Service Level Definitions

The child needing Basic services is capable of responding to limit setting or other interventions used in a normal family setting.  The characteristics of the child may include:

1.       Transient difficulties and occasional misbehavior;

2.       Acting out in response to stress, but episodes of acting out are brief; and

3.       Behavior that is minimally disturbing to others, but the behavior is considered typical for the child’s age and can be corrected.

The characteristics of a child with developmental delays or mental retardation may include minor to moderate difficulties with conceptual, social, and practical adaptive skills.

The child needing Moderate services has problems in one or more areas of functioning.  The characteristics of the child may include:

  1. Frequent non-violent, anti-social acts;
  2. Occasional physical aggression;
  3. Minor self-injurious actions; and
  4. Difficulties that present a moderate risk of harm to self or others.

The characteristics of a child who abuses alcohol, drugs, or other conscious-altering substances may include:

  1. Substance abuse to the extent or frequency that the child is at risk of substantial problems; and
  2. A historical diagnosis of substance abuse or dependency with a need for regular community support through groups or similar interventions.

The characteristics of a child with developmental delays or mental retardation may include:

  1. Moderate to substantial difficulties with conceptual, social, and practical adaptive skills to include daily living and self-care; and
  2. Moderate impairment in communication, cognition, or expressions of affect.

The characteristics of a child with primary medical or habilitative needs may include:

  1. Occasional exacerbations or intermittent interventions in relation to the diagnosed medical condition;
  2. Limited daily living and self-care skills;
  3. Ambulatory with assistance; and
  4. Daily access to on-call, medically skilled caregivers.

The child needing Specialized services has severe problems in one or more areas of functioning.  The characteristics of the child may include:

  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 Being markedly withdrawn and isolated;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.

The characteristics of a child who abuses alcohol, drugs, or other conscious-altering substances may include:

  1. Severe impairment because of the substance abuse; and
  2. A primary diagnosis of substance abuse or dependency.

The characteristics of a child with developmental delays or mental retardation may include:

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.

The characteristics of a child with primary medical or habilitative needs may include:

  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.

The child needing Intense services has severe problems in one or more areas of functioning that presents an imminent and critical danger of harm to self or others.  A child whose characteristics include:

  1. Extreme physical aggression that causes harm;
  2. Recurring major self-injurious actions to include serious suicide attempts;
  3. Other difficulties that present a critical risk of harm to self or others; and
  4. Severely impaired reality testing, communication skills, cognitive, affect, or personal hygiene.

The characteristics of a child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include a primary diagnosis of substance dependency in addition to being extremely aggressive or self-destructive to the point of causing harm.

 The characteristics of a child with developmental delays or mental retardation whose characteristics may include:

  1. Impairments so severe in conceptual, social, and practical adaptive skills that the child’s ability to actively participate in the program is limited and requires constant 1 to 1 supervision for the safety of self or others; and
  2. A consistent inability to cooperate in self-care while requiring, constant 1 to 1 supervision for the safety of self or others.

The characteristics of a child with primary medical or habilitative needs that presents an imminent and critical medical risk whose characteristics may include:

1.       Frequent acute exacerbations and chronic, intensive interventions in relation to the diagnosed medical condition;

2.       Unable to perform daily living or self-care skills; and

3.       Requires 24-hour on-site, medical supervision to sustain life support.

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:

I.   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.

Intense Plus Services consist of a high degree of structure to support the child in his or her environment while intervening as necessary to protect the child. The caregivers have specialized training specific to the characteristics of the child, and the therapists on staff have professional licensure or graduate level education to provide therapeutic services and intense therapeutic supports and interventions, including:

  1. 24-hour supervision to ensure the child’s safety and sense of security, which includes constant one-to-one monitoring during waking hours by an employee who is trained on the child’s therapeutic interventions and is able to provide immediate on-site response.
  2. Participation in individual and/or group therapy sessions that are research-supported, reimbursable by Medicaid, and readily available in the community, including but not limited to specialized therapies such as  Eye Movement Desensitization and Reprocessing Therapy,  Applied Behavior Analysis (certified); and Treatment for Anorexia/Bulimia/Eating Disorders, and others as appropriate;
  3. Use therapeutic programs that are documented as either well supported, supported, promising practice or evidence based and are appropriate to the child’s age and development to promote the child’s well-being. Therapy must address trauma and the behaviors resulting in the need for intense plus level of care.
  4. Contact with siblings, family members, and other persons significant to the child in order to maintain a sense of identity and culture;
  5. Provision of services to help the child learn or improve skills and functioning for daily living;
  6. Medical intervention and therapy that is structured daily and professionally designed and supervised to help the child attain functioning more appropriate to the child’s age and development addressing the behaviors resulting in the need for intense plus services;
  7. Consistent and constant direction, intervention, and structured support to help the child attain stabilization and connect appropriately with the child’s environment.
  8. A child with intellectual or developmental disabilities will receive professionally directed, designed, and monitored interventions to enhance mobility, communication, sensory, motor, cognitive development, behavioral and self-help skills.