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The Oregon Administrative Rules contain OARs filed through October 15, 2014
 
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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 ORS 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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