Integrating Primary Care Into Assertive Community Treatment

Objective: This program evaluation examined integration of primary care nurse practitioners into assertive community treatment (ACT). Methods: From January to June 2019, primary care nurse practitioners in a postgraduate fellowship program were assigned to five ACT teams (N=305 participants). Focus groups explored staff members' and participants' experiences. Screening rates for hemoglobin A1c and cholesterol for ACT participants were compared over time. Results: Staff and participants in ACT described improved engagement in primary care, citing benefit from colocation and consultation. Field visits were not found to be an efficient use of the primary care nurse practitioners' time to serve most ACT participants. A significant increase in screening was observed after 6 months for the ACT teams with integrated primary care. Conclusions: An integrated primary care nurse practitioner readily available for participant engagement and consultation with the ACT team, using a cardiometabolic registry to guide care, may offer a sustainable model of integration.