Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 615 - DEMONSTRATION OF NEED FOR PSYCHIATRIC INPATIENT BEDS › Section 333-615-0000 - General

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of this division is to assure provision of
				accessible, quality care with the least incremental impact in overall community
				health care capital and operating costs. Treatment of the psychiatric patient
				requires special staff, facilities, programs and management policies. These may
				be accomplished either in a unit in a general hospital, or in a specialized
				hospital. In order for Oregon to have a complete mental health system, both
				general hospital units and multispecialty units are needed. However, because of
				Oregon's population size and distribution, the need for subspecialty services
				is limited, and the need for local access to quality general psychiatric
				inpatient care is great. Therefore, the number of large, multispecialty,
				freestanding units feasible in Oregon is limited. The applicant, in providing
				information to the Public Health Division to demonstrate need for psychiatric
				inpatient beds other than those directly operated by the federal Veterans'
				Administration or the state Addictions and Mental Health Division, must satisfy
				the criteria specified in the Certificate of Need Application Instructions
				(chapter 333, division 580). Where appropriate, responses to these instructions
				shall be based on the following:
(1)
			 The methodology of this division (division 615), in order to estimate the
			 appropriate number of psychiatric beds; and
(2) Comparison of estimates of costs and
			 quality arising from conversion of certain of the identified existing licensed
			 capacity, to estimates of costs and quality generated by creation of a new
			 facility.
(3) Statements of
			 preference or priority in this division are expressions of general policy based
			 on Oregon statute and the current literature. Such statements do not
			 necessarily preclude possible approval of an application embodying a less
			 preferred or a lower priority characteristic. Rather, the applicant must bear
			 the burden of demonstrating that any such features are compensated for by other
			 aspects of a proposal, in order to best achieve the policy of ORS 442.025(1).
			 For example, freestanding units under new licenses are not precluded, but the
			 lack of feasible alternatives which better implement state policy must be
			 demonstrated.
(4) In reviewing
			 applications for psychiatric inpatient beds, the division, recognizing that
			 treatment of the psychiatric patient requires special staff, facilities,
			 programs and management policies, shall critically evaluate any proposal for a
			 psychiatric unit which incorporates:
(a)
			 Routine interchangeability of general psychiatric and general acute care in the
			 same unit or on a "swing bed" basis;
(b) Conversion of existing licensed capacity
			 to psychiatric use amounting to no more than minimal cosmetic changes to
			 existing patient rooms without meeting state licensing standards in applicable
			 Public Health Division rules, or Joint Commission on Accreditation of
			 Healthcare Organization standards, as appropriate;
(c) Consideration of costs outweighing
			 adequate quality;
(d) Evidence of
			 insufficient opportunity for potentially affected clinicians to present their
			 views and to obtain serious consideration of these views by any
			 applicant.