Or. Admin. Code § 309-072-0160

Current through Register Vol. 63, No. 11, November 1, 2024

Section 309-072-0160 - Stabilization Services

(1) Stabilization services may be provided to all individuals.

(2) Stabilization services must be provided to eligible children younger than 21 years of age and their families, regardless of insurance type.

(a) Stabilization services are designed to maintain the child, as defined in OAR 309-019-0105 (21), in their current living arrangement; prevent unnecessary emergency room visits and hospitalizations; stabilize behavioral health needs; and improve functioning in life domains. Stabilization services must be provided from a family driven, youth guided, trauma-informed approach;

(b) Providers delivering stabilization services must be trained in accordance with OAR 309-072-0120;

(c) Children younger than 21 years of age must be considered for stabilization services without discrimination on the basis of race, ethnicity, gender, gender identity, gender presentation, sexual orientation, insurance type, religion, creed, national origin, intellectual or developmental disability, IQ score, or physical disability;

(d) Stabilization services must be initiated for eligible children and their families within three days of the initial mobile crisis response and may extend up to 56 calendar days;

(e) Families must be involved in stabilization services for children under the age of 18, to the extent possible. Individuals over the age of 18 may choose the extent to which their family is involved in services;

(f) Providers must collaborate with their local emergency departments and/or crisis clinics to establish pathways and timelines for responding to children being referred to stabilization services;

(g) Providers must maintain and implement written policies and protocols, Letters of Agreement, or MOU in place with their local emergency departments and/or crisis clinics;

(h) Children who meet one or more of the following criteria, may be eligible to receive stabilization services:

(A) Mental health concerns related to patterns of behavioral and emotional challenges, which require continued intervention and coordination to maintain functioning and prevent escalation;

(B) Lack of current connection to the appropriate resources, services, and supports;

(C) Further assessment, referral, and treatment for substance use;

(D) Further assessment, referral, and treatment for children with Intellectual and Developmental Disabilities (IDD);

(E) Suicidal ideation or at significant risk of suicide;

(F) Escalation in frequency and intensity of agitation or aggression, due to behavioral health crisis, putting themselves or others at risk;

(G) Lower levels of care are not expected to be effective in safely supporting the child and their family in the community.

(i) The provider in collaboration with the child and their family must complete and document the following at the start of stabilization services:

(A) Written informed consent for ongoing stabilization services;

(B) An assessment in accordance with OAR 309-019-0135;

(C) Development or update of the crisis and safety plan;

(D) Written program materials including roles and responsibilities of team members, emergency contacts, and connection to a consumer warm line and resources;

(E) Service plan as described in OAR 309-019-0140.

(j) The service plan includes the appropriate treatment and supports to meet assessed clinical needs of the child and family, which may include the following supports, as agreed upon by the youth and family:

(A) Skills training;

(B) Individual therapy;

(C) Family therapy;

(D) Medication management;

(E) Case management;

(F) Care coordination;

(G) Youth peer support services, for children 14 and older;

(H) Family peer support services;

(I) 24-hour crisis response.

(k) Each child and their family receiving stabilization services must be assigned a Qualified Mental Health Professional (QMHP) and a Family Support Specialist, in accordance with OAR 410-180-0305:

(A) The Family Support Specialist must contact the family within 72 hours of starting stabilization services to introduce their role and services;

(B) The assigned QMHP and Family Support Specialist must coordinate services and take a team-based approach to supporting children and their family while they are enrolled in stabilization services.

(l) Services must be provided, in person, whenever possible, with services and supports to the child and their family provided as frequently as necessary to meet the needs outlined in the service plan;

(m) Providers must complete the Authority approved assessment tools at the start and end of services and submit the assessment to an Authority approved database within 14 days of service completion;

(n) Providers must document a transition plan and must include at minimum:

(A) Review service plan and progress towards goals and objectives;

(B) Recommendations for ongoing services and supports;

(C) Referrals to specialized services, including substance use disorders and IDD;

(D) Upcoming scheduled appointments and engagements;

(E) Crisis and safety plan;

(F) How to access crisis services in the future.

(o) The provider must review and provide a copy of the transition plan document to the child and their family;

(p) The provider must connect the child and family to the appropriate services and supports to meet their needs in the least restrictive environment;

(q) When clinically indicated in the service plan, stabilization services may be extended past the initial 56 calendar days to ensure transition to appropriate services, aftercare services, and supports are in place;

(r) Provider must contact the child and their family for follow up within five days of discharge from stabilization services to ensure that they have successfully transitioned to ongoing services and supports. If unable to contact the child and their family the attempt must be documented.

Or. Admin. Code § 309-072-0160

BHS 26-2022, adopt filed 12/20/2022, effective 1/1/2023

Statutory/Other Authority: ORS 179.040, 413.042, 413.032-413.033, 426.072, 426.236, 426.500, 430.021, 430.256, 430.357, 430.560, 430.626-430.630, 430.640, 430.870 & 743A.168

Statutes/Other Implemented: ORS 413.520, 426.060, 426.140, 430.010, 430.254, 430.335, 430.590, 430.620, 430.626-430.630 & 430.637