OAR 309-033-0820
Denial of Payment for Services to Persons In Custody or On Diversion

(1)

Assistant Administrator denial. The Assistant Administrator shall deny part or all payment for services for a person in custody or on a diversion only when the Assistant Administrator determines that evidence required by OAR 309-033-0820 (Denial of Payment for Services to Persons In Custody or On Diversion), Information Payer Must Submit, and the evidence required by 309-033-0820 (Denial of Payment for Services to Persons In Custody or On Diversion), Clinical Records to be Submitted, does not reasonably support the belief that the person in custody demonstrated:

(a)

Mental illness; and

(b)

Dangerousness to self or others as evidenced by thoughts, plans, means, actions, history of dangerousness or other indicators of imminent dangerousness which Division believes are within accepted community standards of professional knowledge.

(2)

Assistant Administrator consultation with psychiatrist or psychologist. When making a determination under this rule which is primarily based on accepted community standards of professional knowledge, the Assistant Administrator shall consult with a psychiatrist or a psychologist.

(3)

Information payer must submit. When making a request for denial of payment the payer responsible for the services provided to the person in custody or on diversion under ORS 426.241 (Payment of care, custody and treatment costs) shall submit the following to the Assistant Administrator:

(a)

A statement requesting the Division review the appropriateness of the hold or diversion for the purpose of approving denial of part or all payment for services rendered.

(b)

An explanation of why the payer believes the services provided to the person in custody or on diversion do not meet criteria described in ORS 426.232 (Emergency admission), 426.233 (Authority of community mental health program director and of other individuals) or 426.237 (Prehearing detention).

(c)

Any documentation which supports the payer’s belief that the services provided to the person in custody or on diversion were inappropriate.

(4)

Clinical records to be submitted. At the request of the Division, as provided by ORS 426.241 (Payment of care, custody and treatment costs)(5)(b), the following shall submit clinical records and other documents requested relating to the services in question to the Division:

(a)

A hospital or a nonhospital facility approved under OAR 309-033-0530 (Approval of Hospitals and Nonhospital Facilities to Provide Services to Committed Persons and to Persons In Custody and On Diversion), Approval of Hospitals and Nonhospital Facilities to Provide Services to Committed Persons and to Persons in Custody and on Diversion.

(b)

A physician or person providing services to the person in custody or on diversion.

Source: Rule 309-033-0820 — Denial of Payment for Services to Persons In Custody or On Diversion, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=309-033-0820.

309‑033‑0200
Statement of Purpose and Statutory Authority 309‑033‑0210
Definitions 309‑033‑0220
General Standards 309‑033‑0230
Custody of Persons Alleged to Be Mentally Ill Prior to Filing a Notification of Mental Illness 309‑033‑0240
Initiation of the Civil Commitment Process 309‑033‑0250
Standards for Custody, Hospital and Nonhospital Holds, Emergency Commitment and Emergency Hospitalization of Persons Under Warrant of Detention 309‑033‑0260
Diversion from Commitment Hearing 309‑033‑0270
Provision of Care, Custody and Treatment of Persons Committed to the Division 309‑033‑0280
Procedures for Committed Persons on Outpatient Commitment or Trial Visit 309‑033‑0290
Assignment and Placement of Persons Committed to the Division 309‑033‑0300
Transfers Between Classes of Facilities 309‑033‑0310
Recertification for Continued Commitment 309‑033‑0320
Revocation of Conditional Release, Outpatient Commitment or Trial Visit 309‑033‑0330
Discharge of Committed Persons, Who Are Placed in the Community, from Commitment Status 309‑033‑0340
Variances 309‑033‑0400
Statement of Purpose and Statutory Authority 309‑033‑0410
Definitions 309‑033‑0420
Transportation and Transfer of Persons in Custody or On Diversion 309‑033‑0430
Transportation of a Committed Person to a State Hospital, Community Hospital or Nonhospital Facility 309‑033‑0432
Standards for the Approval of a Secure Transport Provider to Transport a Person in Custody or On Diversion to an Approved Holding Hospital or Nonhospital Facility 309‑033‑0435
Client Rights with Regards to a Secure Transport Provider 309‑033‑0437
Mechanical Restraint by a Secure Transport Provider 309‑033‑0440
Variance 309‑033‑0500
Statement of Purpose and Statutory Authority 309‑033‑0510
Definitions 309‑033‑0520
Classes of Facility that Provide Care, Custody or Treatment to Committed Persons or to Persons In Custody or On Diversion 309‑033‑0530
Approval of Hospitals and Nonhospital Facilities to Provide Services to Committed Persons and to Persons In Custody and On Diversion 309‑033‑0540
Administrative Requirements for Hospitals and Nonhospital Facilities Approved to Provide Services to Persons In Custody 309‑033‑0550
Standards for the Approval of Hospitals Detaining Persons In Custody Pending Transport to an Approved Holding Hospital or Nonhospital Facility 309‑033‑0560
Variances 309‑033‑0600
Statement of Purpose and Statutory Authority 309‑033‑0610
Definitions 309‑033‑0620
Obtaining Informed Consent to Treatment From a Person and the Administration of Significant Procedures Without the Informed Consent of a Committed Person 309‑033‑0625
Administration of Medication and Treatment without the Informed Consent of a Person in Custody 309‑033‑0630
Administration of Significant Procedures in Emergencies Without the Informed Consent of a Committed Person 309‑033‑0640
Involuntary Administration of Significant Procedures to a Committed Person With Good Cause 309‑033‑0650
Variances 309‑033‑0700
Purpose and Scope 309‑033‑0710
Definitions 309‑033‑0720
Application, Training and Minimum Staffing Requirements 309‑033‑0725
Medical Services 309‑033‑0727
Structural and Physical Requirements 309‑033‑0730
Seclusion and Restraint Procedures 309‑033‑0732
Time Limits 309‑033‑0733
Documentation 309‑033‑0735
Quarterly Reports 309‑033‑0740
Variances 309‑033‑0800
Statement of Purpose and Statutory Authority 309‑033‑0810
Definitions 309‑033‑0820
Denial of Payment for Services to Persons In Custody or On Diversion 309‑033‑0830
Variances 309‑033‑0900
Statement of Purpose and Statutory Authority 309‑033‑0910
Definitions 309‑033‑0920
Certification of Mental Health Investigators 309‑033‑0930
Investigation of Person Alleged to Be a Mentally Ill Person 309‑033‑0940
The Investigation Report 309‑033‑0950
Certification of Mental Health Examiners 309‑033‑0960
Mental Health Examiner’s Report to the Court 309‑033‑0970
Variances
Last Updated

Jun. 8, 2021

Rule 309-033-0820’s source at or​.us