The research-based U.S. Surgeon General's Mental Health Report in presenting a science base for its concluding section, "A Vision for the Future," on page 455 states, "Across the Nation, certain mental health services are in consistently short supply. These include assertive community treatment, an intensive approach to treating people with serious mental illnesses. All too frequently, these effective programs are simply unavailable in communities. It is essential to expand the supply of effective, evidence based services throughout the Nation."
In a June 7, 1999 directive to state Medicaid agencies the Federal Health Care Financing Administration (HCFA) urged state Medicaid directors to fund assertive community treatment programs. HCFA based this guidance on the Agency for Health Care Policy and Research (ANHPR) and National Institute of Mental Health (NIMH) sponsored Schizophrenia Patient Outcomes Research Team (PORT) recommendations developed on the basis of a comprehensive review of the treatment outcomes literature. PORT was conducted by Johns Hopkins University and the University of Maryland. Referencing the PORT study, page 279 of the Surgeon General's Report says, "Systems of care serving persons with schizophrenia who are high users should include ACT (Assertive Community Treatment) and ACM (Assertive Case Management) programs."
The program of assertive community treatment (ACT) approach is supported by two decades of research, most of it financed by the Federal government, that show ACT to be effective and cost-effective.