justicedao/ipfs_state_laws huggingface dataset:
309-045-0590 Temporary rule language in effect until 04/06/2026. Conditions (1) Conditions may be attached to a license and take effect immediately upon issuance by the Division. The type of condition attached to a license must directly relate to a risk of harm or potential risk of harm to individuals. Conditions may be attached upon a finding that: (a) Information on the application or initial inspection requires a condition to protect the health, safety, or welfare of the individuals. (b) A threat to the health, safety, or welfare of an individual exists. (c) There is reliable evidence of abuse, neglect, or exploitation. (d) The Agency with Choice is not being operated in compliance with these rules. (2) Examples of conditions that may be imposed on an Agency with Choice license include, but are not limited to: (a) Restricting the total number of individuals served based upon the ability of the Agency with Choice to meet the health and safety needs of the individuals. (b) Requiring additional qualifications or training of licensee and staff. (c) Restricting new admissions when there is a threat to the current individuals and admitting new individuals would compound that threat. (3) The Division will notify the licensee in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a hearing under ORS 183.411 to 183.502 . A licensee must request a hearing in writing within 21 calendar days after the date the notice was personally served or mailed. Conditions take effect immediately and are a final order of the Division unless later rescinded through the hearings process. (4) In addition to, or in-lieu of, a contested case hearing, a licensee may request an informal conference with the Division to discuss conditions imposed. The informal conference does not diminish the licensee's right to a hearing. (5) Conditions imposed remain in effect until the Division has sufficient cause to believe the situation that warranted the condition has been remedied. If the licensee believes the situation that warranted the condition has been remedied, the licensee may request in writing to the Division that the condition be removed. (6) Conditions must be posted with the license in a prominent place in the Agency with Choice and be available for inspection at all times. Statutory/Other Authority: ORS 413.042, Oregon Law 2024, Chapter 37 & HB 4129 (2024) Statutes/Other Implemented: Oregon Law 2024, Chapter 37 History: BHS 23-2025, temporary adopt filed 10/09/2025, effective 10/09/2025 through 04/06/2026
309-045-0600 Temporary rule language in effect until 04/06/2026. Denial, Suspension, or Revocation of License (1) The Division may deny, suspend, or revoke an Agency with Choice license in accordance with ORS 183.413 when an Agency with Choice fails to comply with these rules, including, but not limited to, a licensee or administrator of the Agency with Choice permitting, aiding, or abetting any illegal act affecting the welfare of the individual. (2) This section does not supersede or limit any other authority of the Division with regard to oversight of contracting entities or the imposition of civil pen alties. (3) The Division may immediately suspend a license for under ORS 183.430(2) . (4) Notice of Suspension of License must be imposed in accordance with ORS 183.411 through 183.470 . Statutory/Other Authority: ORS 413.042, Oregon Law 2024, Chapter 37 & HB 4129 (2024) Statutes/Other Implemented: Oregon Law 2024, Chapter 37 History: BHS 23-2025, temporary adopt filed 10/09/2025, effective 10/09/2025 through 04/06/2026
309-048-0050 Statement of Purpose and Statutory Authority (1) Purpose. These rules prescribe Division standards and procedures regarding the screening, evaluation and provision of specialized services to persons with mental illness who apply for or reside in Medicaid certified nursing facilities. They implement Public Law 100-203 of the Omnibus Budget Reconciliation Act of 1987 that added Section 1919 to the Social Security Act. (2) Statutory authority and procedure. These rules are authorized by ORS 413.042 and to carry out the provisions of ORS 410.535, 414.065 & 426.490 to 426.500 and Public Law 100-203. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0070 Procedures for Level I, Pre-Admission Screening (PAS) (1) Nursing facility placement. A person identified with mental illness indicators who requests placement in a nursing facility must meet APD-PAS criteria demonstrating a need for nursing facility care. The person may be placed in a nursing facility without a Level II evaluation if the person: (a) Meets criteria of categorical determinations OAR 309-048-0060; or (b) Has a primary diagnosis of dementia; and (c) Does not require specialized services OAR 309-048-0060(22). (2) Level II referrals. Persons shall be referred to the Division for a Level II evaluation prior to placement in a nursing facility if: (a) A Level I pre-admission screen or a private admission assessment has identified the individual as having indicators of mental illness; and (b) The individual is not eligible for a categorical determination. (3) Level II waiver. The Division may waive the Level II evaluation requirement if: (a) The individual does not need specialized services or has received maximum benefit from specialized services; and (b) The individual has been determined to be in need of nursing facility services by an APD designee or contractor; and (c) A facility has been identified that can meet the individual’s mental health needs. (4) Level II eligibility. Individuals may be required by he Division to have a Level II evaluation to determine the need for specialized services prior to placement in a nursing facility if any of the above conditions (subsections (3)(a), (b) and (c) of this rule) are not met. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0080 Procedures for Annual Resident Reviews (ARR) A resident screened and referred by a nursing facility as having indicators of mental illness shall be reviewed by a Division designee using a format approved by the Division. (1) Timelines. The review shall be completed by a QMHP within 7 working days of receipt of the referral from the nursing facility. (2) Screening and consultation. The review shall consist of up to two hours of screening and consultation to determine if the indicators of mental illness require a comprehensive evaluation (Level II). Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0090 Level II Evaluations (1) Content. A Level II evaluation shall: (a) Be completed by a QMHP within 30 calendar days of the annual resident review referral or within seven working days of the pre-admission screening referral; (b) Include a mental health assessment, a psychosocial evaluation, relevant testing and a review of the medication regime and physical examination by a licensed medical professional; (c) Establish a diagnosis and determine the need for specialized services. (2) Specialized psychiatric rehabilitation. If the need for specialized services is not established, the evaluation shall include treatment recommendations for specialized psychiatric rehabilitation services whenever indicated. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0100 Documentation (1) Level II waivers. The Division shall send a copy of any waiver from the pre-admission requirement for a Level II, to the APD Level I screener who has determined that the individual needs nursing facility care pursuant to OAR 309-048-0060. (2) Nursing facility. CMHP evaluators shall send copies of the annual resident review and Level II evaluation to the nursing facility within 7 and 30 days respectively. (3) Division. CMHP evaluators shall send copies of the annual resident review, Level II evaluation and the Level II summary sheet to the OMHS within 30 days of receipt of the nursing facility referral. (4) Client Process Monitoring System. CMHP designees shall enter information on all persons receiving a Level II evaluation into CPMS. (5) Standards. Level II evaluations shall follow documentation standards set forth in OAR 309-032-1535. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0110 Specialized Services for Individuals Residing in Nursing Facilities (1) Location. Specialized services for persons with mental illness are provided only in inpatient psychiatric settings that provide 24 hour coverage by trained mental health professionals who can deliver mental health services designed by an interdisciplinary team which includes a psychiatrist. (2) Readmission to nursing facilities. A person identified by a Level II evaluation as in need of specialized services shall not enter or remain in a nursing facility. When a client has received maximum benefit from specialized services, the client can be reconsidered for admission subject to Level I requirements or return to a nursing facility placement subject to APD OAR 411-088-0000 to 411-088-0080, Licensing Requirements for Nursing Facilities, Transfer Rules. (3) Procurement of specialized services. When a client is identified to be in need of specialized services, the Level II evaluator shall: (a) Assist the nursing facility or Level I screener in locating an appropriate treatment resource; (b) Insure that the client in need of specialized services is informed of his/her treatment options including the right to refuse treatment; (c) Inform all parties involved, of procedures related to precommitment investigation, if the client refuses specialized services and presents a danger to self or others; (d) Notify the Division within 72 hours if a client is determined to be in need of specialized services and these services are not being provided. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0120 Relocation of Persons with Mental Illness From Nursing Facilities to Other Residential Settings (1) Coordination of Plans. CMHP, NF and APD staff shall coordinate relocation plans for residents of nursing facilities with mental illness found to be ineligible for nursing facility care. (2) Right of return. All relocations of residents must comply with nursing facility transfer rules, division 88, OAR 411. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-048-0130 Appeals In accordance with ORS 413.042, adults with mental illness, and court approved legal guardians for individuals with mental illness, shall have the right to appeal decisions made by the Division based on screenings, admission waiver request, discharge and relocation plans. (1) Appeals. Appeals shall be submitted to the Children, Adult and Families Division (CAF) Hearings Office and arrive there within 30 calendar days after receipt of the contested determination/decision. (2) Negotiations. The CAF Division Hearings Office shall, when it deems appropriate, refer appealed decisions back to the Division for efforts to negotiate an agreement. If the Division is unable to negotiate an agreement within 10 working days, the Division will remand the appeal back to the CAF Hearings Office for final disposition. (3) Hearings. The CAF Hearings Office shall convene a hearing in accordance with OAR 461-025-0300 through 461-025-0375, and reach a final determination on the appeal within ninety (90) days of the final day of the hearing. (4) Determinations. All decisions of the CAF Hearing Office shall be final. Statutory/Other Authority: ORS 413.042 & 426.500 Statutes/Other Implemented: ORS 410.535, 414.065 & 426.490 to 426.500 History: MHD 2-1995, f. & cert. ef. 4-6-95
309-060-0100 Purpose and Scope (1) These rules establish standards and procedures for the application, review, initial registration, and ongoing registration of Community-Based Structured Housing (CBSH) for provision of services and supports to individuals with mental, emotional, behavioral, or substance use disorders who reside in a CBSH facility pursuant to ORS 443.480 to 443.500. (2) These rules do not apply or establish regulatory procedures for: (a) Any facility operated by an institution of higher education; (b) Any private room and board facility approved by an institution of higher education that has as a resident, a student, or an employee of the institution; (c) Any private or nonprofit retirement facility that does not fall under the generally understood definition of a "room and board facility," a "boarding house," or a "boarding hotel" and where a majority of the residents are retirees; (d) Any privately arranged housing the occupants of which may not be related by blood or marriage; (e) Residential licensure under ORS 443.410 and 443.315; (f) Programs defined under ORS 443.400; (g) CBSH facilities that are licensed or registered under any other law of this state or city or county ordinance or regulation. Statutory/Other Authority: ORS 413.032, ORS 413.042, ORS 413.085 & ORS 443.485 Statutes/Other Implemented: ORS 443.480 - 443.500 & ORS 443.991 History: BHS 43-2023, amend filed 12/22/2023, effective 01/01/2024 BHS 9-2018, adopt filed 04/16/2018, effective 04/16/2018
309-060-0110 Letter of Registration Required (1) The owner or operator of a CBSH facility offered to the general public must register with the Division if the facility: (a) Provides congregate housing, services, and supports as defined by ORS 443.480, and (b) Is not licensed or registered under any other law of this state or city or county ordinance or regulation. (2) Any provider operating CBSH prior to July 1, 2024, must submit a completed application for registration within 30 days following notification by the Division of requirement to become registered. All persons who wish to begin operation of a CBSH on or after July 1, 2024, must submit a completed application for registration prior to accepting residents. Upon finding the applicant is in substantial compliance with these rules, the Division shall issue a Letter of Registration for the CBSH. (3) If a provider operates more than one CBSH, each facility must be registered separately with the Division. (4) No Letter of Registration that has been issued to a provider for the operation of a CBSH for a given location shall be valid for use by any other provider or at any facility other than that for which it was issued. (5) When a CBSH is to be sold or otherwise transferred to another operator, the new operator must apply for and obtain a new Letter of Registration prior to the transfer or operation of the CBSH. (6) A Letter of Registration is valid for one year unless revoked, suspended, or voluntarily relinquished at an earlier date. (7) Any CBSH providing residential care or treatment as defined under ORS 443.400 and OAR 309-060-0105 may be subject to residential licensing under OAR chapter 309, division 35, or OAR chapter 309, division 40. (8) Upon discovery that a CBSH may be operating in a manner such that they can meet the definition of a residential care facility, residential facility, residential training facility, residential training home, residential treatment facility, or residential treatment home defined under ORS 443.400, the Division may notify the provider in writing of the Division’s plan to conduct an inspection to determine if licensure is required. (9) If the Division believes any CBSH facility is operating without registration or is in violation of ORS 443.480 to 443.500, the Division may apply to the circuit court for a search warrant. If the Division finds that a CBSH is operating without a registration, the Division shall impose a civil penalty not to exceed $5,000. (10) Any CBSH that fails to comply with these rules must be issued a notice of intent to revoke registration and have hearing rights under ORS chapter 183. Statutory/Other Authority: ORS 413.032, ORS 413.042, ORS 413.085 & ORS 443.485 Statutes/Other Implemented: ORS 443.480 - 443.500 & ORS 443.991 History: BHS 43-2023, amend filed 12/22/2023, effective 01/01/2024 BHS 9-2018, adopt filed 04/16/2018, effective 04/16/2018
309-060-0115 Waiver of Registration Requirement (1) Any CBSH that is required to be registered or licensed under another governmental entity’s standards that are substantially similar or superior to those under ORS 443.480 to 443.500 and these rules may request a waiver of the requirements of ORS 443.485. Such a request shall be made in writing to the Division and shall include: (a) A copy of the other governmental entity’s standards; and (b) An explanation of why they believe that the standards are substantially similar or superior to the requirements of ORS 443.480 to 443.500 and these rules. (2) If the Division finds that the requirements of the other governmental entity’s standards are substantially similar or superior to ORS 443.480 to 443.500 and these rules, it can issue a waiver: (a) All waivers shall be in writing and signed by the Division; and (b) All approved waivers can be reviewed by the Division upon amendment of the local ordinance or regulation or upon amendment of ORS 443.480 to 443.500 or these rules. (3) If the Division finds that the local requirements are not substantially similar or superior to ORS 443.480 to 443.500 and these rules, the Division may issue a written order to the CBSH denying the request for a waiver. (4) When a CBSH falls within the jurisdiction of both the Division and the Department of Human Services (Department), the Department Director and the Oregon Health Authority Director shall determine the agency responsible for registering the facility. (5) A Division approved waiver must be reviewed at least once every five years. (6) The Division must waive any reporting requirements or review processes for facilities regulated by federal agencies where The Division’s requirements duplicate the reporting requirements or review processes imposed by the federal agency. Statutory/Other Authority: ORS 413.032, ORS 413.042, ORS 413.085 & ORS 443.485 Statutes/Other Implemented: ORS 443.480 - 443.500 & ORS 443.991 History: BHS 43-2023, amend filed 12/22/2023, effective 01/01/2024 BHS 9-2018, adopt filed 04/16/2018, effective 04/16/2018
309-060-0130 Issuance of a Letter of Registration (1) Upon receipt of a completed application the Division must: (a) Review the application to determine compliance with these rules. (b) Request any additional information or documentation that may be necessary to determine compliance with these rules. (c) Conduct a review of the physical setting to determine compliance with OAR 309-060-0155. (2) Upon completion of the reviews described above, the Division must issue a Letter of Registration to an applicant that is found to be in compliance with the requirements of these rules. (3) The Letter of Registration must include: (a) The name and address of the provider of the CBSH; (b) The name and address of the CBSH; (c) The maximum number of residents who can reside at the CBSH; (d) The effective date and expiration date of the registration; and (e) Any variances granted by the Division. (4) If a CBSH is not registered with the Division, the provider may not advertise, represent, or imply that the CBSH is registered with the Division. (5) The Division, in its discretion, may grant a variance to these rules based upon a demonstration by the applicant or provider that an alternative method or different approach provides equal or greater program effectiveness and does not adversely impact the welfare, health, or safety of individuals: (a) The provider seeking a variance must submit in writing an application to the Division that identifies the section of the rules from which the variance is sought, the reason for the proposed variance, and the proposed alternative method or different approach. (b) The director or designee must review and approve or deny the request for a variance; (c) The Division must notify the provider of the decision in writing within 30 days after receipt of the request. A variance may be implemented only after receipt of written approval from the Division; (d) The provider may appeal the denial of a variance request by submitting a request for reconsideration in writing to the Division's Director or designee. The Director or designee must make a decision within 30 days of receipt of the appeal. The decision of the Director shall be final; and (e) A variance must be reviewed by the Division at least every year and may be revoked or suspended based upon a finding that the variance adversely impacts the welfare, health, or safety of the individuals. Statutory/Other Authority: ORS 413.032, ORS 413.042, ORS 413.085 & ORS 443.485 Statutes/Other Implemented: ORS 443.480 - 443.500 & ORS 443.991 History: BHS 43-2023, amend filed 12/22/2023, effective 01/01/2024 BHS 9-2018, adopt filed 04/16/2018, effective 04/16/2018
309-060-0135 Denial of Applications (1) Upon receipt of a completed application, the Division can deny the application if: (a) The applicant or facility manager, if applicable, does not have an approved background check , as required in OAR 407-007-0200 through 407-007-0370. (b) The applicant is associated with any persons whose registration or license for a CBSH, a foster home, residential care facility, residential treatment facility, or residential treatment home licensed by any state entity was denied, suspended, revoked, or not renewed due to abuse of a resident or a threat to the health and safety of a resident within three years preceding the application, unless the applicant or provider can demonstrate to the Division by clear and convincing evidence that the person does not pose a threat to the residents; (c) The applicant fails to demonstrate compliance with these rules; or (d) The applicant has previously had any letter of registration, certification, or license denied, suspended, or revoked by the Division or the Department. (2) An applicant is "associated with" a person as described in subsection (1)(b) of this rule if the applicant: (a) Resides with the person; (b) Employs the person in the CBSH; (c) Receives financial backing from the person for the benefit of the facility; (d) Receives managerial assistance from the person for the benefit of the facility; or (e) Knowingly allows the person to have access to the facility. (3) When an application for a Letter of Registration is denied, the applicant is entitled to an appeal review with the Division as follows: (a) The applicant must submit a written request for the appeal review to the Division within seven calendar days of the receipt of the notice of denial; (b) The Division must conduct an appeal review meeting within 30 days of receipt of the written request; (c) If no written request for a hearing is received within seven calendar days of receipt of the notice of denial or the Division upholds the denial, the notice of denial shall become final, the application closed, and a notice of the appeal review outcome mailed to the applicant. (4) If the Division overturns the denial, the Division shall issue a notice to the applicant within seven calendar days. The notice shall inform the applicant of the outcome of their appeal hearing and either: (a) Include an approved Letter of Registration per these rules; or (b) Provide a notation of required amendment to application materials and a timeframe for re-submission of the application. Statutory/Other Authority: ORS 181A.195, ORS 181.200, ORS 413.032, ORS 413.042, ORS 413.085 & ORS 443.485 Statutes/Other Implemented: ORS 443.480 - 443.500 & ORS 443.991 History: BHS 43-2023, amend filed 12/22/2023, effective 01/01/2024 BHS 9-2018, adopt filed 04/16/2018, effective 04/16/2018