Or. Admin. R. 309-033-0270 - [Effective until 4/11/2023] Provision of Care, Custody and Treatment of Persons Committed to the Division
(1)
Persons under civil commitment have the rights provided under ORS
426.385,
ORS
430.205
through
430.210,
and this rule, including:
(a) A person under
civil commitment's right to fresh air. For the purpose of this rule, these
terms have the following meanings:
(A) "Fresh
air" means the inflow of air from outside the facility where the person under
civil commitment is receiving services. "Fresh air" may be accessed through an
open window or similar method as well as through access to the
outdoors;
(B) "Outdoors" means an
area with fresh air that is not completely enclosed overhead. "Outdoors" may
include a courtyard or similar area.
(b) If a person under civil commitment
requests access to fresh air and the outdoors or the person under civil
commitment's treating health care provider determines that fresh air or the
outdoors would be beneficial to the person under civil commitment, the facility
in which the person under civil commitment is receiving services shall provide
daily access to fresh air and the outdoors unless this access would create a
significant risk of harm to the person under civil commitment or
others;
(c) The determination
whether a significant risk of harm to the person under civil commitment or
others exists shall be made by the person under civil commitment's treating
health care provider. The treating health care provider may find that a
significant risk of harm to the person under civil commitment or others exists
if:
(A) The person under civil commitment's
circumstances and condition indicate an unreasonable risk of harm to the person
under civil commitment or others which cannot be reasonably accommodated within
existing programming should the person under civil commitment be allowed access
to fresh air and the outdoors; or
(B) The facility's existing physical plant or
existing staffing prevent the provision of access to fresh air and the outdoors
in a manner than maintains the safety of the person under civil commitment or
others.
(d) If a facility
determines that its existing physical plant prevents the provision of access to
fresh air and the outdoors in a safe manner, the facility shall make a good
faith effort at the time of any significant renovation to the physical plant
that involves renovation of the unit or relocation of where persons under civil
commitment are treated to include changes to the physical plan or location that
allow access to fresh air and the outdoors, so long as such changes do not add
an unreasonable amount to the cost of the renovation.
(2) Provision of care at a state hospital.
The superintendent of the state hospital shall be responsible for all
admissions to the state hospital pursuant to OAR 309-091-0015. The
superintendent shall implement policies and procedures which afford a person
under civil commitment placed in a state hospital the rights provided by ORS
426.385,
430.205
through
430.210
and this rule.
(3) Provision of
care at a community hospital. The director shall assign and place a person
under civil commitment only at a community hospital approved under OAR
309-033-0530:
(a) The admitting physician, in
consultation with the director, shall determine whether the best interests of a
person under civil commitment are served by an admission to a community
hospital;
(b) The administrator
shall implement policies and procedures which afford a person under civil
commitment placed in a community hospital the rights provided by ORS
426.385,
430.205
through
430.210
and this rule.
(4)
Provision of care at a nonhospital facility or an outpatient program. The
director shall only assign and place a person under civil commitment in a
nonhospital facility that is licensed or certified by the Division:
(a) The administrator, in consultation with
the director, shall determine whether the best interests of a person under
civil commitment are served by an admission to a nonhospital facility or an
outpatient program;
(b) The
administrator shall implement policies and procedures which afford a person
under civil commitment placed in a nonhospital facility or an outpatient
program the rights provided by ORS
426.385,
430.205
through
430.210
and this rule;
(c) The director
shall place the person under civil commitment on a trial visit when the
committed individual is discharged from a level one facility to a lower level
of care in accordance with OAR 309-033-0290 and 309-033-0300;
(d) The director shall place a person under
civil commitment, who the court has ordered on outpatient commitment at the
commitment hearing, on outpatient commitment when the director assigns and
places the person in a facility other than a level one
facility.
(5) Provision
of medical services for a person under civil commitment. The superintendent of
a state hospital, the treating physician at a community hospital or the
director may transfer a person under civil commitment to a general hospital, or
transfer a person under civil commitment from a psychiatric ward to a medical
ward for medical care:
(a) The treating
physician shall only provide medical care with the consent of the person under
civil commitment in accordance with OAR 309-033-0600 through
309-033-0650;
(b) The
superintendent or treating physician shall transfer a person under civil
commitment to a general hospital for medical services on a pass or discharge
the person from the state hospital when it is determined that the person will
not return to the state hospital within a reasonable length of time, or that
discharge is clinically appropriate and is required for the person to have
access to third-party insurance benefits;
(c) The treating physician shall immediately
notify the director that a person was transferred to another hospital for
medical care under this subsection.
Notes
Statutory/Other Authority: ORS 413.042, 426.060, 426.385 & 430.205 - 430.210
Statutes/Other Implemented: ORS 426.005 - 426.395
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(1) Provision of rights. In addition to the rights provided under ORS 426.385, committed persons also have the rights provided under ORS 430.205 through 430.210 and this rule, including:
(a) A Committed Person's Right to Fresh Air. For the purpose of this rule, these terms have the following meanings:
(A) "Fresh air" means the inflow of air from outside the facility where the committed person is receiving services. "Fresh air" may be accessed through an open window or similar method as well as through access to the outdoors.
(B) "Outdoors" means an area with fresh air that is not completely enclosed overhead. "Outdoors" may include a courtyard or similar area.
(b) If a committed person requests access to fresh air and the outdoors or the committed person's treating health care provider determines that fresh air or the outdoors would be beneficial to the committed person, the facility in which the committed person is receiving services shall provide daily access to fresh air and the outdoors unless this access would create a significant risk of harm to the committed person or others.
(c) The determination whether a significant risk of harm to the committed person or others exists shall be made by the committed person's treating health care provider. The treating health care provider may find that a significant risk of harm to the committed person or others exists if:
(A) The committed person's individual circumstances and condition indicate an unreasonable risk of harm to the committed person or others which cannot be reasonably accommodated within existing programming should the committed person be allowed access to fresh air and the outdoors; or
(B) The facility's existing physical plant or existing staffing prevent the provision of access to fresh air and the outdoors in a manner than maintains the safety of the committed person or others.
(d) If a facility determines that its existing physical plant prevents the provision of access to fresh air and the outdoors in a safe manner, the facility shall make a good faith effort at the time of any significant renovation to the physical plant that involves renovation of the unit or relocation of where committed persons are treated to include changes to the physical plan or location that allow access to fresh air and the outdoors, so long as such changes do not add an unreasonable amount to the cost of the renovation.
(2) Provision of care at a state hospital. The superintendent of the state hospital serving the county of commitment shall be responsible for all admissions to the state hospital:
(a) The superintendent, in consultation with the director, shall determine whether the best interests of a committed person are served by an admission to the state hospital;
(b) The superintendent shall implement policies and procedures which afford a committed person placed in a state hospital the rights provided by ORS 426.385, 430.205 through 430.210 and this rule.
(3) Provision of care at a community hospital. The director shall assign and place a committed person only at a community hospital approved under OAR 309-033-0530:
(a) The admitting physician, in consultation with the director, shall determine whether the best interests of a committed person are served by an admission to a community hospital;
(b) The administrator shall implement policies and procedures which afford a committed person placed in a community hospital the rights provided by ORS 426.385, 430.205 through 430.210 and this rule.
(4) Provision of care at a nonhospital facility or an outpatient program. The director shall only assign and place a committed person in a nonhospital facility that is licensed or certified by the Division:
(a) The administrator, in consultation with the director, shall determine whether the best interests of a committed person are served by an admission to a nonhospital facility or an outpatient program;
(b) The administrator shall implement policies and procedures which afford a committed person placed in a nonhospital facility or an outpatient program the rights provided by ORS 426.385, 430.205 through 430.210 and this rule;
(c) The director shall place on a trial visit a committed person who is discharged from a state hospital or a community hospital when the director assigns and places the person in a nonhospital facility;
(d) The director shall place a committed person, who the court has ordered on outpatient commitment at the commitment hearing, on outpatient commitment when the director assigns and places the person in a nonhospital facility.
(5) Provision of medical services for a committed person. The superintendent of a state hospital, the treating physician at a community hospital or the director may transfer a committed person to a general hospital, or transfer a committed person from a psychiatric ward to a medical ward for medical care:
(a) The treating physician shall only provide medical care with the consent of the committed person in accordance with OAR 309-033-0600 through 309-033-0650;
(b) The superintendent or treating physician shall transfer a committed person to a general hospital for medical services on a pass or discharge the person from the state hospital when it is determined that the person will not return to the state hospital within a reasonable length of time, or that discharge is clinically appropriate and is required for the person to have access to third-party insurance benefits;
(c) The treating physician shall immediately notify the director that a person was transferred to another hospital for medical care under this subsection.
Notes
Stat. Auth.: ORS 413.042, 426.060, 426.385 & 430.205 - 430.210
Stats. Implemented: ORS 426.005 - 426.395