History & Overview
The Level of Care Service System
This overview describes the Texas Level of Care (LOC) Service System that existed in Texas from September 1, 1988, until August 31, 2003. During FY ’03, this system was substantially revised by the Texas Department of Family and Protective Services. The Texas Service System changes went into effect on September 1, 2003. Copies of the current Texas Service System standards are available from DFPS Residential Contract Managers (RCM) within each Region. These Standards are also contained in the DFPS Handbook.
The History to the Texas LOC Service System
The Texas Health and Human Services Coordinating Council (THHSCC) was established in 1983 to coordinate planning and policy making for 19 Health and Human Service agencies in Texas. The Council was chaired by the Governor; the Lieutenant Governor and Speaker of the House served as co-chairs. Council membership included State Senators, Representatives, Board Chairs of State agencies, and members of the general public.
In 1984, the Legislative Budget Board required that the Council undertake a study of residential contract child care in Texas. During the next four (4) years, a group referred to as the THHSCC Treatment and Care Work Committee developed a system of care that met the criteria established by the Legislative Budget Board. This system of care is called the Texas Level of Care (LOC) Service System and was implemented throughout Texas on September 1, 1988, and included the following components.
A Common Application for agencies to use when placing children in residential care facilities that includes a mechanism to determine the appropriate level of care for each child. This form replaced all payer and provider admission forms.
A system of services to children that include definition levels of services.
A system of residential standards of care that define a range of services required for Texas public agency children served by residential contract providers.
Child-care provider cost reports and database to assist in determining the median cost of care.
LOC Service System Residential Monitoring Process
There was an interagency process for monitoring the Level of Care Service System of contracting residential facilities by Texas public agencies. The monitoring process focused on the quality of care provided to children. The results of on-site LOC Service System reviews were included with other information in the routine management of residential contracts.
Cost Reporting Process
In 1991, the Council was abolished and some of its responsibilities were transferred to the Health and Human Services Commission. One of the Commission’s responsibilities was to set maximum reimbursement rates (or ceilings) for the purchase of residential services for children based upon the Commission’s unpublished guidelines. The Texas Department of Protective and Regulatory Services reimbursed residential child care providers according to published reimbursement methodology rules. These reimbursement rates were statewide by level of care and are related to services delivered to children.