NAMI - National Alliance on Mental Illness Home | About NAMI | Contact Us | En Espanol  | Donate  
Find
  Advanced Search  
 

Sign In
myNAMI
Communities
Register and Join
Donate
What's New
State & Local NAMIs
Advocate Magazine
NAMI Newsroom
NAMI Store
NAMIWALKS
National Convention
Special Needs Estate Planning
NAMI Travel

 About Public Policy
  Current News & Alerts
  Policy Reports
  Policy Topics
  Policy Research Institute
  Child & Adolescent Action Center
  Assertive Community Treatment (ACT)
  NAMI Policy Platform
  CIT
  New Freedom Commission

Print this page
Graphic Site
Log Out
 | Print this page | 
 | 
act-ta_center

  PACT MODEL FIDELITY REVIEW
NAMI ACT Technical Assistance Center

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

   

COMMENTS:  This fidelity checklist is a companion to the National PACT Standards and is one tool to monitor fidelity to assertive community treatment.

This document was developed with support from the U.S. Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, Community Support Branch, through grant #SM5279-03.

 

 | Print this page | 
 | 

Donate

Support NAMI to help millions of Americans who face mental illness every day.

Donate today

Speak Out

Inspire others with your message of hope. Show others they are not alone.

Share your story

Get Involved

Become an advocate. Register on NAMI.org to keep up with NAMI news and events.

Join NAMI Today
Home  |  myNAMI  |  About NAMI  |  Contact Us  |  Jobs  |  SiteMap

Copyright © 1996 - 2011 NAMI. All Rights Reserved.