Asam Criteria Pdf 2020 Details

In the medical field, there are many aspects that need to be considered before a physician can prescribe the best treatment for their patient. There is no one-size-fits-all approach when it comes to health care and diagnosis. In order to get the most accurate information about a certain ailment or disease, physicians will often turn to resources such as Asam Level Of Care Cheat Sheet in order to make an informed decision on what course of action they should take next with their patients. It's important for patients and doctors alike understand how different levels of care work so they know which level is appropriate for each situation. This way, both parties can set themselves up for success from day one.

Before you decide to fill in asam level of care cheat sheet, you will want to find out more concerning the type of form you are going to work with.

QuestionAnswer
Form NameAsam Level Of Care Cheat Sheet
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesasam levels of care cheat sheet, asam criteria pdf 2020, asam worksheet, asam criteria cheat sheet 2019

Form Preview Example

Patient Placement Criteria Checklist - Kentucky Edition 2012

Based upon ASAM Adult Patient Placement Criteria-Second Edition Revised

Client Name: ____________________________________ Date:_______________________ Case Number__________________

Directions: Rate the client or patient on each of the six Dimensions first and then analyze for Level of Care; emergency needs come first, then the least intensive LOC that is safe and can effectively help client reach goals.

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CLIENT NAME:________________________________________________ DATE: _____________________ CASE NUMBER:________________________ ____

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Medication Assisted Treatments (MAT) can occur at any level of care and includes methadone, buprenorphine, and medications to control cravings and withdrawal when other criteria are met for level of care. Methadone and Suboxone clinics are generally outpatient, but clients on MAT may sometimes need a higher level of care.

**DDC: Dual Diagnosis Capable Program - has a primary target population of individuals with substance related disorders but also has an expectation and willingness to treat individuals with co-occurring mental health conditions, in-house or by

referral to concurrent mental health services.

***DDE: Dual Diagnosis Enhanced Program – the program has the combined capacity to treat both mental health and substance related disorders equally.

Rater’s Signature: ____________________________________________________________

Last revision: 4-3-12, Lynn Posze/Dave Mathews

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .