Center for Evidence Based Practices (CEBP) at Case Western Reserve University

Covid-19 response activity through 3/25/20

The Center for Evidence Based Practices is contracted by the State of Ohio to provide training and consultation to all of Ohio’s Assertive Community Treatment (ACT) teams in the public mental health system. These teams serve those individuals who are most impaired by symptoms of severe and persistent mental illness and co-occurring substance use disorders. The Center is likewise contracted for a range of technical assistance activity with hundreds of ACT teams around the United States.

Given that the population served by ACT teams are often very functionally compromised and in need of considerable support to maintain a presence in their communities (that is, to remain free from psychiatric or other hospitalization, incarceration, or otherwise institutionally care), the work of the ACT treatment teams occurs in the community and seldom as an office based model of service delivery.

In lieu of Covid-19, and social distancing guidelines, how best to remain engaged with the homeless mentally ill and others who present challenges to get much needed care is at the forefront of what ACT teams, and subsequently the CEBP team of consultants and trainers, are dealing with. (Troubleshooting direct care conundrums such as symptom impaired individuals who will not allow ACT team staff to be in direct contact with them, individuals who require hands on assistance to access medical and other care as offered by the ACT teams, access to medications, group and individual therapies, safety of ACT team staff, etc.)

Over the past 2 weeks, the CEBP has been involved in addressing the Covid-19 pandemic by:

1. Authoring recommendations to the State of Ohio at the request of the Ohio Department of Medicaid with regard to regulatory relief for service providers in order to preserve the ability to keep teams operational and actively providing community based care. These recommendations likewise address reimbursement recommendations from the CEBP relative to the aforementioned regulatory guidelines to ensure service providing organizations can continue to be paid while otherwise being forced to work outside of established State guidelines for ACT teams as described in the Ohio Administrative Code. The State of Ohio intends to act on our recommendations this week.
2. Hosting the first of what will be several calls for the network of Ohio ACT team leaders and project managers to facilitate sharing of problem solving processes, resources and other approaches to service delivery modification necessary for a population that already requires an atypical approach to conventional mental health and substance abuse care.
   This has likewise involved being in touch with other ACT provider networks around the United States (presently, the CEBP is actively engaged with twelve other States with respect to ACT services) to monitor and disseminate policy and protocol changes and guidance of shared value around the country.
3. The CEBP team of consultants and trainers maintain relationships with all of Ohio’s ACT teams and many such teams around the country. Support to those teams has shifted to video and teleconferenced problem solving and troubleshooting sessions with any and every organization who is asking for such. This includes support for management teams as well as direct practice clinical casework consultation.

Read the CEBP recommendations re: OAC 5160-27-04 (March 17, 2020)