Private Organization Accreditation

Money Management International is a nationwide nonprofit organization that provides counseling and education related to credit, housing and bankruptcy, and offers debt management assistance if needed. MMI also conducts community education programs in the areas where we have a physical presence.


Children's Foundation of Mid America

James W. Thurman, President/CEO

Children’s Foundation of Mid America has been accredited through COA since 1983. The process of accreditation ensures that we meet or exceed the highest standards in the industry.
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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 18: Care and Supervision

The organization provides 24-hour-a-day care and supervision that is respectful, supportive, and tailored to each resident’s developmental, educational, clinical, and safety needs.

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
  • 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.
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.
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
    • Resident/personnel care and supervision ratios
    • Supervision and scheduling criteria
    • Criteria and procedures used to assign and evaluate workloads
    • Resident/personnel care and supervision coverage schedules for the past year
    • Workload data for direct care personnel for the past six months
    • Interview:
      1. Program director
      2. Relevant personnel
      3. Residents
    • Review case records

  • FP
    RTX 18.01

    Each resident’s basic daily living requirements are met in a culturally responsive manner, including necessary nutrition, clothing, and allowances.

    Interpretation: Residents should be provided with a variety of nutritious food options. Special diets should be planned to meet the modified needs of individual residents. 

  • FP
    RTX 18.02

    Adults that provide direct care and supervision offer residents:
    1. a positive adult role model;
    2. nurturance, structure, support, respect, and active involvement;
    3. predictable limit-setting;
    4. flexibility, when appropriate and in the resident’s best interest;
    5. guided practice to learn effective communication, positive social interaction, and problem solving skills; and
    6. education and skills training specific to risk-taking behaviors, including practice with decision making and anger management.

    Interpretation: Regarding element (d), providing individualized care that is tailored to the resident’s needs requires being flexible with codified rules when they contradict what is best for the resident. For example, being flexible with bedtimes for a resident who may have experienced nighttime trauma rather than strictly enforcing a lights out time allows the organization to be responsive to the needs of residents. 

    Interpretation: Problem solving skills per element (e) should enable residents to resolve issues that can occur in both home and community settings. 

    Research Note: Positive factors associated with lower runaway rates include:

    1. clarity about leadership and how the home should operate; 
    2. a high level of staff support and morale; 
    3. agreement on a consistent approach; and
    4. involvement of youth in setting acceptable boundaries and patterns of behavior.

  • RTX 18.03

    Adults that provide direct care and supervision communicate and implement policies that promote security on-site including the prohibition of weapons and gang activity.

  • FP
    RTX 18.04

    Resident care and supervision is provided by:
    1. at least one on-duty worker for every four children during awake hours and every eight children during sleeping hours; 
    2. at least one on-duty worker for every five adults during awake hours and every ten adults during sleeping hours;
    3. a sufficient number of qualified personnel on-site that can respond to emergency situations and  meet the special needs of residents at busy or more stressful periods;
    4. rotating after-hours and holiday coverage when needed; and
    5. same-gender and cross-gender supervision when indicated by individual treatment needs.

    Interpretation: Staffing requirements and care ratios can vary depending on the age, developmental level, length of treatment, and the service needs of the population. 

    Interpretation: Electronic supervision is not an acceptable alternative to supervision by personnel.

    Interpretation: Programs serving individuals with sexually reactive behaviors should provide supervision and monitoring that accommodates the individual’s safety plan. 

    Note: Organizations must also meet state licensing requirements for care ratios.

    Research Note: National recommendations for the supervision of children in residential care is that there are no more than four children per worker during waking hours and no more than eight children per worker during overnight hours. Smaller ratios are recommended for intensive residential treatment programs and short-term diagnostic centers. 

    Research Note: Research suggests that staffing models impact children’s experience in group care. For example, utilizing live-in staff creates a family-life environment and allows for more consistency in resident’s everyday care compared to rotating shift staff. 

  • RTX 18.05

    Direct care personnel workloads do not exceed 12 residents and their families, and assignments are made, reviewed regularly, and adjusted based on:
    1. case complexity and residents’ special circumstances;
    2. age, gender, and population characteristics including ethnic and cultural considerations;
    3. the qualifications, competencies, and experience of personnel, and level of supervision needed;
    4. work and time required to accomplish assigned tasks and job responsibilities; and
    5. case status and progress toward achievement of desired outcomes.

    Interpretation: Direct care personnel are the residential treatment center’s milieu counselors, case managers, and/or child, youth, adult care workers.

    Research Note: Nationally recognized caseload guidelines recommend that direct care personnel have no more than eight children and their families assigned to their caseload at one time. For intensive residential treatment programs and short-term diagnostic centers, the recommended caseload is six children and their families.

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