OAR 309-019-0225
Assertive Community Treatment (ACT) Definitions

(1) In addition to the definitions in OAR 309-019-0105 (Definitions), the definitions below apply to this and subsequent rule sections.
(2) “Collateral Contacts” means members of the individual’s family or household or significant others (e.g., landlord, employer) who regularly interact with the individual and are directly affected by or have the capability of affecting their condition and are identified in the treatment plan as having a role in the individual’s recovery. For the purpose of the Assertive Community Treatment (ACT) program, a collateral contact does not include contacts with other mental health service providers or individuals who are providing a paid service that would ordinarily be provided by the ACT team (e.g., meeting with a shelter staff who is assisting an ACT recipient in locating housing).
(3) “Community-Based” means services and supports that shall be provided in a participant’s home and surrounding community and not solely based in a traditional office-setting. ACT services may not be provided to individuals residing in an RTF or RTH licensed by the Division unless:
(a) The individual is not being provided rehabilitative services; or
(b) The individual has been identified for transition to a less intensive level of care. When identified for transition to a less intensive level of care, the individual may receive ACT services for up to six months prior to discharge from the RTH or RTF.
(4) “Competency” means one year of experience or training in the specialty area and demonstration of the specific skills or knowledge.
(5) “Competitive Integrated Employment” means full-time or part time work:
(a) At minimum wage or higher;
(b) At a rate that is not less than the customary rate paid by the employer for the same or similar work performed by other employees who are not individuals with disabilities and who are similarly situated in similar occupations by the same employer and who have similar training, experience, and skill;
(c) With eligibility for the level of benefits provided to other employees;
(d) At a location where the employee interacts with other individuals who are not individuals with disabilities (not including supervisory personnel or individuals who are providing services to such employee) to the same extent that individuals who are not individuals with disabilities and who are in comparable positions interact with other individuals; and
(e) As appropriate, present opportunities for advancement that are similar to those for other employees who are not individuals with disabilities and who have similar positions.
(6) “Comprehensive Assessment” means the organized process of gathering and analyzing current and past information with each individual and the family and support system and other significant individuals to evaluate:
(a) Mental and functional status;
(b) Effectiveness of past treatment;
(c) Current treatment, rehabilitation, and support needs to achieve individual goals and support recovery; and,
(d) The range of individual strengths (e.g., knowledge gained from dealing with adversity, personal or professional roles, talents, personal traits) that may act as resources to the individual and the recovery planning team in pursuing goals. The results of the information gathering and analysis are used to:
(A) Establish immediate and longer-term service needs with each individual;
(B) Set goals and develop the first person directed recovery plan with each individual; and,
(C) Optimize benefits that can be derived from existing strengths and resources of the individual and family and natural support network in the community.
(7) “Co-Occurring Disorders (COD) Services” means integrated assessment and treatment for individuals who have co-occurring mental health and substance use condition.
(8) “Division” means the Health Systems Division of the Oregon Health Authority, or its designee.
(9) “Division Approved Reviewer” means the Division’s contracted entity that is responsible for conducting ACT fidelity reviews, training, and technical assistance to support new and existing ACT programs statewide.
(10) “Face to Face” is defined as a personal interaction where both words can be heard and facial expressions can be seen in person or through telehealth services where there is a live streaming audio and video.
(11) “Fidelity” for the purposes of the ACT program means the provider is providing services that are faithful to the evidence-based practice model and obtains a satisfactory score from the Oregon Center of Excellence for ACT as part of the their regular reviews.
(12) “Fixed Point of Responsibility” means the ACT team provides virtually all needed services, rather than sending clients to different providers. If the team cannot provide a service, the team ensures that the service is provided.
(13) “Full-Time Equivalent” (FTE) means a way to measure how many full-time employees are required to provide the appropriate level of services to fulfill minimum fidelity requirements.
(14) “Hospital Discharge Planning” means a process that begins upon admission to the Oregon State Hospital (OSH) or an acute care psychiatric hospital and that is based on the presumption that with sufficient supports and services, all individuals can live in an integrated community setting. Discharge planning is developed and implemented through a person-centered planning process in which the individual has a primary role and is based on principles of self-determination. For OSH, discharge planning teams include a representative of a community mental health provider from the county where the individual is likely to transition.
(15) “Individual Placement and Support (IPS) Supported Employment Services” means individualized services that assist individuals to obtain and maintain integrated, paid, competitive employment. Supported employment services are provided in a manner that allows individuals to work the maximum number of hours consistent with their preferences, interests, and abilities and are individually planned, based on person-centered planning principles and evidence-based practices.
(16) “Individual Treatment Team (ITT)” means a group or combination of three to five ACT team staff members who together have a range of clinical and rehabilitation skills and expertise. The core members are the case manager, the psychiatrist or psychiatric nurse practitioner, one clinical or rehabilitation staff individual who backs up and shares case coordination tasks and substitutes for the service coordinator when they are not working, and a peer support and wellness specialist.
(17) “Initial Assessment and Individualized Treatment Plan” means the initial evaluation of:
(a) The individual’s mental and functional status;
(b) The effectiveness of past treatment; and
(c) The current treatment, rehabilitation, and support service needs. The results of the information gathering and analysis are used to establish the initial treatment plan to support recovery and help the individual achieve their goals.
(18) “Large ACT Team” means an ACT team serving 80 to 120 individuals.
(19) “Life Skills Training” means training that helps individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning, and social environments of their choice.
(20) “Medication Management” means the prescribing and administering and reviewing of medications and their side effects, including both pharmacological management as well as supports and training to the individual. For the purposes of ACT, medication management is a collaborative effort between the individual receiving services and the prescribing psychiatrist or psychiatric nurse practitioner with the ACT treatment team.
(21) “Mid-Size Act Team” means an ACT team serving between 41 and 79 individuals.
(22) “Natural Supports” means personal associations and relationships typically developed in the community that enhance the quality and security of life for individuals, including but not limited to family relationships, friendships reflecting the diversity of the neighborhood and the community, association with fellow students or employees in regular classrooms and work places, and associations developed though participation in clubs, organizations, and other civic activities.
(23) “Psychiatry Services” means the prescribing and administering and reviewing of medications and their side effects, including both pharmacological management as well as supports and training to the individual. Psychiatry services shall be provided by a psychiatrist or a psychiatric nurse practitioner licensed by the Oregon Medical Board.
(24) “Serious and Persistent Mental Illness (SPMI)” means the current DSM diagnostic criteria for at least one of the following conditions, as a primary diagnosis for an adult 18 years of age or older:
(a) Schizophrenia and other psychotic disorders;
(b) Major depressive disorder;
(c) Bipolar disorder;
(d) Anxiety disorders limited to Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD);
(e) Schizotypal personality disorder; or
(f) Borderline personality disorder.
(25) “Single Point of Contact (SPOC)” means the entity designated by OHA that coordinates and tracks referrals, and coordinates the provision of services and supports in collaboration with the provider, the CCO, and the CMHP.
(26) “Small ACT Team” means an ACT team serving between ten to 40 individuals.
(27) “Symptom Management” means to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment.
(28) “Telepsychiatry” means the application of telemedicine to the specialty field of psychiatry. The term describes the delivery of psychiatric assessment and care through telecommunications technology, usually videoconferencing.
(29) “Time-unlimited Services” means services that are provided not on the basis of predetermined timelines but if they are medically appropriate.
(30) “Vocational Services” means employment support services that leads to competitive integrated employment. The Division encourages the use of fidelity IPS Supported Employment for providing vocational services within the ACT program.

Source: Rule 309-019-0225 — Assertive Community Treatment (ACT) Definitions, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=309-019-0225.

309–019–0100
Purpose and Scope 309–019–0105
Definitions 309–019–0110
Provider Policies 309–019–0115
Individual Rights 309–019–0125
Specific Staff Qualifications and Competencies 309–019–0130
Personnel Documentation, Training, and Supervision 309–019–0135
Entry and Assessment 309–019–0140
Service Plan and Service Notes 309–019–0145
Co-Occurring Mental Health and Substance Use Disorders (COD) 309–019–0150
Community Mental Health Programs (CMHP) 309–019–0155
Enhanced Care Services (ECS) and Enhanced Care Outreach Services (ECOS) 309–019–0160
Psychiatric Security Review Board and Juvenile Psychiatric Security Review Board 309–019–0165
Intensive Outpatient Services and Supports (IOSS) for Children 309–019–0167
Intensive In-Home Behavioral Health Treatment (IIBHT) for Children 309–019–0170
Outpatient Problem Gambling Treatment and Recovery Services 309–019–0175
Culturally Specific Substance Use Disorders Treatment and Recovery Services 309–019–0185
Outpatient Substance Use Disorders Treatment and Recovery Programs 309–019–0190
Community-Based Substance Use Treatment Programs for Individuals in the Criminal Justice System 309–019–0195
DUII Services Providers 309–019–0200
Medical Protocols in Outpatient Substance Use Disorders Treatment and Recovery Programs 309–019–0205
Building Requirements in Behavioral Health Programs 309–019–0210
Quality Assessment and Performance Improvement 309–019–0215
Grievances and Appeals 309–019–0220
Variances 309–019–0225
Assertive Community Treatment (ACT) Definitions 309–019–0226
Assertive Community Treatment (ACT) Overview 309–019–0230
ACT Provider Qualifications 309–019–0235
ACT Continued Fidelity Requirements 309–019–0240
ACT Failure to Meet Fidelity Standards 309–019–0241
Waiver of Minimum Fidelity Requirements 309–019–0242
ACT Program Operational Standards 309–019–0245
ACT Admission Criteria 309–019–0248
ACT Admission Process 309–019–0250
ACT Transition to Less Intensive Services and Discharge 309–019–0255
ACT Reporting Requirements 309–019–0270
Definitions 309–019–0275
Individual Placement and Support (IPS) Supported Employment Overview 309–019–0280
Supported Employment Providers 309–019–0285
Continued Fidelity Requirements 309–019–0290
Failure to Meet Fidelity Standards 309–019–0295
Reporting Requirements 309–019–0300
Service Requirements 309–019–0305
Provider Standards 309–019–0310
Minimum Staffing Requirements 309–019–0315
Training Requirements 309–019–0320
Documentation Requirements 309–019–0324
Youth Wraparound Definitions 309–019–0326
Youth Wraparound Program Rules
Last Updated

Jun. 8, 2021

Rule 309-019-0225’s source at or​.us