures; food service arrangements; a summary of each resident's assessment and residential service plan; and other information relevant to the job description and scheduled shift(s).
(b) In-service training will be provided on topics relevant to improving the care and treatment of residents in the facility and meeting the requirements in these administrative rules. In-service training topics include, but are not limited to, implementing the residential service plan, behavior management, daily living skills development, nutrition, first aid, understanding mental illness, sanitary food handling, resident rights, identifying health care needs, and psychotropic medications.
(4) General Staffing Requirements. The licensee and administrator are responsible for assuring that an adequate number of staff are available at all times to meet the treatment, health and safety needs of residents. Regardless of the minimum staffing requirements outlined below, staff will be scheduled to insure safety and to correspond to the changing needs of residents. Minimum staffing requirements are as follows:
(a) In facilities serving 6 to 20 residents, there will be at least one direct care staff person on duty at all times.
(b) In facilities serving 21 to 35 residents, there will be at least two direct care staff on duty from 7:00 a.m. to 9:00 p.m. and at least one direct care staff person on duty from 9:00 p.m. to 7:00 a.m.
(c) In facilities serving 36 to 50 residents, there will be at least three direct care staff on duty from 7:00 a.m. to 9:00 p.m. and at least two direct care staff on duty from 9:00 p.m. to 7:00 a.m.
(d) In facilities serving 51 to 65 residents, there will be at least four direct care staff on duty from 7:00 a.m. to 9:00 p.m. and at least two direct care staff on duty from 9:00 p.m. to 7:00 a.m.
(e) In the case of a specialized RTF, staffing requirements outlined in the contractual agreement for specialized services will be implemented.
(f) Direct care staff on night duty will be awake and dressed at all times. In facilities where residents are housed in two or more detached buildings, direct care staff will monitor each building at least once an hour during the night shift. An approved method for alerting staff to problems will be in place. This method must be accessible to and usable by the residents.
Stat. Auth.: ORS 413.042 & 43.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0125
Facility Requirements
(1) Compliance with Building and Fire Codes. Each Residential Treatment Facility will meet the requirements for approved Group SR or I occupancies in the Building Code and the Fire Code in effect at the time of original licensure. When a change in facility use results in a new building occupancy classification, the facility will meet the requirements for approved Group SR or I occupancies in the Building Code in effect at the time of such change. If occupants are capable of evacuation within 3 minutes refer to Group R occupancies.
(2) Accessibility for Persons with Disabilities. Facilities will be accessible as follows:
(a) Those facilities, or portions of facilities, that are licensed, constructed or renovated after January 26, 1992, and that are covered multi-family dwellings or public accommodations, will meet the physical accessibility requirements in Chapter 11 of the Oregon Structural Specialty Codes. These codes specify requirements for public accommodations as defined in the Americans with Disabilities Act under Title III and for buildings qualifying as multi-family dwellings as defined in the Fair Housing Act, as amended in 1988.
(b) In order to insure program accessibility under Title II of the Americans with Disabilities Act, the Division may require additional accessibility improvements.
(c) Any accessibility improvements made to accommodate an identified resident will be in accordance with the specific needs of the resident.
(3) Outdoor Areas. An accessible outdoor area is required and will be made available to all residents. For facilities, or portions thereof, licensed on or after June 1, 1998, a portion of the accessible outdoor area will be covered and have an all weather surface, such as a patio or deck.
(4) General Storage. The facility will include sufficient and safe storage areas. These will include but not be limited to:
(a) Storage for a reasonable amount of resident belongings beyond that available in resident sleeping rooms will be provided appropriate to the size of the facility;
(b) All maintenance equipment, including yard maintenance tools, will be maintained in adequate storage space. Equipment and tools which pose a danger to facility residents will be kept in locked storage;
(c) Storage areas necessary to insure a functional, safe and sanitary environment consistent with OAR 309-035-0125, 309-035-0130, 309-035-0135, 309-035-0140, 309-035-0170, and 309-035-0175.
(5) Hallways. For facilities initially licensed on or after June 1, 1998, all resident use areas and resident units will be accessible through temperature controlled common areas or hallways with a minimum width of 36 inches except that a minimum width of 48 inches will be provided along the route to accessible bedrooms and bathrooms and between common areas and required exits.
(6) Administrative Areas. Sufficient space will be provided for confidential storage of both resident and business records, for staff use in completing record-keeping tasks, and for a telephone. Other equipment including fire alarm panels and other annunciators will be installed in an area readily accessible to staff in accordance with the Fire Code.
(7) Resident Sleeping Rooms. Resident sleeping quarters will be provided in rooms separated from other areas of the facility by an operable door with an approved latching device.
(a) For facilities licensed prior to June 1, 1998, resident sleeping rooms will include a minimum of 60 square feet per resident and allow for a minimum of three feet between beds.
(b) For facilities, or portions thereof, initially licensed on or after June 1, 1998, each resident sleeping room will be limited to one or two residents. At least ten percent, but no less than one, of the resident sleeping rooms will be accessible for persons with mobility disabilities. All resident sleeping rooms will include a minimum of 70 square feet per resident exclusive of closets, vestibules and bathroom facilities and allow a minimum of three feet between beds.
(c) A clothes closet, with adequate clothes hanging rods will be accessible within each sleeping room for storage of each resident's clothing and personal belongings. For facilities initially licensed on or after June 1, 1998, built-in closet space will be provided totaling a minimum of 64 cubic feet for each resident. In accessible sleeping rooms, the clothes hanging rod height will be adjustable or no more than 54 inches in height to insure accessibility for persons in wheelchairs.
(d) Each resident sleeping room will have exterior window(s) with a combined area at least one-tenth of the floor area of the room. Sleeping room windows will be equipped with curtains or blinds for privacy and control of light. For facilities, or portions of facilities, initially licensed on or after June 1, 1998, an escape window will be provided consistent with Building Code requirements.
(8) Bathrooms. Bathing and toilet facilities will be conveniently located for resident use, provide permanently wired light fixtures that illuminate all parts of the room, provide individual privacy for residents, provide a securely affixed mirror at eye level, be adequately ventilated, and include sufficient facilities specially equipped for use by persons with a physical disability in buildings serving such persons.
(a) In facilities licensed prior to June 1, 1998, a minimum of one toilet and one lavatory will be available for each eight residents, and one bathtub or shower will be available for each ten residents.
(b) In facilities, or portions of facilities, initially licensed on or after June 1, 1998, a minimum of one toilet and one lavatory will be available for each six residents, and a minimum of one bathtub or shower will be available for each ten residents, where these fixtures are not available in individual resident rooms. At least one centralized bathroom along an accessible route will be designed for disabled access in accordance with Chapter 11 of the Oregon Structural Specialty Code. For facilities licensed for more than 16 residents, there will be at least one separate toilet and lavatory provided for staff and visitor use.
(9) Common Use Rooms. The facility will include lounge and activity area(s) for social and recreational use, exclusively by residents, staff and invited guests, totaling 15 square feet per resident.
(10) Laundry and Related Space. Laundry facilities will be separate from food preparation and other resident use areas. When residential laundry equipment is installed, the laundry facilities may be located to allow for both resident and staff use. In facilities initially licensed on or after June 1, 1998, separate residential laundry facilities will be provided when the primary laundry facilities are located in another building, are of commercial type, or are otherwise not suitable for resident use. The following will be included in the primary laundry facilities:
(a) Countertops or spaces for folding table(s) sufficient to handle laundry needs for the facility;
(b) Locked storage for chemicals and equipment;
(c) Outlets, venting and water hook-ups according to state building code requirements. Washers will have a minimum rinse temperature of 155 degrees Fahrenheit (160 degrees Fahrenheit recommended) unless a chemical disinfectant will be used; and
(d) Sufficient storage and handling space to insure that clean laundry is not contaminated by soiled laundry.
(11) Kitchen. Kitchen facilities and equipment in facilities licensed for 16 or fewer residents may be of residential type except as required by the state building code and Fire Code or local agencies having jurisdiction. Facilities serving 17 or more residents will have facilities and equipment meeting Food Sanitation Rules of Health Services under OAR chapter 333 as applicable. For all kitchens, the following will be included:
(a) Dry storage space, not subject to freezing, in cabinets or a separate pantry for a minimum of one week's supply of staple foods;
(b) Sufficient refrigeration space maintained at 45 degrees Fahrenheit or less and freezer space for a minimum of two days' supply of perishable foods;
(c) In facilities licensed to serve 16 or fewer residents, a dishwasher will be provided (may be approved residential type) with a minimum final rinse temperature of 155 degrees Fahrenheit (160 degrees recommended), unless chemical disinfectant is used. In facilities licensed to serve 17 or more residents, a commercial dishwasher is required as specified in Health Services Food Sanitation Rules;
(d) In facilities licensed to serve 16 or fewer residents, a separate food preparation sink and hand washing sink will be provided. In facilities licensed to serve 17 or more residents, a triple pot wash sink will be provided unless pots are sanitized in the dishwasher, in addition to a food preparation sink and separate hand washing sink;
(e) Smooth, nonabsorbent and cleanable counters for food preparation and serving;
(f) Appropriate storage for dishes and cooking utensils designed to be free from potential contamination;
(g) Stove and oven equipment for cooking and baking needs; and
(h) Storage for a mop and other cleaning tools and supplies used for food preparation, dining and adjacent areas. Such cleaning tools will be maintained separately from those used to clean other parts of the facility. In facilities initially licensed on or after June 1, 1998, and licensed to serve 17 or more residents, a separate janitor closet or alcove will be provided with a floor or service sink and storage for cleaning tools and supplies.
(12) Dining Area. A separate dining room or area where meals are served will be provided for the exclusive use of residents, employees, and invited guests.
(a) In facilities licensed prior to June 1, 1998, the dining area will seat at least half of the residents at one time with a minimum area of 15 square feet per resident.
(b) In facilities, or portions of facilities, initially licensed on or after June 1, 1998, dining space will be provided to seat all residents with a minimum area of 15 square feet per resident, exclusive of serving facilities and required exit pathways.
(13) Details and Finishes. All details and finishes will meet the finish requirements of applicable sections of the Building Code and the Fire Code.
(a) Surfaces. Surfaces of all walls, ceilings, windows and equipment will be readily cleanable. In facilities, or portions of facilities, initially licensed on or after June 1, 1998, the walls and ceilings in the kitchen, laundry and bathing areas will be smooth, nonabsorbent, and readily cleanable, and kitchen walls in facilities licensed to serve 17 or more residents will comply with Health Services Food Sanitation Rules, OAR chapter 333, division 150 through 160.
(b) Flooring. In facilities, or portions of facilities, initially licensed on or after June 1, 1998, flooring, thresholds and floor junctures will be designed and installed to prevent a tripping hazard and to minimize resistance for passage of wheelchairs and other ambulation aids. In addition, hard surface floors and base will be free from cracks and breaks, and bathing areas will have non-slip surfaces.
(c) Doors. In facilities, or portions of facilities, initially licensed on or after June 1, 1998, all doors to resident sleeping rooms, bathrooms and common use areas will provide a minimum clear opening of 32 inches. Lever type door hardware will be provided on all doors used by residents. If locks are used on doors to resident sleeping rooms, they will be interactive to release with operation of the inside door handle and be master-keyed from the corridor side. Exit doors will not include locks which prevent evacuation except in accordance with Building Code and Fire Code requirements and with written approval of the Division. An exterior door alarm or other acceptable system may be provided for security purposes and to alert staff when resident(s) or others enter or exit the facility.
(d) Handrails. Handrails will be provided on all stairways as specified in the Building Code.
(14) Heating and Ventilating. All areas of the facility will be adequately ventilated and temperature controlled in accordance with the Mechanical and Building Code requirements.
(a) Temperature Control. All facilities will include heating equipment capable of maintaining a minimum temperature of 68 degrees Fahrenheit at a point three inches above the floor. During times of extreme summer heat, fans will be made available when air conditioning is not provided.
(b) Exhaust Systems. All toilet and shower rooms will be adequately ventilated. In facilities initially licensed on or after June 1, 1998, toilet and shower rooms will be equipped with a mechanical exhaust fan or central exhaust system which discharges to the outside.
(c) Fireplaces, Furnaces, Wood Stoves and Boilers. Where used, design and installation will meet standards of the Oregon Mechanical Specialty Code and the Boiler Specialty Code, as applicable.
(d) Water Temperature. In resident areas, hot water temperatures will be maintained within a range of 110 to 120 degrees Fahrenheit. Hot water temperatures in laundry and kitchen areas will be at least 155 degrees Fahrenheit.
(15) Electrical. All wiring systems will meet the standards of Oregon Electrical Specialty Code in effect on the date of installation, and all electrical devices will be properly wired and in good repair.
(a) When not fully grounded, circuits in resident areas will be protected by GFCI type receptacles or circuit breakers as an acceptable alternative.
(b) All electrical circuits will be protected by circuit breakers or non-interchangeable plug-type fuses in fuse boxes. Electrical loads on distribution panels and circuits will be limited in accordance with the Oregon Electrical Specialty Code.
(c) A sufficient supply of electrical outlets will be provided to meet resident and staff needs. (The use of extension cords will be in accordance with the rules of the Office of State Fire Marshal and the Department of Health Services.)
(d) Lighting fixtures will be provided in each resident bedroom and bathroom, switchable near the entry door, and in other areas as required to meet task illumination.
(e) In facilities, or portions of facilities, initially licensed on or after June 1, 1998, lighting fixtures that illuminate evacuation pathways will be operable within 10 seconds during a failure of the normal power supply and provide illumination for a period of at least two hours.
(16) Plumbing. All plumbing will meet the Oregon Plumbing Specialty Code in effect on the date of installation, and all plumbing fixtures will be properly installed and in good repair.
(17) Telephones. The facility will provide adequate access to telephones for private use by residents. In facilities initially licensed on or after June 1, 1998, a phone for resident use will be provided in addition to the phone used by staff. The facility may establish reasonable house rules governing phone use to insure equal access by all residents. Each resident or guardian (as applicable) will be responsible for payment of long distance phone bills where the calls were initiated by the resident, unless other mutually agreed arrangements have been made.
(18) Smoking. Smoking is not allowed in sleeping areas. If there is a designated smoking area, it will be separated from other common areas. Indoor smoking areas will be equipped with a mechanical exhaust fan or central exhaust system which discharges to the outside. Furniture used in designated smoking areas will be non-flammable and without crevasses. In facilities, or portions of facilities, initially licensed on or after June 1, 1998, indoor smoking areas will be separated from other parts of the facility by a self-closing door and contain sprinkler protection or heat detectors.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef.; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0130
Safety
(1) Training on Safety Procedures. All staff will be trained in staff safety procedures prior to beginning their first regular shift. All residents will be trained in resident safety procedures as soon as possible during their first 72 hours of residency.
(2) Emergency Procedure and Disaster Plan. A written procedure and disaster plan will be approved by the State Fire Marshal or authorized representative. The plan will cover such emergencies and disasters as fires, explosions, missing persons, accidents, earthquakes and floods. The plan will be posted by the phone and immediately available to the administrator and employees. The plan will include diagrams of evacuation routes, and these will be posted. The plan will specify where staff and residents will go if the facility becomes uninhabitable. The plan will be kept up to date and will include:
(a) Emergency instructions for employees;
(b) The telephone numbers of the local fire department, police department, the poison control center, the administrator, the administrator's designee, and other persons to be contacted in emergencies; and
(c) Instructions for the evacuation of residents and employees.
(3) Combustible and Hazardous Materials. Noncombustible and nonhazardous materials will be used whenever possible. When necessary to the operation of the facility, flammable and combustible liquids and other hazardous materials will be safely and properly stored in clearly labeled, original containers in areas inaccessible to residents in accordance with the Fire Code. Any quantities of combustible and hazardous materials maintained will be the minimum necessary.
(4) Poisonous and Other Toxic Materials. Non-toxic cleaning supplies will be used whenever available. Poisonous and other toxic materials will be properly labeled and stored in locked areas distinct and apart from all food and medications.
(5) Evacuation Capability. Evacuation capability categories are based upon the ability of the residents and staff as a group to evacuate the building or relocate from a point of occupancy to a point of safety. Buildings will be constructed and equipped according to a designated evacuation capability for occupants. Categories of evacuation capability include "Impractical" (SR- 2) or "Slow" (SR- 1). The evacuation capability designated for the facility will be documented and maintained in accordance with NFPA 101A.
(a) Only persons assessed to be capable of evacuating in accordance with the designated facility evacuation capability will be admitted to the facility.
(b) Persons experiencing difficulty with evacuating in a timely manner will be provided assistance from staff and offered environmental and other accommodations, as practical. Under such circumstances, the facility will consider increasing staff levels, changing staff assignments, offering to change the resident's room assignment, arranging for special equipment, and taking other actions that may assist the resident. Residents who still cannot evacuate the building safely in the allowable period of time will be assisted with transferring to another facility with an evacuation capability designation consistent with the individual's documented evacuation capability.
(6) Evacuation Drills. Every resident will participate in an unannounced evacuation drill each month. (See Section 408.12.5 of the fire code.)
(a) At least once every three months, the drill will be conducted during resident sleeping hours.
(b) Drills will be scheduled at different times of the day and on different days of the week with different locations designated as the origin of the fire for drill purposes.
(c) Any resident failing to evacuate within the established time limits will be provided with special assistance and a notation made in the resident record.
(d) Written evacuation records will be maintained for at least three years. They will include documentation, made at the time of the drill, specifying the date and time of the drill, the location designated as the origin of the fire for drill purposes, the names of all individuals and staff present, the amount of time required to evacuate, notes of any difficulties experienced, and the signature of the staff person conducting the drill.
(7) Unobstructed Egress. All stairways, halls, doorways, passageways, and exits from rooms and from the building will be unobstructed.
(8) Fire Extinguishers. The provider will provide and maintain one or more 2A10BC fire extinguishers on each floor in accordance with the Fire Code.
(9) Fire Alarms and Smoke Detectors. Approved fire alarms and smoke detectors will be installed according to Building Code and Fire Code requirements. These alarms will be set off during each evacuation drill. The facility will provide appropriate signal devices for persons with disabilities who do not respond to the standard auditory alarms. All of these devices will be inspected and maintained in accordance with the requirements of the State Fire Marshal or local agency having jurisdiction.
(10) Sprinkler Systems. Sprinkler systems will be installed in compliance with the Building Code and maintained in accordance with rules adopted by the State Fire Marshal.
(11) First Aid Supplies. First aid supplies will be readily accessible to staff. All supplies will be properly labeled.
(12) Portable Heaters. Portable heaters are a recognized safety hazard and will not be used.
(13) Safety Program. A safety program will be developed and implemented to identify and prevent the occurrence of hazards at the facility. Such hazards may include, but are not limited to, dangerous substances, sharp objects, unprotected electrical outlets, use of extension cords or other special plug-in adapters, slippery floors or stairs, exposed heating devices, broken glass, inadequate water temperatures, overstuffed furniture in smoking areas, unsafe ashtrays and ash disposal, and other potential fire hazards.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984 (Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0135
Sanitation
(1) Water Supply. The water supply in the facility will meet the requirements of the current rules of Health Services governing domestic water supplies.
(a) A municipal water supply will be utilized if available.
(b) When the facility is not served by an approved municipal water system, and the facility qualifies as a public water system according to OAR 333-061-0020(127), Oregon Health Services rules for public water systems, then the facility will comply with the OAR Chapter 333 rules of the Oregon Health Services pertaining to public water systems. These include requirements that the drinking water be tested for total coliform bacteria at least quarterly, and nitrate at least annually, and reported to Health Services. For adverse test results, these rules require that repeat samples and corrective action be taken to assure compliance with water quality standards, that public notice be given whenever a violation of the water quality standards occurs, and that records of water testing be retained according to the Oregon Health Services requirements.
(2) Surfaces. All floors, walls, ceilings, windows, furniture, and equipment will be kept in good repair, clean, neat and orderly.
(3) Plumbing Fixtures. Each bathtub, shower, lavatory, and toilet will be kept clean, in good repair and regularly sanitized.
(4) Disposal of Cleaning Waste Water. No kitchen sink, lavatory, bathtub, or shower will be used for the disposal of cleaning waste water.
(5) Soiled Laundry. Soiled linens and clothing will be stored in an area or container separate from kitchens, dining areas, clean linens, clothing, and food.
(6) Pest Control. All necessary measures will be taken to prevent rodents and insects from entering the facility. Should pests be found in the facility, appropriate action will be taken to eliminate them.
(7) Grounds Maintenance. The grounds of the facility will be kept orderly and reasonably free of litter, unused articles, and refuse.
(8) Garbage Storage and Removal. Garbage and refuse receptacles will be clean, durable, watertight, insect and rodent proof, and will be kept covered with tight-fitting lids. All garbage and solid waste will be disposed of at least weekly and in compliance with the current rules of the Department of Environmental Quality.
(9) Sewage Disposal. All sewage and liquid wastes will be disposed of in a municipal sewage system where such facilities are available. If a municipal sewage system is not available, sewage and liquid wastes will be collected, treated, and disposed of in compliance with the current rules of the Department of Environmental Quality. Sewage lines, and septic tanks or other non-municipal sewage disposal systems where applicable, will be maintained in good working order.
(10) Biohazardous Waste. Biohazardous waste will be disposed of in compliance with the rules of the Department of Environmental Quality.
(11) Infection Control. Precautions will be taken to prevent the spread of infectious and/or communicable diseases as defined by the Centers for Disease Control and to minimize or eliminate exposure to known health hazards. In accordance with OAR 437, Division 2, Subdivision Z, Section 1910.1030 of the Oregon Occupational Safety and Health Code, staff will employ universal precautions whereby all human blood and certain body fluids are treated as if known to be infectious for HIV, HBV and other blood borne pathogens.
(12) Infection Control for Pets and Other Household Animals. If pets or other household animals exist at a facility, sanitation practices will be implemented to prevent health hazards.
(a) Such animals will be vaccinated in accordance with the recommendations of a licensed veterinarian. Proof of such vaccinations will be maintained on the premises.
(b) Animals not confined in enclosures will be under control and maintained in a manner that does not adversely impact residents or others.
(c) No live animal will be kept or allowed in any portion of the premises where food is stored or prepared, except that aquariums and aviaries will be allowed if enclosed so as not to create a public health problem.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0140
Resident Furnishings
(1) Bedroom Furniture. Residents will be allowed to use their own furniture within space limitations of the resident sleeping room. Otherwise, furniture will be provided or arranged for each resident, maintained in good repair and include:
(a) A bed, including a frame and a clean mattress and pillow;
(b) A private dresser or similar storage area for personal belongings which is readily accessible to the resident; and
(c) Locked storage for the resident's small, personal belongings. In facilities initially licensed before June 1, 1998, this locked storage may be provided in a place other than the resident's bedroom. The resident will be provided with a key or other method to gain access to his/her locked storage space.
(2) Linens. Linens will be provided for each resident and will include:
(a) Sheets, pillowcase, other bedding appropriate to the season and individual resident's comfort;
(b) Availability of a waterproof mattress or waterproof mattress cover; and
(c) Towels and washcloths.
(3) Personal Hygiene Items. Each resident will be assisted in obtaining personal hygiene items in accordance with individual needs. These will be stored in a clean and sanitary manner, and may be purchased with the resident's personal allowance. Personal hygiene items include, but are not limited to, a comb and/or hairbrush, a toothbrush, toothpaste, and menstrual supplies (if needed).
(4) Supplies Provided by Facility. Sufficient supplies of soap, shampoo and toilet paper for all residents will be provided.
(5) Common Area Furniture. An adequate supply of furniture for resident use in living room, dining room and other common areas will be maintained in good condition.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0145
Admission to Facility
(1) Responsibility for Admission Process. Each facility's admission policy and procedures will specify who is responsible for each component of the admission information-gathering and decision-making process. Responsibilities will be organized and assigned to promote effective processing of referrals and admissions.
(2) Referrals. Unless limited by contractual agreement with the Division or other Division-approved party, referrals may be accepted from a variety of sources. Residents whose services will be funded by the Division must be approved for placement by the CMHP or other local entity given responsibility for this function by contract with the Division, and/or approval of the Division.
(3) Release of Information. In accordance with ORS 179.505 and the 42 CFR, Part 2, an authorization for the release of information will be obtained for any confidential information concerning a prospective resident.
(4) Nondiscrimination. Persons will be considered for admission without regard to race, color, sex or sexual orientation (except as may be limited by room arrangement), religion, creed, national origin, age (except under 18 years), familial status, marital status, source of income, or disability in addition to the mental or emotional disorder.
(5) Screening. Prior to accepting a resident for admission to the facility, the administrator or his/her designee will determine that the resident meets admission criteria. The prospective resident will receive an explanation of the program, be given a copy of materials explaining conditions of residency, and be offered the opportunity to visit the facility. Sufficient information will be obtained from the prospective resident, a relative and/or agencies providing services to determine eligibility for admission and service needs. In the case of individuals referred for emergency or crisis-respite admission, the information obtained may be less extensive than for regular admissions but must be sufficient to determine that the resident meets admission criteria and that the facility is appropriate considering the individual's needs. Screening information will include, but not be limited to, the following:
(a) Written documentation that the prospective resident has, or is suspected of having, a mental or emotional disorder;
(b) Background information including a mental health assessment and describing previous living arrangements, service history, behavioral issues and service needs;
(c) Medical information including a brief history of any health conditions, documentation from a Licensed Medical Professional or other qualified health care professional of the individual's current physical condition, and a written record of any current or recommended medications, treatments, dietary specifications, and aids to physical functioning;
(d) Copies of documents, or other documentation, relating to guardianship, conservatorship, commitment status, advance directives, or any other legal restrictions (as applicable);
(e) A copy of the prospective resident's most recent mental health treatment plan, or in the case of an emergency or crisis-respite admission, a summary of current mental health treatment involvement; and
(f) Documentation of the prospective resident's ability to evacuate the building consistent with the facility's designated evacuation capability and other concerns about potential safety risks.
(6) Admission Criteria. Persons considered for admission will:
(a) Be assessed to have a mental or emotional disorder, or a suspected mental or emotional disorder;
(b) Be in need of care, treatment and supervision;
(c) Be at least 18 years of age;
(d) Not require continuous nursing care, unless a reasonable plan to provide such care exists, the need for residential treatment supersedes the need for nursing care, and the Division approves the placement;
(e) Have an evacuation capability consistent with the facility's SR Occupancy classification; and
(f) Meet additional criteria required or approved by the Division through contractual agreement or condition of licensing.
(7) Admission Decisions. An admission decision will be made based upon the existence of an opening within the facility, a review of screening materials at a pre-admission meeting and a determination that the resident meets the admission criteria. A pre-admission meeting will be scheduled to include the facility administrator or designee, the potential resident and his/her legal guardian (as applicable). With the prospective resident's consent, the pre-admission meeting may also include family member(s) or other representative(s) as appropriate, representative(s) of relevant service providing agencies, and others with an interest in the resident's admission. Potential residents, their legal guardian (as applicable) and authorized representative will be informed of admission decisions within 72 hours. When admission is denied, the prospective applicant, their legal guardian (as applicable) and authorized representative will be informed in writing of the basis for the decision and their right to appeal the decision in accordance with OAR 309-035-0157.
(8) Informed Consent for Services. Each resident, or his/her guardian (as applicable), will provide informed consent for services upon admission to the facility, unless the resident's ability to do so is legally restricted.
(9) Orientation. Upon admission, the administrator or his/her designee will provide an orientation to each new resident that includes, but is not limited to, a complete tour of the facility, introductions to other residents and staff, discussion of house rules, explanation of the laundry and food service schedule and policies, review of resident rights and grievance procedures, explanation of the fee policy, discussion of the conditions under which residency would be terminated, and a general description of available services and activities. During the orientation, advance directives will be explained. If the resident does not already have any advance directive(s), she/he will be given an opportunity to complete them. Orientation will also include a description of the facility's emergency procedures in accordance with OAR 309-035-0130(2).
(10) Record Preparation. A resident record will be established concurrent with the resident's admission. Prior to admission, within five days after an emergency admission, or within 24 hours of a crisis-respite admission, the facility will determine with whom communication needs to occur and will attempt to obtain the needed authorizations for release of information. The record established upon admission will include the materials reviewed in screening the resident, the summary sheet and any other available information. Every effort will be made to complete the resident record consistent with OAR 309-035-0117(4) in a timely manner. The assessment and residential service plan will be completed in accordance with OAR 309-035-0159. Records on prescribed medications and health needs will be completed as specified in OAR 309-035-0170.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0150
Termination of Residency
(1) Responsibility for Termination Process. Each facility's termination policy and procedures will specify who is responsible for each step of the process for terminating residency. Responsibilities will be organized and assigned to promote a fair and efficient termination process. Unless otherwise designated as a condition of licensing or in contract language approved by the Division, the Administrator will be responsible for initiating and coordinating termination proceedings. An effort will be made to prevent unnecessary terminations by making reasonable accommodations within the facility.
(2) Voluntary Termination of Residency. A resident or guardian (as applicable) may terminate residency in a facility upon providing at least 30 days notice. Upon mutual agreement between the administrator and the resident or guardian (as applicable), less than 30 days notice may be provided.
(3) Emergency Termination of Residency. If a resident's behavior poses a serious and immediate threat to the health or safety of others in or near the facility, the administrator, after providing 24 hours written notice specifying the causes to the resident or guardian (as applicable), may immediately terminate the residency. The notice will specify the resident's right to appeal the emergency termination decision in accordance with OAR 309-035-0157.
(4) Other Terminations of Residency. When other circumstances arise providing grounds for termination of residency, the Administrator will discuss these grounds with the resident, the resident's guardian (as applicable), and with the resident's permission, other persons with an interest in the resident's circumstances. If a decision is made to terminate residency, the Administrator will provide at least 30 days written notice specifying the causes to the resident or guardian (as applicable). This notice will also specify the resident's right to appeal the termination decision in accordance with OAR 309-035-0157. Upon mutual agreement between the administrator and the resident or guardian (as applicable), less than 30 days notice may be provided. An effort will be made to establish a reasonable termination date in consideration of both facility needs and the needs of the terminated resident to find alternative living arrangements. Criteria establishing grounds for termination include:
(a) Resident no longer needs or desires services provided at the facility and/or expresses a desire to move to an alternative setting;
(b) Resident is assessed by a Licensed Medical Professional or other qualified health professional to require services, such as continuous nursing care or extended hospitalization, that are not available, or can not be reasonably arranged, at the facility;
(c) Resident's behavior is continuously and significantly disruptive or poses a threat to the health or safety of self or others and these behavioral concerns cannot be adequately addressed with services available at the facility or services that can be arranged outside of the facility;
(d) Resident cannot safely evacuate the facility in accordance with the facility's SR Occupancy Classification after efforts described in OAR 309-035-0130(5)(b) have been taken;
(e) Nonpayment of fees in accordance with program's fee policy; and
(f) Resident continuously and knowingly violates house rules resulting in significant disturbance to others.
(5) Pre-termination Meeting. Except in the case of emergency terminations or crisis-respite residents, a pre-termination meeting will be held with the resident, guardian (as applicable), and with the resident's permission, others interested in the resident's circumstances. The purpose of the meeting is to plan any arrangements necessitated by the termination decision. The meeting will be scheduled to occur at least two weeks prior to the termination date. In the event a pre-termination meeting is not held, the reason will be documented in the resident's record.
(6) Documentation. Documentation of discussions and meetings held concerning termination of residency and copies of notices will be maintained in the resident's record.
(7) Disposition of Personal Property. At the time of termination of residency, the resident will be given a statement of account, any balance of funds held by the facility and all property held in trust or custody by the facility.
(a) In the event of pending charges (such as long distance phone charges or damage assessments), the program may hold back the amount of funds anticipated to cover the pending charges. Within 30 days after residency is terminated or as soon as pending charges are confirmed, the resident will be provided a final financial statement along with any funds due to the resident.
(b) In the case of resident belongings left at the facility for longer than seven days after termination of residency, the RTF will make a reasonable attempt to contact the resident, guardian (as applicable) and/or other representative of the resident. The RTF must allow the resident, guardian (as applicable) or other representative at least 15 days to make arrangements concerning the property. If it is determined that the resident has abandoned the property, the RTF may then dispose of the property. If the property is sold, proceeds of the sale, minus the amount of any expenses incurred and any amounts owed the program by or on behalf of the resident, will be forwarded to the resident or guardian (as applicable).
(8) Crisis-respite Services. Because crisis-respite services are time-limited, the planned end of services will not be considered a termination of residency and subject to requirements in OAR 309-035-0150(2), (4) and (5). Upon admission to crisis-respite services, the resident or guardian (as applicable) will be informed of the planned date for discontinuation of services. This date may be extended through mutual agreement between the administrator and the resident or guardian (as applicable). RTFs providing crisis-respite services will implement policies and procedures that specify reasonable time frames and the grounds for discontinuing crisis-respite services earlier than the date planned.
(9) Absences without Notice. If a resident moves out of the facility without providing notice, or is absent without notice for more than seven consecutive days, the administrator may terminate residency in the manner provided in ORS 105.105 to 105.168 after seven consecutive days of the resident's absence. An attempt will be made to contact the resident, guardian (as applicable) and/or other person interested in the resident's circumstances to confirm the resident's intent to discontinue residency.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0155
Resident Rights
(1) Statutory and Constitutional Rights. Each resident will be assured the same civil and human rights accorded to other citizens. These rights will be assured unless expressly limited by a court in the case of a resident who has been adjudicated incompetent and not restored to legal capacity. The rights described in paragraphs (2) and (3) of this section are in addition to, and do not limit, all other statutory and constitutional rights which are afforded to all citizens including, but not limited to, the right to vote, marry, have or not have children, own and dispose property, enter into contracts and execute documents.
(2) Rights of Service Recipients. In accordance with ORS 430.210, residents will have the right to:
(a) Choose from available services those which are appropriate, consistent with the plan developed in accordance with paragraphs (b) and (c) of this subsection, and provided in a setting and under conditions that are least restrictive to the person's liberty, that are least intrusive to the person and that provide for the greatest degree of independence;
(b) An individualized written service plan, services based upon that plan and periodic review and reassessment of service needs;
(c) Ongoing participation in planning services in a manner appropriate to the person's capabilities, including the right to participate in the development and periodic revision of the plan described in paragraph (b) of this subsection, and the right to be provided with a reasonable explanation of all service considerations;
(d) Not receive services without informed consent except in a medical emergency or as otherwise permitted by law;
(e) Not participate in experimentation without informed voluntary written consent;
(f) Receive medication only for the person's individual clinical needs;
(g) Not be involuntarily terminated or transferred from services without prior notice, notification of available sources of necessary continued services and exercise of a grievance procedure;
(h) A humane service environment that affords reasonable protection from harm and affords reasonable privacy;
(i) Be free from abuse or neglect and to report any incident of abuse without being subject to retaliation;
(j) Religious freedom;
(k) Not be required to perform labor, except personal housekeeping duties, without reasonable and lawful compensation;
(l) Visit with family members, friends, advocates and legal and medical professionals;
(m) Exercise all rights set forth in ORS 426.385 and 427.031 if the individual is committed to the Department;
(n) Be informed at the start of services and periodically thereafter of the rights guaranteed by this section and the procedure for reporting abuse, and to have these rights and procedures prominently posted in a location readily accessible to the person and made available to the person's guardian and any representative designated by the person;
(o) Assert grievances with respect to infringement of the rights described in this section, including the right to have such grievances considered in a fair, timely and impartial grievance procedure;
(p) Have access to and communicate privately with any public or private rights protection program or rights advocate; and
(q) Exercise all rights described in this section without any form of reprisal or punishment.
(3) Additional Rights in Residential Treatment Facilities. Residents will also have a right to:
(a) Adequate food, shelter and clothing, consistent with OAR 309-035-0159;
(b) A reasonable accommodation if, due to their disability, the housing and services are not sufficiently accessible;
(c) Confidential communication, including receiving and opening personal mail, private visits with family members and other guests, and access to a telephone with privacy for making and receiving telephone calls;
(d) Express sexuality in a socially appropriate and consensual manner;
(e) Access to community resources including recreation, religious services, agency services, employment and day programs, unless such access is legally restricted;
(f) Be free from seclusion and restraint, except as outlined in OAR 309-035-0167.
(g) To review the Residential Treatment Facility's policies and procedures; and
(h) Not participate in research without informed voluntary written consent.
(4) The Resident's Right to Fresh Air. For the purpose of this rule, these terms have the following meanings:
(a) “Fresh air” means the inflow of air from outside the facility where the resident is receiving services. “Fresh air” may be accessed through an open window or similar method as well as through access to the outdoors.
(b) “Outdoors” means an area with fresh air that is not completely enclosed overhead. “Outdoors” may include a courtyard or similar area.
(c) If a resident requests access to fresh air and the outdoors or the resident's treating health care provider determines that fresh air or the outdoors would be beneficial to the resident, the facility in which the resident is receiving services shall provide daily access to fresh air and the outdoors unless this access would create a significant risk of harm to the resident or others.
(d) The determination whether a significant risk of harm to the resident or others exists shall be made by the resident's treating health care provider. The treating health care provider may find that a significant risk of harm to the resident or others exists if:
(A) The resident 's individual circumstances and condition indicate an unreasonable risk of harm to the resident or others which cannot be reasonably accommodated within existing programming should the resident be allowed access to fresh air and the outdoors; or
(B) The facility’s existing physical plant or existing staffing prevent the provision of access to fresh air and the outdoors in a manner than maintains the safety of the resident or others.
(e) If a facility determines that its existing physical plant prevents the provision of access to fresh air and the outdoors in a safe manner, the facility shall make a good faith effort at the time of any significant renovation to the physical plant that involves renovation of the unit or relocation of where residents are treated to include changes to the physical plan or location that allow access to fresh air and the outdoors, so long as such changes do not add an unreasonable amount to the cost of the renovation.
(5) Program Requirements. The program will have and implement written policies and procedures which protect residents' rights, and encourage and assist residents to understand and exercise their rights. The program will post a listing of resident rights under these rules in a place readily accessible to all residents and visitors.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 5-2009, f. & cert. ef. 12-17-09
309-035-0157
Resident Grievances and Appeals
(1) Procedures. The facility will have a written policy and procedures concerning the resident grievance and appeal process. A copy of the grievance and appeal process will be posted in a place readily accessible to residents. A copy of the grievance and appeal process will be provided to each resident and guardian (as applicable) at the time of admission to the facility.
(2) Grievances. A facility's process for grievances must, at a minimum, include the following:
(a) Residents will be encouraged to informally resolve complaints through discussion with RTF staff.
(b) If the resident is not satisfied with the informal process or does not wish to use it, the resident may proceed as follows:
(A) The resident may submit a complaint in writing to the RTF Administrator. The resident may receive assistance in submitting the complaint from any person whom the resident chooses. If requested by the resident, RTF staff will be available to assist the resident.
(B) The written complaint will go directly to the RTF Administrator without being read by other staff, unless the resident requests or permits other staff to read the complaint.
(C) The complaint will include the reasons for the grievance and the proposed resolutions. No complaint will be disregarded because it is incomplete.
(D) Within five days of receipt of the complaint, the RTF Administrator will meet with the resident to discuss the complaint. The resident may have an advocate or other person of his/her choosing present for this discussion.
(E) Within five days of meeting with the resident, the RTF Administrator will provide a written decision to the resident. As part of the written decision, the Administrator will provide information about the appeal process.
(F) In circumstances where the matter of the complaint is likely to cause irreparable harm to a substantial right of the resident before the grievance procedures outlined in OAR 309-035-0157(2)(b)(D) and (E) are completed, the resident may request an expedited review. The RTF Administrator will review and respond in writing to the grievance within 48 hours. The written decision will include information about the appeal process.
(3) Appeals. Residents, their legal guardians (as applicable) and prospective residents (as applicable) will have the right to appeal admission, termination and grievance decisions as follows:
(a) If the resident is not satisfied with the decision, the resident may file an appeal in writing within ten days of the date of the RTF Administrator's decision to the complaint or notification of admission denial or termination (as applicable).
(b) If program services are delivered by a person or entity other than the Division, the appeal will be submitted to the CMHP Director or designee in the county where the RTF is located.
(A) The resident may receive assistance in submitting the appeal. If requested by the resident, RTF staff will be available to assist the resident.
(B) The CMHP Director or designee will provide a written decision within ten days of receiving the appeal.
(C) If the resident is not satisfied with the CMHP Director's decision, the resident may file a second appeal in writing within ten days of the date of the CMHP Director's written decision to the Assistant Director of the Division or designee. The decision of the Assistant Director of the Division will be final.
(c) If program services are delivered by the Division, the appeal will be submitted to the Deputy Assistant Director or designee.
(A) The resident may receive assistance in submitting the appeal. If requested by the resident, RTF staff will be available to assist the resident.
(B) The Deputy Assistant Director or designee will review and approve or deny the appeal.
(C) The Division will notify the resident of the decision in writing within 10 days after receipt of the appeal.
(D) If the resident is not satisfied with the Deputy Assistant Director's or designee’s decision, the resident may submit a second appeal in writing within ten days of the date of the written decision to the Assistant Director of the Division. The decision of the Assistant Director of the Division will be final.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0159
Resident Assessment and Residential Service Plan
(1) Assessment. An assessment will be completed for each resident within 30 days after admission to the facility, unless admitted to the facility for crisis-respite services.
(a) The assessment will be based upon an interview with the resident to identify strengths, preferences and service needs; observation of the resident's capabilities within the residential setting; a review of information in the resident record; and contact with representatives of other involved agencies, family members and others, as appropriate. All contacts with others will be made with proper authorization for the release of information.
(b) Assessment findings will be summarized in writing and included in the resident's record. Assessment findings will include, but not be limited to, diagnostic and demographic data; identification of the resident's medical, physical, emotional, behavioral and social strengths, preferences and needs related to independent living and community functioning; and recommendations for residential service plan goals.
(2) Residential Service Plan. An individualized plan, identifying the goals to be accomplished through the services provided, will be prepared for each resident, unless admitted to the facility for crisis-respite services, within 30 days after admission.
(a) The residential service plan will be based upon the findings of the resident assessment, be developed with participation of the resident and his/her guardian (as applicable), and be developed through collaboration with the resident's primary mental health treatment provider. With consent of the resident or guardian (as applicable), family members, representatives from involved agencies, and others with an interest in the resident's circumstances will be invited to participate. All contacts with others will be made with proper, prior authorization from the resident.
(b) The residential service plan will identify service needs, desired outcomes and service strategies to address, but not be limited to, the following areas: physical and medical needs, medication regimen, self-care, social-emotional adjustment, behavioral concerns, independent living capability and community navigation.
(c) The residential service plan will be signed by the resident, the administrator or other designated facility staff person, and others, as appropriate, to indicate mutual agreement with the course of services outlined in the plan.
(3) Crisis-respite Requirements. For residents admitted to facilities for 30 days or less, an assessment and residential service plan must be developed within 48 hours of admission which identifies service needs, desired outcomes and the service strategies to be implemented to resolve the crisis or address other needs of the individual that resulted in the short term service arrangement.
(4) Progress Notes. Progress notes will be maintained within each resident's record and document significant information relating to all aspects of the resident's functioning and progress toward desired outcomes identified in the residential service plan. A progress note will be entered in the resident's record at least once each month.
(5) Re-assessments and Revisions to the Residential Service Plan. The assessment and residential service plan will be reviewed and updated at least annually. On an ongoing basis, the residential service plan will be updated, as necessary, based upon changing circumstances or upon the resident's request for reconsideration.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0165
Resident Services and Activities
(1) General Requirements. The services and activities available at the facility will include care and treatment consistent with ORS 443.400 and those services individually specified for the resident in the residential service plan developed as outlined in OAR 309-035-0159. Residents will be encouraged to care for their own needs to the extent possible. All services and activities will be provided in a manner that respects residents' rights, promotes recovery and affords personal dignity.
(2) Services and Activities to Be Available. Services and activities to be available will include but not be limited to:
(a) Provision of adequate shelter consistent with OAR 309-035-0125 through 309-035-0140;
(b) At least three meals per day, seven days per week, provided in accordance with OAR 309-035-0170;
(c) Assistance and support, as necessary, to enable residents to meet personal hygiene and clothing needs;
(d) Laundry services, which may include access to washer(s) and dryer(s) so residents can do their own personal laundry;
(e) Housekeeping essential to the health and comfort of residents;
(f) Activities and opportunities for socialization and recreation both within the facility and in the larger community;
(g) Health-related services provided in accordance with OAR 309-035-0175;
(h) Assistance with community navigation and transportation arrangements;
(i) Assistance with money management, where requested by a resident, to include accurate documentation of all funds deposited and withdrawn when funds are held in trust for the resident;
(j) Assistance with acquiring skills to live as independently as possible;
(k) Assistance with accessing other additional services, as needed; and
(l) Any additional services required under contract the Division.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0167
Use of Seclusion or Restraints
(1) General Prohibition. The use of seclusion or restraints is prohibited, except in Secure Residential Treatment Facilities with the Division's approval.
(2) Approval of Use in Secure Residential Treatment Facilities. A Secure Residential Treatment Facility provider or applicant may submit an application to the Division for approval to use seclusion or restraints pursuant to OAR 309-033-0700 through 309-033-0740. Approval by the Division will be based upon the following:
(a) A determination that the residents served, or proposed to be served, have a history of behavioral concerns involving threats to the safety and well-being of themselves or others;
(b) The applicant demonstrates that the availability of seclusion or restraints is necessary to safely accommodate persons who would otherwise be unable to experience a community residential program; and
(c) The applicant demonstrates an ability to comply with OAR 309-033-0700 through 309-033-0740 and 309-033-0500 through 309-033-0560. These rules include special requirements for staffing, training, reporting, policies and procedures, and the facility's physical environment.
(3) Conditions of Use. Seclusion or restraints will only be used in approved Secure Residential Treatment Facilities when an emergency occurs in accordance with OAR 309-033-0700 through 309-033-0740 and 309-033-0500 through 309-033-0560. In such emergency situations, seclusion and restraint will be used as a last resort behavior management option after less restrictive behavior management interventions have failed, or in the case of an unanticipated behavioral outburst, to insure safety within the facility. Approved Secure Residential Treatment Facilities will implement policies and procedures approved by the Division outlining the circumstances under which seclusion or restraints would be used and the preventive measures to be taken before such use. All incidents involving the use of seclusion or restraints will be reported to the Division. In order to use seclusion or restraints with a resident who is not in state custody under civil commitment proceedings, the resident must be placed on a hold.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0170
Food Services
(1) Well-balanced Diet. Meals will be planned and served in accordance with the recommended dietary allowances found in the United States Department of Agriculture Food Guide Pyramid.
(2) Modified or Special Diets. An order from a Licensed Medical Professional will be obtained for each resident who, for health reasons, is on a modified or special diet. Such diets will be planned in consultation with the resident.
(3) Menus. Menus will be prepared at least one week in advance and will provide a sufficient variety of foods served in adequate amounts for each resident at each meal and adjusted for seasonal changes. Records of menus, as served, will be filed and maintained in the facility for at least 30 days. Resident preferences and requests will be considered in menu planning. Religious and vegetarian preferences will be reasonably accommodated.
(4) Supply of Food. Adequate supplies of staple foods for a minimum of one week and perishable foods for a minimum of two days will be maintained on the premises.
(5) Sanitation. Food will be stored, prepared and served in accordance with Health Services Food Sanitation Rules.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0175
Health Services
(1) General. The administrator will be responsible for assuring that all residents are offered medical attention when needed. Arrangements for health services will be made with the informed consent of the resident and/or guardian (as applicable). The RTF will arrange for physicians or other qualified health care professionals to be available in the event the resident's regular physician or other health care professional is unavailable. A hospital emergency room will be identified and may be used in case of emergency.
(2) Initial Health Screening. Each resident admitted to the facility will be screened by a Licensed Medical Professional or other qualified health care professional to identify health problems and to screen for communicable disease. Documentation of the initial health screening will be placed in the resident record.
(a) The health screening will include a brief history of health conditions, current physical condition and a written record of current or recommended medications, treatments, dietary specifications and aids to physical functioning.
(b) For regular admissions, the health screening will be obtained prior to the resident's admission and include the results of testing for tuberculosis and Hepatitis B.
(c) For emergency admissions, including crisis-respite admissions, the health screening will be obtained as follows:
(A) For individuals experiencing psychiatric or medical distress, a health screening will be completed by a Licensed Medical Professional or other qualified health care professional prior to the resident's admission or within 24 hours of the emergency placement. The health screening will confirm that the individual does not have health conditions requiring continuous nursing care, a hospital level of care, or immediate medical assistance. For each crisis-respite resident who continues in the facility for more than seven consecutive days, a complete health examination will be arranged if any symptoms of a health concern exist.
(B) For other individuals who are admitted on an urgent basis due to a lack of alternative supportive housing, the health screening will be obtained within 72 hours after the resident's admission.
(C) The health screening criteria may be waived for individuals admitted for crisis-respite services who are under the active care of an LMP or other qualified health care professional if it is the opinion of the attending health care professional that the crisis-respite placement presents no health risk to the individual or other residents in the facility. Such a waiver must be provided in writing and be signed and dated by the attending health care professional within 24 hours of the resident's admission.
(3) Regular Health Examinations. Except for crisis-respite residents, the program will insure that each resident has a primary physician or other qualified health care professional who is responsible for monitoring his/her health care. Regular health examinations will be done in accordance with the recommendations of this primary health care professional, but not less than once every three years. New residents will have a health examination completed within one year prior to admission or within three months after admission. Documentation of findings from each examination will be placed in the resident's record.
(4) Written Orders for Special Needs. A written order, signed by a physician or other qualified health care professional, is required for any medical treatment, special diet for health reasons, aid to physical functioning or limitation of activity.
(5) Medications. A written order signed by a physician or other qualified health care professional is required for all medications administered or supervised by RTF staff. This written order is required before any medication is provided to a resident. Medication will not be used for the convenience of staff or as a substitute for programming. Medications will not be withheld or used as reinforcement or punishment, or in quantities that are excessive in relation to the amount needed to attain the client's best possible functioning.
(a) Medications will be self-administered by the resident if the resident demonstrates the ability to self-administer medications in a safe and reliable manner. In the case of self-administration, both the written orders of the prescriber and the residential service plan will document that medications will be self-administered. The self-administration of medications may be supervised by facility staff who may prompt the resident to administer the medication and observe the fact of administration and dosage taken. When supervision occurs, staff will enter information in the resident's record consistent with section (5)(h) below.
(b) Staff who assist with administration of medication will be trained by a Licensed Medical Professional on the use and effects of commonly used medications.
(c) Medications prescribed for one resident will not be administered to, or self-administered by, another resident.
(d) Stock supplies of prescription medications will not be maintained. The facility may maintain a stock supply of non-prescription medications.
(e) The facility will provide and implement a policy and procedure which assures that all orders for prescription drugs are reviewed by a qualified health care professional, as specified by a physician or other qualified health care professional but not less often than every six months. Where this review identifies a contra-indication or other concern, the resident's primary physician, LMP or other primary health care professional will be immediately notified. Each client receiving psychotropic medications will be evaluated at least every three months by the LMP prescribing the medication, who will note, for the resident's record, the results of the evaluation and any changes in the type and dosage of medication, the condition for which it is prescribed, when and how the medication is to be administered, common side effects (including any signs of tardive dyskinesia, contraindications or possible allergic reactions), and what to do in case of a missed dose or other dosing error.
(f) All unused, discontinued, outdated or recalled medications, and any medication containers with worn, illegible or missing labels will be disposed. The method of disposal will be safe, consistent with any applicable federal statutes, and designed to prevent diversion of these substances to persons for whom they were not prescribed. A written record of all disposals will be maintained and specify the date of disposal, a description of the medication, its dosage potency, amount disposed, the name of the individual for whom the medication was prescribed, the reason for disposal, the method of disposal, and the signature of the staff person disposing the medication. For any medication classified as a controlled substance in schedules 1 through 5 of the Federal Controlled Substance Act, the disposal must be witnessed by a second staff person who documents their observation by signing the disposal record.
(g) All medications will be properly and securely stored in a locked space for medications only in accordance with the instructions provided by the prescriber or pharmacy. Medications for all residents will be labeled. Medications requiring refrigeration must be stored in an enclosed locked container within the refrigerator. The facility will assure that residents have access to a locked, secure storage space for their self-administered medications. The facility will note in its written policy and procedures which persons have access to this locked storage and under what conditions.
(h) For all residents taking prescribed medication, staff will record in the medical record each type, date, time and dose of medication provided. All effects, adverse reactions and medications errors will be documented in the resident's record. All errors, adverse reactions or refusals of medication will be reported to the prescribing professional within 48 hours.
(i) P.r.n. medications and treatments will only be administered in accordance with administrative rules of the Board of Nursing, chapter 851, division 47.
(6) Delegation of Nursing Tasks. Nursing tasks may be delegated by a Registered Nurse to direct care staff within the limitations of their classification and only in accordance with administrative rules of the Board of Nursing, chapter 851, division 47.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05
309-035-0185
Civil Penalties
(1) Applicability of Long Term Care Statute. For purposes of imposing civil penalties, residential treatment facilities licensed under ORS 443.400 to 443.455 and subsection (2) of ORS 443.991 are considered to be long-term care facilities subject to ORS 441.705 to 441.745.
(2) Sections of Rule Subject to Civil Penalties. Violations of any requirement within any part of the following sections of the rule may result in a civil penalty:
(a) 309-035-0110;
(b) 309-035-0113;
(c) 309-035-0115;
(d) 309-035-0117;
(e) 309-035-0120;
(f) 309-035-0125;
(g) 309-035-0130;
(h) 309-035-0135;
(i) 309-035-0140;
(j) 309-035-0145;
(k) 309-035-0150;
(l) 309-035-0155;
(m) 309-035-0157;
(n) 309-035-0159;
(o) 309-035-0165;
(p) 309-035-0167;
(q) 309-035-0170; and
(r) 309-035-0175.
(3) Assessment of Civil Penalties. Civil penalties will be assessed in accordance with the following guidelines:
(a) Civil penalties, not to exceed $250 per violation to a maximum of $1,000, may be assessed for general violations of these rules. Such penalties will be assessed after the procedures outlined in OAR 309-035-0110(8) have been implemented;
(b) A mandatory penalty up to $500 will be assessed for falsifying resident or facility records or causing another to do so;
(c) A mandatory penalty of $250 per occurrence will be imposed for failure to have direct care staff on duty 24 hours per day;
(d) Civil penalties up to $1,000 per occurrence may be assessed for substantiated abuse;
(e) In addition to any other liability or penalty provided by the law, the Division may impose a penalty for any of the following:
(A) Operating the RTF without a license;
(B) Operating with more residents than the licensed capacity; and
(C) Retaliating or discriminating against a resident, family member, employee, or other person for making a complaint against the program.
(f) In imposing a civil penalty, the following factors will be taken into consideration:
(A) The past history of the person incurring the penalty in taking all feasible steps or procedures to correct the violation;
(B) Any prior violations of statutes, rules or orders pertaining to the facility;
(C) The economic and financial conditions of the person incurring the penalty;
(D) The immediacy and extent to which the violation threatens or threatened the health, safety or welfare of one or more residents; and
(E) The degree of harm caused to residents.
(4) Notification. Any civil penalty imposed under this section will become due and payable ten days after notice is received, unless a request for a hearing is filed. The notice will be delivered in person, or sent by registered or certified mail and will include a reference to the particular section of the statute or rule involved, a brief summary of the violation, the amount of the penalty or penalties imposed, and a statement of the right to request a hearing.
(5) Request for Hearing. The person to whom the notice is addressed will have ten days from the date of receipt of the notice to request a hearing. This request must be in writing and submitted to the Assistant Director of the Division. If the written request for a hearing is not received on time, the Division will issue a final order by default.
(6) Hearings. All hearings will be conducted pursuant to the applicable provisions of ORS 183.310 and 183.411 to 183.502.
(7) Judgment. Unless the penalty is paid within ten days after the order becomes final, the order constitutes a judgment and may be recorded by the County Clerk which becomes a lien upon the title to any interest in real property owned by the person. The Division may also take action to revoke the license upon failure to comply with a final order.
(8) Judicial Review. Civil penalties are subject to judicial review under ORS 183.480, except that the court may, at its discretion, reduce the amount of the penalty.
(9) Disposition of Funds. All penalties recovered under ORS 443.790 to 443.815 will be paid into the State Treasury and credited to the General Fund.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08
309-035-0190
Criminal Penalties
(1) Specification of Criminal Penalty. Violation of any provision of ORS 443.400 through 443.455 is a Class B misdemeanor.
(2) Grounds for Law Suit. In addition, the Division may commence an action to enjoin operation of a Residential Treatment Facility:
(a) When a Residential Treatment Facility is operated without a valid license; or
(b) When a Residential Treatment Facility continues to operate after notice of revocation has been given and a reasonable time has been allowed for placement of residents in other facilities.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.460 & 443.991(2)

Hist.: MHD 9-1984(Temp), f. & ef. 12-10-84; MHD 9-1985, f. & ef. 6-7-85; MHD 4-1998, f. 5-21-98, cert. ef. 6-1-98; MHD 4-2005, f. & cert. ef. 4-1-05; MHS 4-2008, f. & cert. ef. 6-12-08

Residential Treatment Homes

309-035-0250
Purpose, Scope and Statutory Authority
(1) Purpose. These rules prescribe
standards by which the Addictions and Mental Health Division of the Oregon Health
Authority approves residential treatment homes for adults with mental or emotional
disorders. The standards promote the well-being, health and recovery of adults with
mental or emotional disorders through the availability of a wide range of residential
service options. They prescribe how services will be provided in safe, secure and
homelike environments that recognize the dignity, individuality and right to self-determination
of each resident.
(2) Scope. These rules apply
to residential treatment homes for five or fewer residents.
Stat. Auth.: ORS 413.042 &
443.450

Stats. Implemented: ORS 443.400
- 443.465 & 443.991

Hist.: MHD 7-1999, f. 11-15-99,
cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05; MHS 10-2011(Temp), f.
& cert. ef. 12-5-11 thru 5-31-12; MHS 5-2012, f. 5-3-12, cert. ef. 5-4-12
309-035-0260
Definitions
As used in these rules the following
definitions apply:
(1) "Abuse" includes but is
not limited to:
(a) Any death caused by other
than accidental or natural means or occurring in unusual circumstances;
(b) Any physical injury caused
by other than accidental means, or that appears to be at variance with the explanation
given of the injury;
(c) Willful infliction of physical
pain or injury;
(d) Sexual harassment or exploitation
including, but not limited to, any sexual contact between an employee of a community
facility or community program, or provider, or other caregiver and the adult. For
situations other than those involving an employee, provider, or other caregiver
and an adult, sexual harassment or exploitation means unwelcome verbal or physical
sexual contact including requests for sexual favors and other verbal or physical
conduct directed toward the adult;
(e) Neglect that leads to physical
harm through withholding of services necessary to maintain health and well being;
(f) Abuse does not include spiritual
treatments by a duly accredited practitioner of a recognized church or religious
denomination when voluntarily consented to by the individual. (2) "Administrator"
means the person designated by the licensee as responsible for the daily operation
and maintenance of the Residential Treatment Home (RTH).
(3) "Adult" means an individual
18 years of age or older.
(4) "Aid to Physical Functioning"
means any special equipment ordered for a resident by a Licensed Medical Professional
or other qualified health care professional which maintains or enhances the resident's
physical functioning.
(5) "Applicant" means the person(s)
or entity that owns the business and is applying for the license.
(6) "Approved" means authorized
or allowed by the Department.
(7) “Authority”
means the Oregon Health Authority.
(8) "Building Code" means the
state building code as defined in ORS 455.010 and includes the Oregon Structural
Specialty Code, One and Two Family Dwelling Code and other specialty codes adopted
by the Building Codes Division of the Oregon Department of Consumer and Business
Services.
(9) "Care" means services such
as supervision; protection; assistance with activities of daily living such as bathing,
dressing, grooming, or eating; management of money; transportation; recreation;
and the providing of room and board.
(10) “Caregiver”
means an employee, program staff, provider or volunteer of a licensed Residential
Treatment Facility (RTF), Residential Treatment Home (RTH) or Adult Foster Home
(AFH).
(11) "Community Mental Health
Program (CMHP)" means the organization of all or a portion of services for persons
with mental or emotional disorders, and operated by, or contractually affiliated
with, a local mental health authority, operated in a specific geographic area of the state under an intergovernmental
agreement or direct contract with the Division.
(12) "Contract" means a formal written
agreement between the community mental health program, Mental Health Organization
or the Addictions and Mental Health Division and a Residential Treatment Home (RTH)
owner.
(13) "Crisis-Respite Services"
means the provision of services to individuals for up to 30 days. Individuals receiving
crisis-respite services are RTH residents.
(14) "DSM" means the "Diagnostic
and Statistical Manual of Mental Disorders (DSM-IV)" published by the American Psychiatric
Association.
(15) "Direct Care Staff Person"
means an employee responsible for providing services to residents.
(16) “Division”
means the Addictions and Mental Health Division of the Oregon Health Authority.
(17) "Electrical Code" means
the Uniform Building and Fire Codes adopted on October 1, 2004 by the Building Codes
Division of the Oregon Department of Consumer and Business Services.
(18) "Emergency Admission" means
an admission to an RTH made on an urgent basis due to the pressing service needs
of the individual.
(19) "Employee" means a person
who is employed by a licensed Residential Treatment Home (RTH) who receives wages,
a salary, or is otherwise paid by the RTH for providing the service. The term also
includes employees of other providers delivering direct services to clients of RTHs.
(20) "Evacuation Capability"
means the ability of occupants, including residents and staff as a group, to either
evacuate the building or relocate from a point of occupancy to a point of safety
as defined in the Oregon Structural Specialty Code. The category of evacuation capability
is determined by documented evacuation drill times or scores on National Fire Protective
Association (NFPA) 101A 2000 edition worksheets. There are three categories of evacuation
capability:
(a) Impractical (SR- 2): A group,
even with staff assistance, that cannot reliably move to a point of safety in a
timely manner, determined by an evacuation capability score of five or greater or
with evacuation drill times in excess of 13 minutes.
(b) Slow (SR- 1) for more than
16 residents) and (SR-4 for 6 to 16 residents): A group that can move to a point
of safety in a timely manner, determined by an evacuation capability score greater
than 1.5 and less than five or with evacuation drill times over three minutes but
not in excess of 13 minutes. SR-3 occupancies are those homes with five or fewer
occupants having evacuation capabilities of impractical or slow with assistance.
(c) Prompt: A group with an
evacuation capability score of 1.5 or less or equivalent to that of the general
population or with evacuation drill times of three minutes or less. The Division
shall determine evacuation capability for RTH’s in accordance with the National
Fire Protection Association (NFPA) 101A 2000 edition. Facilities that are determined
to be "Prompt" may be used in Group R occupancies classified by the building official,
in accordance with the building code.
(21) "Fire Code" means the Oregon
Fire Code as adopted by the Office of State Fire Marshal and as amended by local
jurisdictions.
(22) "Home" means the building
and grounds where the Residential Treatment Home program is operated.
(23) “Individual”
means any person being considered for or receiving residential and other services
regulated by these rules.
(24) "Licensed Medical Professional
(LMP)" means a person who meets the following minimum qualifications as documented
by the Local Mental Health Authority (LMHA) or designee:
(a) Holds at least one of the
following educational degrees and valid licensures:
(A) Physician licensed to practice
in the State of Oregon;
(B) Nurse Practitioner licensed
to practice in the State of Oregon; or
(C) Physician's Assistant licensed
to practice in the State of Oregon; and
(b) Whose training, experience,
and competence demonstrate the ability to conduct a Comprehensive Mental Health
Assessment and provide medication management.
(25) "Licensee" means the person
or entity legally responsible for the operation of the RTH to which the Division
has issued a license.
(26) "Local Mental Health Authority
(LMHA)" means the county court or board of county commissioners of one or more counties
who choose to operate a CMHP or MHO; or, if the county declines to operate or contract
for all or part of a CMHP or MHO, the board of directors of a public or private
corporation which contracts with the Division to operate a CMHP or MHO for that
county.
(27) "Mechanical Code" means
the Oregon Mechanical Specialty Code adopted by the Building Codes Division of the
Oregon Department of Consumer and Business Services.
(28) "Medication" means any
drug, chemical, compound, suspension, or preparation in suitable form for use as
a curative or remedial substance either internally or externally by any person.
(29) "Mental or Emotional Disorder"
means a primary Axis I or Axis II DSM diagnosis, other than mental retardation or
a substance abuse disorder that limits an individual's ability to perform activities
of daily living.
(30) "Mental Health Assessment"
means a determination by a Qualified Mental Health Professional of the client's
need for mental health services. It involves collection and assessment of data pertinent
to the client's mental health history and current mental health status obtained
through interview, observation, testing, and review of previous treatment records.
It concludes with determination of a DSM diagnosis or other justification of priority
for mental health services, or a written statement that the person is not in need
of community mental health services.
(31) "Mental Health Organization
(MHO)" means an approved organization that provides most mental health services
through a capitated payment mechanism under the Oregon Health Plan. MHOs may be
fully capitated health plans, community mental health programs, private mental health
organizations or combinations thereof.
(32) “Mistreatment”
means the following behaviors, displayed by an employee, program staff, provider
or volunteer of an RTH when directed toward an individual:
(a) “Abandonment”
means desertion or willful forsaking when the desertion or forsaking results in
harm or places the individual at a risk of serious harm.
(b) “Financial exploitation”
means:
(A) Wrongfully taking the assets,
funds, or property belonging to or intended for the use of an individual.
(BI) Alarming an individual
by conveying a threat to wrongfully take or appropriate money or property of the
individual if the individual would reasonably believe that the threat conveyed would
be carried out.
(C) Misappropriating, misusing,
or transferring without authorization any money from any account held jointly or
singly by an individual.
(D) Failing to use the income
or assets of an individual effectively for the support and maintenance of the individual.
“Effectively” means use of income or assets for the benefit of the individual.
(c) “Involuntary Restriction”
means the involuntary restriction of an individual for the convenience of a caregiver
or to discipline the individual. Involuntary restriction may include but is not
limited to placing restrictions on an individual’s freedom of movement by
restriction to his or her room or a specific area, or restriction from access to
ordinarily accessible areas of the facility, residence or program, unless agreed
to by the treatment plan. Restriction may be permitted on an emergency or short
term basis when an individual’s presence would pose a risk to health or safety
to the individual or others.
(d) “Neglect”
means active or passive failure to provide the care, supervision, or services necessary
to maintain the physical and mental health of an individual that creates a significant
risk of harm to an individual or results in significant mental injury to an individual.
Services include but are not limited to the provision of food, clothing, medicine,
housing, medical services, assistance with bathing or personal hygiene, or any other
services essential to the well-being of the individual.
(e) “Verbal Mistreatment” means
threatening significant physical harm or emotional harm to an individual through
the use of:
(A) Derogatory or inappropriate
names, insults, verbal assaults, profanity, or ridicule.
(B) Harassment, coercion, punishment,
deprivation, threats, implied threats, intimidation, humiliation, mental cruelty,
or inappropriate sexual comments.
(C) A threat to withhold services
or supports, including an implied or direct threat of termination of services. “Services”
include but are not limited to the provision of food, clothing, medicine, housing,
medical services, assistance with bathing or personal hygiene, or any other services
essential to the well-being of an individual.
(D) For purposes of this definition,
verbal conduct includes but is not limited to the use of oral, written, or gestured
communication that is directed to an individual or within their hearing distance
or sight, regardless of their ability to comprehend. In this circumstance the assessment
of the conduct is based on a reasonable person standard.
(E) The emotional harm that
can result from verbal abuse may include but is not limited to anguish, distress,
or fear.
(f) “Wrongful Restraint”
means:
(A) A wrongful use of a physical
or chemical restraint excluding an act of restraint prescribed by a licensed physician
pursuant to OAR 309-033-0730.
(B) Wrongful restraint does
not include physical emergency restraint to prevent immediate injury to an individual
who is in danger of physically harming himself or herself or others, provided that
only the degree of force reasonably necessary for protection is used for the least
amount of time necessary.
(33) "Nursing Care" means the
practice of nursing by a licensed nurse, including tasks and functions that are
delegated by a registered nurse to a person other than a licensed nurse, which are
governed by ORS Chapter 678 and rules adopted by the Oregon State Board of Nursing
in OAR Chapter 851.
(34) "Owner" means the person
or entity including the Division that is legally responsible for the operation of
the facility.
(35) "Plumbing Code" means the
Oregon Plumbing Specialty Code adopted by the Building Codes Division of the Oregon
Department of Consumer and Business Services.
(36) "P.R Nn. (pro re nata)
Medications and Treatments" means those medications and treatments that have been
ordered to be given as needed.
(37) "Program" means the Residential
Treatment Home and may refer to the owner, staff, or services as applicable to the
context.
(38) “Program staff”
means an employee or person who, by contract with an RTH, provides a service and
who has the applicable competencies, qualifications, and certification, required
by the Integrated Services and Supports Rule (ISSR) (OAR 309-032-1500 to 309-032-1565)
to provide the service.
(39) "Progress Notes" means
the notations in the resident record documenting significant information concerning
the resident and summarizing progress made relevant to the objectives outlined in
the residential service plan.
(40) "Protection" means the
necessary actions taken by the program to prevent abuse, mistreatment, or exploitation
of the residents, to prevent self-destructive acts, and to safeguard residents,
property, and funds.
(41) “Provider”
means a qualified individual or an organizational entity operated by or contractually
affiliated with a community mental health program, or contracted directly with the
Division for the direct delivery of mental health services and supports to adults
receiving residential and supportive services in an RTH.
(42) "Qualified Health Care
Professional" means a health care professional licensed to practice in the state
of Oregon who is approved to perform certain health care tasks referenced in the
relevant section of these rules consistent with the scope of practice specified
by the licensing board for the profession. In accordance with the referenced health
care task, the qualified health care professional may include a physician, a physician's
assistant, a nurse practitioner, a registered nurse, or a pharmacist.
(43) "Qualified Mental Health
Professional (QMHP)" means a Licensed Medical Practitioner (LMP) or any other person
meeting the following minimum qualifications as documented by the LMHA or designee:
(a) Graduate degree in psychology;
(b) Bachelor's degree in nursing
and licensed by the State of Oregon;
(c) Graduate degree in social
work;
(d) Graduate degree in behavioral
science field;
(e) Graduate degree in recreational,
art, or music therapy; or
(f) Bachelor's degree in occupational
therapy and licensed by the State of Oregon; and
(g) Whose education and experience
demonstrates the competencies to identify precipitating events; gather histories
of mental and physical disabilities, alcohol and drug use, past mental health services
and criminal justice contacts; assess family, social and work relationships; conduct
a mental status examination; document a multiaxial DSM diagnosis; write and supervise
a Treatment Plan; conduct a Comprehensive Mental Health Assessment; and provide
individual, family, and group therapy within the scope of his or her practice.
(44) "Resident" means any adult
residing in the RTH who receives services on a 24-hour basis, except as excluded
under ORS 443.400(3).
(45) "Residential Service Plan"
means an individualized, written plan outlining the care and treatment to be provided
to a resident in or through the RTH based upon an individual assessment of care
and treatment needs. The residential service plan may be a section or subcomponent
of the individual's overall mental health treatment plan when the RTH is operated
by a mental health service agency that provides other services to the resident.
(46) "Residential Treatment
Home (RTH)" means a home that is operated to provide services on a 24-hour basis
for five or fewer residents.
(47) "Restraints" means any
chemical or physical methods or devices that are intended to restrict or inhibit
the movement, functioning, or behavior of a resident.
(48) "Seclusion" means placing
an individual in a locked room. A locked room includes a room with any type of door
locking device, such as a key lock, spring lock, bolt lock, foot pressure lock,
or physically holding the door shut.
(49) "Secure Residential Treatment
Facility" means any residential treatment facility, or portion thereof, that restricts
a resident's exit from the facility or its grounds through the use of approved locking
devices on resident exit doors, gates or other closures.
(50) "Services" means the care
and treatment provided to residents as part of the RTH program.
(51) "Supervision" means the
daily observation, and monitoring of residents by direct care staff or oversight
of staff by the administrator or administrator's designee, as applicable to the
context.
(52) "Termination of Residency"
means the time at which the resident ceases to live in the RTH and includes the
transfer of the resident to another facility, but does not include absences from
the RTH for the purpose of taking a planned vacation, visiting family or friends,
or receiving time-limited medical or psychiatric treatment.
(53) "Treatment" means a planned,
individualized program of medical, psychological or rehabilitative procedures, experiences
and activities consistent with ORS 443.400(12).
(54)
“Volunteer” means a person who provides a service or who takes part
in a service provided to individuals receiving supportive services in an RTH or
other provider, and who is not a paid employee of the RTH or other provider. The
services must be non-clinical unless the person has the required credentials to
provide a clinical service.
Stat. Auth.: ORS 413.042 & 443.450

Stats. Implemented: ORS 443.400
- 443.455, 443.875, 443.991

Hist.: MHD 7-1999, f. 11-15-99,
cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05; MHS 6-2007(Temp), f. &
cert. ef. 5-25-07 thru 11-21-07; MHS 13-2007, f. & cert. ef. 8-31-07; MHS 10-2011(Temp),
f. & cert. ef. 12-5-11 thru 5-31-12; MHS 5-2012, f. 5-3-12, cert. ef. 5-4-12
309-035-0270
Licensing
(1) License Required. The Department will license any home that meets the definition of a residential treatment home and serves adults with a mental or emotional disorder. In the case of a home serving another category of residents in addition to adults with a mental or emotional disorder, the Department responsible for licensure will be determined by the Director of the Department of Human Services. No person or governmental unit acting individually or jointly with any other person or governmental unit will establish, maintain, manage, or operate a residential treatment home without a license issued by the Department.
(2) Initial Application. An application for a license will be accompanied by the required fee and submitted to the Department using the forms or format required by the Department. The following information will be required in the application:
(a) Full and complete information as to the identity and financial interest of each person, including stockholders, having a direct or indirect ownership interest of five percent or more in the RTH and all officers and directors in the case of RTHs operated or owned by a corporation.
(b) Location (street address) of the home and mailing address;
(c) Maximum number of residents to be served at any one time, their age range and evacuation capability;
(d) Proposed annual budget identifying sources of revenue and expenses;
(e) Signed criminal record authorizations for all persons involved in the operation of the RTH who will have contact with the residents;
(f) A complete set of policies and procedures;
(g) Facility plans and specifications; and
(h) Such other information as the Department may reasonably require.
(3) Plans and Design Approval. A complete set of plans and specifications will be submitted to the Department at the time of initial application, whenever a new structure or addition to an existing structure is proposed, or when significant alterations to an existing facility are proposed. Plans will meet the following criteria:
(a) Plans will be prepared in accordance with the Building Code and requirements of OAR 309-035-0320;
(b) Plans will be to scale and sufficiently complete to allow full review for compliance with these rules; and
(c) Plans will be to scale and carry the stamp of an Oregon licensed architect or engineer when required by the Building Code and ORS Chapters 671 and 672 (laws relating to the practice of architecture and engineering).
(4) Necessary Approvals. Prior to approval of a license for a new or renovated home, the applicant will submit the following to the Department:
(a) One copy of written approval to occupy the home issued by the city, county or state building codes authority having jurisdiction;
(b) One copy of the fire inspection report from the State Fire Marshal or local jurisdiction indicating that the home complies with the Fire Code;
(c) When the home is not served by an approved municipal water system, one copy of the documentation indicating that the state or county health agency having jurisdiction has approved the water supply in accordance with OAR chapter 333, Health Services rules for public water systems.
(d) When the home is not connected to an approved municipal sewer system, one copy of the sewer or septic system approval from the Department of Environmental Quality or local jurisdiction.
(5) Required Fees. The fee for each residential treatment home license application is $30. No fee is required in the case of a governmentally operated residential treatment home.
(6) Renewal Application. A license is renewable upon submission of a renewal application in the form or format required by the Department and a non-refundable fee of $30, except that no fee will be required of a governmentally operated RTH. Filing of an application for renewal before the date of expiration extends the effective date of the current license until the Department takes action upon the renewal application.
(7) Review Process. Upon receipt of an application and fee, the Department will conduct an application review. Initial action by the Department on the application will begin within 30 days of receipt of all application materials. The review will:
(a) Include a complete review of application materials;
(b) Determine whether the applicant meets the qualifications outlined in ORS 443.420 including:
(A) Demonstrates an understanding and acceptance of these rules;
(B) Is mentally and physically capable of providing services for residents;
(C) Employs or utilizes only individuals whose presence does not jeopardize the health, safety, or welfare of residents; and
(D) Provides evidence satisfactory to the Department of financial ability to comply with these rules.
(c) Include a site inspection; and
(d) Conclude with a report stating findings and a decision on licensing of the RTH.
(8) Findings of Noncompliance. The Department will require an owner to submit and complete a plan of correction for each finding of noncompliance with these rules.
(a) If the finding(s) of noncompliance substantially impacts the welfare, health and/or safety of residents, the plan of correction will be submitted and completed prior to issuance of a license. In the case of a currently operating RTH, such findings may result in suspension or revocation of a license.
(b) If it is determined that the finding(s) of noncompliance do not threaten the welfare, health or safety of residents and the facility meets other requirements of licensing, a license may be issued or renewed, and the plan of correction will be submitted and completed as a condition of licensing.
(c) The Department will specify required documentation and set the time lines for the submission and completion of plans of correction in accordance with the severity of the finding(s).
(d) The Department will review and approve each plan of correction. If the plan of correction does not adequately remedy the finding of noncompliance, the Department may require a revised plan of correction.
(e) The RTH owner may appeal the finding of noncompliance or the disapproval of a plan of correction by submitting a request for reconsideration in writing to the Administrator of the Department. The Administrator of the Department or designee will make a decision on the appeal within 30 days of receipt of the appeal.
(9) Variance. The Authority may grant a variance to these rules based upon a demonstration by the applicant that an alternative method or different approach provides equal or greater program effectiveness and does not adversely impact the welfare, health or safety of residents.
(a) Variance Application. The RTH owner requesting a variance will submit, in writing, an application to the Department which identifies the section of the rules from which the variance is sought, the reason for the proposed variance, the proposed alternative method or different approach, and signed documentation from the CMHP indicating approval of the proposed variance.
(b) Addictions and Health Division Review. The Assistant Administrator for the Authority's Addictios and Mental Health Division, or designee, will review and approve or deny the request for a variance.
(c) Notification of Decision. The Department will notify the RTH owner of the decision in writing within 30 days after receipt of the application. A variance may be implemented only after receipt of written approval from the Department.
(d) Appeal of Decision. The RTH owner may appeal the denial of a variance request by submitting a request for reconsideration in writing to the Administrator of the Department. The Administrator of the Department will make a decision on the appeal within 30 days of receipt of the appeal. The decision of the Administrator of the Department will be final.
(e) Duration of the Variance. A variance will be reviewed by the Department at least every two years and may be revoked or suspended based upon a finding that the variance adversely impacts the welfare, health or safety of the RTH residents.
(10) Issuance of License. Upon finding that the applicant is in substantial compliance with these rules, the Department will issue a license.
(a) The license issued will state the name of the owner of the RTH, the name of the administrator, the address of the home to which the license applies, the maximum number of residents to be served at any one time and their evacuation capability, the type of home, and such other information as the Department deems necessary.
(b) A residential treatment home license will be effective for two years from the date issued unless sooner revoked or suspended.
(c) The residential treatment home license is not transferable or applicable to any location, facility, or management other than that indicated on the application and license.
(11) Conditions of License. The license will be valid under the following conditions:
(a) The residential treatment home will not be operated or maintained in combination with a nursing facility, hospital, retirement facility, or other occupancy unless licensed, maintained, and operated as a separate and distinct part. Each residential treatment home will have sleeping, dining and living areas for use only by its own residents, employees and invited guests.
(b) The license will be retained in the home and available for inspection at all times.
(c) Each license will be considered void immediately upon suspension or revocation of the license by the Department, or if the operation is discontinued by voluntary action of the licensee, or if there is a change of ownership.
(12) Site Inspections. Department staff will visit and inspect every residential treatment home at least, but not limited to, once every two years to determine whether it is maintained and operated in accordance with these rules. The RTH owner/applicant will allow Department staff entry and access to the home and residents for the purpose of conducting the inspections.
(a) Department staff will review methods of resident care and treatment, records, the condition of the facility and equipment, and other areas of operation.
(b) All records, unless specifically excluded by law, will be available to the Department for review.
(c) The State Fire Marshal or authorized representative(s) will, upon request, be permitted access to the home, fire safety equipment within the home, safety policies and procedures, maintenance records of fire protection equipment and systems, and records demonstrating the evacuation capability of RTH occupants.
(13) Investigation of Complaints and Alleged Abuse. Incidents of alleged abuse covered by ORS 430.735 through 430.765 will be reported and investigated in accordance with OAR 410-009-0050 through 410-009-0160. Department staff will investigate complaints and other alleged abuse made regarding residential treatment homes, will cause a report to be filed, and will take appropriate action under these rules. The Department may delegate the investigation to a CMHP or other appropriate entity.
(14) Denial, Suspension or Revocation of License. The Department will deny, suspend or revoke a license when it finds there has been substantial failure to comply with these rules; or when the State Fire Marshal or authorized representative certifies that there is a failure to comply with the Fire Code or Building Code.
(a) The Department may immediately suspend a license where there exists an imminent danger to the health or safety of residents.
(A) The Department will provide written notice of the suspension to the licensee citing the violation and stating the corrective action necessary in order for the license to be re-instated.
(B) The licensee may request a review of the decision to immediately suspend a license by submitting a request, in writing, within 10 days of the suspension notice. Within 10 days of receipt of the licensee's request for a review, the Department administrator or designee will review all material relating to the suspension and determine whether to sustain the decision. If the administrator does not sustain the decision, the suspension will be rescinded immediately. The decision of the administrator can be appealed within 90 days as a contested case under ORS 183.310 and 183.400 to 183.502.
(b) The Department will take action to deny or revoke a license in accordance with the following procedures:
(A) The Department will provide written notice of the denial or revocation citing the violation(s), and specifying the effective date (in the case of a currently operating RTH).
(B) The licensee will be entitled to a contested case hearing under ORS 183.310 and 183.400 to 183.502 prior to the effective date of revocation or denial if the licensee requests a hearing in writing, within 21 days after receipt of the written notice. If no such request is received, the decision will be sustained.
(C) A license subject to revocation or denial based upon review of a renewal application, will remain valid during an administrative hearings process, unless suspended, even if the hearing and final order are not issued until after the expiration date of the license.
(D) If an initial license is denied, the applicant will be entitled to a contested case hearing under ORS 183.310 and 183.400 to 183.502 if the applicant requests a hearing in writing within 60 days of receipt of the denial notice. If no such request is received, the decision to deny the license application will be sustained.
(i) In cases where there exists an imminent danger to the health or safety of residents, a license may be suspended immediately.
(ii) Such revocation, suspension, or denial will be done in accordance with rules of the Department under ORS Chapter 183.
(15) Reporting Changes. Each licensee will report promptly to the Department any significant changes to information supplied in the application or subsequent correspondence. Such changes include, but are not limited to, changes in the RTH name, owner entity, administrator, telephone number and mailing address. Such changes also include, but are not limited to, changes in the RTHs physical plant, policies and procedures or staffing pattern when such changes are significant or impact the health, safety or well-being of residents.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0280
Contracts and Rates
(1) Contracts. Residential treatment home operators providing services funded by the Department will enter into a contract with the local community mental health program, the Department or other Department-approved entity. The contract does not guarantee that any number of persons eligible for Department funded services will be referred to or maintained in the home.
(2) Rates. Rates for all services and the procedures for collecting payments from residents and/or payees will be specified in a fee policy and procedures. The fee policy and procedures will describe the schedule of rates, conditions under which rates may be changed, acceptable methods of payment, and the policy on refunds at the time of termination of residency.
(a) For residents whose services are funded by the Department, reimbursement for services will be made according to the rate schedule outlined in the contract. Room and board payments for residents receiving Social Security benefits or public assistance will be in accordance with and not more than rates determined by the Department.
(b) For private paying residents, the program will enter into a signed agreement with the resident, and/or if applicable, resident's guardian, payee or conservator. This agreement will include but not be limited to a description of the services to be provided; the schedule of rates; conditions under which the rates may be changed; and policy on refunds at the time of termination of residency.
(c) Before an RTH increases rates or modifies payment procedures, the program will provide 30 days advance notice of the change to all residents, and their payees, guardians or conservators, as applicable.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0290
Administrative Management
(1) Licensee. The licensee will be responsible for insuring that the RTH is operated in compliance with these rules and all other applicable federal, state and local laws and regulations.
(2) Administrator. The licensee will employ an administrator who:
(a) Has background including special training, experience, and other demonstrated ability in providing care and treatment appropriate to the residents served in the facility;
(b) Has a documented criminal record clearance and no history of abusive behavior;
(c) Will ensure that the RTH operates in accordance with the standards outlined in these rules;
(d) Will oversee the daily operation and maintenance of the RTH and will be available to perform administrative duties at the RTH at least 20 hours per week at the RTH or provide an administrative plan which documents an equivalent level of available supervision.
(e) Will develop and administer written policies and procedures to direct the operation of the RTH and the provision of services to residents;
(f) Will ensure that qualified staff are available, in accordance with the staffing requirements specified in these rules;
(g) Will supervise or provide for the supervision of staff and others involved in the operation of the program;
(h) Will maintain program, personnel and resident records;
(i) Will report regularly to the licensee on the operation of the RTH; and
(j) Will delegate authority and responsibility for the operation and maintenance of the facility to a responsible staff person whenever the Administrator is absent from the RTF. This authority and responsibility will not be delegated to a resident.
(3) Policies and Procedures. Policies and procedures will be developed, updated as necessary, maintained in a location easily accessible for staff reference, and made available to others upon reasonable request. They will be consistent with requirements of these rules, and address, but not be limited to:
(a) Personnel practices and staff training;
(b) Resident selection, admission and termination;
(c) Fire drills, emergency procedures, resident safety and abuse reporting;
(d) Health and sanitation;
(e) Records;
(f) Residential service plan, services and activities;
(g) Behavior management, including prohibition of the use of seclusion or restraints;
(h) Food Service;
(i) Medication administration and storage;
(j) Resident belongings, storage and funds;
(k) Resident rights and advance directives;
(l) Complaints and grievances;
(m) Facility maintenance;
(n) Evacuation capability determination; and
(o) Fees and money management.
(4) House Rules. The RTH will develop reasonable house rules outlining operating protocols concerning, but not limited to, meal times, night-time quiet hours, guest policies, smoking and phone use. The house rules will be consistent with resident rights as delineated in OAR 309-035-0380 and are subject to approval by the Department. House rules will be posted in an area readily accessible to residents. House rules will be reviewed and updated, as necessary. Residents will be provided an opportunity to review and provide input into any proposed changes to house rules before the revisions become effective.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0300
Records
(1) General Requirements. Records will be maintained to document the legal operation of the program, personnel practices and resident services. All records will be properly obtained, accurately prepared, safely stored and readily available within the RTH. All entries in records required by these rules will be in ink, indelible pencil, or approved electronic equivalent and prepared at the time, or immediately following, the occurrence of the event being recorded; be legible; and be dated and signed by the person making the entry. In the case of electronic records, signatures may be replaced by an approved, uniquely identifiable electronic equivalent.
(2) Program Records. Records documenting the legal operation of the RTH will include, but not be limited to:
(a) Written approval for occupancy of the building by the county or city having jurisdiction, any building inspection reports, zoning verifications, fire inspection reports or other documentation pertaining to the safe and sanitary operation of the RTH;
(b) Application for license, related correspondence and site inspection reports;
(c) Program operating budget and related financial records;
(d) Payroll records, employee schedules and time sheets;
(e) Materials Safety and Data Sheets;
(f) Fire drill documentation;
(g) Fire alarm and sprinkler system maintenance and testing records;
(h) Incident reports; and
(i) Policy and procedure manual.
(3) Personnel Records. Records documenting personnel actions will include:
(a) Job descriptions for all positions; and
(b) Individual employee records including, but not limited to, written documentation of employee identifying information and qualifications, criminal record clearance, tuberculosis test results, Hepatitis B vaccinations in accordance with the Oregon Occupational Safety and Health Code, performance appraisals, and documentation of pre-service orientation and other training.
(4) Resident Records. Except as indicated in OAR 309-035-0300(5), an individual resident record will be maintained for each resident and include:
(a) An easily accessible summary sheet which includes, but is not limited to the resident's name, previous address, date of admission to the facility, sex, date of birth, marital status, legal status, religious preference, Social Security number, health provider information, evacuation capability, diagnosis(es), major health concerns, medication allergies, information indicating whether advance mental health and health directives and/or burial plan have been executed, and the name of person(s) to contact in case of emergency;
(b) The names, addresses and telephone numbers of the resident's legal guardian or conservator, parent(s), next of kin, or other significant person(s); physician(s) or other medical practitioner(s); dentist; CMHP case manager or therapist; day program, school or employer; and any governmental or other agency representative(s) providing services to the resident;
(c) A mental health assessment and background information identifying the resident's residential service needs;
(d) Advance mental health and health directives, burial plans or location of these (as available);
(e) Residential service plan and copy(ies) of plan(s) from other relevant service provider(s).
(f) Documentation of the resident's progress and any other significant information including, but not limited to, progress notes, progress summaries, any use of seclusion or restraints, and correspondence concerning the resident;
(g) Health-related information and up-to-date information on medications in accordance with OAR 309-035-0440;
(h) Any authorizations obtained for the release of confidential information.
(5) Records for Crisis-respite Residents. For residents receiving crisis-respite services, an individual resident record will be maintained for each resident and include:
(a) A referral form or forms which include the resident's name; previous address; date of admission; sex; date of birth; marital status; social security number; health care provider names and phone numbers (including primary care physician, psychiatrist, prescriber (if different), and any other known health care providers); health insurance information; entitlements and/or eligibility; source and amount of income; diagnosis(es); major health concerns; current medications; medication or other allergies; name(s) of person(s) to contact in case of emergency; name, address and phone number of guardian or conservator (as applicable); and other information pertinent to the resident's crisis-respite stay;
(b) A mental health assessment and plan which include the reason for placement in crisis-respite care, the nature of crisis necessitating placement, an evaluation of risk for harm to self or others, the residential treatment plan for the crisis-respite stay, the expected duration of the crisis-respite placement, and the discharge plan;
(c) Current written orders by a qualified health care professional for all medications and a plan for obtaining any prescribed medications which are not in the resident's possession in original labeled containers;
(d) A signed resident agreement indicating informed consent for treatment; and
(e) Any authorizations obtained for the release of confidential information.
(6) Storage. All resident records will be stored in a weatherproof and secure location. Access to records will be limited to the Administrator and direct care staff unless otherwise allowed in these rules.
(7) Confidentiality. All resident records will be kept confidential. A signed release of information will be obtained for any disclosure from resident records in accordance with all applicable laws and rules.
(8) Resident Access to His/Her Record. A resident, or guardian (as applicable), will be allowed to review and obtain a copy of his/her resident record as allowed in ORS 179.505(9).
(9) Transfer of Records. Pertinent information from records of residents who are being transferred to another program will be transferred with the resident. A signed release of information will be obtained in accordance with applicable laws and rules.
(10) Maintenance of Records. The RTH will keep all records, except those transferred with a resident, for a period of three years.
(11) Administrative Changes. If an RTH changes ownership or Administrator, all resident and personnel records will remain in the home. Prior to the dissolution of any RTH, the Administrator will notify the Department in writing as to the location and storage of resident records or those records will be transferred with the residents.
(12) Resident Contributions to Record. If a resident or guardian (as applicable) disagrees with the content of the resident record, or otherwise desires to provide documentation for the record, the resident or guardian (as applicable) may provide material in writing that then will become part of the resident record.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0310
Staffing
(1) Staff Qualifications. A job description will be available for each staff position and specify qualifications and job duties.
(a) Any staff person hired to provide direct care to residents will be at least 18 years of age, be capable of implementing the RTHs emergency procedures and disaster plan, and be capable of performing other duties of the job as described in the job description.
(b) In accordance with OAR 943-007-0001 through 943-007-0501, all RTH staff who will have contact with residents will provide evidence of a criminal record clearance prior to starting employment.
(c) In accordance with OAR 333-071-0057 and 437, Division 2, Subdivision Z, 4f(1)(2), all RTH staff who will have contact with residents will be tested for tuberculosis and Hepatitis B within two weeks of first employment; additional testing will take place as deemed necessary; and the employment of staff who test positive for tuberculosis will be restricted if necessary.
(d) In accordance with the Oregon Occupational Safety and Health Code, chapter 437, division 2, Subdivision Z, Hepatitis B vaccinations will be offered within ten working days of initial employment to RTH staff who will have contact with residents. Training about bloodborne pathogens and related safety practices will be completed prior to offering the vaccination.
(e) All staff will meet other qualifications when required by a contract or financing arrangement approved by the Department.
(2) Personnel Policies. Personnel policies will be made available to all staff and will describe hiring, leave, promotion and disciplinary practices.
(3) Staff Training. The administrator will provide or arrange a minimum of 16 hours pre-service orientation and eight hours in-service training annually for each employee.
(a) Pre-service training for direct care staff will include, but not be limited to, a comprehensive tour of the home; a review of emergency procedures developed in accordance with OAR 309-035-0330; a review of RTH house rules, policies and procedures; background on mental and emotional disorders; an overview of resident rights; assessment of resident risk factors; medication management procedures; food service arrangements; a summary of each resident's assessment and residential service plan; and other information relevant to the job description and scheduled shift(s).
(b) In-service training will be provided on topics relevant to improving the care and treatment of residents in the RTH and meeting the requirements in these administrative rules. In-service training topics include, but are not limited to, implementing the residential service plan, behavior management, daily living skills development, nutrition, first aid, understanding mental illness, sanitary food handling, resident rights, identifying health care needs, and psychotropic medications.
(4) General Staffing Requirements. The licensee and administrator are responsible for assuring that an adequate number of staff are available at all times to meet the treatment, health and safety needs of residents. Regardless of the minimum staffing requirements, staff will be scheduled to ensure safety and to correspond to the changing needs of residents. At a minimum, there will be at least one direct care staff person on duty at all times.
(a) In the case of a specialized RTH, staffing requirements outlined in the contractual agreement for specialized services will be implemented.
(b) Direct care staff on night duty will be awake and dressed at all times. In homes where residents are housed in two or more detached buildings, direct care staff will monitor each building at least once an hour during the night shift. An approved method for alerting staff to problems will be in place. This method must be accessible to and usable by the residents.
Stat. Auth.: ORS 413.042 & 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0320
Physical Environment Requirements
(1) Compliance with Building and Fire Codes. Each residential treatment home established on or after December 1, 1999, will meet the requirements for approved Group SR occupancies in the Building Code and the Fire Code in effect at the time of licensure. RTHs licensed as adult foster homes by the Department before the effective date of these rules will demonstrate that the home was in compliance with the Building Code and Fire Code in effect at the time of the original Department licensure. When renovation or a change in the home's use results in a new building occupancy classification, the home will meet the requirements for approved Group SR occupancies in the Building Code in effect at the time of such change.
(2) Accessibility for Persons with Disabilities. RTHs will be accessible as follows:
(a) Those homes that are licensed, constructed or renovated after January 26, 1992, and that are covered multi-family dwellings or public accommodations, will meet the physical accessibility requirements in Chapter 11 of the Oregon Structural Specialty Code. This code specifies requirements for public accommodations as defined in the Americans with Disabilities Act under Title III and for buildings qualifying as multi-family dwellings as defined in the Fair Housing Act, as amended in 1988.
(b) In order to ensure program accessibility under Title II of the Americans with Disabilities Act, the Department may require additional accessibility improvements.
(c) Any accessibility improvements made to accommodate an identified resident will be in accordance with the specific needs of the resident and will comply with the Building Code.
(3) Outdoor Areas. An accessible outdoor area is required and will be made available to all residents. For RTHs licensed on or after December 1, 1999, a portion of the accessible outdoor area will be covered and have an all weather surface, such as a patio or deck.
(4) General Storage. The home will include sufficient and safe storage areas. These will include but not be limited to:
(a) Storage for a reasonable amount of resident belongings beyond that available in resident sleeping rooms will be provided. For homes licensed on or after December 1, 1999, this storage will include 24 cubic feet per resident.
(b) All maintenance equipment stored on site, including yard maintenance tools, will be maintained in adequate storage space. Equipment and tools which pose a danger to RTH residents will be kept in locked storage.
(c) Storage areas necessary to ensure a functional, safe and sanitary environment consistent with OAR 309-035-0320, 309-035-0330, 309-035-0340, 309-035-0350, 309-035-0430, and 309-035-0440.
(5) Hallways. For RTHs initially licensed on or after December 1, 1999, all resident use areas and resident units will be accessible through temperature controlled common areas or hallways with a minimum width of 36 inches.
(6) Administrative Areas. Sufficient space will be provided for confidential storage of both resident and business records, for staff use in completing record-keeping tasks, and for a telephone. Other equipment including fire alarm panels and other annunciators will be installed in an area readily accessible to staff in accordance with the Fire Code.
(7) Resident Sleeping Rooms. Resident sleeping quarters will be provided in rooms separated from other areas of the facility by an operable door with an approved latching device.
(a) For homes licensed prior to December 1, 1999, resident sleeping rooms will include a minimum of 60 square feet per resident and allow for a minimum of three feet between beds.
(b) For homes initially licensed on or after December 1, 1999, each resident sleeping room will be limited to one or two residents. At least ten per cent, but no less than one, of the resident sleeping rooms will be accessible for persons with mobility disabilities. All resident sleeping rooms will include a minimum of 70 square feet per resident exclusive of closets, vestibules and bathroom facilities and allow a minimum of three feet between beds.
(c) A clothes closet, with adequate clothes hanging rods will be accessible within each sleeping room for storage of each resident's clothing and personal belongings. For homes initially licensed on or after December 1, 1999, built-in closet space will be provided totaling a minimum of 64 cubic feet for each resident. In accessible sleeping rooms, the clothes hanging rod height will be adjustable or no more than 54 inches in height to ensure accessibility for persons in wheelchairs.
(d) Each resident sleeping room will have exterior window(s) with a combined area at least one-tenth of the floor area of the room. Sleeping room windows will be equipped with curtains or blinds for privacy and control of light. For homes initially licensed on or after December 1, 1999, an operable, opening window for emergency egress will be provided consistent with Building Code requirements.
(e) When locking devices are used on resident sleeping room doors, they will meet the requirements of the Building Code.
(8) Bathrooms.
(a) Bathing and toilet facilities will be conveniently located for resident use, provide permanently wired light fixtures that illuminate all parts of the room, provide individual privacy for residents, provide a securely affixed mirror at eye level, be adequately ventilated by a mechanical exhaust system or operable windows, and include sufficient facilities specially equipped for use by persons with a physical disability in buildings serving such persons.
(b) A minimum of one toilet, one lavatory and one bathtub or shower will be available for residents.
(9) Common Use Rooms. The home will include lounge and activity area(s), such as a living room or parlor, as required in the Building Code or totaling 25 square feet per resident, whichever is greater, for social and recreational use exclusively by residents, staff and invited guests.
(10) Laundry and Related Space. Laundry facilities will be separate from food preparation and other resident use areas. When residential laundry equipment is installed, the laundry facilities may be located to allow for both resident and staff use. The following will be included in the laundry facilities:
(a) Countertops or folding table(s) sufficient to handle laundry needs for the facility;
(b) Locked storage for chemicals and equipment;
(c) Outlets, venting and water hook-ups according to state building code requirements. Washers will have a minimum rinse temperature of 140 degrees Fahrenheit; and
(d) Sufficient, separate storage and handling space to ensure that clean laundry is not contaminated by soiled laundry.
(11) Kitchen. Kitchen facilities and equipment will be of residential type except as otherwise approved by the Department. For all kitchens, the following will be included:
(a) Dry storage space, not subject to freezing, in cabinets or a separate pantry for a minimum of one week's supply of staple foods;
(b) Sufficient refrigeration space maintained at 45 degrees Fahrenheit or less and freezer space for a minimum of two days' supply of perishable foods;
(c) A dishwasher (may be approved residential type) with a minimum final rinse temperature of 140 degrees Fahrenheit;
(d) Smooth, nonabsorbent and cleanable counters for food preparation and serving;
(e) Appropriate storage for dishes and cooking utensils designed to be free from potential contamination;
(f) Stove and oven equipment for cooking and baking needs; and
(g) Storage for a mop and other cleaning tools and supplies used for food preparation, dining and adjacent areas. Such cleaning tools will be maintained separately from those used to clean other parts of the facility.
(12) Dining Area.
(a) A separate dining room or area where meals are served will be provided for the exclusive use of residents, employees, and invited guests.
(b) Dining space will be provided to seat all residents with a minimum area of 20 square feet per resident, exclusive of serving facilities and required exit pathways.
(13) Details and Finishes. All details and finishes will meet the finish requirements of applicable sections of the Building Code and the Fire Code.
(a) Surfaces. Surfaces of all walls, ceilings, windows and equipment will be readily cleanable. The walls, floors and ceilings in the kitchen, laundry and bathing areas will be nonabsorbent, and readily cleanable.
(b) Flooring. In homes initially licensed on or after December 1, 1999, flooring, thresholds and floor junctures will be designed and installed to prevent a tripping hazard. In addition, hard surface floors and base will be free from cracks and breaks, and bathing areas will have non-slip surfaces.
(c) Doors. In homes initially licensed on or after December 1, 1999, all doors to accessible resident sleeping rooms, bathrooms and common use areas will provide a minimum clear opening of 32 inches. Lever type door hardware will be provided on all doors used by residents in accessible areas. If locks are used on doors to resident sleeping rooms, they will be interactive to release with operation of the inside door handle and be master-keyed from the corridor side. Exit doors will not include locks which prevent evacuation. An exterior door alarm or other acceptable system may be provided for security purposes and to alert staff when resident(s) or others enter or exit the home.
(d) Handrails. Handrails will be provided on all stairways as specified in the Building Code.
(14) Heating and Ventilating. All areas of the home will be adequately ventilated and temperature controlled consistent with Mechanical and Building Code requirements in effect at the time of installation.
(a) Temperature Control. All habitable rooms will include heating equipment capable of maintaining a minimum temperature of 68 degrees Fahrenheit at a point three feet above the floor. During times of extreme summer heat, fans will be made available when air conditioning is not provided.
(b) Exhaust Systems. All toilet and shower rooms will be ventilated by a mechanical exhaust system or operable windows.
(c) Fireplaces, Furnaces, Wood Stoves and Boilers. Where used, design and installation will meet standards of the Mechanical Code and the Boiler and Pressure Vessel Law in effect at the time of their installation, as applicable.
(d) Water Temperature. In resident areas, hot water temperatures will be maintained within a range of 110 to 120 degrees Fahrenheit. Hot water temperatures for washing machines and dishwashers will be at least 140 degrees Fahrenheit.
(15) Electrical. All electrical systems will meet the standards of the Electrical Code in effect on the date of installation, and all electrical devices will be properly wired and in good repair.
(a) When not fully grounded, circuits in resident areas may be protected by GFCI type receptacles or circuit breakers as an acceptable alternative.
(b) All electrical circuits will be protected by circuit breakers or non-interchangeable circuit-breaker-type fuses in fuse boxes.
(c) A sufficient supply of electrical outlets will be provided to meet resident and staff needs without the use of extension cords or outlet expander devices. (See Office of State Fire Marshal and Department of Health Services policy for extension cords.)
(d) Lighting fixtures will be provided in each resident bedroom and bathroom, switchable near the entry door, and in other areas as required to meet task illumination needs.
(16) Plumbing. All plumbing will meet the Plumbing Code in effect on the date of installation, and all plumbing fixtures will be properly installed and in good repair.
(17) Telephones. The home will provide adequate access to telephones for private use by residents. In homes initially licensed on or after December 1, 1999, a phone for resident use will be provided in addition to the phone used by staff. The RTH may establish reasonable house rules governing phone use to ensure equal access by all residents. Each resident or guardian (as applicable) will be responsible for payment of long distance phone bills where the calls were initiated by the resident, unless other mutually agreed arrangements have been made.
(18) Smoking. Smoking is not allowed in sleeping areas. If there is a designated smoking area, it will be separated from other common areas. Indoor smoking areas will be equipped with a mechanical exhaust fan or central exhaust system which discharges to the outside. Furniture used in designated smoking areas will be non-flammable and without crevasses. In homes initially licensed on or after December 1, 1999, indoor smoking areas will be separated from other parts of the home by a self-closing door, contain sprinkler protection or heat detectors, and contain only non-combustible furnishings and materials.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0330
Safety
(1) Training on Safety Procedures. All staff will be trained in staff safety procedures prior to beginning their first regular shift. All residents will be trained in resident safety procedures as soon as possible during their first 72 hours of residency.
(2) Emergency Procedure and Disaster Plan. A written procedure and disaster plan will be developed to cover such emergencies and disasters as fires, explosions, missing persons, accidents, earthquakes and floods. The plan will be posted by the phone and immediately available to the administrator and employees. The plan will specify where staff and residents will go if the home becomes uninhabitable. The plan will be kept up to date and will include:
(a) Emergency instructions for employees;
(b) The telephone numbers of the local fire department, police department, the poison control center, the administrator, the administrator's designee, and other persons to be contacted in emergencies; and
(c) Instructions for the evacuation of residents and employees.
(3) Combustible and Hazardous Materials. Noncombustible and nonhazardous materials will be used whenever possible. When necessary to the operation of the home, flammable and combustible liquids and other hazardous materials will be safely and properly stored in clearly labeled, original containers in areas inaccessible to residents in accordance with the Fire Code. Any quantities of combustible and hazardous materials maintained will be the minimum necessary.
(4) Poisonous and Other Toxic Materials. Non-toxic cleaning supplies will be used whenever available. Poisonous and other toxic materials will be properly labeled and stored in locked areas distinct and apart from all food and medications.
(5) Evacuation Capability. Evacuation capability categories are based upon the ability of the residents and staff as a group to evacuate the home or relocate from a point of occupancy to a point of safety. Homes will be constructed and equipped according to the Building Code occupancy classification for the designated evacuation capability for occupants. Occupancy classification categories of evacuation capability include "Impractical" and "Slow" (SR-3). "Prompt" homes are regulated by the building and fire codes as R-3 occupancies. The evacuation capability designated for the facility will be documented and maintained in accordance with requirements for Group SR Occupancies in the Building Code.
(a) Only persons assessed to be capable of evacuating in accordance with the designated facility evacuation capability will be admitted to the RTH.
(b) Persons experiencing difficulty with evacuating in a timely manner will be provided assistance from staff and offered environmental and other accommodations, as practical. Under such circumstances, the RTH will consider increasing staff levels, changing staff assignments, offering to change the resident's room assignment, arranging for special equipment, and taking other actions that may assist the resident. Residents who still cannot evacuate the home safely in the allowable period of time will be assisted with transferring to another program with an evacuation capability designation consistent with the individual's documented evacuation capability.
(6) Evacuation Drills. Every resident will participate in an unannounced evacuation drill each month. (See Section 408.12.5 of the Fire Code.)
(a) At least once every three months, the drill will be conducted during resident sleeping hours.
(b) Drills will be scheduled at different times of the day and on different days of the week with different locations designated as the origin of the fire for drill purposes.
(c) Any resident failing to evacuate within the established time limits will be provided with special assistance and a notation made in the resident record.
(d) Written evacuation records will be retained for at least three years. They will include documentation, made at the time of the drill, specifying the date and time of the drill, the location designated as the origin of the fire for drill purposes, the names of all individuals and staff present, the amount of time required to evacuate, notes of any difficulties experienced, and the signature of the staff person conducting the drill.
(7) Unobstructed Egress. All stairways, halls, doorways, passageways, and exits from rooms and from the home will be unobstructed.
(8) Fire Extinguishers. The program will install and maintain one or more 2A:10B:C fire extinguishers on each floor in accordance with the Fire Code.
(9) Fire and Smoke Alarms and Detectors. Approved fire and smoke alarms and detectors will be installed according to Building Code and Fire Code requirements. These alarms will be tested during each evacuation drill. The RTH will provide appropriate signal devices for persons with disabilities who do not respond to the standard auditory alarms. All of these devices will be inspected and maintained in accordance with the requirements of the State Fire Marshal or local agency having jurisdiction.
(10) Sprinkler Systems. Sprinkler systems, if used, will be installed in compliance with the Building Code and maintained in accordance with rules adopted by the State Fire Marshal.
(11) First Aid Supplies. First aid supplies will be readily accessible to staff. All supplies will be properly labeled.
(12) Portable Heaters. Portable heaters are a recognized safety hazard and will not be used, except as approved by the State Fire Marshal or authorized representative.
(13) Safety Program. A safety program will be developed and implemented to identify and prevent the occurrence of hazards. Such hazards may include, but are not limited to, dangerous substances, sharp objects, unprotected electrical outlets, use of extension cords or other special plug-in adapters, slippery floors or stairs, exposed heating devices, broken glass, inadequate water temperatures, overstuffed furniture in smoking areas, unsafe ashtrays and ash disposal, and other potential fire hazards.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0340
Sanitation
(1) Water Supply. The water supply in the home will meet the requirements of the current rules of the Health Division governing domestic water supplies.
(a) A municipal water supply will be utilized if available.
(b) When the home is not served by an approved municipal water system, and the home qualifies as a public water system according to OAR 333-061-0020(127), Oregon Health Services rules for public water systems, then the home will comply with the OAR chapter 333 rules of the Oregon Health Services pertaining to public water systems. These include requirements that the drinking water be tested for total coliform bacteria at least quarterly, and nitrate at least annually, and reported to Health Services. For adverse test results, these rules require that repeat samples and corrective action be taken to assure compliance with water quality standards, that public notice be given whenever a violation of the water quality standards occurs, and that records of water testing be retained according to the Oregon Health Services requirements.
(2) Surfaces. All floors, walls, ceilings, windows, furniture, and equipment will be kept in good repair, clean, neat and orderly.
(3) Plumbing Fixtures. Each bathtub, shower, lavatory, and toilet will be kept clean, in good repair and regularly sanitized.
(4) Disposal of Cleaning Waste Water. No kitchen sink, lavatory, bathtub, or shower will be used for the disposal of cleaning waste water.
(5) Soiled Laundry. Soiled linens and clothing will be stored in an area or container separate from kitchens, dining areas, clean linens, clothing, and food.
(6) Pest Control. All necessary measures will be taken to prevent rodents and insects from entering the home. Should pests be found in the home, appropriate action will be taken to eliminate them.
(7) Grounds Maintenance. The grounds of the home will be kept orderly and reasonably free of litter, unused articles, and refuse.
(8) Garbage Storage and Removal. Garbage and refuse receptacles will be clean, durable, watertight, insect and rodent proof, and will be kept covered with tight-fitting lids. All garbage and solid waste will be disposed of at least weekly and in compliance with the current rules of the Department of Environmental Quality.
(9) Sewage Disposal. All sewage and liquid wastes will be disposed of in accordance with the Plumbing Code to a municipal sewage system where such facilities are available. If a municipal sewage system is not available, sewage and liquid wastes will be collected, treated, and disposed of in compliance with the current rules of the Department of Environmental Quality. Sewage lines, and septic tanks or other non-municipal sewage disposal systems where applicable, will be maintained in good working order.
(10) Biohazardous Waste. Biohazardous waste will be disposed of in compliance with the rules of the Department of Environmental Quality.
(11) Infection Control. Precautions will be taken to prevent the spread of infectious and/or communicable diseases as defined by the Centers for Disease Control and to minimize or eliminate exposure to known health hazards.
(a) In accordance with OAR 437, division 2, subdivision Z, Section 1910.1030 of the Oregon Occupational Safety and Health Code, staff will employ universal precautions whereby all human blood and certain body fluids are treated as if known to be infectious for HIV, HBV and other blood borne pathogens.
(b) Bathroom facilities will be equipped with an adequate supply of toilet paper, soap and towels.
(12) Infection Control for Pets and Other Household Animals. If pets or other household animals exist at the home, sanitation practices will be implemented to prevent health hazards.
(a) Such animals will be vaccinated in accordance with the recommendations of a licensed veterinarian. Proof of such vaccinations will be maintained on the premises.
(b) Animals not confined in enclosures will be under control and maintained in a manner that does not adversely impact residents or others.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0350
Resident Furnishings
(1) Bedroom Furniture. Residents will be allowed to use their own furniture within space limitations of the resident sleeping room. Otherwise, furniture will be provided or arranged for each resident, maintained in good repair and include:
(a) A bed, including a frame and a clean mattress and pillow;
(b) A private dresser or similar storage area for personal belongings which is readily accessible to the resident; and
(c) Locked storage for the resident's small, personal belongings. In homes initially licensed before December 1, 1999, this locked storage may be provided in a place other than the resident's bedroom. The resident will be provided with a key or other method to gain access to his/her locked storage space.
(2) Linens. Linens will be provided for each resident and will include:
(a) Sheets, pillowcase, other bedding appropriate to the season and individual resident's comfort;
(b) Availability of a waterproof mattress or waterproof mattress cover; and
(c) Towels and wash cloths.
(3) Personal Hygiene Items. Each resident will be assisted in obtaining personal hygiene items in accordance with individual needs. These will be stored in a clean and sanitary manner, and may be purchased with the resident's personal allowance. Personal hygiene items include, but are not limited to, a comb and/or hairbrush, a toothbrush, toothpaste, and menstrual supplies (if needed).
(4) Supplies Provided by RTH. Sufficient supplies of soap, shampoo and toilet paper for all residents will be provided.
(5) Common Area Furniture. An adequate supply of furniture for resident use in living room, dining room and other common areas will be maintained in good condition.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0360
Admission to Home
(1) Responsibility for Admission Process. Each RTHs admission policy and procedures will specify who is responsible for each component of the admission information-gathering and decision-making process. Responsibilities will be organized and assigned to promote effective processing of referrals and admissions.
(2) Referrals. Unless limited by contractual agreement with the Department or other Department-approved party, referrals may be accepted from a variety of sources. Residents whose services will be funded by the Department must be approved for placement by the CMHP or other local entity given responsibility for this function by contract with the Department.
(3) Release of Information. In accordance with ORS 179.505 and the 45 Code of Federal Registry, Part 164, an authorization for the release of information will be obtained for any confidential information concerning a prospective resident.
(4) Nondiscrimination. Persons will be considered for admission without regard to race, color, sex or sexual orientation (except as may be limited by room arrangement), religion, creed, national origin, age (except under 18 years), familial status, marital status, source of income, or disability in addition to the mental or emotional disorder.
(5) Screening. Prior to accepting a resident for admission to the RTH, the administrator or his/her designee will determine that the resident meets admission criteria. The prospective resident will receive an explanation of the program, be given a copy of materials explaining conditions of residency, and be offered the opportunity to visit the home. Sufficient information will be obtained from the prospective resident, a relative and/or agencies providing services to determine eligibility for admission and service needs. In the case of individuals referred for emergency or crisis-respite admission, the information obtained may be less extensive than for regular admissions but must be sufficient to determine that the resident meets admission criteria and that the RTH is appropriate considering the individual's needs. Screening information will include, but not be limited to, the following:
(a) Written documentation that the prospective resident has, or is suspected of having, a mental or emotional disorder;
(b) Background information including a mental health assessment and describing previous living arrangements, service history, behavioral issues and service needs;
(c) Medical information including a brief history of any health conditions, documentation from a Licensed Medical Professional or other qualified health care professional of the individual's current physical condition, and a written record of any current or recommended medications, treatments, dietary specifications, and aids to physical functioning;
(d) Copies of documents, or other documentation, relating to guardianship, conservatorship, commitment status, advance directives, or any other legal restrictions (as applicable);
(e) A copy of the prospective resident's most recent mental health treatment plan, or in the case of an emergency or crisis-respite admission, a summary of current mental health treatment involvement; and
(f) Documentation of the prospective resident's ability to evacuate the building consistent with the RTHs designated evacuation capability and other concerns about potential safety risks.
(6) Admission Criteria. Persons considered for admission will:
(a) Be assessed to have a mental or emotional disorder, or a suspected mental or emotional disorder;
(b) Be in need of care, treatment and supervision;
(c) Be at least 18 years of age;
(d) Not require continuous nursing care, unless a reasonable plan to provide such care exists, the need for residential treatment supersedes the need for nursing care, and the Department approves the placement;
(e) Have an evacuation capability consistent with the RTHs SR Occupancy classification; and
(f) Meet additional criteria required or approved by the Department through contractual agreement or condition of licensing.
(7) Admission Decisions. A decision to admit a resident to the RTH will be made as follows:
(a) For regular admissions, the decision will be made based upon a review of screening materials at a pre-admission meeting and a determination that the resident meets the admission criteria. A pre-admission meeting will be scheduled to include the RTH administrator or designee, the potential resident and his/her legal guardian (as applicable). With the prospective resident's consent, the pre-admission meeting may also include family member(s) or other representative(s) as appropriate, representative(s) of relevant service providing agency(ies), and others with an interest in the resident's admission. The potential resident, legal guardian (as applicable) and authorized representative will be informed of the admission decision within 72 hours. If a decision is deferred or postponed, the potential resident, legal guardian (as applicable) and authorized representative will be informed of the potential resident's application status within one week of the pre-admission meeting, and weekly thereafter (as necessary). When admission is denied, the prospective resident, their legal guardian (as applicable) and authorized representative will be informed in writing of the basis for the decision and their right to appeal the decision in accordance with OAR 309-035-0390.
(b) For crisis-respite admissions, the decision will be made based upon a review of the referral materials by the RTH administrator or designee and a determination that the resident meets the admission criteria. Due to the urgent nature of crisis-respite admissions, decisions will be made on an immediate basis. The prospective resident, their legal guardian (as applicable) and authorized representative will be directly informed of the decision and their right to appeal in accordance with OAR 309-035-0390.
(8) Informed Consent for Services. The RTH will obtain informed consent for services upon admission to the RTH from each resident, or his/her guardian (as applicable), unless the resident's ability to do so is legally restricted. If such consent is not obtained, the reason will be documented and further attempts to obtain informed consent will be made as appropriate.
(9) Orientation. Upon admission, the administrator or his/her designee will provide an orientation to each new resident that includes, but is not limited to, a complete tour of the home, introductions to other residents and staff, discussion of house rules, explanation of the laundry and food service schedule and policies, review of resident rights and grievance procedures, explanation of the fee policy, discussion of the conditions under which residency would be terminated, and a general description of available services and activities. During the orientation, advance directives will be explained. If the resident does not already have any advance directive(s), she/he will be given an opportunity to complete them. Orientation will also include a description of the RTHs emergency procedures in accordance with OAR 309-035-0330(2).
(10) Record Preparation. A resident record will be established concurrent with the resident's admission. Prior to a regular admission, within five days after an emergency admission, or within 24 hours of a crisis-respite admission, the program will determine with whom communication needs to occur and will attempt to obtain the needed authorizations for release of information. The record established upon admission will include the materials reviewed in screening the resident, the summary sheet and any other available information. Every effort will be made to complete the resident record consistent with OAR 309-035-0300(4) and (5) in a timely manner. The assessment and residential service plan will be completed in accordance with OAR 309-035-0440. Records on prescribed medications and health needs will be completed as specified in OAR 309-035-0440.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0370
Termination of Residency
(1) Responsibility for Termination Process. Each RTHs termination policy and procedures will specify who is responsible for each step of the process for terminating residency. Responsibilities will be organized and assigned to promote a fair and efficient termination process. Unless otherwise designated as a condition of licensing or in contract language approved by the Department, the Administrator will be responsible for initiating and coordinating termination proceedings. An effort will be made to prevent unnecessary terminations by making reasonable accommodations within the RTH.
(2) Crisis-respite Services. Because crisis-respite services are time-limited, the planned end of services will not be considered a termination of residency and will not be subject to requirements in OAR 309-035-0370(3), (5), (6) and (9). Upon admission to crisis-respite services, the resident or guardian (as applicable) will be informed of the planned date for discontinuation of services. This date may be extended through mutual agreement between the administrator and the resident or guardian (as applicable). RTHs providing crisis-respite services will implement policies and procedures that specify reasonable time frames and the grounds for discontinuing crisis-respite services earlier than the date planned.
(3) Voluntary Termination of Residency. A resident or guardian (as applicable) may terminate residency in the RTH upon providing at least 30 days notice. Upon mutual agreement between the administrator and the resident or guardian (as applicable), less than 30 days notice may be provided.
(4) Emergency Termination of Residency. If a resident's behavior poses a serious and immediate threat to the health or safety of others in or near the RTH, the administrator, after providing 24 hours written notice specifying the causes to the resident or guardian (as applicable), may immediately terminate the residency. The notice will specify the resident's right to appeal the emergency termination decision in accordance with OAR 309-035-0390.
(5) Other Terminations of Residency. When other circumstances arise providing grounds for termination of residency, the administrator will discuss these grounds with the resident, the resident's guardian (as applicable), and with the resident's permission, other persons with an interest in the resident's circumstances. If a decision is made to terminate residency, the administrator will provide at least 30 days written notice specifying the causes to the resident or guardian (as applicable). This notice will also specify the resident's right to appeal the termination decision in accordance with OAR 309-035-0390. Upon mutual agreement between the administrator and the resident or guardian (as applicable), less than 30 days notice may be provided. An effort will be made to establish a reasonable termination date in consideration of both program needs and the needs of the terminated resident to find alternative living arrangements. Criteria establishing grounds for termination include:
(a) Resident no longer needs or desires services provided at the RTH and/or expresses a desire to move to an alternative setting;
(b) Resident is assessed by a Licensed Medical Professional or other qualified health professional to require services, such as continuous nursing care or extended hospitalization, that are not available, or can not be reasonably arranged, at the RTH;
(c) Resident's behavior is continuously and significantly disruptive or poses a threat to the health or safety of self or others and these behavioral concerns cannot be adequately addressed with services available at the RTH or services that can be arranged outside of the RTH;
(d) Resident cannot safely evacuate the home in accordance with the RTHs SR Occupancy Classification after efforts described in OAR 309-035-0330(5)(b) have been taken;
(e) Nonpayment of fees in accordance with program's fee policy; and
(f) Resident continuously and knowingly violates house rules resulting in significant disturbance to others.
(6) Pre-termination Meeting. Except in the case of emergency terminations or crisis-respite services, a pre-termination meeting will be held with the resident, guardian (as applicable), and with the resident's permission, others interested in the resident's circumstances. The purpose of the meeting is to plan any arrangements necessitated by the termination decision. The meeting will be scheduled to occur at least two weeks prior to the termination date. In the event a pre-termination meeting is not held, the reason will be documented in the resident's record.
(7) Documentation. Documentation of discussions and meetings held concerning termination of residency and copies of notices will be maintained in the resident's record.
(8) Disposition of Personal Property. At the time of termination of residency, the resident will be given a statement of account, any balance of funds held by the RTH and all property held in trust or custody by the RTH.
(a) In the event of pending charges (such as long distance phone charges or damage assessments), the program may hold back the amount of funds anticipated to cover the pending charges. Within 30 days after residency is terminated or as soon as pending charges are confirmed, the resident will be provided a final financial statement along with any funds due to the resident.
(b) In the case of resident belongings left at the RTH for longer than seven days after termination of residency, the RTH will make a reasonable attempt to contact the resident, guardian (as applicable) and/or other representative of the resident. The RTH must allow the resident, guardian (as applicable) or other representative at least 15 days to make arrangements concerning the property. If it is determined that the resident has abandoned the property, the RTH may then dispose of the property. If the property is sold, proceeds of the sale, minus the amount of any expenses incurred and any amounts owed the program by or on behalf of the resident, will be forwarded to the resident or guardian (as applicable).
(9) Absences without Notice. If a resident moves out of the RTH without providing notice, or is absent without notice for more than seven consecutive days, the administrator may terminate residency in the manner provided in ORS 105.105 to 105.168 after seven consecutive days of the resident's absence. An attempt will be made to contact the resident, guardian (as applicable) and/or other person interested in the resident's circumstances to confirm the resident's intent to discontinue residency.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0380
Resident Rights
(1) Statutory and Constitutional Rights. Each resident will be assured the same civil and human rights accorded to other citizens. These rights will be assured unless expressly limited by a court in the case of a resident who has been adjudicated incompetent and not restored to legal capacity. The rights described in paragraphs (2) and (3) of this section are in addition to, and do not limit, all other statutory and constitutional rights which are afforded to all citizens including, but not limited to, the right to vote, marry, have or not have children, own and dispose property, enter into contracts and execute documents.
(2) Rights of Service Recipients. In accordance with ORS 430.210, residents will have the right to:
(a) Choose from available services those which are appropriate, consistent with the plan developed in accordance with paragraphs (b) and (c) of this subsection, and provided in a setting and under conditions that are least restrictive to the person's liberty, that are least intrusive to the person and that provide for the greatest degree of independence;
(b) An individualized written service plan, services based upon that plan and periodic review and reassessment of service needs;
(c) Ongoing participation in planning services in a manner appropriate to the person's capabilities, including the right to participate in the development and periodic revision of the plan described in paragraph (b) of this subsection, and the right to be provided with a reasonable explanation of all service considerations;
(d) Not receive services without informed consent except in a medical emergency or as otherwise permitted by law;
(e) Not participate in experimentation without informed voluntary written consent;
(f) Receive medication only for the person's individual clinical needs;
(g) Not be involuntarily terminated or transferred from services without prior notice, notification of available sources of necessary continued services and exercise of a grievance procedure;
(h) A humane service environment that affords reasonable protection from harm and affords reasonable privacy;
(i) Be free from abuse or neglect and to report any incident of abuse without being subject to retaliation;
(j) Religious freedom;
(k) Not be required to perform labor, except personal housekeeping duties, without reasonable and lawful compensation;
(l) Visit with family members, friends, advocates and legal and medical professionals;
(m) Exercise all rights set forth in ORS 426.385 and 427.031 if the individual is committed to the Department;
(n) Be informed at the start of services and periodically thereafter of the rights guaranteed by this section and the procedure for reporting abuse, and to have these rights and procedures prominently posted in a location readily accessible to the person and made available to the person's guardian and any representative designated by the person;
(o) Assert grievances with respect to infringement of the rights described in this section, including the right to have such grievances considered in a fair, timely and impartial grievance procedure;
(p) Have access to and communicate privately with any public or private rights protection program or rights advocate; and
(q) Exercise all rights described in this section without any form of reprisal or punishment.
(3) Additional Rights in RTHs. Residents will also have a right to:
(a) Adequate food, shelter and clothing, consistent with OAR 309-035-0410;
(b) A reasonable accommodation if, due to their disability, the housing and services are not sufficiently accessible;
(c) Confidential communication, including receiving and opening personal mail, private visits with family members and other guests, and access to a telephone with privacy for making and receiving telephone calls;
(d) Express sexuality in a socially appropriate and consensual manner;
(e) Access to community resources including recreation, religious services, agency services, employment and day programs, unless such access is legally restricted;
(f) Be free from seclusion and restraint;
(g) To review the RTHs policies and procedures; and
(h) Not participate in research without informed voluntary written consent.
(4) The Resident's Right to Fresh Air. For the purpose of this rule, these terms have the following meanings:
(a) “Fresh air” means the inflow of air from outside the facility where the resident is receiving services. “Fresh air” may be accessed through an open window or similar method as well as through access to the outdoors.
(b) “Outdoors” means an area with fresh air that is not completely enclosed overhead. “Outdoors” may include a courtyard or similar area.
(c) If a resident requests access to fresh air and the outdoors or the resident's treating health care provider determines that fresh air and the outdoors would be beneficial to the resident, the facility in which the resident is receiving services shall provide daily access to fresh air or the outdoors unless this access would create a significant risk of harm to the resident or others.
(d) The determination whether a significant risk of harm to the resident or others exists shall be made by the resident's treating health care provider. The treating health care provider may find that a significant risk of harm to the resident or others exists if:
(A) The resident 's individual circumstances and condition indicate an unreasonable risk of harm to the resident or others which cannot be reasonably accommodated within existing programming should the resident be allowed access to fresh air and the outdoors; or
(B) The facility’s existing physical plant or existing staffing prevent the provision of access to fresh air and the outdoors in a manner than maintains the safety of the resident or others.
(e) If a facility determines that its existing physical plant prevents the provision of access to fresh air or the outdoors in a safe manner, the facility shall make a good faith effort at the time of any significant renovation to the physical plant that involves renovation of the unit or relocation of where residents are treated to include changes to the physical plan or location that allow access to fresh air and the outdoors, so long as such changes do not add an unreasonable amount to the cost of the renovation.
(5) Program Requirements. The program will have and implement written policies and procedures which protect residents' rights, and encourage and assist residents to understand and exercise their rights. The program will post a listing of resident rights under these rules in a place readily accessible to all residents and visitors.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05; MHS 5-2009, f. & cert. ef. 12-17-09
309-035-0390
Grievances and Appeals
(1) Procedures. The RTH will have a written policy and procedures concerning the resident grievance and appeal process. A copy of the grievance and appeal process will be posted in a place readily accessible to residents. A copy of the grievance and appeal process will be provided to each resident and guardian (as applicable) at the time of admission to the RTH.
(2) Grievances. A RTHs process for grievances must, at a minimum, include the following:
(a) Residents will be encouraged to informally resolve complaints through discussion with RTH staff.
(b) If the resident is not satisfied with the informal process or does not wish to use it, the resident may proceed as follows:
(A) The resident may submit a complaint in writing to the RTH administrator. The resident may receive assistance in submitting the complaint from any person whom the resident chooses. If requested by the resident, RTH staff will be available to assist the resident.
(B) The written complaint will go directly to the RTH administrator without being read by other staff, unless the resident requests or permits other staff to read the complaint.
(C) The complaint will include the reasons for the grievance and the proposed resolutions. No complaint will be disregarded because it is incomplete.
(D) Within five days of receipt of the complaint, the RTH administrator will meet with the resident to discuss the complaint. The resident may have an advocate or other person of his/her choosing present for this discussion.
(E) Within five days of meeting with the resident, the RTH administrator will provide a written response to the resident. As part of the written response, the Administrator will provide information about the appeal process.
(F) In circumstances where the matter of the complaint is likely to cause irreparable harm to a substantial right of the resident before the grievance procedures outlined in OAR 309-035-0390(2)(b)(D) and (E) are completed, the resident may request an expedited review. The RTH administrator will review and respond in writing to the grievance within 48 hours. The written response will include information about the appeal process.
(3) Appeals. Residents, their legal guardians (as applicable) and prospective residents (as applicable) will have the right to appeal admission, termination and grievance decisions as follows:
(a) If the resident is not satisfied with the decision, the resident may file an appeal in writing within ten days of the date of the RTH administrator's response to the complaint or notification of admission denial or termination (as applicable). The appeal will be submitted to the CMHP director or designee in the county where the RTH is located.
(b) The resident may receive assistance in submitting the appeal. If requested by the resident, RTH staff will be available to assist the resident.
(c) The CMHP director or designee will provide a written response within ten days of receiving the appeal.
(d) If the resident is not satisfied with the CMHP director's decision, the resident may file a second appeal in writing within ten days of the date of the CMHP director's written response to the Administrator of the Department or designee. The decision of the Administrator of the Department will be final.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0400
Resident Assessment and Residential Service Plan
(1) Assessment. An assessment will be completed for each resident within 30 days after admission to the RTH, unless admitted to the RTH for crisis-respite services.
(a) The assessment will be based upon an interview with the resident to identify strengths, preferences and service needs; observation of the resident's capabilities within the residential setting; a review of information in the resident record; and contact with representatives of other involved agencies, family members and others, as appropriate. All contacts with others will be made with proper authorization for the release of information.
(b) Assessment findings will be summarized in writing and included in the resident's record. Assessment findings will include, but not be limited to, diagnostic and demographic data; identification of the resident's medical, physical, emotional, behavioral and social strengths, preferences and needs related to independent living and community functioning; and recommendations for residential service plan goals.
(2) Residential Service Plan. An individualized plan, identifying the goals to be accomplished through the services provided, will be prepared for each resident, unless admitted to the RTH for crisis-respite services, within 30 days after admission.
(a) The residential service plan will be based upon the findings of the resident assessment, be developed with participation of the resident and his/her guardian (as applicable), and be developed through collaboration with the resident's primary mental health treatment provider. With consent of the resident or guardian (as applicable), family members, representatives from involved agencies, and others with an interest in the resident's circumstances will be invited to participate. All contacts with others will be made with proper, prior authorization from the resident.
(b) The residential service plan will identify service needs, desired outcomes and service strategies to address, but not be limited to, the following areas: physical and medical needs, medication regimen, self-care, social-emotional adjustment, behavioral concerns, independent living capability and community navigation.
(c) The residential service plan will be signed by the resident, the administrator or other designated RTH staff person, and others, as appropriate, to indicate mutual agreement with the course of services outlined in the plan.
(3) Crisis-respite Requirements. For residents admitted to RTHs for 30 days or less, an assessment and residential service plan must be developed within 48 hours of admission which identifies service needs, desired outcomes and the service strategies to be implemented to resolve the crisis or address other needs of the individual that resulted in the short term service arrangement.
(4) Progress Notes. Progress notes will be maintained within each resident's record and document significant information relating to all aspects of the resident's functioning and progress toward desired outcomes identified in the residential service plan. A progress note will be entered in the resident's record at least once each month for regular residents and at least daily for crisis-respite residents.
(5) Re-assessments and Revisions to the Residential Service Plan. The assessment and residential service plan will be reviewed and updated at least annually. On an ongoing basis, the residential service plan will be updated, as necessary, based upon changing circumstances or upon the resident's request for reconsideration.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0410
Resident Services and Activities
(1) General Requirements. The services and activities available at the RTH will include care and treatment consistent with ORS 443.400 and those services individually specified for the resident in the residential service plan developed as outlined in OAR 309-035-0400. Residents will be encouraged to care for their own needs to the extent possible. All services and activities will be provided in a manner that respects residents' rights, promotes recovery and affords personal dignity.
(2) Services and Activities to Be Available. Services and activities to be available will include but not be limited to:
(a) Provision of adequate shelter consistent with OAR 309-035-0320 through 309-035-0350;
(b) At least three meals per day, seven days per week, provided in accordance with OAR 309-035-0430;
(c) Assistance and support, as necessary, to enable residents to meet personal hygiene and clothing needs;
(d) Laundry services, which may include access to washer(s) and dryer(s) so residents can do their own personal laundry;
(e) Housekeeping essential to the health and comfort of residents;
(f) Activities and opportunities for socialization and recreation both within the facility and in the larger community;
(g) Health-related services provided in accordance with OAR 309-035-0440;
(h) Assistance with community navigation and transportation arrangements;
(i) Assistance with money management, where requested by a resident, to include accurate documentation of all funds deposited and withdrawn when funds are held in trust for the resident;
(j) Assistance with acquiring skills to live as independently as possible;
(k) Assistance with accessing other additional services, as needed; and
(l) Any additional services required under contract with the Department.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0420
Prohibition of Seclusion and Restraints
General Prohibition. The use of seclusion or restraints is prohibited in Residential Treatment Homes. Only Secure Residential Treatment Facilities approved by the Department in accordance with OAR 309-035-0100 through 309-035-0190 will be allowed to use seclusion and restraints.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0430
Food Services
(1) Well-balanced Diet. Meals will be planned and served in accordance with the recommended dietary allowances found in the United States Department of Agriculture Food Guide Pyramid.
(2) Modified or Special Diets. An order from a Licensed Medical Professional will be obtained for each resident who, for health reasons, is on a modified or special diet. Such diets will be planned in consultation with the resident.
(3) Menus. Menus will be prepared at least one week in advance and will provide a sufficient variety of foods served in adequate amounts for each resident at each meal and adjusted for seasonal changes. Records of menus, as served, will be filed and maintained in the RTH for at least 30 days. Resident preferences and requests will be considered in menu planning. Religious and vegetarian preferences will be reasonably accommodated.
(4) Supply of Food. Adequate supplies of staple foods for a minimum of one week and perishable foods for a minimum of two days will be maintained on the premises.
(5) Sanitation. Food will be stored, prepared and served in accordance with the Oregon Health Services Food Sanitation Rules.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0440
Health Services
(1) General. The administrator will be responsible for assuring that all residents are offered medical attention when needed. Arrangements for health services will be made with the informed consent of the resident and/or guardian (as applicable). The RTH will arrange for physicians or other qualified health care professionals to be available in the event the resident's regular physician or other health care professional is unavailable. A hospital emergency room will be identified and may be used in case of emergency.
(2) Initial Health Screening. Each resident admitted to the RTH will be screened by a qualified health care professional to identify health problems and to screen for communicable disease. Documentation of the initial health screening will be placed in the resident record.
(a) The health screening will include a brief history of health conditions, current physical condition and a written record of current or recommended medications, treatments, dietary specifications, and aids to physical functioning.
(b) For regular admissions, the health screening will be obtained prior to the resident's admission and include the results of testing for tuberculosis and Hepatitis B.
(c) For emergency admissions, including crisis-respite admissions, the health screening will be obtained as follows:
(A) For individuals experiencing psychiatric or medical distress, a health screening will be completed by a qualified health care professional prior to the resident's admission or within 24 hours of the emergency placement. The health screening will confirm that the individual does not have health conditions requiring continuous nursing care, a hospital level of care, or immediate medical assistance. For each crisis-respite resident who continues in the RTH for more than seven consecutive days, a complete health examination will be arranged if any symptoms of a health concern exist.
(B) For other individuals who are admitted on an urgent basis due to a lack of alternative supportive housing, the health screening will be obtained within 72 hours after the resident's admission.
(C) The health screening criteria may be waived for individuals admitted for crisis-respite services who are under the active care of an LMP or other qualified health care professional if it is the opinion of the attending health care professional that the crisis-respite placement presents no health risk to the individual or other residents in the RTH. Such a waiver must be provided in writing and be signed and dated by the attending health care professional within 24 hours of the resident's admission.
(3) Regular Health Examinations. Except for crisis-respite residents, the program will ensure that each resident has a primary physician or other qualified health care professional who is responsible for monitoring his/her health care. Regular health examinations will be done in accordance with the recommendations of this primary health care professional, but not less than once every three years. New residents will have a health examination completed within one year prior to admission or within three months after admission. Documentation of findings from each examination will be placed in the resident's record.
(4) Written Orders for Special Needs. A written order, signed by a physician or other qualified health care professional, is required for any medical treatment, special diet for health reasons, aid to physical functioning or limitation of activity.
(5) Medications. A written order signed by a physician or other qualified health care professional is required for all medications administered or supervised by RTH staff. This written order is required before any medication is provided to a resident. All medication maintained in the RTH will be provided to residents in accordance with the applicable written orders.
(a) Medications will be self-administered by the resident if the resident demonstrates the ability to self-administer medications in a safe and reliable manner. In the case of self-administration, both the written orders of the prescriber and the residential service plan will document that medications will be self-administered. The self-administration of medications may be supervised by RTH staff who may prompt the resident to administer the medication and observe the fact of administration and dosage taken. When supervision occurs, staff will enter information in the resident's record consistent with section OAR 309-035-0440(5)(h) below.
(b) Staff who assist with administration of medication will be trained by a Licensed Medical Professional or other qualified health care professional on the use and effects of commonly used medications.
(c) Medications prescribed for one resident will not be administered to, or self-administered by, another resident. Medication will not be used for the convenience of staff or as a substitute for programming. Medications will not be withheld or used as reinforcement or punishment.
(d) Stock supplies of prescription medications will not be maintained. The RTH may maintain a stock supply of non-prescription medications.
(e) The RTH will provide and implement a policy and procedure which assures that all orders for prescription drugs are reviewed by a qualified health care professional, as specified by a physician or other qualified health care professional, but not less often than every six months. Where this review identifies a contra-indication or other concern, the resident's primary physician, LMP or other primary health care professional will be immediately notified.
(f) Each resident receiving psychotropic medications will be evaluated at least every three months by the LMP prescribing the medication. The RTH will obtain from the LMP the results of this evaluation and any changes in the type and dosage of medication, the condition for which it is prescribed, when and how the medication is to be administered, common side effects (including any signs of tardive dyskinesia, contra-indications or possible allergic reactions), and what to do in case of a missed dose or other dosing error.
(g) All unused, discontinued, outdated or recalled medications, and any medication containers with worn, illegible or missing labels will be disposed. The method of disposal will be safe, consistent with any applicable federal statutes, and designed to prevent diversion of these substances to persons for whom they were not prescribed. A written record of all disposals will be maintained and specify the date of disposal, a description of the medication, its dosage potency, amount disposed, the name of the individual for whom the medication was prescribed, the reason for disposal, the method of disposal, and the signature of the staff person disposing the medication. For any medication classified as a controlled substance in schedules 1 through 5 of the Federal Controlled Substance Act, the disposal must be witnessed by a second staff person who documents their observation by signing the disposal record.
(h) All medications will be properly and securely stored in a locked space for medications only in accordance with the instructions provided by the prescriber or pharmacy. Medications for all residents will be labeled. Medications requiring refrigeration must be stored in an enclosed locked container within the refrigerator. The RTH will assure that residents have access to a locked, secure storage space for their self-administered medications. The RTH will note in its written policy and procedures which persons have access to this locked storage and under what conditions.
(i) For all residents taking prescribed medication, staff will record in the medical record each type, date, time and dose of medication provided. All side effects, adverse reactions and medications errors will be documented in the resident's record. All serious adverse reactions or errors will be reported immediately to the prescribing health care professional. All other errors, adverse reactions or refusals of medication will be reported to the prescribing professional within 48 hours.
(j) P.r.n. medications and treatments will only be administered in accordance with the parameters specified by the prescribing health care professional, or in cases where a nurse assigns or delegates p.r.n. medication or treatment administration, in accordance with administrative rules of the Board of Nursing, chapter 851, division 47.
(6) Delegation of Nursing Tasks. Where a nurse is involved in the care of an RTH resident, nursing tasks may be assigned or delegated by a Registered Nurse to direct care staff in accordance with administrative rules of the Board of Nursing, chapter 851, division 47.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0450
Civil Penalties
(1) Applicability of Long Term Care Statute. For purposes of imposing civil penalties, RTHs licensed under ORS 443.400 to 443.455 and subsection (2) of ORS 443.991 are considered to be long-term care facilities subject to ORS 441.705 to 441.745.
(2) Sections of Rule Subject to Civil Penalties. Violations of any requirement within any part of the following sections of the rule may result in a civil penalty:
(a) 309-035-0270 Licensing;
(b) 309-035-0280 Contracts and Rates;
(c) 309-035-0290 Administrative Management;
(d) 309-035-0300 Records;
(e) 309-035-0310 Staffing;
(f) 309-035-0320 Facility Requirements;
(g) 309-035-0330 Safety;
(h) 309-035-0340 Sanitation;
(i) 309-035-0350 Resident Furnishings;
(j) 309-035-0360 Admission to Facility;
(k) 309-035-0370 Termination of Residency;
(l) 309-035-0380 Resident Rights;
(m) 309-035-0390 Grievances and Appeals;
(n) 309-035-0400 Resident Assessment and Residential Service Plan;
(o) 309-035-0410 Resident Services and Activities;
(p) 309-035-0420 Use of Seclusion or Restraints;
(q) 309-035-0430 Food Services; and
(r) 309-035-0440 Health Services.
(3) Assessment of Civil Penalties. Civil penalties will be assessed in accordance with the following guidelines:
(a) Civil penalties, not to exceed $250 per violation to a maximum of $1,000, may be assessed for general violations of these rules. Such penalties will be assessed after the procedures outlined in OAR 309-035-0270(8) have been implemented;
(b) A mandatory penalty up to $500 will be assessed for falsifying resident or facility records or causing another to do so;
(c) A mandatory penalty of $250 per occurrence will be imposed for failure to have direct care staff on duty 24 hours per day;
(d) Civil penalties up to $1,000 per occurrence may be assessed for substantiated abuse;
(e) In addition to any other liability or penalty provided by the law, the Department may impose a penalty for any of the following:
(A) Operating the RTH without a license;
(B) Operating with more residents than the licensed capacity; and
(C) Retaliating or discriminating against a resident, family member, employee, or other person for making a complaint against the program.
(f) In imposing a civil penalty, the following factors will be taken into consideration:
(A) The past history of the person incurring the penalty in taking all feasible steps or procedures to correct the violation;
(B) Any prior violations of statutes, rules or orders pertaining to the RTH;
(C) The economic and financial conditions of the person incurring the penalty;
(D) The immediacy and extent to which the violation threatens or threatened the health, safety or welfare of one or more residents; and
(E) The degree of harm caused to residents.
(4) Notification. Any civil penalty imposed under this section will become due and payable ten days after notice is received, unless a request for a hearing is filed. The notice will be delivered in person, or sent by registered or certified mail and will include a reference to the particular section of the statute or rule involved, a brief summary of the violation, the amount of the penalty or penalties imposed, and a statement of the right to request a hearing.
(5) Request for Hearing. The person to whom the notice is addressed will have ten days from the date of receipt of the notice to request a hearing. This request must be in writing and submitted to the Administrator of the Department. If the written request for a hearing is not received on time, the Department will issue a final order by default.
(6) Hearings. All hearings will be conducted pursuant to the applicable provisions of ORS 183.310 to 183.550, Administrative Procedure and Rules for Civil Penalties.
(7) Judgment. Unless the penalty is paid within ten days after the order becomes final, the order constitutes a judgment and may be recorded by the County Clerk which becomes a lien upon the title to any interest in real property owned by the person. The Department may also take action to revoke the license upon failure to comply with a final order.
(8) Judicial Review. Civil penalties are subject to judicial review under ORS 183.480, except that the court may, at its discretion, reduce the amount of the penalty.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05
309-035-0460
Criminal Penalties
(1) Specification of Criminal Penalty. Violation of any provision of ORS 443.400 through ORS 443.455 is a Class B misdemeanor.
(2) Grounds for Law Suit. In addition, the Department may commence an action to enjoin operation of a RTH:
(a) When a RTH is operated without a valid license; or
(b) When a RTH continues to operate after notice of revocation has been given and a reasonable time has been allowed for placement of residents in other programs.
Stat. Auth.: ORS 443.450

Stats. Implemented: ORS 443.400 - 443.455 & 443.991(2)

Hist.: MHD 7-1999, f. 11-15-99, cert. ef. 12-1-99; MHD 5-2005, f. & cert. ef. 4-1-05

Regulation of County Capacity of Residential Care Facilities

309-035-0500
Residential Facilities
(1) Effective September 1, 1988, and except as otherwise provided in this rule, the capacity of all Residential Facilities or home for adults, including foster care homes, group care facilities or residential treatment, training or care facilities, located throughout the state shall not exceed a target based on the number of beds available in 1979, updated at the rate of ten percent per year, as distributed on the basis of the Oregon population by county. The distribution shall be determined by the Department of Human Services annually.
(2) Where a county possesses less than one percentile of the State population, then the county with the lowest percentile within a Department of Human Services' region shall be grouped until such time as the group reaches one percentile of the State population in determining the distribution target.
(3) Nothing in this rule is intended to prevent placement of a person who was not initially a resident of the county in a domiciliary care facility in the county. The targeted number of beds shall not require reduction in any domiciliary care facility capacity existing on October 4, 1977. No domiciliary care facility will be required to suspend operations, nor will the Department of Human Services support be denied such facilities on the basis of the facility being located in a county or county grouping which exceeds the distribution target.
(4) Adult Foster Care Homes as described in section (1) of this rule does not include Adult Foster Care Homes in which the clients of these homes are directly related by blood or marriage to the operator of the homes.
(5) In cases for which the distribution target for residential facilities, except Adult Foster Care Homes, allows for additional capacity in a county or county grouping and such additional capacity is less than ten beds, then one additional facility of the same type of ten-bed capacity may be authorized.
(6) This rule applies only to those residential care facilities as described in sections (1) and (4) of this rule which are established by, contracted for, or operated by the Department of Human Services or any of its divisions.
(7) Nothing in this rule will exempt any residential facility from the regulations of funding limitations of the Department of Human Services or any of its divisions.
(8) Subject to the appropriate licensing requirements, the governing body of a county may authorize a residential facility located in the county to exceed the capacity limit upon:
(a) Request of an individual or organization operating or proposing to operate a residential facility;
(b) Consultation with an advisory committee appointed by the governing body and consisting of persons who are particularly interested in the type of residential facility contemplated; and
(c) Finding of good cause following notice and public hearing.
[Publications: Publications referenced are available from the agency.]
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 1-1978, f. & ef. 2-16-78; HR 17-1979, f. & ef. 11-19-79; HR 5-1988, f. & cert. ef. 9-1-88; Renumbered from 410-004-0001, MHS 7-2007, f. & cert. ef. 5-25-07

Residential Care, Treatment, and Training Facilities Providing Services to Residential Care Clients

309-035-0550
Purpose
(1) OAR 309-035-0060 through 309-035-0090 establish a long-range goal wherein ultimately residential care and adult foster home clients of the Department of Human Services, whose primary service needs are associated with mental retardation or other developmental disabilities, or mental or emotional disturbance, or alcohol or drug abuse or dependence, will reside in Adult Residential Care Facilities and Adult Foster Homes under the jurisdiction of the Division serving only such category of residents. Those clients not having such primary service needs will reside in facilities under the jurisdiction of the Aging and People with Disabilities Division, serving only such category of residents.
(2) The goal is realized by assigning certain facilities to the jurisdiction of the Division with interim procedures for case management of mixed clients and by prescribing those facilities to which new placements will be made.
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0080, MHS 7-2007, f. & cert. ef. 5-25-07
309-035-0560
Definitions
As used in OAR 309-035-0060 through 309-035-0090:
(1) "Mental Retardation" means:
(a) A person with significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period. Persons of borderline intelligence may be considered mentally retarded if there is also serious impairment of adaptive behavior. Definitions and classifications shall be consistent with the Manual on Terminology and Classification in Mental Retardation of the American Association on Mental Deficiency, 1977 Revision, by this reference made a part hereof. Mental retardation is synonymous with mental deficiency;
(b) For community case management and program purposes, mental retardation includes those persons of borderline intelligence who have a history of residency in a state training center.
(2) "Developmental Disability" means a disability attributable to mental retardation, cerebral palsy, epilepsy, or other neurological handicapping conditions which require training similar to that required by mentally retarded individuals, and the disability:
(a) Originates before the individual attains age 22 except that in the case of mental retardation the condition must be manifested before the age of 18;
(b) Has continued, or can be expected to continue, indefinitely; and
(c) Constitutes a substantial handicap to the individual's ability to function in society.
(3) "Mental or Emotional Disturbance" means a disorder of emotional reactions, thought processes, behavior, or relationships (excluding mental retardation, alcoholism and drug abuse or dependency) which results in substantial subjective distress, impaired perceptions of reality, or impaired ability to control or appreciate the consequences of one's behavior, and which constitutes a substantial impairment of personal, interpersonal, work, educational or civic functioning. If a medical diagnosis is made, classification shall be consistent with the current Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association 1980, by this reference made a part hereof.
(4) "Alcohol or Drug Abuse" or "Dependence" means a person who has lost the ability to control the use of alcohol or controlled substances or other substances with abuse potential, or who uses alcohol or such substances to the extent that the person's health or that of others is substantially impaired or endangered or the person's social or economic functions are substantially disrupted. An alcohol or drug dependent person may be physically dependent, a condition in which the body requires a continuing supply of alcohol, a drug, or controlled substance to avoid characteristic withdrawal symptoms, or psychologically dependent, a condition characterized by an overwhelming mental desire for continued use of alcohol, a drug, or a controlled substance.
(5) "Residents" mean persons who are clients of the Department of Human Services who reside in Adult Residential Care Facilities and Adult Foster Homes.
[Publications: Publications referenced are available from the agency.]
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0085, MHS 7-2007, f. & cert. ef. 5-25-07
309-035-0570
Jurisdiction Over Homes and Centers
(1) The Division shall have jurisdiction over and shall license all Adult Residential Care Homes and Centers and certify Adult Foster Homes having residents 60 percent or more of which have primary service needs associated with mental retardation or other developmental disabilities, or mental or emotional disturbance or alcohol or drug abuse dependence.
(2) Adult Residential Care Homes and Centers and Adult Foster Homes not within the criteria in section (1) of this rule shall be under the jurisdiction of and be licensed or certified by the Aging and People with DisabilitiesDivision.
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0090, MHS 7-2007, f. & cert. ef. 5-25-07
309-035-0580
Case Management
(1) Those residents in homes and centers under the jurisdiction of Addictions and Mental Health Division, whose primary service needs are not associated with mental retardation or other developmental disabilities, or mental or emotional disturbances or alcohol or drug abuse or dependence shall be Aging and People with Disabilities Division clients and shall receive case management from such Division. All other residents in such facilities shall be Addictions and Mental Health Division clients and shall receive case management from such Division.
(2) Those residents in Adult Residential Care Homes and Centers and Adult Foster Homes under the jurisdiction of the Aging and People with Disabilities Division whose primary service needs are associated with mental retardation or other developmental disabilities, or mental or emotional disturbance or alcohol or drug abuse or dependence, shall be Division clients and shall receive case management from such Division. All other residents in such facilities shall be Aging and People with Disabilities Division clients and receive case management from such Division.
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0095, MHS 7-2007, f. & cert. ef. 5-25-07
309-035-0590
Placement
(1) Residential Care and Adult Foster Home clients shall be newly placed on the basis of primary service needs -- Those having such needs as those described in OAR 309-035-0070(1) will be placed in the facilities described in that paragraph and those not having such needs shall be placed in those facilities described in OAR 309-035-0070(2).
(2) Exceptions may be made only when a client cannot be placed because of the unavailability of an appropriate facility and the facility in which the client is placed is capable of serving the needs of the client. Exceptions will be granted by the Division responsible for the receiving facility.
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0100, MHS 7-2007, f. & cert. ef. 5-25-07
309-035-0600
Effective Date
OAR 309-035-0550 through 309-035-0590 are prospective as well as retroactive to July 1, 1982. Such prospective and retroactive effect is each severable of the other.
Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042

Hist.: HR 2-1984(Temp), f. & ef. 7-16-84; HR 3-1985, f. 2-28-85, ef. 3-1-85; Renumbered from 410-005-0105, MHS 7-2007, f. & cert. ef. 5-25-07



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