Andy Cruz, MD, is a mission-driven physician-executive working to expand access to transformative, compassion-first mental healthcare. Trained at the Harvard Medical School Adult Psychiatry Residency at Massachusetts General Hospital and McLean Hospital, he received multiple teaching awards from both Harvard medical students and MGH/McLean residents—a reflection of his enduring commitment to mentorship and clinical excellence.
Dr. Cruz has helped lead care in some of the world's most respected institutions, from inpatient psychiatry at McLean to low-barrier substance use treatment at MGH. He served as a medical director at Headway, the largest virtual mental health platform in the country, and currently advises Steadfast Health as they scale their network of substance use clinics rooted in dignity and access.
In 2023, he co-founded Guidelight, a national provider of intermediate behavioral health care (PHP/IOP) that serves patients across all insurance lines. Guidelight exists to close the gap between outpatient and inpatient care—offering a level of treatment that is often the most appropriate and powerful, yet the most challenging to access.
He serves on the board of the Association for Ambulatory Behavioral Healthcare—the national voice for PHP and IOP providers. Through this peer-led coalition, he works to improve access, elevate quality, and advocate for fair reimbursement across the field. He is also a founding member of the Noble Forum, a physician-executive collective dedicated to solving healthcare’s most complex and urgent challenges.
Outside of work, Andy is a classically trained pianist with a particular affection for Rachmaninoff and Chopin, an avid traveler, a devoted film lover, and a proud husband and dog dad to Zeus.
When to Refer: Foundations of PHP and IOP
Intermediate levels of care play a critical role in supporting individuals in crisis, yet determining when PHP or IOP is clinically appropriate can be complex. This continuing education session is designed to help clinicians, referral partners, and healthcare professionals better understand how to assess, recommend, and refer to intermediate levels of care with confidence and clinical clarity. Participants will explore the history and purpose of Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP), including how these levels of care fit within the broader behavioral h...Read moreealth continuum. The session will review current research on inpatient hospitalization, highlight the role of PHP and IOP in stabilizing crisis and reducing unnecessary emergency department and inpatient utilization, and examine common challenges facing these programs today.
A significant portion of the training will focus on the practical application of LOCUS criteria, including how risk of harm, functional status, co-occurring conditions, recovery environment, treatment history, and engagement inform level-of-care decisions. Attendees will also review exclusionary considerations, ethical referral obligations, and best practices when a client does not meet criteria for PHP or IOP. This session emphasizes clinical judgment, real-world decision-making, and patient safety, equipping participants with tools they can apply immediately in assessment, referral, and care coordination conversations. Less...
Learning Objectives
- Describe the historical, policy, and clinical factors that led to the development of partial hospitalization and intensive outpatient programs within the behavioral health continuum.
- Identify the core therapeutic mechanisms of PHP and IOP, including group-based interventions, multidisciplinary coordination, and structured skill acquisition.
- Explain complex or ambiguous clinical presentations that signal potential readiness for PHP or IOP, especially when patients fall between traditional outpatient and inpatient criteria.
- Apply a practical, decision-making framework to improve referral timing, reduce common pitfalls, and more confidently match patients to the appropriate level of care.
Target Audience
This educational activity is intended for behavioral health professionals, including Psychologists, Social Workers, Counselors, and MFT's.
Learning Levels
- Beginner
Wednesday, January 28, 2026
Live Interactive Webinar
12:00 PM EST - 01:00 PM EST
EARN 1 CE Credit Hours
Click Here to Register
Click Here to Register
About the speaker
Andy Cruz, MD
Andy Cruz, Co-founder and Chief Medical Officer, Guidelight Health
Agenda
0:00–0:05 (5 min) – Welcome & Introductions- Brief welcome and speaker intro
- Overview of Guidelight Health and intermediate levels of care
- Review learning objectives for the hour
0:05–0:15 (10 min) – The History & Role of PHP/IOP
- Brief history of PHP in the U.S. (1960s origins, Community Mental Health Act)
- Rationale for intermediate levels of care in the current system
- Challenges and pressures over time (billing, quality concerns, financial margins)
- Framing: why high-quality PHP/IOP programs matter today
0:15–0:25 (10 min) – Inpatient Care vs. Intermediate Levels of Care
- Limitations of inpatient psychiatric hospitalization (lengths of stay, cost, trauma risk)
- How crisis duration, medication timelines, and discharge barriers impact care
- Positioning PHP/IOP as “right-sized” alternatives or step-downs
0:25–0:40 (15 min) – Defining PHP and IOP: Structure & Clinical Focus
- Clear definitions:
- PHP: frequency, hours, interventions, target populations
- IOP: frequency, hours, interventions, target populations
- Core treatment components (skills-based group therapy, process groups, med management)
- When to consider PHP vs. IOP (step-up vs. step-down from outpatient/inpatient)
- Short illustrative case vignette: choosing PHP vs. IOP
0:40–0:50 (10 min) – LOCUS Criteria, Inclusion & Exclusion
- Walk through LOCUS dimensions (risk of harm, functioning, comorbidity, environment, etc.)
- Key rating differences between PHP and IOP (e.g., composite scores, level cutoffs)
- Exclusion criteria and “exclusionary frame” (e.g., active psychosis, acute mania, severe withdrawal, inability to participate in groups)
- How to document when someone does not meet level of care and where to refer
0:50–0:57 (7 min) – Applying It: Referral Decision-Making
- 1–2 brief, de-identified referral scenarios
- Ask participants: PHP, IOP, higher LOC, or outpatient? Why?
- Discuss how to collaborate with clinical outreach / market-specific leadership when unsure
0:57–1:00 (3 min) – Wrap-Up & Q&A
- Summarize key takeaways:
- “Humans in crisis who can safely participate in group therapy” as a guiding frame
- Using LOCUS + clinical judgment together
- Importance of high-quality PHP/IOP to protect the level of care
- Final questions
- Share contact info and referral pathways
CE Information - Earn 1 CE Credit Hour
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CE Process Info
Before the event, you will receive an email from CE-Go with access to the virtual event. After the event, you will receive access to your evaluation and continuing education certificate via a personalized "attendee dashboard" link, hosted on the CE-Go website. This link and access to the virtual event will be sent to the email account you used to register for the event.
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- Complete evaluation forms for the event
- Download your continuing education certificate in a PDF format
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