(a) Outpatient services;
(b) Aftercare for persons released from hospitals;
(c) Training, case and program consultation and education for community agencies, related professions and the public;
(d) Guidance and assistance to other human service agencies for joint development of prevention programs and activities to reduce factors causing alcohol abuse, alcoholism, drug abuse and drug dependence; and
(e) Age-appropriate treatment options for older adults.
(2) As alternatives to state hospitalization, it is the responsibility of the community mental health program to ensure that, subject to the availability of funds, the following services for persons with alcoholism or drug dependence, and persons who are alcohol or drug abusers, are available when needed and approved by the Oregon Health Authority:
(a) Emergency services on a 24-hour basis, such as telephone consultation, crisis intervention and prehospital screening examination;
(b) Care and treatment for a portion of the day or night, which may include day treatment centers, work activity centers and after-school programs;
(c) Residential care and treatment in facilities such as halfway houses, detoxification centers and other community living facilities;
(d) Continuity of care, such as that provided by service coordinators, community case development specialists and core staff of federally assisted community mental health centers;
(e) Inpatient treatment in community hospitals; and
(f) Other alternative services to state hospitalization as defined by the Oregon Health Authority.
(3) In addition to any other requirements that may be established by rule of the Oregon Health Authority, each community mental health program, subject to the availability of funds, shall provide or ensure the provision of the following services to persons with mental or emotional disturbances:
(a) Screening and evaluation to determine the client’s service needs;
(b) Crisis stabilization to meet the needs of persons with acute mental or emotional disturbances, including the costs of investigations and prehearing detention in community hospitals or other facilities approved by the authority for persons involved in involuntary commitment procedures;
(c) Vocational and social services that are appropriate for the client’s age, designed to improve the client’s vocational, social, educational and recreational functioning;
(d) Continuity of care to link the client to housing and appropriate and available health and social service needs;
(e) Psychiatric care in state and community hospitals, subject to the provisions of subsection (4) of this section;
(f) Residential services;
(g) Medication monitoring;
(h) Individual, family and group counseling and therapy;
(i) Public education and information;
(j) Prevention of mental or emotional disturbances and promotion of mental health;
(k) Consultation with other community agencies;
(L) Preventive mental health services for children and adolescents, including primary prevention efforts, early identification and early intervention services. Preventive services should be patterned after service models that have demonstrated effectiveness in reducing the incidence of emotional, behavioral and cognitive disorders in children. As used in this paragraph:
(A) "Early identification" means detecting emotional disturbance in its initial developmental stage;
(B) "Early intervention services" for children at risk of later development of emotional disturbances means programs and activities for children and their families that promote conditions, opportunities and experiences that encourage and develop emotional stability, self-sufficiency and increased personal competence; and
(C) "Primary prevention efforts" means efforts that prevent emotional problems from occurring by addressing issues early so that disturbances do not have an opportunity to develop; and
(m) Preventive mental health services for older adults, including primary prevention efforts, early identification and early intervention services. Preventive services should be patterned after service models that have demonstrated effectiveness in reducing the incidence of emotional and behavioral disorders and suicide attempts in older adults. As used in this paragraph:
(A) "Early identification" means detecting emotional disturbance in its initial developmental stage;
(B) "Early intervention services" for older adults at risk of development of emotional disturbances means programs and activities for older adults and their families that promote conditions, opportunities and experiences that encourage and maintain emotional stability, self-sufficiency and increased personal competence and that deter suicide; and
(C) "Primary prevention efforts" means efforts that prevent emotional problems from occurring by addressing issues early so that disturbances do not have an opportunity to develop.
(4) A community mental health program shall assume responsibility for psychiatric care in state and community hospitals, as provided in subsection (3)(e) of this section, in the following circumstances:
(a) The person receiving care is a resident of the county served by the program. For purposes of this paragraph, "resident" means the resident of a county in which the person maintains a current mailing address or, if the person does not maintain a current mailing address within the state, the county in which the person is found, or the county in which a court-committed person with a mental illness has been conditionally released.
(b) The person has been hospitalized involuntarily or voluntarily, pursuant to ORS 426.130 or 426.220, except for persons confined to the Secure Child and Adolescent Treatment Unit at Oregon State Hospital, or has been hospitalized as the result of a revocation of conditional release.
(c) Payment is made for the first 60 consecutive days of hospitalization.
(d) The hospital has collected all available patient payments and third-party reimbursements.
(e) In the case of a community hospital, the authority has approved the hospital for the care of persons with mental or emotional disturbances, the community mental health program has a contract with the hospital for the psychiatric care of residents and a representative of the program approves voluntary or involuntary admissions to the hospital prior to admission.
(5) Subject to the review and approval of the Oregon Health Authority, a community mental health program may initiate additional services after the services defined in this section are provided.
(6) Each community mental health program and the state hospital serving the program’s geographic area shall enter into a written agreement concerning the policies and procedures to be followed by the program and the hospital when a patient is admitted to, and discharged from, the hospital and during the period of hospitalization.
(7) Each community mental health program shall have a mental health advisory committee, appointed by the board of county commissioners or the county court or, if two or more counties have combined to provide mental health services, the boards or courts of the participating counties or, in the case of a Native American reservation, the tribal council.
(8) A community mental health program may request and the authority may grant a waiver regarding provision of one or more of the services described in subsection (3) of this section upon a showing by the county and a determination by the authority that persons with mental or emotional disturbances in that county would be better served and unnecessary institutionalization avoided.
(9)(a) As used in this subsection, "local mental health authority" means one of the following entities:
(A) The board of county commissioners of one or more counties that establishes or operates a community mental health program;
(B) The tribal council, in the case of a federally recognized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or
(C) A regional local mental health authority comprising two or more boards of county commissioners.
(b) Each local mental health authority that provides mental health services shall determine the need for local mental health services and adopt a comprehensive local plan for the delivery of mental health services for children, families, adults and older adults that describes the methods by which the local mental health authority shall provide those services. The purpose of the local plan is to create a blueprint to provide mental health services that are directed by and responsive to the mental health needs of individuals in the community served by the local plan. A local mental health authority shall coordinate its local planning with the development of the community health improvement plan under ORS 414.575 by the coordinated care organization serving the area. The Oregon Health Authority may require a local mental health authority to review and revise the local plan periodically.
(c) The local plan shall identify ways to:
(A) Coordinate and ensure accountability for all levels of care described in paragraph (e) of this subsection;
(B) Maximize resources for consumers and minimize administrative expenses;
(C) Provide supported employment and other vocational opportunities for consumers;
(D) Determine the most appropriate service provider among a range of qualified providers;
(E) Ensure that appropriate mental health referrals are made;
(F) Address local housing needs for persons with mental health disorders;
(G) Develop a process for discharge from state and local psychiatric hospitals and transition planning between levels of care or components of the system of care;
(H) Provide peer support services, including but not limited to drop-in centers and paid peer support;
(I) Provide transportation supports; and
(J) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems and local mental health programs to ensure that persons with mental illness who come into contact with the justice and corrections systems receive needed care and to ensure continuity of services for adults and juveniles leaving the corrections system.
(d) When developing a local plan, a local mental health authority shall:
(A) Coordinate with the budgetary cycles of state and local governments that provide the local mental health authority with funding for mental health services;
(B) Involve consumers, advocates, families, service providers, schools and other interested parties in the planning process;
(C) Coordinate with the local public safety coordinating council to address the services described in paragraph (c)(J) of this subsection;
(D) Conduct a population based needs assessment to determine the types of services needed locally;
(E) Determine the ethnic, age-specific, cultural and diversity needs of the population served by the local plan;
(F) Describe the anticipated outcomes of services and the actions to be achieved in the local plan;
(G) Ensure that the local plan coordinates planning, funding and services with:
(i) The educational needs of children, adults and older adults;
(ii) Providers of social supports, including but not limited to housing, employment, transportation and education; and
(iii) Providers of physical health and medical services;
(H) Describe how funds, other than state resources, may be used to support and implement the local plan;
(I) Demonstrate ways to integrate local services and administrative functions in order to support integrated service delivery in the local plan; and
(J) Involve the local mental health advisory committees described in subsection (7) of this section.
(e) The local plan must describe how the local mental health authority will ensure the delivery of and be accountable for clinically appropriate services in a continuum of care based on consumer needs. The local plan shall include, but not be limited to, services providing the following levels of care:
(A) Twenty-four-hour crisis services;
(B) Secure and nonsecure extended psychiatric care;
(C) Secure and nonsecure acute psychiatric care;
(D) Twenty-four-hour supervised structured treatment;
(E) Psychiatric day treatment;
(F) Treatments that maximize client independence;
(G) Family and peer support and self-help services;
(H) Support services;
(I) Prevention and early intervention services;
(J) Transition assistance between levels of care;
(K) Dual diagnosis services;
(L) Access to placement in state-funded psychiatric hospital beds;
(M) Precommitment and civil commitment in accordance with ORS chapter 426; and
(N) Outreach to older adults at locations appropriate for making contact with older adults, including senior centers, long term care facilities and personal residences.
(f) In developing the part of the local plan referred to in paragraph (c)(J) of this subsection, the local mental health authority shall collaborate with the local public safety coordinating council to address the following:
(A) Training for all law enforcement officers on ways to recognize and interact with persons with mental illness, for the purpose of diverting them from the criminal and juvenile justice systems;
(B) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests;
(C) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody;
(D) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and
(E) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody.
(g) Services described in the local plan shall:
(A) Address the vision, values and guiding principles described in the Report to the Governor from the Mental Health Alignment Workgroup, January 2001;
(B) Be provided to children, older adults and families as close to their homes as possible;
(C) Be culturally appropriate and competent;
(D) Be, for children, older adults and adults with mental health needs, from providers appropriate to deliver those services;
(E) Be delivered in an integrated service delivery system with integrated service sites or processes, and with the use of integrated service teams;
(F) Ensure consumer choice among a range of qualified providers in the community;
(G) Be distributed geographically;
(H) Involve consumers, families, clinicians, children and schools in treatment as appropriate;
(I) Maximize early identification and early intervention;
(J) Ensure appropriate transition planning between providers and service delivery systems, with an emphasis on transition between children and adult mental health services;
(K) Be based on the ability of a client to pay;
(L) Be delivered collaboratively;
(M) Use age-appropriate, research-based quality indicators;
(N) Use best-practice innovations; and
(O) Be delivered using a community-based, multisystem approach.
(h) A local mental health authority shall submit to the Oregon Health Authority a copy of the local plan and revisions adopted under paragraph (b) of this subsection at time intervals established by the Oregon Health Authority. [1961 c.706 §40; 1973 c.639 §3; 1981 c.750 §3; 1985 c.740 §17; 1987 c.903 §37; 1991 c.777 §2; 1995 c.79 §219; 2001 c.899 §1; 2003 c.553 §5; 2003 c.782 §1; 2005 c.22 §297; 2005 c.691 §2; 2007 c.70 §230; 2009 c.595 §508; 2009 c.856 §§14,23; 2011 c.720 §§171,172; 2012 c.37 §101; 2013 c.640 §§3,4]