Private Organization Accreditation

Lutheran Social Services of New England is a high-performing nonprofit organization. LSS is a powerful difference maker and go-to resource, driving ourselves to constantly anticipate futures that are different from the past. For 140 years, LSS has been caring for people in need in New England.


Brewer-Porch Children's Center

James W. Thompson, Executive Director

The COA standards as applied to the operations at Brewer-Porch Children’s Center at The University of Alabama has given the administration an opportunity to examine best practice and improve the quality of care provided to clients.
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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 4: Restrictive Behavior Management Intervention Training

Personnel who use restrictive behavior management interventions, and foster parents who use manual restraint, are trained and evaluated on an annual basis.

Interpretation: COA recommends that agencies evaluate training programs and models to select a comprehensive and safe curriculum for use with personnel, foster parents, and service recipients.

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

Rating Indicators
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
Partial Implementation, Concerning Performance
  • A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
  • A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Please see Rating Guidance for additional rating examples. 

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
    • Table of contents for personnel and foster parent restrictive behavior management training curriculum(s)
    State Administered Agency (Regional Office)
    • No Self-Study Evidence
    All Agencies
    • Training curriculum that addresses PA-BSM 4.01 and PA-BSM 4.02
    • Documentation of restrictive behavior management training provided
    All Agencies
    • Interview:
      1. Clinical or program directors
      2. Supervisors
      3. Relevant personnel
      4. Foster parents required to participate in restrictive behavior management training

  • FP
    PA-BSM 4.01

    Personnel designated to use restrictive behavior management interventions, and foster parents who use manual restraint, receive annual training on permitted interventions, including:

    1. when it is appropriate to use a restrictive intervention;
    2. proper and safe use of interventions, including time limits for use;
    3. understanding the experience of being placed in seclusion or a restraint;
    4. signs of distress;
    5. response techniques to prevent and reduce injury; and
    6. negative effects that can result from misuse of restrictive interventions.

  • FP
    PA-BSM 4.02

    Annual training for personnel authorized to conduct assessment and evaluation of individuals undergoing a restrictive behavior management intervention covers recognizing and assessing:

    1. physical and mental status, including signs of physical distress;
    2. nutritional and hydration needs;
    3. readiness to discontinue use of the intervention; and
    4. when medical or other emergency personnel are needed.

  • FP
    PA-BSM 4.03

    Personnel and foster parents who receive training on restrictive behavior management interventions receive a post-test and are observed in practice to ensure competency.

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