Addictions & Mental Health Desk Level Reference Guide (DLRG) Residential Programs & Services (RPS) DLRG: Siting Community Based Housing Procedure Number: Version: Effective Date: Approved By: (Authorized Signer) Date Approved For ALL Licensed Residential development, AMH is following the process outlined in ORS 169.690 as it relates to the establishment of specified facilities. Step Lead(s) Action 1 Provider Provider receives notice of conditionally approved award. Award is contingent upon site approval by AMH. 2 Residential Programs & 1) Development Coordinator (DC) meets with provider to: Services Unit (RPS) discuss project; siting process; create draft project management schedule; direct provider to notify Mental Health Organization (MHO)/Community Mental Health Provider (CMHP) of conditional award; provide contact information for AMH principals involved in development process. Partner Siting Liaison (SL) 3 RPS DC Governmental Affairs Manager (GAM) AMH Communications Officer (ACO) 2) During this meeting, DC determines if the provider will need to become a certified mental health provider to operate this program. If certification is necessary, DC will initiate the certification process immediately by directing the provider to contact the Quality Improvement & Certification Unit (QICU) to apply for certification. DC confirms provider has notified MHO/CMHP that project has been conditionally awarded. Provider will confirm notification by email to AMH. DC forwards email to SL, GAM, and ACO. 4a RPS DC/SL Provider begins search for site. 4b RPS DC/SL If a site was identified and approved through the application process, proceed to step 6. 1
5 Provider RPS DC RPS Manager 6 RPS DC RPS Manager Partner SL GAM ACO Provider prepares a report for review by AMH of potential sites utilizing the Residential Siting Matrix provided by AMH. The Provider must not assume site approval by AMH. AMH will only approve sites that have scored high enough using the Residential Siting Matrix. If site approved see steps 6 & 8a-14. If site not approved see step 7. Once the site is approved, AMH in partnership with the Provider will notify the Local Public Safety Coordinating Council (LPSCC) of the proposed residential facility. Following the notification instructions in ORS 169.690, the LPSCC will be informed of: Location Number of residents Type of facility Use of facility Rules of conduct for residents Any other relevant information that AMH and the Provider considers appropriate. If the LPSCC is inactive or non-existent then AMH and the Provider will notify the Local Mental Health Authority (LMHA) of the potential development. The LPSCC will appoint a Facility Advisory Subcommittee, which must issue their written suggestions for changes to the facility within 60 days. AMH and the Provider will jointly respond to any Subcommittee comments. AMH and the Provider will determine the process in place for LPSCC to notify its constituency. Once the LPSCC notification process has concluded and AMH and Provider agree to move forward; The DC will notify the following in writing: Child/Young Adult/Adult MH Specialist Adult Mental Health Services Unit (AMHSU); Quality Improvement & Certification Unit (QICU); Operations and Policy Unit (OPU); AMH Communication Officer (ACO); Governmental Affairs Manager (GAM). The Provider will notify the following in writing: Local Mental Health Authority (LMHA); Community Mental Health Provider (CHMP) / Mental Health Organization (MHO); 2
7 Provider RPS DC RPS Manager SL 8 RPS DC RPS Manager Provider 9 RPS DC Provider 10 RPS DC OPU 11a RPS DC Provider MPU 11b RPS DC Provider OPU MPU 12 RPS DC OPU If no site is found, assess further partnership with provider given development timelines. AMH will provide written notification with an explanation to the following parties if project does not move forward: Provider; OPU; Child/Young Adult/Adult MH Specialist AMHSU and; QICU; GAM and ACO Provide written notification of rescinded award to: MHO/CMHP; LPSCC Collaborate with provider to create a project management schedule which includes the following elements: Acquisition of property Development Budget Construction/Renovation/Rehab; Start-Up & Operating Budgets; Contracts; Provider Enrollment; Residents Selection/Occupancy; Licensing; Payments; Opening date; and Annual compliance document The project schedule will be approved by the RPS Manager and coordinated with all AMH units. Begin Start-Up budget work with provider utilizing the Budget Template provided by AMH Send recommended Start-Up budget and Contract Amendment Request (CAR) with supporting documentation to OPU for processing. Begin Operating Budget work with provider utilizing the Budget Template provided by AMH. Include AMH Medicaid Policy Unit in budget discussions. Set up meeting with provider, OPU staff, and the MPU for discussion regarding payment methodology and contract compliance for the operating budget. Send recommended Operating Budget and Contract Amendment Request (CAR) with supporting documentation to OPU for processing. 3
13 RPS DC Notify OSH, PSRB, QICU, OPU, the ACO, and Child/Young Adult or Adult MH Specialist of expected opening dates so a list of potential residents can be prepared. Include the following information: Housing type; Location (community); Number of beds; and Populations to be served. Ongoing project updates (monthly, then weekly at 60 days before opening) will be provided to partner agencies which may include OSH, PSRB, Child/Young Adult/Adult MH Specialist and OPU to ensure potential residents are identified and evaluated for placement. QICU will receive updates to balance workload and to be aware of when to expect application and 14 RPS DC ACO SL schedule licensing visit. The provider is not required to host an Open House, but if one is scheduled, AMH suggests the following are invited: Legislators; City officials; County officials; Law enforcement; LPSCC; and Immediate Neighbors 4
Oregon Health Authority Addictions and Mental Health Division (AMH) 500 Summer St. NE E86, Salem, OR 97301-1118 Phone 503-945-5736 Fax 503-378-8467 Instructions for AMH Residential Siting Matrix The Addictions and Mental Health Division (AMH) has developed the Residential Matrix using the intent of Oregon Revised Statute (ORS) 197.663(1), which states, It is the policy of this state that persons with disabilities and elderly persons are entitled to live as normally as possibly within the community. As a guiding principle in developing the Matrix, AMH used ORS 197.663(5), which states, It is the policy of this state to integrate residential facilities into the communities of this state. The siting matrix will be used anytime a provider is undertaking the development of licensed residential housing. Please use these instructions to determine how to score each question on the sheet. A form must be completed for each property being considered for the placement of a residential program. The final scores will assist the Addictions and Mental Health Division (AMH) to determine the site that best meets the needs of the clients we serve. Scoring is on a three (3) point scale, with one (1) being the lowest and three (3) being the highest. Two scoring sections have an additional scoring option of fail. A score of fail means that the site is not suitable for AMH residential program development due to licensing requirements. 1. Facility Criteria: The facility criteria section applies only to existing structures that will be used for development. Any projects that will use new construction for development are scored solely based on the community integration section. Bypass this section if the project will be new construction. Resident capacity: Enter the number of residents who will be served in the planned residential program. No score measurement is used for resident capacity. 1
Bedrooms: Enter the number of bedrooms. Score 3: One (1) bedroom per resident and at least one ADA accessible room can be created on the main floor. Score 2: Two (2) people must share a room, and at least one ADA accessible room can be created on the main floor. Score 1: Four (4) or more residents must share a room and at least one (1) ADA accessible room can be created on the main floor. Fail: There is no bedroom on the main floor that can made ADA accessible. Accordingly, the site will not meet AMH licensing requirements. Bathrooms: Enter the number of bathrooms. Score 3: No more than three (3) residents share a full bathroom and there is at least one bathroom that can be made ADA accessible on the main floor. Score 2: No more than four (4) residents share a full bathroom and there is at least one bathroom that can be made ADA accessible on the main floor. Score 1: No more than four (5) residents share a full bathroom and there is at least one bathroom that can be made ADA accessible on the main floor. Fail: There is no bathroom that can be made ADA accessible on the main floor. Parking: Enter highest number of vehicles anticipated at the residential program at one time. Include staff, visitor, and provider vehicles. Score 3: Parking spaces are available for the highest number of vehicles. Score 2: There are not enough parking spaces available to accommodate all vehicles at all times. No more than two (2) vehicles need to park on the street at any one time. There is enough street parking capacity to allow for 2-4 vehicles to park during peak times. Score 1: There are not enough parking spaces available to accommodate all vehicles at all times. Two (2) or more vehicles will need to park on the street at any one time. There is not enough street parking capacity to allow for 2-4 vehicles to park during peak times. Proximity to Existing Mental Health Facilities: Enter the distance between the proposed site and the nearest residential treatment home or facility. Score 3: There are no existing residential treatment homes or facilities within a half mile radius of the proposed site. Score 2: There are existing residential treatment homes or facilities within a half mile radius of the proposed site. Score 1: There are existing residential treatment homes or facilities within a two block radius of the proposed site. 2
Structural Design: Enter number of floors, including basement. Score 3: One story with an open floor plan and all common areas are ADA accessible. Score 2: Two or more stories with an open floor plan on the main floor. All common areas on main floor are ADA accessible. There are additional common areas on the second floor that are not ADA accessible. Score 1: Main level does not have an open floor plan or not all common spaces are ADA accessible. Grounds: This score is based on the type, size, and accessibility of the front, back, and side yards of the property. Score 3: There is a front and a back yard for resident recreational use. There is a covered porch or room for a covered outdoor area. Score 2: There is a front or back yard, for resident recreational use. There is a covered porch or room for a covered outdoor area. Score 1: There is no front or back yard. There is a covered porch or room for a covered outdoor area. Fail: No outdoor covered area can be created on the property as is required by AMH licensing standards. Total Price: Enter the asking price of the property; the estimated renovation costs; and the combined cost (total price) on the Siting Matrix Score sheet. Consult a realtor, as needed, to obtain the fair market value of the property being considered. Score 3: Total price is five (5) percent or more below market value. Score 2: Total price is no more than five (5) percent above market value. Score 1: Total price is more than five (5) percent above market value. 2. Community Integration: The community integration section will place all sites reviewed on equal footing with respect to rural, urban, or suburban demographics. Public transportation: This score is based on the distance between the residential program and access to public transportation. Score 3: Public transportation is less than 0.1 mile away. Score 2: Public transportation is less than 0.5 mile away. Score 1: Public transportation is more than 0.5 mile away, or there is no public transportation. 3
Mental health programs: This score is based on accessibility of available services. Score 3: Residents are able to access community mental health services by walking or public transportation, and travel time will be less than in 30 minutes. Score 2: Residents are able to access community mental health services by walking or public transportation, and travel time will be more than 30 minutes. Score 1: Residents are not able to access community mental health services by walking or public transportation. Crisis services: This score is based on accessibility of available services. Score 3: Residents are able to access an acute care hospital or 24/7 mental health crisis services within 20 minutes. Score 2: Residents are able to access an acute care hospital or 24/7 mental health services within 45 minutes. Score 1: Residents are not able to access an acute care hospital or 24/7 mental health services within 45 minutes. Treatment programs: This score is based on accessibility of available services. Score 3: Residents are able to access treatment services by walking or public transportation, and travel time will be less than 30 minutes. Score 2: Residents are able to access treatment services by walking or public transportation, and travel time will be more than 30 minutes. Score 1: Residents are not able to access treatment services by walking or public transportation. Shopping: This score is based on the accessibility of stores. Score 3: Stores for clothing, household items and groceries can be accessed by walking or public transportation, and travel time is less than 30 minutes. Score 2: Stores for clothing, household items and groceries can be accessed by walking or public transportation, and travel time is more than 30 minutes. Score 1: Stores for clothing, household items and groceries are not accessible by walking or public transportation. Employment: This score is based on the accessibility of employment opportunities. Score 3: Residents are able to access employment opportunities by walking or public transportation, and travel time will be less than 30 minutes. Score 2: Residents are able to access employment opportunities by walking or public transportation, and travel time will be more than 30 minutes. Score 1: Residents are not able to access employment opportunities by walking or public transportation. 4
Education: This score is based on the accessibility of educational opportunities (universities, colleges, trade schools, etc). Score 3: Residents are able to access educational opportunities by walking or public transportation, and travel time will be less than 30 minutes. Score 2: Residents are able to access educational opportunities by walking or public transportation, and travel time will be more than 30 minutes. Score 1: Residents are not able to access educational opportunities by walking or public transportation. Medical, dental, and vision services accessibility: All three of these scores are based on the same criteria of access to healthcare services. Score 3: Residents are able to access services by walking or public transportation, and travel time will be less than 30 minutes. Score 2: Residents are able to access services by walking or public transportation, and travel time will be more than 30 minutes. Score 1: Residents are not able to access services by walking or public transportation. 1. Facility Criteria score: Enter fail if a score of fail was given for any scoring category. Enter the total score of the facility criteria section if the site has an existing structure that will be used for the project. Enter new construction if the project will be housed in new construction. 2. Community Integration score: Enter the total score for the community integration section whether or not there is an existing structure on the site. Additional Information: This space is used to make any comments that the provider would want considered in the final score. For example, the provider could comment that the site: will be remodeled to have five bedrooms instead of four; or that a bathroom will be added or renovated to meet ADA specifications and requirements; or that a fence will be built to enclose part of the home s property for resident privacy. Sign and date the score sheet after it is completed. Date created: 09/13/10 Updated: 11/16/11 C:\Documents and Settings\AGUILLEN\Desktop\Siting Packet\Siting Matrix - Instructions FINAL 11-16-11.doc 5
Oregon Health Authority Addictions and Mental Health Division (AMH) 500 Summer St. NE E86, Salem, OR 97301-1118 Phone 503-945-5736 Fax 503-378-8467 AMH Residential Siting Matrix PROVIDER: CONTACT NAME: TELEPHONE: EMAIL: SITE LOCATION: RESIDENTIAL PROGRAM DESIGNATION: Check one: RTF RTH SRTF Score: Facility Criteria If the project will be new construction, please bypass the facility criteria section. A score of fail in any category indicates the site is not able to meet AMH licensing requirements. There is a maximum possible score of 21 in the facility criteria section. A proposed site must receive a facility criteria score of at least 13 in order to be considered for development. Score 1-3 or fail Resident capacity: n/a Number of bedrooms: Number of bathrooms: Parking: Proximity to existing MH facilities: Structural design: Grounds: Asking price for site $ n/a Renovation Cost $ n/a Total price $ n/a AMH Residential Siting Matrix Page 2
Community Integration Score 1-3 Public Transportation If None, alternative transportation: Mental health programs: Crisis services: Treatment programs: Shopping: Employment: Education: Medical care availability and access: Dental care availability and access: Vision care availability and access: Community Integration score: Facility Criteria score: Additional Information: Scorer s Name (Print) Scorer s signature: Date: / / Created: 09/13/10 Updated 11/17/11 C:\Documents and Settings\AGUILLEN\Desktop\Siting Packet\Siting Matrix - Score Sheet FINAL 11-16-11.doc