|
PACT Model Recommended Standards
|
|
Y
|
N
|
|
A. Staff Composition
|
|
|
|
|
1.
|
Minimum Team Size 10 FTE/Urban; 5-7 FTE/Rural
|
|
|
|
2.
|
Clinical Staff-Client Ratio of 1:10 (excluding MD)
|
|
|
|
3.
|
Psychiatrist(s) – 16 Hours per 50 Clients
|
|
|
|
4.
|
Program Admin Assistant 1 FTE/Urban .5 FTE/Rural
|
|
|
|
5.
|
Full Time Masters Level Clinician as Team Leader
|
|
|
|
6.
|
At least 8 (3 FTE/Rural) of Non MD Staff are Mental Health Professionals (MSW,MSN, BSN, OTR, etc)
|
|
|
|
7.
|
At Least 1 FTE Substance Abuse Specialist
|
|
|
|
8.
|
At Least 3 FTE-R.N./Urban 1.5 FTE R.N./Rural
|
|
|
|
9.
|
At Least 1 FTE-Vocational Specialist
|
|
|
|
10.
|
At Least 1 FTE Peer Specialist
|
|
|
|
B. Key Staff Roles
|
|
|
|
|
1. Team Leader
|
|
|
|
| |
a. Leads Daily Organizational Team Meeting
|
|
|
| |
b. Leads Treatment Planning Meetings
|
|
|
| |
c. Available To Team Members For Clinical Consultation
|
|
|
| |
d. Provides 1:1 Supervision
|
|
|
| |
e. Functions As A Practicing Clinician
|
|
|
| |
|
|
|
|
2. Psychiatrist
|
a. Conducts Psychiatric & Health Assessments
|
|
|
| |
b. Supervises The Psychiatric Treatment Of All Clients
|
|
|
| |
c. Provides Psychopharmacologic Treatment Of All Clients
|
|
|
| |
d. Supervises The Medication Management System
|
|
|
| |
e. Provides Individual Supportive Therapy
|
|
|
| |
f. Provides Crisis Intervention On-Site
|
|
|
| |
g. Provides Family Interventions & Psychoeducation
|
|
|
| |
h. Attends Daily Organizational & Tx Planning Meetings
|
|
|
| |
i. Provides Clinical Supervision
|
|
|
|
3. Registered Nurses
|
|
|
|
| |
a. RNs and MD Manage Medication System
|
|
|
| |
b. Administers And Documents Medication Treatment
|
|
|
| |
c. Conduct Health Assessments
|
|
|
| |
d. Coordinate Services with other Health Providers
|
|
|
|
4. Vocational Specialist
|
|
|
|
|
|
a. Lead Clinician For Vocational Assessment And Planning
|
|
|
| |
b. Maintains Liaison With Voc. Rehab & Training Agencies
|
|
|
| |
c. Provides Full Range Of Voc Services (Job Development, Placement, Job Support, Career Counseling)
|
|
|
|
5. Peer Specialist
|
|
|
|
| |
a. Peer Counselor Position Is Integrated Within The Team
|
|
|
| |
b. Peer Counselor & Other Team Members Share Roles
|
|
|
|
6. Substance Abuse Specialist
|
|
|
|
| |
a.. Serves On Individual Treatment Team Of Clients With SA Disorders
|
|
|
| |
b.. Lead Clinician For Assessing, Planning And Treating Substance Use
|
|
|
| |
c.. Provides Supportive & Cognitive Behavioral Treatment-Individually And In Groups
|
|
|
|
C. Outreach & Continuity of Care
|
|
|
|
|
1.
|
At Least 75% Of All Contacts Occur Of Out The Office
|
|
|
|
2.
|
Difficult To Engage Clients Are Retained
|
|
|
|
3.
|
Difficult To Engage Clients Seen 2x A Month Or More
|
|
|
|
4.
|
Acutely Hospitalized Clients Seen 2x A Week Or More
|
|
|
|
5.
|
Long Term Hosp. Clients Seen Each Week In Hospital
|
|
|
|
6.
|
Team Plans Jointly With Inpatient Staff
|
|
|
|
D. Program Size & Intensity
|
|
|
|
|
1.
|
Program Size Does Not Exceed 120 Clients (80 Rural)
|
|
|
|
2.
|
Staff To Client Ratio Does Not Exceed 1:10
|
|
|
|
3.
|
Clients Contacted Face-To-Face An Average Of 3x A Week
|
|
|
|
4.
|
Unstable Clients Contacted Multiple Times Daily
|
|
|
|
E. Admission & Discharge-Criteria Specified
|
|
|
|
|
1.
|
Admission Criteria Specify Target Population
|
|
|
|
2.
|
At Least 80% Of Clients Have 295-296 Axis I Diagnosis
|
|
|
|
3.
|
Discharges Mutually Determined By Clients And Team
|
|
|
| 4. |
Team Assumes Long-Term Treatment Orientation |
|
|
|
F. Clinical Charts
|
|
|
|
|
1.
|
Charts Are Uniformly Organized
|
|
|
|
2.
|
Prescribed Chart Contents Are Current And Complete
|
|
|
|
3.
|
Progress Notes Follow POMR Format
|
|
|
|
G. Office Space
|
|
|
|
|
1.
|
Easily Accessible To Clients And Families
|
|
|
|
2.
|
Common Workspace, Layout Promotes Communication
|
|
|
|
3.
|
In Office Medication Storage Area
|
|
|
|
H. Inter-Agency Relationship
|
|
|
|
|
1.
|
Active Collaboration With Other Human Services
|
|
|
|
2.
|
Active Client-Specific Liaison With SSA, Health Care Providers, Other Agency Assigned Caseworkers
|
|
|
|
I. Hours of Operation
|
|
|
|
|
1.
|
Staff On Duty 7 Days Per Week
|
|
|
|
2.
|
Program Operates 12 Hours On Weekdays
|
|
|
|
3.
|
Program Operates 8 Hours On Weekends/Holidays
|
|
|
|
4.
|
Team Member On Call All Other Hours
|
|
|
|
J. Team Communication & Planning
|
|
|
|
|
1.
|
Organizational Team Meeting Held Daily M-F
|
|
|
|
2.
|
Meeting Completed Within 45-60 Minutes
|
|
|
|
3.
|
Clients Status Reviewed Via Daily Log & Staff Report
|
|
|
|
4.
|
Team Leader Facilitates Discussion & Tx Planning
|
|
|
|
5.
|
Services & Contacts Scheduled Per Tx Plans And Triage
|
|
|
|
6.
|
Shift Manager Determines Staff Assignments
|
|
|
|
7.
|
Shift Manager Prepares Daily Staff Assignment Schedule
|
|
|
|
8.
|
Shift Manager Monitors/Coordinates Service Provision
|
|
|
|
9.
|
All Staff Contacts With Clients Are Logged
|
|
|
|
K. Assessment & Treatment Planning
|
|
|
|
|
1.
|
Baseline And Ongoing Assessments Are Documented
|
|
|
| |
a. Psychiatric
|
|
|
| |
b. Vocational
|
|
|
| |
c. Activities Of Daily Living & Housing
|
|
|
| |
d. Social
|
|
|
| |
e. Family Interaction
|
|
|
| |
f. Substance Use
|
|
|
| |
g. Health
|
|
|
|
2.
|
Assessment Done By Qualified Staff
|
|
|
|
3.
|
Individual Treatment Teams Of 3 To 5 Staff Per Client
|
|
|
|
4.
|
Tx Planning Meetings Weekly
|
|
|
|
5.
|
Tx Planning Meetings Led By Senior Staff
|
|
|
|
6.
|
Clients Participate In Formulating Goals & Service Plans
|
|
|
|
7.
|
5 Axis DSM-IV On Plans
|
|
|
|
8.
|
Problems, Goals, And Plans Specific And Measurable
|
|
|
|
9.
|
Tx Plans Transferred To Client Weekly Schedule
|
|
|
|
10.
|
Tx Planning Schedule Posted 2 Months Ahead
|
|
|
|
11.
|
Tx Plan Reviewed/Modified At Key Events In Tx Course
|
|
|
|
12.
|
Tx Plan Reviewed & Rewritten At Least Every 6 Months
|
|
|
|
L. Services
|
|
|
|
|
1.
|
Case Management
|
|
|
| |
a. MHP Case Manager Assigned For Each Client
|
|
|
| |
b. Other Individual Tx Team Staff Back Up Case Manager
|
|
|
| |
c. C.M. Provides Supportive Therapy, Family Support,
|
|
|
|
|
Education & Collaboration, And Crisis Intervention
|
|
|
| |
d. C.M. Plans Coordinates, Monitors Services
|
|
|
| |
f. C.M. Advocates, Provides Social Network Support
|
|
|
| |
g. All MHP Staff Perform Case Management
|
|
|
|
2.
|
Crisis Assessment & Intervention
|
|
|
| |
a. 24 Hours Per Day
|
|
|
| |
b. Team Member Available By Phone & Face-To-Face With Back Up By Team Leader And Psychiatrist
|
|
|
| |
c. Collaboration With Emergency Services Providers
|
|
|
|
3.
|
Individual Supportive Therapy
|
|
|
| |
a. Ongoing Assessment Of Symptoms & Tx Response
|
|
|
| |
b. Illness & Medication Effects Education
|
|
|
| |
c. Symptom management education
|
|
|
| |
d. psychological Support, problem solving & assistance Adapting to Illness
|
|
|
|
4.
|
Medication Management
|
|
|
| |
a. Psychiatrist actively supervises/collaborates with RNs
|
|
|
| |
b. Frequent Psychiatrist Assessment Of Client Response
|
|
|
| |
c. All Team Members Monitor Medication
|
|
|
| |
d. Medication Managed In Accordance With P & P Manual
|
|
|
|
5.
|
Substance Abuse Treatment
|
|
|
| |
a. One Or More Designated Substance Abuse Specialists
|
|
|
| |
b. All Team Members Assess And Monitor Substance Use
|
|
|
| |
c. Interventions Follow An Established Dd Tx Model
|
|
|
|
|
d. Individual Interventions Provided
|
|
|
| |
e. Group Intervention Provided
|
|
|
|
6.
|
Work Related Services
|
|
|
| |
a. Assessment Of Interests And Abilities And Of Effect Of Mental Illness On Employment
|
|
|
| |
b. All Team Members Provide Vocational Services, Coordinated By Team Vocational Specialist(S)
|
|
|
| |
c. Interventions To Reduce Symptom And Behavioral Impediments To Employment
|
|
|
| |
d. Ongoing Employment Rehabilitation Plan Developed
|
|
|
| |
e. On The Job Collaboration With Client And Supervisors
|
|
|
| |
f. Off The Job Work Related Supportive Services Provided
|
|
|
|
7.
|
Activities Of Daily Living
|
|
|
| |
a. Self Care Skills Training
|
|
|
| |
b. Home Making Skills Training
|
|
|
| |
c. Financial Management Skills Training
|
|
|
| |
d. Use Of Available Transportation Skills Training
|
|
|
| |
e. Use Of Health And Social Services Skills Training
|
|
|
|
8.
|
Social, Interpersonal Relationship & Leisure Time
|
|
|
| |
a. Communication Skill Training
|
|
|
| |
b. Interpersonal Relations Skill Training
|
|
|
| |
c. Social Skills Training
|
|
|
| |
d. Leisure Time Skills Training
|
|
|
| |
e. Support To Clients In Participating In Social, Recreational Educational & Cultural Community Activities
|
|
|
| |
f. Team Organizes Leisure Time Activities
|
|
|
|
9.
|
Support Services
|
|
|
| |
a. Access To Medical And Dental Services
|
|
|
| |
b. Locate & Maintain Safe, Clean , Affordable Housing
|
|
|
| |
c. 80% Of Clients Live In Independent Community Housing
|
|
|
| |
d. Financial Management Support
|
|
|
| |
e. Access To Social Services
|
|
|
| |
f. Transportation & Access To Transportation
|
|
|
| |
g. Legal Advocacy
|
|
|
|
10.
|
Family And Other Support System Interventions
|
|
|
| |
a. Ongoing Communication & Collaboration Between
|
|
|
| |
Team & Family
|
|
|
| |
b. Education About Clients Illness And Family’s Role In Treatment
|
|
|
| |
c. Interventions To Reduce Conflict
|
|
|
|
M. Policy and Procedure Manual
|
|
|
|
|
1.
|
Admission And Discharge Criteria And Procedures
|
|
|
|
2.
|
Job Descriptions, Performance Appraisal, Training Plan
|
|
|
|
3.
|
Program Organization & Operation (Program Hours, On-Call, Service Intensity, Staff Communication, Team Approach, & Staff Supervision
|
|
|
|
4.
|
Assessment & Treatment Planning
|
|
|
|
5.
|
Medical Record Management
|
|
|
|
6.
|
Service Scope
|
|
|
| |
a. Case Management
|
|
|
| |
b. Crisis Assessment & Intervention
|
|
|
| |
c. Symptom Assessment, Management & Supportive Therapy
|
|
|
| |
d. Medication Prescription, Administration, Monitoring & Documentation
|
|
|
| |
e. Substance Abuse Services
|
|
|
| |
f. Work Related Services
|
|
|
| |
g. Activities Of Daily Living
|
|
|
| |
h. Social, Interpersonal Relationships & Leisure Time
|
|
|
| |
i. Support Services
|
|
|
| |
j. Education & Support To Families & Other Supports
|
|
|
|
7.
|
Client Rights
|
|
|
|
8.
|
Program Performance Improvement And Evaluation
|
|
|
