Private Organization Accreditation

Sweetser, a Maine non-profit agency operating since 1828, provides comprehensive mental and behavioral health and substance abuse treatment services. Statewide, it serves around 15,000 consumers a year, including children, adults, and families in outpatient, office-based, and residential settings.


Audrey Coleman, RN-MSN

Volunteer Roles: Military Reviewer; Peer Reviewer; Team Leader

My first experience with COA was in 1999 with what was a NC Area Program. I started as a peer reviewer in 2005, doing two to four site visits a year. I am also a team leader and have recently been approved to be a military reviewer.
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Individuals and families who receive Disaster Recovery Case Management Services access and use resources and support that build on their strengths and meet their service needs.

DRCM 3: Screening and Intake

The organization utilizes trauma-informed screening to promptly, responsively, and efficiently determine urgency of need and ensure access to needed services. 

Research Note: Some case management models encourage use of written "triage" guidelines to promote consistency in decision making, and as an educational and support tool for personnel with a range of experience. Training and supervision can provide alternative or additional support for staff conducting screenings. 

Research Note: When serving victims of mass violence, evaluating individual exposure levels to the traumatic or stressful event is a critical stage in the triage process and can help service providers determine any urgent unmet needs. SAMHSA identifies 5 levels of exposure that should be considered when serving victims of mass violence or acts of terrorism:

  1. the seriously injured, and family members and loved ones of casualties;
  2. individuals in close proximity to the incident who remained uninjured, but exposed;
  3. first responders and service providers involved in casualty identification, notification, and retrieval;
  4. human service and crime victim assistance providers, religious/spiritual leaders, health care providers, elected/appointed officials, and the media; and
  5. groups that identify with the target victim population, businesses impacted by violent acts, and the community at large.
Research Note: Acts of mass violence and terrorism elicit distinct responses in victims that would otherwise not be expected from victims of natural disasters. Research shows that this is due to the perception that these events are preventable, senseless, cruel, and unexpected, whereas natural disasters and their impact oftentimes are much more predictable and controllable, especially in terms of response activities. The response environments designed to address the needs of mass crime victims are much more demanding, complex, and chaotic, however, maintaining commitment to a trauma-informed approach is critical to service delivery success.

Rating Indicators
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • Referrals procedures need strengthening; or
  • For the most part, established timeframes are met;
  • Active client participation occurs to a considerable extent.
  • In a few rare instances urgent needs were not prioritized.
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Urgent needs are often not prioritized, or
  • Services are frequently not initiated in a timely manner; or
  • Applicants are not receiving referrals, as appropriate; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • Screening and intake done by referral source and no documentation and/or summary of required information present in case record; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • There are no written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Screening, intake, and triage procedures and tools
No On-Site Evidence
    • Interview:
      1. Clinical or program director
      2. Relevant personnel
      3. Individuals or families served
    • Review case records

  • DRCM 3.01

    Individuals and families are screened and informed about:

    1. how well the request matches the organization’s services;
    2. applicable eligibility requirements; and
    3. availability and timeframes for services.

    Interpretation: Information about service availability can include an explanation of the phases of disaster recovery case management.

    NA Another organization is responsible for screening, as defined in a contract.

  • FP
    DRCM 3.02

    Prompt, responsive intake practices:

    1. are culturally responsive, trauma-informed, and non-stigmatizing; include screening for appropriateness, scope, and intensity of service;
    2. ensure equitable distribution of resources;
    3. give priority to urgent needs and individual emergency situations, including early recognition of vulnerable populations;
    4. support timely initiation of services or an appropriate referral; and
    5. provide for placement on a waiting list, if applicable.

    Interpretation: Screening and intake activities involving individuals with disabilities should be performed by staff with relevant, specialized expertise to overcome barriers to service initiation specific to this population. Common barriers include transportation, attitudinal biases on the part of collaborating/referral service providers, and facility accessibility among others.

    Interpretation: Culturally responsive intake practices can include attention to geographic location, language of choice, the person’s religious, racial, ethnic, and cultural background, age, sexual orientation, gender identity, gender expression, and developmental level.

    To ensure that transgender and gender non-conforming candidates for service are treated with respect and feel safe, intake forms and procedures should allow individuals to self-identify their gender and assert their first name/pronoun preference.  

    Interpretation: Trauma-informed intake practices explore whether a candidate for service has been exposed to traumatic events and exhibits trauma-related symptoms and/or mental health disorders. A positive screen indicates that an assessment or further evaluation by a trained professional is warranted should the individual be found eligible for services. During the screening process, individuals seeking services should feel emotionally and physically safe.

    Research Note: Studies performed on disaster recovery case management outcomes after Hurricane Katrina, demonstrated that individuals with disabilities required more intense case management support (e.g. negotiation with other service providers), more frequent contact, and longer recovery times.

  • FP
    DRCM 3.03

    Individuals and families who cannot be served, or cannot be served promptly, are referred and connected to appropriate resources.

    Interpretation: In some instances, the need for services may exceed an agency’s capacity to serve the client or fall outside the agency’s mission. Policies and procedures should be in place to support personnel in making equitable determinations regarding service provision and referral.

    Research Note: Focus group results suggest that established relationships with partner organizations ease the work of making successful connections for clients. A review of program descriptions and training material that address barriers to timely, efficient delivery of services under emergency conditions, suggest that greater clarity about community providers’ span of services, strengths, and limitations can reduce overcrowded or unsafe conditions in facilities, or long wait lists. While some organizations establish formal relationships, for example, with a memorandum of understanding, other organizations do so with informal relationships.

    NA The organization accepts all clients.

  • DRCM 3.04

    During intake, the organization gathers information to identify critical service needs and/or determine when a more intensive service is necessary, including:

    1. personal and identifying information;
    2. emergency health needs; and
    3. safety concerns, including imminent danger or risk of future harm.

    Interpretation: All staff should receive basic training on the organization’s health and safety procedures and understand how to respond to emergency situations, as appropriate to their position and the services provided. For example, staff could receive “gatekeeper training” on how to recognize, interpret, and respond to signs of suicide risk, and/or Mental Health First Aid training for recognizing and responding to signs of a mental health crisis.

    Note: Please refer to training requirements and evidence at TS 2.04.

    Research Note: According to the National Council for Behavioral Health, Mental Health First Aid and Youth Mental Health First Aid are recognized evidence-based practices and training programs designed to empower direct service providers with the skills needed to identify and respond appropriately to mental health distress and crises at the point of initial screening. These practices promote early detection and intervention, especially in cases where the service recipient may pose a threat of physical harm to self or others.

  • FP
    DRCM 3.05

    The organization contributes to effective coordination, delivery, and use of disaster recovery resources through exercising flexibility and cooperation in:

    1. promoting and complying with the standardization of forms used for information gathering; and
    2. sharing client information with necessary safeguards, including client consent for release of information to ensure confidentiality.

    Interpretation: Standardized forms for information gathering, including intake forms, assessment forms, and up-to-date multi-lingual resource guides, are tools considered to be especially useful. Ongoing information sharing between colleagues and organizations is considered critical for effective helping in disaster recovery and minimizing duplicative efforts by organizations and clients, provided written client consent for release of information is obtained. Disaster case management experience warrants special diligence in protecting confidential information and maintaining secure records. Disaster recovery presents special challenges related to identity theft and protection of client information when information is shared with one or more organizations that have various or limited confidentiality policies.

    Note: Organizations should refer to the Clients Rights (CR) standards for more information regarding protection of confidentiality.

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