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 has undergone significant change in the past several years, with increasing emphasis on resource management. This emphasis has raised concerns among consumers and providers of services that needed resources are often withheld. In order to address this issue, the American Association of Community Psychiatrists (AACP) developed an instrument designed to maintain balance between quality care and the wise use of resources. The Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) evaluates clients along six dimensions and defines six levels of resource intensity. It also provides a methodology to facilitate rapid and consistent level of care recommendations. This paper describes the circumstances leading to the creation of LOCUS and the principles used to guide its development. It then describes preliminary reliability and validity testing design and outcome. This initial testing indicates that LOCUS can facilitate consistent placement of clients in psychiatric or addiction services and does so in a manner which trends in a pattern similar to the recommendations of clinicians who are naive to LOCUS assessment and placement methodology.