Appendix 4000-2: ICF-ID/RC Levels of Care
CPS May 2012
The ICF-ID/RC program has its own level-of-care system, which differs from DFPS’s service level system. Each child has an individual level of care. There are two levels of care (LOC I & LOC VIII) related to ICF-ID/RC placement:
To meet the LOC I criteria, a child must be determined by the Local Authority to:
• have a full scale intelligence quotient (IQ) score of 69 or below, obtained by administering a standardized individual intelligence test; or
• have a full scale IQ score of 75 or below, obtained by administering a standardized individual intelligence test, and have a primary diagnosis by a licensed physician of a related condition that is included on the DADS Approved Diagnostic Codes for Persons with Related Conditions; and
• have an adaptive behavior level of I, II, III, or IV (that is, mild to extreme deficits in adaptive behavior), obtained by administering a standardized assessment of adaptive behavior.
If a person has a sensory or motor deficit for which a specially standardized intelligence test or a certain portion of a standardized intelligence test is appropriate, the appropriate test or portion and the score is used.
If a full-scale IQ score cannot be obtained from a standardized intelligence test because of age, functioning level, or other severe limitations, an estimate of a person’s intellectual functioning is documented with clinical justification.
To meet the LOC VIII criteria, a child must:
• have a primary diagnosis by a licensed physician of a related condition that is included on the DADS Approved Diagnostic Codes for Persons with Related Conditions; and
• have an adaptive behavior level of II, III, or IV (that is, moderate to extreme deficits in adaptive behavior) obtained by administering a standardized assessment of adaptive behavior.
For further information about approvals to place a child in an ICF-ID/RC placement, see:
• 4118 Additional Actions for Placing Children with Intellectual or Developmental Disabilities
• Foster and Licensed Facility Placements Resource Guide - Home and Community-Based Services (HCS) Program
For further information regarding work with children with disabilities, see Appendix 6323.5: Placement Checklist for Children With Disabilities.