OCEACT staff contact each ACT program approximately 1-2 months in advance to schedule the annual ACT fidelity review. We coordinate the ACT fidelity review schedule with one agency contact, typically the ACT team leader. The OCEACT fidelity review staff spend two days with the ACT team to conduct the review. The review process includes:

Interviews:
The OCEACT fidelity review team will interview all members of the ACT team: the team leader; substance abuse specialist(s); employment specialist(s); psychiatrist / PMHNP; nurse(s); peer support specialist(s); mental health clinicians/case managers. In addition, OCEACT staff will interview 2-3 ACT participants in a group interview, and 2-3 family members of ACT participants.

Observation of Team Functioning:
The OCEACT fidelity review team will observe a ACT team meeting.

Chart Reviews:
The OCEACT fidelity review team will request access to all charts for ACT participants served in the past 12 months. At least ten open charts and five closed charts will be reviewed to collect information to score items on the DACT.

Oregon ACT Database Data:
The OCEACT fidelity review team will download the most recent data submitted by the ACT team to the Oregon ACT Database (OAD) and create a 12 month roster of all ACT participants served. Each ACT program is required to submit quarterly data to the Oregon Health Authority through OAD. OCEACT staff will download the most recent data submitted to OAD into an excel spreadsheet to be used to represent the most current roster of ACT participants. OCEACT will send this roster of ACT participants to the ACT team leaders at least one month prior to the ACT fidelity review to allow the ACT team leader to evaluate if the OAD data represents a current list of ACT participants. If not, the ACT team leader, or other agency staff, can update ACT client information in OAD and OCEACT will download the updated ACT client roster for use in the ACT fidelity review and chart review procedures.

RESOURCES

• • OCEACT Fidelity Scale (updated 3.11.16)
  • ACT Fidelity Review Preparation for ACT Team Leader (updated 5 25 2021)

• Allness, D. J., & Knoedler, W. H. (1998). The PACT model of community-based treatment for persons with severe and persistent mental illness: A manual for PACT start-up. Arlington, VA: NAMI.




• Brooks, E. B., Jonikas, J. A., Cook, J. A., Engstrom, K., & Witheridge, T. F. (1991). Training staff to provide assertive outreach service to persons with severe mental illness. Chicago, IL: UICC National Research and Training Center on Psychiatric Disability.

• Substance Abuse and Mental Health Services Administration. Assertive Community Treatment: How to Use the Evidence-Based Practice KITs. DHHS Pub. No. SMA-08-4344, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2008. Stein, L. I., & Santos, A. B. (1998). Assertive community treatment of persons with severe mental illness. New York: W. W. Norton.

• Harron, B., Burns, B. J., & Swartz, M. (1993). Hospital without walls. Durham, NC: Duke University.

• Bond, G. R. (1991). Variations in an assertive outreach model. New Directions for Mental Health Services, 52, 65-80.

• Witheridge, T. F. (1991). The “active ingredients” of assertive outreach. New Directions in Mental Health Services, 52, 47-64.

Rural Implementation Research

• Dush, D. M., Ayres, S. Y., Curtis, C., Worthington, G. J., Gabriel, R. M., & Chinnery, T. (2001). Reducing psychiatric hospital use through intensive transitional acute care. Psychiatric Rehabilitation Journal, 25, 28-34.

• Fekete, D. M., Bond, G. R., McDonel, E. C., Salyers, M. P., Chen, A., & Miller, L. D. (1998). Rural assertive community treatment: A field experiment. Psychiatric Journal, 21, 371-379.

• Santos, A. B., Deci, P. A., Lachance, K. R., Dias, J. K., Sloop, T. B., Hiers, T. G., & Bevilacqua, J. J. (1993). Providing assertive community treatment for severely mentally ill patients in a rural area. Hospital and Community Psychiatry, 44, 34-39.

• Harron, B. (1996). Never too far: Rural outreach for serious mental illness. Durham, NC: Duke University.

Research in Oregon

Resources

• National Program Standards for ACT
• ACT Implementation Timeline
• ACT brochure three fold
• ACT Clinician Discussion Guide
• ACT Implementation – OCEACT Presentation
• ACT Team Budget Estimate- Full, half, & micro team (updated 5 3 2022)
• The ACT Multidisciplinary Team Brief Summary of Roles
• Admission Discharge Criteria from National Program Standards
• Discharge & Transition to Less Intensive Services – OCEACT Sample Policy

The Oregon Center of Excellence for Assertive Community Treatment is funded through, and works closely with, the Oregon Health Authority’s Health Systems Division (HSD).

Oregon Administrative Rules (OARs) 309-019-0225 through 309-019-0255 governing the provision of ACT services.  To view these OARs on the State of Oregon website, please click here. Here is a pdf of the OARs.

In an effort to provide Oregon ACT programs with clear guidance around billing and operational practices, HSD has provided OCEACT with a number of policy statements regarding providing and billing for ACT services.

Health Systems Division Policy Statements:

• HSD – Billing for H0039 – 06-21-16
• HSD – Residential Clarification – 03-15-16
• Fidelity Scale Revision Memo – March 25th, 2015
• Fidelity Scale Revision Memo – November 19th, 2013
• ACT and IPS Integration Policy Clarification – January 9th, 2019

To access Contract-Related Documents for Assertive Community Treatment, please click here.

To contact the Health Systems Division for general information on Assertive Community Treatment, please contact

Angella James
Evidence Based Practice Coordinator
Angella.Pulkownik2@dhsoha.state.or.us
.