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Program for Assertive Community Treatment (PACT)
The Program for Assertive Community Treatment (PACT) is an intensive, team-based behavioral health service package which offers individualized support in the community to people with serious mental health conditions and high service needs.
PACT assists participants in their recovery from mental health conditions and in developing fulfilling lives, as well as increasing their time and engagement in community settings rather than institutions such as hospitals and jails.
PACT teams are made up of a variety of service providers who assist individuals with meeting basic needs like housing, finding and keeping employment, improving social connections, sustaining independent living, and pursuing their personal goals. The team also offers an array of behavioral health treatment options including evidence-based psychotherapies and supportive counseling, medication management, nursing and healthcare coordination, peer support, crisis intervention, and treatment for co-occurring substance use and mental health conditions. All services are tailored to a PACT participant’s unique needs and goals.
PACT is primarily a Medicaid-funded program and consumers need to be Medicaid-eligible to receive PACT services. If you have questions about this requirement, please email PACT@kingcounty.gov.
Additional Resources
Resources for Providers
For someone who might benefit from PACT services:
1. Download the PACT Referral Form and submit it with a clinical assessment documenting diagnosis of a serious psychotic disorder such as schizophrenia, schizoaffective disorder, or bipolar affective disorder with psychotic features.
2. Download the King County PACT Brochure, review it with the individual, and get their consent to refer them to this service
What Does PACT Offer?
PACT offers coordinated treatment by a team of behavioral health specialists including a psychiatrist or ARNP, nurse, co-occuring disorders specialist, employment specialist, mental health counselors, case managers, and a peer support specialist. Some of the key elements of PACT include:
- Small caseloads with a ratio of about 10 participants per staff person
- Centralized, integrated care where the PACT team provides coordinated treatment across specialties
- Most services are provided in the community where participants live
- Services are provided as long as they are needed rather than ending on a fixed date
- Services are flexible and are based on individual needs
- Staff are regularly scheduled to offer behavioral health services 8 to 12 hours a day, 7 days a week
- Crisis services are available 24 hours/7 days a week
PACT Teams
King County is in the process of growing total capacity for PACT participants to 360 spaces. Per ACT national standards, each team enrolls up to four to six consumers per month. Local services are part of a state-wide PACT network which receives training and fidelity monitoring by the SPIRIT Lab at the University of Washington.
King County operates four PACT Teams:
Multidisciplinary Care Team in the ACT Model
About the Assertive Community Treatment Model (ACT)
ACT was developed in the early 1970s in Madison, Wisconsin, as a robust outpatient service system to facilitate deinstitutionalization and assist people with serious mental health conditions in moving from long-term state hospitals to community settings.
It has since been replicated and adapted nationally and internationally with a large body of research supporting ACT’s efficacy in reducing hospital and jail recidivism and length of stays, increasing community tenure and perceived quality of life, and diverting individuals at risk of long-term hospitalization.
ACT is one of the six practices endorsed by the "Evidence-Based Practice Project" sponsored by the Robert Wood Johnson Foundation, the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and National Alliance for the Mentally Ill (NAMI).
Washington State adopted the ACT model in 2007 through the implementation of a state-wide PACT network and provided program standards and eligibility criteria. PACT services in WA are supported by Medicaid and state funds, and administered locally.
The ACT model—which supports team operations and informs policy decisions—includes a stakeholder advisory body made up of community partners and at least 51% representation by people with lived experience of mental health conditions and their families. In King County, the Behavioral Health and Recovery Division facilitates a Stakeholder Advisory Group quarterly with representation from Western State Hospital, Harborview, Jail Health Services, consumer advocates with lived experience, and leads, peer support specialists, and participants from each local PACT team.