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Bulletin ID: No. 87 - ACT Work Flow

Monday, August 26, 2013

This Bulletin sets forth the steps for obtaining initial authorization and re-authorization of ACT services, as well as discharge, transition and transfer to another agency.
I. Initial Request:
Request for Initial ACT Authorization Request *All New requests for ACT Services:
 Complete Initial ACT request in Provider Connect
 Include a clinical note that provides a summary of consumer’s current conditions which includes AXISI-V diagnosis and atrategies need to support community tenure.
 For agencies that do not have access to Provider Connect existing consumers, please fax hard copies of:
a) Current assessment of the consumer’s clinical needs
c) IRP
Copies should be faxed to the attn: of ACT Coordinator at: (202) 671-2972
Please note the initial ACT request should not be completed for those consumers that have had previous ACT services:
 All initial requests for ACT Services are to be reviewed by the DMH ACT Coordinator
II. Reauthorization/Continued Stay Request:
Request for Reauthorization/Continued Stay ACT Services:
 Submitted to the Corse Service Agency (CSA) for entry
Complete ongoing ACT request in Provider Connect with clinical summary of consumer’s present need
 Consumer’s need of supplemental ACT units-direct to ACT Coordinator
 For existing authorizations, the next request will require submission of the ACT Service line only(Basically clinical reviews will occur every 6(six) months)
*For those consumers with a reauthorization start date of October 1, 2006, the Continued Stay ACT Event should be completed
III. Transition/Discharge Request:
 Follow protocol in that the ACT Team and CSA collaborate on the request
 All requests should be entered electronically
 All transition/discharge requests are to be reviewed by the DMH ACT Coordinator for disposition and tracking
IV. Transfers to Agencies for ACT Services:
All transfer requests must be directed to the attention of the ACT Coordinator prior to making an electronic submission.
V. Choice of Providers:
Please note that DMH will try to honor all rendering Provider selections. However, Rendering Provider choices are subject to availability/specific eligibility criteria of specialized ACT Teams
VI. Appeal
Clinical requests pertaining to ACT should be forwarded to the ACT Coordinator who will consult with the DMH Medical Director.

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