The Pyramid of Care is a tool for examining the system of resources for children and families. It is based on a model originally circulated by the Children's Defense Fund. In the ideal world there would be preventive resources readily available to meet families' needs before there is a crisis. A pyramid is used to show that the majority of resources and expenditures should be made at the base of the pyramid. Crisis resources should be fewer in number and are represented at the top of the pyramid. Crisis resources are also much more costly than preventive resources.
Today's system looks a little like a piece of Swiss cheese. The system was created to meet the needs of individuals with specific needs. We can now step back, look at the system as a whole, and find out what is missing and what can be rearranged to better meet the needs of these individuals and all children and families.
The levels on the pyramid represent an array of community and family support resources. The Pyramid is a tool that is proposed for use by local, regional, and state groups to determine what resources are available, what should be added and possibly what resources can be reduced. These resources are provided through a mixture of public, private and voluntary sectors.
Levels III through V are known as the Balanced System of Care. These resources include home- and community-based services and out-of-home care. The Balanced System of Care can be (and has been to a certain degree) used as a basis for decisions about public funding and allocation of resources for children and families in crisis.
The Pyramid of Care, including the Balanced System of Care, is based on the philosophy of moving resources from more intensive to less intensive resources wherever possible. It also provides a framework for assessing which resources may best meet the needs of an individual child and family, the families in a particular community, and the families in a specific region of the state. From this point of view, it is important to note that:

	The levels are used to categorize resources, not the people they serve.
	A child and/or family may receive resources from more than one level simultaneously.
	There will always be a need for some crisis-oriented, intensive resources.

The Pyramid of Care may also be used to educate communities and regional and state groups about the full array of resources and the imperative to build, fund and utilize community and family support resources statewide to relieve the pressure for crisis treatment and out-of-home care.

"Today's system looks a little like a piece of Swiss cheese. The system was created to meet the needs of individuals with specific needs. We can now step back, look at the system as a whole, and find out what is missing and what can be rearranged to better meet the needs of children and families."