Marion County, providers press OHA to rewrite treatment home safety rules
Quick Read
Marion County and a coalition of behavioral health providers want the Oregon Health Authority to rewrite rules for residential mental health treatment programs now that public comment closed Oct. 19.
The county says current rules make staff wait until a resident has seriously hurt someone before a fast-track transfer or discharge, and it wants programs allowed to act on serious threats and to ban alcohol.
OHA says it has already made emergency weapons rule changes, now lets providers prohibit alcohol on site, and will review all comments.
Commissioners have told Gov. Tina Kotek they may seek federal oversight of OHA if safety issues are not resolved quickly.
Marion County and a growing group of behavioral health providers are pushing the Oregon Health Authority to change the rules for residential mental health treatment programs, saying the current rules leave staff unable to act on dangerous behavior until after someone is seriously hurt.
Public comment on the county's proposed changes closed Monday, Oct. 19, KATU reported. "Marion County and the Oregon Council for Behavioral Health jointly call on OHA to update and fix rules immediately upon the close of the rulemaking public comment period on October 19, 2026," Marion County Commissioner Danielle Bethell and council Executive Director Heather Jefferis said in a county news release issued the same day. "Ensuring safety of providers and residents simply cannot wait any longer."
OHA says it has already addressed some of the concerns and will review all comments before deciding on further changes.
What the county is asking for
The rules cover residential treatment homes and facilities that provide housing and treatment to adults diagnosed with a qualifying mental illness. They are staffed 24 hours a day and range from homes with up to five residents to facilities with 6 to 16, according to OHA, which says most placements come from state hospitals and acute care facilities. OHA counts 202 licensed residential treatment facilities and homes statewide, according to its notice of proposed rulemaking.
Marion County filed a formal rulemaking petition on Aug. 19 under ORS 183.390, a state law that, according to the county, required OHA to invite public comment on the proposed changes and consider the county's concerns. KATU reported the petition asks OHA to change nine rules, including when facilities can discharge residents, how they screen people for admission, how they handle disruptive visitors and whether they can restrict alcohol.
The biggest fight is over discharges. Under the rule the county is challenging, a program must give a resident at least 30 days' written notice before an involuntary transfer or discharge unless the resident agrees to leave or the resident's behavior "has directly resulted in serious physical harm to other residents in the program or program staff," according to the petition. The county wants programs to be able to act faster when a resident threatens substantial injury, recklessly endangers someone or intentionally causes substantial property damage, the same kinds of standards Oregon landlord-tenant law uses.
"The current rule defies common sense and absurdly means county health staff must wait until a criminal assault occurs against staff or other residents before they can take necessary action in response to an emergency safety threat," the petition states.
The county also wants to strike a rule provision stating that "No policy shall prohibit resident consumption of alcohol," let providers consider an applicant's documented recent threats or violence when deciding on admission, and get clearer guidance on when staff can search for weapons, according to the petition.
At a Marion County board session the day the petition was filed, Horizon House Residential Treatment administrator Anna Macera described a case in which OHA rules kept staff from taking a lighter away from a resident on supplemental oxygen who kept flicking it on and off next to an oxygen tank, according to the county's Aug. 19 release.
What OHA says
In a statement to KATU after comment closed, OHA said it is "dedicated to fostering safe, secure environments that protect the well-being of residential behavioral health clients and the safety of staff who support those clients." The agency said it has made emergency rule changes related to weapons and given facilities more flexibility to set safety policies based on the people they serve, their buildings and identified risks.
OHA also said providers may now adopt policies prohibiting alcohol on their premises, following a change in how the rule is interpreted. In July, an OHA spokesperson told the Statesman Journal that because alcohol and cannabis are legal for adults in Oregon, facilities couldn't limit what adults can do.
The agency has defended the tighter discharge standard. OHA told the Statesman Journal in July that it had "identified a significant increase in the use" of transfers and discharges with less than 30 days' notice for "behaviors that are common in mental health treatment settings, without evidence that the behaviors or underlying triggers had been addressed," and that the rules were updated to make clear those notices "should be reserved for the most serious situations." OHA also said at the time that the rules were developed with input from groups including the Oregon Council for Behavioral Health and the Association of Community Mental Health Programs, according to the newspaper.
OHA's own proposed update to the residential treatment rules, filed Aug. 31, would temporarily remove a requirement that the state approve involuntary discharge notices in advance and would say short-notice discharges cannot be issued with less than five days' notice, to account for residents' right to request an expedited hearing within five days, according to the notice. It would also add a definition of weapons and require policies on reasonable-cause weapons searches. That notice also took comment through 5 p.m. Oct. 19.
A growing coalition
The county said it worked with the Oregon Council for Behavioral Health to bring together providers from across the state on Oct. 15 to discuss the need for changes. In a letter to OHA summarizing that meeting, the county said providers described residents attempting to harm themselves or others, and said OHA applies its rules differently to different providers, with some allowed to ban alcohol and drugs and others not.
Groups backing the county's push include Columbia Community Mental Health, Halfway House Services, Wallowa Valley Center for Wellness, the Oregon Council for Behavioral Health and the Association of Oregon Community Mental Health Programs, according to the county. All three Yamhill County commissioners signed an Aug. 27 letter supporting the petition.
Providers warn that without quick action, more staff will leave, facilities may close and trust in behavioral health care will erode further, KATU reported.
Pressure on the governor
Marion County commissioners also wrote to Gov. Tina Kotek on Aug. 25, asking her to direct OHA to work with counties and providers to address the safety concerns, according to the county. In a letter to Kotek, the commissioners warned, "If ongoing safety issues are not promptly resolved at the state level, we will need to request federal government oversight for OHA's violation of federal Medicaid rules," KATU reported.
In August, Marion County Counsel Steve Elzinga told the Statesman Journal that the county could pursue "several other legal options" if OHA did not fix the rules voluntarily. Willamette News did not find a public response from Kotek's office to the county's letter.
What comes next
OHA said it will review all comments "for feasibility of implementation" and continue to work with counties, providers and communities. "We know that when providers feel safe to do their best work, all of Oregon benefits," the agency said in its statement to KATU. The statement did not include a timeline.
The temporary version of the discharge rule was set to remain in effect until Nov. 25, 2026, according to rule text attached to the county's August petition.
Sources
KATU: Marion County, providers urge OHA to revise residential treatment rules over safety fears, by Jennifer Singh (Oct. 19, 2026)
Marion County: OHA Rules Require Criminal Assault Before Providers Can Discharge Dangerous Residents, news release via FlashAlert (Oct. 19, 2026)
Marion County: County Files Rulemaking Petition for Changes to OHA Rules That Put Staff and Residents at Risk (Aug. 19, 2026)
Marion County: ORS 183.390 rulemaking petition to OHA (Aug. 19, 2026), PDF hosted by KATU
Oregon Health Authority: Notice of Proposed Rulemaking, OAR Chapter 309, Division 35 (filed Aug. 31, 2026)
Oregon Health Authority: Residential Treatment Facilities licensing page
Statesman Journal: Marion County leaders blast 'unnecessary' OHA rules, demand rescission, by Bill Poehler (July 1, 2026)
Statesman Journal: Marion County proposes mental health rules to undo new state mandates, by Bill Poehler (Aug. 20, 2026)
Yamhill County Board of Commissioners: Letter supporting Marion County's rulemaking petition (Aug. 27, 2026)
Cover photo: Barbara Roberts Human Services Building, by Gary Halvorson, Oregon State Archives, via Wikimedia Commons, licensed CC BY 4.0
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