Or. Admin. R. 309-035-0163 - [Effective 4/11/2024] Admission to Program
(1) The
provider shall ensure the admission process includes the following:
(a) The provider shall specify in its
admission policy and procedures the program staff responsible for each
component of the admission information-gathering and decision-making process.
The program shall allocate responsibilities to promote effective processing of
referrals and admissions;
(b) The
provider shall develop and implement admission policies and procedures that
support a prospective individual 's right to select and choose from available
service settings when the individual meets medical necessity
criteria;
(c) The provider shall
support the individual 's right to select a program by assisting the
person-centered service plan coordinator in identifying and documenting program
options in the person-centered service plan, including providing information
regarding program services and rates; and
(d) The provider may close admissions to the
program when accepting an additional prospective individual may cause the
program to exceed its reasonable waitlist. When admissions are closed, the
provider is not required to accept referrals, conduct screenings, or evaluate
admissions criteria as directed by these rules.
(2) Unless limited by contractual agreement
with the Division or other Division -approved party, the program may accept
referrals from a variety of sources.
(3) In accordance with ORS
179.505
and the 42 CFR, Part 2, the program shall obtain an authorization for the
release of information for disclosure for any confidential information
concerning a prospective individual .
(4) The provider shall consider an individual
for admission without regard to race, color, sex or sexual orientation, except
as may be limited by room arrangement, religion, creed, national origin, age,
except under 18 years, familial status, marital status, source of income, or
disability in addition to the mental health disorder.
(5) Prior to accepting an individual for
admission to the program, the program administrator shall determine that the
individual meets admission criteria including the following:
(a) The provider shall offer each individual
referred for placement at the program an opportunity to participate in a
screening interview prior to being accepted or denied placement at a program.
The screening is intended to provide information about the program and the
services available as well as to obtain information from the prospective
individual , a relative, and agencies currently providing services to the
individual sufficient to determine eligibility for admission and service needs;
and
(b) The provider shall receive
screening packets for each individual referred for placement. At a minimum,
screening packets shall include:
(A) Written
documentation that the prospective individual has or is suspected of having a
mental health disorder;
(B)
Background information including a mental health assessment , description of
previous living arrangements, service history, behavioral issues, and service
needs;
(C) Medical information
including a brief history of any health conditions, documentation from a
Licensed Medical Professional or other qualified health care professional of
the individual's current physical condition, and a written record of any
current or recommended medications, treatments, dietary specifications, and
aids to physical functioning;
(D)
Copies of documents or other documentation relating to guardianship,
conservatorship, commitment status, advance directives, or any other legal
restrictions;
(E) A copy of the
prospective individual 's most recent mental health treatment plan or in the
case of an emergency or crisis-respite admission a summary of current mental
health treatment involvement; and
(F) Documentation of the prospective
individual 's ability to evacuate the building consistent with the facility's
designated evacuation capability and other concerns about potential safety
risks.
(c) The provider
shall ensure that screenings be conducted at the prospective program setting
unless:
(A) Travel arrangements cannot be
made due to inclement weather; or
(B) The individual or representative requests
a phone screening or screening at the individual 's current location.
(d) The provider shall contact the
referring agency to schedule a screening appointment within 48 hours of receipt
of the referral packet;
(e) The
provider shall coordinate with the referring agency to schedule a screening
appointment to occur within 14 calendar days from the date of receipt of the
referral packet;
(f) The provider
shall provide the following to each individual referred for placement:
(A) Materials explaining conditions of
residency;
(B) Services available
to individuals residing in the program ; and
(C) An opportunity to meet with a prospective
roommate if the program uses a shared room model.
(g) The screening meeting shall include the
program administrator , the prospective individual , and the individual 's
representative. With the prospective individual 's consent, the meeting may also
include family members, other representatives as appropriate, representatives
of relevant service-providing agencies, and others with an interest in the
individual 's admission.
(6) If an individual is referred for
emergency or crisis-respite admission, an amended or abbreviated screening
process may be used to more quickly meet the needs of individuals seeking
placement. Screening and admission information obtained may be less
comprehensive than for regular admissions but shall be sufficient to determine
that the individual meets admission criteria and that the setting and program
is appropriate considering the individual 's needs. The program shall document
the reasons for incomplete information.
(7) Prior to admission, the provider shall
evaluate and determine whether a prospective individual is eligible for
admission based on the following criteria. The individual shall:
(a) Be assessed to have a mental health
disorder or a suspected mental health disorder;
(b) Be at least 18 years of age;
(c) Not require continuous nursing care
unless a reasonable plan to provide the care exists, the need for residential
treatment supersedes the need for nursing care , and the Division approves the
placement;
(d) Have evacuation
capability consistent with the setting's SR occupancy classification;
and
(e) Meet additional criteria
required or approved by the Division through contractual agreement or condition
of licensing.
(8) For
admission to an SRTF, the provider shall evaluate and determine whether a
prospective individual is eligible for admission, based on the individual
meeting all criteria in OAR 410-172-0720(7).
(9) The provider may deny an individual
admission to its program for the following reasons:
(a) Failure to meet admission criteria
established by these rules;
(b)
Inability to pay for services due to lack of presumed Medicaid eligibility or
other funds;
(c) Documented
instances of behaviors within the last 14 calendar days that would pose a
reasonable and significant risk to the health, safety , and well-being of the
individual or another individual , if the individual is admitted;
(d) Lack of availability of necessary
services required to maintain the health and safety of the individual (no
nursing, etc.) or lack of an opening at the setting; or
(e) The individual declines the offer for
screening.
(10) The
provider may not deny an individual admission to its program as follows:
(a) Prior to offering a face-to-face
screening or other screening process as allowed by these rules; or
(b) Due to county of origin, responsibility,
or residency.
(11) The
provider 's admission decision shall be made as follows:
(a) The program 's decision shall be based on
review of screening materials, information gathered during the face-to-face
screening meeting, and evaluation of the admission criteria;
(b) The program shall inform the prospective
individual and the individual 's representative of the admission decisions
within 72 hours of the screening meeting;
(c) When the program denies admission, the
program shall inform the applicant, the individual 's representative, and the
referring entity in writing of the basis for the decision and the individual 's
right to appeal the decision;
(d)
When the program approves admission, the program shall inform the applicant,
the individual 's representative, and the referring entity through an acceptance
notification that shall include:
(A) When not
waitlisted or first on the waitlist, an estimated date of admission;
(B) When waitlisted, the number on the
waitlist.
(12) Management of waitlists includes the
following:
(a) The program shall establish
admission waitlists of reasonable length;
(b) The program shall document actions taken
in the management of the waitlist;
(c) The program shall contact a waitlisted
individual , the individual 's representative, and the referring entity monthly
to determine if the individual has been placed elsewhere;
(d) The program shall prioritize admissions
on a waitlist as follows:
(A) The program
shall give first priority to those individuals under current civil commitment
or under the jurisdiction of the Psychiatric Security Review Board and seeking
to transition from the Oregon State Hospital or other hospital level of care
into the community;
(B) The program
shall give second priority for admission to individuals seeking admission to
programs as an alternative to or to prevent civil commitment or placement at
the Oregon State Hospital or for the purpose of transitioning from a program or
a secure residential treatment facility;
(e) The program shall determine priority for
admission based on the priorities described above and on a first-come
first-served basis. The program may not consider the individual 's county of
origin, responsibility, or residency;
(f) Within 72 hours of a provider learning of
a pending opening, the program shall notify the first individual on the
waitlist, the individual 's representative, and the referring entity of the
expected opening. The individual shall respond within three business days of
the provider's notification. If any of the following occurs, the program may
offer the opening to the next individual on the wait list:
(A) The program receives no response from the
individual , the individual 's representative, or the referring entity within
three business days;
(B) The
individual will not be ready to transition into the program within one week;
or
(C) The individual no longer
desires placement at the program.
(13) The program shall obtain informed
consent for services from the individual or representative prior to admission
to the program unless the individual 's ability to consent is legally
restricted.
(14) Upon admission,
the program administrator shall provide and document an orientation to each new
individual that includes but is not limited to the following:
(a) A complete tour of the setting;
(b) Introductions to other individuals and
program staff;
(c) Discussion of
house rules ;
(d) Explanation of the
laundry and food service schedule and policies;
(e) Review of the individual 's
rights;
(f) Review of grievance
procedures;
(g) Completion of a
residency agreement ;
(h) Discussion
of the conditions under which residency would be terminated;
(i) General description of available services
and activities;
(j) Review and
explanation of advance directives. If the individual does not already have any
advance directives, the program shall provide an opportunity to complete
advanced directives;
(k) Emergency
procedures in accordance with OAR 309-035-0145(2);
(l) Review of the person -centered planning
process; and
(m) Review of the
process for imposing individually-based limitations on certain program
obligations to the individual .
Notes
Statutory/Other
Statutes/Other Implemented:ORS 413.032, ORS 443.400 - 443.465 & ORS 443.991
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