A dispute over Oregon’s residential mental health treatment rules is widening beyond Marion County, with providers across the state urging health officials to change how facilities respond to safety threats.
Marion County and the Oregon Council for Behavioral Health brought treatment providers together on October 15 to discuss concerns about the rules. Four days later, the public comment period on the county’s formal rulemaking petition closed, placing renewed pressure on the Oregon Health Authority (OHA) to address those concerns.
For workers and residents at Salem-area treatment facilities, the disagreement centers on how quickly staff can respond when threatening behavior puts people at risk.
Under Oregon Administrative Rule 309-035-0170, facilities generally must provide at least 30 days’ written notice before involuntarily transferring or discharging a resident. A shorter notice period, no less than 24 hours, can begin when a resident’s behavior has directly caused serious physical harm to another resident or staff member.
The state defines serious physical harm as an injury warranting medical treatment beyond basic first aid. The rule does not require a criminal conviction, and other serious behavioral concerns can qualify for the standard discharge process.
Marion County argues that these requirements can leave providers without a sufficiently fast response when residents threaten others or engage in dangerous behavior before anyone is injured.
The county also objects to restrictions on managing alcohol consumption and says admission requirements can make it difficult for facilities to reject referrals they consider unsafe or inappropriate.
Marion County filed its formal petition on August 19 after residential treatment workers raised concerns about the regulations. What began as a county-level dispute has since attracted support from organizations across Oregon.
Among those supporting the effort are Columbia Community Mental Health, Halfway House Services, Wallowa Valley Center for Wellness and the Association of Oregon Community Mental Health Programs. Yamhill County commissioners have also endorsed Marion County’s petition.
“Ensuring safety of providers and residents simply cannot wait any longer,”
Marion County Commissioner Danielle Bethell and Oregon Council for Behavioral Health Executive Director Heather Jefferis said in a joint statement.
The rules also protect people receiving mental health treatment from abrupt displacement. Residents have the right to request administrative hearings and generally may remain in their facilities while the process proceeds, unless a supervisory authority orders otherwise.
Under Oregon law, OHA has 90 days after receiving a formal rulemaking petition to deny it in writing or begin rulemaking proceedings. The agency is not required to adopt the changes requested.
OHA’s published rulemaking calendar lists November 1 as the expected effective date for emergency revisions addressing weapons, waitlist priorities and involuntary transfers and discharges.
The existing temporary discharge rules are scheduled to expire November 25. The substance of the upcoming revisions will determine how much of the providers’ concerns the state is prepared to address.