Mental Health

Adult

Children

Substance Use

Developmental

1.800.928.8000

Initial Level of Care (LOC) Assignments

Purpose

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.

Protocol

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]).


SUBMITTING MATERIALS

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

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

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