OAR 309-033-0282: Establishing and Monitoring Conditions of Placement

(1) The conditions of placement serve as the objective and legal civil commitment service goals documented as part of an electronic medical or health record.The conditions of placement shall be established prior to the person’s release from the more restrictive setting. (a) The initial conditions of placement shall be established by the director of the county of commitment. Any subsequent changes to the conditions of placement shall be managed by the director of the county of placement. (b) The conditions of placement shall include at minimum: (A) Where the person is to physically reside. This may be a physical location description or physical address. (B) The identified person responsible for ensuring monitoring tasks are completed including the person’s name, credential(s), and contact information, including email address and phone number. (C) For outpatient commitment, the designation of a facility, program, or service where the person is to receive care, including contact information. Facilities, programs, and services providing mental health treatment shall be designated in accordance with OAR 309-033-0270(4). At least one of the following professional supports shall be identified in the conditions of placement: (i) The identified provider for treatment or medication management, including contact information; or (ii) The identified care coordinator, case manager, or outreach worker who maintains a therapeutic or supportive relationship with the person and assists the person with the following tasks, but not exclusively the following tasks: benefits coordination, ensuring housing needs are met, securing support in meeting instrumental activities of daily living (I/ADLs), money management, and meeting other identified needs. (D) For trial visits pursuant to ORS 426.273(2), should outpatient care be a condition of placement Section (C) of this rule shall apply to the trial visit conditions of placement. (E) A list of activities, behaviors, and tasks that the person on community-based placement shall be expected to adhere to, which may include but are not limited to: (i) Mental health treatment and counseling services; (ii) Co-occurring disorder or substance use disorder services or supports; (iii) Residential treatment services; (iv) Medication management; (v) Case management and care coordination; and (vi) Skills training. (c) The director establishing the conditions of placement shall make reasonable efforts to obtain a release of information signed by the person under civil commitment that authorizes the sharing and exchange of the person’s protected health information (PHI), including mental health and substance use authorizations, between all parties associated with the conditions of placement. Any sharing or exchange of the person’s PHI shall be for care coordination purposes. (d) Conditions of placement shall be distributed to individuals or entities in accordance with ORS 426.278: (A) The committed person; (B) The community mental health program director or designee of the county of placement; (C) The director of any facility, service or other provider designated to provide care or treatment; (D) The court of the county of commitment; (E) The court of the county of placement if the person is living in a different county than the county of commitment. (2) The Community Mental Health Program (CMHP) director shall identify in the conditions of placement a qualified CMHP employee to ensure monitoring services are sufficiently provided for individuals placed on outpatient commitment or trial visit. The identified person is responsible for notifying the court of nonadherence to the conditions of the placement and any request for revocation. (a) Qualifications. A CMHP director shall only identify qualified persons to oversee monitoring services. A qualified person is a person who: (A) Is certified at minimum as a Qualified Mental Health Associate (QMHA), unless otherwise provided for by OAR 309-033-0225, or be actively working toward the QMHA credential as verified by the CMHP director. (B) Has completed the mental health investigator training as provided by the Division or is working toward completing the training. (b) Monitoring services are intended to support the person under civil commitment in fulfilling the legal components of civil commitment by adhering to the conditions of placement and reduce barriers to success. (c) Monitoring services shall be provided by direct contacts on a regular basis. A direct contact is considered a phone call or in-person visit with the person under civil commitment. Direct contacts do not include those with legal guardians, authorized representatives, or other surrogate decision makers. The aim of direct contacts is to obtain primary information regarding the person’s progress toward stabilization or in maintaining stabilization. (d) Monitoring services shall also include indirect contacts. An indirect contact is considered any communication with a person other than the person placed under civil commitment and that is related to the person’s progress. Indirect contacts may include but not be limited to medical and behavioral health providers, prescribers, counselors, case managers, family members, friends, law enforcement, peers, and advocates. (e) Direct and indirect contacts, including unsuccessful attempts, shall be documented in the person’s clinical record. Documentation must include but not be limited to changes to circumstance such as housing or health, observations of mood and behavior, successes or challenges adhering to the conditions of placement, descriptions of supportive services provided, and any recommendations or actions taken pertaining to need for revocation or early discharge of the civil commitment.