72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
 
HA to HB 3638
 
LC 3572/HB 3638-4
 
                       HOUSE AMENDMENTS TO
                         HOUSE BILL 3638
 
            By COMMITTEE ON RULES AND PUBLIC AFFAIRS
 
                            August 1
 
  On page 1 of the printed bill, line 2, after 'ORS' delete the
rest of the line and lines 3 and 4 and insert '430.630; and
declaring an emergency.'.
  Delete lines 6 though 27 and pages 2 through 23 and insert:
  '  { +  SECTION 1. + } ORS 430.630 is amended to read:
  ' 430.630. (1) In addition to any other requirements that may
be established by rule by the Department of Human Services { +
and subject to the availability of funds + }, 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 Department of Human Services:
  ' (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 department.
  ' (3) In addition to any other requirements that may be
established by rule of the department, each community mental
health and developmental disabilities program, subject to the
availability of funds, shall provide or 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 department 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 department 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 department, 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 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.
  ' (8) A community mental health and developmental disabilities
program may request and the department 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 department that mentally or emotionally
disturbed persons in that county would be better served and
unnecessary institutionalization avoided.
  ' (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 2. + }  { + The amendments to ORS 430.630 by
section 1 of this 2003 Act apply to community mental health and
developmental disabilities programs established prior to, on or
after the effective date of this 2003 Act. + }
  '  { +  SECTION 3. + }  { + This 2003 Act being necessary for
the immediate preservation of the public peace, health and
safety, an emergency is declared to exist, and this 2003 Act
takes effect on its passage. + } ' .
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