2018-03: Notification of Authorization Process Change for CPST, PSR Services
Date: 01/10/18
The Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) and the Child and Adolescent LOCUS (CALOCUS) serve as evidence-based decision support tools that assist providers in assigning patients to the appropriate levels of care. Developed by the American Association of Community Psychiatrists, these clinical tools support healthcare providers in evaluating and determining level of care placements for psychiatric and addiction services.
The Louisiana Department of Health (LDH) is considering the adoption of the LOCUS and CALOCUS assessment tools as the standard assessment tools to be used to support appropriate level of care recommendations for adults, adolescents and children who may need, or who are currently receiving, Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) services.
To ensure that Louisiana Healthcare Connections’ authorization request processes are in alignment with best practices in level-of-care decision making for CPST/PSR services, the following changes will be implemented effective February 9, 2018:
- Providers will be required to use a revised Outpatient Treatment Request (OTR) form when requesting CPST/PSR services. (The revised OTR form can be viewed here.)
- Louisiana Healthcare Connections will require that the LOCUS/CALOCUS assessment tool be administered in person and scored by the treating physician or Licensed Mental Health Practitioner (LMHP) appropriately trained and licensed in Louisiana to perform this service.
o The LOCUS assessment will be required for members age 19 or older.
o The CALOCUS assessment will be required for members ages 6-18 years.
- Previously posted and communicated guidelines for level of care, frequency and duration of CPST/PSR services will be updated to reflect those suggested by the assessment score in the LOCUS/CALOCUS tool.
- A LOCUS/CALOCUS assessment will need to be completed and the score submitted along with the OTR to support the initial request for authorization of services. The LOCUS/CALOCUS assessment and score will be a key component in the overall determination for initial CPST/PSR services.
- OTR forms for ongoing CPST/PSR services will be required every 30 days thereafter to assess patient progress against treatment plan goals. Unless requested more frequently, a subsequent LOCUS/CALOCUS assessment will need to be completed every 180 days following the initial request for services. The LOCUS/CALOCUS assessment and score will be a key component in the overall determination of extending CPST/PSR services.
Please Note: Louisiana Healthcare Connections does provide free, web-based specialized behavioral health clinical trainings related to the LOCUS/CALOCUS assessment tools. To register for a LOCUS/CALOCUS training, please visit www.EnvolveU.com.