reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY › Title 114.6 CMR 10.00 - CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE CARE AT ACUTE CARE HOSPITALS AND FREESTANDING COMMUNITY HEALTH CENTERS › Section 10.08 - Notification

Current through Register 1525, July 5, 2024
Hospitals and Community Health Centers must meet certain
				criteria regarding notification of the availability of Free Care and other
				programs of public assistance to patients.
(1)
Signs
.
(a) Hospitals and Community Health Centers
			 shall post signs, in the inpatient, clinic, emergency admissions/registration
			 areas and in business office areas that are customarily used by patients, that
			 conspicuously inform patients of the availability of financial assistance
			 programs and the location at the Hospital or Community Health Center to apply
			 for such programs.
(b) Signs and
			 print fonts shall be large enough to be clearly visible and legible by patients
			 visiting these areas.
(c) All signs
			 and notices shall be translated into language(s) other than English if such
			 language(s) is primarily spoken by 10% or more of the residents in the
			 Hospital's or Community Health Center's service area.
(d) Signs must notify patients of the
			 availability of financial assistance and of the availability of both Free Care
			 and other programs of public assistance. The following language is suggested,
			 but not required:
1. "Are you unable to pay
			 your hospital bills" Please contact a counselor to assist you with various
			 alternatives." or
2. "Financial
			 assistance is available through this institution. Please contact
			 _____________."
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 1.00 - Scope And Authority › Section 1.01 - Scope of Regulations

Current through Register 1525, July 5, 2024
(1)
Scope of Title
. 115 CMR sets forth the regulations of
			 the Department of Developmental Services, in 115 CMR called the Department. 115
			 CMR applies to the operation of the Department and to the operation and
			 provision of services and supports by public and private programs and
			 facilities that are subject to the Department's jurisdiction.
(2)
Scope of Chapters and
			 Sections
. Unless the contrary is specified in a particular chapter
			 or section of 115 CMR, all categories of services and supports, programs and
			 facilities operated, licensed, certified, or contracted by the Department are
			 subject to all chapters and sections of 115 CMR.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 1.00 - Scope And Authority › Section 1.02 - Authority

Current through Register 1525, July 5, 2024
(1)
Department
. The establishment of the Department was
			 authorized by St. 1986, c. 599 as renamed by St. 2008, c. 182. The Authority of
			 the Department derives primarily from the provisions of M.G.L. c. 19B and
			 M.G.L. c. 123B. All regulations adopted pursuant to M.G.L. chs. 19B and 123B,
			 and any rights arising from such regulations, are subject to appropriation. The
			 Department is the intellectual disability and developmental disability
			 authority in Massachusetts.
(2)
Commissioner
. The Department is under the exclusive
			 supervision and control of the Commissioner of Developmental Services, in 115
			 CMR called the Commissioner. The Commissioner is appointed by the Secretary of
			 Health and Human Services subject to the approval of the Governor.
(3)
Breadth of
			 Services
. The Department's authority to provide services and
			 supports derives from statute and is not restricted by the description of
			 specific types of services or supports in 115 CMR. Nothing in 115 CMR shall be
			 interpreted to prevent the Department from developing and implementing new
			 types or models of services or supports, including but not limited to direct
			 cash assistance or vouchers systems.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 1.00 - Scope And Authority › Section 1.03 - Interagency Agreements with Department of Mental Health

Current through Register 1525, July 5, 2024
Pursuant to M.G.L. c. 19B, § 18, interagency agreements
				between the Commissioner of Mental Health and the Commissioner of Developmental
				Services may be entered into for the coordinated regulation, or for the
				coordinated or joint management, of certain services or supports that may be
				required or that should be provided by both the Department of Mental Health and
				the Department of Developmental Services; provided that no such agreement shall
				conflict with the Department's primary responsibility for individuals in
				accordance with M.G.L. chs. 19B and 123B regardless of whether such persons are
				also mentally ill, nor shall any such agreement deprive any individual who also
				has mental illness from equal access to services offered by the Department of
				Mental Health.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 1.00 - Scope And Authority › Section 1.04 - Severability

Current through Register 1525, July 5, 2024
If any regulation or section, sub-section, sentence, clause,
				phrase or portion thereof is found to be invalid by a court of competent
				jurisdiction for any reason, said portion shall be deemed a separate, distinct,
				and independent provision, and the validity of the remaining portion, if any,
				of the affected regulations or of the other regulations shall not be
				affected.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.01 - Establishment of Regions and Area Offices

Current through Register 1525, July 5, 2024
(1)
Authority
. The
			 Department is authorized by M.G.L. c. 19B, §§ 2 and 12, to establish
			 geographic areas for the organization and provision of services or supports to
			 individuals eligible for such services and supports.
(2)
Regions and Area
			 Offices.
The Department shall establish such Regions and Area
			 Offices and give them official names as it deems necessary and appropriate. The
			 Department mayinits discretion determine the total number of such regions and
			 area offices, as well as their geographic scope of responsibility.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.02 - Advisory Boards

Current through Register 1525, July 5, 2024
(1)
Authority and General Requirements
.
(a)
Authority
. The
			 Department is authorized by M.G.L. c. 19B to provide for boards of trustees at
			 its facilities and for such citizen advisory boards for regions and area
			 offices as
the Commissioner deems appropriate.
(b)
Affirmative
			 Action
. Appointments to the Department's advisory boards shall be
			 made so as to provide for representation of minority groups consistent with all
			 applicable affirmative action requirements.
(c)
Special State
			 Employees
. For purposes of tort claims and conflicts of interest,
			 all appointed members of the Department's advisory boards shall be special
			 state employees.
(d)
Waiver
. With respect to any person nominated for
			 appointment to an advisory board, the qualification standards set forth in
			 115 CMR
			 3.00 may be waived by the Commissioner for good cause
			 except where such standards are otherwise required by law.
(e)
Application of Open Meeting
			 Law
. The meetings of any board established under M.G.L. c.19B or
			 subject to 115 CMR 3.02 shall be subject to the provisions of M.G.L. c. 30A,
			 § 11A½ (the open meeting law), concerning the meetings of
			 governmental bodies.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.03 - Designation of Facilities/State Schools

Current through Register 1525, July 5, 2024
The facilities (formerly referred to as the "state schools" and
				referenced in M.G.L. c. 19B, §§ 7 through 10, 12 as such) and the
				names thereof shall be the following: Paul A. Dever Developmental Center
				(formerly Paul A. Dever State School); Walter E. Fernald Developmental Center
				(formerly Walter E. Fernald State School); Wrentham Developmental Center
				(formerly Wrentham State School); Irving Glavin Regional Center; Hogan Regional
				Center; until January 1, 1995, the J.T. Berry Rehabilitation Center; Monson
				Developmental Center; and Templeton Developmental Center (formerly Templeton
				Campus of Fernald State School).
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.04 - Admission to and Discharge from the Facilities

Current through Register 1525, July 5, 2024
The Department shall maintain a written policy on the standards
				and procedures for admission to and discharge from the facilities listed in
				115 CMR
				3.03. No person shall be admitted to a
				facility without providing informed consent to admission and without the
				approval of the facility director and the Commissioner.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.05 - Charges for Care - Community Residential Services and Supports

Current through Register 1525, July 5, 2024
(1)
Authority
. Under
			 M.G.L. c. 123B, § 16, the Department is authorized to make and regulate
			 charges for care.
(2)
Purpose and Scope
. 115 CMR 3.05 sets forth the rules
			 governing charges for residential services and supports provided at a
			 particular location that either the Department operates or funds through a
			 contract.
			 115 CMR
			 3.00 does not apply to residential services and
			 supports provided at a facility.
(3)
Definitions
. As
			 used in 115 CMR 3.05 and
			 3.06
			 only, the terms listed below have the following definitions :
Fee-payor
means any of the following
				persons, each of whom may be liable for charges for residential services and
				supports of an individual:
(a) the
			 individual who receives residential services and supports;
(b) a guardian, conservator, representative
			 payee or other person who controls funds of the individual; however, the
			 guardian, conservator, representative payee, or other person is liable only
			 with respect to the individual's funds under his/her control.
Fee-payor Charge
means the portion of
				the residential rate to be charged to the fee-payor.
Income
means any monies received,
				including recurrent payments, payments in kind, or lump sum payments.
Liquid Asset
means cash and all
				property capable of ready conversion into cash regardless of whether such
				assets are held jointly or solely. Except as otherwise provided, liquid assets
				do not include life insurance or its cash value for the purpose of calculating
				charges for residential services and supports.
Recurrent Payment
means income
				received at regular intervals, though not necessarily in constant amounts, and
				include, but are not limited to:
(a)
			 compensation for services rendered (earned income);
(b) net income derived from a
			 business;
(c) interest;
(d) net rental income;
(e) dividends;
(f) annuities;
(g) pensions;
(h) unemployment compensation;
(i) worker's compensation;
(j) royalties;
(k) Veteran's Administration
			 benefits;
(l) Supplemental Security
			 Income benefits;
(m) Old Age and
			 Survivor Disability Insurance benefits.
Residential Rate
means the annualized
				rate approved by the Division of Purchased Services pursuant to St. 1992, c.
				133, § 113 and/or the Rate Setting Commission pursuant to M.G.L. c. 6A, or
				pending the approval of such rate, the annualized rate the Department submits
				to the Division of Purchased Services or the Rate Setting Commission for
				residential services and supports to be provided at a particular
				location.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.06 - Charges for Care - Department Facilities

Current through Register 1525, July 5, 2024
(1)
Authority
. Under
			 M.G.L. c. 123B, § 16, the Department is authorized to make charges for
			 care of any person in its facilities.
(2)
Purpose and
			 Scope
. 115 CMR 3.06 sets forth the rules governing charges for
			 residential services and supports at any of the facilities listed in
			 115 CMR
			 3.03.
(3)
Definitions
.
See
115
			 CMR 3.05(3).
(4)
Notice
.
(a) The Department shall give written notice
			 of the charge to each fee-payor:
1. prior to
			 the provision of residential services and supports in the facility, where
			 applicable;
2. prior to a change in
			 the charge;
3. at any other time
			 deemed appropriate by the Department.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.07 - Cafe

Current through Register 1525, July 5, 2024
(1) The facilities
			 listed in
			 115 CMR
			 3.03 may sell food and merchandise in an area
			 or areas designated by the facility director or the cafe committee, appointed
			 pursuant to 115 CMR 3.07(2). Such area or areas in any facility shall be known
			 as the "cafe."
(2) A cafe committee
			 shall be selected by each facility. The facility director or designee shall be
			 the chairperson of this committee which will consist of eight members chosen as
			 representatives of the following groups: facility staff; individuals who are
			 residents; parents or families; facility trustees; organizations concerned with
			 the welfare of individuals who are residents. At least three members of the
			 committee shall not be employees of the Department.
(3) The cafe management shall be the
			 responsibility of an employee or employees selected by the cafe committee. Such
			 employee or employees may be assisted by residents, parents, and
			 volunteers.
(4) Income in excess of
			 the cost of operation of the cafe shall be called the cafe fund. The cafe fund
			 shall be held by the treasurer of the facility. Suitable bond shall be required
			 for employees regularly working in the cafe bar. The cost of such bonds shall
			 be paid from the cafe fund.
(5)
			 Cafe merchandise shall be purchased from the cafe fund. No merchandise or
			 property of the state other than that purchased from the cafe fund shall be
			 sold in the cafe without written approval of the Commissioner or
			 designee.
(6) Inventory of goods
			 shall be kept at a reasonable level consistent with sales and an inventory of
			 goods shall be taken monthly.
(7)
			 Income in excess of cost of the operation of the cafe shall be expended for the
			 benefit of residents. The cafe committee will determine the expenditure of all
			 monies received by the cafe fund consistent with
			 115 CMR
			 3.00.
(8)
			 The cafe committee shall make a quarterly report to the facility treasurer on
			 the income to and expenditures from the cafe fund; and the treasurer shall make
			 an annual re port on the fund's income and expenditures to the Assistant
			 Commissioner with responsibility for management and finance. Such annual report
			 shall be in the form and manner prescribed by the Assistant
			 Commissioner.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.08 - Funds Belonging to Residents

Current through Register 1525, July 5, 2024
(1)
Authority
. The
			 facility director of any facility listed in 115 C MR 3.0 3 is authorized under
			 M.G.L. c. 123B, § 12(a) to deposit in a bank those funds belonging to a
			 resident and to use these funds for the benefit of the resident. 115 CMR 3.08
			 is promulgated pursuant to this authority.
(2)
Definition of
			 Funds
. For the purpose of 115 CMR 3.08,"funds" refer to cash,
			 checks, negotiable instruments, or any other income or liquid personal
			 property.
(3)
Scope
. 115 CMR 3.08 shall apply only to the
			 maintenance and expenditure of an individual's funds which are located within
			 the facility or which are deposited with the facility director or
			 designee.
(4)
Upon
			 Admission and Prior to Evaluation
.
(a)115 CMR 3.08(4) shall apply only from the
			 time of admission of the individual until such time as there has been an
			 evaluation under 115 CMR 3.08(5).
(b) Upon the admission of an individual to a
			 facility, the individual shall be encouraged, but shall not be required, to
			 temporarily deposit any funds and other valuables on his or her person with the
			 facility director or dsignee, pending thee valuation required under 115 CMR
			 3.08(5). The individual shall receive a receipt for his or her funds and
			 valuables.
(c) If any funds are so
			 deposited with the facility, an appropriate written record shall be made of the
			 deposit. A copy of such record shall be made available to the individual or his
			 or her conservator or guardian.
(d)
			 Upon admission of an individual and until such time as there has been an
			 evaluation under 115 CMR 3.08(5), the individual's funds which have been
			 deposited with the facility director or designee, shall be maintained in a safe
			 or in a bank account, provided, however, that if the individual's funds exceed
			 $250 the individual's funds shall be maintained in an individual
			 interest-bearing bank account. The interest which accrues on a bank account
			 shall be added to the individual's funds. Unless the individual has a guardian
			 or conservator, the individual shall have an unrestricted right to manage and
			 spend all of his or her funds in his or her sole discretion until such time as
			 there has been an evaluation under 115 CMR 3.08(5). Availability of funds shall
			 be governed by 115 CMR 3.08(9).
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 3.00 - Administration › Section 3.09 - Protection of Human Rights/Human Rights Committees

Current through Register 1525, July 5, 2024
(1) The head of every provider of
			 residential, day, or site-based respite services ("provider" in 115 CMR 3.09 )
			 and every specialized home care placement agency subject to
			 115
			 CMR 5.00 shall establish and empower a human rights
			 committee in accordance with the requirements of 115 CMR 3.09.
(a) Human rights committees may be
			 established jointly by the heads of more than one provider or placement agency,
			 or to serve as the human rights committee for more than one location where
			 services are delivered by the same provider or agency, provided that:
1. no human rights committee may serve
			 locations or placement agencies in more than one region; and
2. the programmatic diversity of the services
			 being provided are not so great so as to limit the effectiveness of the
			 committee in meeting the requirements of 115 CMR 3.09.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.01 - Enabling Authority

Current through Register 1525, July 5, 2024
The Department is authorized by M.G.L. c. 123B, §§ 2
				and 17, to promulgate regulations governing the creation, maintenance,
				destruction of, and access to, records concerning the admission, treatment and
				periodic review of persons served by any provider under its
				supervision.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.02 - Scope

Current through Register 1525, July 5, 2024
115 CMR
				4.00 governs the creation, maintenance and destruction
				of, and access to, records relating to services and supports provided,
				purchased or arranged for individuals by the Department and shall apply to all
				programs and services or supports which are operated, licensed, certified, or
				contracted by the Department.
				115 CMR
				4.00 applies to all providers, including facilities
				and intermediate care facilities for the mentally retarded (ICF's/MR), and to
				all individual records kept by the Department's area offices, unless greater or
				more limited scope is specified at
				115 CMR
				4.04.
				115 CMR
				4.00 supplements other requirements of the
				Department's regulations which involve records.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.03 - Individual Records

Current through Register 1525, July 5, 2024
(1)
Purpose
. The purposes of 115 CMR 4.03 are to set forth
			 requirements of record keeping to ensure:
(a)
			 Sufficient information to promote coordination and continuity of services and
			 supports;
(b) Sufficient
			 specificity to provide a basis for accountability in the provision of services
			 and supports;
(c) Sufficient
			 flexibility to be no more intrusive to the individual or cumbersome to the
			 provider than is necessary to meet the legitimate service needs of the
			 individual and the documentation needs of the Department; and
(d) Sufficient uniformity in records
			 (organization and types of data collected) to serve as the basis for
			 Departmental service and program planning.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.04 - Additional Requirements Applicable to Some Record Holders

Current through Register 1525, July 5, 2024
(1)
Area offices and
			 Facilities
. In addition to the requirements for individual records
			 listed in
			 115 CMR 4.03,
			 which apply to all providers and area offices holding individual records,
			 individual records maintained by area offices and facilities shall contain the
			 following information:
(a) Date found
			 eligible for Department services;
(b) Address of the individual at the time of
			 entry into Department service system and current address and phone
			 number;
(c) Department area of
			 service;
(d) Historical information
			 on past service providers; and
(e)
			 Status as a class member under the Ricciv. Okin (Civil No. 72-469-T)
			 consolidated consent decree cases of the United States District Court for the
			 District of Massachusetts.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.05 - Confidentiality of Records

Current through Register 1525, July 5, 2024
(1)
Authority
. The Department is required by M.G.L. c.
			 123B, § 17, to keep records regarding all persons served by facilities and
			 other providers under its supervision. Such records are private, but may be
			 disclosed under the circumstances specified by that statute, including when
			 disclosure is in the best interest of the individual who is the subject of the
			 records, in accordance with the Department's regulations. 115 CMR 4.05 and
			 4.06
			 are promulgated pursuant to this authority.
(2)
Requests for Records;
			 Procedures
.
(a) Requests for
			 copies of the record of an individual, to inspect such record, and for
			 information concerning any individual shall be sent to the appropriate designee
			 of the Commissioner with custody of the record.
(b) If such request is denied by such
			 designee, the decision may be reviewed by the appropriate Department official
			 as designated by the Commissioner. The decision of the Department official
			 designated by the Commissioner is subject to further review by the Commissioner
			 whose determination shall be final.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.06 - Access to Records and Record Privacy

Current through Register 1525, July 5, 2024
(1)
Access or Inspection by the Individual, Guardian, or
			 Representative
.
(a) The
			 individual, guardian, designated representative, or other legally authorized
			 representative shall be permitted to inspect and copy the individual's records
			 upon request. Legally authorized representatives shall be permitted to inspect
			 and copy on request only those records relevant to those matters within their
			 authority.
(b) When necessary for
			 the understanding of the individual, guardian, or representative, the staff
			 shall read or interpret the record.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 4.00 - Records › Section 4.07 - Storage and Transfer of Records

Current through Register 1525, July 5, 2024
(1)
Authority
. Under M.G.L. c. 19B, § 15(b), each
			 provider licensed or certified by the Department shall maintain and make
			 available to the Department such statistical and diagnostic data as may be
			 required by the Department. Under M.G.L. c. 123B, § 17, the Department is
			 directed to keep records concerning persons served by providers and facilities
			 under its supervision. 115 CMR 4.07 is promulgated pursuant to this
			 authority.
(2)
Maintenance of Individual Records
. Providers of
			 services operated, licensed, certified, or contracted by the Department shall
			 maintain records concerning the individuals they serve for the periods stated
			 in the Department's official retention and disposal schedule. Providers shall
			 make the records available to the Department for archiving in accordance with
			 such retention and disposal schedule. All individual records held by any
			 provider subject to Department regulation shall be the property of the
			 Department.
(3)
Transfer of Records
.
(a) If an individual will no longer be served
			 by a facility, that facility shall deliver the last three years of the
			 individual's record to the provider that will be serving the individual in the
			 facility's place, if any. The facility shall then maintain the remainder of the
			 individual's records in accordance with the Department's record retention and
			 disposal schedule.
(b) If an
			 individual will no longer be served by a provider that is not a facility, that
			 provider shall make the individual's records available to the Department, who
			 shall deliver the last three years of the individual's record to the provider
			 that will be serving the individual in place of the former provider, if any.
			 The Department shall then maintain the remainder of the records in accordance
			 with its retention and disposal schedule.
(c) If an individual will no longer be served
			 by a particular provider, but no provider will be providing a similar service
			 to the individual, then:
1. if the former
			 provider is a facility or other Department-operated service or support, it
			 shall maintain or archive the individual's records as directed by the facility
			 director or area office director, as appropriate.
2. if the former provider is or was licensed,
			 certified, or contracted by the Department, it shall make the individual's
			 records available to the Department and the Department shall maintain or
			 archive the records in accordance with its retention and disposal
			 schedule;
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.01 - Scope and Enabling Authority

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 115
			 CMR 5.00 applies to all providers and to all services
			 or supports operated, certified, licensed, or contracted for or otherwise
			 funded by the Department.
(2)
Enabling Authority
. The Department is directed by
			 M.G.L. c. 123B, § 2 to adopt regulations that establish procedures and the
			 highest practicable professional standards for the reception, examination,
			 treatment, restraint, transfer and discharge of persons with intellectual
			 disability in public or private facilities for the care and treatment of such
			 persons and for community services for persons with developmental disabilities
			 (autism spectrum disorder and Prader-Willi and Smith-Magenis syndromes). 115
			 CMR is subject to appropriation.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.04 - Other Rights of Individuals

Current through Register 1525, July 5, 2024
Individuals served by providers subject to
				115
				CMR 5.00 shall have, in addition to the rights
				specified elsewhere in 115 CMR or in applicable state or federal laws or
				judicial decrees, the following rights:
(1) The right to communicate, including:
(a) The right to have reasonable access to a
			 telephone, the internet, email, social media and other web-based communication
			 applications and the opportunity to make and receive confidential
			 communications, and to have assistance when desired and necessary to implement
			 this right; and
(b) The right to
			 unrestricted mailing privileges, to have access to stationery and postage, and
			 to assistance when desired and necessary to implement this right.
(c) Any restriction of telephone or internet
			 use must be based upon a demonstrable risk, documented in the individual's
			 record, and promptly provided to the provider's human rights
			 committee.
(d) Such restriction
			 shall be accompanied by a training plan to eliminate the need for the
			 restriction, documented in the individual's Individual Support Plan (ISP), and
			 should be included in a PBSP, if clinically required.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.05 - Mistreatment

Current through Register 1525, July 5, 2024
No provider subject to
				115
				CMR 5.00 shall mistreat an individual or permit the
				mistreatment of an individual by persons in its employ or subject to its
				direction. Mistreatment includes any intentional or negligent action or
				omission which exposes an individual to a serious risk of physical or emotional
				harm. Mistreatment includes, but is not limited to:
(a) Corporal punishment or any other
			 unreasonable use or degree of force or threat of force not necessary to protect
			 the individual or another person from bodily harm;
(b) Infliction of mental or verbal abuse,
			 such as screaming, name calling, or any other activity damaging to the
			 individual's self respect;
(c)
			 Incitement or encouragement of individuals or others to mistreat an
			 individual;
(d) Transfer or the
			 threat of transfer of an individual for punitive reasons;
(e) Termination of services or supports or
			 threat of termination of services or supports for punitive reasons;
(f) Any act in retaliation against an
			 individual for reporting any violation of the Department's
			 regulations;
(g) The use of any
			 restraint as punishment, for the convenience of staff, or otherwise in
			 violation of
			 115 CMR
			 5.11 and
			 5.14;
(h) Sexual abuse of an individual;
(i) Intentional failure to obtain or render
			 medical services;
(j)
			 Misappropriation of an individual's funds; and
(k) Any act in violation of
			 115
			 CMR 5.00.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.06 - Special Sanctions for Violations of Rights of Individuals

Current through Register 1525, July 5, 2024
The following special sanctions shall be available to the
				Department, in addition to those set forth in
				115 CMR 8.00:
Certification, Licensing, and Enforcement
, when deemed
				necessary by the Department to protect the interest of the individual involved
				as well as other individuals who currently or may in the future receive
				services or supports from the provider:
(1) Mistreatment of an individual by a person
			 in the employ or subject to the direction of a provider shall be grounds for
			 suspension or revocation of the certification and license of the provider by
			 the Department.
(2) Department and
			 provider employees are mandated reporters under M.G.L. c. 19C and shall comply
			 with reporting requirements in M.G.L. c. 19C, and 118 CMR:
Disabled
			 Persons Protection Commission
.
(3) Failure of the head of the provider to
			 report any allegation or instance of mistreatment to the Department in
			 accordance with
			 115
			 CMR 5.00 and
			 115 CMR 9.00:
Investigations and Reporting Responsibilities
shall be grounds
			 for action by the Department including revocation or suspension of the
			 certification and license of the provider under
			 115 CMR 8.00:
Certification, Licensing and Enforcement
and, if the provider
			 is the Department, grounds for disciplinary action against the head of the
			 provider (as defined at
			 115 CMR 2.01:
Definitions
), including dismissal.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.07 - Legal Competency, Guardianship, and Conservatorship

Current through Register 1525, July 5, 2024
(1)
All Adults Presumed Competent
			 Absent Court Determination to Contrary
. An individual who has
			 reached 18 years of age shall be presumed to be competent to manage his or her
			 affairs, including to contract, to hold a professional, occupational, or
			 vehicle operator's license; to make a will, or to vote and no individual shall
			 be presumed incompetent solely by reason of receiving services or supports from
			 any provider, or services or support operated, certified, licensed or
			 contracted for by the Department, unless otherwise determined by a court in a
			 guardianship or conservatorship proceeding.
(2)
Safeguarding the Rights of
			 Individuals to Make Financial and Health Care Decisions
.
(a)
Competent
			 Individual
.
1.
Health
			 Care Proxy
. Every competent adult shall have the right to appoint
			 a health care agent by executing a health care proxy in accordance with M.G.L.
			 c. 201D. The standard to show competence to name a health care agent, includes:
a. individual is a competent adult 18 years
			 of age or older;
b. of sound mind;
			 and
c. under no constraint or
			 duress.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.08 - Informed Consent

Current through Register 1525, July 5, 2024
(1) The informed
			 and voluntary consent of the individual or of a guardian if the individual is
			 incapacitated or is not capable of providing informed consent shall be required
			 in the following circumstances:
(a) Prior to
			 admission to a facility;
(b) Prior
			 to medical or other treatment and, with respect to medication, in accordance
			 with
			 115 CMR
			 5.15;
(c) Prior to involvement of the individual in
			 research activities, in accordance with
			 115 CMR
			 10.00:
Research
;
(d) Prior to the initiation of a Targeted or
			 Intensive PBSP, in accordance with
			 115 CMR
			 5.14;
(e) Prior to the initiation of level III
			 interventions, in accordance with 115 CMR 5.14A; and
(f) Prior to the release of personal
			 information to other agencies, providers, or persons, unless there exists one
			 of the situations specified in
			 115 CMR
			 4.06:
Access to Records and Record
			 Privacy
, permitting release without the individual's
			 consent.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.09 - Labor

Current through Register 1525, July 5, 2024
(1) No individual
			 shall be required to perform labor which involves the essential operation and
			 maintenance of the provider or the regular care, treatment, or supervision of
			 other individuals; provided however, that:
(a)
			 Individuals may be expected to perform labor involving normal housekeeping and
			 light home maintenance functions in their own home; and
(b) Individuals may be required to perform
			 labor in accordance with a supervised plan of vocational or habilitation
			 training that is included in their ISP. Such labor shall be compensated to the
			 extent of its economic value, in accordance with applicable state and federal
			 laws regarding wages and hours.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.10 - Possessions (and Funds)

Current through Register 1525, July 5, 2024
(1) No provider
			 subject to
			 115
			 CMR 5.00 shall interfere with the right of an
			 individual to acquire, retain, and dispose of personal possessions unless
			 authorized by a guardian, conservator, or representative payee; the
			 interference or restriction is part of a duly developed and reviewed ISP;
			 ordered by the court; or possession poses an immediate threat of serious
			 physical harm to the individual or other persons. In the event of restriction
			 of possession by the provider on the grounds of imminent and serious physical
			 harm, the provider shall be authorized to place the object in custodial
			 safekeeping for the individual.
(a) Any
			 restriction on personal possessions or funds shall be accompanied by a training
			 plan to eliminate the need for the restriction, documented in the individual's
			 Individual Support Plan (ISP), and should be included in a PBSP, if clinically
			 required.
(b) Such restriction
			 shall be accompanied by a training plan to eliminate the need for the
			 restriction, as appropriate, and documented in the individual's
			 record.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.11 - Crisis Prevention, Response, and Restraint

Current through Register 1525, July 5, 2024
(1)
Crisis Prevention, Response,
			 and Restraint (CPRR)
.
(a)
Restrictive Procedures: Restraint
.
1.
Requirements For
			 Use
. The use of restraints must conform to the requirements set
			 forth in 115 CMR 5.11.
a.
Use
			 Permitted Only in Emergency
. Restraint of an individual with
			 intellectual or developmental disability may be used only in cases of emergency
			 as defined in
			 115 CMR
			 5.02.
b.
Acceptable Restraint
			 Techniques
. Restraint techniques are limited to those contained in
			 the Department approved CPRR curricula and administered by persons trained in
			 the specific restraint(s) that is utilized.
c.
Restraint
			 Debriefing
. Debriefings are required following a restraint for:
i. Persons administering a restraint shall
			 debrief with a staff person identified by the PBS Leadership Team. The
			 debriefing shall include:
(i) review of the
			 technique utilized;
(ii)
			 antecedents to the restraint;
(iii)
			 duration of the restraint; and
(iv)
			 alternative de-escalation strategies that may be employed in the
			 future.
ii. Individuals
			 who are subject to a restraint shall participate in a separate debriefing with
			 trained staff persons who did not participate in administering the restraint in
			 order to support the individual and to mitigate distress that may result after
			 experiencing a restraint. In the event the debriefing is clinically
			 contraindicated, the PBS qualified clinician shall document the reason why the
			 debriefing cannot take place in the restraint form.
iii. Restraint debriefings described in 115
			 CMR 5.11(1)(a)1.c.i. shall be completed within three business days after the
			 time the restraint occurred. The restraint debriefing described in 115 CMR
			 5.11(1)(a)1.c.ii shall be completed within 24 hours after the time the
			 restraint occurred.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.12 - Health-related Supports and Protective Equipment

Current through Register 1525, July 5, 2024
(1)
Supports Needed for an
			 Individual to Achieve Proper Body Position, Balance, or Alignment and
			 Health-related Protective Equipment
.
(a) Health-related supports may be used only
			 to achieve proper body position and balance, to permit the individual to
			 actively participate in ongoing activities without the risk of physical harm
			 from those activities, to prevent re-injury during the time that an injury is
			 healing or to prevent infection of a condition for which the individual is
			 being treated, or to enable provider staff to evacuate an individual who is not
			 capable of evacuation. Devices providing such support include, but are not
			 limited to, orthopedically prescribed appliances, surgical dressings and
			 bandages, protective helmets, and supportive body bands.
(b)
Health-related Protective
			 Equipment
.
1. Health-related
			 protective equipment used during a specific medical or dental procedure for the
			 individual's protection during the time the individual is undergoing treatment
			 or to prevent injury for an ongoing medical condition. For example, the use of
			 a helmet for drop seizures, may only be used when ordered by a physician,
			 dentist, physician assistant, or a nurse practitioner.
2. Health related protective equipment used
			 to prevent risk of harm during challenging self-injurious behavior, for
			 example, a helmet or arm splints, may only be used when authorized by a PBS
			 Qualified Clinician. Protective equipment used to prevent risk of harm during
			 self-injurious behavior may only be used as part of an Intensive PBSP, and is
			 subject to human rights committee review.
(c) Providers must assure all health related
			 supports and protective equipment are:
1.
			 described with specificity in the licensed medical professional's order for
			 health related protective equipment identified in 115 CMR 5.12(1)(b)1. or an
			 Intensive PBSP for health related protective equipment identified in 115 CMR
			 5.12(1)(b)2. by a qualified clinician; and
2. are in good repair and properly
			 applied.
(d)
			 Health-related supports and protective equipment do not constitute an emergency
			 restraint and shall not be used for the convenience of staff.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.13 - Transportation Safety Devices

Current through Register 1525, July 5, 2024
(1) A
			 transportation safety device necessary for the safety of the individual during
			 transportation shall not be deemed a restraint, or a health-related support or
			 protective equipment for purposes of
			 115 CMR
			 5.11 and
			 5.12.
(2) Transportation safety devices are
			 permitted during and limited to transportation of the individual. For purposes
			 of 115 CMR 5.13, "transportation" includes temporary stops during
			 transportation where the individual remains in or near the transporting
			 vehicle.
(3) Use of a
			 transportation safety device, other than the use of standard passenger safety
			 devices (for example, seat belts), shall be the least restrictive method of
			 ensuring passenger safety during transportation, and shall not be used for
			 staff convenience. The specific method of transportation safety device shall be
			 determined on an individualized basis and shall be included in the individual's
			 ISP. Any use of a transportation safety device not approved as part of an ISP
			 shall be reported in accordance with
			 115 CMR
			 13.00:
Incident Reporting
, and with
			 115 CMR 9.00:
Investigation and Reporting Responsibilities
, if the reporter
			 has reasonable cause to believe such use meets a criterion identified in
			 115
			 CMR 9.05(1) through
			 (3).
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.14 - Positive Behavior Supports

Current through Register 1525, July 5, 2024
(1)
Policy
. It is the purpose of the Department, reflected
			 in M.G.L. c. 123B, § 2, and 115 CMR 5.14, "to establish procedures and the
			 highest practicable professional standards" for the treatment of persons with
			 intellectual and developmental disability, and to assure the dignity, health,
			 safety, of its clients. System-wide PBS is a widely accepted and utilized
			 framework for both systems change and individual treatment which supports
			 individuals to grow and reach their maximum potential. PBS emerged from three
			 major sources:
(a) applied behavior
			 analysis;
(b) the
			 normalization/inclusion movement; and
(c) person-centered values.
Journal of Positive Behavior Interventions
,
				Positive Behavior Support: Evolution of an Applied Science," (Carr, Edward,
				Dunlap, Glen, Horner, Robert,
et al
.) Vol. 4, No. 1 (2002).
				PBS provides a means for selecting, organizing and implementing evidenced-based
				practices in the treatment of individuals. It focuses on clearly defined
				outcomes, data-based decision making and problem-solving processes that support
				practices with fidelity and durability. PBS emphasizes the use of positive
				behavior approaches and recognizes that behavior is often an individual's
				response or reaction to the environment and the need to communicate his or her
				preferences and wants to others. Therefore, PBS focuses on environmental
				modifications and antecedents. The strategies used to modify the behavior of
				individuals should involve PBS, which promote the dignity and respect of
				individuals, and should not be unduly restrictive or intrusive. It is both
				sound law and policy to use only procedures which have been determined to be
				the least restrictive or least intrusive alternatives.
Code of Massachusetts Regulations › 115 CMR - DEPARTMENT OF DEVELOPMENTAL SERVICES › Title 115 CMR 5.00 - Standards To Promote Dignity › Section 5.14A - Level III Interventions

Current through Register 1525, July 5, 2024
(1)115
			 CMR 5.14A applies only to Level III interventions permitted pursuant to 115 CMR
			 5.14A(4)(b)4. Level III interventions are allowed under 115 CMR 5.14A subject
			 to the provisions herein. Providers utilizing Level III Interventions must
			 comply with all other requirements of
			 115
			 CMR 5.00, including
			 115 CMR
			 5.11 and
			 115 CMR
			 5.14 with the exception of
			 115 CMR
			 5.14(15)(a)1. and 2.
			 Notwithstanding any provision of 115 CMR 5.14A, nothing in 115 CMR 5.14A is
			 intended to contravene the obligations of the parties set forth in the
			 Settlement Agreement in
Behavior Research, Inst. v. Mary Kay
			 Leonard
, Civ. Action No. 86-0018-GI (Rotenberg, J.) (Bristol County
			 Probate Court) (filed Dec. 12, 1986), subject to any changes in said order or
			 in applicable law.
(2) The
			 following shall be deemed Level III Interventions for purposes of 115 CMR
			 5.14A, provided that no such Level III Intervention may be used except in
			 accordance with the standards and procedures set forth in 115 CMR 5.14A(4)
			 including, without limitation, the special certification requirement of 115 CMR
			 5.14A(4)(f) and the general requirement of 115 CMR 5.14A(4)(b) that a
			 determination be made that the predictable risks, as weighed against the
			 benefits of the procedure, would not pose an unreasonable degree of intrusion,
			 restriction of movement, physical harm or psychological harm:
(a) Any Intervention which involves the
			 contingent application of physical contact aversive stimuli such as spanking,
			 slapping, hitting or contingent skin shock.
(b) Time Out wherein an individual is placed
			 in a room alone for a period of time exceeding 15 minutes.
(c) Any Intervention not listed in 115 CMR
			 5.14A which is highly intrusive and/or highly restrictive of freedom of
			 movement.
(d) Any Intervention
			 which alone, in combination with other Interventions, or as a result of
			 multiple applications of the same Intervention poses a significant risk of
			 physical or psychological harm to the individual.