Blended Enhanced Case Management (Non-fidelity ACT)

Steps to a Successful Referral:  

CTT is now accepting referrals into the BE Program. Click here to apply.

Do you know someone with a serious mental illness who would benefit from Blended Enhanced (Non-fidelity ACT) Case Management?  

Please review the eligibility requirements for Blended Enhanced Level of Care prior to completing the application.

* If the applicant is unavailable to sign the electronic referral, please print out this form and have them sign the CTT Application for Services Signature Form.  Upload the completed signature form in the attachments section of the online application.  You can also email additional attachments to cttbeadmissions@pmhcc.org if needed.    
‍
* CTT Case Management Programs are voluntary.  All referrals must be accompanied with a participant signature.

• Review Medical Necessity Criteria.
• Fill-out referral form for the CTT Program you feel is most appropriate for your participant.
• Upload all required paperwork at the end of the referral form. * If you are unable to upload the forms please email them to the program you are referring to:  BE:  cttBEadmissions@pmhcc.org
• CTT will review the referral and provide a conditional authorization.
• Submit a program discharge summary / letter to the program you are referring to.
• Complete closure in Webfocus.
• CTT will send out acceptance forms with an admission date.