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.


Harry Hunter, MSW, MBA, Ph.D.

Volunteer Roles: Peer Reviewer; Team Leader

Peer Reviewer for the month of January 2013, Dr. Hunter has been volunteering for COA since 2005, conducting five site reviews.
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Group Living Services allow individuals who need additional support to regain, maintain, and improve life skills and functioning in a safe, stable, community-based living arrangement.

PA-GLS 19: Personnel

Personnel have the education, training, experience, skills, and supervision that is needed to work with the residents in care and involved families.

Note: For additional standards guidance on the use of non-employee personnel, please refer to Volunteers, Interns, and Consultants: Applicability of COA Standards to Non-Employee Personnel – Private, Public, Canadian.

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 service delivery 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
    • Program staffing chart that includes lines of supervision
    • Job descriptions
    • List of program personnel that includes:
      1. name;
      2. title;
      3. degree held and/or other credentials;
      4. FTE or volunteer;
      5. length of service at the agency;
      6. time in current position
    • Table of contents of training curricula
    • Documentation of training
    • Information and/or data describing staff turnover
    • Interview:
      1. Supervisors
      2. Personnel
    • Review personnel files

  • PA-GLS 19.01

    Residential counselors, house parents, adult care, and/or youth care workers have:
    1. a bachelor’s degree or are actively and continuously pursuing a degree;
    2. knowledge and understanding of organizational mission and values; 
    3. the personal characteristics and experience to collaborate with and provide appropriate care to residents and their families, gain their respect, guide their development, manage a home effectively, and participate in the overall treatment program;
    4. the ability to provide services in a culturally and linguistically competent manner;
    5. the temperament to work with, and care for, children, youth, adults, or families with special needs, as appropriate; 
    6. up-to-date certification in first aid and CPR; and
    7. adequate and continuous training and supervision.

    Interpretation: Competency can be demonstrated through education, training, or experience. The elements of the standard will be considered together in order to provide a rating. Demonstrated competence in elements (b), (c), and (d) with appropriate supervision and specialized training can compensate for a lack of a bachelor’s degree.

    Interpretation: Experience per element (c) can include lived experience as residential programs can have peer support specialists, youth advocates, mentors, and/or family advocates on staff.

    Research Note: Having the personal characteristics, experience, and temperament to work with and provide appropriate care for residents is vital to group living services practice. Literature indicated residents, when asked at discharge, invariably responded that their relationship with their worker had the greatest impact on their treatment.

  • PA-GLS 19.02

    The clinical or program director is qualified by:
    1. an advanced degree in social work or a comparable human service field and two years of relevant experience; or
    2. a bachelor’s degree in social work or a comparable human service field and four or more years of relevant experience.

  • FP
    PA-GLS 19.03

    Depending on resident needs, qualified professionals and specialists provide services and support related to the following:
    1. mental health;
    2. substance use;
    3. medicine and dentistry;
    4. prenatal and postnatal health care, and the developmental needs of children;
    5. prenatal and postpartum depression screenings and care;
    6. nursing;
    7. education;
    8. physical and developmental disabilities;
    9. speech, occupational and physical therapy;
    10. recreation and expressive therapy;
    11. nutrition; and/or
    12. religion and spirituality.

  • PA-GLS 19.04

    Direct service personnel demonstrate experience or receive training and education on:
    1. engagement with residents, including building trust and establishing rapport;
    2. engaging and partnering with families and significant others;
    3. recognizing trauma and coping mechanisms and providing trauma-informed care;
    4. the definitions of human trafficking (both labor and sex trafficking) and sexual exploitation, and identifying potential victims;
    5. protocols for responding to residents who run away;
    6. interventions for addressing the acute needs of victims of trauma; and
    7. collaborating with local law enforcement.

    Interpretation: In relation to element (c), direct service personnel should be trained to recognize and respond therapeutically to manifestations of trauma, such as mood instability, acting out behaviors, and hyper-vigilance.

  • PA-GLS 19.05

    Personnel who conduct assessments are qualified by training, skill, and experience and are able to recognize individuals and families with special needs.

  • PA-GLS 19.06

    Supervisors demonstrate a commitment to providing structure and support to direct staff to:
    1. address and reduce stress, anxiety, and secondary traumatic stress; 
    2. create an atmosphere of problem-solving and learning;
    3. build and maintain morale;
    4. reinforce the organizational values and clinical practices in family-based treatment; 
    5. provide constructive ways to approach difficult situations with clients; and 
    6. facilitate regular feedback, growth opportunities, and a structure for ongoing communication and collaboration.

    Interpretation: Supervision is an important determinant of child and family outcomes, organizational culture, and staff retention.

    Research Note: Secondary traumatic stress (STS) – distress that results from being exposed to the traumatic stories of others – and vicarious trauma (VT) – internal changes in the perception of self due to chronic exposure to traumatic material – have a significant impact on direct care workers and supervisors.  STS has been linked to increased absenteeism among employees, high staff turnover, and decreased compliance with organizational requirements. The impact of VT can exceed organizational function and negatively influence an individual’s sense of trust, safety, control, and esteem. 

    In order to promote workforce well-being, agencies should implement policies that address and help prevent stress-related problems. Strategies to reduce the adverse effects of STS and VT include: helping staff identify and manage the difficulties associated with their respective positions; promoting self-care and well-being through policies and communications with personnel; offering positive coping skills and stress management training; and providing adequate supervision and staff coverage.

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