Continuum of Care (COC) serves children with the most severe and complex emotional or behavioral health challenges through a strengths-based and culturally-competent service delivery model called High Fidelity Wraparound.

Our objective is to empower youth and families to help them realize their hopes and dreams, decrease out of home placements, improve school attendance and performance, decrease interactions with the legal system, and enhance the overall quality of life of the child.

To ensure continuing development and delivery of appropriate services to children with the most severe and complex emotional or behavioral health challenges whose needs are not being adequately met by existing services and programs.

The Continuum of Care for Children with Severe Emotional Disturbance (COC) was established by the South Carolina Legislature in 1983 to demonstrate the feasibility of providing services to children with the most severe and complex emotional or behavioral health challenges, and to serve as the basis for development of future state policy regarding services for such children and youth.

This legislation was the culmination of several years of intense advocacy by many individuals and groups who recognized that children and adolescents with multiple problems and needs were not being adequately treated by the existing system of care in South Carolina.

The result was a three-year pilot project which targeted children between the ages of 11-14 who were diagnosed as severely emotionally disturbed and who had “fallen through the cracks” of the existing service delivery system. During the pilot, COC’s administrative structure was established, client referral and selection procedures were initiated, and services such as intensive case management, in-home treatment, psycho-educational classroom instruction, summer therapeutic recreation, a variety of individualized wraparound services, therapeutic foster care, high management group home care, and comprehensive volunteer services were developed.

In 1984, the Legislature provided additional funds to COC through a contract with the South Carolina Department of Education for the purpose of enabling emotionally handicapped students to benefit from special education. The contract, which became effective in 1985 and has been renewed each year since that time, made sufficient funding available that client services could be provided on a statewide basis.

In 1986, at the end of the “pilot” phase, the Legislature established COC as a permanent part of state government with a policy board composed of the heads of all child-serving agencies in South Carolina. Three years later, in 1989, another legislative act changed COC’s governing body to a policy board comprised of five lay members, one from each of COC’s five service delivery regions.

Between July 1994 and July 1996, in an effort to minimize a budget deficit incurred by the South Carolina Department of Social Services (DSS), COC took the lead in a legislated demonstration project designed to address the needs of the population of children with emotional disturbance who were in state custody and in need of therapeutic residential care. The initiative made COC the primary case manager for those children, increasing COC's caseload by approximately 400 percent and its staff size by 127 percent.

The effort was so successful that in 1996, DSS created the Managed Treatment Services Division (now known as Intensive Foster Care and Clinical Services) and--using COC's service model--began providing services and case management to all clients in the custody of the state.

This also changed COC’s client population. COC now only serves those children who are in the legal custody of their natural families or other non-state guardians. 

In 2019, COC became a division of the South Carolina Department of Children’s Advocacy.