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ACT EXIT Criteria Screening Tool
Discharge from the ACT team should occur when:
☐ No psychiatric hospitalizations in over a year
No crisis services utilized within the last year resulting in an overn
ight stay at a crisis unit
Attending to medical ne
eds identified by medical providers and following treatment
recommendations
No involvement in the criminal justice system in the past 2 years to include incarceration,
probation, or parole (exception should be made for lifetime probation if other criteria is met)
Received minimal contact from the Assertive Team and has maintained stability in the
community with the decreased services
Are rated by the team as functioning independently in all major role areas
Employment: has been assessed by the team and determined to have successfully reached their
level of readiness
Social: has been assessed by the team and determined to have successfully reached their level
of readiness
Housing: is residing in permanent, stable housing
Self-Care: can meet their self-care needs, does not require interventions from providers to
meet needs
Understands medications that are being prescribed, can identify them, and takes them without
prompting
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Appropriate for transition? YES NO
If yes what is the plan for transition? What services will be in place during transition? What is
the date of transfer? Staffing note completed to show all team members are in agreement
with transition? Is the treatment plan updated to reflect decrease in services? Please explain:
QB 3236
