130 C.M.R. 464.402 – Definitions

The following terms used in 130 CMR 464.000 have the meanings given in 130 CMR 464.402, unless the context clearly requires a different meaning.

Adverse Incident. An occurrence that represents actual or potential serious harm to the well-being of a member, or to others under the care of the PACT provider. Adverse incidents may be the result of the actions of a member, actions of a staff member providing services, or incidents that compromise the health, safety, or operations of the program.

Behavioral Health Disorder. Any disorder pertaining to mental health or substance use as defined by the Diagnostic and Statistical Manual of Mental Disorders.

Case Consultation. Intervention, including scheduled audio-only telephonic, audio-video, or in- person meetings, for behavioral and medical management purposes on a member’s behalf with psychiatric status, history, treatment, or progress (other than for legal purposes) for other physicians, agencies, or insurance carriers.

Certified Peer Specialist (CPS). A person who has been trained by an agency approved by the Department of Mental Health (DMH) who is a self-identified person with lived experience of a mental health disorder and wellness who can effectively share their experiences and serve as a mentor, advocate, or facilitator for a member experiencing a mental health disorder.

Diagnostic Evaluation Services. The examination and determination by interview techniques of a member's physical, psychological, social, economic, educational, and vocational capabilities and disabilities for the purposes of developing a diagnostic formulation and designing a treatment plan.

Legally Authorized Representative (LAR). An individual who, under law, can act on behalf of another person (such as a minor). The LAR may be a parent, grandparent, or other caregiver who has the legal authority to grant consent on behalf of the youth.

Medication for Addiction Treatment. The use of a medication approved by the federal Food and Drug Administration (FDA) for the treatment of a substance use disorder.

Mental Health Disorder. Any disorder pertaining to mental health as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

Outreach. Mental health and/or substance use disorder treatment services delivered by a clinical or paraprofessional staff member off the physical premise or facility maintained by the PACT provider including, but not limited to, services in members’ homes or other community environments.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-2

Provider Manual Series (130 CMR 464.000)

Transmittal Letter Date

Program of Assertive Community

Treatment Manual

PACT-1 11/1/2025

PACT Provider. A provider that meets the requirements of 130 CMR 464.404 to provide program of assertive community treatment (PACT) services to MassHealth members.

PACT Team. The multi-disciplinary staff with the responsibility for the provision of PACT services outlined in 130 CMR 464.411.

Pharmacotherapy. Providing therapeutic treatment with pharmaceutical drugs

Program of Assertive Community Treatment (PACT). A person-centered, strengths-based, comprehensive service model for adult members with serious mental illness who may benefit from intensive coordinated services and have not responded well to program or office-based interventions. PACT is provided through a multidisciplinary team approach that offers active, ongoing, comprehensive, integrated community-based services. These services are designed to be responsive to changing needs and are typically long term. Services include outreach, engagement, rehabilitation, clinical, health-related, and recovery-based interventions and support. The PACT model is an evidence-based practice referred to by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Alliance on Mental Illness (NAMI) as an Assertive Community Treatment (ACT) program and is outlined in the Substance Abuse and Mental Health Services Administration’s Assertive Community Treatment manual.

Quality Management Program. A systematic and ongoing process for monitoring, evaluating, and improving the quality and appropriateness of services provided to members, with focused attention on addressing cultural, ethnic, and language differences.

Release of Information. A document that allows a member to authorize and revoke what information they want to release from their record, to whom they want it released, how long it can be released for, and under what statutes and guidelines it is released.

Safety Plan. A written plan developed with the member, caregiver/guardian, and other relevant stakeholders that identifies the skills, strategies, and resources that a member and their supports can use to continually develop self-calming strategies and reduce stress, distress, anxiety, or problematic behavior that can lead to crisis.

Substance Abuse and Mental Health Services Administration (SAMHSA). An agency within the U.S. Department of Health and Human Services that leads public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

Substance Use Disorder. Any disorder pertaining to substance use as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

Telehealth. The use of synchronous or asynchronous audio, video, electronic media, or other telecommunications technology including, but not limited to

(1) interactive audio-video technology;
(2) remote patient monitoring devices;
(3) audio-only telephone; and
(4) online adaptive interviews for the purpose of evaluating, diagnosing, consulting, prescribing, treating, or monitoring a patient's physical health, oral health, mental health, or substance use disorder condition.