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Subject 290-2-17 ORGANIZATION AND ADMINISTRATION

Rule 290-2-17-.01 Purpose

The purpose or function of the Maternity Home shall be clearly defined in its charter and/or constitution and by-laws.

Rule 290-2-17-.02 Need

The Maternity Home shall meet a need in the geographical area it serves or plans to serve.

Rule 290-2-17-.03 Governing Board

Each Maternity Home shall have a board of directors which operates as the governing board of the agency. The governing board shall be organized so that legal responsibility and administrative authority shall be clearly defined. This applies only to Maternity Homes chartered for non-profit operation. In a privately owned home where maternity care is provided, the owner and/or operator is legally responsible for the establishment and enforcement of policies and the operation of the Home.

(a) Composition of Board.
1. The governing board shall be made up of men and women who are representative of the community served. Board members should be selected who have personal qualifications, interest, time and ability to provide leadership, to represent the agency, to interpret its program, and to participate fully and consistently in carrying out their responsibilities.
2. The board shall be composed of not less than ten and not more than thirty-five members unless provided otherwise by local ordinance.
3. Members shall not receive a salary for their services but may be reimbursed for expense incurred in connection with their office.
4. A meeting of the governing body shall be held at least ten (10) times a year.
5. Provisions should be made for systematic rotation of board members through a plan of overlapping terms of office. The number of consecutive terms for membership shall be limited.
(b) Function and Responsibility of the Board. The governing board of a Maternity Home is responsible for establishing and maintaining its corporate entity. In carrying out this responsibility it is the duty of the Board to:
1. Appoint a well-qualified executive to whom responsibility for administration is delegated;
2. Assume joint responsibility with the executive for the determination of the general plans and policies of the Agency;
3. Insure adequate financing and budgeting for the Agency;
4. Interpret the Agency's program to the community. An informed citizenry is necessary for community understanding of unmarried parents and their needs, for wider use of agency services, for appropriate referrals, and for adequate financing;
5. Coordinate the work of the Agency with that of other agencies toward a broad community plan of service. The Maternity Home should be considered as only one resource in the service needed, and should be related to, and integrated with, all services in the community;
6. Periodically review the Agency's program in order to determine whether its existing policies are meeting current needs.

Rule 290-2-17-.04 Finances

The Agency shall have a sound plan of financing which assures sufficient funds to enable it to provide effective services. A new Agency shall have sufficient funds to finance its first year of operation. All accounts shall be audited at least annually by a certified public accountant and the report made a part of the Agency record. An estimated budget, showing details of income and expenditures for the approaching fiscal year, shall be prepared and approved by the board prior to the beginning of each fiscal year. Board officers and staff responsible for handling a substantial amount of funds shall be bonded. Fund raising shall be carried on according to approved and ethical processes. Unless specifically exempt by law, the Maternity Home must be registered with the Secretary of State as a charitable organization. For nonprofit agencies fees for clients shall be flexible, based on actual per diem cost rate. A sliding scale based on the client's ability to pay or her resources to meet the cost and the community's responsibility to provide an adequate facility is desirable.

Rule 290-2-17-.05 Policies and Procedures

(1) The Agency shall have a written statement of purposes and objectives, services offered, eligibility requirements for service and the procedures for implementing services. These should be incorporated in an Agency manual which would be available for guidance of the board of directors, Agency staff and to referring agencies.
(2) The policies and procedures of the Maternity Home should carry out the purposes of services to unmarried parents:
(a) to assure protection of the well-being and rights of the child born out of wedlock and his parents;
(b) to make sure that their current needs are met;
(c) to help them achieve a more satisfying need and socially acceptable way of life;
(d) to promote normal growth and development of the child; and
(e) to prevent the occurrence of consequent problems for the parent, child and community.
(3) No Maternity Home shall assume responsibility for placement directly or indirectly of children for adoption unless the Home has a child-placing license. Any evidence of violation of this requirement shall be sufficient ground for non-issuance of a license, or for revocation of a license already issued.

Rule 290-2-17-.06 Personnel

(1) Staff should be selected not only for their training and competence for the particular position to be filled, but also for their ability to develop and maintain those attitudes which will contribute to the therapeutic climate of the agency and which will enable them to work effectively with unmarried parents. The work program for the unmarried mother shall not be used as a substitute for financing adequate staff. When unmarried mothers are housed on different floors there shall be at least one resident staff member on each floor. There shall be on duty at all times two adults serving in the capacity of housemother and an alternate person to be on call. There shall be on call at all times a registered nurse.
(2) Administrative Staff.
(a) The Executive Director.
1. The executive director should have at least one year of professional training and experience in social work, and knowledge and skill in administration and management. She should have an understanding of the problems involved in pregnancy and out-of-wedlock parenthood.
2. The executive director should have the ability to distinguish between the work she is equipped to undertake and that which must be done by professionally educated specialists.
3. The executive director shall be in full charge of the management of the Home and make regular reports to the board on all phases of its operation. She should perform the following duties:
(i) direction of the agency program;
(ii) provide professional leadership and technical consultation to the board, help to determine policy, and to assist in periodic evaluation of the Agency's services;
(iii) recruit, employ and discharge staff;
(iv) hold staff meetings at regular intervals, and discuss plans and policies with the staff;
(v) provide an in-service training program for personnel;
(vi) prepare annual budget for presentation to the board, keep board advised of financial needs, supervise purchasing, and operate within the budget established;
(vii) establish and maintain good working relationships with other social agencies and represent the Agency in the community;
(viii) interpret the Agency's program and services and give community leadership in developing resources for services to unmarried parents and their children.
(b) Assistant to the Executive. Each Maternity Home shall have an assistant to the executive to whom administrative responsibility can be delegated in the executive's absence.
(3) Social Service Staff.
(a) Caseworkers.
1. At least one caseworker shall be employed who is a graduate from an accredited school of social work. Other caseworkers who are college graduates with a minimum of one year work experience may be utilized as case aides if there is adequate supervision from a professionally trained caseworker.
2. There should be one caseworker for each twenty-five unmarried mothers.
3. There shall be at least one full time supervisor for each six (6) caseworkers. Supervisors shall be graduates of an accredited school of social work.
(b) Group Workers. A group worker with professional training in social work should carry responsibility for planning group activities and for working with selected activity groups that require skilled leadership.
(4) Resident Staff.
(a) A full time resident director shall be employed when the executive director does not live at the Home.
(b) Resident houseparents shall be at least twenty-five years of age and shall have at least a high school education or its equivalent. They shall have the ability to accept and work with unmarried mothers.
(5) Maintenance and Domestic Staff.
(a) Sufficient domestic and maintenance staff shall be employed so that the houseparents and the residents do not have to assume major responsibility for heavy household duties.
(b) Domestic staff shall be selected who have the ability to understand the confidentiality of the work and to respect the program.
(6) Clerical Staff. Each Maternity Home shall have adequate clerical services to keep correspondence, records, bookkeeping and files current and in good order. Unmarried mothers shall not be used in this capacity.
(7) Medical Staff.
(a) A licensed physician and a licensed pediatrician, when the Home operates a nursery, shall be available to coordinate the services of the Home with that of the hospital used for confinement, to provide consultation service to the staff regarding diagnosis and treatment of medical conditions and should be on call in case of illness not directly associated with pregnancy.
(b) A registered nurse shall be on call at all times, when the Home operates a nursery. If there is only one registered nurse, she should live in the Home and be on call by the practical nurse when an emergency arises.
(c) For immediate post partum care it is desirable to have one nurse for each five persons by day and for each ten persons by night.
(d) There shall be on duty at all times one attendant who meets the approval of the Home's physician for every six babies. During the time the attendant is caring for babies she should not give care to bed patients.
(8) Consultants and Other Specialists. Complete services to unmarried parents require utilization of many professional skills. Qualified specialists, including physicians, psychiatrists, psychologists, religious counselors, and attorneys should be available for direct work with the unmarried mother, and for consultation and interpretation to staff.

Rule 290-2-17-.07 Personnel Policies

(1) The Agency shall have written personnel policies and operating practices which should be available to all staff members. These should define:
(a) qualifications, duties and responsibility for each position in the Agency;
(b) salary scales and provisions for increments;
(c) hours of work, holidays, vacations, sick leave;
(d) conditions of employment, dismissal; and
(e) employment benefits, including retirement plan, social security, hospitalization, and other insurance. Personnel policies should be developed by a joint committee of board and staff. Lines of authority should be clearly defined, but with sufficient flexibility for effective intra-agency communication among all levels at administrative responsibility.
(2) Physical Examinations. All staff shall have a physical examination prior to employment and annually thereafter. A report of each examination shall be made a part of the employee's personnel file.
(3) Salaries. A salary scale for each type of position shall be established. Salary should be adequate to attract and keep competent staff, should be equivalent to prevailing rates and commensurate with the duties and responsibilities of the position.
(4) Living Arrangements. Resident staff shall be provided with quarters which are comfortable, insure reasonable privacy, rest during hours off duty, provision for personal belongings, and shall have bath and toilet facilities separate from those used by the unmarried mothers.
(5) Leave.
(a) Hours on duty shall not exceed 44 hours per week.
(b) Provision should be made for annual vacations, time off for study and training, institutes, and legal holidays.
(c) There shall be provision for sick leave for all permanent employees.
(6) Insurance and Retirement. Plans for social security, hospital and/or health insurance, and workmen's compensation should be made available for all staff.