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Ito 0 • s -DURHAM Appendix3 Durham SOC Care Review LEVELS OF RESIDENTIAL CARE The following is a description of the levels of residential care available to the children of North Carolina. These services can be provided in a variety of locations from urban to rural, from facility based to community based and from public sector to private sector. They are all a part of the North Carolina System of Care. As such, each must be considered as serving a unique role in the clinical continuum of services. A clear understanding of the treatment and management capabilities as well as target population of each level of care is paramount to successfully individualizing treatment services to the needs of each child and family served. LEVEL II-Family: One or Two Parent homes where the parents have received special training and have access to additional support 1. Moderate level of structure and supervision to support age appropriate behavior 2 Family may be asleep during child's sleeping hours 3. Family/Caretaker must be available to meet child's treatment needs 24 hours a day (except for planned respite time) Children who are appropriate for this service may have the following behaviors: 1. Difficulty following directions 2. Frequent arguments with caretakers, siblings, teachers etc... 3. Mild Self-Injurious behavior, risk taking, sexual promiscuity 4. Suicidal thoughts 5. Frequent fights at home, school or community 6. Frequent verbally aggressive outbursts 7. Frequent property damage 8. Inability to engage in age appropriate activities without constant supervision (little league, scouts etc.) 9. Low to moderate risk for sexually victimizing others 10.Possible involvement with the legal system 11. Infrequent school suspensions These children have experienced a level of dysfunction that makes it impossible to function at an age appropriate level in their own homes or in a lower level of care. This may be as a result of a combination of factors including their own level of disruptive and maladaptive behavior as well as the nature of their previous living situation. This service provides a structured and supervised environment for the acquisition of skills necessary to enable the child to improve level of functioning to achieve and/or to maintain the most realistic level of independent function where earlier treatment gains are somewhat fragile and the child is subject to regression. Child is fairly accepting of treatment process. Page I