Oregon Administrative Rules
Chapter 309 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: BEHAVIORAL HEALTH SERVICES
Division 91 - STATE HOSPITAL ADMISSIONS AND DISCHARGES
Section 309-091-0015 - Determining Need for State Hospital Care
Universal Citation: OR Admin Rules 309-091-0015
Current through Register Vol. 63, No. 9, September 1, 2024
(1) State hospital level of care is determined appropriate when:
(a) the
individual's condition or symptoms have not improved in an acute care setting
despite having received a comprehensive psychiatric and medical assessment, and
treatment with medications for at least 7 days at an adequate dose;
and
(b) the individual continues to
require hospital level of care services, as evidenced by failure to meet the
state hospital's criteria for readiness to transition
(2) Prior to referral for admission to a state hospital, the individual should have received:
(a) A comprehensive medical assessment to
identify conditions that may be causing, contributing to, or exacerbating the
mental illness;
(b) Services from
an appropriate medical professional for the treatment and stabilization of any
medical or surgical conditions that may be contributing to or exacerbating the
mental illness and
(c) There must
be evidence of additional treatment and services having been attempted,
including:
(A) Use of evidence-based or
promising psychosocial interventions which were delivered in relevant
culturally-competent, strength-based, person-centered and trauma-informed
manners and which adequately treated the assessed and/or expressed needs of the
individual. Treatments should include members of the individual's family,
support network and Peer Delivered Services, unless the individual doesn't
consent.
(B) Documentation of
ongoing review and discussion, by hospital staff and responsible party, of
options for discharge to non-hospital levels of care; and
(C) Documentation of services and supports
attempted by the responsible party to divert an individual from acute admission
and establish treatment and recovery in a non-hospital setting.
(3) To make a referral for admission to a state hospital, the responsible party shall ensure the following documentation is provided:
(a)
Request for OSH and PAITS Services form; and
(b) Community Questionnaire form, to include
the OSH discharge plan, developed by the responsible party; and
(c) Patient demographic information; and
(d) Civil Commitment documents, to
include, Commitment Judgment or Order, and pre-commitment investigations;
or
(e) Guardianship orders, or
health care representative forms; and
(f) History and Physical; and
(g) Psychosocial assessment, if available;
and
(h) Progress notes, from
admission; and
(i) Medication
Administration Record; and
(j) Labs
and other diagnostic testing; and
(k) Involuntary Administration of Significant
Procedures documentation, if applicable.
(4) If the referral is approved, a written notice will be provided to acute care, and responsible party.
(5) If the referral is denied, a letter of denial will be provided, to include a rationale for denial, within 72 hours;
(a) The individual, provider of acute care
services, or responsible party, can appeal the denial, by submitting a written
request, to the OHA director, or designee; and
(b) The OHA director, or designee, will
provide a written response to the appeal
Statutory/Other Authority: ORS 413.042
Statutes/Other Implemented: ORS 179.321, 426.010, 426.020 & 426.072
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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