Initial Level of Care (LOC) Assignments


DCBS Workers are responsible for obtaining an initial Level of Care (LOC) assignment.

  • An LOC is required for all children 4 years of age and older who are in out-of-home care. In addition, all medically complex children, regardless of age, require an LOC.
  • If a child under the age of 4 has significant behavioral, emotional, or developmental issues, an LOC may be requested. See "Protocol" below for related instructions.
  • An LOC is needed before a child can be referred to a residential placement.



DCBS Workers must submit an 886A for all children when requesting a level of care.

  • The 886A must be current—this means that the 886A must have been completed within the last 30 days.

  • DCBS Workers must also submit a finalized version of the Screener (i.e., one that includes a Screener Result Summary section)  with the 886A. If a Screener is not available, one of the following approved supplemental tools may be submitted:

    • 1294B

    • Admission or discharge summary from PRTF or psychiatric hospital

    • DJJ Pre-dispositional report, assessment, etc.

    • IEP

    • Individualized Health Plan or Medically complex report

    • PCC discharge summary

    • PCC biopsychosocial

    • Psychological evaluation

  • The 886A and Screener or supplemental tool should be submitted together when possible.

  • For youth who are ages 18 and older, only the 886A needs to be submitted.  The Screener or supplemental tool is not required.

  • For medically complex children, documentation verifying medically complex status is required.

  • For children under the age of 4 who are not medically complex, the DCBS Worker’s supervisor must also submit a letter that explains why the level is needed.

Note: Questions related to the Screener should be directed to Lizzie Minton ([email protected]).



Submit all materials to the Children’s Review Program. Materials can be:

  • As of 7/1/2021, materials should be submitted via TWIST