reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 973.00 - County Correctional Facilities - Safety And Emergency Standards › Section 973.07 - Prompt Release Procedures (Required)

Current through Register 1525, July 5, 2024
Written policy and procedure shall specify the means for
				immediate release of inmates from locked areas in case of emergency, and
				provide for a secondary means of immediate release.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 973.00 - County Correctional Facilities - Safety And Emergency Standards › Section 973.08 - Fire Prevention Training (Required)

Current through Register 1525, July 5, 2024
Each county correctional facility shall conduct in-service
				training for all personnel in fire prevention, detection, use of emergency fire
				equipment, and evacuation procedures, and shall seek the assistance of local
				fire authorities, or other qualified persons in this effort.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 973.00 - County Correctional Facilities - Safety And Emergency Standards › Section 973.09 - Emergency Power

Current through Register 1525, July 5, 2024
(1) Each county
			 correctional facility shall have an emergency power source capable of providing
			 power to maintain essential lights, power and communications.
(2) Power generators shall be tested tested
			 quarterly or in accordance with the manufacturer's guidelines.
(3) All new county correctional facilities
			 shall have an emergency power source capable of providing 100% power for the
			 normal operation of the facility.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 973.00 - County Correctional Facilities - Safety And Emergency Standards › Section 973.10 - Control, Use, and Storage of Dangerous Materials (Required)

Current through Register 1525, July 5, 2024
Written policy and procedure shall govern the control, use, and
				storage of all flammable, toxic, and caustic materials, in accordance with all
				applicable laws and regulations. The procedures shall include, but not be
				limited to, the following:
(1) Any
			 flammable or combustible work materials shall be used only under staff
			 supervision and shall be locked in a secure fire resistant storage area as
			 approved by the authority having jurisdiction;
(2) Precautions shall be taken in the use and
			 secure storage of all toxic and caustic substances: any substance that may,
			 through chemical reaction, cause harm to an individual. Use of such substances
			 shall occur only under careful staff supervision; and
(3) Each county correctional facility shall
			 provide noncombustible receptacles for combustible refuse at appropriate
			 locations throughout the facility's living quarters. Special containers shall
			 be provided for flammable liquids and for rags used with flammable liquids. All
			 receptacles and containers shall be emptied and cleaned daily.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.01 - General

Current through Register 1525, July 5, 2024
Each facility shall comply with applicable regulations of the
				Massachusetts Department of Public Health, as required by statute, regarding
				maintenance and sanitation in county correctional facilities.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.02 - Environmental Health Officer (Required)

Current through Register 1525, July 5, 2024
In accordance with Department of Public Health regulations,
				each Sheriff/facility administrator shall appoint a qualified environmental
				health officer to ensure that
				103 CMR 900.00 and the
				regulations of the Department of Public Health (105 CMR) are adhered to and
				properly monitored.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.03 - Interior Cleanliness

Current through Register 1525, July 5, 2024
A written housekeeping plan for all areas of the facility's
				physical plant shall provide for daily housekeeping and regular maintenance, by
				assigning duties and responsibilities to staff and inmates.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.04 - Inspection Plans (Required)

Current through Register 1525, July 5, 2024
Written policy and procedure shall govern facility inspection
				plans and shall include, but not be limited to, the following:
(1) At least weekly sanitation inspections of
			 all institution areas by a designated qualified employee;
(2) A comprehensive and thorough monthly
			 inspection of the facility by an environmental health officer;
(3) At least annual inspections by the
			 Department of Public Health;
(4)
			 Semi-annual inspections by the Department of Correction Standards Compliance
			 Unit;
(5) All inspections shall be
			 documented and all inspection reports shall be maintained by the
			 Sheriff/facility administrator or designee; and
(6) Deficiencies noted in any of the above
			 reports shall be responded to with appropriate plans of action and in
			 accordance with any specified guidelines.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.05 - Outside Grounds

Current through Register 1525, July 5, 2024
Each county correctional facility shall develop a written plan
				ensuring that the outside grounds shall be maintained in a neat and orderly
				condition, in good repair and fit the uses intended.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.06 - Insect and Rodent Control (Required)

Current through Register 1525, July 5, 2024
Written policy and procedure shall govern the control of vermin
				and pests. When they exist, such pests shall be exterminated in a manner which
				is not hazardous to the health of inmates or employees, by a person with
				appropriate licensing.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.07 - Liquid and Solid Waste Control (Required)

Current through Register 1525, July 5, 2024
Written policy and procedure shall govern the storage and
				disposal of all liquid and solid wastes in a manner designed to prevent
				transmission of disease, creation of nuisance and the breeding of
				insects.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.08 - Personal Hygiene

Current through Register 1525, July 5, 2024
Each county correctional facility shall provide the means for
				inmates to adhere to acceptable personal hygiene practices, including:
(1) Availability of articles needed for
			 personal hygiene, including, but not limited to, soap, toothpaste or tooth
			 powder, toothbrush, and articles for feminine hygiene;
(2) Availability of sufficient showers or
			 bathtubs as required by State or local codes;
(3) Water temperature for showering or
			 bathing shall be thermostatically controlled (minimum 110°F, maximum
			 130°F); and
(4) Written policy
			 and procedure shall provide for the availability of hair care services. The
			 Sheriff/facility administrator may charge a reasonable fee not to exceed $10.00
			 for any haircut provided.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.09 - Clothing

Current through Register 1525, July 5, 2024
Written policy and procedure shall provide for the
				following:
(1) The issue of clean,
			 suitable and presentable clothing to new inmates, as necessary;
(2) The issue of all clothing shall be
			 recorded to provide accountability for its use;
(3) As necessary, the issue of special
			 clothing and protective clothing and equipment (specialized work assignments);
			 and,
(4) The availability of at
			 least weekly laundering or clothing exchange.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.10 - Linens and Bedding

Current through Register 1525, July 5, 2024
Written policy and procedure shall provide for the
				following:
(1) A standard issue of
			 bedding and linens including:
(a) a suitable,
			 clean, flame retardant mattress, to include a mattress with an integrated
			 pillow;
(b) two clean sheets, a
			 clean pillowcase, and flame retardant pillow;
(c) two clean bath-size towels; and
(d) sufficient clean blankets to provide
			 comfort under existing temperature conditions.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.11 - Water Supply (Required)

Current through Register 1525, July 5, 2024
Each county correctional facility shall provide documentation
				of certification that the water supply meets all applicable laws or regulations
				of the governing jurisdiction.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 974.00 - County Correctional Facilities - Sanitation And Hygiene › Section 974.12 - Tobacco Use Prohibited

Current through Register 1525, July 5, 2024
Pursuant to M.G.L. c. 270, § 22, smoking is prohibited in
				the state house or in a public building or in a vehicle or vessel, owned,
				leased, or otherwise operated by the Commonwealth of Massachusetts or in a
				political subdivision thereof, or in a space occupied by a state agency or
				department of the Commonwealth which is located in another building, including
				a private office in a building or space mentioned in this
				sentence.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 979.00 - County Correctional Facilities - Volunteers And Citizen Involvement › Section 979.01 - General

Current through Register 1525, July 5, 2024
In order to foster reintegration of offenders into the
				community, and augment existing programs, the facility shall establish written
				policy and procedure for volunteer programs.
				103 CMR 979.00 shall not be
				applicable to jail facilities.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 979.00 - County Correctional Facilities - Volunteers And Citizen Involvement › Section 979.02 - Authority and Responsibilities

Current through Register 1525, July 5, 2024
The volunteer plan shall include written policy and procedure
				governing the following:
(1) The lines
			 of authority, responsibility, and accountability for the program;
(2) Goals and objectives of the
			 program;
(3) Types of services
			 generally offered. Volunteers may perform professional services only when
			 certified or licensed to do so. Documentation of credentials shall be
			 provided;
(4) Assignment of a staff
			 member to coordinate volunteer activities;
(5) Approval of all volunteers or volunteer
			 organizations prior to entry into the county correctional facility by the
			 Sheriff/facility administrator or designee; and
(6) Procedures to curtail, postpone, or
			 discontinue the services of a volunteer or volunteer organization.
Code of Massachusetts Regulations › 103 CMR - DEPARTMENT OF CORRECTION › Title 103 CMR 979.00 - County Correctional Facilities - Volunteers And Citizen Involvement › Section 979.03 - Screening, Selection, and Orientation

Current through Register 1525, July 5, 2024
The written volunteer plan shall include written policy and
				procedure specifying:
(1) Methods for
			 application, screening and selection of volunteers;
(2) Recruitment of volunteers from all
			 cultural and socioeconomic segments of the community;
(3) Provisions for an orientation/training
			 program prior to any assignments, to include:
(a) lines of authority within the facility,
			 its history, policies, emergency procedures and any other relevant
			 regulations;
(b) the role for
			 volunteer programs and the specific duties of each volunteer; and
(c) type of inmate population, their needs,
			 attitudes and lifestyles.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 25.00 - Authority, Mission, And Definitions › Section 25.01 - Authority, Vision and Mission

Current through Register 1525, July 5, 2024
(1) The
			 Department is the mental health authority in Massachusetts. It is mandated by
			 M.G.L. c. 19 to take cognizance of all matters affecting the mental health of
			 the citizens of the state. Its primary mission is to provide for services to
			 adults with serious and persistent mental illness and children with serious
			 mental illness or severe emotional disturbance and their families, early and
			 ongoing treatment, and research into the causes of mental illness. Pursuant to
			 M.G.L. c. 19 and c. 123, it is authorized and required to:
(a) develop and maintain a comprehensive
			 program of community mental health services, including forensic mental health
			 services;
(b) operate, control and
			 supervise, directly or by contract, all facilities and programs developed and
			 maintained by the Department as part of the comprehensive program;
(c) maintain state hospitals and other
			 regional and statewide mental health facilities and services; and
(d) license or regulate private, county and
			 municipal facilities and programs providing care and treatment to persons with
			 mental illness.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 25.00 - Authority, Mission, And Definitions › Section 25.03 - Emancipated and Mature Minors

Current through Register 1525, July 5, 2024
Throughout 104 CMR, there are instances where the rights of
				emancipated or mature minors may be relevant. 104 CMR does not attempt to
				identify them. However, where, by operation of law pursuant to M.G.L. c. 112,
				§§ 12E or 12F, a minor is an emancipated minor entitled to consent to
				drug or medical or dental treatment and has the capacity to do so, he or she
				shall be entitled to consent in the same manner as an adult. Further, a
				facility or program may determine, pursuant to applicable Massachusetts law,
				that a minor is a mature minor and is therefore able to provide consent to
				treatment and may decide, in certain circumstances, not to notify the parents.
				Such determinations should be made by facilities and programs in consultation
				with their legal counsel.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 25.00 - Authority, Mission, And Definitions › Section 25.04 - Computation of Time

Current through Register 1525, July 5, 2024
Unless otherwise specified, when a period of time for an action
				or event is specified with 104 CMR, the computation of such time shall be in
				accordance with the following:
(1) the
			 day on which action or event is initiated is not counted;
(2) when the time period is less than seven
			 calendar days, Saturdays, Sundays, and legal holidays are not
			 counted;
(3) when the time period
			 is seven calendar days or longer, the time is counted in calendar days, except
			 when the last day is a Saturday, Sunday, or legal holiday, in which case the
			 final day counted is the next business day.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 26.00 - Organizational Structure and Citizen Participation › Section 26.01 - Organization of the Department

Current through Register 1525, July 5, 2024
The Department is authorized by M.G.L. c. 19, § 12, to
				establish a geographic structure for the organization and provision of mental
				health services. The Department's organization shall include a Central Office,
				Area Offices, and such other offices as may be designated from time to time by
				the Commissioner. The Department shall from time to time issue a Resource Guide
				that describes the geographic structure of the Department and how to access
				community-based service delivery systems throughout the state.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 26.00 - Organizational Structure and Citizen Participation › Section 26.02 - Designation of Departmental Facilities

Current through Register 1525, July 5, 2024
(1) The
			 Commissioner is authorized by M.G.L. c. 19, § 7 to designate the state
			 facilities under the control of the Department. The following have been so
			 designated by the Commissioner:
(a)
State Hospitals
: Taunton State Hospital; Worcester
			 Recovery Center and Hospital.
(b)
Community Mental Health Centers with Inpatient Units
:
			 Cape Cod and Islands Mental Health Center; Corrigan Mental Health Center; Dr.
			 Solomon Carter Fuller Mental Health Center.
(c)
Community Mental Health
			 Centers without Inpatient Units
: Brockton Multi-Service Center;
			 Massachusetts Mental Health Center; Erich Lindemann Mental Health Center; Dr.
			 Harry C. Solomon Mental Health Center; Quincy Mental Health Center.
(d)
State Hospital Psychiatric
			 Units
: Hathorne Psychiatric Services of Tewksbury Hospital; Metro
			 Boston Mental Health Units of Lemuel Shattuck Hospital.
(e) The Recovery from Addictions Program, a
			 facility for the treatment of Individuals committed pursuant to M.G.L. c. 123,
			 § 35.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart A - SCOPE AND DEFINITIONS › Section 27.01 - Scope

Current through Register 1525, July 5, 2024
Unless the contrary is specified in a particular section, the
				  provisions of
				  104 CMR 27.00 apply to all
				  facilities that are licensed, contracted for, or operated by the Department of
				  Mental Health (Department).
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart B - LICENSING › Section 27.04 - Licensing

Current through Register 1525, July 5, 2024
(1)
Adolescent Intensive
				Residential Treatment Program
. An adolescent Intensive Residential
				Treatment Program (IRTP) is a residential mental health program which provides
				comprehensive treatment and education in a secure setting to adolescents with
				serious emotional disturbance or mental illness and which has the capacity to
				admit such adolescents pursuant to the provisions of M.G.L. c. 123,
				§§ 7, 8, 10 and 11. IRTPs may not receive a Class VIII license to
				administer electroconvulsive treatment.
(2)
Eligibility
.
				Only individuals who meet the following criteria may be eligible for admission
				to an IRTP:
(a) The individual shall be 13
				through 18 years of age. An individual already admitted to an IRTP who turns 19
				years old may, upon approval of the Commissioner or designee, remain there to
				complete his or her course of treatment;
(b) The individual has been determined to
				require continuing care and treatment in a secure residential
				setting;
(c) Failure to place the
				individual in a secure treatment setting would create a likelihood of serious
				harm by reason of mental illness; and
(d) There is no appropriate, less restrictive
				setting available.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.06 - Voluntary and Conditional Voluntary Admission

Current through Register 1525, July 5, 2024
(1)
Eligibility for Voluntary or
				Conditional Voluntary Admission
.
(a) A person may be admitted on a voluntary
				status pursuant to M.G.L. c. 123, § 10 or a conditional voluntary status
				pursuant to M.G.L. c. 123, §§ 10 and 11 to a facility upon written
				application, provided that in the opinion of the facility director, or
				designee, such patient qualifies for admission in accordance with
				104 CMR
				27.05(2), and has the
				capacity to apply for such admission and is desirous of receiving
				treatment.
(b) A person's
				application for voluntary or conditional voluntary status shall only be
				accepted upon a determination by the admitting or treating clinician that the
				patient has reached 16 years of age, has capacity to apply for such status, and
				is in need of care and treatment, or if application is made on behalf of the
				patient by a legally authorized representative that the legally authorized
				representative has authority to do so.
1. An
				application made on behalf of a minor by the minor's parent or guardian may be
				accepted upon a determination by the admitting or treating clinician that the
				person making such application is in fact the minor's legally authorized
				representative.
2. An application
				made on behalf of a person by his or her health care agent may be accepted upon
				a determination by the admitting or treating clinician that the health care
				agent is acting pursuant to a valid and invoked health care proxy that has not
				been revoked by the patient.
(c) For purposes of 104 CMR 27.06, capacity
				to apply means:
1. that a patient admitted on
				a voluntary status understands that he or she is in a facility for treatment
				and that he or she may leave the facility at any time.
2. that a patient admitted on a conditional
				voluntary status understands that he or she is in a facility for treatment,
				understands the three-day notice provisions, and understands the facility
				director's right to file a petition for commitment and thereby retain him or
				her at the facility.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.07 - Three-day Involuntary Commitment

Current through Register 1525, July 5, 2024
(1) No
				person shall be admitted to a facility upon application for involuntary
				hospitalization pursuant to M.G.L. c. 123, § 12, unless the person, or his
				or her legally authorized representative, has been given the opportunity by the
				facility to apply for admission under M.G.L. c. 123, §§ 10 and 11.
				For a patient 16 or 17 years of age, this opportunity must be given to both the
				patient and his or her legally authorized representative. The right to convert
				to voluntary or conditional voluntary status may be exercised by a patient or
				his or her legally authorized representative at any time within the three-day
				period. A mental health professional responsible for the patient admitted
				pursuant to M.G.L. c. 123, § 12 shall again inform the patient or legally
				authorized representative, within three days of admission, of the right to
				change status, and shall record so, informing the patient or the legally
				authorized representative in the patient's record.
(2)
Examination Prior to
				Admission
. Persons for whom application has been made for
				three-day involuntary hospitalization pursuant to M.G.L. c. 123, § 12, and
				who have not been examined by a designated clinician prior to reception at the
				admitting facility, shall receive such examination immediately after reception
				at such facility. If the clinician determines that failure to hospitalize such
				person would create a likelihood of serious harm by reason of mental illness,
				he or she may admit such person to the facility for care and treatment.
(a) For the purposes of 104 CMR 27.07(2),
				"immediately" shall mean within two hours of the patient's reception at the
				facility.
(b) If the designated
				clinician at the facility is engaged in an emergency situation elsewhere, he or
				she shall conduct such an examination as soon as such emergency no longer
				requires his or her attention.
(c)
				The requirement for examination may be satisfied through utilization of
				telemedicine or other technology pursuant to protocols approved by the
				Department that assure verbal and visual observation and communication between
				the patient and an off-premises designated clinician and adequate on-premises
				clinical staff; provided however, that a patient admitted involuntarily
				pursuant to M.G.L. c. 123, § 12(b), or who is determined to have capacity
				to be admitted under conditional voluntary status pursuant to M.G.L. c. 123,
				§§ 10 and 11, and has been so admitted after an examination conducted
via
telemedicine, shall be examined by a designated clinician
				as soon as possible and no later than the next calendar day following the
				admission.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.08 - Transfer and Transport of Patients

Current through Register 1525, July 5, 2024
(1)104 CMR
				27.08 governs the transfer of patients pursuant to M.G.L. c. 123, § 3 and
				the transport of patients pursuant to M.G.L. c. 123, § 21.
(2) For the purposes of 104 CMR 27.08(3)
				through (8), "emergency" shall mean those medical, surgical and psychiatric
				crises which, in the opinion of the facility director, threaten the safety,
				health or life of the patient or others, and which could not be appropriately
				treated in the transferring facility.
(3)
Permitted Transfers;
				Exceptions
. Any patient admitted to a facility may be transferred
				from that facility to any other facility, provided that except in an emergency:
(a) Patients on voluntary status under
				104 CMR
				27.06 shall not be subject to transfer
				without their written consent; and
(b) Patients on conditional voluntary status
				under
				104 CMR
				27.06 may refuse transfer. Such refusal may
				be considered equivalent to submission of the patient's three-day written
				notice of his or her intention to leave or withdraw from the facility. Upon
				such refusal, the facility director may file a petition for commitment under
				the provisions of M.G.L. c. 123, §§ 7 and 8 if the patient meets the
				criteria for commitment, or may withdraw the notice of transfer provided to the
				patient pursuant to 104 CMR 27.08(9).
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.09 - Discharge

Current through Register 1525, July 5, 2024
(1)
Discharge
				Procedures
.
(a) A facility shall
				arrange for necessary post-discharge support and clinical services. Such
				measures shall be documented in the medical record.
(b) A facility shall make every effort to
				avoid discharge to a shelter or the street. The facility shall take steps to
				identify and offer alternative options to a patient and shall document such
				measures, including the competent refusal of alternative options by a patient,
				in the medical record. In the case of such discharge, the facility shall
				nonetheless arrange for or, in the case of a competent refusal, identify
				post-discharge support and clinical services. The facility shall keep a record
				of all discharges to a shelter or the street, in a form approved by the
				Department, and submit such information to the Department on a quarterly
				basis.
(c) When a patient in a
				facility operated by or under contract to the Department is a client of the
				Department pursuant to
				104 CMR 29.00:
Application for DMH Services, Referral, Service Planning and
				Appeals
, the service planning process outlined in
				104 CMR 29.00 shall be
				undertaken prior to discharge.
(d)
				A facility shall keep a record of all patients discharged therefrom, and shall
				provide such information to the Department upon request.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.10 - Treatment

Current through Register 1525, July 5, 2024
(1)
Informed Consent, Consent to
				Treatment
.
(a) Upon admission to
				a facility a patient shall, upon giving informed consent, receive treatment and
				rehabilitation when ordered in accordance with accepted therapeutic practice.
				(b) Prior to an adjudication of incapacity or invocation and affirmation of a
				health care proxy, a patient retains the right to accept or refuse
				treatment.
(c) Informed consent
				must be documented in the patient's medical record.
(d) Extraordinary treatment, as defined by
				statute or case law including, but not limited to, treatment with antipsychotic
				medication, may not be administered or performed without the patient's specific
				informed consent. In the case of a patient who lacks capacity to give informed
				consent, such treatment may not be administered or performed without prior
				review and approval by a court of competent jurisdiction or in the case of a
				minor or a patient with a properly invoked healthcare proxy, the consent of his
				or her legally authorized representative.
(e) For a patient who is believed to lack
				capacity to give informed consent to treatment with antipsychotic medication,
				and who is not being treated pursuant to consent by the parent of a minor or by
				a health care agent pursuant to a properly invoked and affirmed health care
				proxy, the right to refuse such medication may be overridden prior to an
				adjudication of incapacity and court approval of a treatment plan only in rare
				circumstances to prevent an immediate, substantial and irreversible
				deterioration of the patient's mental illness. If treatment is to be continued
				over the patient's objection, and the patient continues to lack capacity, then
				an adjudication of incapacity and court approval of a treatment plan must be
				sought.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.12 - Prevention of Restraint and Seclusion and Requirements When Used

Current through Register 1525, July 5, 2024
(1) Restraint and seclusion may only be used
				in facilities operated by the Department, or licensed as Class III through VII;
				provided however, that no such seclusion or restraint of a minor may occur
				except in a facility that has been inspected and specially certified by the
				Department.
(2)
Prevention/Minimal Use of Restraint and Seclusion
. A
				facility subject to 104 CMR 27.12 that uses restraint or seclusion shall
				develop and implement a strategic plan to reduce and, wherever possible,
				eliminate the use of restraint and seclusion. The strategic plan should be
				updated at least annually to reflect progress in implementation and to ensure
				efforts to reduce or eliminate restraint are ongoing. The facility's strategic
				plan shall include, at a minimum, the following:
(a) a posted statement of the facility's
				commitment to the prevention and minimal use of restraint and
				seclusion;
(b) policies and
				procedures that support the prevention and minimal use of restraint and
				seclusion;
(c) staff training that
				focuses on crisis prevention, de-escalation and alternatives to restraint and
				seclusion;
(d) programming and
milieu
that are consistent with the prevention and minimal use
				of restraint and seclusion;
(e) the
				development and integration of peer and family support within the program. This
				should include peer involvement in interventions to reduce the use of restraint
				and seclusion;
(f) the development
				and use of sensory interventions and therapies designed to calm and comfort
				patients that utilize sight, touch, sound, taste, smell, pressure, weight or
				physical activity;
(g) designation
				of a comfort or sensory space on the unit for patients to utilize to practice
				sensory modulation, coping skills, and/ or self-soothing techniques. This space
				should be a dedicated room including, but not limited to, a temporary location
				where staff may bring appropriate supplies and equipment for patient
				use;
(h) the development and use of
				an individual crisis prevention plan for each patient;
(i) assessment of the impact of trauma
				experience and the potential for re-traumatization for both patients and
				staff;
(j) the regular use of
				debriefing activities for both patients and staff;
(k) the process for addressing patient
				concerns and complaints about the use of restraint or seclusion; and
(l) the use of data to monitor and improve
				quality and prevent and minimize the use of restraint and seclusion, such as
				identifying times or shifts with a high incidence of restraint or
				seclusion.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.14 - Human Rights Officer; Human Rights Committee

Current through Register 1525, July 5, 2024
(1)
Human Rights
				Officer
. Each facility shall have a person or person employed by
				or affiliated with the facility appointed to serve as the human rights officer
				and to undertake the following responsibilities:
(a) To participate in training programs for
				human rights officers offered by the Department;
(b) To inform, train and assist patients in
				the exercise of their rights;
(c)
				To assist patients in obtaining legal information, advice and representation
				through appropriate means, including referral to attorneys or legal advocates
				when appropriate; and
(d) In the
				case of Department facilities, to serve as staff to the facility's human rights
				committee.
The human rights officer must have no day-to-day duties that
				  are in conflict with his or her responsibilities as a human rights officer,
				  including carrying out fact-finding activities under
				  104 CMR 32.00:
Investigation and Reporting Responsibilities
.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.15 - Absence without Authorization

Current through Register 1525, July 5, 2024
(1)
Classification as AWA
. Any patient admitted or
				committed to a Department facility pursuant to M.G.L. c. 123, §§ 7,
				8, 10, 11, 12, 15, 16, 17 or 18, who leaves the facility grounds or an
				off-grounds program or activity without permission and fails to return within a
				reasonable time, or any patient who, having left the facility with permission,
				fails to return at the designated time or within a reasonable time thereafter,
				shall be classified by the facility director as "absent without authorization"
				(AWA).
(2)
Classification as AWA: Action to Be Taken
.
(a)
Immediate
				Classification
. A patient who is admitted or committed pursuant to
				M.G.L. c. 123, §§ 7, 8, 10, 11 or 12 and who is at a high risk of
				harm to self or others or a patient who is committed pursuant to M.G.L. c. 123,
				§§ 15, 16, 17 or 18 who leaves the facility grounds or an off-grounds
				program or activity without permission shall be immediately classified as
				AWA.
(b)
Classification
				by Midnight Census
. A patient who does not meet the criteria of
				104 CMR 27.15(2)(a) shall be classified as AWA if he or she has not returned
				within a reasonable time based on clinical judgment or by the midnight census,
				whichever is earlier.
(c) The
				facility shall take prompt and vigorous measures to secure the patient's
				return.
(d) When a patient is
				classified as AWA, the facility director or designee shall immediately notify
				the following parties:
1.
Local
				and State Police
. The police shall be provided with the patient's
				description, other information that would assist the police in locating the
				patient, and information of the patient's tendencies to be assaultive,
				homicidal, suicidal or to use weapons;
2. the district attorney of the county in
				which the facility is located;
3.
				the patient's next of kin;
4. the
				patient's legally authorized representative;
5. any person known to be placed at risk
				because the patient has left the facility; and
6. designated individuals within the
				Department.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.16 - Records and Records Privacy

Current through Register 1525, July 5, 2024
(1) Each
				facility shall maintain a patient record containing all significant clinical
				information for each patient admitted to the facility. "Patient record" shall
				refer to the medical and psychiatric record of a patient admitted to a facility
				providing care and treatment, and shall not include any financial, statistical
				or bookkeeping records of the facility.
(2)
Contents of Patient
				Record
. A patient record shall include:
(a) identification data, including patient's
				admission status;
(b) admission
				information, including admission diagnosis;
(c) health care proxies and advance
				directives;
(d) history and results
				of physical examination and psychiatric examination or mental status;
(e) consent forms;
(f) social service and nurses' notes, and
				psychological reports;
(g) reports
				of clinical laboratory examinations and X-rays, if any;
(h) reports of diagnostic and therapeutic
				procedures;
(i) diagnoses recorded
				in accordance with the
Diagnostic and Statistical Manual of
				Mental
Disorders (DSM-5),
5th edition published by the American
				  Psychiatric Association;
(j)
				progress notes;
(k) reports of
				periodic reviews;
(l) conclusions,
				including primary and secondary final diagnoses and clinical resume;
(m) all restraint and seclusion orders,
				including comment forms;
(n) legal
				documents, including commitment orders and records of transfer, including
				notices of transfer, advanced directives, guardianship;
(o) records of all placements;
(p) reports of treatment for accidents,
				injuries or severe illnesses while the patient is in the care of the
				facility;
(q) any required risk
				identifications and assessments;
(r) requests for and authorizations to
				disclose information from such individual patient record;
(s) discharge information; and
(t) any other information deemed necessary
				and significant to the care and treatment of the patient.
The patient record shall not include evaluations of
				  competence to stand trial or criminal responsibility conducted pursuant to
				  M.G.L. c. 123, §§ 15 or 16, unless such evaluations have been
				  released to the record by the court that ordered such
				  evaluation.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.17 - Interpreter Services

Current through Register 1525, July 5, 2024
(1) For the
				purposes of 104 CMR 27.17, the following words shall have the following
				meanings:
(a)
Competent
				Interpreter Services
. Interpreter services performed by a person
				who is fluent in English and in the language of a non-English speaker, who is
				trained and proficient in the skill and ethics of interpreting and who is
				knowledgeable about the specialized terms and concepts that need to be
				interpreted for purposes of receiving care and treatment.
(b)
Facility
. A
				Department-operated hospital, community mental health center with inpatient
				unit, or psychiatric unit within a public health hospital; a
				Department-licensed psychiatric hospital; or a Department-licensed psychiatric
				unit within a general hospital.
(c)
Non-English Speaker
. A person who cannot speak or
				understand, or has difficulty speaking or understanding, English because the
				speaker primarily or only uses a spoken language other than English.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart D - OPERATIONAL STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT FACILITIES › Section 27.18 - Substance Use Disorder Treatment Facility

Current through Register 1525, July 5, 2024
(1)
Scope
. The provisions of 104 CMR 27.18 apply to all
				Facilities, or units within a facility, that are operated by the Department of
				Mental Health to provide substance use disorder treatment for adults who are
				subject to an order of involuntary commitment under M.G.L. c. 123, § 35.
				Except as expressly provided in 104 CMR 27.18, no other provisions of
				104 CMR 27.00 shall apply to
				Facilities subject to 104 CMR 27.18.
(2)
Commitment Status under
				M.G.L. c. 123, § 35
. A substance use disorder, as defined in
				105 CMR 164.006:
Definitions
shall qualify as a category of mental illness for
				the purpose of involuntary commitment under M.G.L. c. 123, § 35. A
				substance use disorder shall not qualify as a category of mental illness for
				the purpose of involuntary commitment under any other section of M.G.L. c.
				123.
(3)
Substance Use
				Disorder Treatment Facility (facility)
. Substance use disorder
				treatment facility provides a range of services, including medically monitored
				detoxification, medically assisted treatment and clinical stabilization
				services for adults 18 years of age or older who are subject to an order of
				involuntary commitment under M.G.L. c. 123, § 35.
(4)
Approval to
				Operate
. The facility shall not operate without approval of the
				Department of Public Health. The Department of Public Health shall have the
				right to inspect the facility prior to granting such approval, and at any other
				time, to determine compliance with applicable requirements of
				105 CMR 164.000:
Licensure of Substance Abuse Treatment Programs
.
(5)
Applicable Standards for
				Substance Use Disorder Treatment
. In addition to the operational
				standards of
				104 CMR 27.00, the facility
				shall also meet the requirements for substance use disorder treatment as set
				forth in
				105 CMR
				164.012(D)(3). The facility
				may request a waiver of one or more of these requirements in accordance with
				the provisions of
				105 CMR 164.023:
Waivers
.
(6)
Admission Criteria
. A facility or unit within a
				facility may be designated for a specific population, such as male or female,
				and may restrict admission to members of that population. In addition, only
				patients who meet the following criteria may be admitted to and retained in the
				facility:
(a) The individual must be 18 years
				of age.
(b) The individual must be
				subject to an order of involuntary commitment under the provisions of M.G.L. c.
				123, § 35.
Individuals who meet the admission criteria may be admitted
				  to and retained in the facility only in accordance with the provisions of M.G.L
				  c. 123, § 35.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Section 28.01 - Scope

Current through Register 1525, July 5, 2024
(1)
Scope
.
(a)
									104 CMR 28.00:
Subpart A
applies to all community mental health services
			 which are operated, licensed or contracted for by the Department and
			 establishes standards for such services.
(b)
									104 CMR 28.00:
Subpart B
applies to all residential sites which are subject
			 to licensing pursuant to 104 CMR 28.19 as well as state operated residential
			 sites and establishes standards for such sites.
(c)
									104 CMR 28.00:
Subpart C
applies to all Community Crisis Stabilization
			 Services which are subject to licensing pursuant to 104 CMR 28.19 and
			 establishes standards for such services. Subpart C also specifies provisions of
			 Subpart B that apply to Community Crisis Stabilization Services.
(d)
									104 CMR 28.00:
Subpart D
specifies the residential and Community Crisis
			 Stabilization Services sites that are subject to licensure, and the provisions
			 for enforcement of Subparts A, B and C for all community mental health services
			 which are operated, licensed or contracted for by the Department.
(e) Services and residential sites that are
			 subject to licensure by the Department of Early Education and Care pursuant to
			 M.G.L c. 15D are not subject to licensure under the provisions
			 104 CMR 28.00; provided,
			 however, that provisions of
			 104 CMR 28.00 that do not
			 conflict with licensing requirements of the Department of Early Education and
			 Care shall apply to such services and residential sites if operated or
			 contracted for by the Department. Compliance with such provisions shall be
			 enforced in accordance with 104 CMR 28.19(2)(c).
(f) The Department may waive or exempt by
			 contract certain provisions of
			 104 CMR 28.00 that have no
			 practical application to a particular service, such as services purchased for a
			 specific single person.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart A - STANDARDS FOR COMMUNITY SERVICES › Section 28.02 - Standards to Promote Recovery and Resiliency

Current through Register 1525, July 5, 2024
The Department establishes the following standards to promote
				  recovery and resiliency, and to support and increase the capacity of persons
				  who receive services subject to
				  104 CMR 28.00 for independent
				  living in the community. Providers shall provide services which promote:
(1) Human dignity and respect;
(2) Humane and adequate care, treatment and
				treatment environments;
(3)
				Person-centered planning, self-determination and freedom of choice and personal
				responsibility;
(4) The opportunity
				to receive services which are, to the maximum extent possible, culturally
				competent, adequate, responsive to a person's needs, and least restrictive of a
				person's freedom;
(5) The
				opportunity to move toward independent living; and
(6) The opportunity for normal life
				experiences, even if such experiences may entail an element of risk; provided,
				however, that a person's safety or well-being or that of others shall not be
				unreasonably jeopardized.