Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.011 - Social Services

Current through Register 1525, July 5, 2024
(A) Facilities
			 providing Level I, II or III care shall provide for appropriate and sufficient
			 social services to meet the social and emotional needs of residents in
			 accordance with written policies and procedures.
(B) Social services shall be provided either
			 directly by personnel employed by the facility or through written contracts
			 with public or private social agencies, hospitals, clinics or other
			 institutions, or with individual social workers, provided services meet the
			 requirements set out herein, and services are administered in accordance with
			 the facilities' policies and procedures.
(C) Social service supervision shall be
			 provided on a planned basis with sufficient frequency to assure adequate review
			 of social service plans and residents' care.
(D) Social services whether provided directly
			 by the facility or through written contracts shall be integrated with the
			 medical, nursing, activity and other associated resident care
			 services.
(E) The social work
			 staffing of facilities shall be based on the number of residents in the
			 facility rather than on the level of care of the facility.
Social services shall be provided by a MSW social worker or BA
				social worker. If social services are provided by a BA social worker, the
				facility must have a written agreement for social work consultation and
				supervision from a MSW social worker.
(1) All facilities providing care for more
			 than 80 residents shall provide a minimum of one half-time social worker. If
			 the social worker is a BA social worker, the facility shall provide
			 consultation from a MSW social worker for at least eight hours per
			 month.
(2) All facilities providing
			 care for between 40 and 80 residents shall provide the services of a social
			 worker for a minimum of eight hours per week. If the social worker is a BA
			 social worker, appropriate consultation and supervision shall be provided as
			 needed.
(3) All facilities that
			 provide care for fewer than 40 residents shall provide the services of a social
			 worker (MSW or BA) at least four hours per week. If the social worker is a BA
			 social worker, appropriate consultation and supervision shall be provided as
			 needed.
(4) In addition, all
			 facilities shall provide additional social workers and ancillary social service
			 personnel under appropriate supervision to meet the emotional and social needs
			 of the residents.
(5) Facilities
			 providing Level IV care only shall be required to provide social service staff
			 and social services only as indicated by residents' needs.
(a) A CSF, Resident Care Facilities and
			 multi-level facilities with Level IV units with Community Support Residents
			 shall be required to provide or arrange to provide a minimum of one hour of
			 social services per Community Support Resident per month, or more if indicated
			 by the residents' needs.
(b) All
			 social workers providing social services in Level IV facilities shall be
			 licensed according to Board of Registration of Social Workers requirements.
1. Only Master's level licensed social
			 workers will be allowed to provide clinical services, including the development
			 of the Mental Health Treatment Plan for Community Support Residents.
2. LSWs providing clinical services must be
			 supervised by either an LCSW degree or by an LICSW.
(c) Each Community Support Resident shall
			 have a written individualized mental health treatment plan jointly developed by
			 the Community Support Resident and the attending social worker in consultation
			 with the resident's physician, psychiatrist, support services coordinator, and
			 other involved mental health consultants if needed.
The mental health treatment plan shall be developed as soon as
				possible but no later than two weeks after admission. Each plan shall be first
				reviewed by a social worker 30 days after it is first developed and every 90
				days thereafter.
(d)
Content of Mental Health Treatment Plan
. The
			 individual mental health plan should be the focus of the Community Support
			 Resident's plan of care and all other plans should be consistent with this
			 mental health plan. The support plan should include the parts of the mental
			 health plan which require the development of specific activities, arrangement
			 of services, or other specific actions which should be implemented by the
			 Coordinator in conjunction with other facility based staff. The Mental Health
			 Plan should include the following:
1. an
			 annual psychosocial assessment;
2.
			 a psychosocial history that includes the mental health history and clinical
			 diagnoses of the resident;
3. an
			 assessment of a resident's psychosocial strengths, weaknesses and service
			 needs;
4. recommended short and
			 long term treatment goals and objectives, described in clear, specific, and
			 measurable narrative statements;
5.
			 recommended services, agencies and programs to meet the mental health needs of
			 a resident;
6. a recommended
			 starting date for services and the anticipated duration of these
			 services;
7. evaluation procedures,
			 recordings and criteria for determining a resident's progress and how a
			 resident's mental health needs are being addressed;
8. modification(s) of a resident's treatment
			 plan and psychotropic medications and an explanation of the rationale(s) used
			 for modifying the plan, and medications;
9. written record(s) of the results of mental
			 health or psychiatric consultations and written records of the psychotropic
			 medications a resident has received or is receiving.
10. written consent by the resident or his or
			 her guardian.
(e) If a
			 mental health treatment plan is declined by a resident, the attending social
			 worker, in consultation with the resident's psychiatrist and/or physician,
			 shall make all efforts to meet with the resident, to determine how a plan might
			 be developed and/or modified in order to accommodate the resident's objections,
			 concerns, and suggestions. Reasons for partial or total rejection of the plan
			 must be noted in the resident's record.
(6) A SNCFC with a minimum of 40 beds shall
			 provide the services of one full time LCSW who has training and/or experience
			 in developmental disabilities and one full time LSW. For every additional 20
			 beds there shall be provided an additional half-time LSW.