Section He-M 426.16 - Assertive Community Treatment (ACT)(a) Assertive community treatment (ACT) services shall be: (1) Based on "The Assertive Community Treatment Implementation Resource Kit" (Evaluation Edition 2003) available as noted in Appendix A;(2) Provided with fidelity to the Dartmouth Assertive Community Treatment Scale (DACTS) found in "The Assertive Community Treatment Implementation Resource Kit" (Evaluation Edition 2003);(3) Customized to the individual's needs, and shall vary over time as the individual's needs change; and(4) Provided to allow the individual a reasonable opportunity to live independently in the community.(b) ACT teams shall be available: (1) To the individual 24 hours per day, 7 days per week.(2) From midnight to 8:00 a.m. services shall be provided on an on-call basis;(3) In the event of a crisis and consistent with safety concerns, to conduct a face to face meeting within 3 hours, to de-escalate the crisis.(c) Every individual eligible for services under He-M 401 shall be assessed for ACT services at the time of intake, at quarterly service reviews, upon request, and in the event of discharge from a facility, the Glencliff Home, or from emergency department admission.(d) The decision to provide ACT services shall be made on an individualized basis with careful consideration for the individual's clinical needs and shall utilize the following criteria: (1) The individual shall have a severe mental illness or a severe and persistent mental illness;(2) The individual shall have a primary diagnosis of psychotic or major mood disorder, with or without a co-occurring substance use disorder;(3) An individual diagnosed with a personality disorder shall not be excluded from ACT services solely due to diagnosis;(4) The individual shall be 18 years or older; and(5) The individual shall meet at least one of the following criteria: a. Has had lengthy or multiple uses of acute psychiatric hospitalization in past 12 months;b. Has used multiple emergency services or crisis services within the past 12 months due to symptoms of a mental illness;c. Has consistently demonstrated the inability to engage in and benefit from other community based mental health services as a result of symptoms of mental illness for the past 12 months;d. Had involvement with the legal system as a result of symptoms of mental illness that have resulted in arrest, incarceration, probation, or parole within the past 12 months;e. Is currently in-patient at a facility and could move to a less restrictive environment if the individual were to receive ACT services; orf. Is currently residing in a community residence as identified in He-M 1002 and could move to a less restrictive environment if the individual were to receive ACT services.(e) The decision to transfer individuals to a less intensive level of care shall be made on an individualized basis with careful consideration of the individual's clinical needs and shall utilize the following criteria: (1) The individual has maintained stable housing in the community for more than 12 months;(2) The individual has utilized an emergency room due to psychiatric symptoms no more than twice in the past 12 months;(3) The individual has consistently demonstrated the ability to engage in and benefit from community based mental health services;(4) The individual has not been arrested or incarcerated during the past 12 months due to psychiatric symptoms;(5) The individual has mutually agreed with ACT team members that he or she is ready to transition to a less intensive level of care; and(6) The individual has required no more than 2 ACT team contacts for the month in a 6 month period.(f) Once the individual has satisfied criteria in He-M 426.16(e) , the ACT team shall take steps below to commence transition planning. Once these steps have been accomplished, the individual shall be transitioned from ACT to lower intensity services: (1) The ACT team meets with the individual to identify and discuss individual transition planning goals and objectives;(2) The ACT team and the individual have identified and met with appropriate non-ACT service providers in order to coordinate continuity of care;(3) The individualized service plan is updated to reflect transition planning goals and identified service needs; and(4) The crisis plan has been updated and developed with the assistance of identified non-ACT service providers.(g) No ACT team shall terminate services provided to an individual because that individual has withdrawn consent or cannot be located unless the ACT team can document at least 3 months of persistent, caring attempts to engage that individual.(h) The requirement in (g) above shall not limit the individual's right to decline ACT services in accordance with RSA 135-C:16 and RSA 135-C:57, III.(i) The community mental health program (CMHP) providing ACT services shall make available written information provided by the department to individuals that describes ACT services, the right to file a complaint, and contact information for legal assistance.(j) The written information in (i) shall be given directly to any individual who has specifically requested ACT service but for whom the treatment team has determined that ACT services are not clinically appropriate.(k) Commencing in 2017, the department shall conduct an ACT fidelity assessment of each CMHP every other year. The CMHP shall conduct a self-assessment fidelity review in the year(s) the department does not conduct the review.N.H. Admin. Code § He-M 426.16
(See Revision Note at part heading for He-M 426) #5433, eff 7-2-92; amd by #5589, eff 2-25-93; ss by #5703, eff 9-17-93; amd by #5971, eff 2-1-95; amd by #6568, eff 8-22-97; ss by #7088, eff 8-31-99; ss by #8282, eff 2-8-05; ss and moved by #8867, eff 4-13-07 (from He-M 426.15 ); ss by #9285, eff 9-30-08 (from He-M 426.15 )
Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11182, Effective 9/29/2016, Expires 3/28/2017.Amended by Volume XXXVII Number 2, Filed January 12, 2017, Proposed by #12079, Effective 12/29/2016, Expires 12/29/2026.