Section 22-A3423. ASSERTIVE COMMUNITY TREATMENT

 

3423.1ACT is an intensive, integrated, rehabilitative, crisis, treatment, and mental health rehabilitative community support service provided by an interdisciplinary team to children and youth with serious emotional disturbance and to adults with serious and persistent mental illness with dedicated staff time and specific staff to consumer ratios.

 

3423.2Service coverage by the ACT team is required twenty-four (24) hours per day, seven (7) days per week.

 

3423.3The consumer’s ACT team shall complete a comprehensive or supplemental assessment and develop a self-care-oriented IRP (if a current and effective one does not already exist). 

 

3423.4Services offered by the ACT team shall include:

 

(a)Mental health-related medication prescription, administration, and monitoring;

 

(b)Crisis assessment and intervention;

 

(c)Symptom assessment, management, and individual supportive therapy;

 

(d)Substance abuse treatment for consumers with a co-occurring addictive disorder;

 

(e)Psychosocial rehabilitation and skill development;

 

(f)Interpersonal, social, and interpersonal skill training; and

 

(g)Education, support, and consultation to consumers' families and their support system which is directed exclusively to the well-being and benefit of the consumer.

 

3423.5ACT services shall include a comprehensive and integrated set of medical and psychosocial services for the treatment of the consumer's mental health condition that is provided in non-office settings by the consumer's ACT team.

 

3423.6The ACT team provides community support services that are interwoven with treatment and rehabilitative services and regularly scheduled team meetings. ACT team meetings shall be held a minimum of three (3) times a week.

 

3423.7ACT services and interventions shall be highly individualized and tailored to the needs and preferences of the consumer, with the goal of maximizing independence and supporting recovery.

 

3423.8 Each ACT provider shall have policies and procedures included in its Service Specific Policies that address the provisions of ACT (ACT Organizational Plan) which include the following:

(a)A description of the particular treatment models utilized, types of intervention practice, and typical daily curriculum and schedule; and

(b) A description of the staffing pattern and how staff are deployed to ensure that the required staff-to-consumer ratios are maintained, including how unplanned staff absences and illnesses are accommodated.

 

3423.9At a minimum, the ACT team shall include the following members:

 

(a)A full-time team leader or supervisor who is the clinical and administrative supervisor of the ACT team and who is a qualified practitioner;

 

(b)A psychiatrist working on a full-time or part-time basis for a minimum of four (4) hours per week per twenty (20) consumers that provides clinical and crisis services to all consumers served by the ACT team, works with the ACT team leader to monitor each consumer's clinical status and response to treatment, and directs psychopharmacologic and medical treatment;

 

(c)A registered nurse working on a full-time basis and providing nursing services for all ACT team consumers who works with the ACT team to monitor each consumer's clinical status and response to treatment and functions as a primary practitioner on the ACT team for a caseload of consumers;

 

(d)An addiction counselor working on a full-time basis and providing or accessing substance abuse services for ACT team consumers who functions as a primary practitioner on the ACT team for a caseload of consumers;

 

(e)A clinically trained generalist practitioner working on a full-time basis and providing individual and group supportive therapy to ACT team consumers who functions as a primary practitioner on the ACT team for a caseload of consumers and is a qualified practitioner; and

 

(f)Recovery specialists carrying out rehabilitation and support functions who may be consumers in recovery that have been specially credentialed based on their psychiatric and life experiences. Recovery specialists are fully integrated ACT team members who provide consultation to the ACT team, highly individualized services in the community, and who promote consumer self-determination and decision making.

 

3423.10The ACT team shall maintain a minimum consumer-to-staff ratio of no more than twelve (12) consumers per staff person, and such ratio shall take into consideration evening and weekend hours, needs of special populations, and geographical areas to be covered.

 

3423.11Pre-authorization from DMH is required prior to enrollment for ACT.

 

3423.12ACT shall not be billed on the same day as any other MHRS except for Crisis/Emergency.

 

3423.13ACT shall be provided in:

 

(a)The MHRS provider's service site; or

 

(b)The consumer's home or other community setting.

 

3423.14Qualified practitioners of ACT are:

 

(a)Psychiatrists;

 

(b)Advance Practice Registered Nurses;

 

(c)RNs; and

 

(d)Addiction counselors.

 

3423.15Credentialed staff shall be authorized to provide ACT under the supervision of a qualified practitioner as set forth in § 3413.3.

 

authority

Sections 104 and 105 of the Department of Mental Health Establishment Amendment Act of 2001, effective December 18, 2001 (D.C. Law 14-56; D.C. Official Code §§ 7-1131.04 and 7-1131.05 (2008 Repl.)).

source

Final Rulemaking published at 48 DCR 10297 (November 9, 2001); as amended by Final Rulemaking published at 51 DCR 9308 (October 1, 2004); as amended by Final Rulemaking published at 52 DCR 5682 (June 17, 2005); as amended by Emergency and Proposed Rulemaking published at 58 DCR 1482 (February 18, 2011)[EXPIRED]; as amended by Final Rulemaking published at 58 DCR 3476 (April 22, 2011).