ACT Case Manager Job Description
ACT Peer Specialist Job Description
ACT Psychiatrist Job Description
ACT Registered Nurse Job Description
ACT Substance Abuse Team Member Job Description
ACT Team Leader Job Description
ACT Vocational Team Member Job Description

ACT Case Manager Job Description

Specialist Role

The following responsibilities are unique to the Case Manager position:

• Provide formal and informal ongoing clinical and non-clinical assessments of all clients (within the appropriate scope of practice)
• Assume primary responsibility for developing, writing, implementing, and revising consumer treatment plans while receiving input from team members
• Provide in vivo case management for ACT clients including coordinating and monitoring services
  • Act as the liaison between client and community, building relationships with families and community agencies
  • Advocate on client’s behalf for resources and access to services
• Provide ongoing assessment and encouragement in regards to Activities of Daily Living (ADLs)
• Assume the role of an informal specialist in an area such as benefits or housing

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Works with consumers and staff in developing and implementing person-centered individual treatment plans
• Provides direct service, including social and emotional support, coupled with instrumental support to team clients>
• Assists in the teaching of daily living skills; this includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Transports and/or accompanies clients to appointments which connect them to community resources and services
• Acts as an advocate for clients to secure needed services and financial entitlements
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff
• Provide On-Call crisis response and back up interventions and services
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

The ACT Case Manager shall hold a bachelor’s degree in psychology, social work or other health related field and/or have documented competency/experience in community mental health or other social service related area.

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ACT Peer Specialist Job Description

Specialist Role

The following responsibilities are unique to the Peer Specialist position:

• Uses experiences with personal recovery in assisting and supporting team clients
• Helps clients aspire to roles which emphasize their strengths by
  • Sharing first hand experiences in their own recovery journey
  • Offering hope and reassurance
• Provides peer interventions to clients regarding, but not limited to, symptoms of mental illness, coping skills, medications/side effects, and relapse prevention, and resource connection including:
  • Engaging clients, through  outreach and support
  • Assisting clients in developing self directed care/advance directive plans
• Promotes recovery through:
  • Role modeling and sharing experiences
  • Providing hope and encouragement
  • Self-determination
  • Connection to the community
• Provides training and education to other ACT team members and clients on: **
  • Recovery
  • Community Resources and Advocacy Organizations
  • Peer Support
  • Psychiatric advance directives: advocacy, information and referral
• Provides direct service, including social and emotional support, coupled with instrumental support to clients of the ACT team**

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with the team during the treatment plan meeting
• Works with clients and staff in developing and implementing person-centered individual treatment plans
• Assists in the teaching of daily living skills; this includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Transports and/or accompanies clients to appointments which connect them to community resources and services
• Acts as an advocate for client to secure needed services and financial entitlements
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff
• Provide on-call crisis interventions and back up according to team’s policy
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards

Qualifications

• The ACT Peer Specialist is an individual who has a unique perspective because of his/her own experience with serious and persistent mental illness
• The ACT Peer Specialist shall have documented competency in the following areas, or receive core training to be completed within six months of hire: **
  • Recovery;
  • Peer support;
  • Consumer advocacy organizations; and
  •  Psychiatric advance directives:
    • education and advocacy; and
    • information and referral

**these were taken directly from the ODMH ACT Certification Standard

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ACT Psychiatrist Job Description

Specialist Role

The following responsibilities are unique to the Psychiatrist position:

• Along with the Team Leader, provides clinical leadership to the ACT team in assessment, treatment planning, general healthcare, medical and psychosocial approaches**
• Collaborates with each nurse practitioner and/or clinical nurse specialist, in assessment, treatment planning, general healthcare, medical and psychosocial   approaches, and a review of each ACT client's progress and treatment**
• Provides consultation and training to other ACT team members regarding the client's medical psychiatric care, including pharmacologic management needs**
• Works with consumers and staff in developing and implementing person-centered individual treatment plans which address psychiatric issues
• Conduct psychiatric assessments, including MSE, psychiatric history, establishing DSM IV diagnoses
• Regularly assess consumers & prescribe psychotropic medications for all ACT team clients via office AND home visits>
• Educate consumers & their families regarding medications/symptoms/illness/side effects
• Provide on-site crisis assessment & management & collaborate with acute & long-term inpatient providers
• Collaborates with other service providers as necessary (i.e., inpatient psychiatrists, primary care physicians)

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Works with ACT team members in engaging and motivating clients to achieve their treatment goals
• Assists ACT team members to help ensure that team clients maintain financial entitlements
• Attends all ACT team meetings when on duty in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client (attend at least weekly)
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff (the ACT psychiatrist will occasionally lead this meeting)
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

• The ACT Psychiatrist shall be appropriately licensed to treat all ACT team clients and to provide supervision as well as education to the ACT team staff

**these were taken directly from the ODMH ACT Certification Standard

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ACT Registered Nurse Job Description

Specialist Role

The following responsibilities are unique to the Nurse position:

• Assess overall physical health of consumers
• Conducts health assessments**
• Completes all other assessments which are appropriate for the RN’s scope of practice (as part of comprehensive assessment & on an ongoing basis)
• Works with consumers and staff in developing and implementing person-centered individual treatment plans which include goals to address physical health issues
• Take the lead role in the direction, coordination, & provision of physical health treatment as stated in the treatment plan
  • Collaborating with consumer’s physical health providers**
  • Build relationships with medical providers in the community, which will provide the team with a network of physical health resources
  • Accompany consumers to medical appointments, facilitate  medical follow up
• Provide training to other ACT team members to help them monitor psychiatric symptoms and medication side effects**
• Provide education to consumers, families, and other team members about mental illness, physical health, medications and side effects
• Take lead role in coordinating and providing the team’s medication administration services
• Collaborates closely with the ACT Team Psychiatrist in assessment, treatment planning, medication issues, general healthcare, medical and psychosocial; approaches, and a review of each ACT client's progress and treatment

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Works with consumers and staff in developing and implementing person-centered individual treatment plans
• Provides direct service, including social and emotional support, coupled with instrumental support to team clients
• Assists in the teaching of daily living skills. This includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean living environment, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Acts as an advocate for clients to secure needed services and financial entitlements
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff (the ACT nurse will occasionally lead this meeting)
• Provide on-call crisis interventions and back up according to team’s policy
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

• The ACT Registered Nurse shall have a specialty or documented competency in psychiatry as well as be in compliance with current, applicable scope of practice and supervisory requirements identified by appropriate licensing, certifying or registering bodies**

**these were taken directly from the ODMH ACT Certification Standard

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ACT Substance Abuse Team Member Job Description

Specialist Role

The following responsibilities are unique to the Substance Abuse position:

• Completes assessments of client’s substance abuse history and current status
  • as part of comprehensive assessment & on an ongoing basis
• Engagement to develop trusting relationships to enhance successful substance abuse outcomes
  • educational, behavioral, and motivational interventions
• Assists in coordinating individual treatment planning including aftercare and recovery support services for each client actively involved in alcohol and drug treatment**
• Participates in engaging and motivating team clients in all of the treatment goals of the client, especially and specifically those related to substance abuse issues
• Assists each client receiving drug and alcohol treatment in becoming involved with self-help support groups**
• Assists each client receiving drug and alcohol treatment in becoming involved with self-help support groups**
• Assists each client receiving drug and alcohol treatment in developing and maintaining social support networks**
• Collaborates closely with any inpatient substance abuse treatment providers
• Ensures that each client referred by the ACT team for alcohol and other drug treatment is referred to an individual or program licensed or certified to provide alcohol and other drug treatment
• Provide training to other ACT team members on the signs, symptoms and early identification of alcohol and other drug use and abuse, and the disease of alcoholism and drug dependency**

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Works with consumers and staff in developing and implementing person-centered individual treatment plans
• Provides direct service, including social and emotional support, coupled with instrumental support to team clients
• Assists in the teaching of daily living skills; this includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Transports and/or accompanies clients to appointments which connect them to community resources and services
• Acts as an advocate for clients to secure needed services and financial entitlements
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff (Substance Abuse Specialist may lead this meeting occasionally)
• Provide On-Call crisis response and back up interventions and services
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

• The ACT Substance Abuse Team Member shall have documented competency in the following areas, or receive core training to be completed within six months of hire: **
  • Engagement strategies
  • Motivational strategies
  • Relapse prevention

**these were taken directly from the ODMH ACT Certification Standard

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ACT Team Leader Job Description

Specialist Role

The following responsibilities are unique to the Team Leader position:

• Along with the team psychiatrist, provides clinical leadership to the ACT team in assessment, treatment planning, general healthcare, medical and psychosocial approaches
• Direct the day-to-day clinical operations of the team
  • provides direct supervision of team members**
  • scheduling staff work hours to assure appropriate coverage
  • lead daily team meetings & treatment planning meetings
  • continuously evaluate status of all consumers & do appropriate coordination of treatment to meet their changing needs
• Direct & coordinate the consumer admission & assessment processes
  • schedule admission interview
  • supervise, direct, and coordinate completion of the comprehensive assessment/reassessment of each consumer
• Use of management tools to help ensure the team’s philosophy and goals are in accordance with the ACT model
• Participate in staff recruitment, interviewing, hiring, orientation, performance plans
• Supervise the medical record documentation to ensure quality and accuracy
• Provide on-call crisis interventions and back up according to team’s policy
• Participate in engaging and motivating team clients in all of the treatment goals of the client while providing direct service**
• Supervise the ACT Team in maintaining agency required productivity standards
• Supervise the completion of all required documentation in a timely manner consistent with agency guidelines

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Provides direct services, including social and emotional support, coupled with instrumental support to clients of the ACT Team
• Supervises and facilitates ACT Team Members in developing and implementing person-centered individual treatment plans.
• Assists in the teaching of daily living skills; this includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Transports and/or accompanies clients to appointments which connect them to community resources and services
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Acts as an advocate for client to secure needed services.
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff (the ACT  Team Leader will occasionally lead this meeting)
• Provide On-Call crisis response and back up interventions and services
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times.
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

The ACT Team Leader shall be qualified to supervise ACT services by having one or more of the following competencies and/or licensures:

• Medical doctor or doctor of osteopathic medicine
• Master of science in nursing
• Clinical nurse specialist
• Nurse practitioner
• Independent social worker
• Professional clinical counselor
• Psychologist

**these were taken directly from the ODMH ACT Certification Standard

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ACT Vocational Team Member Job Description

Specialist Role 

The following responsibilities are unique to the Vocational position:

• Provides a full range of supported employment services. Eligibility is based upon client choice, and efforts are made to engage the client in supported employment regardless of diagnosis, symptoms, work history, substance use, or treatment compliance**
• Provide individual vocational-supportive counseling to enable clients to identify vocational strengths, establish vocational/career goals, and recognize symptoms of mental illness that interfere with work
• Works with clients and other team members in developing treatment goals, specifically those related to employment issues
• Assuring that treatment goals related to employment issues are based on the client’s individual needs, abilities and interests
• Teach and assist with job-seeking efforts such as resume writing and interview skills
• Plan, coordinate and provide work-related supportive services based on the treatment plan(assistance with hygiene, securing appropriate clothing, wake-up calls, and transportation)
• Provides or makes appropriate referral for benefits planning**
• Liaisons with other providers of vocational rehabilitation services, if applicable**
• Provides training to other ACT team members to help them integrate interventions to support vocational goals**

Generalist Role

All team members are generally responsible for the following activities:

• Participates in the ongoing assessment and therapeutic engagement of ACT team clients
• Completes, as directed, elements of the comprehensive assessment for clients within 60 days of admission and uses in collaboration with team during the treatment planning meeting
• Works with consumers and staff in developing and implementing person-centered individual treatment plans
• Provides direct service, including social and emotional support, coupled with instrumental support to team clients
• Assists in the teaching of daily living skills; this includes teaching and assistance in medically necessary services such as grocery shopping, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, etc.
• Transports and/or accompanies clients to appointments which connect them to community resources and services
• Acts as an advocate for clients to secure needed services and financial entitlements
• Locates and/or establishes self-help and support groups for team clients, families, and/or significant others
• Attends all ACT team meetings in order to facilitate an integrated, multidisciplinary team approach to service:
  • Daily Team Meeting- to organize work for each day and to review recent contact with each client
  • Treatment Planning Meeting- weekly or bi-weekly to develop and review treatment plans/decisions
  • Clinical Supervision Meeting- 1 to 2 times monthly for training, education and professional development of ACT team staff
• Provide On-Call crisis response and back up interventions and services
• Maintains compliance with all applicable practice standards and guidelines
• Maintains client confidentiality and adherence to HIPAA requirements at all times
• Completes all required documentation in a timely manner consistent with agency guidelines
• Maintains agency required productivity standards
• With documented consent, engages the client’s family and/or significant others to provide education regarding mental illness and system resources

Qualifications

The ACT Vocational Specialist shall have documented competency in the following areas, or receive core training to be completed within six months of hire: **

• Supported Employment
• Job placement
• Individualized job development
• Benefits planning

**these were taken directly from the ODMH ACT Certification Standard

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