Mental Health - Adult Single Point of Access (SPOA) Referrals

For Assertive Community Treatment (ACT) Services

ACT is a licensed, community-based service for individuals with mental illness that have intensive needs and have difficulty engaging in traditional clinic based services.  Monroe County now has three ACT teams available, two at Strong Ties and one through Rochester Regional Health System.  Click on the link above for "Assertive Community Treatment (ACT) Services" to download the form to complete electronically (Use Save As to save the copy) OR print from manual completion.  Completed forms should be submitted via secure email, fax or regular mail. 

English Form Spanish Form

For Adult Mental Health Residential Services

Click on the link above for "Adult Mental Health Residential Services" to access the PDF referral form.  This form should be downloaded and can then be completed electronically (Use Save As to save the copy) and submitted via secure email OR can be printed for manual completion and submitted via secure e-mail, fax or regular mail.  Please do not use this link to make care management referrals.  If a referral to both residential and care management services is desired, you must complete both forms. 

English Form Spanish Form

For Adult Behavioral Health Care Management

All referrals for adult behavioral health care management (including Health Home care management and non-Medicaid care management) should be submitted using the new Monroe County Community Referral for Care Management.  Click on the link above for "Adult Behavioral Health Care Management" to access the PDF referral form.  This form should be downloaded and can then be completed electronically (Use Save As to save the copy) and submitted via secure email OR can be printed for manual completion and submitted via secure e-mail, fax or regular mail.

English Form Spanish Form

Eligibility for Adult Behavioral Health Care Management

Individuals must meet all eligibility requirements to be considered for enrollment.

Behavioral Health Care Management

  1. Individual is not eligible for Health Home Care Management services because:
    • Individual is not eligible for Medicaid;
    • OR Individual does not meet DOH eligibility criteria;
  2. AND Individual has a primary mental health diagnosis;
  3. AND Individual resides in Monroe County;
  4. AND Individual has significant behavioral, medical or social risk factors which can be addressed through care management.

Health Home Care Management

  1. Individual meets the NYS DOH eligibility criteria of:
    • two chronic conditions,
    • OR HIV/AIDS and the risk of developing another chronic condition,
    • OR one or more serious mental illnesses;
  2. AND Individual currently has active Medicaid OR Medicaid and Medicare;
  3. AND Individual resides or receives services in Monroe County;
  4. AND Individual has significant behavioral, medical or social risk factors which can be addressed through care management.

Community Referrals for Behavioral Health Care Management and Health Home Care Management are now being accepted in Monroe County from providers, community organizations, individuals and/or family members.

  • Behavioral Health Care Management is being triaged through the Monroe County Office of Mental Health for individuals with mental health and/or chronic substance abuse disorders who are not eligible for Health Home Care Management.
  • Health Home Care Management is being provided by Greater Rochester Health Home Network (GRHNN) AND Health Homes of Upstate New York - Finger Lakes (HHUNY - Finger Lakes) for eligible Medicaid and Medicaid/Medicare dual eligible persons.

If you have questions about the process to submit a referral, contact the Monroe County Single Point of Access (SPOA) office at (585) 753-2874.

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