Chapter 899 Oregon Laws 2001
AN ACT
HB 3024
Relating to mental health
services; creating new provisions; amending ORS 430.342, 430.630, 430.640 and
430.672; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1.
ORS 430.630 is amended to read:
430.630. (1) In addition to any other requirements [which] that may be established by rule by the Mental Health and
Developmental Disability Services Division, each community mental health and
developmental disabilities program shall provide the following basic services
to persons with mental retardation and developmental disabilities and alcohol
abuse, alcoholism, drug abuse and drug dependence:
(a) Outpatient services;
(b) Aftercare for persons released from hospitals and training
centers;
(c) Training, case and program consultation and education
for community agencies, related professions and the public; and
(d) Guidance and assistance to other human service agencies
for joint development of prevention programs and activities to reduce factors
causing mental retardation and developmental disabilities and alcohol abuse,
alcoholism, drug abuse and drug dependence.
(2) As alternatives to state hospitalization, it shall be
the responsibility of the community mental health and developmental
disabilities program to insure that, subject to the availability of funds, the
following services for the mentally retarded and developmentally disabled,
alcohol abuser, alcoholic, drug abuser and drug-dependent persons are available
when needed and approved by the Mental Health and Developmental Disability
Services Division:
(a) Emergency services on a 24-hour basis, such as
telephone consultation, crisis intervention and prehospital screening
examination;
(b) Care and treatment for a portion of the day or night,
which may include day treatment centers, work activity centers and preschool
programs;
(c) Residential care and treatment in facilities such as
halfway houses, detoxification centers and other community living facilities;
(d) Continuity of care, such as that provided by service
coordinators, community case development specialists and core staff of
federally assisted community mental health centers;
(e) Inpatient treatment in community hospitals; and
(f) Other alternative services to state hospitalization as
defined by the division.
(3) In addition to any other requirements [which] that may be established by rule of the division, each community
mental health and developmental disabilities program, subject to the
availability of funds, shall provide or [assure]
ensure the provision of the
following services to persons with mental or emotional disturbances:
(a) Screening and evaluation to determine the client’s
service needs;
(b) Crisis stabilization to meet the needs of persons suffering
acute mental or emotional disturbances, including the costs of investigations
and prehearing detention in community hospitals or other facilities approved by
the division for persons involved in involuntary commitment procedures;
(c) Vocational and social services that are appropriate for
the client’s age, designed to improve the client’s vocational, social,
educational and recreational functioning;
(d) Continuity of care to link the client to housing and
appropriate and available health and social service needs;
(e) Psychiatric care in state and community hospitals,
subject to the provisions of subsection (4) of this section;
(f) Residential services;
(g) Medication monitoring;
(h) Individual, family and group counseling and therapy;
(i) Public education and information;
(j) Prevention of mental or emotional disturbances and
promotion of mental health;
(k) Consultation with other community agencies; and
(L)(A) Preventive mental health services for children and
adolescents, including primary prevention efforts, early identification and
early intervention services. Preventive services should be patterned after
service models that have demonstrated effectiveness in reducing the incidence
of emotional, behavioral and cognitive disorders in children.
(B) As used in this subsection:
(i) “Early identification” means detecting emotional
disturbance in its initial developmental stage;
(ii) “Early intervention services” for children at risk of
later development of emotional disturbance means programs and activities for
children and their families that promote conditions, opportunities and
experiences that encourage and develop emotional stability, self-sufficiency
and increased personal competence; and
(iii) “Primary prevention efforts” means efforts that
prevent emotional problems from occurring by addressing issues early so that
disturbances do not have an opportunity to develop.
(4) A community mental health and developmental
disabilities program shall assume responsibility for psychiatric care in state
and community hospitals, as provided in subsection (3)(e) of this section, in
the following circumstances:
(a) The person receiving care is a resident of the county
served by the program. For purposes of this paragraph, “resident” means the
resident of a county in which the person maintains a current mailing address
or, if the person does not maintain a current mailing address within the state,
the county in which the person is found, or the county in which a court
committed mentally ill person has been conditionally released.
(b) The person has been hospitalized involuntarily or
voluntarily, pursuant to ORS 426.130 or 426.220, except for persons confined to
the Secure Child and Adolescent Treatment Unit at Oregon State Hospital, or has
been hospitalized as the result of a revocation of conditional release.
(c) Payment is made for the first 60 consecutive days of
hospitalization.
(d) The hospital has collected all available patient
payments and third-party reimbursements.
(e) In the case of a community hospital, the division has
approved the hospital for the care of mentally or emotionally disturbed
persons, the community mental health and developmental disabilities program has
a contract with the hospital for the psychiatric care of residents and a
representative of the program approves voluntary or involuntary admissions to
the hospital prior to admission.
(5) Subject to the review and approval of the division, a
community mental health and developmental disabilities program may initiate
additional services after the services defined in this section are provided.
(6) Each community mental health and developmental
disabilities program and the state hospital serving the program’s geographic
area shall enter into a written agreement concerning the policies and
procedures to be followed by the program and the hospital when a patient is
admitted to, and discharged from, the hospital and during the period of
hospitalization.
[(7) Each community
mental health and developmental disabilities program shall submit a biennial
plan, budget information and progress report documenting needs and conformance
with the requirements of this section and shall maintain records and submit
other data, including the evaluation data described in ORS 430.665, as required
by the division.]
[(8)] (7) Each community mental health and
developmental disabilities program shall have a mental health advisory
committee, appointed by the board of county commissioners or the county court
or, if two or more counties have combined to provide mental health services,
the boards or courts of the participating counties or, in the case of a Native
American reservation, the tribal council.
[(9)] (8) A community mental health and
developmental disabilities program may request and the division may grant a
waiver regarding provision of one or more of the services described in
subsection (3) of this section upon a showing by the county and a determination
by the division that mentally or emotionally disturbed persons in that county
would be better served and unnecessary institutionalization avoided.
[(10)] (9) Each community mental health and
developmental disabilities program shall cooperate fully with the Governor’s
Council on Alcohol and Drug Abuse Programs in the performance of its duties.
(10)(a) As used in
this subsection, “local mental health authority” means one of the following
entities:
(A) The board of county
commissioners of one or more counties that establishes or operates a community
mental health and developmental disabilities program;
(B) The tribal council,
in the case of a federally recognized tribe of Native Americans that elects to
enter into an agreement to provide mental health services; or
(C) A regional local
mental health authority comprised of two or more boards of county
commissioners.
(b) Each local mental
health authority that provides mental health services shall determine the need
for local mental health services and adopt a comprehensive local plan for the
delivery of mental health services for children, families and adults that
describes the methods by which the local mental health authority shall provide
those services. The local mental health authority shall review and revise the
local plan biennially. The purpose of the local plan is to create a blueprint to
provide mental health services that are directed by and responsive to the
mental health needs of individuals in the community served by the local plan.
(c) The local plan shall
identify ways to:
(A) Coordinate and
ensure accountability for all levels of care described in paragraph (e) of this
subsection;
(B) Maximize resources
for consumers and minimize administrative expenses;
(C) Provide supported
employment and other vocational opportunities for consumers;
(D) Determine the most
appropriate service provider among a range of qualified providers;
(E) Ensure that
appropriate mental health referrals are made;
(F) Address local
housing needs for persons with mental health disorders;
(G) Develop a process
for discharge from state and local psychiatric hospitals and transition
planning between levels of care or components of the system of care;
(H) Provide peer support
services, including but not limited to drop-in centers and paid peer support;
(I) Provide
transportation supports; and
(J) Coordinate services
among the criminal and juvenile justice systems, adult and juvenile corrections
systems and local mental health programs to ensure that persons with mental
illness who come into contact with the justice and corrections systems receive
needed care and to ensure continuity of services for adults and juveniles
leaving the corrections system.
(d) When developing a
local plan, a local mental health authority shall:
(A) Coordinate with the
budgetary cycles of state and local governments that provide the local mental
health authority with funding for mental health services;
(B) Involve consumers,
advocates, families, service providers, schools and other interested parties in
the planning process;
(C) Coordinate with the
local public safety coordinating council to address the services described in
paragraph (c)(J) of this subsection;
(D) Conduct a population
based needs assessment to determine the types of services needed locally;
(E) Determine the
ethnic, cultural and diversity needs of the population served by the local
plan;
(F) Describe the
anticipated outcomes of services and the actions to be achieved in the local
plan;
(G) Ensure that the
local plan coordinates planning, funding and services with:
(i) The educational
needs of children and adults;
(ii) Providers of social
supports, including but not limited to housing, employment, transportation and
education; and
(iii) Providers of
physical health and medical services;
(H) Describe how funds,
other than state resources, may be used to support and implement the local
plan;
(I) Demonstrate ways to
integrate local services and administrative functions in order to support
integrated service delivery in the local plan; and
(J) Involve the local
mental health advisory committees described in subsection (7) of this section.
(e) The local plan must
describe how the local mental health authority will ensure the delivery of and
be accountable for clinically appropriate services in a continuum of care based
on consumer needs. The local plan shall include, but not be limited to,
services providing the following levels of care:
(A) Twenty-four-hour
crisis services;
(B) Secure and nonsecure
extended psychiatric care;
(C) Secure and nonsecure
acute psychiatric care;
(D) Twenty-four-hour
supervised structured treatment;
(E) Psychiatric day
treatment;
(F) Treatments that
maximize client independence;
(G) Family and peer
support and self-help services;
(H) Support services;
(I) Prevention and early
intervention services;
(J) Transition
assistance between levels of care;
(K) Dual diagnosis
services;
(L) Access to placement
in state-funded psychiatric hospital beds; and
(M) Precommitment and
civil commitment in accordance with ORS chapter 426.
(f) In developing the
part of the local plan referred to in paragraph (c)(J) of this subsection, the
local mental health authority shall collaborate with the local public safety
coordinating council to address the following:
(A) Training for all law
enforcement officers on ways to recognize and interact with persons with mental
illness, for the purpose of diverting them from the criminal and juvenile
justice systems;
(B) Developing voluntary
locked facilities for crisis treatment and follow-up as an alternative to
custodial arrests;
(C) Developing a plan
for sharing a daily jail and juvenile detention center custody roster and the
identity of persons of concern and offering mental health services to those in
custody;
(D) Developing a
voluntary diversion program to provide an alternative for persons with mental
illness in the criminal and juvenile justice systems; and
(E) Developing mental
health services, including housing, for persons with mental illness prior to
and upon release from custody.
(g) Services described
in the local plan shall:
(A) Address the vision,
values and guiding principles described in the Report to the Governor from the
Mental Health Alignment Workgroup, January 2001;
(B) Be provided to
children and families as close to their homes as possible;
(C) Be culturally
appropriate and competent;
(D) Be, for children and
adults with mental health needs, from providers appropriate to deliver those
services;
(E) Be delivered in an
integrated service delivery system with integrated service sites or processes,
and with the use of integrated service teams;
(F) Ensure consumer
choice among a range of qualified providers in the community;
(G) Be distributed
geographically;
(H) Involve consumers,
families, clinicians, children and schools in treatment as appropriate;
(I) Maximize early
identification and early intervention;
(J) Ensure appropriate
transition planning between providers and service delivery systems, with an
emphasis on transition between children and adult mental health services;
(K) Be based on the
ability of a client to pay;
(L) Be delivered
collaboratively;
(M) Use age-appropriate,
research-based quality indicators;
(N) Use best-practice
innovations; and
(O) Be delivered using a
community-based, multisystem approach.
(h) A local mental
health authority shall submit to the Department of Human Services a copy of the
local plan and biennial revisions adopted under paragraph (b) of this
subsection at time intervals established by the department.
SECTION 1a.
Each local mental health authority that
provides mental health services shall submit to the Department of Human
Services a copy of the first comprehensive local plan adopted under ORS 430.630
(10) no later than March 1, 2002.
SECTION 2.
ORS 430.640 is amended to read:
430.640. (1) The [Mental
Health and Developmental Disability Services Division] Department of Human Services, in carrying out the legislative
policy declared in ORS 430.610, subject to the availability of funds shall:
(a) Assist Oregon counties and groups of Oregon counties in
the establishment and financing of community mental health and developmental
disabilities programs operated or contracted for by one or more counties.
(b) If a county declines to operate or contract for a
community mental health and developmental disabilities program, contract with
another public agency or private corporation to provide the program. The county
must be provided with an opportunity to review and comment.
(c) In an emergency situation when no community mental
health and developmental disabilities program is operating within a county or a
county is unable to provide a service essential to public health and safety,
operate the program or service on a temporary basis.
(d) At the request of the tribal council of a land-based
tribe of Native Americans whose reservation extends into two or more counties,
contract with the tribal council for the establishment and operation of a
community mental health and developmental disabilities program in the same
manner that the [division] department contracts with a county
court or board of county commissioners.
(e) If a county agrees, contract with a public agency or
private corporation for all services within one or more of the following
program areas: Mental or emotional disturbances, drug abuse, mental retardation
or other developmental disabilities and alcohol abuse and alcoholism.
[(f) Establish and
promulgate the standards and requirements to be met by the biennial plan and
budget information for the establishment and operation of each community mental
health and developmental disabilities program including the requirement that
all services described in ORS 430.630 (3) are provided by each program unless a
waiver has been granted.]
[(g)] (f) Approve or disapprove the biennial
plan and budget information for the establishment and operation of each
community mental health and developmental disabilities program. No subsequent
amendments to or modifications of an approved plan or budget information
involving more than 10 percent of the state funds provided for services under
ORS 430.630 shall be placed in effect without prior approval of the [division] department. However, an amendment or modification affecting 10
percent or less of state funds for services under ORS 430.630 within the
portion of the program for persons with mental or emotional disturbances, or
within the portion for persons with mental retardation and developmental
disabilities or within the portion for persons with alcohol and drug dependence
may be made without [division] department approval.
[(h)] (g) Make all necessary and proper rules
to govern the establishment and operation of community mental health and
developmental disabilities programs, including adopting rules defining the
range and nature of the services which shall or may be provided under ORS
430.630.
[(i)] (h) Collect data and evaluate services
in the state hospitals in accordance with the same methods prescribed for
community mental health and developmental disabilities programs under ORS
430.665.
(i) Develop
guidelines that include, for the development of comprehensive local plans in
consultation with local mental health authorities:
(A) The use of
integrated services;
(B) The outcomes
expected from services and programs provided;
(C) Incentives to reduce
the use of state hospitals;
(D) Mechanisms for local
sharing of risk for state hospitalization;
(E) The provision of
clinically appropriate levels of care based on an assessment of the mental
health needs of consumers; and
(F) The transition of
consumers between levels of care.
(j) Work with local mental
health authorities to provide incentives for community-based care whenever
appropriate while simultaneously ensuring adequate statewide capacity.
(k) Provide technical
assistance and information regarding state and federal requirements to local
mental health authorities throughout the local planning process required under
ORS 430.630 (10).
(L) Provide incentives
for local mental health authorities to enhance or increase vocational
placements for adults with mental health needs.
(m) Develop or adopt
nationally recognized system-level performance measures, linked to the Oregon
Benchmarks, for state-level monitoring and reporting of mental health services
for children and adults, including but not limited to quality and
appropriateness of services, outcomes from services, structure and management
of local plans, prevention of mental health disorders and integration of mental
health services with other needed supports.
(n) Develop standardized
criteria for each level of care described in ORS 430.630 (10), including
protocols for implementation of local plans, strength-based mental health
assessment and case planning.
(o) Develop a
comprehensive long-term plan for providing appropriate and adequate mental
health treatment and services to children and adults that is derived from the
needs identified in local plans, is consistent with the vision, values and
guiding principles in the Report to the Governor from the Mental Health
Alignment Workgroup, January 2001, and addresses the need for and the role of state
hospitals.
(p) Report biennially to
the Governor and the Legislative Assembly on the progress of the local planning
process and the implementation of the local plans adopted under ORS 430.630
(10)(b) and the state planning process described in paragraph (o) of this
subsection, and on the performance measures and performance data available
under paragraph (m) of this subsection.
(q) On a periodic basis,
not to exceed 10 years, reevaluate the methodology used to estimate prevalence
and demand for mental health services using the most current nationally
recognized models and data.
(r) Encourage the
development of regional local mental health authorities comprised of two or
more boards of county commissioners that establish or operate a community
mental health and developmental disabilities program.
(2) The department may
provide technical assistance and other incentives to assist in the planning,
development and implementation of regional local mental health authorities
whenever the department determines that a regional approach will optimize the
comprehensive local plan described under ORS 430.630 (10).
[(2)] (3) The enumeration of duties and
functions in subsection (1) of this section shall not be deemed exclusive nor
construed as a limitation on the powers and authority vested in the [division] department by other provisions of law.
SECTION 3.
ORS 430.342 is amended to read:
430.342. (1) The governing body of each county or
combination of counties in a mental health administrative area, as designated
by the Mental Health and Developmental Disability Services Division shall
appoint a local alcoholism planning committee or shall designate an already
existing body to act as the local alcoholism planning committee.
(2) The committee shall identify needs and establish
priorities for alcoholism services [in
the annual community mental health plan required by ORS 430.630]. In doing
so, it shall coordinate its activities with existing community mental health
planning bodies.
(3) Members of the committee shall be representative of the
geographic area and shall be persons with interest or experience in developing
programs dealing with alcohol problems. The membership of the committee shall
include a number of minority members which reasonably reflects the proportion
of the need for alcoholism treatment and rehabilitation services of minorities
in the community.
SECTION 4.
ORS 430.672 is amended to read:
430.672. (1) Except for community mental health and
developmental disabilities programs operated by the county, a county may impose
only standards, requirements and conditions for mental health and developmental
disabilities programs that are substantially similar to the standards,
requirements and conditions established for such programs by the [Mental Health and Developmental Disability
Services Division] Department of
Human Services.
(2) When a county contracts with a public agency or private
corporation for a community mental health and developmental disabilities
program, the county shall include in the contract only terms that are
substantially similar to model contract terms developed by the [division] department under ORS 430.640 [(1)(h)]
(1)(g). The county may not add
contractual requirements, including qualifications for contractor selection,
that are nonessential to the services provided under ORS 430.630. The county
may add contract requirements that the county considers necessary to ensure the
siting and maintenance of facilities of the community mental health and
developmental disabilities program.
(3) The provisions of subsections (1) and (2) of this
section apply only insofar as funds are provided by the [division] department to
the county for community mental health and developmental disabilities programs.
(4) As used in this section, “community mental health and
developmental disabilities program” includes those program elements that serve
only persons with developmental disabilities.
SECTION 5.
A local mental health authority shall
submit to the Department of Human Services by October 1 of each even-numbered
year a report on the implementation of the comprehensive local plan adopted
under ORS 430.630 (10).
SECTION 6.
Section 5 of this 2001 Act becomes
operative on January 2, 2004.
SECTION 7.
By February 28, 2003, each local mental
health authority that provides mental health services shall submit to the
Department of Human Services a report on the implementation of the first
comprehensive local plan submitted to the department pursuant to section 1a of
this 2001 Act.
SECTION 8.
This 2001 Act being necessary for the
immediate preservation of the public peace, health and safety, an emergency is
declared to exist, and this 2001 Act takes effect on its passage.
Approved by the Governor
August 2, 2001
Filed in the office of
Secretary of State August 2, 2001
Effective date August 2,
2001
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