Asam Level Of Care Cheat Sheet – Fill Out and Use This PDF

ASAM-PPC Levels

and Services

Level of Care I

Level of Care

II.1

Level of

Care III.1

Level of

Care III.3

Level of Care III.5

Level of

Care IV

OUTPATIENT

TRANSITIONAL

RECOVERY CENTER

INTENSIVE OUTPATIENT

RESIDENTIAL TREATMENT

INPATIENT HOSPITAL

(Less

than 6

weekly

(including

(Staffed by peers and may include

Service Levels:

(6 to 20 service hours per week.

(Clinically managed. Includes licensed short

(Including medical

service

hours.

Includes

sober

living

facility with

credentialed or

non-credentialed

Can be combined

with

housing

or long term

rehabilitation

unit, crisis

detoxification and

Medication Assisted

5+

hours

of clinical

staff rather

than clinically

and supports to be

level

III care.)

stabilization

unit, licensed

detox unit)

inpatient psychiatric units)

Treatments/MAT*)

services per week)

managed.)

Admission

Meets

all Dimensions

Meets all

Dimensions

Meets one of Dimensions

Meets Dimensions 1,2 & 3 at this

Meets all Dimensions below at this

Meets all Dimensions at this level plus

1, 2, or 3; plus meets

specifications

below

at this

level (if

below

at this level; has

for each Level

not, consider

a higher

level (if applicable),

and one of

completed

services for

level plus meets

the criteria for a

meets criteria for a Substance Dependence

criteria for

a Substance

Dimensions 4,5, or

6 at this level

Substance Dependence Disorder

Disorder

Dependence

Disorder or

of Care:

level of care)

acute symptoms

severe mental disorder

Dimension 1:

No withdrawal

If present, minimal risk of

If present, mild to moderate risk of

High risk of severe

Acute

needs OR needs can

No withdrawal needs OR

No signs or

severe withdrawal that can

severe withdrawal that can be

withdrawal which

Intoxication

be safely managed

needs can be safely

symptoms of

be managed at a social

managed at a social setting detox

cannot be managed

and/or

at this level, such as

managed at this level.

withdrawal

setting intake level with no

level with possible medication

in a social-setting

Withdrawal

with MAT.

medication support

support

detox

Potential













Dimension 2:

If present, stable OR

If present, stable and

If present, stable and can

If present, stable and can self-

Biomedical

no medical

self-administer meds OR able

administer meds OR severe enough

Severe enough to

None or sufficiently

receiving concurrent

Conditions

monitoring needed,

to obtain medical supports

to warrant medical monitoring but

warrant inpatient

stable

medical attention that will

and

OR can be monitored

from outside provider

not in need of inpatient treatment.

medical care

not interfere with treatment.

Complications

by outside provider.

May include pregnancy.













If present, mild to moderate severity

Dimension 3:

If present, stable, OR if

If present, mild to moderate

needing a 24-hour structured

Severity of mental

If present, mild severity

severity: needs structure to

setting; repeated inability to control

Emotional,

distracting, can

disorder requires

None or very stable

responds to outpatient

focus on recovery. Could be

impulses; personality disorder

Behavioral or

respond to the level

medical monitoring,

(cognitively able to

monitoring to minimize

referred out to MH services.

requires high structure to shape

Cognitive

of 24-hour structure

such as for danger to

participate and no

distractions from recovery;

If stable a DDC** program is

behavior. Needs

Conditions

in this program; can

self or others

risk of harm)

can receive concurrent

appropriate. If not a DDE***

counseling/therapy. If stable a

and

receive concurrent

COD services.

program is required.

DDC** program is appropriate. If

Complications

COD services.

not a DDE*** program is required.













Level of Care I

Level of

Care

II.1

Level of

Care III.1

Level of Care III.3

Level of Care III.5

Level of Care IV

OUTPATIENT

INTENSIVE OUTPATIENT

Transitional

RECOVERY CENTER

RESIDENTIAL TREATMENT

INPATIENT HOSPITAL

(Less

than 6

weekly

(6 to

20 service hours per

(including

(Staffed by peers and may include

(Clinically

managed. Includes

licensed short

(Including medical

Service Levels:

service

hours.

Includes

week. Can

be combined

sober

living

facility with

credentialed or non-credentialed

or long

term

rehabilitation

unit, crisis

detoxification and

Medication Assisted

with

housing

and

supports

5+

hours

of

clinical

staff rather than clinically

stabilization

unit, licensed

detox unit)

inpatient psychiatric units)

Treatments/MAT*)

to

be level III

care.)

services per

week)

managed.)

Ready to change and

Has marked difficulty with or

Willing to cooperate

Resistance is high

Has little awareness & needs

opposition to treatment, with

cooperate at this

or is ambivalent and

enough to require

interventions available only

dangerous consequences; or there

Dimension 4:

level, OR externalizes

needs motivation,

structured program,

at this level to engage & stay

is high severity in this dimension but

Readiness to

problems and needs

recovery support,

but not so high as to

in recovery. May have

not others. The client therefore

Change

this level of structure,

and monitoring

render outpatient

external leverage to support

needs a motivational enhancement

motivation and

strategies

treatment ineffective.

participation.

program with 24 hour structure.

support.











Has little awareness & needs

Intensification of

Client is at high risk

intervention available only at

Has little awareness & needs

Able to maintain

for imminent relapse

this level to prevent

intervention available only at this

symptoms despite

Dimension 5:

abstinence and

with dangerous

continued use, with

level to prevent continued use, with

active participation in

Relapse,

recovery goals or

consequences. Client

dangerous consequences to

dangerous consequences to self or

Outpatient, OR high

Continued Use or

achieve awareness

needs 24-hour

self or others.

others.

likelihood of relapse

Continued

of a substance use

structure and support

Does not recognize triggers,

Does not recognize triggers, unable

without close

Problem Potential

problem with minimal

OR needs this support

unable to control use, in

to control use, in danger of relapse

monitoring and

support

to transition into

danger of relapse without

without close 24-hour monitoring

support

community.

close 24-hour monitoring

and structure.

and structure.











Has a using,

Supportive recovery

Lacks social contacts

unsupportive,

Homelessness or lack of

environment OR

or social contacts

dangerous, or

Environment is dangerous or

Dimension 6:

safe, supportive recovery

willingness to obtain

aren’t conducive to

victimizing social

unsupportive of recovery and client

Recovery

environment and client

such OR supports

recovery, but with

network, or lacks a

lacks skills to cope outside of highly

Environment

needs 24-hour structure to

need professional

structure or support,

social network,

structured 24-hour setting.

learn to cope.

interventions.

the patient can cope

requiring this level of

24-hour support.



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