Or. Admin. R. 309-019-0226 - Assertive Community Treatment (ACT) Overview

(1) The Substance Abuse and Mental Health Services Administration (SAMHSA) characterizes ACT as an evidence-based practice for individuals with a serious and persistent mental illness. ACT is characterized by:

(a) A team approach;

(b) Community based;

(c) A small client to staff caseload, typically 10:1, to consistently provide necessary staffing diversity and coverage;

(d) Time-unlimited services;

(e) Flexible service delivery;

(f) A fixed point of responsibility; and

(g) 24/7 availability for response to psychiatric crisis.

(2) ACT services shall include but are not limited to:

(a) Hospital discharge planning, including OSH and acute care psychiatric hospitals;

(b) Case management;

(c) Symptom management;

(d) Psychiatry services;

(e) Nursing services;

(f) Co-occurring substance use and mental health disorders treatment services;

(g) Individual Placement and Support (IPS) supported employment services;

(h) Life skills training; and

(i) Peer delivered services.

(3) SAMHSA characterizes a high fidelity ACT program as one that includes the following staff members:

(a) Psychiatrist or Psychiatric Nurse Practitioner;

(b) Psychiatric Nurse;

(c) Qualified Mental Health Professional (QMHP) ACT Team Supervisor;

(d) Qualified Mental Health Professional (QMHP) Mental Health Clinician;

(e) Substance Abuse Treatment Specialist;

(f) Employment Specialist;

(g) Mental Health Case Manager; and

(h) Certified Peer Support Specialist.

(4) SAMHSA characterizes high fidelity ACT programs as those that adhere to the following:

(a) Providing explicit admission criteria with an identified mission to serve a particular population using quantitative and operationally defined criteria;

(b) Managing intake rates. ACT eligible individuals are admitted to the program at a low rate to maintain a stable service environment;

(c) Maintaining full responsibility for treatment services that includes, at a minimum, the services required in these rules;

(d) Twenty-four hour responsibility for covering psychiatric crises;

(e) Involvement in hospital admissions, including OSH and acute care psychiatric hospitals;

(f) Involvement in planning for hospital discharges, including OSH and acute care psychiatric hospitals; and

(g) As long as medically appropriate, time-unlimited services.

Notes

Or. Admin. R. 309-019-0226

MHS 26-2016(Temp), f. 12-27-16, cert. ef. 12-28-16 thru 6-23-17; MHS 1- 2017(Temp), f. 1-17-17, cert. ef. 1-18-17 thru 7-16-17; 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

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