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Care Coordination/Care Management in Oregon

        The state of Oregon has taken a number of steps to ensure that health care is coordinated among providers.  Primarily, Oregon has established a patient centered primary care home program within the Office of Health Policy and Research.  The medical home model must promote care coordination, disease management and prevention.1  The Office of Health Policy and Research must establish a collaborative that allows state agencies, medical homes, and insurers, to share information to improve the quality of care, coordinate efforts to align payment incentives, coordinate research efforts, and share best practices.2  Other efforts to promote collaboration among state health agencies include increased coordination between the Department of Human Services, the Oregon Health Authority, the Department of Consumer and Business Services, and other stakeholders to develop a health care information system using the data that has been reported by all health insurers within the state.3  This increased cooperation should be made available for quality improvement and comparison purposes.4

        The state’s Public Health Division allows the sharing of cancer treatment service information of a patient who has been seen by multiple facilities or practitioners to allow for more coordinated care.5  The state requires all mental health providers to make available relevant clinical and financial information about a patient to other community health and developmental disability service agencies within the state.6  Similarly, the regional acute care psychiatric service (RACPS) must provide the Addictions and Mental Health Division of the Oregon Health Authority with information about persons admitted to or discharged from the service via the Division’s on-line Oregon Patient/Resident Client System.7  In addition, RACPS must also conduct discharge planning with the patient and his/her family.8  To further the goal of better care management, providers participating in the Family Planning Expansion Program (part of the state’s Medicaid program) must take steps to ensure that staff and personnel have special cultural and language skills to better serve their communities.9

        Oregon also encourages the patient’s involvement in his or her care.  Clients of the Division of Medical Assistance have the right to be actively involved in their own care and treatment plans.10  Nursing home residents11, home health residents12 and clients of in-home care have the right to participate in their own care and are required to provide informed consent to care.13  Patients receiving mental health community treatment and support services have the right to participate in their care, have all services explained to them, are required to give informed consent to treatment, and have the right to have their family involved in treatment.14  Non-inpatient mental health treatment services are also required to involve the patient at all stages of treatment.15  Providers taking part in the Family Planning Expansion Program must also obtain the patient’s informed consent to participate and receive services.16

 

Footnotes

  • 1. Or. Rev. Stat. §442.210
  • 2. Or. Rev. Stat. §442.210
  • 3. Or. Rev. Stat. §442.466
  • 4. Or. Rev. Stat. §442.466
  • 5. Or. Admin. Code R. 333-010-0050
  • 6. Or. Admin. Code R. 309-014-0035
  • 7. Or. Admin. Code R. 309-032-0870
  • 8. Or. Admin. Code R. 309-032-0870
  • 9. Or. Admin. Code R. 333-004-0060
  • 10. Or. Admin. Code R. 410-120-1855
  • 11. Or. Rev. Stat. §441.605; Or. Admin. Code R. 411-085-0310
  • 12. Or. Admin. Code R. 333-027-0080
  • 13. Or. Admin. Code R. 333-536-0060
  • 14. Or. Rev. Stat. §430.210; Or. Admin. Code R. 309-032-1515
  • 15. Or. Admin. Code R. 309-039-0540
  • 16. Or. Admin. Code R. 333-004-0060

 

Care Coordination/Care Management in Oregon

Subtopic Statute/Regulation Description
Care Coordination/Care Management Or. Admin. R. 309-014-0035 - General Standards for Delivery of Community Mental Health and Developmental Disability Service Elements All community mental health and developmental disability contractors providing services under a contract with the Oregon Health Authority’s...
Or. Admin. R. 309-039-0540 - General Standards Each provider of non-inpatient mental health treatment services are required to meet a number of standards, including: Have written policies and...
Or. Admin. R. 333-536-0060 - Clients’ Rights Clients of in-home care agencies have a number of a rights, including the following: To be given the informed choice and opportunity to select or...
Or. Admin. R. 410-120-1855 - Client’s Rights and Responsibilities Client’s Rights and Responsibilities Division of Medical Assistance Program clients have several rights, including: Be actively involved in...
Discharge instructions/Required follow-up. Or. Admin. R. 309-032-0870 - Standards for Approval of Regional Acute Care Psychiatric Service In order to be granted approval for operation, regional acute care psychiatric services must comply with the following requirements: Maintain...
Licensure laws requiring or recommending care coordination or care management activities (Cross reference with private insurance/Medicaid/Medicare data requirements) Or. Admin. R. 309-032-0870 - Standards for Approval of Regional Acute Care Psychiatric Service In order to be granted approval for operation, regional acute care psychiatric services must comply with the following requirements: Maintain...
Or. Admin. R. 309-040-0410 - Residents’ Rights, Complaints, and Grievances Each resident of an adult foster home has a number of rights, including: Be informed of the resident’s medical condition Be informed of...
Or. Rev. Stat. § 430.210 - Rights of persons receiving mental health services Persons receiving mental health and development disability services have many rights, including the following: Choose from available services...
Or. Rev. Stat. § 441.605 - Legislative declaration of rights intended for residents Residents of nursing homes are guaranteed several rights, including the following: To be fully informed by a physician of the medical condition...
Or. Rev. Stat. § 443.739 - Rights of residents Residents of adult foster homes have a number of rights that include the following: To be informed of the resident’s medical condition;...
Treatment planning when using interdisciplinary team (including assessments, plan of care, discharge/transfer planning Or. Admin. R. 309-032-0870 - Standards for Approval of Regional Acute Care Psychiatric Service In order to be granted approval for operation, regional acute care psychiatric services must comply with the following requirements: Maintain...
New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) Or. Admin. R. 309-040-0390 - Standards and Practices for Care and Services Adult Foster Homes must comply with a number of standards for care and services, including the following: Maintain a copy of medication,...
Informed consent requirements (If the information is going beyond the patient and provider Or. Admin. R. 333-004-0060 - Standards of Care for Contraceptive Management Services Providers participating in the Family Planning Expansion Program must agree to provide contraceptive management services according to the following...
Information sharing across providers (including communication with other providers, across state lines, patient transfer) Or. Admin. R. 333-010-0050 - Confidentiality and Access to Data All identifying information regarding individual patients, cancer reporting facilities, and practitioners required to be reported to the central...
Patient authorization requirements (to provide health information to another individual) Or. Admin. R. 333-027-0080 - Patients' Rights Each patient of a home health agency has a number of rights, including the following: To be informed, in advance, about the care to be furnished...
Or. Admin. R. 411-085-0310 - Residents’ Rights: Generally All residents in a nursing facility have the following rights: To be fully informed of one’s health and medical status; To be fully...