COMMUNITY INTEGRATION.
ColumbiaCare supports the initiative to increase community integration by designing, developing, and operating residential treatment facilities and service programs for people with mental illness. Community integration and a complete continuum of care allows those living with a mental illness to access the most clinically appropriate and most integrated level of care based on individual readiness and need. It allows for flexible movement from more institutional settings to integrated community settings that provide adequate supports and treatment services, and which promote increased self-sufficiency, well being and health. In addition to moving away from the “warehousing” of people who have a mental illness, community-based residential treatment facilities can provide better care in a dramatically less expensive treatment environment, saving taxpayer dollars.
ColumbiaCare is not alone in our belief that community integration makes good treatment sense. It is also supported at multiple levels, as demonstrated by the United States Department of Justice investigation which resulted in an Oregon Performance Plan that "seeks to decrease hospitalization and jail time and improve resources through community-based care, housing and peer support, and expanded crisis services". It is also clearly mandated by the Americans with Disabilities Act, as demonstrated by the Supreme Court’s Olmstead v. L.C. Decision and the Federal Fair Housing Act of 1988. The ‘integration mandate’ of the Americans with Disabilities Act requires public agencies to provide services “in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” The high court upheld that mandate, ruling that Georgia’s department of human resources could not segregate two women with mental disabilities in a state psychiatric hospital long after the agency’s own treatment professionals had recommended their transfer to community care. All states must now comply with the decision. These rulings have been upheld in in multiple Oregon cases involving professional advocacy center's such as Disability Rights Oregon.
ColumbiaCare is not alone in our belief that community integration makes good treatment sense. It is also supported at multiple levels, as demonstrated by the United States Department of Justice investigation which resulted in an Oregon Performance Plan that "seeks to decrease hospitalization and jail time and improve resources through community-based care, housing and peer support, and expanded crisis services". It is also clearly mandated by the Americans with Disabilities Act, as demonstrated by the Supreme Court’s Olmstead v. L.C. Decision and the Federal Fair Housing Act of 1988. The ‘integration mandate’ of the Americans with Disabilities Act requires public agencies to provide services “in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” The high court upheld that mandate, ruling that Georgia’s department of human resources could not segregate two women with mental disabilities in a state psychiatric hospital long after the agency’s own treatment professionals had recommended their transfer to community care. All states must now comply with the decision. These rulings have been upheld in in multiple Oregon cases involving professional advocacy center's such as Disability Rights Oregon.
Long-Term Hospitalization
The Oregon State Hospital, with campuses in Salem and Junction City, is the state’s primary state-run psychiatric facility for adults. The State Hospital delivers inpatient psychiatric and medical care to patients through Forensic Psychiatric Services for patients who are judged guilty except for insanity and Psychiatric Recovery Services for civilly committed patients.
Short-Term Crisis Resolution Centers (CRCs)
CRCs are state licensed, locked or non-locked community-based facilities serving adults with a mental illness. CRCs are an important link in the continuity of care between long term hospitalization and completely independent living. They can serve as a less restrictive and more clinically appropriate treatment option for persons who are in psychiatric crisis but who do not need the medical capabilities of an acute care hospital, and can also result in significant cost savings.
Secure Residential Treatment Facilities (SRTF)
SRTFs are state licensed, community-based, locked facilities that restrict a residents exit from the facility or its grounds through the use of approved locking devices on resident exit doors, gates or other closures for the purpose of protecting the public. This level of care may be prescribed for clinical purposes and for the protection of the residents living there. SRTFs may serve those under the jurisdiction of the Psychiatric Security Review Board, civilly committed clients who are stepping-down from the state hospital, and occasionally those who are voluntarily seeking and in need of this level of care and do not need to be committed to state hospitalization, or any combination thereof. Each SRTF is specifically designed, constructed and staffed based on the population served.
Residential Treatment Facilities (RTF)
RTFs are state licensed, non-locked, community-based facilities with a service capacity for 6 or more adults with mental illness. RTFs may serve those under the jurisdiction of the Psychiatric Security Review Board, civilly committed clients stepping down from the state hospital, or any combination thereof. Each RTF is specifically designed (or modified), constructed and staffed based on the population served.
Residential Treatment Homes (RTH)
RTHs are state licensed, non-locked, community-based homes with a service capacity of 5 or less adults with mental illness. RTHs may serve those under the jurisdiction of the Psychiatric Security Review Board, civilly committed clients stepping down from the state hospital, or any combination thereof. Each RTH is specifically designed (or modified), constructed and staffed based on the population served.
Adult Foster Homes (AFH)
AFHs are state licensed (by Addictions and Mental Health Division, Seniors and People with Disability), community-based homes that with a services capacity for 5 or fewer adults. AFHs may serve individuals with mental illness, developmental disabilities, or the elderly or disabled.
Enhanced Care Services Programs (ECF)
An ECF is a program in a residential care facility, nursing facility or foster home licensed by Seniors and Peoples with Disabilities (SPD) in which mental health is provided.
Supportive and Integrated Housing
In addition to structured or specialized residential services, Supportive and Integrated Housing programs are unlicensed and provide supported independent living and other minimally structured settings where services and housing are made available to residents. Integrated Housing is specifically mandated by the USDOJ to include less than 25% program-designated units for individuals with a disability--creating a truly integrated housing environment.
Independent Living
Independent living is an achievable goal for individuals with mental illness, and the continued development of low-income and fair housing is such an important component in the residential continuum.
Standards and Accountability. The community integration process must be developed and maintained in a responsible and professional manner, in a way that also promotes community safety, education and involvement, and according to applicable federal, state and policy, rule and local law. Oregon Health Authority, Health Systems Division sets standards for mental health residential facilities through Oregon Administrative Rule which “prescribe how services will be provided in safe, secure and homelike environments that recognize the dignity, individuality and right to self-determination of each resident”
The Health Systems Division manages the flow of consumers between acute and extended care services using high clinical standards of care, and serves to maximize the efficacy and efficiency of state and federal resources devoted to treatment and placement of consumers in alternatives to the state hospital.
The Psychiatric Security Review Board (PSRB) has the responsibility and “authority to commit a person to a state hospital designated by the Department of Human Services; conditionally release a person from a state hospital to a community-based program with close monitoring and supervision; discharge a person from its jurisdiction; and, when appropriate, revoke the conditional release of a person under its jurisdiction and order the person’s return to a state hospital pending a full hearing before the board.”
The Health Systems Division manages the flow of consumers between acute and extended care services using high clinical standards of care, and serves to maximize the efficacy and efficiency of state and federal resources devoted to treatment and placement of consumers in alternatives to the state hospital.
The Psychiatric Security Review Board (PSRB) has the responsibility and “authority to commit a person to a state hospital designated by the Department of Human Services; conditionally release a person from a state hospital to a community-based program with close monitoring and supervision; discharge a person from its jurisdiction; and, when appropriate, revoke the conditional release of a person under its jurisdiction and order the person’s return to a state hospital pending a full hearing before the board.”