Assertive Community Treatment (ACT) Referral Process June 14, 2017 OCEACT Statewide Conference Health Systems Division

Background Oregon does not have a universal standardized process to access ACT services. OHA is obligated to track and report data to federal oversight agencies and to the State Legislature OHA has implemented a standardized referral process to track all referrals to ACT from OSH. OHA is in the planning phase to coordinate with CCOs to track all referrals for individuals who are enrolled in managed care. Once a referral process is in place for individuals transitioning to less intensive services from OSH is in place and CCOs have a standardized process, OHA will roll out a referral tracking process for individuals who are covered by OHP, but not enrolled in managed care. Health Systems Division

How will the referral process affect ACT programs? OHA updated Oregon Administrative Rules to include the admission process (OAR 309-019-0248). The new process does not affect a qualified ACT service provider’s autonomy over the admissions to the program. The ACT program, depending on their contract with the CCO and/or CMHP will determine if additional criteria is allowed. Health Systems Division

Standardization The intention of the referral process is to: Track admission rates Track reasons for denials Streamline access to ACT programs Develop baseline data Help OHA determine need to expand capacity Health Systems Division

OSH Referral Process to ACT All referrals from OSH through a single point of contact (SPOC) for each service area. The SPOC for the current process is the as the ENCC (Choice Model Contractor). Referrals are routed through the ENCC from OSH. The ENCC is responsible for working with the ACT programs in their respective service area to forward the referral to the ACT program within two business days. The ACT program has five business days to review the referral materials, agree or disagree to screen the individuals for ACT services, and to schedule a face-to-face screening with the referred individual. The ACT program must return the ACT referral form within five business days. The ENCC receives the referral, tracks the disposition of the referral and returns the referral form to OHS within two days of receipt from the ACT program. The ENCC reports all referrals and dispositions from OSH to ACT programs monthly. Health Systems Division

How will it work? Client is identified as someone who would benefit from ACT services within 30 days of admission to OSH Client is assessed and meets statewide admission standards Nine (9) business day referral turnaround time Referral form is populated and forwarded (with supporting documentation) to the SPOC and copy OHA with the referral form The SPOC reviews the form and engages the ACT program(s) in their service area ACT program(s) receive referral and evaluate if the patient can be accepted into the program (five (5) calendar days) The SPOC receives determination from ACT program and provides OHA with completed tracking form Health Systems Division

? Questions? Wendy Chávez, MPA Coordinator for Adult Mental Health Programs Health Systems Division Ruth.A.Chavez@state.or.us Health Systems Division