Description of the Specialized Service Level

The Specialized Service Level consists of a treatment setting, preferably in a family, in which caregivers have specialized training to provide therapeutic, habilitative, and medical support and interventions including:

  1. 24-hour supervision to ensure the child’s safety and sense of security, which includes close monitoring and increased limit setting;
  2. Affection, reassurance, and involvement in therapeutic activities appropriate to the child’s age and development to promote the child’s well-being;
  3. Contact, in a manner that is deemed in the best interest of the child, with family members and other persons significant to the child to maintain a sense of identity and culture; and
  4. Therapeutic, habilitative, and medical intervention and guidance that is regularly scheduled and professionally designed and supervised to help the child attain functioning appropriate to the child’s age and development.
  1. In addition to the description in subsection (a) of this section, a child with primary medical or habilitative needs may require regular interventions from a caregiver who has demonstrated competence.

Characteristics of a child that needs the Specialized Services

A child needing specialized services has severe problems in one or more areas of functioning. The children needing specialized services may include:

  1. A child whose characteristics include one or more of the following:
    1. Unpredictable non-violent, anti-social acts;
    2. Frequent or unpredictable physical aggression;
    3. Being markedly withdrawn and isolated;
    4. Major self-injurious actions to include recent suicide attempts; and
    5. Difficulties that present a significant risk of harm to self or others.
  2. A child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include one or more of the following:
    1. Severe impairment because of the substance abuse; and
    2. A primary diagnosis of substance abuse or dependency.
  3. (3) A child with developmental delays or mental retardation whose characteristics include one or more of the following:
    1. Severely impaired conceptual, social, and practical adaptive skills to include daily living and self-care;
    2. severe impairment in communication, cognition, or expressions of affect;
    3. Lack of motivation or the inability to complete self-care activities or participate in social activities;
    4. Inability to respond appropriately to an emergency; and
    5. Multiple physical disabilities including sensory impairments.
  4. A child with primary medical or habilitative needs whose characteristics include one or more of the following:
    1. Regular or frequent exacerbations or interventions in relation to the diagnosed medical condition;
    2. Severely limited daily living and self-care skills;
    3. Non-ambulatory or confined to a bed; and
    4. Constant access to on-site, medically skilled caregivers with demonstrated competencies in the interventions needed by children in their care.