justicedao/ipfs_state_laws huggingface dataset:
333-600-0020 Principles (1) Chemical dependency service systems should provide a continuum of care which gradually increases demands for personal responsibility. (2) Chemical dependency services systems should allow entry at any point in the treatment continuum based on individual need. (3) All levels of chemical dependency treatment should be readily available for use with no person remaining too long at one level because of the lack of services at the next level. (4) The chemical dependency service system should be designed to allow people to remain in less intensive treatment modes longer than in the initial, more intensive modes. (5) Chemical dependency services should be delivered in the least expensive, least restrictive setting required to produce the desired results. (6) Chemical dependency services systems should provide a variety of treatment approaches to meet any given level of need. (7) Quick geographical access is considered essential for outpatient care, detoxification care and day treatment. If 90 percent of the chemically-dependent persons in the proposed service area who need to use a specific non-24-hour treatment program such as outpatient, day treatment, or detoxification are more than 35 miles by road from existing programs of the type that is needed, then more treatment capacity may be needed in a location accessible to the population. (8) Quick geographical access is not considered essential for inpatient hospital care or other types of 24-hour treatment programs. If 90 percent of the chemically-dependent persons in the proposed service area who need to use a specific 24-hour treatment program such as inpatient hospital, residential treatment, rehabilitation, or residential maintenance care are more than 75 miles by road from existing programs of the type that is needed, then more beds may be needed in a location more accessible to the population. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-600-0030 Need Methodology The method for estimating the needed number of beds or service capacity for each type of chemical dependency treatment setting consists of the following steps: (1) For a service which is designed to serve persons in the present service area of a given hospital or hospitals, determine the hospital service area according to OAR 333-590-0040. (2) For a service with a geographical targeting different from section (1) of this rule, evaluate the proposed service area according to OAR 333-600-0020(7) and (8), considering also the likelihood of contractual commitments to serve specific groups of potential clients. (3) Determine the estimated population for the service area for the calendar year five years beyond the letter of intent year of the application. (4) Obtain the estimated number of problem drinkers in the service area in five years for adults by calculating seven percent of the service area’s population age 19 and over; and for adolescents by calculating 19 percent of the 12–18 year old population. (5) Determine the estimated number of problem drinkers who will seek treatment in a one-year period, by calculating 15 percent of the number derived in section (4) of this rule. (6) Determine the specific levels and kinds of services required to meet the need, for all services other than outpatient: Multiply the number derived in section (5) of this rule by the beds per contact figure from Table 1, for the particular type of chemical dependency treatment service requested and divide by .90 to allow for occupancy variations. For outpatient service, utilize the service ratios figures in Table 1: Table 1 Chemical Dependency Beds per Service Treatment Services Contact Ratios Medical facility-based detoxification .0014 1 Nonmedical facility-based detoxification .0127 9 Inpatient hospital services .0072 5 Residential treatment, 24-hour .00689 49 Residential treatment, partial .00641 46 (day, night, or weekend) Rehabilitation (long-term) .00336 24 Residential maintenance care .01160 83 Outpatient care --- 781 (7) Determine the number of existing beds or service capacity for each of the service elements in the service area. (8) Subtract the level of existing services determined in section (7) of this rule from the projected need for services derived in section (6) of this rule. (9) Evaluate the estimated need against the principles in OAR 333-600-0020 to determine need for proposed service. (10) Although separate bed need standards are not established for specialty types of chemical dependency beds, the division recognizes that chemical dependency beds could be used to deliver various subspecialty services, such as adolescent or geriatric chemical dependency programs, and programs for patients with both a mental illness and a chemical dependency problem (“dual diagnosis” patients). Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-610-0000 General In order to demonstrate need for nursing home beds, an applicant must satisfy the criteria specified in the Certificate of Need Application Instructions (division 580). Where appropriate, responses to these instructions shall be based on the methodology of this division (division 610). Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-610-0060 Hospital Long-Term Care Beds (1) Long-term care facility services and beds offered in or through a hospital must be separately licensed by the Seniors and People with Disabilities Division. Therefore, the creation of a long-term care facility by a hospital will be considered to constitute the establishment of a new health care facility, subject to review under OAR 333-550-0010(1). Additions to the bed capacity of such facilities will be subject to review if such additions are greater than 10 percent of the existing capacity of the long-term care facility, or greater than 10 beds, whichever is less, as provided in OAR 333-550-0010(3). (2) When a hospital proposes to create a new long-term care facility which will either be associated with, or located in, the hospital; or increase the number of long-term care beds (as defined in OAR 333-610-0010(12)) in such a facility by more than 10 beds or 10 percent of the facility’s bed capacity, whichever is less, or when a hospital proposes to relocate long-term care beds to such a facility, the project will be subject to certificate of need on the same basis as any freestanding nursing home project would be under OAR 333-610-0000 to 333-610-0030. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 10-1995, f. & cert. ef. 11-14-95 HD 3-1995(Temp), f. & cert. ef. 8-18-95 HD 13-1994, f. & cert. ef. 4-22-94
333-610-0070 Swing Long-Term Care Beds in Hospitals When a hospital proposes to utilize a given number of its licensed hospital acute beds intermittently as skilled nursing facility swing beds under applicable federal regulations, the hospital is expected to submit a letter of intent to the Public Health Division. The organized and regular provision of skilled nursing facility services within the licensed physical plant of the hospital may be subject to review as a new long-term care facility under OAR 333-550-0010(3)(a). In addition: (1) The proposal will not be subject to county-specific nursing home bed need criteria under OAR 333-610-0000 to 333-610-0030 because it will not create permanent new nursing home beds. The division, in reviewing the proposal for need under OAR 333-580-0040 and for alternative uses of resources under OAR 333-580-0050, will take into consideration such factors as: (a) Health policy of the state, as reflected in ORS 410.010, 410.020, 410.050 and 410.060; ORS Chapter 442 generally; and other applicable statutes; (b) Interpretation of that policy, as reflected in the plans and administrative rules of the Health Division and the Senior and Disabled Services Division. In considering strategies for increasing the accessibility of nursing home beds, priority will be given to increasing the utilization of appropriate alternative care (thereby freeing up existing nursing home beds), rather than increasing the number of nursing home beds; (c) Comparative experience with, and quality of, long-term care provided by staff in licensed acute care hospitals and in licensed long-term care facilities. (2) The division, in reviewing the proposal for financial feasibility under OAR 333-580-0060, will take into consideration such factors as: (a) A conservative projection of Medicare utilization according to the current stringent “skilled” level of care criteria of the fiscal intermediaries; (b) Estimated potential for diversion of public and private funds now available for alternative care into facility-based long-term care when the patient needs involved could be met, at equal or lesser cost, through provision of alternative care; (c) Balanced against section (3) of this rule, estimated potential for diversion of public and private funds now available for acute care into facility-based and alternative long-term care; (d) Comparative costs of long-term care provided in licensed hospitals and in licensed long-term care facilities, and the feasibility of the hospitals contracting for skilled care in an existing long-term care facility at equal or lesser cost; and (e) Potential that the proposal will or will not increase Medicare costs, per illness episode, beyond those allowed for under diagnosis-related groups reimbursement. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: OHD 11-1998, f. & cert. ef. 10-22-98 HD 13-1994, f. & cert. ef. 4-22-94
333-610-0080 Residential Care Beds in Long-Term Care Facilities When a long-term care facility chooses to obtain a Seniors and People with Disabilities Division license as a “licensed residential care facility” as described in OAR 333-610-0010(11) for all, or for a separate and distinct part of its currently licensed long-term care facility bed capacity, it is not required, under statute, to accept a correspondingly reduced Seniors and People with Disabilities Division “long-term care facility” license as described in OAR 333-610-0010(12). Federal regulations, however, may require this under some circumstances. The following certificate of need rules will apply at such time that appropriate, coordinated licensing rules are adopted by the Seniors and People with Disabilities Division: (1) Future reconversion of such beds from residential care to long-term care (nursing home) beds will be considered an expansion of the then existing Seniors and People with Disabilities Division licensed long-term care facility service, and may be subject to the certificate of need law under applicable thresholds regarding expansions in long-term care bed capacity; and (2) In evaluating a reconversion project, the division shall give strong consideration to the costs, compared to new construction, and to the comparative quality and cost of care currently provided at the facility; and (3) Reconversion projects as described in this rule will be subject to county-specific bed need criteria under OAR 333-610-0020 to 333-610-0030. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-610-0090 Intermediate Care Facilities for the Mentally Retarded Distinct part intermediate care beds for mentally retarded or developmentally disabled individuals, when the facility houses any individuals who require nursing care services of a level, frequency and duration equivalent to intermediate facility care nursing as defined by the Seniors and People with Disabilities Division, must be licensed by the Seniors and People with Disabilities Division, rather than by the Addictions and Mental Health Division, and are subject to certificate of need according to ORS Chapter 442. In determining need, the division shall take into account long-range plans of the Addictions and Mental Health Division; shall consider comparative bed ratios in other states; and shall search, review and analyze existing professional literature and reports. The division shall evaluate local, substate, regional and statewide need, considering access, quality and costs. Public and private facility beds shall be considered as equivalent for purposes of meeting the limited need for this category of care. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-610-0100 Intermediate Care Facilities for the Mentally or Emotionally Disturbed Distinct part intermediate care beds for mentally or emotionally disturbed individuals, when the facility houses any such individuals who require nursing care services of a level, frequency and duration equivalent to intermediate care facility nursing as defined by the Seniors and People with Disabilities Division, must be licensed by the Seniors and People with Disabilities Division, rather than by the Addictions and Mental Health Division, and are subject to certificate of need according to ORS Chapter 442. In determining need, the division shall take into account long-range plans of the Addictions and Mental Health Division; shall consider comparative bed ratios in other states; and shall search, review and analyze existing professional literature and reports. The division shall evaluate local, substate, regional and statewide need, considering access, quality and costs. Public and private facility beds shall be considered as equivalent for purposes of meeting the limited need for this category of care. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-610-0110 Intermediate Care Facilities for Chemically Dependent Persons, Including Alcoholics Distinct part intermediate care beds for Chemically dependent persons, including alcoholics, when the facility houses any such individuals who require nursing care services of a level, frequency and duration equivalent to intermediate care facility nursing as defined by the Seniors and People with Disabilities Division, must be licensed by the Seniors and People with Disabilities Division, rather than by the Addictions and Mental Health Division, and are subject to certificate of need according to ORS Chapter 442. In determining need, the division shall take into account long-range plans of the Addictions and Mental Health Division; shall consider comparative bed ratios in other states; and shall search, review and analyze existing professional literature and reports. The division shall evaluate local, substate, regional and statewide need, considering access, quality and costs. Public and private facility beds shall be considered as equivalent for purposes of meeting the limited need for this category of care. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94
333-615-0000 Temporary rule language in effect until 04/19/2026. General Complete application. To be ruled complete, an application for a psychiatric hospital must: (1) Include a narrative organized in accordance with each major section of this division of rules; (2) Satisfy the criteria specified in the Certificate of Need Application Instructions (OAR chapter 333, division 580); and (3) Include the application fee as specified in OAR 333-565-0000, Table 4. Statutory/Other Authority: ORS 431.120, ORS 442.310 & ORS 442.315 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary amend filed 10/22/2025, effective 10/22/2025 through 04/19/2026 HD 13-1994, f. & cert. ef. 4-22-94
333-615-0010 Temporary rule language in effect until 04/19/2026. Definitions (1) "Alternate Health Service Area" means a deviation from the Traum System Area as the Health Service Area. (2) "Alternatives" means, but is not limited to: (a) Residential Treatment Facility (RTF); (b) Residential Treatment Home (RTH); (c) Adult Foster Home (AFH); (d) Residential Substance Use Disorder Facility; and (e) Inpatient Psychiatric unit or floor in a hospital. (3) "Health Service Area for a psychiatric hospital" means the Trauma System Area in which the proposed hospital will be located. Trauma System Areas are defined by the Oregon Health Authority (OAR 333-200-0040). (4) "Subspecialty beds" means an inpatient setting designed specifically for an: (a) Individual under the age of 15; (b) Individual between the ages of 15 to 21; or (c) Individual over the age of 65. Statutory/Other Authority: ORS 431.120 & ORS 442.315 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary amend filed 10/22/2025, effective 10/22/2025 through 04/19/2026 HD 13-1994, f. & cert. ef. 4-22-94
333-615-0025 Temporary rule language in effect until 04/19/2026. Criteria for Approval for a New Psychiatric Hospital A Certificate of Need for a psychiatric hospital may be granted if the Oregon Health Authority determines that an applicant has shown by a preponderance of the evidence that each of the below criteria are met: (1) Within the proposal’s Health Service Area, access to care is tailored to the specific demographical needs, including appropriate: (a) Access to public transportation; (b) Access for individuals with disabilities; (c) Availability of adequate staffing; and (d) Accessibility to other care providers. (2) The number of beds needed to provide an anticipated range of patient days in a given psychiatric hospital Health Service Area will not exceed 36 beds per 100,000 individuals in the Health Service Area. (3) Applicants must describe how the proposed project will improve access to care for all individuals in the Health Service Area, with particular attention to vulnerable populations, including those who are uninsured, underinsured, high-deductible plans, or enrolled in Medicaid. (4) All other criteria in OAR chapter 333, division 615 are met, including analyses of: (a) Need; (b) Quality; (c) Cost; and (d) Availability of Alternatives in the Health Service Area. Statutory/Other Authority: ORS 430.021, ORS 430.610, ORS 431.120, ORS 442.310, ORS 442.315 & ORS 743A.168 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary adopt filed 10/22/2025, effective 10/22/2025 through 04/19/2026
333-615-0035 Temporary rule language in effect until 04/19/2026. Alternatives to Health Service Areas If an application for a psychiatric hospital proposes a deviation from the Health Service Area based on the Area Trauma Advisory Board (ATAB), the applicant must provide justification for any changes. The Oregon Health Authority (Authority) will consider factors including, but not limited to, deviation requests based on demonstrated referral patterns, formal changes made by the Authority to the ATAB regions, anticipated changes to historical use patterns, demographic shifts, or out-of-state use (or other relevant migration patterns). The applicant must provide the Authority with the evidence justifying the proposed deviation. The Authority will have full discretion in electing to permit a Health Service Area that deviates from the trauma system planning unit defined by OAR 333-200-0040 or similar successor service area model defined in rule used by the Authority for healthcare planning. Statutory/Other Authority: ORS 431.120 & ORS 442.315 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary adopt filed 10/22/2025, effective 10/22/2025 through 04/19/2026
333-615-0060 Temporary rule language in effect until 04/19/2026. Cost A determination that a proposed project will foster cost-efficient services without compromising quality, shall be based on the following criteria: (1) Superior alternatives, in terms of cost, efficiency, or effectiveness, are not available or feasible. (2) In the case of a project involving construction: (a) The costs, scope, and methods of construction and energy conservation are consistent with current construction standards for health care facilities; and (b) The project’s potential impact on the social and financial costs to the public of providing health services is consistent with ORS 442.310. (3) The project will involve appropriate improvements or innovations in the financing and delivery of health services which foster cost-containment, and promote quality assurance and cost effectiveness. (4) Rates which reflect low capital and operating costs and a justifiable rate of return. Statutory/Other Authority: ORS 431.120, ORS 442.315 & ORS 743A.168 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary adopt filed 10/22/2025, effective 10/22/2025 through 04/19/2026
333-615-0070 Temporary rule language in effect until 04/19/2026. Use of Other Sources for Evaluating Applications (1) In the event the Certificate of Need rules applicable to a psychiatric hospital do not contain standards in sufficient detail to make the required determinations, the Oregon Health Authority may consider: (a) Nationally recognized standards from professional organizations; (b) Standards developed by professional organizations in the State of Oregon; (c) Federal Medicare and Medicaid certification requirements; (d) State licensing requirements; (e) Applicable standards developed by other individuals, groups, or organizations with recognized expertise related to inpatient psychiatric care and treatment. (2) Any external standards or guidelines considered must not conflict with Health Services Area or the methodology described in this division. Statutory/Other Authority: ORS 431.120, ORS 442.315 & ORS 743A.168 Statutes/Other Implemented: ORS 431.120 & ORS 442.315 History: PH 20-2025, temporary adopt filed 10/22/2025, effective 10/22/2025 through 04/19/2026
333-645-0000 General (1) The purpose of this division is to assure provision of accessible, quality care with the least incremental impact in overall community health care costs. Rehabilitation services assist people with a wide range of physical disabilities, focused on gaining optimum mobility and functioning. Least costly alternatives will be considered in determining an appropriate level of care. (2) The applicant, in providing information to the Public Health Division to demonstrate need for inpatient rehabilitation services, must satisfy the criteria specified in the Certificate of Need Application Instructions (division 580) and in this division (division 645). (3) Division 645 is not intended to apply to rehabilitation beds in long-term care facilities. Statutory/Other Authority: ORS 431.120(6) & 442.315 Statutes/Other Implemented: ORS 431.120(6) & 442.315 History: HD 13-1994, f. & cert. ef. 4-22-94