OAR 859-200-0147: Content of Examination Reports for PSRB Hearings

(1) The requirements in this rule apply to examination reports prepared for use in hearings before the Psychiatric Security Review Board (Board). The examination is conducted to provide clinical and behavioral information to assist the Board in making determinations regarding jurisdiction, certification, placement, and supervision in proceedings before the Board under ORS 426.701 and 426.702. The examiner is not required to provide ultimate legal conclusions or use statutory terminology. (2) The examination report shall be prepared using a format or template approved by the Board. The Board may prescribe the structure and content of the report to ensure consistency and completeness of information presented for Board review. (3) The examination shall include information relevant to the person’s mental health condition and behavior in the foreseeable future if the person were not committed, including how the person may function without the structure, supervision, or treatment associated with civil commitment. To the extent possible, the examination will include the following: (a) The nature, course, and current severity of the person’s qualifying mental disorder, including symptom presentation over time; (b) The relationship between the qualifying mental disorder and the person’s prior qualifying act, as well as any subsequent serious incidents associated with the qualifying mental disorder; (c) Whether the person continues to exhibit symptoms or behaviors of the qualifying mental disorder that are substantially similar to those that preceded the qualifying act, including consideration of the type, pattern, and severity of such symptoms or behaviors; (d) The extent to which the qualifying mental disorder affects the person’s ability to make informed and safe decisions, recognize and understand the relationship between their mental disorder and potential for harmful behavior, and regulate behavior to avoid actions that may pose a risk to the safety of others; (e) The person’s response to and engagement with treatment, including the type, duration, and outcome of treatment provided, and any history of accepting or refusing treatment; (f) The extent to which symptoms or impairments associated with the qualifying mental disorder persist despite treatment or in the absence of treatment; (g) The person’s history of stability or decompensation associated with the qualifying mental disorder under varying levels of supervision, structure, or treatment; (h) Any conditions, structure, or supports that have affected the manifestation of the qualifying mental disorder, and the extent to which those conditions are expected to continue or be available if the person is not committed; (i) The extent to which any progress made during commitment is likely to be sustained if the person is not committed; (j) Protective, stabilizing, or mitigating factors relevant to the person’s behavior, including strengths, skills, insight, treatment gains, support systems, and environmental conditions that reduce the likelihood of behavior that may pose a risk to the safety of others. (k) Any limitations in the available information or evaluation that may affect the examiner’s observations; and (l) Any other information the examiner considers relevant to the relationship between the qualifying mental disorder and the person’s potential for behavior that may pose a risk to the safety of others. (4) The examination shall include information relevant to the Board’s determination of whether the person can be adequately controlled in the community with proper care, medication, supervision, and treatment if conditionally released. (5) To the extent available, the examination should include: (a) Current placement, level of care, and privileges; (b) Stability, compliance, and performance at the current level of care; (c) History of success or difficulty with privileges or community access; (d) Relevant clinical, treatment, or risk review recommendations and whether they have been incorporated; (e) Risk assessment information supporting community management; (f) Availability of supports, supervision, and treatment in the community; (g) Dependence on current placement structure and supports. (6) The examination shall also provide information relevant to determining whether the person could be controlled in the community with proper care, medication, supervision, and treatment. (a) If the person currently resides at the Oregon State Hospital, the examination should incorporate information from the person's treatment team, the hospital risk review panel, the psychology department, and other relevant collateral contacts to provide an opinion as to whether the person should remain hospitalized or be considered for conditional release. (b) If the person is on conditional release, the examination should incorporate information from the person's designated case monitor, treatment team, including residential team, as well as relevant collateral contacts, to assess whether the current level of care, supervision, and treatment remains appropriate or should be modified. Any specific proposed modifications to conditions must be submitted separately using a Board-approved template for modification requests.