Rule 24-2-32.2 - Program of Assertive Community Treatment StaffingA. Each PACT Team must have the organizational capacity to provide a minimum employee person ratio of at least one (1) full-time equivalent employee for every 10 people (this ratio does not include the psychiatrist or psychiatric nurse practitioner or the service assistant).B. Each PACT Team must have a sufficient number of employees to provide treatment, rehabilitation, and support services 24 hours a day, seven (7) days per week.C. The following positions are required for Programs of Assertive Community Treatment Teams; the specific requirements for the positions listed below are outlined in Chapter 11: 1. Team Leader: A full-time team leader/supervisor who is the clinical and administrative supervisor of the team and who also functions as a practicing clinician on the Program of Assertive Community Treatment Team.2. Psychiatrist/Psychiatric Nurse Practitioner: A psychiatrist/psychiatric nurse practitioner, who works on a full-time or part-time basis for a minimum of 20 hours per week for every 50 people. For teams serving over 50 people, the number of hours required are determined by the following formula: (.4 x # on caseload) = hours required for psychiatrist/psychiatric nurse practitioner per week. The psychiatrist/psychiatric nurse practitioner provides clinical services to all PACT people; works with the team leader to monitor each person's clinical status and response to treatment; supervises employee delivery of services; and directs psychopharmacologic and medical services.3. At least two (2) full-time RNs. A team leader with a nursing degree cannot replace one of the full-time equivalent nurses.4. At least one (1) master's level or above mental health professional (in addition to the team leader).5. At least one (1) Substance Use Specialist.6. At least one (1) Employment Specialist.7. At least one (1) full-time equivalent certified Peer Support Specialist Professional. Peer Support Specialists must be fully integrated team members.8. The remaining clinical personnel may be bachelor's level and paraprofessional mental health workers who carry out rehabilitation and support functions. A bachelor's level mental health worker has a bachelor's degree in social work or a behavioral science, and work experience with adults with severe and persistent mental illness. A para-professional mental health worker may have a bachelor's degree in a field other than behavioral sciences or have a high school degree and work experience with adults with severe and persistent mental illness or with people with similar human-service needs. These paraprofessionals may have related training (e.g., certified occupational therapy assistant, home health care aide) or work experience (e.g., teaching).9. At least one (1) service assistant who is responsible for organizing, coordinating, and monitoring all non-clinical operations of Programs of Assertive Community Treatment, including managing medical records; operating and coordinating the management information system; maintaining accounting and budget records for individual and service expenditures; and, providing receptionist activities, including triaging calls and coordinating communication between the team and people.D. Each PACT Team must develop a written policy for clinical supervision of all employees providing treatment, rehabilitation, and support services. The team leader and psychiatrist must assume responsibility for supervising and directing all employee activities. This supervision and direction must consist of: 1. Individual, side-by-side sessions in which the supervisor accompanies an individual employee to meet with people in regularly scheduled or crisis meetings to assess employee performance, give feedback, and model alternative treatment approaches;2. Participation with team members in daily organizational employee meetings and regularly scheduled Individual Service Planning meetings to review and assess employee performance and provide employees direction regarding individual cases;3. Regular meetings with individual employees to review their work with people, assess clinical performance, and give feedback;4. Regular reviews, critiques, and feedback of employee documentation (e.g., progress notes, assessments, Individual Service Plans, Individual Service Plan reviews); and5. Written documentation of all clinical supervision provided to Program of Assertive Community Treatment Team personnel.