Implementation/Expansion of High-Fidelity ACT
In the summer of 2008, OMHSAS contracted with Mercer Government Human Services Consulting (Mercer) to do the fidelity, cost and outcome analyses of the ACT and Community Treatment Teams (CTT) teams in the state. CTT is a service model similar to ACT, though its implementation approaches vary. The findings from the fidelity, cost and outcomes analyses were compelling, though not entirely unexpected. The findings were consistent with the research literature findings that those programs with lower fidelity cost much more when compared to those programs that were rated high on the fidelity study. Furthermore, teams that rated low on fidelity relied more heavily on additional services resulting in substantial increases in costs, which contravenes the basic principle of ACT as an all-inclusive team approach to service provision. The results of the outcome analysis, which focused on the areas of housing and employment, also showed a relationship between adherence to fidelity and positive outcomes.
In order to support the expansion of fidelity-based ACT programs in the state, OMHSAS hired the services of a national consultant (Wisconsin PACT) as well as a state consultant to provide training and technical assistance (TA) to the ACT/CTT programs. OMHSAS also sought the services of The Washington Institute for Mental Health Research & Training (University of Washington) for training on the fidelity measurement tool TMACT (Tools for Measurement of ACT).
In July 2009, OMHSAS convened a stakeholder meeting to discuss the findings from the Mercer study and to formulate plans to move towards full ACT fidelity for the existing ACT/CTT programs. One of the key recommendations that emerged from this meeting was to select some of the existing ACT or CTT teams as pilot programs to receive intensive technical assistance and training to transition to full ACT fidelity. OMHSAS also provided one-time funding to the selected programs for start-up/organizational enhancement. Additionally, training was available for other teams in areas like basic organizational structure and program operation as well as training in areas identified by outcome data and TMACT/DACTS (Tool for Measurement of ACT/Dartmouth Assertive Community Treatment Scale) scores.
In November 2009, as requested by OMHSAS, all counties that have ACT/CTT programs submitted Fidelity Action Plans outlining their strategy to transition to fidelity-based ACT teams. The plans were reviewed by a workgroup and OMHSAS held follow-up meetings to discuss specific details with each county.
In the summer of 2010, an OMHSAS internal ACT Workgroup was formed with staff from Regional Operations, each regional OMHSAS Field Office and the OMHSAS Bureau of Policy, Planning and Program Development. This workgroup meets regularly to discuss issues/concerns with the various ACT teams across the state.
In 2012, OMHSAS Field Office staff began to license ACT teams. ACT team locations as of 06/2017.
In November of 2016, OMHSAS held the first annual ACT summit for Pennsylvania’s licensed ACT teams. All teams had representation at the summit. Consultants from Case Western Reserve University’s Center for Evidence-Based Practices provided an overview of ACT and workshops on leadership and the TMACT. Plans are underway for the second summit in 2017.