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Group Living Services Definition
Purpose
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.Definition
Recovery Housing provides individuals in recovery with a safe, home-like environment that is free of alcohol and illicit drugs, where they can receive peer support from fellow residents and access additional services, when desired, to promote recovery and prevent relapse. When licensed, clincal staff are providing services directly within the program, recovery homes will be reviewed under Group Living Services (PA-GLS). Recovery housing reviewed under PA-GLS offers 24/7 supervision by paid staff, 24/7 medical oversight of the proram by a phsyican or other qualified medical provider, and 24/7 on-call coverage by clinical personnel. It also tends to be time-limited with residents working towards achieving identified recovery goals and then transitioning to a lower level of support. All other recovery homes will be reviewed under Housing Stablization and Community Living (PA-HSCL).
- children or youth from the child welfare, juvenile justice, mental health, or education systems;
- children or adolescents who have been victims of human trafficking;
- individuals who are pregnant or parenting;
- adults or children transitioning from a more intensive setting;
- adults or children with developmental and/or physical disabilities;
- adults with serious and persistent mental health conditions;
- unaccompanied alien children;
- adults with substance use disorders or adults in recovery; or
- older adults who require a structured group living situation.
Examples: A trauma-informed program may be described as one that:
- routinely screens for trauma exposure and related symptoms;
- uses culturally and linguistically appropriate evidence-based assessment and treatment for traumatic stress and associated mental health symptoms;
- makes resources available to children, families, and providers on trauma exposure, its impact, and treatment;
- engages in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma;
- addresses parent and caregiver trauma and its impact on the family system;
- emphasizes continuity of care and collaboration across child-serving systems; and
- maintains an environment of care and provides access to needed services for staff to address, minimize, and treat secondary traumatic stress, and increase staff resilience.
Note:Group Living Services are distinct from Residential Treatment Services (PA-RTX), which provide an interdisciplinary, 24-hour-a-day structured program and therapeutic service array. The service needs of individuals in group living are not as intensive as those in residential treatment. As such, group living programs are less restrictive in nature.
Transitional housing programs are separately reviewed under Shelter Services (PA-SH).
Agencies that provide adventure-based programming will also complete the Experiential Education Supplement (PA-EES).
Note:Though the term trafficking is used throughout this section, there are additional terms that may be utilized, including sex trafficking, commercial sexual exploitation of children (CSEC), domestic minor sex trafficking, and minor prostitution. The term victim is commonly used when referring to individuals who have been trafficked to emphasize that they have been coerced and exploited, though the term survivor may also be used.
Note:Please see PA-GLS Reference List for the research that informed the development of these standards.
Note:For information about changes made in the 2020 Edition, please see the GLS Crosswalk.
Group Living Services (PA-GLS) 1: Person-Centered Logic Model
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.
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.
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.
PA-GLS 1.01
- needs the program will address;
- available human, financial, agency, and community resources (i.e. inputs);
- program activities intended to bring about desired results;
- program outputs (i.e. the size and scope of services delivered);
- desired outcomes (i.e. the changes you expect to see in persons served); and
- expected long-term impact on the agency, community, and/or system.
Examples: Please see the W.K. Kellogg Foundation Logic Model Development Guide and COA Accreditation’s PQI Tool Kit for more information on developing and using program logic models.
Examples: Information that may be used to inform the development of the program logic model includes, but is not limited to:
- needs assessments and periodic reassessments;
- risks assessments conducted for specific interventions; and
- the best available evidence of service effectiveness.
PA-GLS 1.02
The logic model identifies desired outcomes in at least two of the following areas:
- change in clinical status;
- change in functional status;
- health, welfare, and safety;
- permanency of life situation;
- quality of life;
- achievement of individual service goals; and
- other outcomes as appropriate to the program or service population.
Interpretation: Outcomes data should be disaggregated to identify patterns of disparity or inequity that can be masked by aggregate data reporting. See PA-PQI 5.02 for more information on disaggregating data to track and monitor identified outcomes.
Examples: Common resident outcomes for recovery housing include:
- housing stability;
- decreased alcohol and illicit drug use;
- lower rates of criminal justice involvement;
- increased income;
- increased employment over time;
- improved psychological and emotional well-being;
- increased social connectedness; and
- improved family functioning.
Group Living Services (PA-GLS) 2: Personnel
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.
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.
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.
PA-GLS 2.01
- a bachelor’s degree or are actively, continuously pursuing a degree;
- the personal characteristics and experience to collaborate with and provide appropriate support to residents and their families, gain their respect, guide their development, manage a home effectively, and participate in the overall treatment program; and
- the temperament to work with, and care for, children, youth, adults, or families with special needs, as appropriate.
Interpretation: Experience per element (b) can include lived experience when residential programs have peer support specialists, peer support providers, peer navigators, recovery support specialists, youth advocates, mentors, and/or family advocates on staff.
PA-GLS 2.02
- an advanced degree in social work or a comparable human service field and two years of relevant experience; or
- a bachelor’s degree in social work or a comparable human service field and four or more years of relevant experience.
PA-GLS 2.03
Interpretation: COA recognizes that geographic placement and resources can pose barriers. The use of an emergency room or urgent care facility is acceptable for overnight hours when protocols are established. Agencies can also leverage alternative service delivery methods such as telehealth when regional shortages of certain professional groups make in-person consultation impractical.
PA-GLS 2.04
- mental health;
- substance use;
- crisis intervention;
- medicine and dentistry;
- psychological services, such as testing and evaluation;
- prenatal and postnatal care, and the developmental needs of children;
- prenatal and postpartum depression screenings and care;
- nursing;
- education and vocational skill development;
- physical and developmental disabilities;
- speech, occupational and physical therapy;
- recreation and expressive therapy;
- nutrition; and/or
- religion and spirituality.
Examples: Examples of populations with specialized care needs include, but are not limited to:
- older adults;
- children and youth with pervasive developmental disorders;
- children and youth who engage in fire setting;
- individuals who exhibit sexually reactive behavior;
- victims of physical, psychological, or sexual abuse;
- LGBTQ population, especially those with gender identity issues;
- individuals with eating disorders; and
- individuals who have trouble communicating or being understood without special assistance.
PA-GLS 2.05
- obtain certification, as defined by their state;
- are willing to share their personal recovery stories;
- have a job description and clearly understand the role of peer support worker; and
- have adequate support and appropriate supervision, including mentoring and/or coaching from more experienced peers when indicated.
PA-GLS 2.06
- how to recognize the need for more intensive services and make an appropriate linkage;
- established ethical guidelines, including setting appropriate boundaries and protecting confidentiality and privacy;
- wellness support methods, trauma-informed care practices, and recovery resources;
- managing personal triggers that may occur during the course of their role as a peer support provider; and
- skills, concepts, and philosophies related to recovery and peer support.
PA-GLS 2.07
PA-GLS 2.08
- understanding the definitions of human trafficking (both labor and sex trafficking) and sexual exploitation, and identifying potential victims;
- procedures for responding to residents who run away;
- interventions for addressing the acute needs of victims of trauma; and
- collaborating with local law enforcement.
PA-GLS 2.09
- medication assisted recovery and applicable policies and procedures;
- how to identify and report unethical practices including patient brokering or excessive confirmation testing; and
- emphasizing peer support and experiential learning in recovery.
PA-GLS 2.10
- assigning a worker at intake or early in the contact; and
- avoiding the arbitrary or indiscriminate reassignment of direct service personnel.
PA-GLS 2.11
- the qualifications, competencies, and experience of the worker, including the level of supervision needed;
- the needs of the population served;
- special circumstances, such as multi-need residents;
- the work and time required to accomplish assigned tasks and job responsibilities; and
- service volume.
Group Living Services (PA-GLS) 3: Access to Service
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.
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.
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.
PA-GLS 3.01
The agency defines in writing:
- eligibility criteria, including age, developmental stage, and populations served;
- scope of services, special areas of expertise, and the range of resident issues addressed; and
- how the facility promotes living-unit compatibility based on the characteristics, diverse service needs, and preferences of individuals.
Interpretation: In regards to element (c), COA Accreditation recognizes that organizations, particularly those that receive residents through referrals only, may have limited control of group composition. In these instances, the organization should identify the population(s) served; state how residents’ diverse service needs, preferences, and characteristics will be considered; and include strategies for promoting living-unit compatibility when possible.
Characteristics and needs that should be considered can include age, necessary accommodations, ability to adjust to a group, gender, gender identity, and gender expression. Transgender and gender non-conforming individuals should be given access to sleeping quarters, bathroom facilities, and services based on their preferences and in accordance with applicable federal and state laws.
Examples: Examples of ways that agencies can meet the grouping needs of transgender and gender non-conforming people can include, but are not limited to:
- respecting the individual’s name and pronouns;
- providing gender neutral restrooms where facility structure allows;
- having residents use restrooms one at a time;
- allowing for single bedroom models; or
- providing LGBTQ+ specific units.
PA-GLS 3.02
PA-GLS 3.03
- personal items residents may bring with them, consistent with a safe, therapeutic setting;
- items that are discouraged or prohibited; and
- any safety procedures the program follows, or consequences that can result, when prohibited items are brought to the program site.
Group Living Services (PA-GLS) 4: Intake and Assessment
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.
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.
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.
PA-GLS 4.01
- how well their request matches the agency's services;
- what service options and levels of care will be available and when;
- the effectiveness of treatment, when available; and
- opportunities for active family participation and support, and involvement in community activities.
Interpretation: When agencies provide services under contract with a “no reject” provision the interdisciplinary team should carefully review admission decisions to ensure the agency is prepared to address any special needs or services the resident may require.
Interpretation: Matching individuals in recovery to a recovery house that will meet their needs is critical to ensuring resident safety. While this determination will sometimes be made by the referring provider, agencies should have procedures in place to ensure an appropriate match has been made prior to the individual moving in. Individual needs, preferences, and expectations should be considered when assessing the appropriateness of the living arrangement including, but not limited to:
- intensity of recovery supports needed or desired (e.g. availability of certified peer specialists, staff qualifications, etc.);
- any special needs (e.g. co-occurring mental health diagnoses, mothers with children, veterans, etc.);
- geographic preferences;
- transportation availability;
- chosen recovery pathway (e.g. medication assisted recovery, AA, etc.);
- level of medication assisted recovery support needed or desired (e.g. do others in medication assisted recovery live in the home); and
- time in recovery.
PA-GLS 4.02
- gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
- give priority to urgent needs and emergency situations;
- support timely initiation of services; and
- provide placement on a waiting list or linkages to appropriate resources when individuals cannot be served or cannot be served promptly.
PA-GLS 4.03
- completed within established timeframes; and
- focused on information pertinent for meeting service requests and objectives.
PA-GLS 4.04
- behavioral and physical health;
- a trauma screen and, when appropriate, a trauma assessment;
- an evaluation of suicide risk, self-injury, neglect, exploitation, and violence towards others;
- family strengths, risks, and protective factors;
- community and social support, resources, and helping networks;
- environmental, religious or spiritual, and cultural factors;
- educational and vocational accomplishments;
- level of community engagement;
- social skills, recreational activities, hobbies, strengths and special interests;
- factors related to successful group living;
- additional tests and assessments needed; and
- a summary of symptoms and diagnoses.
Interpretation: The Assessment Matrix - Private, Public, Canadian, Network determines which level of assessment is required for COA’s Service Sections. The assessment elements of the Matrix can be tailored according to the needs of specific individuals or service design.
Interpretation: Vulnerable populations, such as people that are lesbian, gay, bisexual, transgender, and questioning (LGBTQ), are at high risk of violence and harassment while in residential care. The agency should consider these factors to ensure all people are safe and welcomed by staff and residents.
- Interpretation: Personnel that conduct evaluations should be aware of the indicators of a potential trafficking victim, including, but not limited to evidence of mental, physical, or sexual abuse;
- physical exhaustion;
- working long hours;
- living with employer or many people in confined area;
- unclear family relationships;
- heightened sense of fear or distrust of authority;
- presence of older significant other or pimp;
- loyalty or positive feelings towards an abuser;
- inability or fear of making eye contact;
- chronic running away or homelessness;
- possession of excess amounts of cash or hotel keys; and
- inability to provide a local address or information about parents.
Several tools are available to help identify a potential victim of trafficking and determine next steps toward an appropriate course of treatment. Examples of these tools include, but are not limited to, the Rapid Screening Tool for Child Trafficking and the Comprehensive Screening and Safety Tool for Child Trafficking.
Interpretation: In recovery housing, assessments should be driven by the resident and focused on their barriers to recovery, unmet service needs, strengths, and resources.
Examples: Factors that can impact group living success can include:
- possible reciprocal individual and group effects;
- the individual's ability to adjust to a group;
- safety issues;
- previous placements; and
- trauma history.
PA-GLS 4.05
- provides an appropriate level of service and detoxification, as necessary; or
- connects the resident and/or family members to appropriate services when the program does not serve individuals with substance use conditions.
PA-GLS 4.06
- after significant treatment progress;
- after a lack of significant treatment progress;
- after new symptoms are identified;
- when significant behavioral changes are observed;
- when there are changes to a family situation or parental status;
- when significant environmental changes occur; or
- when a resident returns following an episode of running away.
Group Living Services (PA-GLS) 5: Family Involvement
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.
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.
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.
PA-GLS 5.01
- express the nature of family involvement desired;
- prevent, manage, and reduce family conflicts and develop problem-solving skills;
- identify family strengths that help members meet challenges;
- understand separation from family or significant others and grieve the loss of family;
- maintain relationships with family members through time spent at home and shared activities, as often as possible;
- participate in neighborhood activities; and
- prepare for returning home or for living with another family, if appropriate.
Interpretation: Unless contraindicated by court-order or there are compelling reasons to limit contact, residents should have the opportunity to spend time with their family at home and receive visits from family and friends. For adults, and some young adults, every attempt should be made to include family members identified by the resident. In cases where adults do not want family involvement, they should receive help to identify friendship opportunities based on common interests, and for young adults efforts should be made to help them connect with a non-custodial parent and/or other extended family members.
PA-GLS 5.02
- providing assistance or support, as needed;
- encouraging the family’s active participation in decision-making;
- providing an environment conducive to family visits and activities; and
- reestablishing parental and family care, or termination of parental rights, when in the best interest of or desired by the resident.
PA-GLS 5.03
- assisting the family with travel arrangements;
- coordinating or facilitating family services to be delivered in the community; and/or
- employing methods for telecommunication through web-based or electronic systems.
PA-GLS 5.04
Group Living Services (PA-GLS) 6: Service Planning and Monitoring
Interpretation: When the agency is working with Indian children and families, tribal or local Indian representatives must be included in the service planning process and culturally relevant resources available through or recommended by the tribe or local Indian agencies should be considered when developing the service plan.
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.
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.
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.
PA-GLS 6.01
- agreed upon goals, desired outcomes, and timeframes for achieving them;
- services and supports to be provided, and by whom;
- procedures for expedited service planning when crisis or urgent need is identified; and
- the resident’s and/or legal guardian’s signature.
Interpretation: In recovery housing, recovery planning should be driven by the resident and focused on their recovery barriers, service needs, strengths, and resources. Outcome measures of recovery capital that can be the focus of a strengths-based recovery plan include the person’s percieved level of satisfaction or well being as well as measures of personal, social, and community capital including physical health, housing, engagment in meaningful activities, and the presence of social supports.
Unmet service needs can slow the growth of positive recovery capital for individuals in recovery. Examples of common service needs among residents in recovery homes include:
- mental health;
- substance use;
- legal, including criminal record expungement services;
- crisis intervention;
- primary care and dentistry;
- education and vocational skill development; and/or
- housing.
PA-GLS 6.02
- assume a service coordination role, as appropriate, when the need has been identified and no other agency has assumed that responsibility;
- ensure that they receive appropriate advocacy support;
- assist with access to the full array of services to which they are eligible; and
- mediate barriers to services within the service delivery system.
PA-GLS 6.03
The worker and a supervisor, or a clinical, service, or peer team, review the case quarterly, or more frequently depending on program design or the needs of the resident, to assess:
- service plan implementation;
- progress toward achieving service goals and desired outcomes; and
- the continuing appropriateness of agreed-upon service goals and chosen interventions.
Interpretation: Quarterly case reviews may not be appropriate in shorter term programs when services are only provided for a few months. In these cases, reviews should be conducted more frequently to confirm progress and the continued appropriateness of the service plan.
PA-GLS 6.04
- review progress toward achievement of agreed upon service goals; and
- sign revisions to service goals and plans.
Interpretation: When working with individuals in recovery, the frequency of reviews will vary based on the needs of the individual and the level of recovery support being provided. For example, individuals new to recovery may have daily meetings with staff to discuss progress, while those with more time in recovery may review progress with staff monthly.
Group Living Services (PA-GLS) 7: Child Permanency
In addition, agencies should demonstrate their role in supporting timely permanency planning through regular case record documentation and official reports provided to the local child welfare agency or the court which comment on children’s and/or families’ progress towards permanency goal(s).
Interpretation: The permanency planning process for American Indian and Alaska Native children and families must always involve tribal representatives and service providers to ensure compliance with the Indian Child Welfare Act’s placement preferences and support culturally responsive planning that recognizes and incorporates tribal definitions of permanency and tribal perspectives of the best interests of the child into the permanency plan. To facilitate full participation, the agency must ensure that the tribe or local Indian agency receives timely notification of court or administrative case reviews, and is informed of any changes made to the permanency plan.
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.
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.
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.
PA-GLS 7.01
- occurs with families and the team of people that support them, including out-of-home care providers, service providers, and extended family members or other supportive individuals identified by the family, as appropriate;
- is scheduled at times when appropriate parties can attend; and
- is child-driven, with children actively involved in every stage of the process as appropriate to their age and developmental level.
- conversations about what permanency means to them;
- the discovery of extended family and other significant adults; and
- the formation of a permanency team that will support their desired outcomes and have an ongoing role in their lives.
PA-GLS 7.02
- engaging children and family members in identification;
- conducting a thorough review of the case record;
- using technological resources for family-finding;
- providing notification in family members' preferred languages; and
- providing notifications in multiple forms, including written form.
PA-GLS 7.03
- early, preliminary, and reasoned assessment of the potential for reunification, the best interests of the child, and the need for an alternative plan;
- full disclosure to involved parties of all permanency options, including expectations, implications, available supports, and legal timelines;
- joining a resource family that is prepared to develop a life-long relationship with the child; and
- counseling parents about relinquishment and alternative permanency options if needed.
PA-GLS 7.04
- permanency goals;
- why goals are in the best interest of children and their well-being;
- why other permanency options are not appropriate; and
- how service plans and identified interventions support permanency and child well-being.
PA-GLS 7.05
- within 60 days of placement a court-determined permanency plan is developed;
- at least every six months a court or administrative review of progress towards permanency occurs;
- within 12 months of placement, and every 12 months thereafter, a permanency hearing evaluates the permanency goal and determines the need for an alternative goal; and
- after a child has been in placement for 15 of the most recent 22 months, a legally-exempted permanency decision is made or proceedings are initiated for the termination of parental rights.
Interpretation: Regarding element (d), federal law permits American Indian and Alaska Native families to move forward with a customary adoption, without terminating parental rights. Customary adoptions, approved or adjudicated by the tribal court, are arranged through custom and tradition and allow for the transfer of custody while preserving parental rights.
Other circumstances that preclude termination of parental rights when the case involves an American Indian or Alaska Native child include: placement with extended family per ICWA placement preferences; transfer of jurisdiction to the tribal court; insufficient provision of “active efforts” to support reunification; and inability to satisfy the legal requirements for termination of parental rights under ICWA.
PA-GLS 7.06
- involvement in assessment, service planning and service selection;
- access to needed services and supports, including both formal and informal community resources;
- ongoing, constructive, and progressive contact with their children; and
- reduction of barriers to contact and involvement in the child’s care.
Group Living Services (PA-GLS) 8: Group Living Program
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.
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.
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.
PA-GLS 8.01
- treatment for severe emotional disturbance or mental health and substance use conditions;
- individual and group counseling;
- family therapy;
- educational and/or vocational programming;
- linkages to needed services in the community;
- life skills training;
- recreational activities;
- legal advocacy;
- opportunities to participate in religious observances in a faith or spirituality of choice;
- community cultural enrichment, shopping, volunteer and paid work activities; and
- independent living preparation.
PA-GLS 8.02
- participating in the development and enforcement of program rules;
- contributing to program design and decision making; and
- sharing feedback including dissatisfaction with aspects of the program.
PA-GLS 8.03
- a variety of nutritious meals and snacks;
- personal items such as clothing and an individual allowance;
- companionship;
- support and assistance needed to participate in community activities and contribute to the resident community; and
- a flexible daily schedule to develop and enhance positive personal and interpersonal skills and behaviors.
Group Living Services (PA-GLS) 9: Healthcare Services
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.
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.
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.
PA-GLS 9.01
If the agency does not have a qualified medical practitioner on staff, it should research community resources and consider creating a formal arrangement or a memorandum of understanding (MOU) with a local physicians group, local health department, federally-qualified health center, urgent care clinic, community-based health clinic, or telehealth providers.
When possible, the screening should be performed by the resident’s primary care physician who has knowledge of the resident’s medical history or a physician that can serve as the resident’s medical home while in care. For children in foster care, the local child welfare agency may be responsible for ensuring the initial health screening is completed or may assist the agency to identify possible medical resources.
Interpretation: When a resident returns following a runaway episode, a health screen should be conducted within 24 hours of entry back into care to identify whether the individual was victimized or otherwise hurt or injured while on the run.
Interpretation: In situations where the resident is unable to receive an initial health screening by a qualified medical practitioner within 24 hours, the agency can receive a rating of 2 if it has procedures in place for accommodating exceptional circumstances and is able to provide evidence that the screening occurred within 72 hours of admission. Exceptional circumstances include, but are not limited to:
- weekend placements; and
- when a person is transferring from the care of a public agency that has arranged for an initial health screening to be conducted within 72 hours of admission to the program.
PA-GLS 9.02
The agency ensures that each resident receives:
- a comprehensive medical examination within seven days after admission, unless the resident has received a medical exam within the last year, and annually thereafter; and
- a dental examination within six months prior to or one month after admission with appropriate follow-up thereafter.
Interpretation: The purpose of the medical examination is to identify and assess medical, developmental, and mental health conditions that require treatment, additional evaluation, and/or referrals to other healthcare professionals or specialists. The examination must be comprehensive, build on history gathered during the initial medical screening, and focus on specific assessments that are appropriate to the individual’s age and developmental level. Findings from the exam should be used to develop individualized treatment plans, as well as inform follow-up assessments and services.
Interpretation: In situations where resources are not available for preventive dental care to occur every six months, the agency can receive a rating of 2 if there is an annual preventive exam and evidence that recommendations from the dental practitioner indicate the child is not in need of more frequent care. Children with dental issues or at high risk of dental problems must be receiving the care they need. Families should be engaged in the process and solution for getting their child the needed dental care.
PA-GLS 9.03
- retains documentation of the resident’s and his or her family’s known medical history, including immunizations, operations, medications, and medical conditions and illnesses; and
- provides the information to the resident and/or his or her legal guardian upon request.
PA-GLS 9.04
- proper nutrition and exercise;
- personal hygiene;
- substance use and smoking;
- sexual development;
- safe and healthy relationships;
- family planning and pregnancy options;
- pregnancy, prenatal care, and effective parenting; and
- prevention and treatment of diseases, including sexually transmitted infections/diseases and HIV/AIDS.
PA-GLS 9.05
Interpretation: For agencies that do not serve pregnant and parenting individuals, implementation of this standard should include a plan for arranging specialized health services when individuals become pregnant while in care including services that support well-being and informed decision-making and facilitate access to prenatal healthcare until transfer to another provider can be arranged.
- tobacco cessation;
- fetal alcohol syndrome screening;
- speech, language, and occupational therapy;
- prenatal care, well-baby care, and accessing child and infant health insurance programs;
- gender identity counseling; and
- screening for onset or existence of common cancers.
Group Living Services (PA-GLS) 10: Education Services
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VIEW THE STANDARDS
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.
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.
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.
PA-GLS 10.01
PA-GLS 10.02
PA-GLS 10.03
NA The agency does not directly provide the educational program nor develop the education plans for children or youth.
PA-GLS 10.04
- tutoring;
- preparation for a high school equivalency diploma;
- college preparation;
- parent-teacher meetings;
- vocational or continuing education opportunities; and/or
- advocacy and support.
Group Living Services (PA-GLS) 11: Community and Social Connections
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.
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.
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.
PA-GLS 11.01
- remaining knowledgeable about local, regional, and state resources, including networking and leadership opportunities; and
- identifying opportunities for residents to develop positive ties to the community based on mutual interests and abilities.
PA-GLS 11.02
- culturally and developmentally appropriate social, recreational, volunteer, educational, or vocational activities in their community;
- religious observances in the faith group or spirituality of choice; and
- family and neighborhood activities consistent with their ethnic and cultural heritage and tribal affiliation.
PA-GLS 11.03
- helped to develop social support networks and build healthy, meaningful relationships with caring individuals of their choosing; and
- actively connected with peer support services appropriate to their request or need for services.
Examples: "Caring individuals" may include mentors, community members, friends, classmates, peers, siblings, cousins, grandparents, former foster parents, and extended family members.
PA-GLS 11.04
- navigate the surrounding environment;
- perform activities of daily living;
- obtain safe and stable housing;
- manage a household;
- pursue educational, occupational, and volunteer opportunities;
- manage finances including credit and debt counseling when needed;
- maintain personal safety;
- access community resources;
- access public assistance;
- communicate effectively and avoid or resolve conflicts;
- reduce risk-taking behaviors, including practice with decision making and anger management;
- participate in recreational activities and/or hobbies; and
- prepare for family reintegration, independent living, or another less restrictive setting, if applicable.
PA-GLS 11.05
- a written, signed permission slip from the resident's legal guardian;
- a medical records release;
- a signed document from a qualified medical professional stating that the resident is physically capable of participating; and/or
- an adult waiver and release of liability.
PA-GLS 11.06
- ensures residents are matched with jobs and training opportunities that reflect their goals and interests;
- maximizes resident choice and does not mandate participation; and
- prohibits resident exploitation.
PA-GLS 11.07
Agencies that purchase services from providers that operate adventure-based activities with a significant degree of risk request proof of accreditation, licensure, or certification with a nationally recognized authority for the activity being conducted, when available.
Group Living Services (PA-GLS) 12: Services for Pregnant and Parenting Residents
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.
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.
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.
PA-GLS 12.01
- health and medical needs;
- mental health needs;
- trauma history;
- educational needs;
- social and recreational needs;
- developmental needs, including any developmental delays;
- attachment to parents and extended family; and
- behavioral issues.
PA-GLS 12.02
- inform residents of their children’s educational rights;
- help residents coordinate educational services with relevant school districts; and
- assist children and youth to stay current with the curricula.
PA-GLS 12.03
PA-GLS 12.04
- pregnancy counseling;
- prenatal health care;
- genetic risk identification and counseling services;
- fetal alcohol syndrome screening;
- labor and delivery services;
- postpartum care;
- mental health care, including information, screening, and treatment for prenatal and postpartum depression;
- pediatric health care, including well-baby visits and immunizations;
- peer counseling services; and
- children’s health insurance programs.
PA-GLS 12.05
- fetal growth and development;
- the importance of prenatal care;
- nutrition and proper weight gain;
- appropriate exercise;
- medication use during pregnancy;
- effects of tobacco and substance use on fetal development;
- what to expect during labor and delivery; and
- benefits of breastfeeding.
PA-GLS 12.06
- basic caregiving routines;
- child growth and development;
- meeting children’s social, emotional, and physical health needs;
- environmental safety and injury prevention;
- parent-child interactions and bonding;
- age-appropriate behavioral expectations and appropriate discipline, including alternatives to corporal punishment;
- family planning; and
- establishing a functioning support network of family members or caring adults.
PA-GLS 12.07
To promote positive parenting practices, the agency:
- establishes a policy that prohibits corporal punishment of children by parenting individuals;
- ensures all parenting individuals are informed of this policy; and
- promotes and educates parenting individuals about alternatives to corporal punishment.
Group Living Services (PA-GLS) 13: Substance Use Services
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.
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.
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.
PA-GLS 13.01
- administering or reviewing diagnostic, toxicological, and other health related examinations;
- determining the optimal level and intensity of care, including clinical and community support services;
- evaluation for psychotropic medications and medication-assisted treatment;
- prescribing and managing medication, including appropriate management of pharmacotherapy for individuals with co-occurring conditions;
- review of complicated cases where co-occurring substance use, health, and mental health conditions intersect; and
- coordinating care with other service providers, including primary care and mental health providers, when appropriate and with the consent of the individual.
PA-GLS 13.02
- individual and group therapy;
- illness management and psychoeducation interventions;
- medication education;
- clinical monitoring and drug screening;
- coping skills training;
- relapse prevention; and
- acute care.
PA-GLS 13.03
- manage mental health and/or substance use disorders;
- develop and practice prosocial behaviors;
- cultivate and sustain positive, meaningful relationships with peers, family members, and the community;
- develop self-efficacy; and
- promote recovery, resilience, and whole-person wellness.
Group Living Services (PA-GLS) 14: Residential Facilities
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
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.
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.
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.
PA-GLS 14.01
- a common room, dining and/or kitchen area, and space for indoor recreation;
- private areas where residents can meet with family and friends; and
- private facilities for bathing, toileting, and personal hygiene, that are developmentally appropriate.
PA-GLS 14.02
- single rooms, rooms for groups of two to four residents, and/or accommodations for larger groups, if appropriate for therapeutic reasons;
- adequately and attractively furnished rooms with a separate bed for each resident, including a clean, comfortable, covered mattress, pillow, sufficient linens, and blankets;
- a non-stacking crib for each infant and toddler that is 24 months or younger that meets safety guidelines, as applicable; and
- a safe place such as a locker to keep personal belongings and valuables.
Examples: The Consumer Product Safety Commission (CPSC) provides standards to ensure safety for full-size and non-full size cribs.
PA-GLS 14.03
PA-GLS 14.04
- decorating and personalizing their sleeping area;
- choosing clothing based on their personal preferences;
- food preparation and meal planning; and
- contributing to decisions about how to make living areas inviting, comfortable, and reflective of their interests and diversity.
PA-GLS 14.05
- individual, small, and large group activities;
- activities that invite use of community resources;
- a variety of after school, evening, weekend, holiday, and school break programs for use by residents, guests, family, and community members;
- a variety of activities that are focused around the resident's home, community, and extended family and friends;
- quiet reading, study hours, and help with school assignments;
- individual hobbies and group projects that may be large and constructed over time; and
- alternatives to watching television, such as art, photography, or other creative activities.
PA-GLS 14.06
- sufficient supplies and equipment to meet residents’ needs;
- access to a telephone, computer, and the internet as permitted, for use by residents and personnel;
- adequate space for administrative support functions, food preparation, housekeeping, laundry, maintenance, and storage;
- rooms for providing on-site services, as applicable;
- accommodations for informal gathering of residents including during inclement weather;
- at least one room suitably furnished for the use of on-duty personnel; and
- private sleeping accommodations for personnel who sleep at the facility, if applicable.
PA-GLS 14.07
Group Living Services (PA-GLS) 15: Recovery Homes
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.
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.
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.
PA-GLS 15.01
PA-GLS 15.02
- collection procedures including whether collection is observed;
- timing and frequency of testing including initial testing; ongoing, random point-of-care testing; and confirmation testing when indicated;
- potential out-of-pocket costs to the resident;
- how test results from outside providers may be used, with resident consent, to reduce the number of tests conducted at the home; and
- what will happen if tests come back positive.
PA-GLS 15.03
- are designed to protect the health and well-being of the individual and the rest of the residents in the recovery house;
- define what protections are in place to prevent relapse;
- outline what will happen if relapse occurs;
- include timely due process provisions; and
- describe the conditions or process for re-admittance if separation from the home is necessary.
PA-GLS 15.04
Individuals are permitted to have guests, including overnight guests, as appropriate to the population and type of living situation, and are informed of the guest policy including their responsibility for the behavior of their guests.
Interpretation: In a recovery home, overnight guests may not be permitted or may be limited to the young children of residents.
Group Living Services (PA-GLS) 16: Privacy Provisions
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.
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.
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.
PA-GLS 16.01
- prohibiting the use of surveillance cameras or listening devices in bedrooms;
- maintaining doors on sleeping areas and bathroom enclosures;
- providing one- or two-person rooms to residents who need extra sleep, protection from sleep disturbance, or extra privacy for clinical reasons; and
- requiring employees and residents to knock before entering an individual's room unless there is an immediate health or safety concern.
Sensitivity should always be taken to ensure that all residents, especially abuse or trauma survivors and the LGBTQ population, feel safe and not violated.
Note: Please see the Facility Observation Checklist for additional guidance on this standard.
PA-GLS 16.02
- communicating policies for searches of individuals or their property to residents in writing;
- timely notification of a parent and/or legal guardian, when applicable;
- definition and documentation of reasonable cause and assessed risk of harm to self or others;
- trained, qualified staff; and
- an administrative review process including documentation, notification, and the timetable for review.
PA-GLS 16.03
- the mail is suspected of containing unauthorized, dangerous, or illegal material or substances, in which case it may be opened by the resident in the presence of designated personnel; or
- receipt or sending of unopened mail is contraindicated.
PA-GLS 16.04
- based on contraindications and/or a court order;
- approved in advance by the program director or an appropriate designee;
- documented in the case record; and
- reauthorized weekly by the immediate supervisor of the direct service provider.
Group Living Services (PA-GLS) 17: Care and Supervision
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.
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.
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.
PA-GLS 17.01
- nurturance, structure, support, respect, and active involvement;
- services provided in a safe, secure environment that prohibits weapons and gang activity;
- predictable limit-setting;
- flexibility, when appropriate and in the resident’s best interest; and
- guided practice to learn effective communication, positive social interaction, and problem solving skills.
Examples: Regarding element (d), being flexible with codified rules that contradict a resident's best interest can allow the agency to provide individualized care that is tailored to the resident's needs. 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 agency to be responsive to the needs of residents.
PA-GLS 17.02
- personnel-to-resident ratios for day time and overnight hours that are appropriate to the program model, length of treatment, population served, and their age, developmental and clinical needs;
- a sufficient number of qualified personnel on-site to respond to emergency/crisis situations and meet special needs of residents during busy or more stressful periods;
- an on-call, professional clinical staff member available on a 24-hour basis;
- rotating after-hours and holiday coverage when needed; and
- same-gender and cross gender supervision when indicated by individual treatment needs.
Interpretation: The agency may use direct care workers or counselors to provide supervision to residents. Personnel must be awake at all times unless convincing evidence demonstrates the resident group does not need awake supervision during sleeping hours. Examples of reasons certain homes or programs might not have awake personnel are: care for a long-term, stable population; majority of unit residents are ready to move to a less restrictive setting; low runaway rates; and low rates of night-time incidents. Electronic supervision is not an acceptable alternative to supervision by personnel.
Interpretation: Regarding element (c) the professional clinical staff person is permitted to sleep during sleeping hours.
PA-GLS 17.03
- creating an environment that provides a sense of safety, support, and community;
- identifying risks or triggers that may indicate likeliness to run away from programs;
- communication and reporting to relevant staff, authorities, and parents or legal guardians; and
- welcoming, screening, and debriefing when children return to the program.
Group Living Services (PA-GLS) 18: Transition from the Service System
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.
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.
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.
PA-GLS 18.01
PA-GLS 18.02
- transfer or termination of custody for youth, as applicable;
- their rights and services to which the person may have access as a result of a disability;
- access to specialized services and navigating adult-serving systems;
- availability of affordable community based healthcare and counseling;
- public assistance and court systems;
- child care services; and
- support through community volunteers, peers, or persons who have made a successful transition.
PA-GLS 18.03
- educational and vocational development;
- interpersonal skills;
- financial management;
- household management; and
- self-care.
PA-GLS 18.04
PA-GLS 18.05
PA-GLS 18.06
- a safe, stable living arrangement with basic necessities;
- a source of income;
- affordable health care; and
- access to education and career development.
PA-GLS 18.07
- at least one committed, caring adult;
- cultural and community supports; and
- positive peer support and mentoring, including peer advocates and peer support programs.
PA-GLS 18.08
- an identification card or a driver’s license, when the ability to drive is a goal;
- a social security or social insurance number;
- a resume, describing work experience and career development;
- medical records and documentation, including a Medicaid card or other health eligibility documentation;
- an original copy of a birth certificate;
- bank account access documents;
- religious documents and information;
- documentation of immigration or refugee history and status;
- death certificates when parents are deceased;
- a life book or a compilation of personal history and photographs, as appropriate;
- a list of known relatives, with relationships, addresses, telephone numbers, and permissions for contacting involved parties;
- previous placement information and health facilities used, when appropriate; and
- educational records, such as high school diploma or general equivalency diploma, and a list of schools attended, when appropriate.
Group Living Services (PA-GLS) 19: Case Closing and Aftercare
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.
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.
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.
PA-GLS 19.01
- is clearly defined and includes assignment of responsibility;
- begins at intake; and
- involves the worker, the resident, family members or a legal guardian, and others, as appropriate to the needs and wishes of the individual or family.
PA-GLS 19.02
PA-GLS 19.03
Interpretation: To promote safety, recovery housing residents who must be separated from the home should be linked with other housing and/or treatment options that will better fit their service needs and goals.
PA-GLS 19.04
- a transition/aftercare plan summary, including the resident’s options;
- a list of emergency contacts; and
- the agency's contact information.