1. (1) The applicant shall provide a complete description of all alternatives to inpatient treatment at a psychiatric hospital available in the Health Service Area. This includes an inventory with provider name, type of mental health services provided, address, and if relevant and available: bed capacity, occupancy and utilization averages for each of the past five years in the Health Service Area.

2. (2) The methods of meeting acute inpatient psychiatric bed need, in order of preference, shall be preceded by a demonstration that alternatives have been evaluated and found infeasible based on cost, capacity, or access barriers:

   1. (a) Conversion of existing licensed hospital space for the purposes of psychiatric treatment where such conversion is feasible to provide an adequate inpatient program at less cost than building new licensed space.
   2. (b) A project resulting in the smallest feasible net increase in acute licensed capacity within an existing hospital or special inpatient care facility.

   3. (c) A separately licensed new psychiatric hospital, not part of an existing licensed hospital, which will provide psychiatric inpatient care at the most reasonable charges per day and per inpatient stay event, for care that must be rendered on an inpatient basis. Evaluation of reasonableness of charges are qualities that tend to show charges are fair, competitive, and consistent with quality care. These factors include, but are not limited to, consideration of:

      1. (A) Market rates for similar services by similarly situated entities;
      2. (B) Patient outcomes and satisfaction;
      3. (C) Regulatory compliance;
      4. (D) Accreditation and certification; and
      5. (E) Qualification of staff.

3. (3) A proposed psychiatric hospital shall be evaluated by comparison to alternatives with preference given in the following order:

   1. (a) Projects which include development of alternative care resources as part of the project, if an unmet need for such resources in the Health Service Area is demonstrated.
   2. (b) Projects for which formal arrangements, together with triage criteria and mechanisms, are documented in the application with respect to all levels of low-cost alternative care provided by the applicant.
   3. (c) Documentation of triage criteria and mechanisms consistent with the level of care evaluation provided at ORS 743A.168(2).
4. (4) In evaluating the relationship of the proposed project to the existing health care system of the Health Service Area, the applicant shall address possible compromising of quality of care. The Oregon Health Authority shall consider the conformity to state safety and program standards of both the proposed project and existing providers, related health services now provided to the population of the Health Service Area; the impact of the project, once completed and operational, upon the financial ability of providers of related services to maintain present quality; and the feasibility that the proposed project will be sufficiently efficient to maintain quality standards at reasonable cost.
5. (5) The applicant shall address whether the insufficient availability of alternatives in the Health Service Area result in an over utilization of inpatient psychiatric services.

Statutory/Other Authority

ORS 431.120, ORS 442.315 & ORS 743A.168

Statutes/Other Implemented

ORS 431.120 & ORS 442.315

History

PH 19-2026, amend filed 04/17/2026, effective 04/17/2026
PH 20-2025, temporary amend filed 10/22/2025, effective 10/22/2025 through 04/19/2026
HD 13-1994, f. & cert. ef. 4-22-94