Or. Admin. Code § 333-615-0000

Current through Register Vol. 63, No. 12, December 1, 2024

Section 333-615-0000 - General

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.

(5) To be ruled complete, an application for psychiatric beds must include a narrative organized in the following sequence of separate major sections:

(a) A complete response to each rule of division 615;

(b) If a new facility is proposed, analysis under division 590, the rules for acute hospital beds in general;

(c) Based on the foregoing, and other information included directly or as appendix materials or exhibits, a complete response to the general application form narrative instructions regarding the general statutory criteria which apply to all health care facility requests, in the sequence given in the instructions.

Or. Admin. Code § 333-615-0000

HD 13-1994, f. & cert. ef. 4-22-94

Stat. Auth.: ORS 431.120(6), 442.025& 442.315

Stats. Implemented: ORS 431.120(6) & 442.315