Functional assessment in partial hospitalization: clinical and administrative applications and implications after one year's utilization of the Framingham Functional Assessment Scale.

This paper presents the use of functional assessment as one response to the growing need for objective measures of outcome in psychiatric treatment. The Framingham Functional Assessment Scale was developed in 1979 as a functional assessment measure to form the basis of a client-oriented cost-outcome system for Medicaid reimbursement in Massachusetts. Clinical and administrative findings from 1 year's utilization of the scale are presented. Level of functioning (LOF) scores in a sample of 45 clients are analyzed to determine the amount of LOF change that occurred during the course of an intensive, 13-week, day-treatment program. Trends and patterns of LOF change are described. Utilization of functional assessment input/outcome data in administrative decision making is discussed, in light of increasing economic constraints in mental-health programs and concomitant demands for service accountability.