Assertive Community Treatmentc. Only ACT consumers are permitted to attend these group services.d. Acceptable group practitioners are those on the ACT team who meet the practitioner levels as follows:• Practitioner Level 1: Physician/Psychiatrist• Practitioner Level 2: Psychologist, CNS-PMH• Practitioner Level 3: LCSW, LPC, LMFT, RN• Practitioner Level 4: LMSW; LAPC; LAMFT; Psychologist/LCSW/LPC/LMFT’s supervisee/trainee with at least a Bachelor’s degree in one <strong>of</strong> the helpingpr<strong>of</strong>essions such as social work, community counseling, counseling, psychology, or criminology, functioning within the scope <strong>of</strong> the practice acts <strong>of</strong> thestate; MAC, CAC-II, CADC, CCADC, GCADC (II, III); CAC-I or Addiction Counselor Trainees with at least a Bachelor’s degree in one <strong>of</strong> the helpingpr<strong>of</strong>essions such as social work, community counseling, counseling, psychology, or criminology (may only perform these functions related to treatment <strong>of</strong>addictive diseases).• Practitioner Level 5: CAC-I, RADT (I, II, or III), Addiction Counselor Trainees with high school diploma/equivalent (practitioners at this level may onlyperform these functions related to treatment <strong>of</strong> addictive diseases).e. ACT groups must be led by more than one practitioner.i. If there are 2 practitioners leading the group who are the same practitioner level (i.e. two U3 practitioners), then each may split the responsibility fordocumentation <strong>and</strong> singly sign a note. In this situation, there must be evidence in the note <strong>of</strong> who was the co-leader <strong>of</strong> that group to document theStaffingRequirementsii.compliance expectations for two practitioners.If a group is facilitated by two practitioners who are not the same U-level (i.e. one is a U3 <strong>and</strong> one is a U4), then these co-leaders may split the responsibilityfor documenting group progress notes. If the lower-leveled practitioner writes the progress note, the upper level person's practitioner level can be billed ifthe higher practitioner-leveled person co-signs the note. If the higher level practitioner writes the note, then he/she shall document the co-leadersparticipation <strong>and</strong> can solely sign that note.1. Assertive Community Treatment Team members must include:• (1 FT Employee required) A fulltime Team Leader who is the clinical <strong>and</strong> administrative supervisor <strong>of</strong> the team <strong>and</strong> also functions as a practicing clinician on theteam; this individual must have at least 2 years <strong>of</strong> documented experience working with adults with a SPMI <strong>and</strong> one <strong>of</strong> the following qualifications to be an“independently licensed practitioner.” It is expected that the practicing ACT Team Leader provides direct services at least 50% <strong>of</strong> the time. The Team Leadermust be a FT employee <strong>and</strong> dedicated to only the ACT team.• Physician• Psychologist• Physician’s Assistant• APRN• RN with a 4-year BSN• LCSW• LPC• LMFT• (Variable:.4-1.0 FTE required) Depending on consumer enrollment, a full or part time Psychiatrist who:• provides clinical <strong>and</strong> crisis services to all team consumers with emphasis in delivering services in the recipient’s natural environment,• works with the team leader to monitor each individual’s clinical <strong>and</strong> medical status <strong>and</strong> response to treatment, <strong>and</strong>FY2013 Provider Manual for Community <strong>Behavioral</strong> <strong>Health</strong> Providers Page 98
Assertive Community Treatment• directs psychopharmacologic <strong>and</strong> medical treatment (at a minimum, must provide monthly medication management for each consumer),• must provide a minimum <strong>of</strong> 16 hours per week <strong>of</strong> direct support to the ACT team/ACT consumers• the psychiatrist must participate in at least one time/week in the ACT team meetingsThe psychiatrist to ACT consumer ratio must not be greater than 1:100. Specifically:• With 1-50 consumers, the requirement for the agency is to have a Psychiatrist at least 16 hours per week providing support to the team consumers;• With 51-75 consumers, the ACT agency must have .75 FTE psychiatrist providing support to the team <strong>and</strong>;• With 76-100 consumers, the ACT agency must have 1 FTE psychiatrist providing support to the team.• (1-2 Fulltime Employee/s) RN/s who provide nursing services for all consumers, including health <strong>and</strong> psychiatric assessments, education on adherence totreatment, prevention <strong>of</strong> medical issues, rehabilitation, nutritional practices <strong>and</strong> works with the team to monitor each individual’s overall physical health <strong>and</strong>wellness, clinical status <strong>and</strong> response to treatment• With 1-50 consumers, one Registered Nurse;• With 51-75 consumers, a second RN is expected to work .75 FTE• With 76-100 consumers, the second RN is expected to work 1 FTE.• (1/2 FTE minimum) A 1/2 to fulltime equivalent substance abuse practitioner who holds a CACI (or an equally recognized SA certification equivalent or higher)<strong>and</strong> assesses the need for <strong>and</strong> provides <strong>and</strong>/or accesses substance abuse treatment <strong>and</strong> supports for team consumers. If any single team serves 50 or moreindividuals with a co-occurring SA issue, then there must be 1 FTE on the team.• (1 FT employee) A full-time practitioner licensed to provide psychotherapy/counseling under the practice acts or a person with an associate license who issupervised by a fully licensed clinician, <strong>and</strong> provides individual <strong>and</strong> group support to team consumers (this position is in addition to the Team Leader).• (1 FTE) One FTE Certified Peer Specialist who is fully integrated into the team <strong>and</strong> promotes consumer self-determination <strong>and</strong> decision-making <strong>and</strong> providesessential expertise <strong>and</strong> consultation to the entire team to promote a culture in which each client’s point <strong>of</strong> view <strong>and</strong> preferences are recognized, understood,respected <strong>and</strong> integrated into treatment, rehabilitation <strong>and</strong> community self-help activities.• (2 FTEs) Two parapr<strong>of</strong>essional mental health workers who provide rehabilitation <strong>and</strong> support services under the supervision <strong>of</strong> a Licensed Clinician. The sum <strong>of</strong>the FTE counts for the following two bullets must equal 2 FTEs.• (1/2 to 1 FTE) One <strong>of</strong> these staff must be a Vocational Rehabilitation Specialist. A VRS is a person with a minimum <strong>of</strong> one year verifiable vocationalrehabilitation experience. This person may be a ½ FTE if the team serves less than 50 individuals.• (1 to 1 ½) FTE Other Parapr<strong>of</strong>essional2. It is critical that ACT team members build a sound relationship with <strong>and</strong> fully engage in supporting the served individuals. To that end, no more than 1/3 <strong>of</strong> the teamcan be “contracted”/1099 team members.3. The ACT team maintains a small consumer-to-clinician ratio, <strong>of</strong> no more than 10 consumers per staff member. This does not include the psychiatrist, programassistant/s, transportation staff, or administrative personnel. Staff-to-consumer ratio takes into consideration evening <strong>and</strong> weekend hours, needs <strong>of</strong> specialpopulations, <strong>and</strong> geographical areas to be served.4. Documentation must demonstrate that all team members are engaged in the support <strong>of</strong> each consumer served by the team including the “time-in” <strong>and</strong> “time-out” foreach staff intervention (excluding the substance abuse practitioner, if substance related issues have been ruled out).5. At least one ACT RN must be dedicated to a single ACT team. “Dedicated” means that the RN works with only one team at least 32 hours/week (up to 40hours/week) <strong>and</strong> is a full-time employee <strong>of</strong> the agency (not a subcontractor/1099 employee). The Team RN must be dedicated to a single ACT team. “Dedicated”means that the team leader works with only one team at least 32 hours/week (up to 40 hours/week) <strong>and</strong> is a full-time employee <strong>of</strong> the agency (not aFY2013 Provider Manual for Community <strong>Behavioral</strong> <strong>Health</strong> Providers Page 99
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Georgia Department of Behavioral He
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UPDATED FOR JULY 1, 2013SUMMARY OF
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C&A Core ServicesBehavioral Health
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Community Supportsupports;9) Assist
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Community SupportServiceAccessibili
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Community Transition Planningv. App
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Diagnostic AssessmentTransactionCod
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Family Outpatient Services: Family
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Family Outpatient Services: Family
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Family Outpatient Services: Family
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Group Outpatient Services: Group Co
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Group Outpatient Services: Group Tr
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Individual CounselingServiceDefinit
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Medication AdministrationAdmissionC
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Nursing Assessment and Health Servi
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Continuing StayCriteriaDischargeCri
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Psychiatric TreatmentAdditionalMedi
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Service Plan DevelopmentPractitione
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CHILD & ADOLESCENT SPECIALTY SERVIC
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Behavioral AssistanceAssistance.Ser
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Crisis Stabilization Unit (CSU) Ser
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Crisis Stabilization Unit (CSU) Ser
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Intensive Family Intervention5. Bec
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c. Is not permitted in developmenta
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2. Policies, procedures, and guidel
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3. Safe transport of persons served
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iv. There are safeguards utilized f
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i. The date and time the medication
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Training Requirements for all Staff
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Qualified MedicationAide (QMA)Psych
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Addiction CounselorTrainees (ACT)Hi
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CADC, CCADC, CAC II or MAC and is r
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practitioner), s/he could bill as a
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COMMUNITY SERVICE STANDARDS FOR ALL
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4. ORDER/RECOMMENDATION FOR COURSE
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ii. Services, supports, and treatme
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xv.xvi.xvii.Recorded changes - Any