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Youth Assertive Community Treatment (Youth ACT)

• Authorization

• Billing

• Legal Reference

Youth Assertive Community Treatment (Youth ACT) is an intensive, comprehensive, non-residential rehabilitative mental health service team model. Services are consistent with Children’s Therapeutic Services and Supports (CTSS), except Youth ACT services are:

• Provided by multidisciplinary, qualified staff who have the capacity to provide most mental health services necessary to meet the recipient’s needs, using a total team approach

• Directed to eligible recipients who require intensive services

• Available 24 hours per day, 7 days per week, for as long as the recipient requires this level of service

The team promptly and appropriately responds to emergent needs and makes necessary staffing adjustments to assure the health and safety of recipients.

Eligible Youth ACT Providers

An eligible Youth ACT program must:

• Have a contract with the Minnesota Department of Human Services (DHS)

• Be certified by DHS to provide Adult Mental Health Rehabilitative Services (ARMHS) or CTSS

• Follow all Minnesota Youth Assertive Community Treatment Standards

A Youth ACT team must include the following staff:

• Mental Health Professional

• Licensed alcohol and drug counselor trained in mental health interventions

• Certified Peer Specialist level I or II

• One of the following, credentialed to prescribe medications:

• Advanced Practice Registered Nurse certified in psychiatric or mental health care

• Board-certified child and adolescent Psychiatrist

Based on recipient needs, the team may include:

• Additional mental health professionals

• A vocational specialist

• An educational specialist

• A child and adolescent psychiatrist retained on a consultant basis

• Mental health practitioners

• Mental health case manager

• A housing access specialist

Additional Team Members

Other individuals may be included as members of the treatment team for specific recipients. These individuals must contract with the Youth ACT program. Recipient-specific team members may include:

• The mental health professional treating the recipient prior to entering the Youth ACT team (includes therapist and/or psychiatrist)

• The current substance abuse counselor

• A lead member of the recipient’s individualized education program or school-based mental health provider

• A representative from the recipient’s Tribe

• The recipient’s probation agent or other juvenile justice representative

• The recipient’s current vocational or employment counselor

The Youth ACT team may only bill for services provided by these additional team members when the services are not reimbursed through another funding source. For example, the Youth Act team may not bill for services provided by the school district through the individualized education plan, as these services are reimbursed separately.

Eligible Recipients

To be eligible for Youth Act, MHCP recipients must be 16 – 20 years old and have:

• Diagnosis of serious mental illness or co-occurring mental illness and substance abuse addiction

• CASII level of care determination of level 4 or above

• Functional impairment and a history of difficulty in functioning safely and successfully in the community, school, home, or job

• Probable need for services from the adult mental health system within the next two years

• Have a current diagnostic assessment indicating the need for intensive nonresidential rehabilitative mental health services

Covered Youth ACT Services

The Youth ACT team provides the following services:

• Individual, family, and group psychotherapy

• Individual, family, and group skills training

• Crisis assistance

• Medication management

• Mental health case management

• Medication education

• Care coordination with other care providers

• Psycho-education to, and consultation and coordination with, the recipient’s support network (with or without recipient present)

• Clinical consultation to the recipient’s employer or school

• Coordination with, or performance of, crisis intervention and stabilization services

• Assessment of recipient’s treatment progress and effectiveness of services using outcome measurements

• Transition services

• Integrated dual disorders treatment

• Housing access support

Recipients and or family members must receive at least 3 face-to-face contacts per week, totaling a minimum of 85 minutes of service.

Authorization

Refer to Authorization for general authorization policy and procedures. Authorization is required for Youth ACT services to exceed 75 units of service in a calendar year.

To request authorization, submit the following:

• MHCP Authorization Form (DHS-4695) (except when using MN–ITS)

• Most Current Diagnostic Assessment

• Previous and Current Individual Treatment Plan

• Completed Child & Adolescent Service Intensity Instrument (CASII)

Billing

MHCP reimburses Youth ACT services:

• Based on one, all-inclusive daily rate

• To one provider per day

Each claim must be for a face-to-face contact. Count the following services as face-to-face when the need for the recipient’s absence is documented:

• Family psycho-education

• Family psychotherapy

• Clinical Consultation to school or employer

Only one agency may bill when team members are from more than one agency. The billing provider reimburses other contributing agencies. Mental Health professionals acting as team members may not bill their services separately from the Youth ACT team.

Bill Youth ACT program services to MHCP using MN–ITS 837P:

• Use procedure code H0040 and modifier HA

• Enter one date of service per line, one unit per day

• Do not enter a rendering provider

Contact the MHCP Provider Call Center when Youth ACT claims are denied due to claims for concurrent ARMHS, CTSS, day treatment, outpatient psychotherapy or crisis response services. Resubmit the Youth ACT claims once the concurrent claims have been reversed.

Youth ACT & Other Concurrent Services The Youth ACT team must coordinate all concurrent services When requesting authorization, clearly document medical necessity for the additional service(s). Include the reasons Youth ACT does not/cannot meet recipient’s needs (specialty service, transitional service, etc).
Other Service	Is service included in Youth ACT?	Can service be provided in addition to Youth ACT?	Service Limitations
MH-TCM	Yes	No	Case management functions are bundled in the Youth ACT rate. CMH-TCM is covered only in the month of admission or discharge from Youth ACT. CMH-TCM must request authorization for coverage other than month of admission/discharge.
Children’s Mental Health Day Treatment	No	When authorized	Day Treatment program must request authorization. If Youth ACT team approves Day Treatment, Youth ACT team must provide a statement to the Day Treatment provider for authorization request purposes. Day Treatment providers may not be additional Youth ACT team members. Day Treatment providers must accept clinical direction from the Youth ACT team.
Children’s Residential Treatment Services	No	No	Cannot be billed separately. No authorization required.
Partial Hospitalization	No	Yes	Partial hospitalization thresholds and limitations apply.
IRTS	No	Yes	Youth ACT and IRTS may be provided concurrently without authorization.
CTSS and ARMHS	Yes	No	Rehabilitative skills training is a component of Youth ACT services, cannot be billed separately.
Mental Health Behavioral Aide Services	No	No	Cannot be billed separately.
Crisis Assessment and Intervention (mobile)	Yes	No	A component of Youth ACT. Team must provide or contract with a Crisis provider for this service. Cannot be billed separately. No authorization required.
Crisis Stabilization – Non-residential	Yes	No	A component of Youth ACT. Cannot be billed separately. No authorization required.
Crisis Stabilization – Residential	No	Yes	Service limits apply. Services must be coordinated between the Youth ACT and residential crisis providers.
Medication Management	Yes	No	Provided by physician or advanced practice registered nurse team members.
Outpatient Psychotherapy	Yes	No	A component of Youth ACT. Cannot be billed separately. No authorization required.
Inpatient Hospitalization	No	Yes	Inpatient hospitalization services are reimbursed separately from Youth ACT.
Waivered Services	No	Yes	County must approve concurrent care.
Other medical services (e.g., PCA)	No	Yes	Service limits apply to each service.

Legal References

MS 256B.0947

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