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Who Are the Kids in Level 4 Foster Care?

What is treatment level foster care? What are the kids like at a higher level of care? There are many myths surrounding Wisconsin kids in treatment foster care. A higher level ensures that children and youth living in a foster home get additional services to aid in growth and healing. It takes a team of case managers, service providers, social workers, and biological family members—all working together to help children in treatment foster care heal and grow.

What are the levels of Wisconsin foster care?

Each level speaks to the needs of a child. Levels 3 and 4 are considered treatment levels. Level 4 foster care is the highest level of care at CCR. Foster parents begin caring for kids at levels 2 and 3 and can help kids at level 4 after gaining experience. It requires both strength and patience for children and youth who have experienced significant trauma. Our trauma-informed team provides foster parents with an enhanced and individualized level of support to help children heal and prepare for the future. We can explain behaviors, diagnoses, and emotions common with kids in treatment level care. However, it may be easier to understand by getting to know two youth recently referred to CCR.

Teen boy in Level 4 foster care.

Gary is very organized and thrives with a structured routine. He is a fun-loving 16-year-old who can be very kind and considerate. Gary can be quiet at times and has difficulty expressing likes and dislikes. He becomes silent and withdrawn when he is not having a good day. He is currently living in a residential facility and is looking forward to transitioning to a home environment with a family.

He has made great strides in developing peer relationships during his time at the residential center. Gary has been diagnosed with ADHD and is prescribed Ritalin to help with symptoms and support his focus. Weekly appointments with a psychiatrist are helpful to Gary and will need to continue when he moves to a foster home.boy with dog at home backyard SBI 301037333

An Individual Education Plan (IEP) is in place for Gary. He has also been diagnosed with Specific Learning Disability and Emotional Behavior Disability. His IEP team agrees that Gary will struggle without consistent, at-home academic support. Gary currently works at a 7th-grade level. The most recent IEP evaluation confirms social, emotional, and behavioral functioning is not consistent with his age and adversely affects Gary's academic progress, social relationships, and classroom adjustment.

Gary requires enhanced instruction not available in a regular education program. The following will require a continued IEP:

  • Reading skills
  • Math
  • Written language
  • Self-regulation
  • Social skills

Gary would do best in a two-parent home with one parent at home full-time. If there are other children in the house, they are recommended to be older than Gary. Biological family interaction is dependent on where Gary is placed.

Level 4 foster care offers support for a teen girl.

Shanta is a social, active 13-year-old girl who enjoys being with others. She loves to color, dance, bake, and play outside. Her sense of humor makes others laugh, and she responds well to praise from others. Shanta enjoys being read to and spending one-on-one time with an adult. She enjoys playing with other children but does not have the appropriate social skills or play skills to have an interactive experience with a peer. Shanta struggles with transitions, especially from a favorite or preferred activity.girl chalk

Shanta has been diagnosed with a rare chromosomal abnormality disorder. Symptoms include seizures, moderate to severe learning problems, speech delays, behavior problems, trouble sleeping, and developmental delays.

She can physically perform personal hygiene but does not have the cognitive ability to track the steps independently. If given a washcloth and told to wash her body, she will wash one body part and say she is done. Brushing of teeth and hair requires redirection and prompting to continue until complete.

Shanta is fully continent but does have an occasional accident if not prompted to use the bathroom. She likes to pick out her clothing and dress herself. Often clothing will be backward or inside out.

An IEP is often necessary for youth at Level 4.

An IEP is in place at school where Shanta receives one-on-one instruction and support. She receives Occupational and Speech therapy at school. Her intellectual ability is lower than her chronological age. Functioning is similar to that of a 5-year-old. Instructions must be broken down into steps with additional time for her to process. Shanta is very well-liked by school staff and benefits from the emotional support received while at school.

A two-parent home is desired for Shanta. Ideally, one parent at home or a very flexible schedule would be best. Shanta would do best in a home with no other children. Biological family visits will occur 2x weekly with Shanta's mother and two sisters. A long-term placement is anticipated.

Qualify to care for youth at Level 4.

Considered specialized treatment foster care, structured to meet the higher needs of children, those on the autism spectrum, significant developmental delays, self-harm, sex trafficking, or youth with problematic sexual behaviors. Foster parents must meet 4 of the prior experience requirements:

  • A minimum of 1 year of experience with children who have a level of need of 3 as a foster parent or kinship care provider
  • A minimum of 5 years of experience working with or parenting children
  • A minimum of 500 hours of experience as a respite care provider
  • A high school diploma or equivalent
  • A college, vocational, or advanced technical degree in an area related to a child’s treatment needs, such as nursing, medicine, social work, or psychology
  • Work or personal experience demonstrating the knowledge, skills, ability, and motivation to meet the needs of a child with a level of need of 3

Many CCR foster parents across the state do great work caring for Level 4 children and youth. If you are interested in learning more about higher-level care, we would love to talk with you. If Level 4 scares you, we understand. We have many families that become foster parents at levels 2 and 3. Some families will move up levels over time; others will remain at their original level.


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