The Aetna Level of Care Assessment Tool, or "LOCAT" is an instrument used to aid in the decision-making process that determines the level of care appropriate for effective treatment and medically necessary for a patient with symptoms of a mental health condition. LOCAT is used as a guideline to help determine the appropriate levels and types of care for patients in need of evaluation and treatment for behavioral health symptoms and diagnoses. It is applicable to patients in need of treatment in a variety of settings, ranging from routine outpatient offices through to placement in specialized behavioral health care facilities or units.
LOCAT is used as a guideline to help evaluate a patient’s symptoms by identifying and scoring various behavioral health dimensions, and by narrowing down some of those dimensions into sub-dimensions to further assist in providing a more complete clinical picture of the patient.
Dimension 1, Acute Dangerousness, assists in determining whether a patient is exhibiting dangerous symptoms. The four sub-dimensions are Suicidal Intent, Self-Injuriousness, Homicidal Intent and Irritability/Aggression/Mania.
Dimension 2, Functional Impairment, helps determine the severity of impairment in functioning by assessing the following sub-dimensions: Social Isolation, Nutritional Impairment, Sleep Disturbance and School or Work Impairment.
Dimension 3, the Mental Status and Comorbid Factors, helps assess a patient's mental status, (including appearance, speech, affect, delusions, hallucinations, thought process/content, behavioral/neurovegetative and orientation); co-occurring substance use and co-occurring medical illness.
Dimension 4, Psychosocial Factors, helps assess outside influences that may be affecting the patient. Sub-dimensions include family stress, stress from non-family members, housing, school or job, and the support system.
Dimension 5, Additional Modifiers, examines other factors relevant to determining the appropriate level and type of care needed. Sub-dimensions include treatment history, personal resources and past history of dangerousness.
The LOCAT instrument does not replace clinical judgment, where a provider believes that a different level of care or course of treatment is necessary. Treating providers are solely responsible for clinical advice and treatment of members.