309-060-0125 Application for Initial Registration and Renewal Registration (1) Application for a Letter of Registration, including renewal registration, must be submitted by the applicant in writing on the forms furnished by the Division that are legible and complete and in the manner specified by the Division. Applications must include: (a) A description of the facility in or upon which the applicant proposes to operate a CBSH; (b) Signed attestation by the applicant that all applicable rules for the provision of a CBSH facility shall be met and maintained in compliance with applicable rules and any variances granted by the Division; (c) A copy of all policies and procedures the proposed facility will operate under including, but not limited to: (A) Referrals of residents to the CMHP, a CCO, or other agencies as part of the resident’s treatment needs. (B) A list of house rules to be followed by residents and program staff. (C) Emergency and Disaster response policies. (D) Abuse and Grievance reporting policies. (E) Eviction policies and procedures. (d) The maximum number of residents who must reside at the CBSH; (e) The number of bedrooms, apartment units, or single room occupancy units; (f) The name, address, telephone number, and email address of the applicant; (g) The names, addresses, telephone numbers, and email address of any partner, corporate officer, entities, or other persons having an ownership interest in the CBSH and the percent ownership corresponding to each; (h) The name, address, telephone number, and email address of the facility manager, if applicable; (i) The qualifications and documentation of training requirements for the applicant, facility manager if not the applicant, and each program staff; (j) A description of each of the services and supports the provider shall offer to residents; (k) A copy of the applicant’s current rental agreement; and (l) Copies of all approved criminal history checks for all persons involved in the operation of the CBSH and who have contact with the residents, as required in OAR 407-007-0200 through 407-007-0370. (2) The registration fee shall be $20 per year, per CBSH, paid via check or money order to Health Systems Division and shall accompany the application. (3) The application is not complete until all required forms, information, and application fees are received by the Division. (4) If the Division receives a complete application for renewal 90 calendar days prior to the expiration date listed on the Letter of Registration, the Letter of Registration may not be deemed to have expired until the Division completes its review of the renewal application and either issues a new Letter of Registration or denies the application. (5) If the Division does not receive a complete application for renewal prior to the expiration listed on the Letter of Registration, the Letter of Registration shall expire on the date listed on the Letter of Registration, and the CBSH must be considered un-registered. (6) Applicants who fail to submit a complete application shall be notified by the Division. The notification shall identify the components required to complete the application. The Division’s notification may also identify the due date by which a completed application shall be received by the Division. 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