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Guidelines for State or County PACT Initiatives
Program of Assertive Community Treatment Guidelines for:
- State NAMI PACT Steering Committees
- State Government/Advocate Multi-organization PACT Initiative Committees
- Local PACT Team Advisory/Oversight Committees
The National PACT Center suggests state NAMI organizations may participate in 3 kinds of PACT committees. Some NAMI staff or members will participate in all three levels; other NAMI members will take part in one or two of the committees. Your particular state and local circumstances will guide your activities. The committees are:
- 1. NAMI Statewide PACT Steering Committee
- 2. State Government and Advocate Multi-organization PACT Initiative Committee
- 3. Local PACT Team Advisory Group, often called an Oversight Committee
- NAMI State Organization PACT Steering Committee.
- To assist and guide the NAMI state organization with advocacy for assertive community treatment teams
- To be a resource to local affiliates, providing education on programs of assertive community treatment (PACT)
- To conduct internal NAMI discussion on policy and strategy to enable NAMI members and staff to "be on the same page" when stating NAMI positions to the State Government and Advocate Multi-organization PACT Initiative Committee described in #2, and when giving interviews to the media, or speaking to the general public.
- This group is for NAMI members, usually including at least one state-level NAMI board member.
- Key NAMI members who are particularly interested in assertive community treatment serve on this committee.
- The NAMI PACT Steering Committee includes NAMI consumers from the start; if possible, the NAMI Consumer Council Representative serves on the PACT Steering Committee.
- This committee actively advocates with state and local mental health leaders, and with managed care organizations, for the development of PACT teams.
- This committee learns about PACT and provides information to local affiliates by activities such as giving presentations and writing articles for NAMI newsletters.
- The NAMI State Steering Committee alerts affiliates to opportunities to serve on local PACT team advisory groups/oversight committees and lets consumers know about opportunities to be employed as peer specialist staff on PACT teams.
- The NAMI PACT Steering Committee discusses NAMI state organization positions on developments brought forward by the state government, or other entities that seek NAMI comment.
- If there is no State Government and Advocate Multi-organization PACT Initiative Committee, the NAMI PACT Steering Committee may initiate the formation of such a committee to bring together government officials, providers, advocates, legislators, and others dedicated to funding, developing, expanding, and/or strengthening PACT teams.
- State Government and Advocate Multi-organization PACT Initiative/Oversight Committee.
- Usually, to provide input to the state (county) government agency responsible for developing--often through a request for proposals (RFP) process--and monitoring assertive community treatment.
- To assist the state government, or managed care company in a managed care environment, in monitoring on-going operations, quality, and outcomes of PACT teams.
- To advocate for adequate funding, training and consultation for PACT teams.
- To advocate for sufficient state--and county in a county-based system such as California--mental health authority staff to provide oversight, accountability, quality control, and on-going support to PACT teams.
- This group consists of state mental health authority officials, state Medicaid officials, NAMI PACT Steering Committee representatives including consumers, and other advocacy spokespersons, and sometimes provider agency and managed care representatives and legislators.
- The State Government and Advocate Multi-organization PACT Initiative Committee is often chaired by the state department of mental health, but the state NAMI organization, or another entity, may initiate and/or chair this committee.
- Several members of the NAMI State Organization PACT Steering Committee should be members of this multi-organization group.
- Consumers should be part of the NAMI delegation to this multi-organization committee.
- The NAMI Consumer Council Representative should be (if at all possible) one of the NAMI consumer members of the State Government and Advocate Multi-organization PACT Initiative Committee.
- The NAMI representatives provide the NAMI viewpoint within the committee.
- The NAMI members are a liaison between this committee and the NAMI PACT Steering Committee, described above in #1.
- Local PACT Team Advisory Group (often called an Oversight Committee) PACT Team Advisory Group/Oversight Committee Guidelines
Advisory Group/Oversight Committee Mission:
- To assist and guide the local PACT team in implementation and on-going management of a program of assertive community treatment (PACT)
- To assist and guide the PACT team’s administering agency on assertive community treatment issues
- To maintain fidelity to the PACT model, as described in the federal Substance Abuse and Mental Health Services Agency’s (contract #97MO4766501D) National PACT Standards. The standards are in Appendix 8 of The PACT Model of Community-Based Treatment for Persons with Severe and Persistent Mental Illnesses: A Manual for PACT Start-UP. They are also on the NAMI Web site at www.nami.org in the PACT section, accessible from the NAMI Web site home page.
Advisory Group/Oversight Committee Membership:
- Each PACT team should have a PACT Advisory/Oversight Committee whose members are at lease 51% consumers and family members.
- The local NAMI affiliate, local consumer organizations, and the management of the agency sponsoring the team should collaborate to determine membership. At times, the NAMI Statewide PACT Steering Committee may assist.
- The Advisory Group/Oversight Committee must have at lease three consumer members.
- PACT Advisory Group/Oversight Committee members are community stakeholders with an interest in the success of the PACT team. These may include representatives of organizations that interact with the PACT team, such as homeless services, consumer peer support organizations, food shelf, criminal justice providers, landlords, employers, and community colleges.
- The Advisory Group should have at least 10 members, but usually fewer than 15 members to facilitate discussion. Members typically serve for a staggered, two-year term.
Advisory Group/Oversight Committee Membership Qualifications:
- Members should be knowledgeable about severe mental illnesses and the challenges that people with severe mental illnesses face in living in the community the team will serve, or already serves.
- People recovering from mental illnesses, and their relatives, are very well qualified to identify problems and solutions that others overlook.
- Members should be good problem solvers who have a positive attitude.
- Members listen to and seek to understand the perspective of all stakeholders.
- Members must make a commitment to regularly attend Advisory Group meetings.
Advisory Group/Oversight Committee Formation:
- With a new PACT team, the Advisory Group may be formed in preparation for obtaining, or implementing, a contract to develop a PACT team. In other situations, the Advisory Group/Oversight Committee may form following award of a PACT contract, or when a provider decides to reorganize its services to establish a PACT team and form the team’s advisory group.
- In a competitive bid environment, the Advisory Group may form as part of developing a proposal to make a bid for a contract, or shortly after the contract is awarded.
- With an assertive community treatment team that is already in place, an Advisory Group is formed to strengthen the team and increase the team’s resources and community understanding and support for assertive community treatment. The state, or county, mental health authority may contractually require that new and existing PACT teams form advisory groups.
Advisory Group/Oversight Committee Meetings:
- The Advisory Group meets within 30 days of the award of a contract to develop a PACT team.
- The Advisory Group meets as often as needed, frequently monthly.
- The Advisory Group meets at least 4 times a year.
Advisory Group/Oversight Committee Relationship to Staff:
- The Advisory Group is independent of, and communicates directly with, management level staff in the agency sponsoring the team.
- The PACT team leader, and other team staff as requested by the Advisory Group, participate in Advisory Group meetings.
- The PACT team, or its sponsoring agency, provides administrative support to the Advisory Group.
Advisory Group/Oversight Committee Member Role:
- Become knowledgeable about assertive community treatment by participating in PACT training sessions and reading material on the model.
- At the invitation of the team, spend at least one day with the PACT team as it goes about its work.
- Understand where the PACT team fits into the community’s overall system of mental illness treatment and support for recovery.
- Be actively involved in team implementation and on-going management by providing input on team resources, policies, and staff hiring recommendations. Seek staff who are truly interested in working with, and learning from, PACT team staff members who are consumers.
- Participate in the advisory group as a forum for the review and resolution of issues that the team, or its consumers, face. Do problem solving on issues of concern to the team, to consumers, to family members, to other stakeholders, to the community.
- Establish a mechanism by which the PACT team staff, PACT consumers, and related family members, or significant others, can communicate with the Advisory Group/Oversight Committee as a problem-solving body.
- Advise the PACT team on how to make services relevant, collaborative, respectful and desirable (user-friendly) to PACT team consumers. Promote community understanding of the model and its goals.
- Advisory Group members may give presentations to the public and to community organizations.
- Monitor ongoing program evaluation data.
- Participate in program assessment. Conduct surveys, interviews and/or focus groups of team consumers and focus groups of family members of team consumers.
- Monitor consumer complaints.
- Monitor consumer rights issues.
- Examine areas needing improvement and make recommendations, review data in a continuous quality improvement effort.
- Advocate for resources for the team and resources, such as affordable housing, for persons served by the team.
NAMI ACT Technical Assistance Center, February 2000
These guidelines were developed with support from the U.S. Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, Community Support Branch, through grant #KD1 SM52579-02.