Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 35 - REHABILITATIVE PSYCHIATRIC SERVICES › Section 471-35-013 - Assertive Community Treatment

Current through June 17, 2024
The Assertive Community Treatment (ACT) Team provides high intensity
	 services, available to provide treatment, rehabilitation, and support
	 activities seven days per week, twenty-four hours per day, 365 days per year.
	 The team has the capacity to provide multiple contacts each day as dictated by
	 client need. The team provides ongoing continuous care for an extended period
	 of time, and clients admitted to the service who demonstrate any continued need
	 for treatment, rehabilitation, or support will not be discharged except by
	 mutual agreement between the client and the team.
Assertive Community Treatment (ACT) is provided by a self-contained
	 clinical team which:
1. Assumes
  overall responsibility and clinical accountability for clients disabled by
  severe and persistent mental illness by directly providing treatment,
  rehabilitation and support services and by coordinating care with other
  providers;
2. Does not refer
  clients to outside service providers when services are identified as a
  responsibility of the ACT program. See 471 NAC
  35-013.04C
  Treatment, Rehabilitation, and Supportive Interventions;
3. Provides services on a long-term basis
  with continuity of care givers over time;
4. Delivers most of the services outside
  program offices;
5. Emphasizes
  outreach, relationship building, and individualization of services;
6. Provides psychiatric treatment and
  rehabilitation that is culturally sensitive and competent; and
7. Shares team roles expecting each staff
  member to know all the clients and assist in assessment, treatment planning,
  and care delivery as needed.
This model of integrated treatment, rehabilitation, and support
	 services is intended to help clients stabilize symptoms, improve level of
	 functioning, and enhance the sense of well being and empowerment. Services
	 provided will focus on treatment and rehabilitation of the effects of serious
	 mental illness, as well as support and assistance in meeting such basic human
	 needs as housing, transportation, education, and employment as necessary for
	 client satisfaction with services and increased quality of life. The goal of
	 the program is to provide assistance to individuals in maximizing their
	 recovery, to ensure client directed goal setting, to assist clients in gaining
	 hope and a sense of empowerment, and provide assistance in helping clients
	 become respected and valued members of their community.
013.01 Admission and Discharge Criteria
35-013.01A
Admission
  Criteria:
NMAP covers ACT services for those persons disabled by
  severe and persistent mental illness who are unable to remain stable in
  community living without high intensity services. ACT services must be prior
  authorized by the Division of Medicaid and Long-Term Care or its designee. To
  be eligible for ACT services clients must meet all of the criteria described in
  471 NAC 35-001.01, and demonstrate indicators of high need and
  utilization.
35-013.01B
Discharge Criteria
: The ACT Program is intended to
  provide services over a long period of time. Clients admitted to the service
  who demonstrate continued need for treatment, rehabilitation, or support must
  not be discharged except by mutual agreement between the client and the ACT
  Team.
Discharge from the ACT Team occurs when the client and program staff
	 mutually agree to termination of services. Specific documentation must be
	 included in the client's clinical chart when a discharge occurs. Discharge may
	 occur in the following situations:
1.
Geographic Relocation:
The client moves outside the
  team's geographic area of responsibility. In such cases, the ACT Team must
  arrange for transfer of mental health service responsibility to a provider
  wherever the client is moving. To meet this responsibility, the ACT team must
  maintain contact with the client until this service transfer is
  arranged.
2.
Significantly Improved Functioning
: The client
  demonstrates by functional assessment measurement the ability to function in
  all major role areas (i.e., work, social, self-care) with minimal
  assistance.
3.
Client
  Requested Discharge:
Requested discharge despite the team's best
  efforts to develop an Individual Treatment, Rehabilitation, and Recovery Plan
  acceptable to the client. Efforts to develop an acceptable Individual
  Treatment, Rehabilitation, and Recovery Plan must be documented in the client's
  clinical record.
4.
Hospitalization of the Client in an Institute for Mental Disease
  (IMD):
The NMAP is not able to reimburse for services provided to
  clients over age 20 and under age 64 who are being treated in an Institute for
  Mental Disease.