Or. Admin. Code § 309-019-0245

Current through Register Vol. 63, No. 11, November 1, 2024

Section 309-019-0245 - ACT Admission Criteria

(1) Participants shall meet the medically appropriate standard as designated in OAR 309-019-0105. Participants who are medically appropriate shall have the following characteristics:

(a) Participants who meet the SPMI Eligibility per OAR 309-019-0225(27) are the primary target population for ACT services per evidence-based model

(b) Individuals with a primary diagnosis of a substance use disorder intellectual developmental disabilities, traumatic brain injury, personality disorder, or an autism spectrum disorder are not the intended recipients of ACT and may not be referred to ACT if they do not have a co-occurring, qualifying SPMI Eligibility disorder;

(c) Participants with significant functional impairments as demonstrated by at least one of the following conditions:

(A) Significant difficulty consistently performing the range of practical daily living tasks required for basic adult functioning in the community (e.g., caring for personal business affairs; obtaining medical, legal, housing services; recognizing common dangers or hazards meeting nutritional needs; maintaining personal hygiene) or persistent or recurrent difficulty performing daily living tasks except with significant support or assistance from others such as friends, family, or relatives;

(B) Significant difficulty maintaining consistent employment at a self-sustaining level or significant difficulty consistently carrying out activities needed for independent living(e.g., household meal preparation, washing clothes, budgeting, or child-care tasks and responsibilities);

(C) Significant difficulty maintaining a safe living situation (e.g., repeated evictions or loss of housing).

(2) Participants with one or more of the following problems, which are indicators of continuous high service needs (e.g., greater than eight hours per month):

(a) High use of acute care psychiatric hospitals or emergency departments for psychiatric reasons, including psychiatric emergency services as defined in OAR 309-023-0110(18) (e.g., two or more readmissions in a six-month period);

(b) Intractable (e.g., persistent or very recurrent) severe major symptoms, affective, psychotic, suicidal;

(c) Coexisting substance use disorder of significant duration (e.g., greater than six months);

(d) High risk or history of criminal justice involvement (e.g., arrest, incarceration);

(e) Significant difficulty meeting basic survival needs, residing in substandard housing, homelessness, or imminent risk of becoming homeless;

(f) Residing in an inpatient or supervised community residence in the community, and clinically assessed to be able to live in a more independent living situation if intensive services are provided or requiring a residential or institutional placement if more intensive services are not available;

(g) Difficulty effectively utilizing traditional office-based outpatient services.

(3) The ACT program provides community-based, long-term, or time-unlimited services.

(4) If an individual is unable to maintain in community without 1:1 constant care; this is beyond the scope of what ACT could provide. ACT program may deny if the care requires 1:1 intervention on a continuum basis that is beyond the scope of ACT and make proper recommendations for higher level of care.

Or. Admin. Code § 309-019-0245

MHS 11-2016(Temp), f. 6-29-16, cert. ef. 7-1-16 thru 12-27-16; MHS 18-2016, f. 11-28-16, cert. ef. 11/30/2016; MHS 26-2016(Temp), f. 12-27-16, cert. ef. 12-28-16 thru 6-23-17; MHS 6-2017, f. & cert. ef. 6/23/2017; MHS 10-2017(Temp), f. 9-15-17, cert. ef. 9-15-17 thru 3-13-18; MHS 4-2018, amend filed 02/27/2018, effective 3/1/2018; BHS 44-2023, amend filed 12/22/2023, effective 1/1/2024

Statutory/Other Authority: ORS 161.390, 413.042, 430.256 & 430.640

Statutes/Other Implemented: ORS 161.390 - 161.400, 428.205 - 428.270, 430.010, 430.205 - 430.210, 430.254 - 430.640, 430.850 - 430.955 & 743A.168