Earlier this year, we made the decision to change how we approach accreditation—transitioning from the Joint Commission to the Council on Accreditation (COA). This decision wasn’t about meeting a requirement—it was about aligning our programs with a standard that better reflects who we are and the work we do.
“Joint Commission is more medical based,” explained Director of Compliance Hope Perini. “COA is social-services-based, which makes it a better fit for us. It asks the right questions—about intake, referral, case management—areas that the Joint Commission didn’t really touch. COA peels back the curtain on what matters in our work.”
COA’s peer review model is based on real-world experiences. Review teams are made up of leaders from similar organizations across the country. During our most recent visit, COA sent three professionals to our Sioux Falls campuses to assess the Shelter, Outpatient (3rd Street) and Administration buildings. The peer reviewers are all COA volunteers who lend their time and knowledge to help other organizations grow. Their experience in similar environments brought authenticity, insight, and a shared understanding of the work we do and clients we serve.
“This was the first time any of our programs went through a review like this,” said Hope. “It was wonderful having peer reviewers who understood why we run our programs the way we do—but still wanted to help make us better.”
The process was intense, and Hope had to submit more than 700 items for the COA team to review. While gathering all the documents that were needed, she had already identified areas of potential growth opportunities. “As I was gathering documents, I was already identifying gaps—so nothing that COA brought up was a blindside, and actually it felt validating,” said Hope. “The biggest areas of improvement were around the performance and quality improvement (PQI) and risk prevention—thinks like how we analyze incidents or adjust practices. Both fall under compliance, so it’s in my wheelhouse.”
What stood out to Hope—even before the visit—was the collaboration between departments. Everyone came together, shared documents and reworked procedures and policies to meet COA’s standards.
“I dropped into this project when it was already in motion,” said Hope. “I had just joined the agency and didn’t know all of the programs yet. But everyone—frontline staff, directors, the executive team—stepped up. No one gatekept information or got defensive when changes needed to be made. It was always ‘What do you need help with?’ which was a huge help for me.”
One of the most rewarding parts of the review was hearing the positive feedback.
“They absolutely loved the Shelter,” exclaimed Hope. “They said it didn’t feel like a shelter—it felt warm and dignified. One even said, ‘You want to be here,’ which is not what you usually hear about shelters. And they called our Outpatient Mental Health program ‘new but mighty.’”
Other comments we received were:
Once completed, COA accreditation will apply to all CHS programs and campuses. Hope explained that her next steps include meeting with departments individually once she receives the formal feedback report. After submitting the necessary updates and documentation, we expect to achieve full accreditation by early 2026.
“This process brought us together,” said Hope. “Everyone embraced the change, even when it meant hard conversations or creating procedures from scratch. This review was a great example of how we are truly better together.”