The Level of Care Service System

The LOC Service System contains levels of residential services available to children. 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.

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