Partial Hospitalization Program (PHP) in Ohio

A partial hospitalization program is outpatient care at its most intensive, and it is sometimes called day treatment. It is a structured, comprehensive level of care aimed at helping you stabilize, build coping skills and make progress toward your treatment goals. You spend most of the day in treatment and go home each evening. Despite the name, PHP involves no hospital stay: Leora has no beds and provides no overnight care.

People come to PHP after ambulatory detox, as a step down from residential or inpatient treatment elsewhere, or when intensive outpatient has not held. Some start here in place of residential treatment, when the assessment finds they can safely spend nights at home.

Leora runs PHP in three tracks: mental health, dual diagnosis (mental health and substance use together) and substance use. That makes it one of Leora's mental health programs as well as an addiction treatment program. It treats:

• Depression and anxiety disorders
• Bipolar disorder
• Trauma and PTSD
• A mental health condition and substance use occurring together
• Drug or alcohol addiction

Two of the three tracks are for mental health. The mental health track treats a mental health condition on its own, and the dual diagnosis track treats one alongside substance use. Each runs at both facilities. For bipolar disorder, PHP can treat symptoms of mania when that is clinically appropriate.

The pages on mental health treatment in Ohio and co-occurring disorders describe each side in more detail.

PHP fits someone who needs treatment most of the day, most days, and who has a safe, stable home to return to each evening and a reliable way to get to the facility. Leora does not provide transportation. It often suits these situations:

• You have just finished ambulatory detox and need daily contact while things settle
• An inpatient or residential program elsewhere has discharged you, and a few hours a week would be too big a drop
• Intensive outpatient has not held
• A mental health condition and substance use are feeding each other

The treatment day is made up of therapeutic and psychoeducational groups led by licensed clinicians. They cover recovery, emotional regulation, coping skills, relapse prevention, mental health education and building healthier habits. The groups draw on cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), with 12-step facilitation for people it suits. CBT and DBT help you notice unhelpful thought patterns, manage strong emotions, tolerate distress and find better ways to cope. Your treatment plan is built individually with you, and you meet with a licensed therapist for an individual session every week.

Medication management is with a nurse practitioner at least once a week, with additional services available based on clinical need. Medication assisted treatment (MAT) is available for substance use disorders: it continues if you started it during detox, and it can be started here. Registered nurses are on staff to give clinical support, keep an eye on how you are doing, help with any concerns about medication and support the coordination of your care.

Partial hospitalization programs sit between an overnight stay and a few hours of treatment a week. The levels differ in hours and in where you sleep.

• Inpatient and residential treatment: you stay overnight. Leora does not provide either one.
• Partial hospitalization (PHP): most of the day, Monday to Friday, 9:00 am to 4:15 pm at Leora. You sleep at home.
• Intensive outpatient (IOP): three hours of therapy group a day, three to five days a week at Leora.
• Outpatient: one to two days a week.

Medicare's page on partial hospitalization gives a weekly figure for it: "You may benefit from partial hospitalization if your care plan states that you require at least 20 hours of therapeutic services each week." That figure is Medicare's.

Ohio's Medicaid rule for substance use treatment, rule 5160-27-09 of the Ohio Administrative Code, follows the criteria of the American Society of Addiction Medicine (ASAM). It groups intensive outpatient and partial hospitalization together as level of care 2, numbers partial hospitalization 2.5, and puts residential and inpatient services at level 3.

The assessment points elsewhere for:

• A need for 24/7 supervision or medical monitoring, which means an inpatient program
• Withdrawal that has not been managed, which comes first through ambulatory detox, or inpatient detox when it is severe
• No safe place to stay overnight
• A job that cannot spare Monday to Friday, 9:00 am to 4:15 pm, where intensive outpatient or virtual IOP may fit

Leora accepts every Ohio Medicaid plan and all major commercial insurance, and admissions can check your coverage while you are on the phone.

For substance use treatment, Ohio's Medicaid rule requires prior authorization for partial hospitalization, which it sets at a minimum of 20 hours of services a week. The pages on Ohio Medicaid and UnitedHealthcare cover what each asks for. Other plans set their own terms, so ask your insurer whether PHP needs prior authorization before you start.

Both facilities run all three tracks on the same schedule.

• Partial hospitalization in Columbus: 5432 N High St, Columbus, OH 43214
• Partial hospitalization in Dayton: 948 Patterson Rd, Dayton, OH 45419

Each page covers that building: getting there, and the programs you can step down to without changing provider.

How long you stay depends on your progress toward the goals you set with your treatment team in the first few days. The program prepares you to move to a lower level of care when that is clinically appropriate, and you and the team plan the discharge date and the next step together. The path down runs through:

1. Intensive outpatient, three to five days a week
2. Outpatient, one to two days a week
3. Outpatient therapy and community recovery support, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA)

Leora welcomes walk-ins at both facilities, or call Columbus at (614) 665-8878 or Dayton at (937) 660-4145. Bring:

• Your ID
• Your insurance card
• A current list of your medications
• A copy of your discharge plan, if you are coming from another program

Leora accepts all major commercial insurance and Medicaid.