The Level of Care Service System

The LOC Service System contains levels of residential services available to youth. These levels are referred to Basic, Moderate, Specialized and Intense Services.

The Basic Service Level consists of a supportive setting, preferably in a family, that is designed to maintain or improve the child’s functioning, including:

  1. Routine guidance and supervision to ensure the child’s safety and sense of security;
  2. Affection, reassurance, and involvement in 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. Access to therapeutic, habilitative, and medical intervention and guidance from professionals or paraprofessionals, on an as-needed basis, to help the child maintain functioning appropriate to the child’s age and development.

The Moderate Service Level consists of a structured supportive setting, preferably in a family, in which most activities are designed to improve the child’s functioning including:

  1. More than routine guidance and supervision to ensure the child’s safety and sense of security;
  2. Affection, reassurance, and involvement in structured 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. Access to therapeutic, habilitative, and medical intervention and guidance from professionals or paraprofessionals to help the child attain or maintain 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 intermittent interventions from a skilled caregiver who has demonstrated competence.

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.

The Intense Service Level consists of a high degree of structure, preferably in a family, to limit the child’s access to environments as necessary to protect the child. The caregivers have specialized training to provide intense therapeutic and habilitative supports and interventions with limited outside access, including:

  1. 24-hour supervision to ensure the child’s safety and sense of security, which includes frequent one-to-one monitoring with the ability to provide immediate on-site response.
  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;
  4. Therapeutic, habilitative, and medical intervention and guidance that is frequently scheduled and professionally designed and supervised to help the child attain functioning more appropriate to the child’s age and development; and
  5. Consistent and frequent attention, direction, and assistance to help the child attain stabilization and connect appropriately with the child’s environment.

In addition to the description in subsection (a) of this section, a child with developmental delays or mental retardation needs professionally directed, designed and monitored interventions to enhance mobility, communication, sensory, motor, and cognitive development, and self-help skills.
(c) In addition to the description in subsection (a) of this section, a child with primary medical or habilitative needs requires frequent and consistent interventions. The child may be dependent on people or technology for accommodation and require interventions designed, monitored, or approved by an appropriately constituted interdisciplinary team.

Intense Plus Definition

A child needing Intense plus services has severe problems in two or more areas of functioning that present an extreme, imminent and critical danger of harm to self or others. The youth needing intense plus services may include a child whose characteristics include more than one of the following:

  1. Extreme and reoccurring episodes of physical aggression that causes harm;
  2. Extreme and reoccurring episodes of sexually aggressive behaviors;
  3. Assaultive, homicidal, suicidal, recurring major self-injurious actions;
  4. Chronic runaway behaviors;
  5. Severely impaired reality testing, communication skills, and cognition;
  6. A child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include a primary diagnosis of substance dependency or abuse in addition to being extremely aggressive or self-destructive to the point of causing harm;
  7. A child who is Lesbian, Bisexual, Gay, Transgendered or Questioning
  8. A child with eating disorders causing concerns for health and well-being;
  9. A child with intellectual or developmental disabilities whose characteristics include; impairments so extreme in conceptual, social, and practical adaptive skins that the child’s ability to actively participate in the program is limited and requires constant 1:1 supervision for the safety of self or others; and a consistent inability or unwillingness to cooperate in self-care while requiring, constant 1: 1 supervision for the safety to self/others.
  10. A child who is actively psychotic and has acted out on the psychosis;
  11. A child who is a survivor of human or sex trafficking;
  12. A child with chronic criminal behaviors that result in current or recent involvement with the justice system; and/or
  13.  A child who has displayed animal cruelty in the last 90 days.

Emergency care was not specifically defined in the LOC Service System. Any child, at any care level, may require emergency care.