If you are a hiker, you know what “The 14ers” are; they are mountains that many like to climb located around the world. Not all of the hikes are difficult. What makes them difficult are the elevation changes. They are over 14,000 feet to the top and usually require a hiker to start at 6 am and “get back down” before noon as thunderstorms can develop quickly.

We titled this new series The 14ers because we feel that understanding a Higher Level of Care (HLOC) can be difficult without exposure and a basic understanding of how to navigate:

 
• When to decide to refer a patient to a HLOC
 
• What are the different levels?
 
• What facility do you refer your client to?
 
• What level do you recommend?

We will be having guest speakers that have worked in the various levels of care to give you perspective and an “inside look” into each level. If you are new to the field, knowing the basics and lingo is vital so that you can more accurately coordinate care and provide a good recommendation.

Here are some resources on your journey from your tour guides!

Know the lingo:

 
• IP: Inpatient
 
• RTC: Residential Treatment
 
• PHP: Partial Hospitalization Program
 
• IOP: Intensive Outpatient
 
• OP: Outpatient

Most states now have most levels of care (RTC through IOP). However, that doesn’t mean those programs take your client’s insurance or that they are a solid program. Ask around to other colleagues who are more seasoned in the field about which programs they might recommend.

Keep in mind, not all clients do well in residential care on their “first round.” They may not be ready or motivated, they may not have “stepped down” appropriately, or they may be too young and need family-based treatment, for example.

We hope you find some good nuggets or perhaps just some validation of how difficult a 14er is. Experience, supervision, and knowledge are a good starting point even if you have never worked in that level of care.