Level of care determination for individuals with co-occurring psychiatric and substance disorders

Abstract

Individuals with co-occumng psychiatric and substance disorder (ICOPSD) have been recognized as a population associated with poorer treatment outcomes and higher service utilization. While consensus is growing on basic principles of integrated treatment, little technology has been developed that assists in implementation of level of case or service intensity determination for this population. One such bit of technology is a manual for utilization management for dual disorders. This paper describes the development of just such a manual which outlines an array of program models and settings of varying intensities, and describes specific utilization management criteria for each model and setting. The manual describes a horizontally and vertically integrated continuum of care for individuals with dual disorders that incorporates the principles of: a) independent dimensions of service intensity, b) multi-dimensional service intensity assessment, and c) individualized treatment matching based on integrated dual-primary/phasespecific treatment.