Forensic Assertive Community Treatment (FACT) Central New York Region

The New York State (NYS) Office of Mental Health (OMH) announces the availability of funds for the development of one (1) Forensic Assertive Community Treatment (FACT) team (either a 48-capacity team or 68-capacity team) in the Central New York Region. The Forensic ACT team will serve individuals who are justice-involved and have serious mental illness (SMI) who have not been successfully engaged by the traditional mental health treatment and rehabilitation system.

ACT is a multidisciplinary, evidence-based, team approach to providing comprehensive and flexible treatment, support, and rehabilitation services. ACT teams are configured to have a low individual-to-staff ratio with professional staff including members from the fields of psychiatry, nursing, psychology, social work, substance use, employment/education, and peers/persons with lived experience. The majority of services are provided by ACT staff directly (not brokered) in the community or where the individual lives. In this way, newly acquired skills are applied in their real-world environment and situations. ACT is designed to be flexible and responsive to the needs of individuals, offering support 24 hours a day, seven (7) days a week. ACT is “assertive” and intentional in its engagement methods, incorporating individual choice, cultural competencies, concrete services, consistency, and persistence. Finally, ACT is structured to provide a review during daily team meetings of every individual on the ACT team’s caseload. This level of accountability allows for immediate changes in service planning and leads to improved outcomes.

ACT teams strive to develop a culturally sensitive understanding of each ACT participant and their family’s personal preferences (i.e., preferred pronoun, spiritual practices). Additionally, ACT teams take social determinants of health into account as they are domains likely to have inherent disparities (healthcare access, housing, employment status, food security). The ACT teams provide on-going opportunities for participants to share their culture with others. ACT staff elicits and accepts participants’ personal religious or spiritual practices and leverages this information to support self-directed recovery goals.

Forensic ACT builds on the evidence-based model of ACT by making adaptations based on criminal justice involvement—in particular, addressing risk and protective factors associated with arrest and recidivism.

Forensic ACT is intended for individuals with SMI who are involved with the criminal justice system. These individuals may have co-occurring substance use and physical health disorders, trauma histories, engagement difficulties, and behavioral challenges. Their needs are often complex, and their disorders are often under-managed and further complicated by varying degrees of involvement with the criminal justice system.

Similar to ACT, Forensic ACT provides services that are person-centered, community- based, and delivered by a multidisciplinary team. These services include intensive, continuous engagement. While Forensic ACT adds program enhancements to meet the needs of the population who are justice-involved with SMI, providers should always strive to meet the fidelity to the ACT model.

Forensic ACT is designed to: improve clients’ mental health outcomes and daily functioning; reduce recidivism by addressing risk and supporting protective factors associated with arrest and recidivism; divert individuals in need of treatment away from the criminal justice system; manage costs by reducing reoccurring arrest, incarceration, and hospitalization; and increase public safety.

The new Forensic ACT team will provide traditional ACT services, as well as specialized services to reduce risk factors associated with arrest, recidivism, and recurring involvement with the criminal justice system, including probation, parole, and incarcerations. The expansion of Forensic ACT represents a commitment by the NYS OMH to develop specialized Forensic ACT teams that are designed to better meet the needs of the SMI population who are involved in the criminal justice system. As this expansion moves forward, there are several principles from classic ACT, as well as principles specific to Forensic ACT that inform the overall process. These include:

• Promoting the concepts of recovery and the power of individual choice;
• Providing a majority of services through the ACT team, rather than brokering
• Supporting the seamless integration of individuals into the communities in which they have chosen to live. ACT teams are expected to become experts in the natural supports available to recipients so that full community integration is possible;
• Supporting individuals to develop a vocational or educational plan that will provide a path to independence;
• Supporting adults who may have limited social or family support to strengthen existing family relationships, including their family of choice;
• Reviewing and attempting to mitigate the effects of discrimination based on the client’s demographic identity (gender, sexual identity, race, ethnicity). Team shows sensitivity towards participants’ personal stories as they may relate to oppression and inequality.
• Ensuring service access by managing ACT referrals through the County Local Government Unit (LGU) Single Point of Access (SPOA/SPA) system;
• Ensuring the continuous quality improvement of ACT services through regular monitoring of treatment/rehabilitation outcomes by both the agency and NYS OMH;
• Facilitating continuity of care from the ACT team to the community when transitioning off ACT; and
• Utilizing data to inform continuous program

The following forensic components distinguish Forensic ACT from ACT:

• Addressing criminogenic needs and risk factors associated with arrest and recidivism as part of the treatment plan, including the use of evidence based cognitive behavioral therapies shown to reduce recidivism.
• Enhanced staffing, including criminal justice specialists and a peer specialist who has lived experience with the criminal justice system (preferred).
• Training specific to working with Justice-Involved Individuals and the clinical impact of incarceration.
• Developing and maintaining strong working relationships with regular on- going communications with community supervision (probation, parole, court involvement, etc.).
• Dedicated slots for individuals being released from

Notice: Notification of intent to apply should be made to the Local Governmental Unit (county director of community services) for each county to be served under the program application, as defined in Section 41 of the New York State Mental Hygiene Law.

The full RFP can be found at: https://omh.ny.gov/omhweb/rfp/

All applicants must be Prequalified by the due date/time of the RFP.

All applications/proposals must be submitted through the Statewide Financial System.