A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

Fallon, Theodore; Pumariega, Andrés J.; Sowers, Wesley; Klaehn, Robert L.; Huffine, Charles; Vaughan, Thomas L.; Winters, Nancy C.; Chenven, Mark; Marx, Larry; Zachik, Albert; Heffron, William M.; Grimes, Katherine E.

doi:10.1007/s10826-005-9012-y

Cited by 22 publications

(13 citation statements)

References 26 publications

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“…These ratings are combined through a detailed algorithm into a seven category level of care judgment: basic services (Level 0), recovery maintenance and health management (Level 1), outpatient services (Level 2), intensive outpatient services (Level 3), intensive integrated service without 24-h medical monitoring (Level 4), non-secure, 24-h, medically monitored services (Level 5), and secure, 24-h, medically managed services (Level 6). Preliminary studies have supported the reliability and validity of this measure (Fallon et al, 2006). Case managers serve as the primary raters for the CALOCUS and are certified for administration annually.…”

Section: Child and Adolescent Level Of Care Utilization System (Amerimentioning

confidence: 98%

Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement

2007

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We examined whether clinical progress ratings on the Monthly Treatment and Progress Summary form (MTPS), an idiographic treatment progress measure, were meaningfully related to changes measured by two separate standardized instruments; the Child and Adolescent Functional Assessment Scale (CAFAS) and the Child and Adolescent Level of Care Utilization System (CALOCUS). Validity coefficients were examined at intake and three-, six-, and nine-month follow-up periods. Samples were selected for each measure and follow-up period from the population of youth receiving services through the Hawaii Child and Adolescent Mental Health Division's (CAMHD) system of care. Significant youth improvement was evident on all three measures across all follow-up intervals. The type of changes measured by the MTPS and CAFAS were more alike over longer follow-up intervals than changes measured by the CALOCUS. The MTPS captures distinct aspects of client change that overlaps somewhat with CAFAS and CALOCUS measures. The MTPS is a brief client-tailored measure that seems to provide valid, sensitive, and nonredundant client specific treatment outcome information that can be collected on a frequent basis within a complex system of care.

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Section: Child and Adolescent Level Of Care Utilization System (Amerimentioning

confidence: 98%

Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement

2007

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“…These ratings are combined through a detailed algorithm into a level of care judgment in one of seven categories: basic services (Level 0), recovery maintenance and health management (Level 1), outpatient services (Level 2), intensive outpatient services (Level 3), intensive integrated service without 24-h medical monitoring (Level 4), non-secure, 24-h, medically monitored services (Level 5), and secure, 24-h, medically managed services (Level 6). Preliminary studies have indicated acceptable reliability and validity for the CAL-OCUS (Fallon et al 2006). In CAMHD, the CALOCUS, like the CAFAS, is administered on a quarterly basis by MHCCs and is also used to assist the treatment team in determining the appropriateness of a youth's current level of care and suitability for stepping up or down of services.…”

Section: Child and Adolescent Level Of Care Utilization System (Calocmentioning

confidence: 99%

Intensive Home Based Services Within a Comprehensive System of Care for Youth

Daleiden¹,

Pang

Roberts

et al. 2009

J Child Fam Stud

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Within a comprehensive mental health service array for youth, Intensive Home Based Services (IHBS) are designed to meet the needs of youth with significant emotional and behavioral problems in their home communities, avoiding the need for out-of-home services, particularly residential care. We examined youth receiving IHBS as their first service in the state of Hawaii system of care (N = 163) to determine how successful IHBS were in preventing the need for more restrictive services within 12 months of intake. Subsequently, we investigated characteristics that might be predictive of a youth's need for service intensification within 12 months. Logistic regression analyses found that greater age, level of service need, and functional impairment at intake predicted use of more restrictive services within 12 months of intake, whereas gender, ethnicity, diagnosis, service intensity, and clinician credentials did not. Overall, our findings suggested that IHBS were reasonably successful in preventing residential placements, and provided some basis for determining characteristics of youth likely to require more restrictive placements within a one year period.

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“…A detailed algorithm is used to combine ratings into a level of care judgment in one of seven categories: basic services (Level 0), recovery maintenance and health management (Level 1), outpatient services (Level 2), intensive outpatient services (Level 3), intensive integrated service without 24-h medical monitoring (Level 4), non-secure, 24-h, medically monitored services (Level 5), and secure, 24-h, medically managed services (Level 6). Preliminary studies have indicated acceptable reliability and validity for the measure (Fallon et al 2006). Care coordinators, certified for administration on an annual basis, served as the primary raters for the CALOCUS in the current study.…”

Section: Child and Adolescent Level Of Care Utilization System (Calocmentioning

confidence: 99%

Outcomes from Multisystemic Therapy in a Statewide System of Care

et al. 2008

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We examined client outcomes from the implementation of Multisystemic Therapy (MST) in a statewide child and adolescent mental health system. Specifically, we examined (1) the validity of therapist-rated MST outcome measures by comparing them to ratings of functional impairment and level of service needs by CAMHD care coordinators, who provide case management and care coordination services, (2) potential client and service predictors of therapist-rated outcomes, and (3) improvement in youth functioning around the time of entry to and exit from MST compared with rates of improvement reported in randomized controlled trials (RCTs) by the developers of MST. Results suggested that therapist-rated MST outcomes were valid indicators of treatment success. Similar to other findings in the MST literature, few client or service characteristics predicted these outcomes. Finally, although MST entry-exit effect sizes were lower than the mean derived from RCTs published by the developers, they were within the 95% confidence interval. Together, these findings support the implementation of MST in complex systems of care with continued attention to quality assurance and ongoing use of data for evaluation.

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A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

Cited by 22 publications

References 26 publications

Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement

Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement

Intensive Home Based Services Within a Comprehensive System of Care for Youth

Outcomes from Multisystemic Therapy in a Statewide System of Care

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