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):