Contact:

Netsmart Technologies, Inc
James Conway, CEO
800-451-7503
jconway@csmcorp.com

Carpe DM, Inc.
Stuart Fine
908-490-0075
stuart@carpedminc.com


                 NETSMART ANNOUNCES RECORD THIRD QUARTER RESULTS

    Revenues increase 18%, Net Income Up 667% from Third Quarter Fiscal 2002

ISLIP, NY - October 20, 2003 - Netsmart Technologies, Inc. (Nasdaq: NTST), a
leading supplier of enterprise-wide software solutions for health and human
services providers, today reported results for the third quarter ended September
30, 2003.

Net income for the quarter ended September 30, 2003 was $1,546,000, or $0.34 per
share (basic) and $.33 per share (diluted), as compared to $202,000 or $0.05 per
share (basic and diluted), for the same period last year. The net income for the
quarter ended September 30, 2003 also reflects an $800,000 deferred tax benefit
associated with our tax loss carry forward. Revenue for the quarter ended
September 30, 2003 was $7,108,000 as compared to $6,044,000 for quarter ended
September 30, 2002, representing an increase of 18 percent.

Net income for the nine months ended September 30, 2003 was $2,339,000, or $.56
per share (basic) and $.52 per share (diluted), as compared to $447,000, or $.12
per share (basic) and $.11 per share (diluted) for the same period last year.
The net income for the nine months ended September 30, 2003 reflects a $900,000
deferred tax benefit associated with our tax loss carry forward. Revenue for the
nine months ended September 30, 2003 was $19,816,000 as compared to $16,321,000
for the nine months ended September 30, 2002, representing an increase of 21
percent.

James Conway, CEO of Netsmart Technologies, Inc., stated "We continue to be
pleased with the performance of our operating team in meeting scheduled contract
expectations coupled with the development of new business opportunities by our
marketing executives. These efforts have lead to increased order backlog and
improved performance. Our firm order backlog of $25.5 million at September 30,
2003 is a record high, more importantly, 48% of this backlog is recurring
revenue. Our gross margins for the quarter ended September 30, 2003 have
improved to 44% from 31% for the same period last year which, along with the
increase in our recurring revenue base, has contributed significantly to our
profitability and improvements in our balance sheet."

About Netsmart Technologies, Inc.

Netsmart   Technologies,   Inc.  of  Islip,  N.Y.,  through  Creative
Socio-Medics, is  an established,  leading  supplier of  enterprise-wide
software  solutions  for health and human services  providers  with  over  580
clients,  including  25  systems  with  state  agencies.  Creative's  clients
include health and human services  organizations:  public health agencies,
mental health and substance
                                    - more -




abuse clinics, psychiatric hospitals, and managed care organizations. Avatar
Practice Management and the Avatar Clinician Work Station, Creative's core
products, are full-featured information systems that operate on a variety of
operating systems, hardware platforms, and mobile devices and offer unlimited
scalability.

Statement on Behalf of Netsmart Technologies, Inc.
- --------------------------------------------------

Statements in this press release may be "forward-looking statements" within the
meaning of the Private Securities Litigation Reform Act of 1995. Words such as
"anticipate", "believe", "estimate", "expect", "intend" and similar expressions,
as they relate to the company or its management, identify forward-looking
statements. These statements are based on current expectations, estimates and
projections about the company's business based, in part, on assumptions made by
management. These statements are not guarantees of future performance and
involve risks, uncertainties and assumptions that are difficult to predict.
Therefore, actual outcomes and results may, and probably will, differ materially
from what is expressed or forecasted in such forward-looking statements due to
numerous factors, including those described above and those risks discussed from
time to time in Netsmart's filings with the Securities and Exchange Commission.
In addition, such statements could be affected by risks and uncertainties
related to product demand, market and customer acceptance, competition, pricing
and development difficulties, as well as general industry and market conditions
and growth rates, and general economic conditions. Any forward-looking
statements speak only as of the date on which they are made, and the company
does not undertake any obligation to update any forward-looking statement to
reflect events or circumstances after the date of this release. Information on
Netsmart's or Creative's website do not constitute a part of this release.

                           NETSMART TECHNOLOGIES, INC.
                           ---------------------------

Comparative Operating Results for the Three and Nine Months Ended September 30,
- -------------------------------------------------------------------------------
                                           Three Months                     Nine Months
                                           ------------                     -----------
                                                                       


                                        2003            2002            2003           2002
                                        ----            ----            ----           ----

Revenue                               $7,108,000      $6,044,000      $19,816,000    $16,321,000

Net Income(1)                         $1,546,000      $  202,000      $ 2,339,000    $   447,000

Net Income
Per Share Basic                       $      .34      $      .05      $       .56    $       .12

Weighted
Average Shares of Common
Stock Outstanding Basic                4,513,000       3,697,000        4,160,000      3,696,000

Net Income Per
Share Diluted                         $      .33      $      .05      $       .52    $       .11

Weighted
Average Shares of Common
Stock and Common Stock
Equivalents Outstanding Diluted        4,706,000       4,070,000        4,469,000      4,062,000

(1) The Company's tax provision has been reduced in all periods as a result of
available net operating loss carry forwards. In addition, the Company recognized
a $800,000 tax benefit during the September 2003 Quarter and a $900,000 tax
benefit during the nine months ended September 30, 2003, as a result of a
further reduction in its deferred tax asset valuation allowance.

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