Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1370 - Treatment team and staffing plan

Current through Register Vol. 40, No. 24, July 15, 2024
A. ACT services
					 are delivered by interdisciplinary teams.
1.
					 ACT teams shall have sufficient staffing composition to meet the varying needs
					 of individuals served by the team as required by this section. Each ACT team
					 shall meet the following minimum position and staffing requirements:
a. Team leader. There shall be one full-time
					 LMHP with three years of work experience in the provision of mental health
					 services to adults with serious mental illness; a resident who is under the
					 supervision of a licensed professional counselor in accordance with
					 18VAC115-20-10 and who is
					 registered with the Virginia Board of Counseling with three years of experience
					 in the provision of mental health services to adults with serious mental
					 illness; a resident in psychology who is under supervision of a licensed
					 clinical psychologist and is registered with the Virginia Board of Psychology
					 in accordance with
					 18VAC125-20-10 and who has three
					 years of experience in the provision of mental health services to adults with
					 serious mental illness; a supervisee, in social work who is under the
					 supervision of a licensed clinical social worker and who is registered with the
					 Virginia Board of Social Work in accordance with
					 18VAC140-20-10 and who has three
					 years of experience in the provision of mental health services to adults with
					 serious mental illness; or one full-time registered QMHP-A with at least three
					 years of experience in the provision of mental health services to adults with
					 serious mental illness who was employed by the provider as a team leader prior
					 to July 1, 2020. The team leader shall oversee all aspects of team operations
					 and shall provide direct services to individuals in the community.
b. Nurses. ACT nurses shall be full-time
					 employees or contractors with the following minimum qualifications: a
					 registered nurse shall have one year of experience in the provision of mental
					 health services to adults with serious mental illness, or a licensed practical
					 nurse shall have three years of experience in the provision of mental health
					 services to adults with serious mental illness.
(1) Small ACT teams shall have at least one
					 full-time nurse, who shall be either an RN or an LPN;
(2) Medium ACT teams shall have at least one
					 full-time RN and at least one additional full-time nurse who shall be an LPN or
					 RN; and
(3) Large ACT teams shall
					 have at least one full-time RN and at least two additional full-time nurses who
					 shall be LPNs or RNs.
c.
					 Vocational specialist. There shall be one or more full-time vocational
					 specialist, who shall be a registered QMHP with demonstrated expertise in
					 vocational services through experience or education.
d. Co-occurring disorder specialist. There
					 shall be one or more full-time co-occurring disorder specialists, who shall be
					 a LMHP; a resident who is under the supervision of a licensed professional
					 counselor in accordance with
					 18VAC115-20-10 and who is
					 registered with the Virginia Board of Counseling; a resident in psychology who
					 is under supervision of a licensed clinical psychologist and is registered with
					 the Virginia Board of Psychology in accordance with
					 18VAC125-20-10; a supervisee in
					 social work who is under the supervision of a licensed clinical social worker
					 and who is registered with the Virginia Board of Social Work in accordance with
					 18VAC140-20-10; registered QMHP;
					 or certified substance abuse specialist (CSAC) with training or experience
					 working with adults with co-occurring serious mental illness and substance use
					 disorder.
e. ACT peer specialists.
					 There shall be one full-time equivalent peer recovery specialists who is or has
					 been a recipient of mental health services for severe and persistent mental
					 illness. The peer specialist shall be certified as a peer recovery specialist
					 in accordance with 12VAC35-250, or shall become certified in the first year of
					 employment. The peer specialist shall be a fully integrated team member who
					 provides peer support directly to individuals and provides leadership to other
					 team members in understanding and supporting each individual's recovery
					 goals.
f. Program assistant. There
					 shall be one full-time or two part-time program assistants with skills and
					 abilities in medical records management shall operate and coordinate the
					 management information system, maintain accounts and budget records for
					 individual and program expenditures, and perform administrative support
					 activities.
g. Psychiatric care
					 provider. There shall be one physician who is board certified in psychiatry or
					 who is board eligible in psychiatry and is licensed to practice medicine in
					 Virginia or a psychiatric nurse practitioner practicing within the scope of
					 practice as defined in
					 18VAC90-30-120. An equivalent
					 ratio of 16 hours of psychiatric time per 50 individuals served must be
					 maintained. The psychiatric care provider shall be a fully integrated team
					 member who attends team meetings and actively participates in developing and
					 implementing each individual ISP.
h. Generalist clinical staff. There shall be
					 additional clinical staff with the knowledge, skill, and ability required,
					 based on the population and age of individuals being served, to carry out
					 rehabilitation and support functions, at least 50% of whom shall be LMHPs,
					 QMHP-As, QMHP-Ts, or QPPMHs.
(1) Small ACT
					 teams shall have at least one generalist clinical staff;
(2) Medium ACT teams shall have at least two
					 generalist clinical staff; and
(3)
					 Large ACT teams shall have at least three generalist clinical staff.