The Continuum of Care is a program that serves children with
severe emotional disturbance. It is housed within the Governor's
Office of Executive Policy and Programs. The Continuum has one
administrative office (State Office) in Columbia and four regional
offices located in Columbia, North Charleston, Greenville and
Florence that provide services throughout the state. The Continuum
is funded primarily with state revenues and Medicaid funds.
The mission of the Continuum of Care is to ensure continuing development and delivery of appropriate services to those children with severe emotional disturbance and their families in SC whose needs are not being adequately met by existing services and programs. It will meet this mission by supplementing existing services available to this population and promoting support that encourages family strength and self-sufficiency.
What are the Continuum of Care's basic goals and principles?
The Continuum of Care will be guided by the following principles as it serves children with severe emotional disturbance and their families:
1. Families have the primary responsibility to care for their children's basic and special needs.
2. The Continuum will not reject a qualified applicant because of the severity of his/her emotional problems, the severity of need, or difficulty to manage.
3. The Continuum will not eject a client because of the severity of his/her emotional problems, the severity of need, or difficulty to manage.
4. The Continuum will develop a plan for services for each client in partnership with the client's family. This plan will be individualized and based on the specific needs of the client and on the support needs of the family related to the client.
5. The Continuum will use a multidisciplinary, interagency approach to service planning.
6. Clients will be provided services appropriate to their age and gender and sensitive to unique racial, ethnic and cultural distinctions.
7. Clients will have access to an interrelated array of therapeutic services with intensive case management as the unifying element of the array. Case managers will be aggressive advocates for individual clients and their families.
8. Clients will be served in the most normalized, least restrictive appropriate setting. Clients should remain with their families whenever possible and services will be provided, to the greatest extent possible, within the client's home community.
9. A range of support services should be available to families to strengthen their functioning and their ability to meet the needs of their child.
10. Efforts to reunify families will be a primary focus of case management when a child has been placed outside the home. Case management efforts should focus on maintaining the child's connections with family members whenever a child is placed outside his/her home.
11. Clients should not be confined in a state institution unless that confinement is in the best interest of the child and offers the most appropriate setting for the delivery of needed services.
How do children become eligible?
In order to be considered for selection as a client, a child must meet the following initial screening criteria:
Be a legal resident of South Carolina; parent or guardian must remain a resident of South Carolina for the child to continue to be eligible for Continuum services;
Have not yet reached his/her eighteenth (18) birthday or, if 18 or older, be enrolled in a Special Education program for handicapped pupils;
Be certified either with a primary diagnosis of severe emotional disturbance by a psychiatrist, licensed clinical psychologist, counseling psychologist; or be classified as emotionally handicapped under the Department of Education regulations by a certified school psychologist;
Have emotional disturbance which has persisted for at least one year in spite of documented interventions provided in a therapeutic manner;
Have treatment needs which are not being met by the existing service delivery systems and which require a comprehensive and organized system of care which can be met by programs designed to accept and serve children with severe emotional disturbance;
Be in the custody of his or her parents or other non-SCDSS legal custodian/guardian.
An application must be submitted with a signed consent of the parent or guardian; if (18) years or older, be enrolled in a special Education Program for handicapped pupils, and competent to do so, the consent must be signed by the applicant. Children who meet these criteria are eligible for information and referral services and limited case management assessment and support services.
In addition, in order to become a Continuum of Care client, the
applicant must be determined to be the child with the most severe emotional disturbance in greatest need of Continuum of Care services
compared to other applicants on the Priority Ranking (waiting) list.
What is severely emotionally disturbed?
Severe Disturbance is the inclusive term for children and adolescents whose severity of emotional, mental and behavioral disturbance requires a comprehensive and organized system of care. As these parameters indicate, the designation of "severe emotional disturbance" among children reflects a two dimensional relationship between the severity of the dysfunction and the system of care necessary to meet the needs of the children and adolescents with severe emotional disturbance. This two dimensional description can be further defined as:
SEVERITY OF DYSFUNCTION: In order for a child to be considered severely emotionally disturbed, the child's behavior must exhibit the following characteristics:
The behavior shall have occurred with sufficient frequency to be considered a pattern of situational inappropriate behavior which deviates substantially from behavior appropriate to one's age and cultural peer group.
The behavior shall have occurred with sufficient intensity to be considered seriously detrimental to the child's growth, development or welfare, or the safety and welfare of others.
The behavior shall have occurred over an extended period of time or to the extent the problem is disabling, handicapping or in some way interferes with the effective functioning of the individual.
SYSTEM OF CARE: The severity of the problem shall indicate the system of care necessary based upon the following criteria:
Range of Service
The severity of the behavior is judged to require a range of services which necessitates the involvement of multiple agencies.
The severity of the behavior is judged sufficiently disruptive to lead to the removal of the child from his or her current home, school, community or therapeutic setting.
The severity of behavior is judged persistent in spite of documented interventions provided in a coordinated and therapeutic manner.
How does the Continuum serve children with severe emotional disturbance?
Once a child is selected as a client, that child is assigned to a Continuum Service Coordinator who will begin gathering additional information in preparation for the Total Service Plan (TSP), the comprehensive plan of services for the child.
The TSP for each child is developed by an interagency group of professionals who work with the parents and/or legal guardians. The Continuum Service Coordinator coordinates and manages this process. This intensive case management allows the Continuum to meet the individual needs of each child.
The Service Coordinator and the TSP team develop a plan that fits the child, rather than attempting to fit a child into a pre-established program that may not meet his or her needs. Although the treatment needs for each child are different, there are certain standards which the Continuum uses when developing every TSP.
Community-based treatment: To the degree possible, the Continuum looks for community based services that will enable the child to stay at home or as close to his or her family as possible, in the least restrictive setting in which the child can function.
Rehabilitative Behavior Health Services (RBHS) : The service planning team (TSP Team) may use many different services to enable the family to keep the child at home, in the community and in school. These services often include Therapy, Crisis Management, Behavior Modification, Family Support and Rehabilitative Psychosocial Services.
Wrap-around services: These services provide support to the client and family and include educational services such as tutoring and transportation.
Family involvement: The child’s parents or legal guardians are expected to actively participate in all aspects of the child's treatment and provide physical and financial support whenever possible.
No eject, no reject: Even with extremely difficult behavior, the Continuum will not eject a client from its program. The Continuum will work with a child and family to find solutions until the child and family no longer need intensive interagency case management services or until a client transitions to adult services.