Or. Admin. Code § 309-014-0023

Current through Register Vol. 63, No. 12, December 1, 2024

Section 309-014-0023 - The Appeal Process

(1) Notice of Appeal.

(a) If a service provider believes that the contract offered by the CMHP contains terms or conditions that are not substantially similar to those established by the Division in the model contract, the service provider may appeal imposition of the disputed terms or conditions by sending a written notice of appeal to the Division's Chief Officer within 30 calendar days after the effective date of the contract requirement. The notice of appeal shall include:

(A) A copy of the contract and any pertinent contract amendments;

(B) Identification of the specific term(s) that are in dispute; and

(C) A complete written explanation of the dissimilarity between terms.

(D) The service provider shall send a copy of its notice of appeal to the CMHP. Upon receipt of this notice, the CMHP shall suspend enforcement of compliance with any contract requirement under appeal by the contractor until the appeal process is concluded.

(2) The Chief Officer or designee, shall offer to meet with both to mediate a solution. If a solution cannot be mediated, the Chief Officer shall declare an impasse through written notification to all parties and immediately appoint a panel to consider arguments from both parties.

(3)

(a) The Mediation Panel The panel shall include, at a minimum, a representative from the Division, a representative from another CMHP, and a representative from another service provider organization.

(b) The panel shall meet with the parties, consider their respective arguments, and send written recommendations to the Chief Officer of the Division within 45 business days after an impasse was declared. If an appeal requiring panel consideration has been received from more than one contractor, the Division may organize materials and discussion in any manner it deems necessary, including combining appeals from multiple contractors, to assist the panel in understanding the issues and operating efficiently.

(c) The Chief Officer shall notify all parties of his/her decision within 15 business days after receipt of the panel's recommendations. The decision of the Administrator is final. The CMHP shall take immediate action to amend contracts as needed to comply with the Administrator's decision.

(3)

(a) Expedited Appeal Process. The CMHP or the contractor may request an expedited appeal process that provides a temporary resolution, if it can be shown that the time needed to follow procedures to reach a final resolution would cause imminent risk of serious harm to individuals or organizations.

(b) The request shall be made in writing to the Division's Chief Officer. It shall describe the potential harm and level of risk that will be incurred by following the appeal process. The Division shall notify all parties of its decision to approve an expedited appeal process within two business days.

(c) If an expedited process is approved, the Chief Officer shall notify all parties of his/her decision concerning the dispute within three additional business days. The Chief Officer's decision resulting from an expedited appeal process shall be binding, but temporary, pending completion of the appeal process. All parties shall act according to the Chief Officer's temporary decision until notified of a final decision.

(4) Exception to Facility Requirements. The CMHP may add contract requirements that the CMHP considers necessary to ensure the siting and maintenance of residential facilities in which individual care is provided. These requirements shall be consistent with all applicable state and federal laws and regulations related to housing.

(5) Needs Assessment and Planning. The CMHP shall assess local needs for services to persons with mental or emotional disturbances, drug abuse problems, mental retardation or other developmental disabilities, and alcoholism and alcohol abuse problems. The CMHP shall plan for meeting those needs within the constraints of resources available. The local mental health authority shall review and approve the plan before it is submitted to the Division.

(6) Monitoring. The local mental health authority shall monitor all CMHP service elements to assure that:

(a) Service elements are provided as specified in the contract with the Division; and

(b) Service elements are in compliance with these rules and other applicable Division administrative rules.

Or. Admin. Code § 309-014-0023

MHS 23-2016, f. & cert. ef. 12/1/2016

Stat. Auth.: ORS 413.042 & 430.640

Stats. Implemented: ORS 430.610 - 430.640