RD442 - Program of Assertive Community Treatment – Program Funding, Cost Effectiveness, and Impact – October 19, 2020
Assertive Community Treatment (ACT, or PACT as it is currently known in Virginia) is an evidencebased practice (EBP) proven to improve outcomes for people with severe mental illness. One of the oldest and most widely researched EBPs for people with severe mental illness, research shows that ACT reduces hospitalizations and incarceration, increases housing stability, and improves quality of life for people with the most severe symptoms of mental illness.(*1) To do so, ACT utilizes a multidisciplinary, communitybased team of medical, behavioral health, and rehabilitation professionals who work together to meet the needs of the individuals that they serve.
In response to the General Assembly’s request to provide recent data on PACT, the Department of Behavioral Health and Development Services (DBHDS) assessed general financial figures – costs per team and costs per individual served, the program’s impact on state and local hospitalization and incarceration, and the associated cost implications from diverting PACT clients from these more expensive services. DBHDS used a cohort approach to analyze the impact of PACT overtime on PACT clients admitted in FY17.The assessment of data indicated PACT services resulted in lower hospitalization and incarceration rates for individuals being served and substantial associated cost reductions.
Some of the main findings in this report supporting the value of investment in PACT services across the Commonwealth include:
• The average cost per individual served by PACT teams across the Commonwealth in FY19 (the most recent full year of data available at the time of report preparation) is $15,071, representing a reduction from the previous fiscal year in FY18.
• State hospitalization usage for all PACT served individuals admitted in FY17 was reduced by 45%, representing a cost avoidance of $12,061,852 related to this population.
• All new FY17 PACT served individuals accounted for 33,098 state hospital bed days in the two years prior to their PACT admission, and just 18,280 in the two years post their PACT admission.
• Across the FY16 and FY17 cohorts, the PACT program contributed to an overall cost avoidance of $20,123,708 in state hospital costs in the two years following initiation of PACT services.
• Local psychiatric hospitalization use for all PACT served individuals admitted in FY17 had a 45% reduction, which represents a cost avoidance of $5,821,920 related to this population.
• All new FY17 PACT served individuals accounted for 13,721 local hospital psychiatric bed days in the two years prior to PACT admission, and just 7,501 in the two years post PACT admission.
• Incarceration of all PACT-served individuals admitted in FY17 was reduced by 51% and represents a cost avoidance of $891,173 related to this population.
• In the two years prior to admission to PACT, all new FY17 individuals served 20,382 days in confinement compared to only 9,999 days in the two years post entering PACT services.
• Across the FY16 and FY17 cohorts, the PACT program contributed to an overall cost avoidance of $1,579,873 in jail costs in the two years post initiation of PACT services.