72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
 
NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .
 
LC 3572
 
                           A-Engrossed
 
                         House Bill 3638
                  Ordered by the House August 1
            Including House Amendments dated August 1
 
Sponsored by COMMITTEE ON GENERAL GOVERNMENT (at the request of
  Association of Oregon Counties)
 
 
                             SUMMARY
 
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.
 
  Specifies that   { - requirements - }   { + requirement + }
that counties provide   { - certain services in areas of - }
 { + specified + } mental health { + , + }
  { - and - }  developmental disabilities  { - , children and
families, civil commitment and local public health apply - }
 { + and drug and alcohol services applies + } subject to
availability of   { - moneys from General Fund - }  { +
funds + }.
    { - Allows counties to relinquish responsibility to state to
provide services in areas of mental health and developmental
disabilities, children and families and local public health. - }
    { - Allows counties to provide limited services under
contract with state in areas of mental health and developmental
disabilities, children and families, local public health and
community corrections. - }
    { - Directs state to defend, save harmless and indemnify
counties against liabilities arising out of relinquishment of
responsibility or provision of limited services under
contract. - }
  Declares emergency, effective on passage.
 
                        A BILL FOR AN ACT
Relating to county delivery of certain services; creating new
  provisions; amending ORS 430.630; 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 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. + }
                         ----------