WHO IS ACCREDITED?

Private Organization Accreditation

Children's Home Society of Florida delivers a unique spectrum of social services designed to protect children at risk of abuse, neglect or abandonment; to strengthen and stabilize families; to help young people break the cycle of abuse and neglect; and to find safe, loving homes for children.
read more >>

VOLUNTEER TESTIMONIAL

Mike Angstadt

Volunteer Roles: Commissioner; Hague Evaluator; Lead Evaluator; Peer Reviewer; Team Leader

Serving as a Team Leader for COA has been an enriching experience in many ways. Utilizing the Contextual Accreditation process to discern the means in which agencies, offering a variety of services, located throughout the US, Canada ,the Philippines and other countries provide best and most promising practices to their consumers has been particularly rewarding. read more>>

Purpose

The organization’s behavior support and management policies and practices promote positive behavior and protect the safety of service recipients and staff.

FOC
BSM 2: Behavior Support and Management Practices

A culture and structure exists within every facility that promotes respect, healing, and positive behavior of the service recipient and prevents the need for crisis interventions.

Update:

  • Revised Standard - 05/07/18
     
Rating Indicators
1
The organization's practices fully meet the standard, as indicated by full implementation of the practices outlined in the BSM 2 Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the BSM 2 Practice standards.
3
Practice requires significant improvement, as noted in the ratings for the BSM 2 Practice standard; and/or
  • One of the BSM 2 Fundamental Practice Standards received a 3 or 4 rating.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the BSM 2 Practice standards; and/or
  • Two or more of the BSM 2 Fundamental Practice Standards received a 3 or 4 rating.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Copy of written behavior support and management philosophy and procedures provided to service recipients and/or parents/legal guardians
    • Procedures that address harassment and violence towards other service recipients and personnel
    • Protocol for obtaining consent
    • Procedures for conducting organization-wide assessments regarding behavior management support and management interventions and related reports
    • For organizations using restrictive behavior management interventions, procedures for developing behavior management plans
    • Protocol for notifying parents/guardians of incidents and use of restrictive interventions
    • Interview:
      1. Parents/legal guardians
      2. Persons served
      3. Relevant personnel
    • Case record review

  • BSM 2.01

    Personnel support positive behavior by:

    1. developing positive relationships with service recipients;
    2. being trauma-informed;
    3. building on strengths and reinforcing positive behavior; and
    4. responding with appropriate consistency to all incidents that challenge the safety of service recipients.

    Update:

    • Revised Standard - 05/07/18

    Note: Staff training on the organization’s approach to promoting positive behavior is addressed in BSM 3.02.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • One of the elements is not fully addressed but training is being offered to personnel.
    3
    Practice requires significant improvement; e.g.,
    • Two of the elements are not fully implemented and training is not sufficient or consistently provided.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all; e.g.,
    • One of elements is not addressed at all.

  • FP
    BSM 2.02

    The organization prohibits the use of restrictive interventions:

    1. by service recipients, peers, or any person other than trained, qualified staff;
    2. as a form of punishment or discipline;
    3. for the convenience of staff;
    4. in response to property damage that does not involve imminent danger to self or others; and
    5. when contraindicated in the individual’s service or behavior plan. 

    Update:

    • Revised Standard - 05/07/18
       

    Interpretation: As referenced in BSM 1.02, organizations serving youth involved with the juvenile justice system may also be authorized to use restrictive interventions to prevent escapes or protect property, but should only do so when absolutely necessary, as referenced throughout these standards.

    NA The organization prohibits the use of restrictive behavior management interventions.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • There have been a few instances of prohibited interventions, but corrective action was implemented immediately.
    3
    Practice requires significant improvement; e.g.,
    • There have been a few instances of prohibited interventions, and no evidence of immediate and appropriate corrective action.
    4
    One or more of the prohibited intervention is consistently being used.

  • FP
    BSM 2.03

    The organization:

    1. provides an explanation for and offers a copy of its written behavior support and management philosophy and procedures to service recipients or their parents or legal guardians at admission;
    2. informs service recipients or parents or legal guardians of strategies used to maintain a safe environment and prevent the need for restrictive behavior management interventions;
    3. obtains the service recipient’s or parent’s or legal guardian’s consent when restrictive behavior management interventions are part of the treatment modality; and
    4. when the service recipient is a minor, notifies the parents or legal guardians promptly when the minor is involved in an incident involving harassment or violence or when a restrictive intervention was used.

    Update:

    • Revised Standard - 05/07/18

    Interpretation: COA recognizes that it may be difficult for organizations providing residential juvenile justice services to involve youths’ parents or legal guardians, especially when youth are placed outside of their communities and far from their families; however, organizations should still strive to involve families to the extent possible. In any instance when promptly notifying parents or legal guardians in the wake of an intervention proves difficult, the organization should document its efforts to initiate contact in the case record. See JJR 4.03 for guidance on ways to minimize barriers to family participation.

    Interpretation: Consent should be reviewed on an annual basis. The service recipient, and/or parent or legal guardian, has the right to refuse consent to treatment and the organization may determine that the individual cannot be served as a result of refusal. When an organization serves youth involved with the juvenile justice system and services are involuntary, obtaining consent may not be relevant.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedures need minor clarification; or
    • One of the required elements is not fully addressed.
    3
    Practice requires significant improvement;  e.g., 
    • Two of the elements are not fully addressed; or
    • One element is not addressed at all; or
    • Annual consents as delineated in the interpretation are not consistently obtained; or
    • Parents or legal guardians are frequently not notified.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all; e.g.,
    • Three or more of the elements are not fully addressed; or
    • Two of more of the elements are not addressed at all.

  • FP
    BSM 2.04

    The organization conducts an organization-wide assessment of its service population to determine the potential risk and appropriate crisis interventions to employ. 

    Update:

    • Revised Standard - 05/07/18
       

    Interpretation: An organization-wide assessment includes, but is not limited to, descriptive statistics of the service population, their needs, services provided, and risks associated with serving them; reviewing data on the use of behavioral intervention or crisis response in the past year; as well as the annual critical incident reports and any corrective action taken in response. The resulting report should clearly describe the service population and the organization’s behavior and support management needs. 

    Note: Organizations can include reports and data aggregates they create in RPM 2.02, elements b-e, or information about service recipients they receive through the screening and intake process.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • The screening assessment needs clarifying.
    3
    Practice requires significant improvement; e.g.,
    • Screening practices are not consistently done for all clients; or
    • The organization prohibits the use of restrictive behavior management interventions but does not conduct a program- wide assessment as delineated in the interpretation.
    4
    The organization does not prohibit the use of restrictive behavior management interventions and each service recipient does not have a screening and/or have documentation of a screening in the case record.

  • FP
    BSM 2.05

    Organizations utilizing restrictive behavior management interventions collaborate with the service recipient and/or parents or legal guardian to assess for:

    1. the individual’s perception of emotional and physical safety;
    2. past experiences with restrictive behavior management interventions;
    3. antecedents, emotional triggers, and the resulting challenging behaviors;
    4. previous successes in utilizing strategies and coping skills to mitigate need for restrictive behavior management interventions;
    5. psychological and social factors that can influence use of such interventions, including trauma history; and
    6. medical conditions or factors that could put the person at risk.

    Update:

    • Revised Standard - 05/07/18

    Interpretation: Medical factors may include issues related to use of medications, such as an insulin imbalance. Psychological and social factors may include psychosis, history of abuse or other trauma, or claustrophobia.

    Interpretation: This standard is typically related to BSM 2.04. However, when organizations serving youth involved with the juvenile justice system also use restrictive behavior management interventions for other purposes (such as to prevent escapes during transport), any youth who might be subject to these interventions should be assessed for the factors listed in this standard, regardless of whether the screening addressed in BSM 2.04 indicates risk of harm to self or others.

    Research Note: A common traumatic element is the massive control of one person over another. For individuals with a history of abuse or other trauma, undergoing a restrictive behavior management intervention can be extraordinarily retraumatizing.

    NA The organization prohibits the use of restrictive behavior management interventions.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedures need clarifying or do not adequately address one of the elements.
    3
    Practice requires significant improvement; e.g.,
    • Procedures related to two of the elements need clarifying.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all; e.g.,
    • Behavioral assessments do not address one of the elements.

  • BSM 2.06

    A behavior support and management plan is based on assessment results, identifies proactive interventions to prevent the potential need for crisis interventions, and:

    1. identifies strengths-based strategies that will help the person de-escalate their behavior and prevent harassing, violent, or out-of-control behavior;
    2. specifies interventions that may or may not be used, taking the individual’s trauma history into account;
    3. is modified as necessary; and
    4. is developed in collaboration with the service recipient and is signed by the person, his/her parent or legal guardian, and personnel, as appropriate.

    Update:

    • Revised Standard - 05/07/18

    Note: The behavior support plan, sometimes called a crisis plan, can be part of, and reviewed with, the overall service or treatment plan.

    Note: Organizations serving youth involved with the juvenile justice system should refer to the Interpretation in BSM 2.01 regarding the involvement of youths’ parents or legal guardians.

    NA The organization prohibits the use of restrictive behavior management interventions.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • One of the elements needs strengthening; or
    • There are a few instances where signatures were missing.
    3
    Practice requires significant improvement; e.g.,
    • Two of the elements need strengthening or one of the elements is not addressed; or
    • There is no evidence that the plans, once developed, are rarely reviewed or updated; or
    • Most plans are not signed.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.
Copyright © 2018 Council on Accreditation. All Rights Reserved.  Privacy Policy and Terms of Use