Oregon Mental Health Residential Facilities

BENTON COUNTY

[CCO: Intercommunity Health Network]
Please contact Benton County for screening process and referrals:
Kenny Lowe | su.ro.notneb.oc|ewol.htenneK#su.ro.notneb.oc|ewol.htenneK | (541)766-0148 | Fax: (541)766-6186

  • RTF - Janus House (Corvallis): MH Facility - (10/12) (referrals pending) Not reviewing referrals at this time.
  • RTH - Sequoia Creek (Corvallis): MH Facility - (5/5) (Full)
  • RTH- Lewisburg House- Renew (Corvallis/Lewisburg) MH Facility (2/3) (reviewing multiple referrals Male bed, specializing in older adults dual diagnosed MH/APD clients with sex offense history. And 1:1 staffing)
  • AFH- Stride Residential (Corvallis): MH Facility - (5/5) (Full)
  • AFH - Mary's River AFH (Philomath): MH Facility (Full)

Updated: 8/28/2019


CLACKAMAS COUNTY

[CCO: Clackamas HealthShare]
Contact for Referrals:
Referrals/Other Choice inquiries: su.ro.samakcalc.oc|maeTtludAHBsamakcalC#su.ro.samakcalc.oc|maeTtludAHBsamakcalC | (503)742-5335 | Fax: (503)742-5355 Email monitored Monday-Thursday ONLY
(Please send referrals only to the listed email address and not directly to facilities)

After ALL referral requirements are received, the Residential Specialist will forward the referral to the providers indicated on PRTS coversheet. Please submit a separate PRTS cover sheet for each residential facility referring to. Within 48 hours of the residential provider receiving the referral packet, the residential provider will contact the referring party to schedule a screening. The screening appointment must occur within 14 calendar days from the date the residential provider receives the referral packet.

Within 72 hours of the screening, the residential provider will inform CCBHD via e-mail of their decision, including the completed PRTS cover sheet.

Each RTF/RTH will keep a waitlist of up to three applicants. When the wait list is at three, the facility will close for any additional referrals. When wait lists are closed, the provider will not be required to accept referrals, conduct screenings, or evaluate admissions criteria as directed by OAR. When the provider’s waitlist falls below three, CCBHD will resume sending referrals to the provider.

As always, referrals from the state hospital will be prioritized.
Priority 1: Patients who are designated as RTT (Ready to Transition) from OSH
Priority 2: Clients who are being diverted off the OSH waitlist, Clients who need to step down from Telecare TRC or SRTF
Priority 3: Patients stepping down from acute care
Priority 4: Community referrals

NOTE: Please be sure to indicate the type of referral (Pre-RTT packet or RTT Packet).

1. Oregon PRTS Application or CLAR, include signed ROI and PRTS Cover sheet
2. Level of Service Inventory (LSI) for level of care being referred to (in last 30 days)
3. Mental Health Assessment
4. Treatment Plan
5. Psychiatric Assessment
7. Progress notes for last 30 days MUST submit most current progress notes dated within two days of referral submission. Referrals will not be accepted without current progress notes
8. Prescriber notes for last 30 days
9. Income verification
10. Copy of current medication orders
12. Legal documents/ Civil Commitment paperwork / Guardianship paperwork

Please send referrals for waitlists.

  • RTF - Leland (Oregon City): MH Facility - (Full)Waitlist closed
  • RTF - Pearl Street (Oregon City): MH Facility - (Full) Waitlist closed
  • RTF - Alder Creek (Milwaukie): MH Home - (Full) Waitlist closed
  • RTH - Portland Ave (Gladstone): MH Home - (Full) Waitlist closed
  • RTH - Fieldstone (Wilsonville): MH Home - (Full) Waitlist closed
  • RTH - Bridgestone (Wilsonville): MH Home - (Full) Waitlist closed
  • RTH - Autumn Ridge (Milwaukie): MEDICAL MH Home - (Full) Waitlist closed
  • 09/3/2019

CLATSOP COUNTY

[CCO: CPCCO]
Contact for Referrals:

  • RTF - North Coast Crisis Respite Center (Warrenton) gro.hbpostalc|slarreferCRCCN#gro.hbpostalc|slarreferCRCCN - Accepting referrals.

Clarissa Torres gro.hbpostalc|tassiralc#gro.hbpostalc|tassiralc

  • AFH - Hearts Care - (FULL) - Not accepting referrals at this time.
  • AFH - Winterlite - (FULL) - Not accepting referrals at this time.

Updated: 09/12/2019


COLUMBIA COUNTY

[CCO: CPCCO]
Contact for Referrals:
Carla Herb moc.1hmcc|halrac#moc.1hmcc|halrac AND
Miriam Parker | moc.1hmcc|pmairim#moc.1hmcc|pmairim |Phone (503)397-5211 | Fax: (503)397-5379

  • RTF- Cornerstone (St. Helens)(Columbia Co.) - 15-Bed MH Facility - (Full) Closed to referrals as of 8/15/19.
  • RTF- Alternatives (St. Helens)(Columbia Co.): 8-Bed PSRB only Facility -(Full) Accepting Referrals for PSRB.

Updated: 08/15/2019


CURRY COUNTY

[CCO: WOAH and AllCare]
Contact for Referrals:
ENCC:Terry Marier gro.hcyrruc|treiram#gro.hcyrruc|treiram | Phone (541)373-8001 FAX (541) 425-5330 Send referrals to Columbia care person.
Driftwood/Bungalows: Rajean Lakson | gro.eracaibmuloc|noskalr#gro.eracaibmuloc|noskalr | (541)247-6566 FAX (541) 247-6549
Bell Cove: Alonzo Nalls | gro.eracaibmuloc|sllanl#gro.eracaibmuloc|sllanl (541)469-0222

  • RTF - Driftwood (Gold Beach): MH Facility - (Full) - Requesting referral for wait list
  • RTH - Bell Cove (Brookings): MH Facility - PSRB Medical- (Full) - Requesting Referrals
  • Supported Housing - Bungalows (Gold Beach): MH Facility - (Full) - No Referrals Needed

Updated: 11/20/18


DESCHUTES COUNTY

[CCO: PacificSource Community Solutions]
Contact for Referrals:
Carlie Mathias| gro.setuhcsed|saihtam.eilrac#gro.setuhcsed|saihtam.eilrac | (541) 330-4679 | Fax: (541) 388-6617

  • SRTF - Descutes Recovery Center (Bend): MH Facility - (Full) - Not accepting referrals
  • RTH - 12th Street RTH (Bend): MH Facility - (Full) - Not accepting referrals
  • RTH - Edgecliff (Bend): MH Facility - (Full) - Not accepting referrals
  • AFH- Golden Eagle AFH (Bend): MH Facility - (Full) - Not accepting referrals
  • AFH- Clubhouse at Breitenbush (Bend): MH Facility - (Full) - Not accepting referrals
  • AFH - Clubhouse at Clairway (Bend): MH Facility - (Full)- Not Accepting referrals

Updated:09.13.2019


DOUGLAS COUNTY

[CCO: Umpqua Health Alliance]
Contact for Referrals:
Holly Oltman| gro.nogerossapmoc|oylloh#gro.nogerossapmoc|oylloh | (541)440-3532 ext 1938 |

  • AFH - Freemont (Roseburg): MH Facility - (FULL) Not accepting referrals
  • AFH - Neely House (Roseburg): MH Facility - (FULL) Not accepting referrals
  • AFH - Wednesday's House (Sutherlin): MH Facility-(FULL) Not accepting referrals

Updated: 9/13/2019


EOCCO (GOBHI)

[CCO: EOCCO]
[Counties: Lake, Harney, Malheur, Baker, Grant, Wheeler, Sherman, Gilliam, Morrow, Umatilla, Union, and Wallowa]
Contact for Referrals:
Please email all referrals directly to the Residential Provider

  • SRTF- Lakeview Heights (Heppner): Matt Bergstrom - gro.liamescc|mortsgreb.ttam#gro.liamescc|mortsgreb.ttam - (FULL) Closed to referrals- 9/12/19.
  • SRTF- McNary Place (Umatilla): Rory Schilling - gro.syawefil|gnillihcsr#gro.syawefil|gnillihcsr and Kathy - Breese gro.syawefil|eseerbk#gro.syawefil|eseerbk - (FULL) Closed to referrals- 9/12/19.
  • RTF - Independence Place (Hines): moc.cnieracyrtemmys|larreferpi#moc.cnieracyrtemmys|larreferpi - (FULL) Accepting Referrals for waitlist- 9/12/19.
  • RTF - Columbia River Ranch (Boardman): Stephanie Cronen - gro.eracaibmuloc|nenorcs#gro.eracaibmuloc|nenorcs - Accepting referrals- 9/12/19.
  • RTF - Wallowa River House (Wallowa): ENHANCED-MEDICAL Facility Hannah Hillock - gro.ssenllewrofretnecvw|kcollih.hannah#gro.ssenllewrofretnecvw|kcollih.hannah - (FULL) Not accepting referrals- 9/12/19.
  • RTF - Pioneer Guest Home II (Enterprise): Hannah Hillock - gro.ssenllewrofretnecvw|kcollih.hannah#gro.ssenllewrofretnecvw|kcollih.hannah - (Full) Not Accepting referrals- 9/12/19.
  • RTH - Joseph House (Joseph): MILD MEDICAL-ENHANCEMENT Facility Hannah Hillock - gro.ssenllewrofretnecvw|kcollih.hannah#gro.ssenllewrofretnecvw|kcollih.hannah - (FULL) Not Accepting referrals- 9/12/19.

Contact for Malheur County AFH:
Kristi Barraza gro.syawefil|azarrabk#gro.syawefil|azarrabk - Updated 9/12/19

  • AFH - M. Burgess 1 (Ontario): 5-Bed MH Home - (FULL) - Not accepting referrals.
  • AFH - Martarano House #1 (Ontario): 5-Bed MH Home - (FULL) - Not accepting referrals.
  • AFH - Sandhu (Ontario) MALE ONLY 5-Bed MH Home- (FULL) - Not accepting referrals.
  • AFH - Spanish Villa (Ontario): 5-Bed MH Home - (FULL) - Not accepting referrals.
  • AFH - Frontier (Malheur Co.): 3-Bed MH Home - (FULL) - Not accepting referrals.
  • AFH - Bunkhouse (Malheur Co.): 5-Bed MH Home - (Full) – Not accepting referrals.
  • AFH - 8th Ave. House (Malheur Co.) 5-Bed MH Home - (FULL) - Not accepting referrals.
  • AFH - Skyview House House MALE ONLY (Umatilla Co.) Jessica Dyer - gro.syawefil|reydej#gro.syawefil|reydej - (Full) - Not accepting referrals- 9/12/19.
  • AFH - Liberty House (Hines): -moc.cnieracyrtemmys|larreferpi#-moc.cnieracyrtemmys|larreferpi (FULL) Not accepting referrals- 9/12/19.

When sending referrals, please be sure to include the following:
1. Oregon PRTS Application or CLAR
2. Oregon PRTS Program Referral Cover Sheet (Attach separately from the rest of packet)
3. Mental Health Assessment, current within the last year. If referring to Dual Dx please include A&D Assessment.
4. Current Medication list or MARS
5. At Least 30 days of progress notes or more.
6. Labs - if available.
7. Legal paper work - if applicable.
8. History and Physical - Any current medical documents.
9. If referring to an AFH please include a current within the last 6 months LOCUS


JACKSON COUNTY

Contact for Referrals:
1. Jennifer Watkins, MA, QMHP Choice ENCC | gro.ytnuoCnoskcaJ|AJniktaW#gro.ytnuoCnoskcaJ|AJniktaW | (541)774-7801 (office) | (541)841-2743 (cell) | Fax: (541)774-7979
2. LouAnn Edwards M.Ed. Choice Supervisor | (541)774-7957

Updated: 8/8/2017


KAIROS

Young Adult Facilities: Applicants must be 17 1/2-24 years old
Contact for Referrals:

Tony Polk | gro.wnsoriak|klopt#gro.wnsoriak|klopt | (541)474-5579, ext. 3102 | Fax: (541)476-7410

  • RTH - Momentum (Grants Pass): Young Adult 5-Bed MH Facility - (Full)
  • RTH - Tempo (Eugene): Young Adult 5-Bed MH Facility - (Full)
  • RTH - Cadenza (Salem): Young Adult 5-Bed MH Facility - (Full)

Updated: 8/26/19


KLAMATH COUNTY

[CCO: Cascade Health Alliance]
Contact for Referrals:
Wendsday Cohen| gro.HBBK|nehoCW#gro.HBBK|nehoCW | (541)883-1030, ext. 2149 | Fax: (541)884-2338

  • RTF - Phoenix Place (Klamath Falls): 9-Bed MH Facility - (Full) - Accepting PSRB referrals only.

Updated: 8/21/2019


LANE COUNTY

[CCO: Trillium / Trillium Behavioral Health]
Contact for Referrals:
ENCC: Melissa Miller (541) 852-1133 (acting ENCC)
All referrals and referral related questions should be made to the su.ro.enal.oc|eciohc#su.ro.enal.oc|eciohc email.

*CURRENTLY NO VANANCIES OR REFERRALS BEING ACCEPTED**

When sending referrals, please be sure to indicate the type of referral (Pre-RTT packet or Referral to Transition Packet). If the referral being made is a Referral to Transition Packet, the following needs to be included:
1. Oregon PRTS Application or CLAR (if referral to SRTF, send proof of SRTF approval), include signed ROI and PRTS Cover sheet
2. Level of Service Inventory for level of care being referred to (in last 30 days)
3. Mental Health Assessment
4. Treatment Plan
5. Psychiatric Assessment
6. Copy of all Incident Reports (last 30 days or more)
7. Progress notes for last 30 days or more
8. Prescriber notes for last 30 days or more
9. Income verification
10. Copy of current medication orders
11. SRTF approval letter (if applicable)
12. Legal documents/ Civil Commitment paperwork
13. Guardianship paperwork if applicable

If accepted:
1. TB results (results have to be provided before placement)
2. Recent crisis plan (if applicable)
3. Signed ROI for Lane County Behavioral Health and the referrer and/or hospital, all MH providers including county of responsibility, Payee (if applicable)
4. Recent physical (within last 60 days)
5. If client is being referred from another COR, how the COR intends on coordinating care (ensuring MH and medical services are authorized due to OHP captivation of COR and the return of the individual back to COR if desired by the resident).

PLEASE NOTE WAITLIST VS. ADMIT POTENTIAL

  • SRTF-River Bridge (Eugene): (FULL) - No Referrals being accepted
  • RTF - Garden Place (Eugene): Closing 8/30/19
  • RTF - Gateway 2 Community Living (Springfield): (FULL) - Closed for referrals
  • RTF - Alder Street (Eugene): Male only program (FULL) - Waitlist Full
  • RTF - William Ware (Eugene): (Full) - Waitlist Full
  • RTH - Danebo (Eugene): (FULL) - No Referrals being accepted
  • RTH - Myers [370 Program] (Eugene): (FULL) - Referrals Via .370 only
  • RTH - Tempo [YAT Program] (Eugene): (FULL) - Referrals Via OHA/Alex Palm
  • RTH - ClearView (PSRB) - Referrals via PSRB only

Foster Care Homes

  • AFH - Bohemia (Cottage Grove): (FULL)
  • AFH - Bee Haven (Cottage Grove): (FULL)
  • AFH - Campbell (Eugene): Closing 9/27/19
  • AFH - Fillmore Lane (Eugene)Male Only home: (FULL)
  • AFH - Forest Ridge (Springfield) (FULL)
  • AFH – Smiles (Lorane): (FULL)
  • AFH - Stargazer (Eugene): (FULL)
  • AFH - Werner (Pleasant Hill): (FULL)

Updated: 8/30/2019


LINCOLN COUNTY

[CCO: Intercommunity Health Network (IHN)]
Contact for Referrals:
AMHI /ACT MGR. Amy Yates, MSW, CSWA | su.ro.nlocnil.oc|setaya#su.ro.nlocnil.oc|setaya | (541) 265- 0509| Fax: (541)265-0601

  • RTH – Benton Place (Newport): MH Facility/PSRB - (FULL) - Closing as of May 1, 2019
  • Oceanside (Lincoln City) MH Facility/ APD Facility

Updated: 1/14/2019


LINN COUNTY

[CCO: Intercommunity Health Network (IHN); Mid-Valley Behavioral Care Network]
Contact for Referrals:
(Include all 3 on emails)- Sandra Garver, LPC, ENCC | su.ro.nnil.oc|revrags#su.ro.nnil.oc|revrags , (541)967-3866, ext. 2683| Fax: 541-812-8804; Mia Schroer, MA; su.ro.nnil.oc|reorhcsm#su.ro.nnil.oc|reorhcsm | 541-967-3866 ext.2522| Fax: 541-812-8804

  • RTH – Casa Rio (Albany): 5-Bed - (FULL) - Closed to Referrals
  • RTH - Colorado Lake (Albany): 3-Bed - (FULL) - Closed to Referrals

Updated: 08/01/2018


MARION COUNTY

[CCO: Willamette Valley Community Health (WVCH)]
Contact for Referrals:
Siddharth "Sid" Venkatachalam | su.ro.noiram.oc|malahcatakneVS#su.ro.noiram.oc|malahcatakneVS | (503) 576-4573 | Fax: (503)361-2728
Rebecca Thompson | su.ro.noiram.oc|nospmohTR#su.ro.noiram.oc|nospmohTR | (503) 361-2749 | Fax: (503)361-2728

  • RTF - Carrolls (Salem): MALE Only Facility - (Full) - Closed for referrals
  • RTF - Royvonne (Salem): FEMALE Only Facility - (Full) - Closed for referrals
  • RTF - Horizon House (Salem): Co. operated; co-ed - (Full) - No Referrals at this time please
  • RTH - Chinook House (Keizer): Co-occurring - must be interested in recovery; co-ed - (Full) - (Full
  • RTH - Adams Lane (Jefferson): MH Facility - (Full) - No Referrals at this time please
  • RTH - Via Verde (Salem): PSRB Facility - (Full) - No Referrals at this time please

No referrals requested at this time

  • AFH - Dukes (So. Salem): co-ed - (Full)
  • AFH - LibertyCare Homes [2] (Salem): co-ed - (Full)
  • AFH - Star House (NE Salem): co-ed - (Full)
  • AFH - Meggie's Place (Aumsville): co-ed - (Full)
  • AFH - Hillside Ranch (Aumsville): co-ed - (Full)
  • AFH - Boxwood (SE Salem): co-ed - (Full)
  • AFH - Eastland Place (SE Salem): co-ed - (Full)
  • AFH - Amazing Grace [4] (SE Salem): co-ed - (Full)
  • AFH - Hope Ranch (Keizer): co-ed - (Full)

Updated: 8/16/19


MULTNOMAH COUNTY

[CCO: Multnomah Mental Health (Part of HealthShare)]
Contact for Referrals:
Referrals should be sent directly to the Residential Provider. Please copy su.octlum|stsilaiceps.laitnediser#su.octlum|stsilaiceps.laitnediser when sending any referral to a contracted residential program.

__Monthly Program Notes: (Note: for Multnomah residential program staff)
Monthly Program (client summary) Notes: Multnomah County is asking residential providers to send via secure email, their referral packet to BOTH their AMHI contact and to email su.octlum|stsilaiceps.laitnediser#su.octlum|stsilaiceps.laitnediser each month for all clients placed in Multnomah County mental health residential treatment programs.

The Residential Specialist, assigned to the Multnomah County residential treatment program you contract with, will:
• continue to provide waitlist management for structured care, in concert with the program Administrator and AMHI;
• continue to provide regulatory oversight of residential treatment programs, for client health, safety and welfare;
• continue to facilitate community (non-AMHI) referrals, screenings and placements;
• continue to conduct pre-screens for Adult Foster Care waitlist;
• continue to maintain Adult Foster Care wait list;
• continue to conduct client pre-screens and placement activities for Adult Foster Care.

Please include the following with each referral:
PRTS Application for Residential Services or CLAR if referral from OSH
PRTS Program Referral Cover Sheet for each site referred to
Guardianship papers if applicable
LOCUS Scores
Current LSI if currently in licensed residential placement
Please include the DSO Prime # (AKA the OHP Medicaid #)
Psycho / Social History &/or
Current Mental Health Assessment
Most recent admit & discharge summaries
(Includes Hospitals, Sub-Acute, & Respite)
Current progress notes (two months)
Prescriber assessment & progress notes (two months)
Typed summary, outlining housing history & need for housing.
Current Mental Health Treatment Plan (ISSP) & assessment
Occupational Therapy / Skills Assessment or other relevant assessments (as requested)

Multnomah County sites. Updated 9/19/19

  • SRTF - 72nd Ave. Place (Portland): MALE Only Facility - (Full) - Closed to Referrals
  • SRTF - Arbor Place (Portland): MH Facility - (Full) - Closed to Referrals
  • SRTF - Barbara Roberts East (Portland): MALE Only Facility - Closed to Referrals
  • SRTF - Barbara Roberts West (Portland): FEMALE Only Facility - (Full) - Closed to Referrals
  • SRTF - Fairview Firs (Portland): POLYDIPSIA Facility - (Full) - Closed to Referrals
  • SRTF - Faulkner Place (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - CODA 8041 (Portland): Dual-Diagnosis Facility - (Full) - Closed to Referrals
  • RTF - CEC (Portland): Medically-Focused Facility - (Full) -Closed to Referrals
  • RTF - Andrea Place (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Cameron Boise (Portland): MH Facility - (Full) - Open to Females (Shared Rooms Only)
  • RTF - Cameron Garfield (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Cameron Powell (Portland): MH Facility - (Full) -Closed to Referrals
  • RTH - Court House (Portland): FEMALE only Facility - (Full) - Closed to Referrals
  • RTF - Columbia Rose (Portland): MH Facility - (Full) - Closed to Referrals
  • RTH - Estuesta (Portland): MH Facility (Full) - Closed to Referrals
  • RTF - Hoodview (Portland): MH Facility - (Full) - Closed to Referrals
  • RTH - Hazelwood & Horizon (Portland): MALE only Facility - (Full) - Closed to Referrals (please submit two cover sheets, one for each house)
  • RTF - McCarthy (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Nadine's Place (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Pisgah (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Rita May Manor (Portland): MH Facility - (Full) - Closed to Referrals
  • RTH - Rockwood (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Stults House (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Wallula Place (Portland): MH Facility - (Full) - Closed to Referrals
  • RTF - Willamette Rose (Portland): FEMALE Only Facility - (Full) - Closed to Referrals
  • SSH - Alberta Plaza (Portland): Supported Housing Units - (Full) - Closed to Referrals
  • SSH - Instar (Portland): Supported Housing Units - (Full) - Closed to Referrals
  • SSH - Sandy (Portland): Supported Housing Units - (Full) - Closed to Referrals

OPTIONS FOR SOUTHERN OREGON

[CCO: Primary Health and AllCare]
Contact for Referrals:
Jason Margulis | gro.enilnosnoitpo|silugramj#gro.enilnosnoitpo|silugramj | (541)472-9991 | Fax: (541)472-9974

  • SRTF - Hazel Center (Medford): MH Facility - (Full) - Closed to Referrals
  • SRTF - Ramsey Place (Grants Pass): MH Facility - (Full) - Closed to Referrals
  • RTF- Carnahan Court (Grants Pass): MH Facility - (Full) - Closed to Referrals

When sending referrals, please be sure to indicate the type of referral (Pre-RTT packet or Referral Packet). If the referral being made is a Referral Packet, the following needs to be included:
1. Oregon PRTS Application or CLAR (if referral to SRTF, send proof of SRTF approval), include signed ROI and PRTS Cover sheet
2. Level of Service Inventory for level of care being referred to (in last 30 days)
3. Mental Health Assessment
4. Treatment Plan
5. Psychiatric Assessment
6. Copy of all Incident Reports (last 30 days or more)
7. Progress notes for last 30 days or more
8. Prescriber notes for last 30 days or more
9. Income verification
10. Copy of current medication orders
11. SRTF approval letter (if applicable)
12. Legal documents/ Civil Commitment paperwork
13. Guardianship paperwork if applicable

If accepted:
1. TB results (results have to be provided before placement)
2. Recent crisis plan (if applicable)
3. Signed ROI for Lane County Behavioral Health and the referrer and/or hospital, all MH providers including county of responsibility, Payee (if applicable)
4. Recent physical (within last 60 days)
5. If client is being referred from another COR, how the COR intends on coordinating care (ensuring MH and medical services are authorized due to OHP captivation of COR and the return of the individual back to COR if desired by the resident).

Updated: 9/19/19


POLK COUNTY

[CCO: Willamette Valley Community Health (WVCH); MHO: Mid-Valley Behavioral Care Network (MVBCN)]
[MVBCN Contact: Suzanne Smith | gro.ncbvm|ennazus#gro.ncbvm|ennazus | (503)576-4697 | Fax: (503)585-4989]
Contact for Referrals:
Kaila Moles | su.ro.klop.oc|aliak.selom#su.ro.klop.oc|aliak.selom | (503)623-9289 ext. 2161 |

  • RTF – Fir Hill (Dallas): MH Facility - (FULL) - Not accepting Referrals
  • RTH – Linden Lane (Dallas): MH Facility - (Full) - No Referrals Needed
  • AFH – Heise AFH LLC (West Salem): MH Facility - (Full) - No Referrals Needed
  • AFH – J.D. Homecare (West Salem): MH Facility - (Full) - No Referrals Needed

When sending referrals, please be sure to include at least the following:

1. Oregon PRTS Application or CLAR
2. Level of Service Inventory for level of care being referred to (in last 30 days)
3. Mental Health Assessment
4. Treatment Plan
5. Psychiatric Assessment
6. Copy of all Incident Reports (last 30 days or more)
7 Progress notes for last 30 days or more
8. Prescriber notes for last 30 days or more
9. Income verification
10. Copy of current medication orders

If accepted:
1. TB results (results have to be provided before placement)
2. Recent crisis plan (if applicable)
3. Signed ROI for Polk County Behavioral Health
4. Recent physical (within last 60 days)
5. Guardianship paperwork if applicable
6. PCBH Intake Packet
7. ROI for all Mental Health Providers including current provider
8. ROI for Payee if applicable
9. If client is being referred from another COR, how the COR intends on coordinating care (ensuring MH and medical services are authorized due to OHP captivation of COR and the return of the individual back to COR if desired by the resident).
10. Prior Authorizations: If the client being referred is outside of the Polk/Marion County region, the CRO/CCO will need to complete a prior authorization for services at Polk County Behavioral Health (A&D, Mental Health, Prescriber Services).
*If the resident does not have social security, the County of Responsibility is asked to develop a plan with the future residential provider to ensure room and board payments are paid.

Updated: 05/02/2019


TILLAMOOK COUNTY

[CCO: CPCCO]
Contact for Referrals:

Melani Gregory gro.ccft|GinaleM#gro.ccft|GinaleM

  • AFH - Cedar - (FULL) - Not accepting referrals at this time.
  • AFH - Stewart House: All bedrooms upstairs - (FULL) - Not accepting referrals at this time.

Updated: 09/12/2019


WASCO COUNTY

[PacificSource Community Solutions - Columbia Gorge Region]
Contact for Referrals:
Liz Barteld | gro.lfccm|dletraB.ziL#gro.lfccm|dletraB.ziL | (541)296-5452 Ext. 5045

  • RTF - Creekside (The Dalles): 9-Bed MH Facility: (No openings, Respite: 1 Open**) - Not accepting referrals at this time.

Updated:08/15/19


WASHINGTON COUNTY

[CCO: Health Share]

Please note there is a change in how Washington County will be involved in the referral process.

All Referrals should be sent directly to the Residential Treatment Provider. Please copy su.ro.notgnihsaw.oc|nielnieH_accebeR#su.ro.notgnihsaw.oc|nielnieH_accebeR when sending any referral to a contracted residential program.

Sequoia Programs (Edwards RTF, Myrtlewood RTH, Rosewood RTH) Serving individuals 18+

  • Send all referrals to: gro.shmaiouqes|slarrefeRlaitnediseR#gro.shmaiouqes|slarrefeRlaitnediseR

Luke-Dorf Programs (Sandvig RTF, Christopher RTH, Meusch RTH) Serving individuals 18+

  • Send all referrals to: gro.frod-ekul|oChsaWslarrefeRlaitnediseR#gro.frod-ekul|oChsaWslarrefeRlaitnediseR

LWNW: (Zenith RTH) Serving individuals 17-25

  • Send All Referrals to: Jessica Stout su.ro.etats.ahoshd|tuotS.L.acisseJ#su.ro.etats.ahoshd|tuotS.L.acisseJ

If you are wanting to referral to all programs, please only send one cover letter using: Washington County Residential, as the program name

  • RTF - Sandvig (Tigard): MH 7-bed Facility: (Full) wait list closed
  • RTF - Edwards House (Aloha): MH 7-bed Facility: (Full) wait list closed
  • RTH - Christopher House (Tigard): MH 5-bed program: (Full) wait list closed
  • RTH - Matthews House (Beaverton): PSRB ONLY Facility: (Full)
  • RTH - Meusch (Tigard): MH 5-bed program: (Full) wait list closed
  • RTH - Rosewood House (Forest Grove): MH 5-bed program: (Full) wait list closed
  • RTH - Myrtlewood House (Aloha): MH 5-bed program: (Full) wait list closed
  • RTH - Zenith House (Tigard): Youth in Transition 5-bed program: (Full) Not accepting Referrals at this time (Must send all referrals through Jessica Stout)

Please Note: Washington County Criteria and Policy for all Referrals

Referral Application Requirements
1. Cover Letter summarizing why you feel the client is appropriate for Residential Treatment, clinical or otherwise.
2. Oregon PRTS Application (click to view form) or CLAR, including your contact email
3. Attach the following items:
a. Mental Health Assessment
b. LSI: current within the last year
c. Treatment Plan
d. Income Verification
e. 30 days of progress notes, direct care and clinical if applicable
f. Most recent LMP notes
g. Current Medication orders (if any)
h. TB/Hep B results (if not readily available, you can submit the packet and work on this with the clients, as it must be completed before move-in to any residential program)
i. Crisis plan (if applicable)
j. Signed ROI for Washington County Residential
k. Health and Physical (from PCP – if not readily applicable, you can submit the packet and work on this with the client, as it must be completed before move-in to any residential program)
l. Residential Preliminary Discharge Form

Time Frame Criteria
1. If an application does not have all the above mentioned components to be adequately screened, the residential program will contact the referring party via email for the missing items. The referring party then has 14 days from the email to send in the requested information; if the needed documents are not received the packet will be considered inactive.
2. Once the referral has been accepted, the client screened, and placed on a wait list with one or more of our providers, it may be necessary for the referrer to send in updated notes and information if the referral has been on the wait list for more than 30 days. The providers will notify the referring party who will then have 7 days to respond to the email, answering any and all questions requiring the client’s current status and providing updated documentation. If the email is not returned in the time frame, then the referral will be placed in the inactive file.
3. If a referral has been placed inactive, but the referring party sends the information in after the time frame and contacts the residential specialist regarding restarting this referral, a new PRTS with updated information and updated notes will need to be sent in and the time frame will reset.

Please contact Becca Heinlein, Washington County Residential Systems Coordinator @503-846-3165 if you have any questions regarding all licensed residential.

Updated: 9/16/2019


YAMHILL COUNTY

[CCO: YCCO]
Contact for Referrals:
Referrals to Parkside Living RTF are sent to both ENCC and Parkside Coordinator:
ENCC: Caitlin Schrage | su.ro.llihmay.oc|cegarhcs#su.ro.llihmay.oc|cegarhcs | (503) 434.7523
Parkside Coordinator: Kathy Yonker | su.ro.llihmay.oc|kreknoy#su.ro.llihmay.oc|kreknoy | (503) 472-4055

  • RTF - Parkside Living (McMinnville): 16-Bed MEDICALLY-FOCUSED Facility;(FULL) - Please read entire entry prior to sending referral packets. We will review packets for a waitlist however anyone accepted to the waitlist will likely have to wait over a year or more before a bed is available. In order to qualify for this facility a person must have a medical condition for which they need assistance to manage and/or a need for hands on physical care. The culture at Parkside is not supportive of tobacco use, tobacco products and paraphernalia are not allowed in the facility and there is no nearby community access to tobacco products, so do not send referrals for people who are currently using tobacco products and are not interested in quitting.

Updated 9/10/19


YOUNG ADULT TRANSITIONAL

For placements that require referrals to be screened by Alex Palm at Oregon Health Authority.

  • Alex Palm |su.ro.etats.ahoshd|mlap.j.xela#su.ro.etats.ahoshd|mlap.j.xela | Cell: (503)884-3292 | Fax: (503)947-5043


For problems with editing or this Wiki page, contact: Matt Vinson | moc.kooltuo|nosniV.ttaM#moc.kooltuo|nosniV.ttaM | Phone: (541)891-9841

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