Marion County's ACT team serves individuals who are (1) adults 18 years of age or older, (2) Marion County residents, and (3) have the Oregon Health Plan (OHP) and are enrolled with PacificSource CCO. We have a limited number of slots for individuals who have Medicare only or no insurance.
1. Individuals diagnosed with serious and persistent mental illness (SPMI) per OAR 309-019-022
a) SPMI diagnoses include Schizophrenia and other psychotic disorders; Major Depressive Disorder; Bipolar Disorder; anxiety disorders, limited to Obsessive Compulsive Disorder (OCD) and Posttraumatic Stress Disorder (PTSD); and Schizotypal Personality Disorder.
b) Individuals with a primary diagnosis of a substance abuse disorder, intellectual developmental disabilities, traumatic brain injury, personality disorder, or 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.
2. Individuals 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, and 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).
3. Individuals with one or more of the following problems, which are indicators of continuous high service
needs (i.e., greater than 8 hours per month):
a) High use of acute psychiatric hospitals or emergency departments for psychiatric reasons, including psychiatric emergency services as defined in OAR 309-023-0110(18) (e.g., 2 or more readmissions in a 6-month period).
b) Intractable (e.g., persistent or very recurrent) severe major symptoms (e.g., affective, psychotic, suicidal).
c) Coexisting substance abuse disorder of significant duration (e.g., greater than 6 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.
Referrals to ACT are accepted from the Oregon State Hospital, local acute psychiatric hospital, mental outpatient programs, residential treatment facilities or homes, families or individuals, and other community sources.
1. Ensure individual with being referred to ACT. Obtain a Release of Information (ROI) from individual being referred.
2. Call Marion County's Centralized Intake line at 503-576-4676, to obtain the universal ACT referral form.
3. Completely answer all the questions on the ACT referral form (please do not say "refer to records"). Include the approximate date the individual will be able to enroll in an ACT program.
4. Gather the following supporting medical documentation that supports an individual meets ACT criteria to include with the referral form and signed ROI:
- Mental health assessment conducted in the last year
- Treatment plan
- Psychiatric prescriber assessment and notes
- Last 90 days of progress/service notes
- List of dates and reasons for inpatient psychiatric hospitalization in the last 12 months
- List of dates and reasons for psychiatric emergency room visits in the last 12 months
- Incident reports regarding any aggressive or violent behaviors
- If referral is being made by OSH or an acute psychiatric hospital, please include admission, psychiatric, and psychosocial assessments as well as hospital notes.
5. Email the referral form, signed ROI, and records to: CentralizedIntake@co.marion.or.us
6. Please note that a complete referral form and the above-listed records are required in order to make a determination for ACT services. If the necessary information and documents are not received, the referral will be closed without the individual being screened for ACT. The referring party may submit a new ACT referral with the required records to restart the referral/screening process.
Health & Human Services Behavioral Health
