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OREGON HEALTH AUTHORITY,
ADDICTIONS AND MENTAL HEALTH DIVISION: MENTAL HEALTH SERVICES
DIVISION 14
COMMUNITY MENTAL HEALTH PROGRAMS
General Administrative Standards for Mental Health Division
Community Mental Health Contractors
309-014-0000
Purpose and Statutory
Authority
(1) Purpose. These rules prescribe
general administrative standards for Division community mental health and developmental
disability services contractors and their component parts.
(2) Statutory Authority. These
rules are authorized by ORS 413.042 & 430.640 and carry out the provisions of
ORS 430.610 to 430.695.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.695
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; MHD 14-1982, f. & ef. 7-7-82, Sections (3) thru (13) Renumbered to
309-014-0005 thru 309-014-0040; MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0005
Definitions
As used in these rules:
(1) "Administrator" means the
Assistant Director of Addictions and Mental Health Division.
(2) "Client" means a person
receiving services under these rules.
(3) "Community Mental Health
and Developmental Disability Advisory Committee" means the advisory committee to
a local mental health authority.
(4) "Community Mental Health
and Developmental Disability Contractor" means an entity which provides or contracts
for a distinct service or group of services for persons with mental or emotional
disturbances, drug abuse problems, mental retardation or other developmental disabilities,
and alcoholism and alcohol abuse problems, operated in the community under a contract
or a subcontract with the Division.
(5) "Community Mental Health
and Developmental Disability Contractor Budget" means the financial plan of projected
expenditures and projected revenues for community mental health and developmental
disability service elements submitted by the local mental health authority.
(6) "Community Mental Health
and Developmental Disability Contractor Plan" means the plan for community mental
health and developmental disability service elements submitted by the local mental
health authority.
(7) "Community Mental Health
and Developmental Disability Program" means an entity that is responsible for planning
and delivery of services for persons with mental or emotional disturbances, drug
abuse problems, mental retardation or other developmental disabilities, and alcoholism
and alcohol abuse in a specific geographic area of the state under a contract with
the Division or a local mental health authority.
(8) "Community Mental Health
and Developmental Disability Program Area" means the organization of all services
for persons with either mental or emotional disturbances, drug abuse problems, mental
retardation or other developmental disabilities, or alcoholism and alcohol abuse
problems, operated by, or contractually affiliated with, a local mental health authority,
operated in a specific geographic area of the state under a contract with the Division.
(9) "Community Mental Health
and Developmental Disability Program Director" means the director of a community
mental health and developmental disability program which operates or contracts for
all services for persons with mental or emotional disturbances, drug abuse problems,
mental retardation or other developmental disabilities, and alcoholism and alcohol
abuse problems under the omnibus contract with the Division.
(10) "Developmental Disability
Services" means services for people with developmental disabilities as defined by
the Division in administrative rule or contract terms.
(11) "Division" means the Addictions
and Mental Health Division of the Oregon Health Authority.
(12) "Local Mental Health Authority"
means the county court or board of county commissioners of one or more counties
who operate a community mental health and developmental disability program, or in
the case of a Native American reservation, the tribal council, or if the county
declines to operate or contract for all or part of a community mental health and
developmental disability program, the board of directors of a public or private
corporation.
(13) "Local Revenues" means
all money, other than state or federal grant or contract funds, expended by a local
mental health authority and any of its subcontractors for community mental health
and developmental disability services and included in the approved community mental
health and developmental disability contractor plan and budget. However, federal
funds expended for alcoholism treatment and rehabilitation services provided under
ORS 430.345 to 430.380 in accordance with ORS 430.359(3) by community mental health
and developmental disability contractors shall be considered local revenues.
(14) "Omnibus Contract" means
the Financial Assistance Grant Agreement or contract between the Addictions and
Mental Health Division and a local mental health authority for all services for
persons with mental or emotional disturbances, drug abuse problems, mental retardation
or other developmental disabilities, and alcoholism and alcohol abuse problems,
operated in a specific geographic area.
(15)
"Quality Assurance" means a systematic procedure for assessing the effectiveness,
efficiency, and appropriateness of services provided by the community mental health
and developmental disability contractor.
(16) "Service Element" means a distinct
service or group of services for person with mental or emotional disturbances, drug
abuse problems, mental retardation or other developmental disabilities, and alcoholism
and alcohol abuse problems, operated in the community under a contract with the
Addictions and Mental Health Division, or under contract with a local mental health
authority.
(17) "Service Provider" means
an entity or person that delivers services funded wholly or in part by the Division
under a contract with a community mental health and developmental disability program,
a local mental authority, or the Division.
(18) "State Institution" means
Oregon State Hospital in Portland and Salem, and Eastern Oregon Psychiatric Center
and Training Center in Pendleton.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(3), MHD 14-1982, f. & ef. 7-7-82; MHD
8-2000(Temp), f. 3-20-00, cert. ef. 3-21-00 thru 9-16-00; MHD 13-2000, f. 9-15-00
cert. ef. 9-16-00
309-014-0010
Purpose of a Community
Mental Health and Developmental Disability Program
The purpose of a community mental
health and developmental disability program is to provide a system of appropriate,
accessible, coordinated, effective, efficient services to meet the mental health
needs of the citizens of the community.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(4), MHD 14-1982, f. & ef. 7-7-82; MHD
13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0015
Division Responsibility
for Community Addictions and Mental Health
The Division shall assist the
local mental health authority in establishing and operating community mental health
and developmental disability services and shall integrate such services with other
mental health system components in the state by:
(1) Assessing needs for community
mental health and developmental disability services in the state.
(2) Identifying priorities among
needs and preparing state plans for community mental health and developmental disability
services.
(3) Conducting the Division's
activities in the least costly and most efficient manner so that delivery of services
to the mentally or emotionally disturbed, mentally retarded and developmentally
disabled, alcohol abuser, alcoholic, drug abuser and drug-dependent persons shall
be effective, coordinated and integrated with other services within the Oregon Health
Authority.
(4) Establishing and enforcing
minimum standards for community mental health and developmental disability services.
(5) Obtaining resources and
contracting with local mental health authorities for the operation of community
mental health and developmental disability service.
(6) Subject to the availability
of funds, providing public information, program consultation, technical assistance,
and training concerning community mental health and developmental disability services.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(4) & (7), MHD 14-1982, f. & ef. 7-7-82;
MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0020
Standards for Management
of Community Mental Health and Developmental Disability Programs
Each community mental health
and developmental disability contractor providing a community mental health and
developmental disability program under an omnibus contract with the Division is
required to meet the following standards for management:
(1) Community Mental Health
and Developmental Disability Program Director:
(a) The community mental health
and developmental disability program director shall be a full time employee of the
local mental health authority or the public or private corporation operating the
community mental health and developmental disability program;
(b) The community mental health
and developmental disability program director shall meet the following requirements:
(A) Hold at least a master's
degree in a behavioral, social, health science, special education, public administration,
or human service administration; and
(B) Have a minimum of five years
of experience in human services programs, two of which are in community mental health
and developmental disability and two of which are program managerial experience
in human services; and
(C) Present references documenting
experience, training, and ability to manage a community mental health and developmental
disability program.
(c) When the position of community
mental health and developmental disability program director becomes vacant, an interim
director shall be appointed to serve until a permanent director is appointed.
(2) Program Management for Developmental
Disability Services:
(a) Program Manager. The local
mental health authority or the public or private corporation operating the community
mental health and developmental disability services program shall designate a full-time
employee who will, on at least a part-time basis, be responsible for management
of developmental disability services.
(b) Program Manager Qualifications.
The program manager for developmental disability services shall meet the following
qualifications for employment:
(A) Hold at least a bachelor’s
degree in a behavioral, social, health science, special education, public administration,
or human service administration; and have a minimum of four years experience, with
at least two of those in developmental disability services, that provided recent
experience in program management, fiscal management, and staff supervision.
(B) On an exceptional basis,
the county may hire an individual who does not meet these program manager qualifications
if the county and the Division have mutually agreed on a training and technical
assistance plan which assures that the individual will quickly acquire all needed
skills and experience.
(C) When the position of program
manager for developmental disability services becomes vacant, an interim program
manager shall be appointed to serve until a permanent program manager is appointed.
The community mental health and developmental disability services program shall
request a variance as provided in these rules if the individual(s) appointed interim
program manager do not meet the qualifications and the term of the appointment(s)
total more than 180 days.
(c) Management Functions. In
addition to other duties as may be assigned in the area of developmental disability
services, the community mental health and developmental disability services program
shall, at a minimum, assure the following duties are performed:
(A) Develop plans as may be
needed to provide a coordinated and efficient use of resources available to serve
people with developmental disabilities;
(B) Develop positive and cooperative
working relationships with families, advocates, service providers, the Division,
and other state and local agencies with an interest in developmental disability
services;
(C) Develop programs funded
by the Division to encourage pursuit of defined program outcomes and monitor the
programs to assure service delivery that is in compliance with related contracts
and applicable local, state, and federal requirements;
(D)
Assure collection and timely reporting of information as may be needed to conduct
business with the Division, including but not limited to information needed to license
foster homes, to collect federal funds supporting services, and to investigate complaints
related to services or suspected client abuse; and
(E) Develop and assure use of procedures
that attempt to resolve disputes and grievances involving persons or organizations
that are associated with developmental disability services.
(d) Management Plan. The community
mental health and developmental disability services program shall maintain a plan
assigning responsibility for the management functions and duties described in this
section. The community mental health and developmental disability services program
shall assure that the functions and duties are assigned to people who have the knowledge
and experience necessary to perform them.
(3) Community Mental Health
and Developmental Disability Advisory Committee. Each community mental health and
developmental disability program shall have a mental health and developmental disability
advisory committee appointed by the local mental health authority:
(a) The committee shall meet
at least quarterly;
(b) The membership of the committee
shall be broadly representative of the community, with a balance of age, sex, ethnic,
socioeconomic, geographic, professional and consumer interests represented. Membership
shall include advocates for persons with mental or emotional disturbances, drug
abuse problems, mental retardation or other developmental disabilities, and alcoholism
and alcohol abuse problems;
(c) The Community Mental Health
and Developmental Disability Advisory Committee shall advise the local mental health
authority and the community mental health and developmental disability program director
on community needs and priorities for services and shall assist in planning and
in review and evaluation of services.
(4) Organization:
(a) Each community mental health
and developmental disability program shall have an up-to-date organizational chart
showing the line of authority and responsibility from the local mental health authority
to the community mental health and developmental disability program director and
to each of the components of the community mental health and developmental disability
program;
(b) Contracts:
(A) For all components of the
community mental health and developmental disability program operated by agencies
other than the local mental health authority, there shall be a contract between
the local mental health authority and the service provider specifying the authorities
and responsibilities of each party and conforming to the requirements of any Division
rule or contract requirement pertaining to operation and delivery of services.
(B) In keeping with the principles
of family support expressed in ORS 417.342, and notwithstanding 430.670(2) or
291.047(3), an entity operating a community mental health and developmental disability
program may purchase services for an individual from a service provider without
first providing an opportunity for competition among other service providers if
the service provider is selected by the individual, the individual's family or the
individual's guardian, as long as the service provider has been approved by the
Division to provide such service.
(C) Limit on contract requirements.
When a community mental health and developmental disability program contracts with
a public agency or private corporation for delivery of developmental disability
services, the community mental health and developmental disability program shall
include in the contract only terms that are substantially similar to model contract
terms established by the Division. The community mental health and developmental
disability program may not add contractual requirements, including qualifications
for contractor selection, that are nonessential to the service element(s) being
provided under the contract. The community mental health and developmental disability
program shall specify in contracts with service providers that disputes, which arise
from these limitations, shall be resolved according to procedures contained in these
rules. For purposes of this section, the following definitions apply:
(i) "Model contract terms established
by the Division" means all applicable material terms and conditions of the omnibus
contract, as modified to appropriately reflect a contractual relationship between
the service provider and community mental health and developmental disability program,
and any other requirements approved by the Division as local options under procedures
established in these rules.
(ii) "Substantially similar
to model contract terms" means that the terms developed by the community mental
health and developmental disability program and the model contract terms require
the service provider to engage in approximately the same type activity and expend
approximately the same resources to achieve compliance.
(iii) "Nonessential to the service
element(s) being provided" means requirements that are not substantially similar
to model contract terms developed by the Division.
(D) Local Option. The community
mental health and developmental disability program may, as a local option, impose
on a public agency or private corporation delivering developmental disability services
under a contract with the community mental health and developmental disability program,
a requirement that is in addition to or different from requirements specified in
the omnibus contract if all of the following conditions are met:
(i) The community mental health
and developmental disability program has provided the affected contractors with
the text of the proposed local option as it would appear in their contract, including
the date upon which the local option would become effective, and a complete written
description of how the local option would improve client independence, productivity,
or integration into the community, or how it would improve protection of client
health, safety, or rights;
(ii) The community mental health
and developmental disability program has sought input from the affected contractors
concerning ways the proposed local option will impact client services;
(iii) The community mental health
and developmental disability program, with assistance from the affected contractors,
has assessed the impact on the operations and financial status of the contractors
if the local option is imposed;
(iv) The community mental health
and developmental disability program has sent a written request for approval of
the proposed local option to the Division’s Assistant Administrator that includes:
(I) A copy of the information
provided to the affected contractors;
(II) A copy of any written comments
and a complete summary of oral comments received from the affected contractors concerning
the impact of the proposed local option; and
(III) The text of the proposed
local option as it would appear in contracts with service providers, including the
proposed date upon which the requirement would become effective.
(v) The Division has notified
the community mental health and developmental disability program that the new requirement
is approved as a local option for that program; and
(vi) The community mental health
and developmental disability program has advised the affected contractors of their
right and afforded them an opportunity to request mediation as provided in these
rules before the local option is imposed.
(E) Notice of Appeal.
(i) If a service provider believes
that the contract offered by the community mental health and developmental disability
program contains terms or conditions that are not substantially similar to those
established by the Division in the model contract, the service provider may appeal
imposition of the disputed terms or conditions by sending a written notice of appeal
to the Division’s Assistant Administrator within 30 calendar days after the
effective date of the contract requirement. The notice of appeal shall include:
(I) A copy of the contract and any pertinent contract amendments;
(II) Identification of the specific term(s)
that are in dispute; and
(III) A complete written explanation
of the dissimilarity between terms.
(ii) The service provider shall
send a copy of its notice of appeal to the community mental health and developmental
disability program. Upon receipt of this notice, the community mental health and
developmental disability program shall suspend enforcement of compliance with any
contract requirement under appeal by the contractor until the appeal process is
concluded.
(F) Appeal Process. The Assistant
Administrator or designee, shall offer to meet with both to mediate a solution.
If a solution can not be mediated, the Assistant Administrator shall declare an
impasse through written notification to all parties and immediately appoint a panel
to consider arguments from both parties. The panel shall include, at a minimum,
a representative from the Division, a representative from another community mental
health and developmental disability program, and a representative from another service
provider organization. The panel shall meet with the parties, consider their respective
arguments, and send written recommendations to the Administrator of the Division
within 45 business days after an impasse was declared. If an appeal requiring panel
consideration has been received from more than one contractor, the Division may
organize materials and discussion in any manner it deems necessary, including combining
appeals from multiple contractors, to assist the panel in understanding the issues
and operating efficiently. The Administrator shall notify all parties of his/her
decision within 15 business days after receipt of the panel’s recommendations.
The decision of the Administrator is final. The community mental health and developmental
disability program shall take immediate action to amend contracts as needed to comply
with the Administrator’s decision.
(G) Expedited Appeal Process.
The community mental health and developmental disability program or the contractor
may request an expedited appeal process that provides a temporary resolution, if
it can be shown that the time needed to follow procedures to reach a final resolution
would cause imminent risk of serious harm to individuals or organizations. The request
shall be made in writing to the Division’s Assistant Administrator. It shall
describe the potential harm and level of risk that will be incurred by following
the appeal process. The Division shall notify all parties of its decision to approve
an expedited appeal process within two business days. If an expedited process is
approved, the Administrator shall notify all parties of his/her decision concerning
the dispute within three additional business days. The Administrator’s decision
resulting from an expedited appeal process shall be binding, but temporary, pending
completion of the appeal process. All parties shall act according to the Administrator’s
temporary decision until notified of a final decision.
(H) Exception to limit on contract
requirements for facilities. The community mental health and developmental disability
program may add contract requirements that the community mental health and developmental
disability program considers necessary to ensure the siting and maintenance of residential
facilities in which client care is provided. These requirements shall be consistent
with all applicable state and federal laws and regulations related to housing.
(5) Needs Assessment and Planning.
The community mental health and developmental disability program shall assess local
needs for services to persons with mental or emotional disturbances, drug abuse
problems, mental retardation or other developmental disabilities, and alcoholism
and alcohol abuse problems, and shall plan for meeting those needs within the constraints
of resources available. The local mental health authority shall review and approve
the plan before it is submitted to the Division.
(6) Monitoring. The local mental
health authority shall monitor all community mental health and developmental disability
service elements to assure that:
(a) Service elements are provided
as specified in the contract with the Division; and
(b) Service elements are in
compliance with these rules and other applicable Division administrative rules.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(5), (6), (9), (10) & (12), MHD 14-1982,
f. & ef. 7-7-82; MHD 8-2000(Temp), f. 3-20-00, cert. ef. 3-21-00 thru 9-16-00;
MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0025
Standards for Management
of All Community Mental Health and Developmental Disability Program Areas
Each community mental health
and developmental disability contractor providing a community mental health and
developmental disability program area under a contract with the Division is required
to meet the following standards for management:
(1) Organizations:
(a) Each community mental health
and developmental disability program area contractor shall have an up-to-date organization
chart showing the line of authority and responsibility from the local mental health
authority to the community mental health and developmental disability program area
director and to each of the components of the community mental health and developmental
disability program area contractor;
(b) For all components of the
community mental health and developmental disability program area contractor operated
by agencies other than the local mental health authority, there shall be a contract
between the local mental health authority and the subcontract agency specifying
the authorities and responsibilities of each party and conforming to the requirements
of any Division rule pertaining to contracts.
(2) Needs Assessment and Planning:
When the Division contracts for a community mental health and developmental disability
program area, the contractor shall assess local needs for services to persons within
that program area, and shall plan to effectively and efficiently meet those needs
within the constraints of available resources. The local mental health authority
shall review and approve the plan before it is submitted to the Division.
(3) Monitoring: The local mental
health authority shall monitor all community mental health and developmental disability
service elements within the program area to assure that:
(a) Service elements are provided
as specified in the contract with the Division; and
(b) Service elements are in
compliance with these rules and other applicable Division administrative rules.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(5) & (6), MHD 14-1982, f. & ef. 7-7-82;
MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0030
Standards for Management
of All Service Elements
All contractors providing community
mental health and developmental disability service elements under a contract with
the Division are required to meet the following standards for management:
(1) Fee Policy. For all community
mental health and developmental disability service elements, except local administration
and those provided by a public education district, the agency providing the service
element shall:
(a) Determine the cost of each
type of service element provided;
(b) Establish a schedule of
fees for service elements based on the costs of the service elements, adjusted on
the basis of the client's ability to pay;
(c) At the time the service
elements is initiated, inform the client of the agency fee policy, the agency fee
schedules, and the fee rate to be collected from the client in the event that third
party payments do not cover the cost of the client's service elements;
(d) Billings for Title XIX funds shall in no case exceed the
customary charges to private clients for any like item or service charged by the
service element; and
(e) Charge fees for service elements as
follows:
(A) Except where expressly prohibited
by federal law or regulation, when third party payments do not cover the full fee
for the service elements provided, charge the client or those legally responsible
for the cost of the client's care, in an amount which is the lesser of:
(i) The balance of the fee charged
to but not paid by the third party payor(s); or
(ii) A fee adjusted on the basis
of the client's ability to pay.
(B) Charge any third party payor
in the amount of the full fees for the service elements provided. Should the sum
of any third party payments and client payments exceed the fee, a refund of the
excess payment shall be given to the client.
(2) Quality Assurance. Each
provider of community mental health and developmental disability service elements
shall implement and maintain a quality assurance program.
(3) Internal Management. Each
provider of community mental health and developmental disability service elements
funded by the Division shall meet the following internal management standards:
(a) There shall be an up-to-date
organization chart showing lines of authority and responsibility for the services
within the agency;
(b) There shall be up-to-date,
written position descriptions for all staff providing community mental health and
developmental disability services;
(c) If four or more staff provide
community mental health and developmental disability services, there shall be written
personnel policies and procedures concerning:
(A) Recruitment and termination
of employees;
(B) Compensation plan;
(C) Performance appraisals,
promotions and merit increases, and staff development;
(D) Employee benefits; and
(E) Grievance procedures.
(d) Each employee providing
community mental health and developmental disability services shall have the opportunity
for in-service training with pay;
(e) There shall be up-to-date
accounting records for each mental health service element accurately reflecting
all revenue by source, all expenses by object of expense, and all assets, liabilities,
and equities, consistent with generally accepted accounting principles and conforming
to the requirements of OAR 309-013-0120 to 309-013-0220;
(f) There shall be written statements
of policy and procedure as are necessary and useful to assure compliance with any
Division administrative rule pertaining to fraud and embezzlement and abuse of patients,
residents, and clients; and
(g) There shall be such other
written statements of policy and procedure as are necessary and useful to enable
the agency to accomplish its mental health service objectives and to meet the requirements
of these rules and other applicable standards and rules.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(5) & (6), MHD 14-1982, f. & ef. 7-7-82;
MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0035
General Standards for
Delivery of Community Mental Health and Developmental Disability Service Elements
All community mental health
and developmental disability contractors providing community mental health and developmental
disability service elements under a contract with the Division are required to meet
the following general standards for delivery of community mental health and developmental
disability service elements:
(1) Eligibility for Service:
(a) In accordance with the Civil
Rights Act of 1964, community mental health and developmental disability services
shall not be denied any person on the basis of race, color, creed, sex, national
origin or duration of residence. Community mental health and developmental disability
contractors shall also comply with Section 504 of the Rehabilitation Act of 1973
as implemented by 45 CFR 84.4, which states in part, "No qualified person shall,
on the basis of handicap, be excluded from participation in, be denied benefits
of, or otherwise be subjected to discrimination under any program or activity which
receives or benefits from federal financial assistance";
(b) No person shall be denied
services or be discriminated against on the basis of age or diagnostic or disability
category unless predetermined clinical or program criteria for service restrict
the service to specific age or diagnostic groups or disability category;
(c) No person shall be denied
community mental health and developmental disability services based on ability to
pay;
(d) Any person eligible for
community mental health and developmental disability services provided by one agency
shall also be eligible for other community mental health and developmental disability
services provided by any other agency, unless admission to the service is subject
to diagnostic or disability category or age restrictions based on predetermined
criteria.
(2) Continuity and Coordination:
(a) Each agency providing community
mental health and developmental disability services shall make pertinent clinical
and financial eligibility information concerning a client of the agency readily
available to other community mental health and developmental disability service
agencies responsible for the client's care, consistent with state statutes and federal
laws and regulations concerning confidentiality;
(b) In the event that a person
seeking or receiving services from one community mental health and developmental
disability contractor requires services not provided by the contractor, the person
shall be referred to an available appropriate agency which can provide the needed
services;
(c) Planning and implementation
of service for clients of the community mental health and developmental disability
contractor shall be coordinated between components of the community mental health
and developmental disability contractor, and other human service agencies, and between
components of the community mental health and developmental disability contractor
and state institutions. Each community mental health and developmental disability
program or community mental health and developmental disability program area contractor
shall maintain a written agreement with state institutions serving the county. The
agreement shall include, but need not be limited to:
(A) The procedures to be followed
to assure necessary communication between the state institution and the community
mental health and developmental disability program or community mental health and
developmental disability program area contractor when a client is admitted to, and
discharged from, the state institution and during the period of care, treatment
or training;
(B) The type of client information
which will be shared by the community mental health and developmental disability
program or community mental health developmental disability program area contractor
and the state institution, the manner in which the information will be transmitted
and the times when such information will be provided;
(C) The names of the staff members
from the state institution and the community mental health and developmental disability
program, or program area contractor, who will have principal responsibility for
liaison and implementation of the agreement; and
(D) Each agreement between the
state institution and a community mental health and developmental disability program,
or program area contractor, shall be reviewed and renewed at least once a year.
(3) Service Records. A record
shall be maintained for each client who receives direct treatment training and/or
care services. The record shall contain
client identification, problem assessment, treatment, training and/or care plan,
medical information when appropriate; and progress notes.
(4) Retention of Records. Records shall
be retained in accordance with OAR 166-005-0000 through 166-040-0010 (State Archivist).
Financial records, supporting documents, statistical records, and all other records
(except client records) shall be retained for a minimum of three years after the
close of the contract period, or until audited. Client records shall be kept for
a minimum of seven years.
(5) Confidentiality of Client
Records. Client records shall be kept confidential in accordance with ORS 179.505,
45 CFR 205.50 and 42 CFR Part 2, any Division administrative rule pertaining to
client records, and the most current edition of the Division Handbook on Confidentiality.
(6) Client Rights. Each agency
providing any community mental health and developmental disability service shall
have written procedures to assure:
(a) Protection of client privacy
and dignity;
(b) Confidentiality of records
consistent with state statutes and federal statutes and regulations;
(c) Involvement of the client
in planning the service through the provision of information, presented in general
terms, which explains the following:
(A) The training or treatment
to be undertaken;
(B) Alternative training or
treatment methods available, if any; and
(C) Risks that may be involved
in the training or treatment, if any.
(d) Client's right to refuse
service unless otherwise ordered by a court; and
(e) Client is provided with
information, presented in general terms, concerning the agency fee policies.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(8) & (11), MHD 14-1982, f. & ef. 7-7-82
; MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0037
Dispute Resolution
(1) The community mental health
and developmental disability program shall adopt a dispute resolution policy that
pertains to disputes that may arise from contracts with service providers that deliver
services funded by the Division for the community mental health and developmental
disability program. Procedures implementing this policy shall be included in the
contract with any such service provider.
(2) When a dispute exists between
a county or a community mental health and developmental disability program and a
service provider regarding the terms of their contract or the interpretation of
an administrative rule of the Division relating to Division programs under ORS Chapter
430, and local dispute resolution efforts have been unsuccessful, either party may
request assistance from the Division in mediating the dispute.
(a) Procedure. The parties shall
demonstrate a spirit of cooperation, mutual respect, and good faith in all aspects
of the mediation process. Mediation shall be conducted as follows:
(A) Request. The party requesting
mediation shall send a written request to the Division administrator, the community
mental health and developmental disability program director, and the provider agency
director, unless other persons are named as official contact persons in the specific
rule or contract under dispute. The request shall describe the nature of the dispute
and identify the specific rule or contract provisions that are central to the dispute.
(B) Arrangements. The division
administrator, or designee, shall arrange the first meeting of the parties at the
earliest possible date. The agenda for the first meeting should include:
(i) Consideration of the need
for services of an outside mediator. If such services are desired, agreement should
be made on arrangements for obtaining these services.
(ii) Development of rules and
procedures that will be followed by all parties during the mediation;
(iii) Agreement on a date by
which mediation will be completed, unless extended by mutual agreement.
(C) Cost. Unless otherwise agreed
to by all parties:
(i) Each party shall be responsible
for the compensation and expenses of their own employees and representatives; and
(ii) Costs that benefit the
group, such as services of a mediator, rental of meeting space, purchase of snack
food and beverage, etc. shall be shared equally by all parties.
(b) Final Report. A written
statement documenting the outcome of the mediation shall be prepared. This statement
shall consist of a brief written statement signed by all parties or separate statements
from each party declaring their position on the dispute at the conclusion of the
mediation process. In the absence of written statements from other parties, the
Division representative shall prepare the final report. The final report on each
mediation shall be retained on file at the Division. The Division will, from time
to time, or as requested by the legislature or others, prepare summary reports that
describe the success of mediation in resolving disputes.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 8-2000(Temp), f.
3-20-00, cert. ef. 3-21-00 thru 9-16-00; MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00
309-014-0040
Variances
A variance from these rules
may be granted to a community mental health and developmental disability program
in the following manner:
(1) An agency requesting a variance
shall submit, in writing, through the community mental health and developmental
disability program to the appropriate program or administrative office:
(a) The section of the rule
from which the variance is sought;
(b) The reason for the proposed
variance;
(c) The alternative practice
proposed;
(d) A plan and timetable for
compliance with the section of the rule from which the variance is sought; and
(e) Signed documentation from
the local mental health authority indicating its support of the proposed variance.
(2) The assistant administrator
of the program or administrative office shall approve or deny the request for variance.
(3) The program or administrative
office shall notify the community mental health and developmental disability program
of the decision. The community mental health and developmental disability program
will forward the decision and reasons therefore to the program requesting the variance.
This notice shall be given the program within 30 days of receipt of the request
by the program or administrative office with a copy to other relevant sections of
the Division.
(4) Appeal of the denial of
a variance request shall be to the Administrator of the Division, whose decision
shall be final.
(5) A variance granted by the
Division shall be attached to, and become part, of the contract for that year.
Stat. Auth.: ORS 413.042 &
430.640
Stats. Implemented: ORS 430.610
– 430.640
Hist.: MHD 39, f. 5-20-76, ef.
6-11-76; Renumbered from 309-014-0000(13), MHD 14-1982, f. & ef. 7-7-82; MHD
13-2000, f. 9-15-00, cert. ef. 9-16-00
Central Oregon Health Council
and Regional Health Improvement Plan
309-014-0300
Purpose and Scope
These rules relate to the implementation
of Chapter 418, Oregon Laws 2011 sections 13 through 20. The scope is limited to
the creation of the Central Health Council and the implementation of the Central
Oregon Health Improvement Plan.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2011 OL SB 204, Sec. 13-20
Hist.: MHS 6-2011(Temp), f.
8-26-11, cert. ef. 9-1-11 thru 2-28-12; MHS 3-2012, f. & cert. ef. 2-23-12
309-014-0310
Definitions
(1) “Authority”
means the Oregon Health Authority (OHA).
(2) “Central Oregon Health
Council” (COHC) means a council which shall, as a minimum, conduct a regional
health assessment and adopt a regional health improvement plan to serve as a strategic
population health and health care system service plan for the region served by the
council.
(3) “Commission”
means the Commission on Children and Families.
(4) “Council” means
the Central Oregon Health Council (COHC).
(5) “Plan” means
the Regional Health Improvement Plan.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2011 OL SB 204, Sec. 13-20
Hist.: MHS 6-2011(Temp), f.
8-26-11, cert. ef. 9-1-11 thru 2-28-12; MHS 3-2012, f. & cert. ef. 2-23-12
309-014-0320
Regional Health Improvement
Plan
(1) The Regional Health Improvement
Plan (RHIP) submitted by the Central Oregon Health Council, defined in OAR 309-014-0300,
must include, but need not be limited to the following:
(a) Federally required components;
(b) Health policy;
(c) System design;
(d) Outcome and quality improvement;
(e) Integration of service delivery
and
(f) Workforce development.
(2) Any additional requirements
to the RHIP will be agreed upon in advance by the Council, the Authority and the
Commission.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2011 OL SB 204, Sec. 13-20
Hist.: MHS 6-2011(Temp), f.
8-26-11, cert. ef. 9-1-11 thru 2-28-12; MHS 3-2012, f. & cert. ef. 2-23-12
309-014-0330
Central Oregon Health
Council
(1) The council may not convene
until the governing body of each county adopts a resolution signifying the body’s
intention to do so.
(2) Subsequent to the formation
of the council, a county that is adjacent to Crook, Deschutes or Jefferson County
may join the council if:
(a) The governing body of the
county seeking to join the council adopts a resolution signifying the body’s
intention to include a portion of that county in the region served by the council;
(b) The portion of the county
to be included in the region is part of a natural health care referral pattern with
the other counties on the council; and
(c) The authority and the council
approve.
(3) The COHC shall consist of
no more than 11 members, including:
(a) A formative council consisting
of:
(A) One member each from the
governing bodies of Crook, Deschutes and Jefferson Counties, appointed by each body;
(B) The chief executive officer,
or a designee of the chief executive officer, of the health care system serving
the region; and
(C) The chief executive officer,
or a designee of the chief executive officer, of the Medicaid contractor serving
the region; and
(b) At least three members appointed
by the formative council established under paragraph (3)(a)(A) of this rule. Members
appointed under this section shall be representatives of:
(A) Consumers of physical and
behavioral health services;
(B) Health care professionals;
(C) School districts or educational
service districts;
(D) The business community;
or
(E) A member from the governing
body of each county that joins the council defined in (3)(a)(A) of this rule.
(4) The term of office of the
members of the council is four years.
(5) A majority of the members
of the council constitutes a quorum for the transaction of business.
(6) The council shall elect
a member of the council to serve as the chairperson.
(7) If there is a vacancy for
any cause, the appointing authority shall make an appointment to the vacated position
to become effective immediately.
(8) The council may enter into
necessary contracts, apply for and receive grants, hold and dispose of property
and take other actions necessary to carry out the activities, services and responsibilities
assumed by the council.
(9) The council may adopt rules
necessary for the operation of the council.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2011 OL SB 204, Sec. 13-20
Hist.: MHS 6-2011(Temp), f.
8-26-11, cert. ef. 9-1-11 thru 2-28-12; MHS 3-2012, f. & cert. ef. 2-23-12
309-014-0340
Central Oregon Health
Improvement Plan (COHIP)
(1) The COHC shall develop a
health improvement plan as detailed in OAR 309-017-0030.
(2) The COHIP will replace all
prior plans required by the Authority in ORS 430.630, 430.640, 431.385 and 624.510
and plans required by the State Commission on Children and Families under ORS 417.705
through 417.801.
(3) The COHC will submit the
plan no later than March 1, 2012 to the Authority.
(4) The Authority shall have
45 days from the date the plan is submitted to review the plan and return it to
the Council either approved or with suggested modifications.
(a) If modifications are suggested
the Council will have 45 days to respond to the suggestions and resubmit the plan.
(b) The Authority will have
a final 30 days to review the plan.
(5) The plan is effective July
1, 2012.
(6) New plans must be submitted
every four years if the sunset in the enabling legislation is removed by the Legislative
Assembly.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2011 OL SB 204, Sec. 13-20
Hist.: MHS 6-2011(Temp), f.
8-26-11, cert. ef. 9-1-11 thru 2-28-12; MHS 3-2012, f. & cert. ef. 2-23-12
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