WHO IS ACCREDITED?

Private Organization Accreditation

Germaine Lawrence is a residential treatment center for girls ages 12-18 with complex behavioral, psychological and learning challenges.   Girls live at our programs while receiving special education, individual, family and group therapy; psychiatric and primary medical care; and a wide variety of therapeutic activities and interventions.
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VOLUNTEER TESTIMONIAL

Judy Kay, LCSW

Volunteer Roles: Peer Reviewer; Team Leader

In administration for 22 of 24 years at Child Saving Institute, a COA-accredited not-for-profit child welfare agency in Omaha, Nebraska. Retired approximately two years ago, I moved to Tucson, Arizona, where I advocate for children's rights as a Court Appointed Special Advocate (CASA) volunteer to three young children.
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Purpose

Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behavior, improve functioning and well-being, and return to a stable living arrangement in the community.

RTX 12: Crisis Stabilization

The organization provides residents in crisis with structured, trauma-informed stabilization and treatment services in order to help them return to their previous level of functioning.

Interpretation: Children and adults seeking crisis stabilization services may be experiencing an acute psychiatric crisis, a substance use related crisis, or severe emotional or mental distress.

NA The organization does not operate a crisis stabilization unit. 

Rating Indicators
1
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.
2
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
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (HR 6.02) and training (TS 2.03); or
  • Active client participation occurs to a considerable extent.
3
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
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
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.,
  • 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
    • Procedures for delivering crisis stabilization services
    • Table of contents for training curricula specific to crisis stabilization 
    • Documentation of training specific to crisis stabilization
    • Interview:
      1. Program director
      2. Relevant personnel
      3. Residents
    • Review case records

  • RTX 12.01

    Crisis stabilization services focus on crisis resolution and are delivered in a trauma-informed, developmentally appropriate, and culturally and linguistically responsive manner by qualified personnel.


  • RTX 12.02

    Organizations that offer crisis stabilization provide the following services on a 24/7 basis: 
    1. emergency reception; 
    2. assessment and evaluation; 
    3. observation and monitoring; 
    4. crisis counseling; 
    5. medication management;  
    6. structured, therapeutic activities; 
    7. support services and psycho-education for family members; and 
    8. referrals to specialists and other community-based services, as needed. 

    Interpretation: In regards to element (a), emergency reception means that individuals in crisis are accepted on a 24-hour basis without undue delays or barriers. 
     
    Interpretation: Structured, therapeutic activities may be recreational, social, and/or educational in nature, and are consistently provided in accordance with the resident’s service plan. Organizations can also address these services in RTX 8. 


  • RTX 12.03

    Residents receive a crisis assessment within 24 hours of admission to determine the appropriate level of care.

    Note: Organizations that operate a crisis stabilization unit will complete the applicable assessment standards in RTX 4.

    Research Note: A crisis assessment is an immediate, face-to-face evaluation that is conducted by a physician or licensed mental health professional to: determine the level of crisis; identify any immediate need for emergency services; and provide immediate intervention to de-escalate the resident’s distress and/behavior.


  • RTX 12.04

    Residents participate in the development of an initial service plan within 24 hours of admission and a comprehensive service plan within five days.

    Interpretation: When care extends beyond thirty days the organization must review and update the resident’s service plan according to the change in the individual’s clinical condition.

    Note: This standard is specific to service planning timeframes. Organizations that operate a crisis stabilization unit will also complete the applicable service planning and monitoring standards in RTX 5.


  • RTX 12.05

    Residents and their families participate in the development of a crisis plan to identify strategies and interventions that may be employed to prevent or minimize the escalation of a crisis and promote stabilization.

    Interpretation: The crisis plan should specify interventions that may or may not be implemented by personnel in order to help the resident de-escalate his or her behavior. The plan can be part of, and reviewed with, the resident’s overall service or treatment plan.


  • RTX 12.06

    Organizations arrange educational services and supports, as appropriate, to ensure that residents can pursue their educational goals once they achieve a crisis resolution.


  • RTX 12.07

    During the first 48 hours a resident is in care, a minimum of two staff members must be on-duty 24 hours per day to ensure that adequate care and supervision are provided.

    Note: For care ratio requirements, please see RTX 18.04.


  • RTX 12.08

    Personnel who provide crisis stabilization services participate in ongoing training that addresses:
    1. assessing needs in crisis situations;
    2. special issues regarding age, gender identity/crisis, substance use and mental health conditions, developmental disabilities, and other needs typically presented by the service population;
    3. de-escalation techniques for crisis situations;
    4. culturally-sensitive, trauma-informed engagement techniques; and
    5. procedures for making referrals.

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