Level of Care Utilization System (LOCUS) Implementation: Summary and Procedures

Brief Purpose: 

The American Association of Community Psychiatrists (AACP) developed the Level of Care Utilization System (LOCUS) as a tool to provide mental health clinicians and service providers with a systematic approach to the assessment and determination of the service and support needs of individuals with mental health challenges.

The LOCUS tool is used in Maine for the following purposes:

  1. Guide and support clinical decisions on the appropriate level and intensity of consumer supports and services;
  2. Support and inform the development of Individualized Support Plans (ISPs);
  3. Inform and guide program and system planning and development activities;
  4. As a component of eligibility criteria for specific MaineCare Services 

It is important to note that the LOCUS is not to be used in place of clinical judgment, but as a tool to support and guide clinical and support decisions.  

Description of the LOCUS

This instrument is used to derive level of service intensity appropriate to an individual's needs. It includes two primary components; 1) an assessment of the individual along six dimensions (i.e. Risk of Harm; Functional Status; Medical, Addictive and Psychiatric Co-Morbidity; Recovery Environment–Stressors and Supports; Treatment and Recovery History and Attitude and Engagement; and 2) a structured decision making guide that uses assessment results to determine an appropriate Level of Care for Services. The LOCUS specifies six Service Levels. Each assessment dimension is rated from least to most acute using a five-point scale. The rater, based on knowledge of the consumer, completes the assessment. Summing the individual dimension ratings generates the composite score.

Who is assessed?

The LOCUS is intended for use with Adults 18 years and older experiencing mental health challenges in the following service areas:

  1. Community Support Services provided through MaineCare Chapter II, Section 17;
  2. Residential Treatment, provided through MaineCare Section 97, Adult Mental Health Private Non-Medical Institution Services (PNMIs).
  3. Psychiatric Nursing/Psychotropic Medication Services provided through MaineCare Chapter II, Section 40 Home Health Services

Who Completes The LOCUS?

It is expected that service providers will use existing intake/assessment tools and procedures to gather the information necessary to complete the LOCUS.  The LOCUS is completed by a Mental Health Professional (see MaineCare Benefits Manual, Chapter II, Section 17.09), Community Integration/ACT Worker or MHRT-C.  Individuals shall only use the LOCUS after they have received training and met the reliability criteria.  Some of the licenses and qualifications of those who can use the LOCUS include; CRC, LCPC, LCSW as well as APR-N or an RNC within Psychiatric Nursing. 

Further questions regarding who can be trained to complete the LOCUS, or any other LOCUS related questions should be directed to DHHS Office of Substance Abuse and Mental Health Services at (207) 822-2172 or (207) 822-2173.