Program of Assertive Community Treatment Admissions and Discharge

Program of Assertive Community Treatment Admissions and Discharge A. In order to be admitted into PACT Services, people must meet the criteria outlined in this rule. B. PACT Teams serve people with severe and persistent mental illness, as listed in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, that seriously impairs their functioning in community living. Priority is given to people with schizophrenia, other psychotic disorders (e.g., schizoaffective disorder), and bipolar disorder because these illnesses more often cause long-term psychiatric disability. People with other psychiatric illnesses are eligible, dependent on the level of the long-term disability. (People with a primary diagnosis of a substance use disorder, intellectual disability, or personality disorder are not the intended groups). C. People with significant functional impairments as demonstrated by at least one (1) of the following conditions: 1. Significant difficulty consistently performing the range of practical daily living tasks required for basic adult functioning in the community (e.g., caring for personal business affairs; obtaining medical, legal, and housing services; recognizing and avoiding common dangers or hazards to self and possessions; meeting nutritional needs; maintaining personal hygiene) or persistent or recurrent difficulty performing daily living tasks except with significant support or assistance from others such as friends, family, or relatives. 2. Significant difficulty maintaining consistent employment at a self-sustaining level or significant difficulty consistently carrying out a homemaking role (e.g., household meal preparation, washing clothes, budgeting, or child-care tasks and responsibilities). 3. Significant difficulty maintaining a safe living situation (e.g., repeated evictions or loss of housing). D. People must have one (1) or more of the following problems, which are indicators of continuous high-service needs (i.e., greater than eight [8] hours per month): 1. High use of acute psychiatric hospitals (e.g., two [2] or more admissions per year) or psychiatric emergency services. 2. Intractable (i.e., persistent or very recurrent) severe major symptoms (e.g., affective, psychotic, suicidal). 3. Coexisting substance use disorder of significant duration (e.g., greater than six [6] months). 4. High risk or recent history of criminal justice involvement (e.g., arrest, incarceration). 5. Significant difficulty meeting basic survival needs, residing in substandard housing, homelessness, or in imminent risk of becoming homeless. 6. Residing in an inpatient or supervised community residence, but clinically assessed to be able to live in a more independent living situation if intensive services are provided, or requiring a residential or institutional placement if more intensive services are not available. 7. Difficulty effectively utilizing traditional office-based outpatient services. E. Discharges from the PACT Team occur when people and agency provider employees mutually agree to the termination of services. This must occur when people: 1. Have successfully reached established goals for discharge, and when the person and agency provider employees mutually agree to the termination of services. 2. Have successfully demonstrated an ability to function in all major role areas (i.e., work, social, self-care) without ongoing assistance from the agency provider, without significant relapse when services are withdrawn, and when the person requests discharge, and the agency provider employees mutually agree to the termination of services. 3. Move outside the geographic area of the PACT Team’s responsibility. In such cases, the PACT Team must arrange for transfer of mental health service responsibility to a Program of Assertive Community Treatment Service or another agency provider wherever the person is moving. The PACT Team must maintain contact with the person until this service transfer is implemented. 4. Decline or refuse services and request discharge, despite the team’s best efforts to develop an acceptable Individual Service Plan with the person.