Summary: <p>Assessment Tools ASAM, FARS, LOCUS</p> <p>Counseling CEU courses which include this podcast can be found at <a href="https://www.allceus.com/member/cart/index/search?q=patient+placement+criteria">https://www.allceus.com/member/cart/index/search?q=patient+placement+criteria</a></p> <p>Objectives<br> ~ Differentiate between level of care guidelines and patient placement criteria<br> ~ Learn about the Functional Assessment Rating Scale (Required in some states)<br> ~ Learn about the ASAM (Required by most insurers)<br> ~ Learn about the LOCUS (Often an alternate to the ASAM<br> ~ Discuss why these tools are used and how they can benefit clinician and client</p> <p>Patient Placement vs. Level of Care<br> ~ Patient placement criteria suggests a treatment intensity level that meets the needs of the client<br> ~ Level of Care Guidelines are defined by:<br> ~ Insurance Providers<br> ~ State Law (in some states)<br> Why Use Them<br> ~ Provides a biopsychosocial approach to care management<br> ~ Assists in defining potential strengths and obstacles to the recovery process as the client sees them<br> ~ Helps guide treatment planning for<br> ~ Biomedical Issues<br> ~ Cognitive/Emotional/Behavioral Issues<br> ~ Motivational Issues<br> ~ Recovery Environment (including social supports)<br> ~ Assists in providing Specific, Measurable, Achievable, Realistic, Time Limited Goals<br> FARS<br> ~ Functional Assessment Rating Scale<br> ~ Not a placement guideline per se<br> ~ Helps more clearly define anchors for behavioral observations<br> FARS<br> FARS<br> FARS<br> ASAM– Assessment, Reassessment & Discharge<br> ~ Physical<br> ~ Acute Intoxication/Withdrawal Potential<br> ~ Biomedical Conditions<br> ~ Emotional/Cognitive<br> ~ Emotional/Behavioral Conditions<br> ~ Treatment Acceptance/Resistance (Readiness for change)<br> ~ Behavioral<br> ~ Relapse or Continued Use Potential<br> ~ Social/Environmental<br> ~ Recovery Environment<br> ASAM Levels<br> ~ Level .05: Early Intervention (Relapse Prevention)<br> ~ Level I: Outpatient (<9 hours per week)<br> ~ Level II: IOP (9-19 hours per week)<br> ~ Level II.5: PHP (20+ Hours per week)<br> ~ Level 3: Residential<br> ~ Level 4: Medically Managed Intensive Inpatient Services<br> LOCUS Dimensions<br> ~ Risk of Harm<br> ~ 1-Minimal<br> ~ 2-Low<br> ~ 3-Moderate<br> ~ 4-Serious<br> ~ 5-Extreme<br> ~ Functional Status<br> ~ 1-Minimal Impairment<br> ~ 2-Mild Impairment<br> ~ 3-Moderate Impairment<br> ~ 4-Serious Impairment<br> ~ 5-Severe Impairment<br> LOCUS Dimensions<br> ~ Medical, Addictive and Psychiatric Comorbidity<br> ~ 1-No Comorbidity<br> ~ 2-Minor Comorbidity<br> ~ 3-Moderate Comorbidity<br> ~ 4-Major Comorbidity<br> ~ 5-Severe Comorbidity<br> Recovery Environment<br> ~ Level of Stress (A)<br> ~ 1-Low<br> ~ 2-Mild<br> ~ 3-Moderate<br> ~ 4-High<br> ~ 5-Extremely Stressful<br> ~ Level of Support (B)<br> ~ 1-Highly supportive<br> ~ 2-Supportive<br> ~ 3-Limited Support<br> ~ 4-Minimal Support<br> ~ 5-No Support<br> LOCUS Dimensions<br> ~ Treatment and Recovery History<br> ~ 1-Fully Responsive<br> ~ 2-Significant Response<br> ~ 3-Moderate or Equivocal Response<br> ~ 4-Poor Response (goals not achieved or gains not maintained)<br> ~ 5-Negligible Response<br> LOCUS Dimensions<br> ~ Engagement<br> ~ 1-Optimal (Action)<br> ~ 2-Positive (Preparation/Determination)<br> ~ 3-Limited (Contemplation)<br> ~ 4-Minimal (Contemplation)<br> ~ 5-Unengaged (Precontemplation)<br> EXAMPLE Guidelines LOCUS Placement<br> ~ Level 1 LOCUS Placement (up to 3h/week)<br> ~ 1. Risk of Harm – clients with a rating of two or less<br> ~ 2. Functional Status – clients should demonstrate ability to maintain a rating of two or less<br> ~ 3. Co-morbidity – a rating of two or less<br> ~ 4. Recovery Environment – a comb</p>
