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 27.03 - Licensing; Generally

Current through Register 1525, July 5, 2024
(1) Pursuant to
				M.G.L. c. 19, the Department is responsible for developing and maintaining a
				comprehensive area-based system of mental health services for citizens of the
				Commonwealth. Critical to fulfilling this responsibility is striving to assure
				that individuals in need of mental health services are able to access those
				services in a timely manner and from a geographically reasonable location.
				Facilities licensed in accordance with
				104 CMR 27.00 fill an
				essential role in the Commonwealth's mental health service system and as such
				must be operated so as to meet the mental health needs of the Commonwealth as a
				whole as such needs may be determined from time to time by the
				Department.
(2) In determining the
				needs of the Commonwealth, the Department shall consider the health needs of
				persons with a mental illness in the commonwealth, including underserved
				populations and persons with co-occurring mental illness and substance use
				disorder, and in particular shall evaluate whether individuals have access to
				the appropriate services that meet their specific behavioral health care needs
				in a timely manner and, where possible, a geographically appropriate location.
				The Department will evaluate factors across the delivery system including, but
				not limited to, the number of beds in facilities that are licensed pursuant to
				104 CMR 27.00 and in
				operation, by region and by license type,
i.e
., general
				psychiatric services, or services for specialty populations.
(3) The Department will review the needs of
				the Commonwealth no less frequently than biannually to determine sufficiency of
				licensed capacity for general and specialty populations and in conducting such
				review may consider factors including, but not be limited to, emergency
				department utilization and wait time, inpatient utilization and wait time, and
				judicial referrals. In conducting this review, the Department will consult with
				stakeholders including, but not limited to, commercial and public payers,
				emergency departments, inpatient facilities, intermediate care providers, and
				patients, and shall consult with and utilize data from the Department of Public
				Health, the Center for Health Information and Analysis, and the Health Policy
				Commission.
(4) All private, county
				or municipal mental health facilities are subject to licensing by the
				Department pursuant to M.G.L. c. 19, § 19. A hospital, clinic or nursing
				home licensed by the Department of Public Health under M.G.L. c. 111 which
				admits persons with mental illness only on voluntary status, need not be
				licensed by the Department of Mental Health. All other hospitals licensed by
				the Department of Public Health which admit persons with mental illness on any
				admission status other than, or in addition to, voluntary status pursuant to
				104 CMR 27.00, Subpart C
				shall also be licensed by the Department of Mental Health.
(5)
General and Specialty
				Populations
.
(a) The Department
				may establish clinical competencies and additional operational standards for
				care and treatment of patients admitted to facilities licensed pursuant to
				104 CMR 27.00, including for
				specialty populations. Clinical competencies and operational standards
				established by the Department shall incorporate national and local standards of
				practice where such standards of practice exist, and to the extent deemed
				appropriate by the Department.
(b)
				No facility shall hold itself out as providing specialized care for
				population(s) for which the Department has established clinical competencies
				and operational standards, nor shall any facility preferentially admit patients
				within such population(s), unless it has applied for and received a license
				certifying that the facility meets the applicable clinical competencies and
				operational standards for care and treatment of the specialty
				population(s).
(c) Nothing in 104
				CMR 27.03(5) shall permit a facility to have exclusion criteria that would
				result in the refusal to admit a patient who meets the general admission
				criteria for the facility, based solely upon the determination that the patient
				may also meet the criteria for a specialty population.