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.
ACT WORK FLOW:
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
b) LOCUS
c) IRP
d) ISSP
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
LOCUS
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.
Bulletin ID: No. 87 - ACT Work Flow
Monday, August 26, 2013