1. (1) Planned transitions to less intensive services shall occur if the individual has confirmed they no longer require or want ACT level of care and requests a voluntarily discharge.

2. (2) The ACT Program may transition a participant to lower level of care and graduate when the participant has:

   1. (a) Successfully maintained a baseline for the identified self-directed goals within the Strength-based treatment plan in a way that supports improvement of their level of functioning capabilities and enhanced self-awareness that reflect ACT services are no longer needed;
   2. (b) Successfully demonstrated an ability to function in all major role areas including but not limited to work, social, and self-care without ongoing intervention assistance from the ACT Program;
   3. (c) Moves outside of the geographic area of the ACT program’s responsibility. In such cases, the ACT team shall arrange for transfer of mental health service responsibility to an ACT provider or another provider wherever the individual is moving. The ACT team shall maintain contact with the individual until this service is implemented.
3. (3) If the Individual is incarcerated or institutionalized for more than two months with a date of discharge and/or release longer than three months out, the ACT Team may discharge & close services as this time duration would warrant a closure of Medicaid medical benefits.

4. (4) The ACT Program may discharge and close ACT services if a Participant displays behavior that is abusive to the extent that any continuation efforts would no longer be trauma informed care & impaired to the extent of no longer being effective. This includes but not limited to:

   1. (a) The Participant commits or attempts to inflict physical violence & harm directed at ACT staff;
   2. (b) The Participant conducts themselves in a way of verbal threats of harm towards ACT staff that could be realistically carried out at any sporadic moment eliminating ACT staff to properly safeguard themselves or bystanders if the threat escalated from verbal to physical action.
   3. (c) If an ACT Program discharges a participant for based on this rule, they must provide a copy of the discharge notice per 309-019-0250(4) to The Division Designee, legal guardian and appropriate CCO.

5. (5) Discharge and closure of services can occur if there have been several unsuccessful documented attempts to contact the participant by the ACT program that last up to 90 days. This discharge reason is referred to as whereabouts unknown and must include the following;

   1. (a) All attempts must be documented by the ACT Team in good faith, and various different methods of those attempts that could include:

      1. (A) Seeking out the individual in-person with identified locations of search,
      2. (B) Mail to last known address,
      3. (C) Phone calls to participant or relevant Natural and Informal Supports in attempt to locate any new information.
   2. (b) If an individual is discharged for whereabouts unknown and they make contact after the discharge date, the program has discretion on readmittance or re-referral.

6. (6) Documentation for discharge including transition to lower levels of care even for graduation purposes shall follow OAR 410-120-1865 and include at minimum the following:

   1. (a) The reasons for discharge citing administrative rule or highlighting accomplishments that warranted graduation;
   2. (b) The individual’s biopsychosocial status at discharge, transition or last known (if whereabouts unknown applies).
   3. (c) The identified new provider if known and effective date.

   4. (d) The ACT program, in good faith, must provide a copy of discharge or transition to lower level of care to the participant:

      1. (A) Mailed or electronic copy as long as HIPAA approved/permission given to communicate electronically.
      2. (B) Mailed or faxed to facility of known incarceration/institutionalization.

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

History

BHS 29-2025, amend filed 12/29/2025, effective 01/01/2026
BHS 17-2025, amend filed 06/25/2025, effective 06/29/2025
BHS 44-2023, amend filed 12/22/2023, effective 01/01/2024
MHS 4-2018, amend filed 02/27/2018, effective 03/01/2018
MHS 10-2017(Temp), f. 9-15-17, cert. ef. 9-15-17 thru 3-13-18
MHS 6-2017, f. & cert. ef. 6-23-17
MHS 1-2017(Temp), f. 1-17-17, cert. ef. 1-18-17 thru 7-16-17
MHS 18-2016, f. 11-28-16, cert. ef. 11-30-16
MHS 11-2016(Temp), f. 6-29-16, cert. ef. 7-1-16 thru 12-27-16