309-091-0015 Determining Need for State Hospital Care (1) State hospital level of care is determined appropriate when: (a) the individual’s condition or symptoms have not improved in an acute care setting despite having received a comprehensive psychiatric and medical assessment, and treatment with medications for at least 7 days at an adequate dose; and (b) the individual continues to require hospital level of care services, as evidenced by failure to meet the state hospital’s criteria for readiness to transition (2) Prior to referral for admission to a state hospital, the individual should have received: (a) A comprehensive medical assessment to identify conditions that may be causing, contributing to, or exacerbating the mental illness; (b) Services from an appropriate medical professional for the treatment and stabilization of any medical or surgical conditions that may be contributing to or exacerbating the mental illness and (c) There must be evidence of additional treatment and services having been attempted, including: (A) Use of evidence-based or promising psychosocial interventions which were delivered in relevant culturally-competent, strength-based, person-centered and trauma-informed manners and which adequately treated the assessed and/or expressed needs of the individual. Treatments should include members of the individual’s family, support network and Peer Delivered Services, unlerss the individual doesn't consent. (B) Documentation of ongoing review and discussion, by hospital staff and responsible party, of options for discharge to non-hospital levels of care; and (C) Documentation of services and supports attempted by the responsible party to divert an individual from acute admission and establish treatment and recovery in a non-hospital setting. (3) To make a referral for admission to a state hospital, the responsible party shall ensure the following documentation is provided: (a) Request for OSH and PAITS Services form; and (b) Community Questionnaire form, to include the OSH discharge plan, developed by the responsible party; and (c) Patient demographic information; and (d) Civil Commitment documents, to include, Commitment Judgment or Order, and pre-commitment investigations; or (e) Guardianship orders, or health care representative forms; and (f) History and Physical; and (g) Psychosocial assessment, if available; and (h) Progress notes, from admission; and (i) Medication Administration Record; and (j) Labs and other diagnostic testing; and (k) Involuntary Administration of Significant Procedures documentation, if applicable. (4) If the referral is approved, a written notice will be provided to acute care, and responsible party. (5) If the referral is denied, a letter of denial will be provided, to include a rationale for denial, within 72 hours; (a) The individual, provider of acute care services, or responsible party, can appeal the denial, by submitting a written request, to the OHA director, or designee; and (b) The OHA director, or designee, will provide a written response to the appeal Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 179.321, 426.010, 426.020 & 426.072 History: BHS 8-2019, amend filed 06/24/2019, effective 06/24/2019 BHS 1-2019, temporary amend filed 01/04/2019, effective 01/04/2019 through 07/02/2019 MHS 6-2012, f. 5-3-12, cert. ef. 5-4-12 MHS 16-2011(Temp), f. 12-29-11, cert. ef. 1-1-12 thru 6-29-12