Purpose

To determine the extent of implementation of the two recommendations and their sub-sections included in our initial audit report, Assertive Community Treatment Program (2014-S-25).

Background

The New York State Office of Mental Health (OMH) promotes the mental health and well-being of all New Yorkers. Its mission is to facilitate recovery for adults receiving treatment for serious mental illness; to support children and families in their social and emotional development and in the early identification and treatment of serious emotional disturbances; and to improve the capacity of communities across New York to achieve these goals. One way OMH accomplishes its mission is through the Assertive Community Treatment (ACT) program, which provides treatment, rehabilitation, and support services to individuals diagnosed with severe mental illness whose needs have not been well met by more traditional mental health services.

The ACT program goals are to reduce hospitalizations and emergency room visits. To achieve those goals, ACT teams employ evidence-based practices to provide services. ACT teams include members from various fields (e.g., psychiatry, nursing, vocational rehabilitation). According to OMH officials, there are currently 83 ACT provider teams licensed by OMH and operating throughout the State to provide services for nearly 5,500 recipients. Based on their respective areas of expertise, ACT provider team members collaborate to deliver integrated services throughout the State. OMH has established certain requirements to ensure effective delivery of those services. For example:

• ACT provider teams are licensed by OMH and therefore must be recertified through its Targeted Recertification program approximately every three years.
• Staff must complete specific training courses through the ACT Institute (part of the Center for Innovations operated by OMH’s New York State Psychiatric Institute). Required courses include Person-Centered Treatment Planning, Motivational Interviewing, Wellness for Transition, and Child and Adult Integrated Reporting System (CAIRS) Reporting.
• ACT provider teams must conduct recipient assessments and develop comprehensive individualized treatment plans at least every six months, including goals and intervention strategies, based on assessment outcomes. 
• All treatment plans must be approved and ratified by clinicians.

In October 2015, ACT treatment became a qualified service under Medicaid Managed Care, and billing for services began in early 2016. In 2014 and 2015, 89 percent of the funding came through DOH for services provided to Medicaid recipients.  ACT program teams received over $74 million and $77 million in 2014 and 2015, respectively.

Key Finding

We found OMH has addressed the issues identified in our initial audit.  Of the two recommendations contained in our audit report, both have been implemented.