Current through Register Vol. 63, No. 9, September 1, 2024
(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.
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
