A higher level of care (HLOC) may be appropriate when a client requires treatment intensity, structure, monitoring, services, or support beyond what can reasonably be provided at their current level of care.
What factors should I consider?
There is no single factor that automatically determines the appropriate level of care. Consider the client's overall clinical presentation and individual circumstances.
Factors may include:
- Increasing clinical acuity or symptom severity
- Significant deterioration in functioning
- Persistent or escalating safety concerns
- Difficulty maintaining safety within the current setting
- An ongoing need for increased session frequency
- Severe psychiatric or behavioral symptoms
- A need for intensive specialized services, such as eating disorder or detox/substance-use treatment
- Recurrent crises or emergencies
- Significant barriers to maintaining stability between sessions
- A need for a multidisciplinary approach that is not available at the current level of care
What should I consider when determining the appropriate level of care?
Consider:
- Nature and severity of symptoms
- Current risk and ability to maintain safety
- Functional and cognitive limitations
- Frequency and intensity of treatment needed
- Medical or substance-related needs
- Ability to engage in and benefit from the recommended treatment
- Available supports, resources, and living environment
- Previous response to treatment and HLOC history
- Client preferences and treatment goals
- Availability and accessibility of appropriate services
When possible, recommendations should identify the least restrictive level of care that can safely and effectively meet the client's clinical needs.
Important distinction: HLOC vs. emergency responseAn HLOC recommendation is not a substitute for an emergency or crisis response. If a client has an immediate safety concern or is experiencing an emergency, follow the appropriate crisis or emergency response process without delay. |