Aid and Assist Consultation Report (ORS 161.370)

☐Initial Consultation: Date completed: Click here to enter a date.

☐Supplemental Consultation: Date Completed: Click here to enter a date.

Defendant’s Name:Click here to enter text. DOB: Click here to enter a date.

SID: Click here to enter text.MOTS Personal ID #:

County: Click here to enter text.Court: Click here to enter text.Judge: Click here to enter text.

Current Criminal Charges: Click here to enter text.

Date of Referral: Click here to enter a date.Consultation Date: Click here to enter a date.

Name of the Person Conducting the Consultation: Click here to enter text.

Recommendation to the Court:

Defendant’s mental healthappears to be☐Deteriorating☐In Stasis☐Improving

☐Community Restoration Recommended

☐Outpatient

☐Available☐Not Available☐Refused

☐Residential Treatment Facility or Home (RTF or RTH)

☐Available☐Not Available☐Refused

Conditions Recommended: Click here to enter text.

☐Secured Restoration Recommended

☐Secure Residential Treatment Facility (SRTF)

☐Available☐Not Available☐Refused

☐Oregon State Hospital (OSH)

Barriers to Community Restoration:

☐Defendant Refused Community Restoration Services

Document Attempts at Engagement: Click here to enter text.

☐Intensity of Mental Health Care Needs

☐ Outpatient Treatment ☐Not Available ☐ Refused ☐ N/A

☐Intensive Case Management ☐NotAvailable ☐ Refused ☐ N/A

☐ Assertive Community Treatment (ACT) ☐Not Available ☐Refused ☐ N/A

☐ Acute Inpatient Psychiatric Hospitalization ☐Not Available ☐Refused ☐ N/A

Has civil commitment been considered? ☐ Yes ☐ No Barriers: Click here to enter text.

☐Other: Click here to enter text. ☐Not Available ☐ Refused ☐ N/A

Brief Explanation: Click here to enter text.

☐Specialized Housing

☐ Motel/Shelter Vouchers ☐ Not Available ☐ Refused ☐ N/A

☐ Room & Board ☐ Not Available ☐ Refused ☐ N/A

☐ Clean & Sober Housing ☐ Not Available ☐ Refused ☐ N/A

☐ Independent Housing with Supports ☐ Not Available ☐ Refused ☐ N/A

☐ Residential Treatment Facility☐ Not Available ☐ Refused ☐ N/A

☐Other: Click here to enter text. ☐Not Available ☐ Refused ☐ N/A

Brief Explanation: Click here to enter text.

☐Co-Occurring Substance Use Disorder

☐Outpatient Treatment☐Not Available ☐ Refused ☐ N/A

☐Inpatient Treatment☐Not Available ☐ Refused ☐ N/A

☐Other: Click here to enter text.☐Not Available ☐ Refused ☐ N/A

Brief Explanation:Click here to enter text.

Summary of Consultation:

  1. ☐Initial In-Person Meeting: ☐Jail ☐Hospital ☐ Community☐Other Click here to enter text.

☐Supplemental Meeting: ☐Jail ☐Hospital ☐ Community ☐Video/Teleconference ☐OtherClick here to enter text.

  1. Sources of Information: ☐ Mental Health Files ☐Medical Files ☐Collateral Interviews

☐Criminal Justice Files☐Other Click here to enter text.

  1. Was the Defendant enrolled in OHP? ☐Yes ☐No
  2. Was the Defendant engaged in services? ☐ Yes ☐ No

Brief Explanation if No: Click here to enter text.

  1. Other agencies that might have a vested interest in the case.☐DD ☐ APD ☐ VA ☐ PPO

☐ Other: Click here to enter text.

  1. What was the Extent of Defendant’s Participation in the Consultation?☐Engaged ☐Refused

☐Unable to Engage

Brief Explanation: Click here to enter text.

  1. Defendant’sbeliefs and requests regarding placement and services.

Brief Explanation: Click here to enter text.

  1. Barriers to accessingnecessary information: Click here to enter text.
  2. Other Comments: Click here to enter text.

Resources:

-Template court orders developed by the Oregon State Hospital

-Aid and Assist related Oregon Revised Statutes (ORS) and Oregon Administrative Rules (OAR)

-Legal Skills Curriculum developed by the Oregon State Hospital

-Aid and Assist Consultation Report Template

Instruction Sheet

Aid and Assist Findings Reports shall be completed, disseminated, and archived by the CMHP Director or Designee as determined by the Authority in keeping with OAR 309-088-0105 through 309-088-0135.

Findings Reports associated with Defendants who are referred to OSH shall be attached the judgement order for OSH Admittance. The CMHP Director or Designee is responsible for archiving all completed Finding Reports.

Type of Consultation:

Initial Consultations shall be performed in person. Supplemental Consultations may be performed via tele- or video- conference.

Demographics:

Demographic information is required to the best of your ability. Accuracy of reporting known information is the responsibility of the CMHP Director or Designee.

Recommendation to the Court:

Mental Health Status: Check appropriate box.

The Level of Care recommendation is divided between community and secure settings that are further subdivided. Please select both a primary category and a subcategory.

Conditions Recommended for Community Restoration may include, but not be limited to NA/AA, voluntary medications, participation in substance use disorder treatment, specific community based recovery oriented services, peer services, and Community Restoration Plan co-developed with defendant.

If the CMHP Director or Designee recommends that restoration does not occur in the community due to lack of services and supports, the CMHP or Director or Designee is required to document what services were not available by checking the boxes and providing brief explanations when appropriate.

Summary of Consultation:

Summarizes the CMHP Director or Designee’s interview with the Defendant and supports the CMHP Director or Designee’s recommendation to the court. Please fill out completely and succinctly.

Resources:

Include the Resources section when submitting the Aid and Assist Consultation Report to the court.

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Updated 11/16/17