The King County Program for Assertive Community Treatment (PACT) Health and Wellness Expansion Project proposes to create additional capacity within existing PACT service providers and expand the scope of services delivered within an ACT model toward integration of physical-behavioral health care and improving the overall health of PACT participants in King County. By leveraging a current ACT structure supported by Medicaid and Washington State resources we will maximize the impact of a SAMHSA ACT grant to achieve outcomes that will benefit the community and people with complex behavioral health needs by expanding overall access to divert and discharge people from costly inpatient care, making significant strides in improving health of adults with serious mental illness (SMI) and comorbid health conditions, and bridging a critical system transition to fully integrated managed care. Demographics of individuals served are expected to be similar to current PACT participants in King County, approximately 52% white and 48% people of color, 73% male, and 91% between the ages of 25-64.
Through the addition of physical health-focused clinical staff, a nurse care manager and peer wellness coach, to three existing PACT teams this project creates two distinct program expansions:
1) Increasing overall caseload capacity for 30 people, providing core ACT services to an additional estimated 45 people over the life of the grant, and
2) Advancing physical-behavioral health integration within an ACT scope of service to improve care coordination with healthcare providers, embed health, wellness, and chronic disease self-management programming, and improve health outcomes for PACT participants across the team caseload.
It is anticipated that approximately 60% of all PACT participants will engage in some form of proposed health and wellness project activities, serving about 180 people in the duration of the grant. Expected outcomes of project activities are:
• Increased access to core ACT services, particularly for individuals with SMI and complex and/or chronic co-morbid medical conditions,
• Reduction in emergency department, hospital, and jail utilization for added PACT participants,
• Implementation of physical health and wellness services within PACT teams,
• Increase in PACT participant health-promoting/wellness activities,
• Integration of physical health care management within an ACT model including population health management practices, and
• Improvement of health metrics for PACT participants with complex and/or chronic medical conditions.
Beyond the time span of the proposed project it is intended that the programmatic changes implemented with support of this grant will be sustained as standard health-integrated ACT services and will help reduce negative health outcomes of co-morbid medical conditions for PACT participants and consequently reduce risk of early mortality for these individuals with SMI.