Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 615 - DEMONSTRATION OF NEED FOR PSYCHIATRIC INPATIENT BEDS › Section 333-615-0020 - Principles

Current through Register Vol. 63, No. 7, July 1, 2024
Under ORS 442.025(1), state policy gives priority to the
				achievement of reasonable access to quality health care at a reasonable cost.
				It is legislative policy under ORS 430.610(3) that to the greatest extent
				possible, mental health services be delivered in the community where the person
				lives in order to achieve maximum coordination of services and minimum
				disruption in the life of the person. Under ORS 430.021(3), it is state policy
				to encourage and assist community general hospitals to establish psychiatric
				services. Consistent with legislative policy, priority is given in this
				division to establishment of access to local hospitalization in geographically
				distributed, quality psychiatric units, within community hospitals; and
				hospitalization is to be utilized only when an individual's needs cannot be
				safely and effectively met by less costly alternatives. The following
				principles, therefore, are applicable to this division:
(1) Service areas for general psychiatric
			 beds other than those directly operated by the state Addictions and Mental
			 Health Division or the federal Veterans' Administration, shall be delineated so
			 as to encourage the greatest feasible utilization of community hospitals, and
			 of alternatives to hospitalization, by both private and public patients. The
			 division will use as a basis for general psychiatric inpatient service areas
			 the state administrative districts. The districts are based on natural market
			 areas defined by geographical barriers, transportation networks and historical
			 patterns of general trade. In addition, community mental health services in
			 Oregon are organized on a county or multicounty basis, compatible with these
			 districts, thus facilitating planning and coordination with, and access to,
			 local inpatient services in such districts.
(2) Service areas for psychiatric specialty
			 beds, other than those directly operated by the state Addictions and Mental
			 Health Division or the federal Veterans' Administration, as defined in OAR
			 333-615-0010(2),
			 other than holding rooms, shall be delineated so as to assure availability of
			 quality service at reasonable cost in economically viable subspecialty units:
(a) Factors to be considered in delineating
			 such service areas shall include the sizes of the respective populations at
			 risk in Oregon; the current rates of inpatient hospitalization in Oregon for
			 those groups; and the availability, accessibility, quality and levels of
			 utilization of existing inpatient services addressing the needs of those groups
			 in Oregon. These factors will generally lead to delineation of subspecialty
			 service areas according to health service area, multiple health service area or
			 statewide boundaries;
(b) In order
			 to assure viable, quality subspecialty units, economies of scale shall be given
			 greater weight than geographical distribution;
(c) In estimating subspecialty need, the
			 state will consider the population ratios proposed in "total system" models
			 such as Nebraska (1981) and California (1981);
(d) For each subspecialty service, an
			 applicant will be expected to indicate the anticipated percentage and origins
			 of utilization from outside the general psychiatric service area, based on
			 section (1) of this rule, in which the facility is, or will be located, and to
			 provide the evidence and assumptions related to the analysis.