Private Organization Accreditation

HeartShare assist individuals with developmental disabilities through education, day, residential and recreation programs, case management, and health services, and provides foster care/adoption services, counseling, after school and energy assistance programs, and programs for people with HIV/AIDS.


Domestic Violence Intervention Services, Inc.

Donna Mathews, Associate Director

Becoming accredited and maintaining our accreditation through COA has helped us increase our professionalism and thereby provide better services to domestic violence, sexual assault, stalking, and dating violence survivors.
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The agency’s behavior support and management policies and practices promote positive behavior and protect the safety of service recipients and staff.

PA-BSM 1: Philosophy and Agency Policy

The agency’s leadership and senior management promote a safe and therapeutic environment and provide necessary supports and resources to:

  1. keep staff, foster parents, and service recipients safe; and
  2. minimize the use of restrictive behavior management interventions.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    County/Municipality Administered Agency, State Administered Agency (Central Office), or other Public Entity 
    • Aggregate of the two most recent quarterly reviews of incidents requiring restrictive behavior management interventions
    • See PA-BSM Narrative Question 1 for: A description of the agency's BSM philosophy
    • BSM policy and procedures
    • Incident review procedures
    State Administered Agency (Regional Office)
    • Aggregate of the two most recent quarterly reviews of incidents requiring restrictive behavior management interventions
    All Agencies
    • For agencies using restrictive behavior management interventions, provide documentation of clinical director notification of restrictive behavior management interventions
    • Documentation of compliance with applicable laws or regulations
    All Agencies
    • Interview:
      1. Clinical or program directors
      2. Supervisors
      3. Personnel
      4. Persons served
      5. Parents/legal guardians

  • PA-BSM 1.01

    The agency’s behavior support and management policies and practices comply with federal, state, and local legal and regulatory requirements.

    Interpretation: The Public Health Service Act, as amended by the Children’s Health Act of 2000 and the Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services to Individuals Under Age 21 are federal regulations that govern the use of behavior management in the United States. Agencies serving youth involved with the juvenile justice system may be subject to different laws and regulations.

    Note: The agency is required to comply with the more stringent standard or regulation.

    Note: COA recognizes that the laws or regulations governing agencies serving youth involved with the juvenile justice system may sometimes authorize practices that conflict with the standards to which COA holds other agencies, and has addressed some of the potential discrepancies throughout the standards in PA-BSM.

  • PA-BSM 1.02

    Behavior support and management policies cover:

    1. practices used to maintain a safe environment and prevent the need for restrictive behavior management interventions;
    2. whether isolation, manual or mechanical restraint, or locked seclusion are permitted as emergency safety measures;
    3. other practices that may be used and under what circumstances; and
    4. prohibited practices, including chemical restraint.

    Interpretation: In relation to element (d), chemical restraint does not include situations when a psychopharmacological drug:

    1. is used according to the requirements for treatment authorized by a court; or
    2. is provided using specified criteria in a person’s approved treatment plan as per a physician’s order to provide medical treatment for a specific diagnosis and known progression of symptoms, such as in cases of a PRN; or
    3. is administered in an emergency to prevent immediate, substantial, and irreversible deterioration of a person’s mental status when prescribed by a physician or other qualified medical practitioner.

    Interpretation: Although most agencies only use restrictive behavior management interventions in emergencies to prevent harm to self or others, agencies serving youth involved with the juvenile justice system may also be legally authorized to use restrictive interventions to prevent escapes, or protect properly, in order to maintain safety, security, and order. However, they should still only employ restrictive interventions when absolutely necessary, as referenced throughout these standards.

    Note: Refer to COA’s glossary for a definition of chemical restraint.

  • PA-BSM 1.03

    The agency head and leadership conduct regular reviews of the use of behavior support and management interventions and:

    1. review how agency practices compare with current information and research on effective practice;
    2. use findings from quarterly risk management reviews of restrictive behavior management to inform staff about current practice and the need for change;
    3. revise policies and procedures when necessary;
    4. determine whether additional resources are needed; and
    5. support efforts to minimize the use of restrictive behavior management interventions.

    Research Note: Agreement has been reached among experts that the best way to reduce injuries and deaths is to minimize the use of restraints to the greatest extent possible. Reductions in the use of locked seclusion and restraint can also contribute to less staff turnover.

  • PA-BSM 1.04

    The program or clinical director is notified following each use of locked seclusion or manual or mechanical restraint, and each incident is administratively reviewed no later than one working day following an incident.

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

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