Assertive Community Treatment (ACT)

The services that ACT teams are required to provide include:

• Service coordination
• 24-hour crisis assessment and intervention
• Symptom assessment and management
• Medication prescription, administration, monitoring, and documentation
• Co-occurring substance use services
• Employment services
• Activities of daily living
• Social/interpersonal relationship and leisure-time skill training
• Peer support services
• Support services
• Education, support, and consultation to families

In alignment with CBH and the PA DHS Office of Mental Health and Substance Abuse Services (OMHSAS), a CBH Member must:

1. Receive a primary diagnosis of schizophrenia or other psychotic disorders such as schizoaffective disorder, as defined in the DSM-5 or any subsequent revisions thereof (Members with a primary diagnosis of substance use disorder (SUD), intellectual disability, or brain injury are not the intended consumer group.);
2. Be 18 years of age or older;
3. Have at least two or more acute episodes of psychiatric inpatient treatment within the past 12 months or 30 days or more on an acute psychiatric unit or state hospital during the last 12 months, or three or more contacts with crisis intervention/emergency services within the past six months;
4. Exhibit significant difficulty meeting basic survival needs, residing in substandard housing, homelessness, or imminent risk of becoming homeless;
5. Not have a primary diagnosis of a personality disorder, traumatic brain injury, SUD, or intellectual disability;
6. Have difficulty effectively utilizing traditional community-based services (i.e., outpatient, case management, etc.); AND
7. Have a history of inadequate follow-through with elements of a treatment/service plan that resulted in member psychiatric or medical instability.

OR

Alternate admission: Members not meeting all criteria may be designated appropriate for ACT by a multidisciplinary team, including CBH Clinical Management consultation, a CBH physician advisor, or a targeted case management (TCM) unit with DBHIDS.

For Provider Organizations in the CBH Provider Network:

CBH-contracted provider staff should use the CBH ACT Referral Form, also available on the CBH Provider Manual page under the Authorization tab, and submit it via the CBH Provider Portal.

Approved referrals will then be appropriately delegated to ACT providers based on capacity and member needs. CBH will review referrals within two business days. Providers will be notified of the referral outcome via the portal, and this process will follow the Authorizations section of the CBH Provider Manual.

Please note: Referrals submitted by CBH Providers outside of the Provider Portal will not be accepted.

For Out-of-Network Providers

Staff of organizations that do not have an active contract with CBH should use the CBH ACT Referral Form and submit it via the secure Non-CBH Provider ACT Referral Smartsheet.

Referral Forms

All referral forms need to be completed in full and include:

• A Comprehensive Biopsychosocial Evaluation (CBE) that has been completed within the last 60 days
• Referral source information, including:
  • Referring Organization’s Name
  • Referral Contact Name
  • Referral Contact Number
  • Referral Contact Email

• CBH Provider Manual
• CBH Clinical Performance Standards: Assertive Community Treatment (ACT)
  located under the “Clinical Performance Standards” tab
• CBH Provider Bulletin 26-13: Assertive Community Treatment (ACT) Referrals
• CBH Provider Bulletin 26-03: Assertive Community Treatment (ACT) Referrals
• OMHSAS Bulletin 08-03
  all located under the “Bulletins and Licensing Standards” heading, including:
  • Appendix A (Definitions)
  • Appendix B (Standards and Guidelines)
• Tool for Measurement of ACT (TMACT)