Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS): A Preliminary Assessment of Reliability and Validity

The financing of mental health care services hasundergone significant change in the past several years,with increasing emphasis on resource management. Thisemphasis has raised concerns among consumers and providers of services that needed resourcesare often withheld. In order to address this issue, theAmerican Association of Community Psychiatrists (AACP)developed an instrument designed to maintain balance between quality care and the wise useof resources. The Level of Care Utilization System forPsychiatric and Addiction Services (LOCUS) evaluatesclients along six dimensions and defines six levels of resource intensity. It also provides amethodology to facilitate rapid and consistent level ofcare recommendations. This paper describes thecircumstances leading to the creation of LOCUS and theprinciples used to guide its development. It thendescribes preliminary reliability and validity testingdesign and outcome. This initial testing indicates thatLOCUS can facilitate consistent placement of clients in psychiatric or addiction services and doesso in a manner which trends in a pattern similar to therecommendations of clinicians who are naive to LOCUSassessment and placement methodology.