(a) "Assessment" means an on-site quality assessment of an organizational provider that is conducted:
(A) If the provider has not been accredited by a national organization meeting the quality standards of the Oregon Health Authority;
(B) By the Oregon Health Authority, another state agency or a contractor on behalf of the authority or another state agency; and
(C) For the purpose of issuing a certificate of approval.
(b) "Organizational provider" means an organization that provides mental health treatment or chemical dependency treatment and is not a coordinated care organization.
(2) The Oregon Health Authority shall convene a committee, in accordance with ORS 183.333, to advise the authority with respect to the adoption, by rule, of criteria for an assessment. The advisory committee shall advise the authority during the development of the criteria. The advisory committee shall be reconvened as needed to advise the authority with respect to updating the criteria to conform to changes in national accreditation standards or federal requirements for health plans and to advise the authority on opportunities to improve the assessment process. The advisory committee shall include, but is not limited to:
(a) A representative of each coordinated care organization certified by the authority;
(b) Representatives of organizational providers;
(c) Representatives of insurers and health care service contractors that have been accredited by the National Committee for Quality Assurance; and
(d) Representatives of insurers that offer Medicare Advantage Plans that have been accredited by the National Committee for Quality Assurance.
(3) The advisory committee described in subsection (2) of this section shall recommend:
(a) Objective criteria for a shared assessment tool that complies with national accreditation standards and federal requirements for health plans;
(b) Procedures for conducting an assessment;
(c) Procedures to eliminate redundant reporting requirements for organizational providers; and
(d) A process for addressing concerns that arise between assessments regarding compliance with quality standards.
(4) If another state agency, or a contractor on behalf of the state agency, conducts an assessment that meets the criteria adopted by the authority under subsection (2) of this section, the authority may rely on the assessment as evidence that the organizational provider meets the assessment requirement for receiving a certificate of approval.
(5) The authority shall provide a report of an assessment to the organizational provider that was assessed and, upon request, to a coordinated care organization, insurer or health care service contractor.
(6) If an organizational provider has not been accredited by a national organization that is acceptable to a coordinated care organization, the coordinated care organization shall rely on the assessment conducted in accordance with the criteria adopted under subsection (2) of this section as evidence that the organizational provider meets the assessment requirement.
(7) This section does not:
(a) Prevent a coordinated care organization from requiring its own on-site quality assessment if the authority, another state agency or a contractor on behalf of the authority or another state agency has not conducted an assessment in the preceding 36-month period; or
(b) Require a coordinated care organization to contract with an organizational provider.
(8)(a) The authority shall adopt by rule standards for determining whether information requested by a coordinated care organization from an organizational provider is redundant with respect to the reporting requirements for an assessment or if the information is outside of the scope of the assessment criteria.
(b) A coordinated care organization may request additional information from an organizational provider, in addition to the report of the assessment, if the request:
(A) Is not redundant and is within the scope of the assessment according to standards adopted by the authority as described in this subsection; and
(B) Is necessary to resolve questions about whether an organizational provider meets the coordinated care organization’s policies and procedures for credentialing.
(c) The authority shall implement a process for resolving a complaint by an organizational provider that a reporting requirement imposed by a coordinated care organization is redundant or outside of the scope of the assessment criteria.
(9)(a) The authority shall establish and maintain a database containing the documents required by coordinated care organizations for the purpose of credentialing an organizational provider.
(b) With the advice of the committee described in subsection (2) of this section, the authority shall adopt by rule the content and operational function of the database including, at a minimum:
(A) The types of organizational providers for which information is stored in the database;
(B) The types and contents of documents that are stored in the database;
(C) The frequency by which the documents the authority shall obtain updated documents;
(D) The means by which the authority will obtain the documents; and
(E) The means by which coordinated care organizations can access the documents in the database.
(c) The authority shall provide training to coordinated care organization staff who are responsible for processing credentialing requests on the use of the database. [2013 c.362 §1; 2015 c.152 §1]
Note: 430.637 and 430.638 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 430 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
Structure 2021 Oregon Revised Statutes
Volume : 11 - Juvenile Code, Human Services
Chapter 430 - Mental and Behavioral Health Treatment; Developmental Disabilities
Section 430.010 - Definitions.
Section 430.050 - Mental Health Advisory Board; Disability Issues Advisory Committee; rules.
Section 430.071 - Policy to support and promote self-determination.
Section 430.073 - Consumer Advisory Council.
Section 430.140 - Federal grants for promoting mental health.
Section 430.197 - Mental Health Services Fund.
Section 430.205 - Definitions for ORS 430.205 and 430.210.
Section 430.210 - Rights of persons receiving mental health services.
Section 430.212 - Reconnection of family members to individual with developmental disability; rules.
Section 430.216 - Report to Legislative Assembly.
Section 430.220 - Director; appointment; powers and duties.
Section 430.221 - Commission members; terms; subcommittees.
Section 430.223 - Comprehensive addiction, prevention, treatment and recovery plan; rules.
Section 430.230 - Definitions.
Section 430.235 - Grant Review Committee; approval and distribution of grants.
Section 430.236 - Establishment of quality improvement subcommittee; statewide data tracking.
Section 430.243 - Grants to coordinated care organizations authorized.
Section 430.254 - Goal of treatment programs for persons with substance use disorders.
Section 430.262 - Registration of sobering facilities; fees prohibited.
Section 430.270 - Publicizing effects of alcohol and drugs.
Section 430.272 - Educational resources on risks of inhalant use.
Section 430.275 - Oregon Health Authority to provide funding for peer respite centers; rules.
Section 430.306 - Definitions.
Section 430.338 - Purposes of laws related to alcoholism.
Section 430.342 - Local planning committees; duties; members.
Section 430.347 - Definitions for ORS 430.345 to 430.380.
Section 430.350 - Assistance and recommendation of local planning committee.
Section 430.357 - Minimum standards; rules.
Section 430.358 - Opioid treatment center required to accept Medicare payments.
Section 430.359 - Funding of services.
Section 430.362 - Application requirements for priority consideration.
Section 430.364 - Consideration given requests for priority.
Section 430.366 - Requirements for service proposals and data reporting.
Section 430.368 - Appeal and review of funding requests; conclusiveness of review.
Section 430.370 - County contracts for services; joint county-city operation.
Section 430.380 - Mental Health Alcoholism and Drug Services Account; uses.
Section 430.383 - Findings and policy.
Section 430.384 - Drug Treatment and Recovery Services Fund established.
Section 430.386 - Moneys in fund not to replace current funding for programs and services.
Section 430.387 - Distribution of moneys in fund.
Section 430.388 - Oversight and Accountability Council.
Section 430.390 - Administration of grants; rules.
Section 430.391 - Behavioral Health Resource Network statewide telephone hotline.
Section 430.393 - Report to Legislative Assembly.
Section 430.397 - Voluntary admission of person to treatment facility; notice to parent or guardian.
Section 430.420 - Integration of drug treatment services into criminal justice system; plans.
Section 430.422 - Drug Prevention and Education Fund.
Section 430.424 - Distribution of funds; funding criteria.
Section 430.426 - Rules; acceptance of gifts, grants and donations.
Section 430.450 - Definitions for ORS 430.450 to 430.555.
Section 430.455 - Information to arrested person believed to have substance use disorder.
Section 430.470 - Notice of right to evaluation if not given at time of arrest.
Section 430.490 - Diversion plan for defendant; participation as condition of probation or parole.
Section 430.495 - Content of diversion plan; duration.
Section 430.500 - Dismissal of charges.
Section 430.535 - Requirement to develop bilingual forms.
Section 430.540 - Designation of and standards for evaluation sites.
Section 430.545 - Procedures at evaluation sites; administration of antagonist drugs.
Section 430.572 - Internet access to providers of opiate use disorder treatment.
Section 430.573 - Statewide capacity to provide opiate use disorder treatment.
Section 430.590 - Regulation of location of methadone clinic; enforcement.
Section 430.610 - Legislative policy.
Section 430.626 - Definitions.
Section 430.627 - Statewide coordinated crisis system; rules.
Section 430.629 - Planning and ongoing oversight of services.
Section 430.631 - Local advisory committees.
Section 430.634 - Evaluation of programs; population schedule for distributing funds.
Section 430.638 - Immunity from civil liability for reliance on certificate of approval.
Section 430.641 - Behavioral Health Housing Incentive Fund established.
Section 430.643 - Disbursement of moneys in fund.
Section 430.644 - Priorities for services provided by community mental health programs.
Section 430.646 - Priorities for services for persons with mental or emotional disturbances.
Section 430.648 - Funding distribution formula; matching funds; administrative expenses.
Section 430.651 - Use of population data in funding formula.
Section 430.673 - Mediation; retaliation prohibited; action for damages; attorney fees; rules.
Section 430.705 - Mental health services for children.
Section 430.708 - Priority for preventive services for children.
Section 430.731 - Uniform investigation procedures; rules.
Section 430.735 - Definitions for ORS 430.735 to 430.765.
Section 430.737 - Mandatory reports and investigations.
Section 430.738 - Privileges not applicable to abuse proceedings.
Section 430.739 - County multidisciplinary teams; protocols; reports.
Section 430.745 - Investigation of abuse; notice to medical examiners; findings; recommendations.
Section 430.746 - Training requirements for persons investigating reports of alleged abuse.
Section 430.747 - Photographs of victim during investigation; exception; photographs as records.
Section 430.753 - Immunity of persons making reports in good faith; confidentiality.
Section 430.755 - Retaliation prohibited; liability for retaliation.
Section 430.756 - Immunity of employer reporting abuse by employee.
Section 430.757 - Reports of abuse to be maintained by Department of Human Services.
Section 430.763 - Confidentiality of records; when record may be made available to agency.
Section 430.768 - Claims of self-defense addressed in certain reports of abuse; review teams; rules.
Section 430.850 - Treatment program; eligibility.
Section 430.860 - Participation in program; report to court.
Section 430.880 - Gifts, grants or services.
Section 430.955 - Standardized screening instrument; assessing drug use during pregnancy.