Current through Register Vol. 63, No. 12, December 1, 2024
(1) The
provider shall ensure the admission process includes the following:
(a) The provider shall specify in its
admission policy and procedures the program staff responsible for each
component of the admission information-gathering and decision-making process.
The program shall allocate responsibilities to promote effective processing of
referrals and admissions.
(b) The
provider shall develop and implement admission policies and procedures that
take into consideration; the placement of individuals by a supervisory
authority under ORS chapters 161 or 426 or by the informed consent of the
individual's legal representative, the ability of the program to meet the
service needs of both the individual and current residents of the facility, and
the prospective individual's right to select and choose from available service
settings when the individual has the capacity to engage in the treatment
programs offered by the facility. An individual under civil commitment has the
right to appeal the placement by the OHA designee as outlined in OAR
309-033-0290(5).
(c) The provider shall support the
individual's right to select a program by assisting the person-centered service
plan coordinator in identifying and documenting program options in the
person-centered service plan, including providing information regarding program
services and rates. The individual's right to select a service setting may be
limited by a court, OHA, CMHP, or PSRB order under ORS chapters 161 or 426, or
by the informed consent of the individual's legal representative.
(d) The provider may close admissions to the
program when accepting an additional prospective individual may cause the
program to exceed its reasonable waitlist. When admissions are closed, the
provider is not required to accept referrals, conduct screenings, or evaluate
admissions criteria as directed by these rules.
(2) Unless limited by contractual agreement
with the Division or other Division-approved party, the program may accept
referrals from a variety of sources.
(3) In accordance with ORS
179.505 and the 42 CFR, Part 2,
the program shall obtain an authorization for the release of information for
disclosure for any confidential information concerning a prospective
individual.
(4) The provider shall
consider an individual for admission without regard to race, color, sex or
sexual orientation, except as may be limited by room arrangement, religion,
creed, national origin, age, except under 18 years, familial status, marital
status, source of income, or disability in addition to the mental health
disorder.
(5) Prior to accepting an
individual for admission to the program, the program administrator shall
determine that the individual meets admission criteria including the following:
(a) The provider shall offer each individual
referred for placement at the program an opportunity to participate in a
screening interview prior to being accepted or denied placement at a program.
The screening is intended to provide information about the program and the
services available as well as to obtain information from the prospective
individual, a relative, and agencies currently providing services to the
individual sufficient to determine eligibility for admission and service needs;
and
(b) The provider shall receive
screening packets for each individual referred for placement. At a minimum,
screening packets shall include:
(A) Written
documentation that the prospective individual has or is suspected of having a
mental health disorder;
(B)
Background information including a mental health assessment, description of
previous living arrangements, service history, behavioral issues, and service
needs;
(C) Medical information
including a brief history of any health conditions, documentation from a
Licensed Medical Professional or other qualified health care professional of
the individual's current physical condition, and a written record of any
current or recommended medications, treatments, dietary specifications, and
aids to physical functioning;
(D)
Copies of documents or other documentation relating to guardianship,
conservatorship, commitment status, advance directives, or any other legal
restrictions;
(E) A copy of the
prospective individual's most recent mental health treatment plan or in the
case of an emergency or crisis-respite admission a summary of current mental
health treatment involvement; and
(F) Documentation of the prospective
individual's ability to evacuate the building consistent with the facility's
designated evacuation capability and other concerns about potential safety
risks.
(c) The provider
shall ensure that screenings be conducted at the prospective program setting
unless:
(A) Travel arrangements cannot be made
due to inclement weather; or
(B)
The individual or representative requests a phone screening or screening at the
individual's current location.
(d) The provider shall contact the referring
agency to schedule a screening appointment within 48 hours of receipt of the
referral packet;
(e) The provider
shall coordinate with the referring agency to schedule a screening appointment
to occur within 14 calendar days from the date of receipt of the referral
packet;
(f) The provider shall
provide the following to each individual referred for placement:
(A) Materials explaining conditions of
residency;
(B) Services available
to individuals residing in the program; and
(C) An opportunity to meet with a prospective
roommate if the program uses a shared room model.
(g) The screening meeting shall include the
program administrator, the prospective individual, and the individual's
representative. With the consent of the prospective individual or the
individual's legal representative, the meeting may also include family members,
other representatives as appropriate, representatives of relevant
service-providing agencies, and others with an interest in the individual's
admission.
(6) If an
individual is referred for emergency or crisis-respite admission, an amended or
abbreviated screening process may be used to more quickly meet the needs of the
individual. Screening and admission information obtained may be less
comprehensive than for regular admissions but shall be sufficient to determine
that the individual meets admission criteria and that the setting and program
is appropriate considering the individual's needs. The program shall document
the reasons for incomplete information.
(7) Prior to admission, the provider shall
evaluate and determine whether a prospective individual is eligible for
admission based on the following criteria. The individual shall:
(a) Be assessed to have a mental health
disorder or a suspected mental health disorder;
(b) Be at least 18 years of age;
(c) Not require continuous nursing care
unless a reasonable plan to provide the care exists, the need for residential
treatment supersedes the need for nursing care, and the Division approves the
placement;
(d) Have evacuation
capability consistent with the setting's SR occupancy classification;
and
(e) Meet additional criteria
required or approved by the Division through contractual agreement or condition
of licensing.
(8) For
admission to an SRTF, the provider shall evaluate and determine whether a
prospective individual is eligible for admission, based on the individual
meeting all criteria in OAR
410-172-0720(7).
(9) The provider may deny an individual
admission to its program for the following reasons:
(a) Failure to meet admission criteria
established by these rules;
(b)
Inability to pay for services due to lack of presumed Medicaid eligibility or
other funds;
(c) Documented
instances of behaviors within the last 14 calendar days that would pose a
reasonable and significant risk to the health, safety, and well-being of the
individual or another individual, if the individual is admitted;
(d) Lack of availability of necessary
services required to maintain the health and safety of the individual (no
nursing, etc.) or lack of an opening at the setting; or
(e) The individual declines the offer for
screening.
(10) The
provider may not deny an individual admission to its program as follows:
(a) Prior to offering a face-to-face
screening or other screening process as allowed by these rules; or
(b) Due to county of origin, responsibility,
or residency.
(11) The
provider's admission decision shall be made as follows:
(a) The program's decision shall be based on
review of screening materials, information gathered during the face-to-face
screening meeting, and evaluation of the admission criteria;
(b) The program shall inform the prospective
individual, and the individual's legal representative supervisory entity, and
referring entity, as applicable, of the admission decisions within 72 hours of
the screening meeting;
(c) When the
program denies admission, the program shall provide written notification to the
individual and the individual's legal representative, supervisory entity and
referring entity, as applicable, of the basis for the decision and the
individual's right to appeal the decision;
(d) When the program approves admission, the
program shall inform the individual and the individual's legal representative,
supervisory entity, and referring entity, as applicable, through an acceptance
notification that shall include:
(A) When not
waitlisted or first on the waitlist, an estimated date of admission;
and
(B) When waitlisted, the number
on the waitlist.
(12) Management of waitlists includes the
following:
(a) The program shall establish
admission waitlists of reasonable length;
(b) The program shall document actions taken
in the management of the waitlist;
(c) The program shall contact a waitlisted
individual, the individual's representative, and the referring entity monthly
to determine if the individual has been placed elsewhere;
(d) The program shall prioritize admissions
on a waitlist as follows:
(A) The program
shall give first priority consideration to each of those individuals who may
be:
(i) Under a current civil commitment or
extremely dangerous person commitment pursuant to ORS chapter 426;
(ii) Placed on court-ordered community
restoration as an aid and assist defendant pursuant to ORS chapter
161;
(iii) Found guilty except for
insanity of a criminal offense and is currently under the jurisdiction of the
Psychiatric Security Review Board pursuant to ORS
161.327;
(iv) Found guilty except for insanity of a
criminal offense and has been committed to a facility designated by OHA
pursuant to ORS 161.328; or
(v) Is seeking to transition from the Oregon
State Hospital or other hospital level of care into the
community.
(B) The
program shall give second priority consideration for admission to those
individuals seeking admission to programs:
(i) As an alternative to or to prevent civil
commitment or placement at the Oregon State Hospital; or
(ii) For the purpose of transitioning from a
program or a secure residential treatment facility.
(e) The program shall determine
priority for admission based on the priorities described above and on a
first-come first-served basis. The program may not consider the individual's
county of origin, responsibility, or residency; and
(f) Within 72 hours of a provider learning of
a pending opening, the program shall provide written or electronic notification
to the referring CMHP, the individual on the waitlist, their legal
representative, or supervisory entity as applicable, of the expected opening.
The CMHP is responsible to verify the individual or their representative
received the notification of the opening and respond to the program within
three business days of the provider's notification. If any of the following
occurs, the program may offer the opening to the next individual on the wait
list:
(A) The program receives no response
from the individual the individual's legal representative, supervisory entity
or the referring entity, as applicable, within three business days;
(B) The individual will not be ready to
transition into the program within one week; or
(C) The individual no longer desires
placement at the program.
(13) The program shall obtain informed
consent for services from the individual or the individual's legal
representative prior to admission to the program. Informed consent is not
required for individuals placed at a program pursuant to a court, OHA, CMHP or
PSRB order issued under ORS chapter 161 or 426.
(14) Upon admission, the program
administrator shall provide and document an orientation to each new individual
that includes but is not limited to the following:
(a) A complete tour of the setting;
(b) Introductions to other individuals and
program staff;
(c) Discussion of
house rules;
(d) Explanation of the
laundry and food service schedule and policies;
(e) Review of the individual's
rights;
(f) Review of grievance
procedures;
(g) Review of the
residency agreement;
(h) Discussion
of the conditions under which residency would be terminated;
(i) General description of available services
and activities;
(j) Review and
explanation of advance directives. If the individual does not already have any
advance directives, the program shall provide an opportunity to complete
advanced directives;
(k) Emergency
procedures in accordance with OAR
309-035-0145(2).
(l) Review of the person-centered planning
process; and
(m) Review of the
process for imposing individually-based limitations on certain program
obligations to the individual.
Statutory/Other Authority: ORS
413.042 & ORS
443.450
Statutes/Other Implemented: ORS
413.032, ORS
443.400 -
443.465 & ORS
443.991