Adult Community Clinical Services (ACCS) to replace CBFS

Information about the reconfigured service model

Reconfigured service model highlights

For more detailed information on ACCS and the transition from CBFS readReforms to strengthen and improve behavioral health care for adults (PDF)

The Department of Mental Health is pleased to announce that it has developed a reconfigured service model as its primary service for DMH adults who live in or are transitioning to the community. This service, Adult Community Clinical Services (ACCS), will replace Community Based Flexible Supports effective July 1, 2018. DMH has posted a Request for Response to procure ACCS on a statewide basis.

DMH’s ACCS program will deliver evidence based interventions within the context of a standardized, clinically focused model to promote: 

  • Active engagement and assertive outreach to prevent homelessness; 
  • Clinical coverage 24/7/365 days a year 
  • Consistent assessment and treatment planning 
  • Risk assessment, crisis planning and prevention 
  • Skill building and symptom management, 
  • Behavioral and physical health monitoring and support 
  • Addiction treatment support;  
  • Family engagement; 
  • Peer support and recovery coaching  
  • Reduced reliance on emergency departments, hospitals and other institutional levels of care.

Key Features and Changes

                                  ACCS                               CBFS
Team Structure/ Engagement
  • Standard clinical staffing model with licensed clinical staff
  • Assign all clients a primary clinician – accountable for all service components provided by the team
  • Defines clinical staff responsibility as 24/7/365 coverage
  • Standards require family focus approach and emphasize role of peer supports
  • No requirements regarding team composition
  • No requirements regarding clinical responsibility beyond screening, assessment, and treatment planning
Treatment for Co-Occurring SUDs
  • Team model includes licensed substance abuse counselors and recovery coaches
  • Housing first, harm reduction approach
  • Contractors must utilize standardized screening and assessment tools for risk and substance use
  • No standard approach to treatment or required staffing
  • No standard form for screening
Healthcare Integration
  • Integrate with the healthcare delivery system through care coordination entity
  • DMH and MassHealth developing information-sharing capabilities to support process for shared management and oversight
  • Align assessment and treatment planning activities with care coordination entity
  • Wellness promotion
  • Support in accessing psychiatric and medical care, collateral contacts
  • Rate accounts for all clinical, direct care and peer staff needed to fulfill RFR requirements
  • Model expenses are accounted for, including geographic adjustment
  • Per c.257, rates are adjusted for inflation
  • Contract-specific rates est. based on historical resource base
  • Every contract has a different rate and expected to deliver same service
Performance/ Outcomes Measurement
  • DMH re-institutes its authority to apply consistent clinical criteria to determine enrollments and level of care
  • Standardize approach to contract monitoring, w/ focus on key measures: engagement rates, community tenure, etc.
  • Data sharing w/ MassHealth to monitor utilization patterns of DMH clients
  • Continue measurement of community tenure, w/ 90% target
  • Vendors will have access to real time information from care coordination entities
  • Extensive list of outcome measures - difficult to collect, analyze and use
  • No consistent approach to site-level contract monitoring
  • Data reported to DMH by vendors is based upon ability to gather info.


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