South Carolina Department of Social Services  
P O Box 1520 ? Columbia, SC 29202-1520  
 
 

Program/Service Areas
- Adoption
- Adult Services
- Child Day Care Licensing
- Child Protective/ Preventive Services
- Humans Services Helpline
- Foster Care Services
- Out-of-Home Care
 
General Information
- Mission Statement
- Developments
- State Overview Efforts
 
Human Services Review Reports
- Qualititative Reports Index
 


Division of Human Services

P O Box 1520
Columbia, South Carolina 29202-1520
Concept Photo

For information on a specific program area, see:
Adoption | Child Day Care Licensing |
Child Protective/Preventive Services | Human Services Helpline | Foster Care



 

Mission Statement

The mission of public child welfare is to maintain or to secure in a timely manner safe nurturing and permanent living environments for children who are abused or neglected or are at risk of being abused or neglected.


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Legislative and Programmatic Developments

Legislative and programmatic developments in recent years have expanded the range of services available to children and their families. With the goal of achieving permanency for all foster children, there has been a major shift away from viewing foster care as a long-term solution for children. Services and programs designed to either maintain or reunify families have begun to receive more focus and are proving to be more cost effective in addition to being philosophically sound. This trend has resulted in the development of programs which are community based and which require the involvement and cooperation of both the public and private sectors. This section highlights some of the major legislative and programmatic developments.

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State Overview Efforts

South Carolina's social services and health communities are working hand in hand to search out and develop a new delivery system to improve services to our state's children and their families. No longer can one agency attempt to be all things to its children and families. If we are to make a difference, we must learn to join efforts, pool resources, and develop partnerships with public and private sector to improve services and to meet the changing needs of our children and families.

At the center of this exciting and important effort are the Governor's 1997 Health and Human Services Plan and a multi-agency program to invite the private sector to be a full partner in helping children and their families. As we move ahead, we will focus on prevention and early intervention. We will promote and support individual and family responsibility. We will listen to our children and families as we develop and evaluate programs.

  1. The Department has developed and issued a Request for Qualified Providers (RFQP). Several private entities responded to this RFQP. The RFQP was cancelled due to the time since its issuance (1 year). The Department decided to complete a more indepth study of the issues involved in this effort.

    The Department is still reviewing its options in seeking a single vendor to develop and manage an organized system of care for in-home care, foster care, adoption and services for special needs populations. DSS will retain responsibility for child protection and safety investigations and initial placement decisions. DSS will manage the provider contract from that position and authority. The provider will be held to the same outcomes and performance indicators as the Department.

    The contracted services will be family-focused, culturally competent and community-based, delivering all services needed to fulfill our statutory responsibility and commitment to families and to children at risk.
     
  2. Other Collaborative Efforts
     
    1. DSS has joined with the Department of Disabilities and Special Needs (DDSN) to gain access to the Disabilities and Special Needs Medicaid Waiver. The two agencies meet monthly to review and staff cases for inclusion in the Waiver and/or to develop efforts to jointly care for children by sharing the cost of the child's care.
       
    2. A Medical Foster Care Program was developed and implemented as a joint project by DSS, Richland Memorial Hospital and the S. C. Department of Health and Human Services. The governing board for the project is made up of representatives of these three agencies. This is a pilot program funded by Medicaid, Title IV-E, Title IV-B, state and local funds. The project provides a broad array of services under one umbrella from prescription and over the counter medications, primary care nursing care, therapies (speech, occupational, physical, etc.), and medical day care services. Intensive training is provided to the foster parents in the project. The three agencies are working with the University of South Carolina to perform a project evaluation and a statewide comparative evaluation. This service is available to Richland and Lexington County foster children with severe medical problems. This effort will be expanded by contracting with another hospital system in a different part of the State during FY98-99.
       
    3. Therapeutic Support Services is a pilot jointly operated and staffed by Anderson Youth Association (private non-profit agency) and DSS in Anderson and Greenville Counties. We are in the process of expanding the service to the Greenville six county region. Funding is provided through Medicaid, SSBG, Title IV-E, Title IV-B, Part 1 and 2, state and local funds.

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Array of Services

Adoption Preservation
Funding: Medicaid, IV-B Part 2, State, Local

Birth Parent Services
Counseling and support services are provided to assist in determining the permanent plan for children when care and nurturing may not be possible in the genetic or birth family.

Parents, or prospective parents, apply for these services during or after a pregnancy. Clients may also be other family members or guardians of children needing permanent family plans.

Through this service, the agency has the responsibility to support and protect the legal and personal rights of all parties. The goals of this service are as follows: (1) to strengthen family life, (2) to alleviate stress in the lives of clients, (3) to develop alternate families for children, (4) to reduce the incidence of unplanned pregnancy, and (5) to reduce the risk of child abuse and neglect.

Children's Day Treatment
An intensive treatment program for young children and adolescents with severe emotional/behavioral disorders who are at risk for a more serious, long-term psychiatric disturbance that will make their education and medical/psychiatric care costly in the future. Without appropriate intervention and treatment, serious emotional problems in preschool (0 to 5) and school age children can contribute to developmental and educational delays and lead to increased family difficulties, seriously impaired interpersonal relationships, increased risk for the occurrence or recurrence of child abuse and the exacerbation of inappropriate behaviors.
Children's Day Treatment provides a program of individualized, coordinated, comprehensive care that is multifaceted, and has the advantage of retaining the child in a home setting. Through caregiver involvement in the Children's Day Treatment program, the therapeutic process is extended into the child's natural environment. The ultimate goal of Day Treatment is to effect sufficient change so that the child can be transitioned to less restrictive, intensive educational or child care settings.
This is provided in two project areas (Greenville and Aiken Counties).
Funding: Medicaid, State, Local

Clinical Day Programming (CDP)
A comprehensive system of individual, family and group treatment services dedicated to the mitigation of the effects (of serious emotional and/or behavioral disturbances) on children and adolescents. Children referred to Clinical Day Programming are typically needing an alternative educational/social setting in which their maladaptive bahaviors can be therapeutically remediated with the ultimate goal of producing sufficient change so that the child can function successfully in a less restrictive setting.
Clinical Day Programming treatment services are provided in coordination with public education services for children ages six through adolescence. Treatment is provided within a psycho-social context including programming that integrates therapeutic interventions and educational and recreational activities, crafted to provide a more effective response to the individual needs of children and their families.
Funding: Medicaid, State, Local

Crisis Management
Crisis Management is an intense component provided immediately to the identified child following abrupt or substantial changes in the child's functioning. Crisis Management can be employed to reduce the immediate personal distress; to assess the precipitant(s) that resulted in the crisis; and/or to reduce the chance of future crisis situations through the implementation of preventive strategies.
Funding: Medicaid, SSBG, IV-B Part 1 and 2, State Local

Crisis Stabilization
Crisis Stabilization is defined as services provided to a child with emotional and/or behavioral disturbances in need of short-term therapeutic intervention. Crisis Stabilization placements provide for intensive, short-term services designed to de-escalate a potential crisis situation and/or provide a therapeutic outlet for a child's emotional problems.
The overriding goal of Crisis Stabilization services is to prevent the permanent disruption of a child's placement.
Crisis Stabilization services may be rendered in a Treatment Home program, in a Crisis Care residential group home or in an Intensive Crisis Care program. The level of care in which Crisis Stabilization is provided depends upon the medical necessity criteria furnished by a physician or other licensed practitioner of the healing arts. Unless otherwise specified, a therapeutic residential care in which the service is provided.
Crisis Stabilization services are time limited and must meet a specific treatment need.
Funding: Medicaid, IV-E, IV-B Part 1, State, and Local

Day Care Services
Day Care Services is provided on a limited basis for working foster parents and CPS families where parents work or the child needs the services.
Funding: Child Care Block Grant

Emergency Shelter
This service is provided by local nonprofit organizations to provide for 24 hour care with little or no advance warning. Providers are licensed by the state.
Funding: Title IV-E, IV-B Part 1, State, and Local

Family Management Counseling
Counseling is provided through this service to individuals or families who require assistance in maintaining or improving their ability to manage their homes, their finances and/or their family relationships. The services include acting as payee for a client, providing counseling in handling limited financial resources, housekeeping and/or securing and maintaining employment. Supportive counseling in child rearing or in developing skills to enhance other interpersonal relationships is also provided.
Clients receiving this service may be experiencing family disruption or personal crisis, needing assistance in budgeting their income, in fulfilling their responsibilities as parents, in acquiring employable skills, or in adequately managing their household responsibilities.
The above broad services are funded in accordance with the Department's approved cost allocation plan through the use of several funding sources. Those funding sources are Social Service Block Grant (SSBG), Title IV-B, Subpart 1 and 2; Title IV-E, Title IV-E Independent Living, Child Care Block Grant Funds; Title XIX-Medicaid; State and local funding Sources; and Private Foundation Grants and donations.

Flex Funding
This provides funding to purchase any service needed by a child or family to maintain or reunite the family. It includes hard core fiscal services such as paying rent, fixing a car, repairing a house or purchasing appliances, and paying utilities.
Funding: SSBG, Local, State, Emergency Funds, IV-B Part 1 and 2

High & Moderate Rehabilitation
These services are defined as highly structured therapeutic group homes having intensive staff supervision and programs for emotionally disturbed children which may include severely emotional disturbed, aggressive and multi-handicapped children or adolescents. These children are not able to live in a less restrictive environment due to the intensity or severity of their current emotional problems, behavioral disorders and/or acting-out behaviors. The treatment program is behavioral, psychological, and psychosocial in orientation.
The goal of these therapeutic group homes is to enable children to overcome their problems to the degree that they may move to a less restrictive community placement with plans toward eventual placement in a family or independent living situation. Therapeutic group homes which are a part of this program may be described as either high or moderate management.
High Management refers to level of supervision and intensity of programming required to manage and treat children who present severe emotional and/or behavior management problems.
Programming and interventions are tailored to the age and diagnosis of the children served.
Frequent structured therapeutic group and individual interventions along with specialized behavior management techniques are often offered several times per day.
The children are provided with 24 hour awake supervision.
Moderate Management refers to level of supervision and intensity of programming required to manage and treat children who present less intensive emotional and/or behavioral problems than those treated in high management group homes.
Structured therapeutic interventions such as individual and group therapy are provided several times per week.
Staff often supervise a greater number of children at a given time than might be supervised in a high management setting and children may be allowed some degree of independence.
The children are provided with 24 hour supervision, 16 hours of which is awake.
Funding: Medicaid, IV-E, IV-B Part 1, State, and Local

Home Based Treatment
Home Based Treatment Services shall be provided for the identified child based on the assessed needs. The purpose of Home-Based Treatment Services is to reinforce and enhance the identified child's ability to function within his/her home environment and to enhance the family's level of functioning. The aim of services should be to identify and assist the identified child and his/her family in resolving conflicts, coordinate efforts between the LCS and the child and family and the designated referring agent in order to maintain the child in the home, reunify the family unit, communicate and demonstrate methods of appropriate parenting skills and/or behavior management techniques in order to help family members more effectively manage certain behaviors or supporting/strengthening the identified child's home environment. In addition, Home-Based Treatment Services should promote the family's relations with a social network that supports positive and pro-social behavior. Likewise, difficulties in the child's peer relations and school performance should be identified, and the family should be encouraged to promote the child's positive social relations and academic performance in these contexts. Services shall be made available 24 hours per day, seven days per week.
Funding: Medicaid, SSBG, Title IV-B Part 1 and 2, State, and Local

Home Evaluation and Supervision
A study of current home conditions is made by the Department of Social Services when it becomes necessary to move children from their present living arrangements into a more stable environment or when a court or the Interstate Compact on the Placement of Children needs family/home information to make a decision on custody matters. Supervision of a placement and provision of other supportive social services to make the placement more secure is also a vital part of this service.

Inpatient Psychiatric Care
This service is provided on a short term (1 to 30 days) and a long term basis (15 to 365 days).
Funding: Medicaid, State, and Local

Low Management
This service provider for more structure and a higher child to staff ratio than standard group care services.
Funding: IV-E, IV-B Part 1, State, and Local

Permanency Planning for Foster Children
Permanency planning services include the placement in licensed/ approved substitute care facilities of children who are unable to remain safely in their own homes, and to assure the timely development and implementation of permanent plans for each foster child.

Personal Care Aide Programs
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Psychological Services
This service includes psychological evaluations, individual, family and group counseling and consultation services.
Funding: Medicaid, Title IV-B Part 1, SSBG, State, and Local

Psychosocial Evaluation
Activities related to gathering and assessing information needed to develop a comprehensive assessment of the clients problem areas and needs for initial Total Service Plan development. Specific activities include review of application and pertinent background information such as psychological evaluation reports, medical reports, school information, etc.; interviews with family and/or guardian, school personnel, representatives of human service agencies, and service providers to obtain family history, educational history, involvement with juvenile justice system, previous service and treatment history, and comprehensive information about child's problems and needs; and writing the psychosocial evaluation report.
Funding: Medicaid, IV-E, SSBG, IV-B Part 1 and 2, State, Local

Residential Treatment
A Residential Treatment Facility (RTF) provides for the diagnosis and treatment of severely emotionally disturbed and/or mentally ill children under the age of twenty-one (21) who require less than acute inpatient care but who need a structured environment with intensive treatment services.
The RTF services are inpatient psychiatric services provided in a Joint Commission on Accreditation of Health Care Organizations residential "hospital-like" treatment program.
Services are designed to stabilize a crisis or to provide long-term care.
Services are physician driven and include input from nurses, social workers, psychologists, and other clinical staff in the treatment planning and service delivery. The various disciplines work together to provide a variety of treatment modalities to clients which are both medical and behavioral in nature.
The Residential Treatment Facility program is implemented under the Federal guidelines for Inpatient Psychiatric Services.
Funding: Medicaid, IV-B Part 1, State, and Local

Respite Care
Respite is defined as a short-term, planned or emergency service which is provided for families or family substitutes of children who are emotionally disturbed, and, under certain circumstances, for the children themselves, when they require temporary alternative living arrangements. The service is provided under one or more of the following circumstances:
Planned respite is a short-term service for families or family substitutes who require periodic relief from the constant and often stressful care of these children. The goal of respite provided under this circumstance is to enable the families or family substitutes to continue the care and treatment of a child who might otherwise require treatment in a more restrictive setting.
emergency respite is a short-term service for families or family substitutes who become ill or otherwise require the temporary services of an alternative caregiver for a limited period of time. The goal of respite provided under this circumstance is to ensure that the quality of the care and treatment of a child is not compromised until the family or family substitute is again able to become the primary caregiver.
Planned or emergency respite is a short-term service for the children themselves who require short-term, highly structured residential care while they are between placements.
Funding: Title IV-B Part 1 and 2, State, and Local

Specialized Residential Treatment for Children through Managed Treatment Services
This service is for children who have emotional problems so severe they cannot function effectively at home or adjust in regular foster care. DSS refers and helps place these children in facilities that are most appropriate to the child's needs, depending upon the degree of the child's emotional disturbance. The purpose of the service is to treat the child and work with the family to facilitate an early return home through intensive case management services. This service is provided through the Division for Managed Treatment Services for the severely emotionally disturbed children and by county permanency planning staff for children with less severe problems.

Specialized Treatment for Sexual Offenders
The Specialized Treatment Services for Sexual Offenders program involves intensive clinical services provided in a high management group home having specialized staff and programs for severely emotionally disturbed children who exhibit sexually aggressive behavior. These children are not able to be treated in a less restrictive environment due to the severity of their emotional and behavioral problems, their history of sexual abuse of other children/adolescents, and the potential for recurrence of sexually offending behaviors.
This specialized treatment program is designed for sexual offenders under the age of 21, and must provide the structure, supervision, and array of intensive treatment services necessary to treat this special population. This program must be tailored to the age, diagnosis, and background (i.e., history of sexually abusive behavior) of each child being served.
In order for placement in this program to be appropriate, the child must exhibit symptomatic behaviors that are both high risk and persistent. Examples of behavior exhibited by sexual offenders may include: previous victimization, sexual assault, sexual deviance, violent aggression (severe physical acting out), fire setting, or abusive acts toward animals.
Funding: Medicaid, State, and Local

Standard Foster Care
Standard Foster Care is provided and paid at the rate approved by the South Carolina Legislature. Service is statewide.
Funding: IV-E, IV-B Part 1, State, and Local

Standard Group Care
The service is provided by licensed nonprofit organizations in a group setting of five or more children. Many have houseparents, while others have around the clock staff. They provide a place to live for a child who cannot stay at home or in a home setting.
Funding: Title IV-E, IV-B Part 1, State, and Local

Supervised Independent Living
Supervised Independent Living is defined as a range of rehabilitative services provided to adolescents ages 16 to 21. Services are designed to improve the quality of life for adolescents by assisting them to assume responsibility over their lives and to function as actively and independently in the community as possible. Supervised Independent living is designed to both strengthen the adolescent's skills and develop environmental supports necessary to enable them to function independently in the community.
Supervised Independent Living services are restricted to adolescents who have completed an intensive, out-of-home therapeutic placement or who have been incarcerated in the Juvenile Justice System and who are in need of continued treatment services in a less intensive therapeutic environment which offers independent living skills.
Supervised Independent Living services are intended to enable the adolescent to transition to a less intensive environment while encouraging the adolescent to maintain community tenure, obtain all necessary treatment services, access services from a variety of community programs, and improve his/her capacity for independent living. Services are provided in the context of a supportive, noninstitutional environment in the community and should be offered in a manner that maximizes the adolescent's responsibility, control and feelings of self worth, and encourages ownership in the rehabilitation process.
Funding: Medicaid, IV-E, IV-E Independent Living, IV-B, State, Local

Therapeutic Child Care
A psychosocial and developmental system of services for young children (ages 0 to 6) whose goal is to cultivate the psychological and emotional well-being of children and to promote their developing competencies. The child/client will show significant problem indicators in any one or more of the following developmental areas: attachment, emotional, social, cognitive, self concept, self-help, behavioral, receptive/expressive language, and physical. The family will frequently be found at the highest risk for caregiving dysfunction.
In the absence of focused, individualized interventions, these children and their families will be at high risk for more serious emotional/social problems.
Service delivery is facilitated through direct treatment services to the child and intervention with the family. An integrated complement of services provided by professional and paraprofessional staff includes a well structured treatment program for young children provided in a safe, nurturing, stimulating environment; monitored interactions of child and family; individual, group and family therapy and in-home observation and intervention modalities.
Expected outcomes of this service are the prevention of child maltreatment, the mitigation of the effects of abuse and neglect, and the empowerment of families as skilled caregivers.
This is one project in Richland County.
Funding: Medicaid, State, Local

Therapeutic Foster Care Programs
Therapeutic Foster Care is defined as individualized foster care provided to children by Treatment Parents who are specially recruited, trained, and matched with a child with whom they can best work. The Treatment Parents are then supported by clinical staff throughout the child's length of stay. The purpose of therapeutic foster care programs is to enable children to overcome their problems in a highly supportive, individualized, and flexible residential placement which will assist them to move to a less intensive foster or group care placement or to return to their families.
Funding: Medicaid, IV-E, IV-B Part 1, State, and Local

Therapeutic Foster Care - Level A
Therapeutic Foster Care, Level A is a therapeutic residential service provided in a specially recruited, professional supervised, therapeutic foster home. The service goal is to enable the mentally and behaviorally challenged child to develop skills that promote successful functioning in normalized familiar and other social settings.
Level A services are provided by therapeutic foster parents who are trained and skilled in working with children whose needs are challenging and more complex than children served in regular foster care homes. Level A therapeutic foster parents must provide a structured and supportive environment that seeks to maximize the child's chances for successful living within a family and in a community.
Prevention of more costly and restrictive treatment options and facilitation of reuniting the child with his or her family of origin and/or permanent guardian, are expected outcomes of this service.
Funding: Medicaid, Title IV-E, Title IV-B Part 1, State, and Local

Therapeutic Support
TSS is designed to work with committed foster families and children with severe emotional and/or behavioral disturbances to minimize the need for restrictive services. The TSS program provides intensive services in-home to children with severe emotional and/or behavioral disturbances in a foster care setting or in the child's parents home or relatives to reunite the family or prevent placement.
The TSS program involves a range of clinical services predominantly provided within the child's foster home and surrounding environment. TSS services are designed to serve children under the age of 18 and are tailored to prevent disruption of the child from the foster family, prevent occurrences of abuse and neglect, promote potential reunification of the child with his/her natural family, as well as, strengthen and empower the foster family. TSS is behavioral, psychological, and psycho-social in orientation.
TSS focuses on the child's problems and needs as they relate to his/her foster family, natural family, school, and community. TSS is multi-faceted and may include assessment, crisis management, counseling, and skills training. Services should be flexible and tailored to the needs of each child being served. Services must be available twenty-four hours a day, seven days a week.
This is being piloted in the six county Greenville Region of the state.
Funding: Medicaid, SSBG, IV-B Part 2, State, and Local

Working Together Project
From Richland expansion to Aiken, Greenville, and Charleston.

Wrap-Around Services
Services rendered to a child and/or the child's family which will stabilize or strengthen the child's placement or prevent out-of-home care. Services are classified as Wrap-Around Services. Wrap-Around Services are defined as treatment-oriented, goal directed services which provide a therapeutic benefit for the child. Specific services included in the array of Wrap-Around Services are intended to help stabilize or strengthen the placement of children, some of whom are severely emotionally disturbed, aggressive, and multi handicapped. Without the provision of services a child may be at jeopardy of placement disruption and/or movement to a more intensive and costly setting or service. The array includes evaluation and assessment, counseling, therapy (activity, recreation, occupational and expressive/adjunctive), positive role model, behavior management, non-residential independent living skills, temporary de-escalation care, caregiver services, and family and group services.
Funding: Medicaid, IV-B Part 1 and 2, SSBG, State, and Local

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