Maine DHHS - Questionnaire - Child Assertive Community Treatment (ACT)

Status: Incomplete

Child Assertive Community Treatment (ACT)

1. What tool was completed?

(Please select one.)

2. Provide rationale why member requires a multidisciplinary team available seven days per week, twenty four hours per day:

3. Is the member at clear risk for psychiatric hospitalization or residential treatment or admission to a crisis stabilization unit?

(Please select one.)

4. Has member been discharged from a psychiatric hospital, residential treatment facility, or a crisis stabilization unit within the past month?

(Please select one.)

Disclaimers (please check to confirm acceptance):