Job description

OB DESCRIPTION:
Assertive Community Treatment Team
Register Nurse

Definition:
A service provided by an interdisciplinary team that ensures service availability 24 hours a day, 7 days per week and is prepared to carry out a full range of treatment functions wherever and whenever needed. A service recipient is referred to the Assertive Community Treatment Team service when it has been determined that his/her needs are so pervasive and/or unpredictable that they cannot be met effectively by any other combination of available community services. Typically this service should be targeted to the 10% of MH/DD/SA service recipients who have serious and persistent mental illness or co-occurring disorders, dual and triply diagnosed and the most complex and expensive treatment needs. The service objectives are addressed by activities designed to: promote symptom stability and appropriate use of medication; restore personal, community living and social skills; promote and maintain physical health; establish access to entitlements, housing, work and social opportunities; and promote and maintain the highest possible level of functioning in the community. ACT Teams should make every effort to meet critical standards contained in the most current edition of the National Program Standards for ACT Teams as established by the National Alliance for the Mentally Ill or US Department of Health and Human Services, Center for Mental Health Services.

This service is delivered in a team approach designed to address the identified needs of specialized populations and/or the long term support of those with persistent MH/DD/SA issues that require intensive interventions to remain stable in the community. These service recipients would tend to be high cost, receive multiple services, decompensate to the point of requiring hospitalization before seeking treatment, seek treatment only during a crisis, or unable to benefit from traditional forms of clinic based services. This population has access to a variety of interventions 24 hours a day, 7 days a week, by staff that will maintain contact and intervene as one organizational unit.
This team approach involves structured face-to-face scheduled therapeutic
interventions to provide support and guidance in all areas of functional domains: adaptive,
communication, personal care, domestic, psychosocial, problem solving, etc. in preventing, overcoming,
or managing the recipient's level of functioning and enhancing his/her ability to remain in the community.

This service includes interventions that address the functional problems associated with the most complex and/or pervasive conditions of the identified population. These interventions are
strength based and focused on promoting symptom stability, increasing the recipient's ability to cope and
relate to others and enhancing the highest level of functioning in the community. ACTT provides ongoing
assertive outreach and treatment necessary to address the service recipient's needs effectively. Consideration of geographical locale may impact on the effectiveness of this service model. This model is primary a mobile unit, but includes some clinic based services. A service order for ACTT must be completed by a physician, licensed psychologist, physician’s assistant or nurse practitioner according to their scope of practice prior to or on the day that the services are to be provided.

Service Type:
ACTT is a direct and indirect periodic service where the ACTT staff provides direct intervention and also
arranges, coordinates, and monitors services on behalf of the recipient. This service is provided in any
location. ACTT are intended to be provided on an individualized basis. ACTT services are primarily provided in a range of community settings such as recipient’s home, school, homeless shelters, libraries, etc.

Responsibilities include:

• Providing treatment, rehabilitation, and supportive services to adult clients;
• Providing physical and psychological assessments;
• Engaging in medication management;
• Offering education and administration;
• Providing individual and group therapy possible; mental and physical health education
• Assisting with crisis intervention.

REQUIREMENTS:

• The ACT team shall provide an average of three contacts per week for all individuals.
• Program services are primarily delivered face-to-face with the consumer and in locations outside the

Agency’s facility.

• The aggregate services that have been delivered by the agency will be assessed annually

for each provider agency using the following quality assurance benchmarks:
o A minimum of 80% of staff time must be face-to-face with the recipient. The remaining units may either be phone or collateral contacts; and
o Each team shall set a goal of providing 75% of service contacts in the community in non–office-based or non–facility-based settings.

• To ensure appropriate ACT team development, each new ACT team is recommended to titrate ACTT

intake (e.g., 4–6 individuals per month) to gradually build up capacity to serve no more than 100–120
individuals (with 10–12 staff) and no more than 42–50 individuals (with 6–8 staff) for smaller teams.

• The ACT team shall be available to provide treatment, rehabilitation, and support activities seven days per week.
• It is recommended that ACT team schedules should follow the standards established in the National Program Standards for ACT Teams.
• Must participate in DMH/DD/SAS approved ACTT training with 90 days of employment.
• Document direct service delivery according to Medicaid and CSEUC standards to include: purpose of contact, describes the provider’s interventions, the time spent performing the intervention, the effectiveness of the interventions, the signature (degree, credentials or position) of the person providing the service.

QUALIFICATIONS:

• Nursing Degree from an accredited school and must be licensed as a registered nurse in the state of North Carolina.
• A minimum of four years experience in a psychiatric treatment facility (either inpatient or outpatient) is preferred.
• Must have a QP status according to 10A NCAC 27G .0104 or be an Advanced Practice Nurse (APN) according to NCGS Chapter 90 Article I, Subchapter 32M.

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