Level of Care Assessments (LOCA)

“Level of Care” refers to the intensity, frequency, duration, and type of of treatment involved in your care. There are different levels of care that people can be referred to based on a lot of factors including safety, substance use, past/current risk, severity of mental illness, willingness to engage in treatment, etc. It's so important that a person is assessed and referred to the correct level of care because if the level of care is too low then the person may be at risk.
For example: Outpatient individual psychotherapy is the lowest level of care because people who would be assessed as appropriate for it would tend to be relatively stable and engaged in treatment, need less frequent therapeutic contact, and require less intense intervention. In contrast, someone who is at elevated risk of hurting themself would be referred to a higher level of care as they would need more close and regular monitoring, restricted access to dangerous things, and more frequent and intense interventions.
A Level of Care Assessment (LOCA) is a comprehensive assessment of your individualized and unique needs. The assessment is holistic in its approach, assessing for the biological, psychological, and social factors that impact you and play a role in the issues you are facing.
You would get a LOCA for a lot of reasons including:
- If you are not succeeding in your current treatment and you are curious about other options
- For an unbiased second opinion
- If you are unsure if individual therapy alone is appropriate to meet your needs
- To assess for specific and specialized needs such as substance use treatment
- For referrals that are more than just therapy and psychiatry
- To identify gaps in care and potential areas of intervention in domains of your life that have gone unaddressed thus far
- To assess for specific and specialized needs such as substance use treatment options
There are four main steps in a LOCA. They include:
1. Interviews
2. Screeners
3. Integrative Summary
4. Feedback Session
*Please review details of each of these steps on this page.
Yes! I also provide a specialized Level of Care Assessment specific to the American Society of Addiction Medicine’s Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions.
The ASAM-LOCA is best for a patient who is questioning treatment options for substance use/co-occurring disorders. It is a similar process as the standard LOCA but with a more focused evaluation of substance use. The Recommendations and Referrals provided at the Feedback Session will also be structured in alignment with the Six ASAM Dimensions (outlined below).
*A patient seeking an ASAM-LOCA would likely be asked to get a medical evaluation if they are not in treatment with a medical provider/psychiatrist at the time of the assessment.
The exact cost of the LOCA depends on the amount of time and resources needed to complete it. This is determined on an individualized basis and takes into account the necessary steps to address the referral question. I will provide you with an estimation of cost through a Good Faith Estimate, which you will approve, prior to the initiation of the LOCA.
The average cost of a LOCA is around $4-$5k.
As with other services I offer, I do not accept insurance and all fees for the LOCA are out of pocket expenses. I do provide a SuperBill to all patients.
*No Call/No Show or Late Cancel without 48hr notice and starred items above cannot be reimbursed through insurance.
*Patients are required to pay up to 48hrs prior to the administration of services for the LOCA. Patients are expected to keep an active credit card on file at all times during the assessment process.

Five Levels of Care

“Level of Care” refers to the intensity, frequency, duration, and type of of treatment involved in your care. There are different levels of care that can meet your needs based on the severity of symptoms.

Level 5- Inpatient Treatment

The highest LOC is Inpatient Treatment in a hospital. Inpatient is appropriate for those at risk of hurting themselves or others, are medically compromised due to an eating disorder, and/or need medically monitored withdrawal from substances.

Level 4- Residential Treatment

Residential Treatment involves living on site for typically a minimum of 30 days. These individuals are medically stable and focusing primarily on skills building and emotional stabilization.

Level 3- Partial Hospitalization Programming

“PHP” is an outpatient treatment where individuals live at home and attend programming on average five days/week for around 5-6 hours per day. PHP is typically a step-down from Residential or Inpatient and helps reduce readmission to higher levels.

Level 2- Intensive Outpatient Programming

“IOP” is similar to PHP but attended less frequently and for fewer hours each day. IOP typically is 3-4 days/week for 3-4 hours/day, depending on the program.

Level 1- Outpatient Treatment

Outpatient is the lowest level of care and involves therapies, medication management, clinical groups, case management, support groups like AA, and more. People are usually in Outpatient for longer than any other level.

Components of a Level of Care Assessment

You would participate in a full Assessment with me including semi-structured and structured clinical interviews.
I would also speak with important loved ones, other providers, and anyone else that you think would have a unique and important perspective on your current needs.
If you have been to a treatment program or received a testing assessment in the past, I would request a copy of those results or discharge summaries for review.
Both before and after our interview, I would identify specific screeners, some self-report and others administered by me, which are most applicable to the specific concerns you are looking to address.
I then take all of the data collected throughout the LOCA administration including the interviews, records review, and screeners, score, interpret, and write up the results in a comprehensive, integrated report that you will receive a copy of.
You and any important loved ones/providers would then participate in a feedback session where I will review the report, the findings, and the recommendations. I will also provide you with recommendations to specific providers, programs, and groups that you can call that day!
*Referrals are not screened for availability.

Addiction-Specific Level of Care Assessment (ASAM-LOCA)

All patients regardless of their reason for getting a LOCA will be assessed for their relationship with substances but there is also an addiction-specific option called the ASAM-LOCA

The ASAM-LOCA’s feedback will include a Dimensional Assessment, which means the write up you receive is a full report and recommendations based on the American Society of Addiction Medicine’s (ASAM) Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. These criteria are broken up into six “Dimensions.”