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DEPARTMENT OF CORRECTIONS

 

DIVISION 124

HEALTH SERVICES (INMATE)

291-124-0005

Authority, Purpose, and Policy

(1) Authority: The authority for this rule is granted to the Director of the Department of Corrections in accordance with ORS 179.040, 423.020, 423.030 and 423.075.

(2) Purpose: The purpose of this rule is to:

(a) Specify the level of healthcare services to be provided to inmates under the custody of the Department of Corrections; and

(b) Establish department policies and procedures for reimbursement to those hospitals and community based healthcare professionals providing inpatient and outpatient services to inmates.

(3) Policy: It is the policy of the Department of Corrections to:

(a) Provide essential and important healthcare services that support the health status of inmates during incarceration, including end of life care.

(b) Deliver constitutionally mandated healthcare using an efficient managed care system in support of the mission of the department.

(c) Ensure there is an organized system in place to provide inmates with access to care to meet their serious medical, dental, and mental health needs.

(d) Conduct procedures in a clinically appropriate manner using appropriately credentialed personnel in an appropriate setting consistent with the standards for similar care provided in the community.

(e) Death with Dignity Act: It is the policy of the department not to participate in or allow other health care providers to participate on its premises in the Death with Dignity Act (ORS 127.800 to 127.897). Consistent with this policy, inmates will not be permitted to access end of life counseling or drugs under the DWDA, However, the department will continue to offer inmates medically appropriate end of life care, including counseling, hospice and palliative care, through Health Services.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; CD 6-1996(Temp), f. 6-28-96, cert. ef. 7-1-96; CD 19-1996, f. 11-20-96, cert. ef. 12-1-96; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0010

Definitions

(1) Department of Corrections Facility: Any institution, facility or staff office, including the grounds, operated by the Department of Corrections.

(2) Employee: Any person employed full-time, part-time, or under temporary appointment by the Department of Corrections; any person employed under contractual arrangement to provide services to the department; any person employed by private or public sector agencies who is serving under department-sanctioned special assignment to provide services or support to department programs within any Department of Corrections facility.

(3) Functional Unit: Any organizational component within the Department of Corrections responsible for the delivery of services or coordination of programs.

(4) Functional Unit Manager: Any person within the Department of Corrections who reports to the Director, an Assistant Director or an administrator and has responsibility for the delivery of services or coordination of programs.

(5) Healthcare Provider: Any professional who is licensed or certified to provide health care services, including physicians and hospitals (and the various entities/forms in which they do business), and public, quasi-public and private organizations and entities that contract with direct service providers to furnish health care services, such as insurance companies and managed care organizations.

(6) Inmate: Any person under the supervision of Department of Corrections who is not on parole, probation, or post-prison supervision status.

(8) Treating Practitioner: Any Health Services employee who by licensure is authorized to prescribe treatment, including but not limited to, physicians, dentists, nurse practitioners, optometrists and physician assistants.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-1998, f. & cert. ef. 7-1-98; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0016

Delivery of Inmate Healthcare

(1) The Health Services administrator is responsible for directing inmate healthcare services in the Department of Corrections. These activities include:

(a) Developing standards for the organization, coordination and delivery of inmate healthcare;

(b) Ensuring the organization and delivery of inmate healthcare meets established standards; and

(c) Ensuring the operation of all areas of inmate healthcare, including medical, dental, mental health care and pharmacy services, comply with appropriate professional standards, statutory requirements, and administrative rules and policies of the department.

(2) The Health Services clinical director is responsible for professional oversight of clinical healthcare providers. The clinical director has authority for all decisions requiring medical judgment and directly affecting outcomes of clinical practice. The clinical director shall appoint a chief medical officer to provide oversight for professional clinical services to inmates for each DOC institution.

(3) The Pharmacy and Stores administrator is responsible for the overall organization and delivery of Pharmacy services.

(4) The Behavioral Health Services administrator is responsible for the overall organization and delivery of mental health services to inmates. The chief psychiatrist shall have clinical oversight of the professional services of behavioral health practitioners.

(5) The administrator for Clinical Operations is responsible for the overall organization and delivery of institutional clinical care.

(6) The administrator for Business Operations is responsible for the overall organization and coordination of business functions, including fiscal management and organizational development.

(7) The Dental Program director, a licensed dentist, is responsible for the overall organization, delivery, and professional oversight of dental services.

(8) Health Services administration shall appoint a Medical Services manager to organize and coordinate delivery of healthcare services to inmates for each DOC institution.

(9) Inmates are prohibited from performing any healthcare duties reserved for licensed or certified health professionals. Inmates may be assigned to assist other inmates with activities of daily living as are commonly done in the community by family or friends.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0017

Professional Credentials

(1) Treating practitioners who provide medical, dental, mental healthcare or pharmacy services to inmates shall be appropriately licensed to practice in their respective professions. Specialists providing healthcare, mental healthcare or dental services shall be board certified in the specialty field or recognized as specialists in the medical community.

(2) All other employees of Health Services requiring licensure, registration or certification shall be licensed, registered, or certified to practice as stipulated by the regulatory agency of their respective discipline.

(3) Employees providing health services shall practice within the scope defined by statute and administrative rule of the respective regulatory professional licensing or certification board.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0020

Facilities and Equipment for Provision of Health Care

(1) Space, Equipment and Supplies:

(a) Sufficient space, equipment, and supplies will be available to provide the level of healthcare designated at each state operated correctional facility.

(b) Health Services administrators are responsible for evaluation of the adequacy of space allocated, review of major equipment purchases, and the system for distribution of healthcare services and supplies within their individual scope of authority.

(2) Level of Service at Each Facility:

(a) The assigned Medical Service managers is responsible for coordinating inmate access to healthcare services either at the site, in the community, or at another correctional facility.

(b) Healthcare services at correctional facilities shall at a minimum include instruction and supervision of self care, ambulatory care, emergency care, and referrals for specialty services.

(c) Inpatient infirmary beds, on site dental clinics, optometry clinics and mental health treatment are not available at each correctional facility. Inmates needing these services may be transferred to the most appropriate correctional facility to receive the needed service.

(d) Inmates with complex medical conditions who cannot be referred to providers in the immediate community may be transported to a correctional facility in another geographic area to receive medically necessary care and treatment.

(e) At correctional facilities with patients occupying inpatient infirmary beds, healthcare staff shall be on duty 24 hours per day with a physician on call 24 hours per day. At correctional facilities without 24 hour on duty coverage, a registered nurse and a treating practitioner shall be designated and on call to provide 24 hours per day coverage.

(f) Health Services staff will be make provisions for hospital access and specialty care as necessary for the healthcare of the inmate.

(g) Each health services program shall have a written plan and maintain readiness to provide basic emergency healthcare services to anyone in emergency situations. This plan shall be in accordance with the emergency response plan for the facility.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0030

Health Evaluation and Screening

(1) During the admission process each inmate shall receive a baseline medical, dental, and mental health evaluation.

(a) The medical evaluation shall consist of a physical examination and medical history including a review of available information and verification of any medication, care or treatment requirements. The evaluation should occur within seven days of admission.

(b) The dental baseline evaluation shall be completed within one month of admission to include review of the dental history, examination of the oral cavity, and diagnostic X-rays, if necessary. If there is documented evidence of an examination of the inmate's dental condition within the previous six months, a dental exam is not required unless determined to be clinically necessary by the treating dentist. If treatment is recommended based upon the baseline dental examination, a treatment plan shall be written and the recommendations reviewed with the inmate.

(c) The mental health evaluation will include a screening for the presence of mental illness and suicide history. Inmates who have a history of mental illness and suicide attempts or who report current suicidal ideations will be referred for further evaluation by a mental health treatment provider. Inmates with mental illness will be housed in a facility with services appropriate for their treatment needs.

(d) A clinical record will be initiated at the time of initial admission into the Department of Corrections.

(e) If the inmate has a documented baseline evaluation from the department within the previous 90 days, the prior evaluation and health record is reviewed and updated as clinically necessary.

(f) Inmates will be informed of relevant recommendations based on the baseline health evaluations and will be provided with self care instruction.

(2) Health Screening at Transfer:

(a) A brief health screening shall be completed on all inmates received on intra-department transfers by healthcare staff at the receiving facility. This shall include review of medical, dental and mental health records information transferred with the inmate and verification of any care or treatment requirements prearranged by the sending facility Medical Services manager.

(b) This information will be used to determine disposition of the inmate.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0035

Emergency Services

(1) Health Services employees will be trained to respond to health emergency situations involving inmates, employees, visitors, and others on the facility’s premises or worksites.

(2) Health Services will work with the Department Emergency Response Command Structure in declared emergencies.

(3) Each facility Medical Services manager shall assure that healthcare employees are trained and prepared to provide emergency medical assistance.

(4) Emergency medical care exceeding the scope or capacity of the facility or staff will be supplemented by emergency medical response agencies in the community.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0041

Healthcare and Treatment

(1) Health care and treatment is authorized and provided according to priorities established by the clinical director and is subject to peer review.

(a) Level 1:

(A) Medically mandatory is care and treatment that is essential to life and health, without which rapid deterioration may be an expected outcome and where medical/surgical intervention makes a very significant difference.

(B) Level 1 care and treatment shall be routinely provided to all inmates by the department. Any DOC licensed health professional may authorize care and treatment of Level 1 conditions.

(b) Level 2:

(A) Presently medically necessary is care and treatment without which an inmate could not be maintained without significant risk of either further serious deterioration of the condition or significant reduction in the chance of possible repair after release or without significant pain or discomfort.

(B) Level 2 care and treatment may be provided to inmates subject to periodic utilization review by the chief medical officer. Any treating practitioner may authorize care and treatment of Level 2 conditions.

(c) Level 3:

(A) Medically acceptable but not medically necessary is care and treatment for non-fatal conditions where intervention may improve the quality of life for the inmate.

(B) Level 3 care and treatment may or may not be authorized based upon review of each case. Only the clinical director and as delegated, the chief medical officer, may authorize or deny care and treatment of Level 3 conditions.

(d) Level 4: Of limited medical value is care and treatment which may be valuable to a certain individual but is significantly less likely to be cost effective or to produce substantial long term improvement. Level 4 care and treatment will not be routinely provided to inmates by the department.

(2) Infirmary care shall be made available to provide limited medical, dental, and nursing services.

(a) Infirmary services may include, but are not limited to, isolation, observation, first aid, postoperative care, short or long term nursing care, treatment of minor illnesses, sheltered living, convalescence, and end of life care.

(b) Infirmary care shall not be used as an alternative to hospital level acute care. Only appropriately licensed health service employees shall admit and discharge inmates from medical infirmary care.

(3) Therapeutic diets may be ordered by a treating practitioner for an inmate with a medical condition requiring nutritional adjustment that is not obtainable from the regular food services menu. Diets to achieve weight loss are the responsibility of the individual inmate.

(4) Health Services will screen inmates for work limitations at the assignment supervisor’s request. Ongoing daily review of inmate workers for symptoms of illness that would interfere with the work assignment is the responsibility of the on site work supervisor.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 1987 OL, Ch. 486
Hist.: CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0055

Health Education

(1) Each facility health services program shall provide inmate health education, including information on self care.

(2) Inmates with chronic diseases will be provided with information designed to increase their ability to monitor and manage their health status.

(3) Material provided by community health education groups, public health departments, or developed by other correctional facilities may be used with appropriate citation.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0060

Transfer, Travel, or Release Arrange?ments

(1) Transfers Between Oregon Department of Corrections Facilities:

(a) Information about an inmate's health status shall be provided to Office of Population Management to consider for institution assignments and continuity of care of inmates.

(b) Health Services staff shall provide instructions to the Transport Unit regarding any inmate that requires medication or medical care during transport or any other special precautions that are recommended during transport.

(c) The inmate's healthcare record shall be transferred in a confidential manner to the health services program responsible for health care at the receiving facility simultaneously with the inmate.

(2) Coordination of medical and mental healthcare for release:

(a) Prior to release, the facility Medical Services manager or Behavioral Health Services manager shall identify inmates with severe medical or severe mental health conditions that will require ongoing treatment in the community.

(b) Designated staff may assist with referrals to agencies, programs or practitioners in the community to facilitate continuity of care and on going treatment of inmates with severe medical or mental health conditions.

(c) The department is not responsible for medical evaluations or diagnostic workups that are required for admission to treatment facilities in the community.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: OL 433, ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0065

Communicable Disease Control

(1) The department shall have a communicable disease screening program.

(2) Management of communicable diseases shall be in accordance with Oregon Health Division recommendations and department administrative rules and policies.

(3) Standard precautions shall be made known and available to correctional employees working in department facilities to prevent transmission of communicable diseases. Health service employees shall provide specific instructions if additional precautions are necessary for a particular inmate.

(4) Communicable disease control precautions as required by OR-OSHA or recommended by the Oregon Health Division shall be followed.

(5) Information about communicable disease prevention shall be provided to inmates as part of health education.

(6) Immunization and preventative treatment shall be made available to inmates as medically indicated.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0070

Management of Pharmaceuticals

(1) Pharmacy services shall be provided under the professional direction of registered pharmacists.

(2) A central pharmacy(ies) shall be established in accordance with the Oregon Board of Pharmacy regulation for the appropriate and secure purchase, packaging, labeling and distribution of medications needed for inmate healthcare.

(3) Medications shall be made available for the treatment of inmate patients;

(a) Upon prescription by appropriately licensed staff or

(b) From non-prescription stock made available for such purposes.

(4) An organized and regulated system shall be in place in each institution for the secure receipt, storage, accounting and distribution of prescription and non-prescription medications.

(5) Medications shall be administered by appropriately trained healthcare personnel in accordance with professional standards and the laws and regulations governing drug administration.

(6) Psychotropic medications shall be prescribed only when clinically indicated and as one facet of a treatment program in accordance with the department’s rule on Informed Consent to Treatment with Psychotropic Medication (OAR 291-064)

(7) Inmates may be allowed to administer their own medication:

(a) As part of a self-care program;

(b) When the medication is on an approved self medication list;

(c) When in the opinion of the health services professional, the inmate is appropriately able to manage his/her own medication; and

(d) In conformance with institutional security practice.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0075

Healthcare Records

(1) A healthcare record shall be established for each inmate received at a DOC facility.

(2) Inmate healthcare records shall be maintained separately from the inmate's custody file.

(3) The healthcare record shall be transferred at the time an inmate is transferred to another Department of Corrections facility.

(4) Personally identifiable confidential health Information contained in the healthcare record may be released to other parties only according to ORS 179.495 through 179.505 and other Oregon statutes relevant to medical confidentiality.

(5) Inactive healthcare records shall be retained in accordance with the authorized retention schedules established in accordance with OAR 166-030.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 179.495-505, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0080

Patient Rights

(1) Medical Research: The use of inmates for medical, psychiatric, or psychological experimentation or research is prohibited as stipulated in ORS 421.085.

(2) Informed Consent:

(a) The inmate's written informed consent or refusal shall be obtained prior to an invasive healthcare procedure with major adverse health risks or prior to beginning non emergent mental health or medication services. An inmate may change their informed consent or refusal.

(b) Informed consent shall include providing the inmate with information about:

(A) The nature, purpose, and benefits of the procedure or treatment;

(B) The risks, if any, of the procedure or treatment; and

(C) Any alternative procedures or methods of treatment that are available.

(c) Informed consent is not required in:

(A) A medical emergency if the inmate is unable to give or to refuse consent and there is an immediate threat to the life of, or irreversible bodily harm to, the inmate;

(B) A psychiatric emergency if the inmate does not have the mental capacity to make an informed decision; and

(C) Certain public health matters.

(3) Confidentiality:

(a) The inmate's healthcare record, which includes medical, dental, and mental health information obtained by health service employees, is confidential and shall not be released except as provided in ORS 179.495 through 179.509, and other Oregon statutes.

(b) Health Services employees shall communicate to correctional employees pertinent information that has a direct impact on the safety and security of the facility or is relevant to the inmate's ability to function.

(4) Inmates may use the inmate grievance system as outlined in OAR 291-109 for health related issues.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0085

Charges for Elective Care or Treatment

(1) An inmate may request approval to purchase healthcare from a healthcare provider in the community. The department will only approve those requests that in the department’s judgment are medically appropriate and are otherwise consistent with the department’s concerns for institution security and order, public safety, and sound correctional practice.

(a) The inmate's trust account must have sufficient funds to pay for the purchase of care BEFORE the treatment is scheduled, unless other financial arrangements have been made. Cost of care includes expenses associated with providing the treatment, including follow-up care, as well as all costs associated with transport and security.

(b) The chief medical officer of the facility must review and approve follow-up care and treatment recommended by community practitioners.

(3) Prosthetics and Self Care Items:

(a) An inmate is required to pay for prostheses or other devices that become the personal property of the inmate.

(b) The inmate must sign a withdrawal request (CD28) before the service is provided. The inmate's trust account will be charged for the estimated or actual cost of the device.

(c) Upon delivery of the device, any variance from the actual cost will be indebted or credited to the inmate's trust account accordingly.

(d) An inmate shall not be denied prostheses or other devices that are medically necessary because of lack of funds. However, the inmate may incur debt if his/her trust account does not have sufficient funds to cover the cost of the device.

(e) Items for self care are available on the commissary list. An inmate may be advised to purchase a particular self care item by health services employees. Such advice is intended as education in self care and is not a directive that the item is considered medically necessary.

(3) Expenses for Medical Care for Inmates on Escape, Transitional Leave, Parole, Post-Prison Supervision, or Emergency Leave:

(a) Expenses incurred for healthcare of offenders on parole or post-prison supervision are the responsibility of the offender.

(b) Expenses incurred for healthcare of inmates on escape status are not the responsibility of the department.

(c) Expenses incurred for healthcare of inmates on short term transition leave are the responsibility of the inmate.

(4) Refusal of Medical Appointments:

(a) Any inmate who willfully refuses to keep a prearranged medical appointment in the community may have his/her trust account charged or indebted.

(b) A decision under this section to charge or indebt an inmate's trust account is subject to the administrative review process in the rule on Trust Accounts (Inmate) (OAR 291-158).

(5) Destruction of Property: Any inmate who willfully destroys or misuses health services equipment or supplies is subject to disciplinary action in accordance with the rule on Prohibited Inmate Conduct and Processing Disciplinary Actions (OAR 291-105).

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: CD 3-1990, f. & cert. ef. 1-29-90; CD 18-1995, f. 9-25-95, cert. ef. 10-1-95; DOC 16-2010, f. & cert. ef. 11-19-10

291-124-0090

Reporting and Evaluation

Health Services shall prepare a report each quarter listing the deaths which have occurred in Department of Corrections facilities, including the age of the deceased, cause of death, and disposition of remains. This report shall be submitted to the President of the Senate and the Speaker of the House of Representatives according to ORS 179.509 by the 30th of the month following the end of the quarter.

Stat. Auth.: ORS 179.040, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 423.020, 423.030 & 423.075
Hist.: DOC 16-2010, f. & cert. ef. 11-19-10

Certification of Employees to Provide Mental Health Services to Inmates

291-124-1000

Purpose and Policy

(1) Purpose: The purpose of these rules OAR 291-124-1000 through -1040 is to establish standards for the Department of Corrections to certify employees that provide mental health services to inmates in DOC facilities as qualified mental health professionals or qualified mental health associates.

(2) Policy: It is the policy of the Department of Corrections that employees providing mental health services to inmates meet the standards established in these rules and be certified accordingly by the department.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

291-124-1010

Definitions for Rules OAR 291-124-1000 through 291-124-1050

(1) Behavioral Health Services Administrator: The person responsible for the overall organization and delivery of mental health services to inmates.

(2) Behavioral Health Services (BHS): A Health Services unit with primary responsibility for the assessment and treatment of inmates with mental illness and developmental disabilities.

(3) Case Management: Delivery of mental health services to inmates. Case management activities include:

(a) Identifying, screening and evaluating inmates to determine their eligibility for services;

(b) Implementing individualized service plans, assistance in applying for financial benefits;

(c) Coordinating release planning services with other agencies and resources,

(d) Participating in case staffing;

(e) Providing emotional support and counseling;

(f) Crisis intervention for immediate safety concerns; and

(g) Daily structure, support, supervision, and skills training;

(4) Clinical Director: The person responsible to monitor clinical operations statewide who reports to the Behavioral Health Services Administrator. The clinical director must have a minimum of eight years of experience providing mental health services, a Master’s degree, two years of post graduate clinical supervision and licensure in the State of Oregon.

(5) Clinical Supervisor: The Behavioral Health Services program manager that supervises mental health treatment services provided by mental health specialists to inmates. The clinical supervisor must meet the requirements of a qualified mental health professional and have a minimum of five years of experience providing mental health services, with at least one year that includes supervision of staff.

(6) Crisis: An urgent or emergency situation that occurs when an inmate’s stability or functioning is disrupted and there is an immediate need to resolve the situation to prevent serious deterioration or self injury.

(7) Diagnosis: A diagnosis consistent with the current “Diagnostic and Statistical Manual of Mental Disorders (DSM)” published by the American Psychiatric Association.

(8) Mental Health Assessment: A process in which an inmate’s need for mental health services is determined through an evaluation of the inmate’s strengths, goals, needs, and current level of functioning.

(9) Mental Status Examination: An overall assessment of an inmate’s mental functioning and cognitive abilities.

(10) Mental Health Specialist: A Behavioral Health Services employee responsible for the delivery of mental health services to inmates.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

291-124-1020

Credentialing and Certification Process

(1) The clinical director is responsible for credentialing employees hired as mental health specialists.

(2) A mental health specialist must meet the requirements established in OAR 291-124-1030 as a qualified mental health associate (QMHA) or qualified mental health professional (QMHP).

(3) The clinical director shall review the employee’s education, experience and competencies to determine if the employee can be certified as meeting the professional standards of a qualified mental health associate or qualified mental health professional.

(4) Personnel Documentation: A copy of transcripts, academic degrees, licenses, certifications, and a verification form used to record the credentialing and certification information shall be retained in the employee’s personnel file.

(5) The employee will be provided with a position description that includes a description of duties that a qualified mental health associate or qualified mental health professional are certified to provide.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

291-124-1030

Qualified Mental Health Associate and Qualified Mental Health Professional Standards

(1) A qualified mental health associate (QMHA) must meet the following minimum qualifications:

(a) Bachelor's degree in a behavioral sciences field; or

(b) A combination of at least three years relevant work, education, training or experience; and

(c) Demonstrate the competency necessary to communicate effectively; understand mental health assessment, treatment and service terminology and apply these concepts; provide psychosocial skills development; implement interventions as assigned on an individual plan of care; and provide behavior management and case management duties.

(2) A qualified mental health professional (QMHP) is a licensed medical practitioner or any other person who holds any of the following educational degrees and meets the following minimum qualifications:

(a) Graduate degree in psychology;

(b) Bachelor's degree in nursing and licensed by the State of Oregon;

(c) Graduate degree in social work;

(d) Graduate degree in a behavioral science field;

(e) Graduate degree in recreational, music, or art therapy

(f) Bachelor's degree in occupational therapy and licensed by the State of Oregon; and

(g) Whose education and experience demonstrate the competency to identify precipitating events; gather histories of mental and physical disabilities, alcohol and drug use, past mental health services and criminal justice contacts; assess family, social and work relationships; conduct a mental status examination; document a multiaxial DSM diagnosis; write and supervise an individual plan of care; conduct a mental health assessment and provide individual, family or group therapy within the scope of their training.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

291-124-1040

Supervision of Qualified Mental Health Associates and Qualified Mental Health Professionals

(1) A qualified mental health associate shall deliver mental health services to inmates under the direct supervision of a qualified mental health professional.

(2) A qualified mental health professional shall deliver mental health services to inmates under the direct supervision of a clinical supervisor.

(3) Clinical Supervisor: A clinical supervisor shall demonstrate the competency to oversee and evaluate the mental health treatment services provided by qualified mental health professionals and qualified mental health associates.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

291-124-1050

Variances

(1) The Behavioral Health Services Administrator has the authority to grant a variance to the criteria used to determine the status of a qualified mental health professional or a clinical supervisor.

(2) The clinical director must document the reason for the variance and propose a timeline for the duration of the variance.

(3) Signed documentation from the Behavioral Health Services Administrator indicating support of the proposed variance shall be retained in the employee’s personnel file.

Stat. Auth.: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Stats. Implemented: ORS 179.040, 423.020, 423.030, 423.075 & 2011 OL ch 333
Hist.: DOC 12-2011(Temp), f. & cert. ef. 6-16-11 thru 12-13-11; DOC 19-2011, f. & cert. ef. 10-11-11

The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives Division, 800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the published version are satisfied in favor of the Administrative Order. The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of State. Terms and Conditions of Use

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