Statewide implementation of high-fidelity recovery-oriented ACT: A case study

Area of Science:

• Implementation Science
• Mental Health Services Research
• Public Health Policy

Background:

• Assertive Community Treatment (ACT) is an evidence-based practice for severe mental illness.
• The application of Translation Science to ACT implementation requires further exploration.
• Oregon's statewide implementation of high-fidelity, recovery-oriented ACT is examined.

Purpose of the Study:

• To explore Oregon's use of Translation Science strategies for statewide ACT implementation.
• To evaluate the maintenance of high-fidelity, recovery-oriented ACT services.
• To identify key factors in ensuring uniform, high-quality ACT care.

Main Methods:

• A single intrinsic case study design was employed.
• Data sources included ACT fidelity reports, outcome data, surveys, and focus groups.
• Evaluation focused on implementation strategies and fidelity monitoring.

Main Results:

• Oregon established a Center of Excellence for ACT to provide training and technical assistance.
• Administrative rules mandate annual re-certification based on minimum fidelity levels.
• Funding is linked to fidelity benchmarks, supporting ongoing oversight and training.

Conclusions:

• Codifying minimum ACT implementation standards into state rules is crucial.
• Linking fidelity scores to Medicaid reimbursements incentivizes high-quality care.
• A dedicated technical assistance center ensures sustained fidelity and integration of practices.