2024 Edition

Program Administration Introduction

Purpose

Service delivery practices guide the administration of safe, effective programs that respect personal dignity and self-determination.

Introduction

COA’s Program Administration (PA-PRG) standards promote the development of safe, effective, and respectful programs through the implementation of practices for maintaining complete, organized, and confidential case records; establishing safe, uniform practices for prescribing, dispensing, storing, and administering medication; effectively harnessing technology-based service delivery to better meet the needs of service recipients; and providing services that promote integration and self-determination for individuals with intellectual and developmental disabilities.  

Note: Please see the PA-PRG Reference List for the research that informed the development of these standards.


Note: Program Administration is a new section in the 2020 Edition that includes content previously contained in other sections. Please see the PA-RPM Crosswalk, the CR Crosswalk, and the PA-PDS Crosswalk for more information.

2024 Edition

Program Administration (PA-PRG) 1: Case Records

Case records contain sufficient, accurate information to:
  1. identify the individual or family being served;
  2. support decisions about interventions or services; and
  3. document the delivery of services.

NA The agency is only assigned the Early Childhood Education (PA-ECE), Out-of-School Time Services (PA-OST), and/or Community Change Initiatives (PA-CCI) standards.


NA The agency provides only non-clinical group, crisis intervention, and/or information and referral services.

Note: Please see the Case Record Checklist for additional guidance on this standard.


Note: Please see the PRG Reference List for the research that informed the development of these standards. 

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 
Fundamental Practice

PA-PRG 1.01

The agency maintains a case record for each individual or family.
 
Fundamental Practice

PA-PRG 1.02

Case records comply with all legal requirements and contain information necessary to provide services including:
  1. demographic and contact information;
  2. the reason for requesting or being referred for services;
  3. up-to-date assessments;
  4. the service plan including mutually developed goals and objectives;
  5. copies of all signed consent forms;
  6. a description of services provided directly or by referral;
  7. routine documentation of ongoing services;
  8. documentation of routine supervisory review;
  9. discharge or aftercare plan;
  10. recommendations for ongoing and/or future service needs and assignment of aftercare or follow-up responsibility, if needed; and
  11. a closing summary entered within 30 days of termination of service.
Related Standards:
Interpretation: This standard describes the basic elements to be included in individual case records. COA recognizes that in some cases not all listed information is obtainable for an individual or family. In these cases, an explanation should be placed in the case record. Additionally, the listed information may not be routinely available due to the nature of the service, e.g., a low demand shelter or drop-in center.

Interpretation: Regarding element (h),"documentation of routine supervisory review" refers to the quarterly review of individual cases that is found in the Service Planning and Monitoring sections of most Service Standards. This review is unrelated to Supervision between the supervisor and personnel addressed in PA-PDS 4.

Interpretation: Case records and signatures can be paper, electronic, or a combination of paper and electronic.

CFS Interpretation: For agencies providing child and family services, element (d) also includes permanency plans for every child who is currently in out-of-home care or has been in care in the last 12 months. 

EAP Interpretation: In Employee Assistance Programs, case records contain appropriate information to demonstrate the status of the case and whether it is open or closed. 

DV Interpretation: When domestic violence services are provided, documentation in case records should be limited to essential information. Personnel should be conscious of the language they choose, avoid unnecessary detail, and refrain from editorializing or recording opinions.
 
Fundamental Practice

PA-PRG 1.03

The case record contains essential medical and legal information including, as applicable:
  1. orders for and results of psychological, medical, toxicological, diagnostic, or other evaluations;
  2. documentation of all prescribed and over-the-counter medications including copies of all written orders for medications, when applicable; 
  3. special treatment procedures, allergies, or adverse treatment responses; and
  4. court reports, documents of guardianship or legal custody, birth or marriage certificates, and any legal directives related to the service being provided.
Interpretation: In regards to element (b), documentation of prescribed medication should include a system for tracking the use of pharmacological interventions at the case level including efforts to:
  1. engage prescribers and other partnering providers in corrective action when concerns are noted; and
  2. advocate for increased availability and use of appropriate, non-pharmacological interventions.  
CFS Interpretation: For agencies providing child and family services, element (d) includes the status and location of every child who is currently in out-of-home care or has been in care in the last 12 months. 
NA The agency does not obtain legal or medical information.
 
Fundamental Practice

PA-PRG 1.04

Case record entries are made by authorized personnel only, and are:
  1. specific, factual, relevant, and legible; 
  2. kept up to date from intake through case closing; 
  3. completed, signed, and dated by the person who provided the service; and 
  4. signed and dated by supervisors, where appropriate.

Examples: When selecting an electronic record keeping system, the agency may consider, among other things, whether or not the system has the capacity to:
  1. verify the individual's identity and ensure that each electronic signature is unique to the individual; and
  2. ensure that the signature will remain tied or connected to the content being signed for as long as the record is maintained. 

Examples of ways to verify the authenticity of digital signatures when using electronic records include, but are not limited to: a digitalized signature via tablet or two identifying components such as a user identification code (ID) and password/personal identification number (PIN).
 
Fundamental Practice

PA-PRG 1.05

Progress notes comply with legal requirements and are entered:
  1. at least quarterly; or 
  2. monthly for individuals receiving protective services, out-of-home care, day treatment, or frequent or intensive counseling or treatment.
Related Standards:
 

PA-PRG 1.06

Unless otherwise mandated by law, the agency maintains case records as follows:
  1. for at least seven years after case closing for adults;
  2. until the age of majority or seven years after case closing, whichever is longer, for minors; and
  3. disposes of case records in a manner that protects privacy and confidentiality in the event of the agency's dissolution.
Related Standards:

Examples: Proper disposal of paper and electronic records can include, but is not limited to, shredding paper records, clearing electronic files when computers are replaced or reassigned, and destroying electronic media such as flash drives.
2024 Edition

Program Administration (PA-PRG) 2: Access to Case Records

Persons served or designated legal representatives can access their case records, consistent with legal requirements.

NA The organization is only assigned the Early Childhood Education (PA-ECE), Out-of-School Time Services (PA-OST), and/or Community Change Initiatives (PA-CCI) standards.


NA The agency provides only non-clinical group, crisis intervention, and/or information and referral services.

Related Standards:

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 
Fundamental Practice

PA-PRG 2.01

Access to confidential case records meets legal requirements and is limited to:
  1. the service recipient or, as appropriate, a parent or legal guardian; 
  2. personnel authorized to access specific information on a “need-to-know” basis;
  3. former service recipients; 
  4. requests for records of deceased service recipients; and 
  5. auditors, contractors, and licensing or accrediting personnel consistent with the agency’s confidentiality policy.

Note: Please see the Facility Observation Checklist for additional guidance on this standard.

 

PA-PRG 2.02

Service recipients may review and, when desired, add a statement to their files in accordance with applicable laws and regulations, and:
  1. reviews are conducted in the presence of professional personnel on the agency’s premises; 
  2. reviews are carried out in a manner that protects the confidentiality of family members and others whose information may be contained in the record;
  3. any personnel responses to service recipient additions are added with the service recipient’s knowledge; and 
  4. the service recipient is given the opportunity to review and comment on personnel responses. 

Examples: Agencies using electronic record keeping systems can provide safe access to case records by, for example, creating a separate user portal or printing the case record.

Note: Please see the Case Record Checklist for additional guidance on this standard.

 
Fundamental Practice

PA-PRG 2.03

If the agency determines that serious harm would likely ensue if an individual were to review their case record, and applicable law provides no guidance on case record access, then:
  1. senior management reviews, approves in writing, and enters into the case record the reasons for refusal; and 
  2. procedures permit a qualified professional to review records on behalf of service recipients, provided the professional signs a statement that information determined to be harmful will be withheld.
Interpretation: A person's right to review their care or treatment may be denied, or otherwise limited, only in the most extreme circumstances where serious harm is likely to ensue. In all cases, the agency must operate in accord with applicable law.

NA Applicable law prohibits limiting a person’s access to their case record for any reason. 

Note: Please see the Case Record Checklist for additional guidance on this standard.

2024 Edition

Program Administration (PA-PRG) 3: Medication Control and Administration

The agency ensures safe, uniform medication control and administration.

Interpretation: PA-PRG 3.01- PA-PRG 3.07 do not apply to resource family homes or adult foster care homes. See PA-CFS 24.04 or PA-AFC 7.02 for medication training and administration requirements for resource parents or adult foster care caregivers.  

NA The agency does not prescribe, dispense, administer, or store medication.
Related Standards:

Note: When an agency’s medication management activities are limited to administering naloxone in the event of an opioid overdose, the NA at PA-PRG 3 applies. See PA-ASE 6.03 for more information on training and procedures related to treating opioid overdose. 

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 
Fundamental Practice

PA-PRG 3.01

Personnel directly involved in medication control and administration are qualified by license or training in accordance with law and regulation.
 

Interpretation: Physicians who prescribe and dispense approved buprenorphine products for opioid addiction are appropriately credentialed by the Drug Enforcement Agency (DEA) and provide treatment in accordance with DEA policy.


Interpretation: Programs, such as shelters and safe homes, that allow service recipients to store medications in a safe, lockable personal space (e.g., individual lock boxes or private use lockers) should train staff in the agency’s medication management procedures, including the proper handling and disposal of medications.


 
Fundamental Practice

PA-PRG 3.02

When medication is initially prescribed, the prescribing clinician provides education to service recipients about the medication including:
  1. medication name;
  2. dose;
  3. reason for use; 
  4. how to administer; 
  5. desired effects; and 
  6. potential side effects.
Interpretation: Written, detailed information regarding specific medications may be provided by the pharmacy responsible for filling a prescription.
NA The agency does not prescribe medication.

Note: Please see the Case Record Checklist for additional guidance on this standard.

 
Fundamental Practice

PA-PRG 3.03

When individuals are receiving prescription medication:
  1. qualified personnel obtain and/or update information about the medications the individual is taking at each visit; and
  2. the prescribing clinician compares current medications the individual is taking at each visit, including vitamins or other non-prescription medications, with new or changed medication orders to identify possible adverse interaction of medications.
Related Standards:
NA The agency does not prescribe or administer medication.

Note: Please see the Case Record Checklist for additional guidance on this standard.

 
Fundamental Practice

PA-PRG 3.04

Procedures for the proper administration of medication address:

  1. maintaining a record of who received medications, what medications were dispensed or administered, and when and by whom medications were dispensed or administered; 
  2. administration of over-the-counter medications; and
  3. safe dispensing or administering of sample medications, in accordance with law and regulation.

NA The agency does not dispense or administer medication.

 
Fundamental Practice

PA-PRG 3.05

Procedures for the proper storage of medication address:  

  1. locked, supervised storage with access limited to authorized personnel and in accordance with law, regulation, and manufacturer's instruction;  
  2. maintaining medication in original packaging and labeling with the name of the service recipient, medication name, dosage, prescribing physician name, and number or code identifying the written order; and 
  3. appropriate disposal of expired or unused medication, syringes, medical waste, or medication prescribed to former service recipients.  

Interpretation: Storage of medication in a secure, central location with access by authorized personnel only is an effective risk management measure and best practice. However, COA Accreditation recognizes that some programs, such as shelters and safe homes, allow service recipients to store medications in a safe, lockable personal space (e.g., individual lock boxes or private use lockers). In these instances, agencies can demonstrate implementation of the standard by providing protocols, procedures or other documents that demonstrate that they have acknowledged the potential risks of this method and subsequently taken appropriate measures to minimize those risks.  

   

Agencies also need to clearly communicate that service recipients are personally responsible for administering and storing their own medications. Intake processes should stipulate what service recipients are allowed to store in their secure, personal space and assign responsibility of the space to the individual to support this approach to storing medication.

NA The agency does not store medication. 

Note: Please see the Facility Observation Checklist for additional guidance on this standard.

 
Fundamental Practice

PA-PRG 3.06

Immediately prior to administration, qualified personnel review with the individual the medication to be administered and its purpose, and verify: 
  1. the identity of the individual and the medication ordered; 
  2. that the medication to be administered matches the medication order; and
  3. the integrity of the medication through visual inspection.
NA The agency does not administer medication.
 
Fundamental Practice

PA-PRG 3.07

Following administration of medication, personnel observe and assess the effects of medication on the individual and consult with medical professionals, as necessary.
NA The agency does not administer medication.
 
Fundamental Practice

PA-PRG 3.08

The agency tracks the use of psychotropic medications in children and youth at the individual and program level and:
  1. engages prescribers and other partnering providers in corrective action when concerns are noted; and
  2. advocates for increased availability and use of non-pharmacological interventions.
Interpretation: See PA-PRG 1.03 for more information on tracking pharmacological interventions at the individual case level.
NA The agency does not prescribe or administer psychotropic medication for children and youth. 

Examples: Measures to prevent inappropriate or unnecessary use of psychotropic medications can include:
  1. ensuring prescribing providers are familiar with child and adolescent trauma symptoms; and
  2. establishing a team- or peer-based prescribing model. 

Note: Please see the Case Record Checklist for additional guidance on this standard.

2024 Edition

Program Administration (PA-PRG) 4: Technology-Based Service Delivery

When engaging service recipients in technology-based service delivery, services are based on the needs of the service population and are provided by appropriately trained and licensed personnel.
NA The agency does not engage service recipients in technology-based service delivery. 

Examples: Examples of different technologies that may be used include, but are not limited to: telephones/mobile phones, computers, tablets, videoconferencing, interactive messaging systems, or any other tool that allows personnel to see, hear, and/or interact with service recipients from a remote location and provide services at a distance. 

Terms that are often used to refer to the delivery of services via technologies include, but are not limited to: telehealth, teleservices, telepractice, telemental health, telepsychiatry, mHealth, online therapy, distance counseling, internet- or web-based interventions, telephonic services, and digital services. 
 

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 

PA-PRG 4.01

The agency develops policies and procedures to guide technology-based service delivery that address: 
  1. privacy and security measures specific to the service delivery model; 
  2. the use of acceptable technologies, including personnel-owned devices if applicable; and 
  3. collecting, storing, tracking, and transmitting information gathered electronically.   
 
Fundamental Practice

PA-PRG 4.02

For each individual, the agency:
  1. assesses the appropriateness of technology-based service delivery based on the individual's preferences, established criteria, and suitability factors;
  2. monitors whether or not the service delivery model is effective; and 
  3. arranges for services to be delivered in person when necessary.  

Note: Please see the Case Record Checklist for additional guidance on this standard.

 
Fundamental Practice

PA-PRG 4.03

Prior to engaging in technology-based service delivery, service recipients receive information needed to make an informed decision about engaging in the service including:
  1. the service provider’s physical location, contact information, and credentials;
  2. alternate methods of service delivery, including access to other service providers, in the event of a technological failure; 
  3. privacy and confidentiality limitations associated with electronic communication; 
  4. instructions on how to access services and use the technologies;
  5. risks and benefits associated with the service delivery model; 
  6. emergency response procedures including verifying the person's current location for the purposes of emergency management;
  7. how personal information and data will be documented, stored, protected, and used; and 
  8. under what conditions a referral for face-to-face services may be made. 

Note: Please see the Case Record Checklist for additional guidance on this standard.

 

PA-PRG 4.04

Personnel are trained on, or demonstrate competency in: 
  1. use of equipment and software as appropriate to their position and the services provided; 
  2. privacy and confidentiality issues specific to the service delivery model; 
  3. recognizing and responding to emergency or crisis situations from a remote location; and
  4. engaging and building rapport with service recipients when communicating electronically.

Examples: Examples of equipment and software training topics include, but are not limited to:
  1. set up;   
  2. features; 
  3. maintenance;
  4. safety and security measures; and
  5. responding to technical matters (e.g., maintenance issues and troubleshooting) directly or by contacting the appropriate parties for assistance.
Examples: Regarding element (c), in the event of a medical emergency, personnel would need to know how and when to contact local emergency responders (e.g., 911) and/or service recipients' emergency contacts. 
 
Fundamental Practice

PA-PRG 4.05

Personnel comply with all applicable legal and ethical requirements related to technology-based service delivery and only provide technology-based services to service recipients located in states where they are appropriately licensed, if required.
2024 Edition

Program Administration (PA-PRG) 5: Services for Persons with Intellectual and Developmental Disabilities

Children, youth, and adults with intellectual and developmental disabilities receive inclusive services that help them achieve full integration, make choices, exert control over their lives, and fully participate in, and contribute to, their communities.

Interpretation: Throughout these standards the term "person" is defined to include children, youth, and adults with intellectual and developmental disabilities. In instances where the person cannot make his or her own decisions, sign documents, or is otherwise limited in his/her ability to provide informed consent, the term, "person" may be understood to also include an advocate or legal guardian, as in "...the person, his/her advocate, or legal guardian."

NA The agency does not provide any programs or services focused on serving persons with intellectual and developmental disabilities.


NA The agency is implementing the standards for Intellectual and Developmental Disabilities Services (PA-IDDS).

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VIEW THE STANDARDS

Note: Please see the Case Record Checklist for additional guidance on this standard.

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 
Fundamental Practice

PA-PRG 5.01

The agency works in partnership with the person, and his or her team according to the wishes of the person, to develop and implement a service plan that promotes self-determination and enables the fullest and most independent life possible in the community.
NA State-administered agency central office

Examples: Individuals that may be members of the person's team include, but are not limited to: the person's family, friends and other natural supports, circle of support, support/service broker, and service coordinator.

Service planning topics for persons with intellectual and developmental disabilities can include, but are not limited to:
  1. health and safety issues;
  2. degree of supervision needed;
  3. independent living, social, and daily living skills;
  4. dietary needs;
  5. leisure and vocational interests and aptitudes and the need for greater social inclusion;
  6. screening and treatment for co-occurring psychiatric disorders or substance use conditions;
  7. the need for assistive technology, auxiliary aids, and other special accommodations;
  8. positive behavior support planning;
  9. medication needs;
  10. issues related to adaptive, behavior, and cognitive functioning including concrete and abstract reasoning;
  11. specialized supports such as physical, speech, and occupational therapy;
  12. ancillary services;
  13. end of life planning; and
  14. the need for hospice or palliative care.
 
Fundamental Practice

PA-PRG 5.02

Interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort are implemented only when:
  1. the agency can document its reasons for believing that the intervention will be beneficial to the person served;
  2. the person has been fully informed about the risks and benefits of the intervention and has consented to it;
  3. the intervention is prescribed by a qualified medical practitioner or recommended by an interdisciplinary team, and specific parameters for use of the intervention, such as time limits and clear criteria for when the intervention should be applied, have been established;
  4. the agency periodically reviews the continued need for and effectiveness of the treatment or intervention; and
  5. the intervention is not used as a substitute for appropriate staffing patterns, for the convenience of personnel, or as punishment.
NA The agency does not use interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort.

Examples: Examples of such treatments and interventions include, but are not limited to: splints or poseys to prevent self-injury; use of visual or auditory screens to reduce stimulation; and use of distasteful substances, textures, or activities as a consequence for behavior.
 
Fundamental Practice

PA-PRG 5.03

The agency provides assistive technology, or helps the person gain access to assistive resources, as needed, and the person is:
  1. involved in the selection of specific technologies;
  2. afforded the opportunity to try the device prior to purchase or assignment; and
  3. trained on the use of specific assistive devices being provided.
 

PA-PRG 5.04

The agency supports persons with intellectual and developmental disabilities to establish meaningful social relationships, build and maintain natural support systems, exercise their rights and responsibilities, and participate in the life of their community by:
  1. helping them identify and pursue the types of social roles and relationships they wish to pursue;
  2. providing opportunities for social and physical interaction with people, other than service providers and other service recipients; and
  3. helping them achieve an optimal level of community involvement and participation.
 

PA-PRG 5.05

Family support services and information are available to:
  1. strengthen the family's ability to provide care;
  2. prevent unwanted and inappropriate out-of-home placements; 
  3. help resolve conflicts between the person and his/her family, advocate, or others involved in establishing and implementing the person's plan; and 
  4. help maintain family unity.

Examples: Informational topics that may assist caregivers include, but are not limited to: early childhood development, behavior, home economics, work-life balance, and nutrition. 

Examples of community support services include, but are not limited to: behavioral support, case management, counseling, early intervention services, financial assistance, in-home support, public entitlements, respite services, and support groups.
 
Fundamental Practice

PA-PRG 5.06

Persons with intellectual and developmental disabilities receive support and education regarding sexuality and relationships that has been tailored to their assessed needs, capacity, and learning style including:
  1. sexual health and development;
  2. family planning;
  3. prevention of STDs and HIV/AIDS; and
  4. sexual abuse and exploitation including giving and receiving sexual consent.
2024 Edition

Program Administration (PA-PRG) 6: Personnel Training for Intellectual and Developmental Disabilities Services

Personnel who provide direct services to people with intellectual and developmental disabilities are trained and able to provide services, supports, and other forms of direct assistance. 

NA The agency does not provide any programs or services focused on serving persons with intellectual and developmental disabilities.


NA The agency is implementing the standards for Intellectual and Developmental Disabilities Services (IDDS).

1
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
2
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.
3

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.
4
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed administration and management infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
 

PA-PRG 6.01

Direct service personnel are trained on, or demonstrate competency in, the following topics as appropriate to the service and needs of persons served:
  1. assisted dining techniques and good nutrition;
  2. lifting and transfer techniques;
  3. safe transportation techniques; 
  4. health related supports;
  5. use of assistive technology; and
  6. teaching ADLs.
 
Fundamental Practice

PA-PRG 6.02

Direct service personnel are trained and evaluated on the restrictive interventions identified in the treatment plan prior to working with the individual and annually thereafter including:
  1. the parameters under which interventions may be used;
  2. the proper and safe use of chosen interventions; and
  3. the potential for re-traumatization.
NA The agency does not permit the use of restrictive interventions.

Examples: Restrictive interventions are those that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort.
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