LEVEL OF CARE UTILIZATION SYSTEM (LOCUS)
Welcome to the LOCUS (adults) and CALOCUS (children) resource page. Here you will find materials and resources to successfully complete the utilization management instruments for the clients you serve. This page also provides other necessary documents such as the LOCUS and CALOCUS Navigators and Score Sheets.
LOCUS Questions and Answers
Click here for a downloadable version of the Q&A.
What is the LOCUS and CALOCUS?
- LOCUS – Level of Care Utilization System (18 years and older)
- CALOCUS – Child & Adolescent Level of Care Utilization System (ages 0 to 17)
- The LOCUS and CALOCUS are assessments and placement instruments developed by the American Association of Community Psychiatrists (AACP) and the American Academy of Child & Adolescent Psychiatry (AACPA). They are not intended to be a diagnostic tool, rather an instrument to assist in the appropriate placement into a service (or, Level of Care).
What are the objectives of the Assessment tools?
- The LOCUS/CALOCUS assesses the enrollees needs based on level of functioning, rather than a diagnosis and psychiatric risk alone.
- The LOCUS/CALOCUS assesses the enrollee’s needs and informs Level of Care placement based on the six evaluation dimensions.
- The LOCUS/CALOCUS score is used to inform placement into an outpatient Level of Care; however, it is not a substitute for clinical judgment.
When is TMBHO requiring the LOCUS and CALOCUS to be used?
- TMBHO is implementing the LOCUS/CALOCUS on January 1, 2014. This means:
- All new authorizations for outpatient mental health services must be based on the completion of a LOCUS/CALOCUS instrument beginning on January 1, 2014. Note: No new LOC “B” or “C” authorizations, with a start date after January 1, 2014, will be accepted after January 1, 2014.
- All re-authorizations for existing consumers must be based on the completion of a LOCUS/CALOCUS instrument beginning on January 1, 2014.
What happens if I authorized a consumer as a Level of Care “C” in December 2013? Is my authorization still valid?
- The TMBHO Management Information System (MIS) will allow both types of Levels of Care to exist side by side until June 30, 2014. This means that authorization requests made during 2013 will remain valid into 2014. Network Providers must administer a LOCUS/CALOCUS on all consumers by June 30, 2014 and request a new Level of Care. All consumers must be converted to the new Level of Care system by July 1, 2014.
Who should have a LOCUS/CALOCUS?
- All consumers who are receiving outpatient mental health services from a CORE TMBHO provider. This means providers who offer the full range of outpatient services. At this time this means BHR, SeaMar and PSPH. Providers of ancillary services are not required to conduct a LOCUS/CALOCUS for their consumers at this time.
What does administering a LOCUS/CALOCUS look like?
- For new consumers (coming into the agency) the LOCUS/CALOCUS is generally completed after the intake assessment. The consumer does not need to be present in order to complete the instrument. Information gathered during the intake assessment process should be sufficient to complete the instrument.
- Clinicians should have a copy of their LOCUS or CALOCUS instruments with them when they complete the LOCUS/CALOCUS Score Sheet. Clinicians should complete the Score Sheet by circling the most appropriate response in each dimension. Clinicians should read the LOCUS/CALOCUS manual for guidance and further instructions.
- For re-authorizations, and for consumers who need to be converted to the new Level of Care (I, 2, 3, 4), the LOCUS/CALOCUS should be completed by the therapist / case manager of record. Using information known about the consumer, the agency will complete the LOCUS/CALOCUS Score Sheet. Again, the consumer does not need to be present in order to complete the instrument.
- Based on national averages – from thousands of practitioners using the instruments across the country – the LOCUS/CALOCUS should only take about 7-10 minutes to complete.
Who can complete a LOCUS/CALOCUS?
- Administration of the LOCUS/CALOCUS is restricted to qualified mental health professionals (MHPs) only, or individuals under the supervision of an MHP. If a non-MHP completes a LOCUS/CALOCUS, the instrument must be co-signed by an MHP.
When I complete a LOCUS/CALOCUS I end up with a “Composite Score”. What does this score mean, and how should I use it?
- The Composite Score that results from the completion of the LOCUS/CALOCUS helps direct you to an appropriate Level of Care. In most cases, the score will indicate the Level of Care you will request for the consumer. However, there are exceptions. That is why it is critical that you use the LOCUS/CALOCUS Decision Tree (located in the LOCUS/CALOCUS instruments) to help guide LOC placement decisions.
What do I need to submit for an Authorization after January 1, 2014?
- Each new request for an authorization will require the following documents downloaded on IRMS:
- The intake evaluation
- The LOCUS/CALOCUS Score Sheet
What do I need to submit for a Re-Authorization after January 1, 2014?
- Each request for a re-authorization will require the following documents downloaded on IRMS:
- Most recent treatment plan
- Treatment Plan Review document (summarizing services and progress of the prior authorization period)
- The LOCUS/CALOCUS Score Sheet
What if the required documents are not submitted with the authorization / re-authorized request?
- Your request will be “pended” and not processed until all documents have been received. The request will be authorized once all required documents are submitted via IRMS.