reglab/statecodes huggingface dataset:
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 28.04 - Protection from Mistreatment

Current through Register 1525, July 5, 2024
(1) No provider
				shall mistreat a person or permit the mistreatment of a person by staff subject
				to its direction. Mistreatment includes any intentional or negligent action or
				omission which exposes a person to a serious risk of physical or emotional
				harm. Mistreatment includes, but is not limited to:
(a) Corporal punishment or any unreasonable
				use or degree of force or threat of force;
(b) Infliction of mental or verbal abuse,
				such as abusive screaming or name calling;
(c) Incitement or encouragement of persons or
				others to mistreat a person;
(d)
				Transfer or the threat of transfer of a person for punitive reasons;
(e) The use of restraint as punishment or for
				the convenience of staff; or
(f)
				Any act in retaliation against a person for reporting any violation of the
				provisions of the Department regulations or other provisions of law.
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 28.06 - Medication

Current through Register 1525, July 5, 2024
(1) The following terms as used in 104 CMR
				28.06 shall be defined as follows:
Certified Staff
Unlicensed staff
				  members who are certified to administer medications pursuant to the Medication
				  Administration Program. Certified Staff are authorized to administer
				  medications at MAP registered service sites. These individuals have
				  successfully completed the training and examination requirements established in
				  105
				  CMR 700.003(F)  and 104 CMR
				  28.06(13) to be certified.
MAP Registered Service Site
. The
				  service site has been issued a MAP Massachusetts Controlled Substance
				  Registration by the Department of Public Health to administer medications
				  pursuant
				  105
				  CMR 700.003:
Registration of Persons
				  for a Specific Activity or Activities in Accordance with M.G.L. c. 94C, §
				  7(g)
at the site.
Medication Administration Program
				  (MAP)
. A program administered by the Department of Public Health
				  (DPH) in conjunction with the Department, the Department of Developmental
				  Disabilities and the Department of Children and Families pursuant to
				  105
				  CMR 700.003(F).
Non-self-administering
. Personally
				  taking, consuming or applying medication in the manner directed by the
				  Prescribing Practitioner with more than minimal assistance or direction by
				  provider staff in accordance with the procedures and criteria approved by the
				  Department of Public Health.
Prescribing Practitioner
. A licensed
				  physician, or a Qualified APRN, a licensed dentist, or licensed physician
				  assistant, acting within the scope of applicable practice.
Self-administering
or
Self-administration of Medication
. Personally taking,
				  consuming or applying medication in the manner directed by the Prescribing
				  Practitioner, with no more than minimal assistance, or direction by provider
				  staff in accordance with the procedures and criteria approved by the Department
				  of Public Health.
(2) For
				prescription medication to be administered by a provider, the medication shall
				be prescribed by the Prescribing Practitioner.
(3) Each person receiving medication shall be
				encouraged to see his or her Prescribing Practitioner at clinically appropriate
				intervals, as determined by the Prescribing Practitioner. The prescription
				shall be documented in the person's record together with the following
				information, if provided by the Prescribing Practitioner:
(a) The current dosage;
(b) A reconciliation of all medications being
				taken by the person;
(c) Any signs
				or complaints of neurologic side effects including tardive dyskinesia,
				metabolic syndrome, or other side effects;
(d) The reason for the use of the medication;
				and
(e) The effectiveness of the
				medication.
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 28.07 - Labor

Current through Register 1525, July 5, 2024
(1) No person, other than an employee or
				contractor of the service, shall be required to perform labor which involves
				the essential operation and maintenance of a service site or the regular care,
				treatment or supervision of other persons; provided, however, that:
(a) Persons who reside at a residential site
				may be required to perform labor involving normal housekeeping and home
				maintenance functions;
(b) Persons
				may perform labor in accordance with a planned and supervised program of
				vocational and rehabilitation training as set forth in the person's individual
				service plans or individualized treatment plans.
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 28.08 - Possessions

Current through Register 1525, July 5, 2024
(1) No provider shall interfere with the
				right of a person to acquire, retain and dispose of personally owned property
				unless:
(a) the person is a minor, under
				guardianship or conservatorship, or has had a representative payee
				appointed;
(b) in accordance with
				the provisions of
				104 CMR
				30.02:
Client Funds in Community
				Programs
or
				104
				CMR 30.07:
Disposition of Personal
				Property Abandoned at Facilities or Programs
;
(c) the person possesses contraband or any
				item prohibited by law;
(d) ordered
				by a court of competent jurisdiction; or
(e) possession of such property poses an
				imminent threat of serious physical harm to the person or others.
If the provider takes possession of a person's
				  personally-owned property for the purposes of storage, the provider shall issue
				  a receipt to the person and place the property in
				  safekeeping.
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 28.09 - Records and Record Privacy

Current through Register 1525, July 5, 2024
(1) A provider shall
				ensure that each of its services maintains an individual record of services
				provided to each person served. Such record shall contain accurate, complete,
				timely, and relevant information, and shall be sufficiently detailed to enable
				a person to identify the types of services the person receives.
(a) Records shall be maintained in a
				consistent format that facilitates information retrieval. Records may be
				handwritten, printed, typed or in electronic digital format, or any combination
				thereof.
(b) A provider shall
				employ reasonable physical, technical and administrative safeguards to ensure
				the confidentiality, integrity and availability of records, and shall comply
				with all applicable federal and state laws and regulations.
(c) A person who is the subject of a record,
				or the person's legally authorized representative, who believes that the record
				contains inaccurate or misleading information, may request that it be amended.
				A provider shall respond to such request in accordance with applicable state
				and federal requirements.
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 28.10 - Legal Capacity, Guardianship and Conservatorship

Current through Register 1525, July 5, 2024
(1) No person shall be deemed to be
				incapacitated to manage his or her affairs, to contract, to hold a
				professional, occupational or vehicle operator's license, to make a will, to
				vote or to exercise any other civil or legal right solely by reason of
				enrollment in a service.
(2) All
				persons who are 18 years of age or older shall be presumed to have the legal
				capacity to conduct their personal and financial affairs, unless otherwise
				determined by a court of competent jurisdiction.
(3) In any assessment of capacity, a person's
				need for a guardian, conservator, or for other fiduciary, shall be based on the
				following considerations:
(a) Generally, a
				person shall be determined to be in need of guardianship, conservatorship, or
				other fiduciary services only if the person's capacity to make informed
				decisions concerning his or her life, property, or both is so limited that the
				person lacks the ability to meet essential requirements for physical health,
				safety or self-care. That a person may even routinely make what others consider
				to be poor decisions is not a proper basis for recommending guardianship,
				conservatorship or other fiduciary.
(b) Although the capacity of the person to
				make important decisions is the central benchmark for determining the person's
				need for guardianship, conservatorship or other fiduciary, the capabilities of
				the person's family and other persons with whom the individual is associated,
				particular strengths and weaknesses in the person's living circumstances, and
				the availability and utility of non judicial alternatives to guardianships such
				as trusts, representative payees, citizen advocacy programs, or community
				support services should also be considered and may increase or lessen the
				degree of the person's need; and
(c) The assessment should identify the
				specific areas of the person's functioning which are the basis of the
				recommendation relative to the need for a guardian, conservator or other
				fiduciary, such as inability to respond appropriately to health problems or
				consent to medical care, or inability to manage savings or routine
				expenses.
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 28.11 - Human Rights Committee; Human Rights Officer

Current through Register 1525, July 5, 2024
(1) The provider of a service shall
				establish, appoint and empower at least one Human Rights Committee in
				accordance with the provisions of 104 CMR 28.11. A provider shall establish
				more than one Human Rights Committee if the total number of persons served, or
				the number, geographical separateness, or programmatic diversity of the service
				is so great as to limit the effectiveness of a single Committee in meeting the
				requirements of 104 CMR 28.11 as determined by the Department.
(2) Subject to the approval of the
				Department, a single Human Rights Committee may be established to cover more
				than one service; provided that the total number of persons served, or the
				number, geographical separateness, or programmatic diversity of the services is
				not so great as to limit the effectiveness of the Committee in meeting the
				requirements of 104 CMR 28.11, as approved by the Department.
(3) The general responsibility of the
				Committee shall be to monitor the activities of the service with regard to the
				human rights of persons served by the provider. The specific duties of the
				Committee shall include:
(a) Reviewing and
				making inquiry into complaints and allegations of mistreatment, harm or
				violation of a person's rights and referral of such complaints for
				investigation in accordance with the requirements of
				104 CMR 32.00:
Investigation and Reporting Responsibilities.
(b) Reviewing and monitoring the use of
				physical restraint and other limitations on movement in accordance with
				104
				CMR 28.05.
(c) Reviewing and monitoring the methods
				utilized by the provider to inform persons and staff of persons' rights, to
				train persons served by the provider in the exercise of their rights, and to
				provide persons with opportunities to exercise their rights to the fullest
				extent of their capabilities and interests.
(d) Making recommendations to the provider
				and to the Department to improve the degree to which the human rights of
				persons served by the provider are understood and enforced.
(e) Visiting the service sites of the
				applicable service, including all staffed residential sites as defined in
				104 CMR 28.13,
				at least once per year, with prior notice, or without notice, provided good
				cause exists.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart B - STANDARDS FOR RESIDENTIAL SERVICE SITES › Section 28.14 - Self-preservation Standards

Current through Register 1525, July 5, 2024
(1)
Classification of Persons
.
(a) Self-preservation means the capability
				both mentally and physically to take action to preserve one's own life,
				specifically to egress the building in which one resides unassisted within 2
				1/2 minutes.
(b) The Department and
				Providers shall classify persons residing at each residential site as follows:
1.
Impaired
. An
				impaired person is a person who is not capable of self-preservation, who
				requires physical assistance to exit the building within 2 1/2
				minutes.
2.
Partially
				Impaired
. A partially impaired person is a person who is not
				capable of self-preservation, who is capable of exiting the building within 2
				1/2 minutes without physical assistance, but with supervision and/or
				instruction.
3.
Unimpaired
. An unimpaired person is a person who is
				capable of self-preservation, who is capable of exiting the building within 2
				1/2 minutes without physical assistance and/or supervision or
				instruction.
(c)
Procedures and Documentation Requirements for Person
				Classification
.
1. The provider
				shall conduct a test of the person's ability to exit the building from the
				person's sleeping quarters, and common areas if more remote, prior to placement
				into the service; except that a provider may classify a person as impaired
				without such a test.
2. Test
				documentation shall include the time required to exit the building, the type of
				assistance required, if any, either physical or verbal, date of testing, and
				name of the person(s) conducting the test.
3. Test results shall be documented in the
				person's record.
4. The provider
				shall keep a central record of the classification of each person in the
				residential site.
5. Except for a
				residence or apartment for up to four persons in which all of the residents are
				capable of self-preservation, testing for person classification shall be
				conducted at least quarterly, and may be part of the quarterly fire drill.
				Where quarterly fire drills are not required self-preservation testing shall be
				conducted at least annually.
6. No
				person shall have his or her status changed to a less restrictive
				classification without substantiating documentation for at least two
				consecutive tests, which shall be conducted at least one week apart.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart C - STANDARDS FOR COMMUNITY CRISIS STABILIZATION SERVICES › Section 28.15 - General Provisions

Current through Register 1525, July 5, 2024
(1)
Licensing
. All providers of Community Crisis
				Stabilization Services (CCS) are subject to licensure by the Department
				pursuant to 104 CMR 28.19.
(2)
Types of Licenses
. Licensed providers shall be issued
				a single license which may incorporate one or more of the following classes:
(a)
Class I
. License
				to provide CCS services to adults, 18 years of age or older.
(b)
Class II
.
				License to provide CCS services to youth, 13 years of age up to and including
				18 years of age.
(c)
Class III
. License to provide CCS services to youth,
				up to, and including, 12 years of age.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart C - STANDARDS FOR COMMUNITY CRISIS STABILIZATION SERVICES › Section 28.16 - Community Crisis Stabilization Services for Adults (ACS)

Current through Register 1525, July 5, 2024
(1) Adult Crisis Stabilization (ACS) is a
				sub-acute community-based mental health treatment service for adults with
				mental illness, substance use disorder or comorbid mental illness and substance
				use disorders who are in need of staff-secure, safe and structured short-term
				crisis stabilization and treatment in a 24-hour unlocked community treatment
				setting. ACS serves as a medically necessary, less restrictive and voluntary
				alternative to inpatient psychiatric hospitalization. Although this service is
				primarily designed as an alternative to and diversion from inpatient care, it
				may also be used as a transition from an inpatient setting, provided there is
				sufficient capacity, and the admission criteria are met.
(2) The primary objective of ACS is to
				restore or improve functioning; strengthen the resources and capacities of the
				person served and family or other natural supports; provide a timely return to
				a natural, least restrictive setting; develop a crisis/safety and
				wellness/recovery plan; and facilitate linkages to medically necessary services
				and supports. While the anticipated length of stay for this service is seven
				days or less, a person's actual length of stay is based on the documented
				clinical assessment.
(3) Minimum
				service components shall include crisis prevention, stabilization and treatment
				by a multidisciplinary team; initial and continuing bio-psychosocial
				assessment; care coordination; psychiatric evaluation and medication
				management, including bridging and induction onto FDA approved medication(s) to
				treat opioid use disorder (MOUD) as clinically appropriate; peer support and/or
				other recovery-oriented services including relapse prevention and recovery
				maintenance counseling and education; mobilization of and coordination with
				family and other natural supports, community treaters, and other resources; and
				psycho-education, including providing education and information about recovery,
				wellness, crisis self-management, and how to access wellness and recovery
				services available in the person's specific community.
(4)
Admission
				Criteria
. Persons who meet the following criteria may be admitted
				to an adult Class I licensed service:
(a) The
				person must be 18 years of age or older.
(b) The person must demonstrate symptoms
				consistent with a diagnosis specified within the current edition of the
				Diagnostic and Statistical Manual of Mental Disorders (DSM), which can
				reasonably be expected to respond to short term, structured treatment
				intervention.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart C - STANDARDS FOR COMMUNITY CRISIS STABILIZATION SERVICES › Section 28.17 - Community Crisis Stabilization Services for Youth (YCS)

Current through Register 1525, July 5, 2024
(1) Youth Crisis Stabilization (YCS) is a
				sub-acute community-based mental health treatment service for youth who have
				emotional or behavioral issues or comorbid emotional or behavioral issues with
				substance use disorders who are in need of crisis stabilization in a 24-hour
				unlocked community treatment setting.
(2) The primary objective of YCS is to
				provide short-term (one to five days) crisis stabilization, therapeutic
				intervention, and specialized programming with a high degree of supervision and
				structure. YCS is designed to improve functioning; strengthen the resources and
				capacities of the youth, family, and other natural supports; and ensure a
				timely return to the youth's previous living environment. While the anticipated
				length of stay for this service is one to five days, a person's actual length
				of stay is based on the documented clinical assessment.
(3) Services shall include comprehensive
				assessment and treatment by a multidisciplinary team; psychiatric evaluation,
				substance use screenings, pharmacological assessment, nursing; individual,
				group, and family therapy; care coordination; family consultation; peer and
				family support; and discharge and transition planning, including referrals for
				post discharge assessment and treatment of substance use disorders. The YCS
				provider must develop a comprehensive, multi-disciplinary, and individualized
				treatment plan that is frequently reviewed and updated based on the youth's
				clinical status and response to treatment. The treatment plan shall include
				provision for the coordination of services with the youth's existing or newly
				established treatment provider(s).
(4)
Admission
				Criteria
. Persons who meet the following criteria may be admitted
				to a YCS service for youth:
(a) The person
				shall be 13 years of age up to and including 18 years of age for admission to a
				Class II licensed service and 12 years of age or younger for admission to a
				Class III licensed service.
(b) The
				person must demonstrate symptoms consistent with a diagnosis specified in the
				current edition of the DSM which requires and can be reasonably expected to
				respond to therapeutic intervention within a brief period.
(c) The person must be experiencing a serious
				emotional or behavioral challenge in the home, school, or community, and is not
				sufficiently stable, emotionally or behaviorally, to be treated outside of a
				highly structured, 24-hour therapeutic environment.
(d) The person must require intensive
				treatment intervention to stabilize their acute mental health needs and need
				extra support, linkage and services.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart D - LICENSING REQUIREMENTS AND COMPLIANCE WITH STANDARDS › Section 28.19 - General Provisions

Current through Register 1525, July 5, 2024
104 CMR 28.19 through 28.21 describes the residential and
				  community crisis stabilization 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.
(1)
Sites
				Subject to Licensure, Requirements
.
(a)
Residential Sites Operated
				under Contract with the Department
. A license is required for
				providers under contract with the Department for each residential site where
				one or more persons reside, or are provided with sleeping accommodations, and
				the provider has a direct or indirect ownership interest, or leases or
				co-leases.
1. If the provider is a guarantor
				of a person's residential lease, the provider is not required to obtain a
				residential site license for the leased property; provided, however, the
				Director of the service shall provide the Area Director or designee with a
				letter attesting that the leased property meets applicable health, safety and
				fire codes. For good cause the Department may require a site inspection to
				assess the general condition of the leased property.
2. A license is not required for residential
				sites located outside of the state or licensed by another Massachusetts
				agency.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart D - LICENSING REQUIREMENTS AND COMPLIANCE WITH STANDARDS › Section 28.20 - Process for Obtaining or Renewing a License

Current through Register 1525, July 5, 2024
(1)
Application Process for
				License or Renewal
.
(a) Any
				applicant seeking to obtain a license for a residential site or a Community
				Crisis Stabilization Service (CCS) site as specified in
				104 CMR 28.00:
Subpart D
shall file an application in writing with the
				Department in a manner and on a form prescribed by the Department. The
				applicant must be the agency or person with principal legal responsibility for
				the administration and operation of a residential site.
(b) If any agency or individual operates more
				than one residential or CCS service site, such agency or individual must apply
				for a separate license for each such site.
(c) Any agency or person seeking to renew a
				license shall file an application for such renewal in writing with the
				Department, in a manner and on a form prescribed by the Department, not less
				than 90 days prior to the date of expiration of its current license. It shall
				be the responsibility of the Department to act upon an application for renewal
				within the 90-day period. Failure to do so shall not invalidate a previously
				existing license.
(d) A licensing
				applicant shall maintain the following documentation which shall be made
				available to the Department upon request:
1.
				For business corporations that are for profit, a copy of an Administration and
				Finance Form 4-A, together with any special or periodic reports submitted in
				amendment or supplementation to the annual report, as well as a copy of the
				Articles of Incorporation and by- laws.
2. For nonprofit corporations, a copy of the
				last annual report filed with the Secretary of the Commonwealth pursuant to
				M.G.L. c. 180, § 26A, together with any special or periodic reports
				submitted in amendment or supplementation to the annual report, and a certified
				copy of the last annual report filed with the Office of the Attorney General
				pursuant to M.G.L. c. 12, § 8F; as well as, a copy of the Articles of
				Incorporation and by-laws.
3. A
				list of the names of all persons with any financial interest in the provider
				including, but not limited to, persons with ownership interests in the building
				or buildings used by the provider, paid or unpaid directors, shareholders,
				partners, loan creditor mortgagees, salaried employees and consultants. The
				financial interest statement shall be updated as necessary to accommodate
				changes.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 28.00 - Licensing and Operational Standards for Community Services › Subpart D - LICENSING REQUIREMENTS AND COMPLIANCE WITH STANDARDS › Section 28.21 - Licensing, Compliance and Enforcement

Current through Register 1525, July 5, 2024
(1)
Departmental Inspection
.
(a) Any employee or agent of the Department,
				including a consultant providing services for the Department, authorized by the
				Area Director or the Office of Community Licensing, may visit and inspect
				residential or CCS sites subject to
				104 CMR 28.00, and any
				service site of the service or program of which the residential site is a part,
				to determine whether such sites are in compliance with law, including the
				regulations of the Department.
(b)
				The Department shall inspect each licensed residential or CCS site at least
				annually and more frequently if deemed necessary.
(c) Inspections should ordinarily be made
				with prior notice and at reasonable times, giving due regard to the privacy of
				the persons and the interruption that inspection may cause. However, the
				Department shall have the right to inspect any site at any time without prior
				notice providing good cause exists.
(d) Refusal to permit an inspection in
				accordance with 104 CMR 28.21 shall be grounds for suspension or revocation of
				a license.
(e) The personal
				belongings and clothing of persons shall not be subject to inspection by the
				Department; provided, however that storage spaces, including, but not limited
				to closets and storage areas may be inspected for purposes of determining
				compliance with applicable health and safety standards and the structural
				integrity of the site.
(f) The
				scope of the Department's inspections shall include any aspect of the operation
				of the site or provider and may include, but is not limited to, confidential
				interviews with persons and staff, and examination and review of all
				records.
(g) The Department shall
				provide a copy of the inspection report to the provider; provided, however,
				that confidential information concerning persons shall not be disclosed except
				in accordance with the confidentiality requirements of
				104 CMR
				28.09.
(h) The contents of a Department inspection
				report are subject to the Massachusetts Public Records law, including all
				exemptions to disclosure.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.01 - Scope and Purpose

Current through Register 1525, July 5, 2024
(1)
Scope
.
			 104 CMR
			 29.00 applies to the application for and the provision
			 of DMH services in community programs and services that are contracted for, or
			 operated by the Department.
(2)
Purpose
.
			 104 CMR
			 29.00 is issued to provide a framework by which DMH
			 services are provided in the community to adults with serious and long term
			 mental illness and children and youth with serious emotional
			 disturbance.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.03 - General Provisions

Current through Register 1525, July 5, 2024
(1) The Department
			 is responsible for providing or arranging for DMH services to adults with
			 serious and long term mental illness, and children and youth with serious
			 emotional disturbance, who are determined to meet clinical criteria and to need
			 DMH services. DMH services are provided along a continuum of intensity, and are
			 authorized in accordance with individuals' needs, as determined pursuant to
			 104 CMR
			 29.00. DMH service planning activities include
			 provisions for transitions between levels of intensity as individuals' needs
			 may change. An individual will only be authorized to receive a DMH community
			 service if the Department has the available capacity and resources to provide
			 the DMH community service.
(2) To
			 be authorized to receive a DMH service, an individual must:
(a) be domiciled within
			 Massachusetts;
(b) meet the
			 clinical criteria set forth in
			 104
			 CMR 29.04(3); and
(c) be determined to need a DMH service in
			 accordance with
			 104
			 CMR 29.04(4).
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.05 - Case Management

Current through Register 1525, July 5, 2024
(1) Individuals who
			 are determined to need Case Management shall be referred to the appropriate
			 case management office.
(2)
Case Management
. Case Management shall include:
(a) arranging for and completing
			 comprehensive assessments of service needs;
(b) convening service planning
			 meetings;
(c) developing and
			 reviewing individual service plans;
(d) reviewing community service plans, when
			 applicable, to ensure compatibility with clients' individual service
			 plans;
(e) assisting clients in
			 obtaining other available services from public or private entities as are
			 identified in clients' individual service plans, including behavioral health
			 and medical benefits available through commercial and publicly funded health
			 plans and programs;
(f)
			 coordinating services for clients, and/or monitoring the coordination of DMH
			 and non DMH services;
(g) providing
			 outreach, as needed;
(h) providing
			 intensive support and advocacy, as needed;
(i) reviewing private and public health plan
			 entitlements and options to assist the client in selecting third party benefits
			 that best match service needs and maintain continuity of care;
(j) other services within the scope of the
			 Medicaid service known as targeted case management.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.06 - General Provisions for All DMH Services Planning Activities

Current through Register 1525, July 5, 2024
(1) Planning activities incorporate
			 strengths, preferences, service needs and goals of clients, and where
			 appropriate, of their families and include assessments, the development and
			 review of individual service plans and community service plans. Clients who
			 receive Case Management will have individual service plans developed in
			 accordance
			 104
			 CMR 29.06 and
			 104
			 CMR 29.07. Clients who receive DMH community
			 services will have community service plans developed in accordance with
			 104
			 CMR 29.06 and
			 104
			 CMR 29.11.
(2) DMH Services planning activities are:
(a) trauma informed, person centered, and
			 strength based; and when the client is a youth, are also youth guided and
			 family driven;
(b) sensitive and
			 responsive to a client's cultural, ethnic, linguistic background, sexual
			 orientation, gender identity, parental status, and other individual family
			 needs, where appropriate;
(c) based
			 on the results of assessments which are reviewed and modified as the client's
			 service needs, preferences or circumstances change;
(d) informed by information obtained through
			 interactions with the client, when appropriate the client's family, other
			 natural supports, and the client's service providers with the appropriate
			 authorizations, as well as previous records as available;
(e) conducted in the client's preferred
			 language by staff fluent in the language or through competent interpreters;
			 and
(f) coordinated with the
			 client, the client's legally authorized representative, current and potential
			 service providers, other Department staff, and any other person, including
			 family members, whose participation is requested or consented to by the client
			 or the client's legally authorized representative.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.07 - Individual Service Plans

Current through Register 1525, July 5, 2024
(1) Each client who
			 receives Case Management shall have a written individual service plan based on
			 a comprehensive assessment of service needs conducted in accordance with
			 104
			 CMR 29.07(2)  and developed
			 in accordance with
			 104
			 CMR 29.07; provided however, for individuals
			 who receive critical need case management or transition case management, the
			 content and time frame for conducting the assessment of service needs and
			 development of an individual service plan may be modified consistent with the
			 reasons for which critical need case management or transition case management
			 was approved pursuant to
			 104
			 CMR 29.05(3).
(2)
Comprehensive Assessment of
			 Service Needs
. The individual service plan shall be based on a
			 comprehensive assessment of the client's strengths, preferences, service needs
			 and goals.
(a) The case manager shall arrange
			 for and complete a comprehensive assessment of the client's service needs
			 within 20 business days of assignment, unless an extension is granted by the
			 Area Director or designee.
(b) The
			 comprehensive assessment of service needs shall include review of the documents
			 submitted with the client's application and other records, as needed; a
			 personal interview with the client that will include, but not be limited to,
			 identification of the client's service preferences and recovery goals; an
			 interview with the client's legally authorized representative; and interviews
			 with other persons as agreed upon by the case manager and the client or the
			 client's legally authorized representative, and shall be documented using a
			 Department approved report form.
(c) The comprehensive assessment of service
			 needs shall be updated at least once each year before the completion of the
			 annual individual service plan review provided in
			 104
			 CMR 29.09.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.08 - Acceptance or Rejection of the Individual Service Plan

Current through Register 1525, July 5, 2024
(1) Once the written individual service plan
			 is complete, it shall be given to the client and, if applicable, the client's
			 legally authorized representative for acceptance or rejection.
(a) Upon acceptance by the client or the
			 client's legally authorized representative, the individual service plan shall
			 be implemented.
(b) If the client
			 or the client's legally authorized representative does not reject the
			 individual service plan within 20 days of receipt, the plan shall be deemed to
			 be accepted.
(c) If the client, or
			 the client's legally authorized representative rejects some or all of the
			 services identified in the individual service plan, the case manager shall
			 record this rejection in the client's record and shall inform the client's of
			 the right to meet with the case manager within five business days of the
			 rejection to discuss the individual service plan and possible modifications. If
			 agreement regarding any such modifications is not reached and the client or the
			 client's legally authorized representative continues to reject the proposed
			 plan, the client, or the client's legally authorized representative may appeal
			 the individual service plan pursuant to
			 104
			 CMR 29.16.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.09 - Annual Review of the Individual Service Plan

Current through Register 1525, July 5, 2024
(1)
			 No later than one year from the date of the last completed or substantially
			 modified individual service plan, the case manager, the client, and the
			 client's legally authorized representative shall complete a review of the
			 client's individual service plan. The purpose of this review is to:
(a) ensure that treatment and services
			 continue to be consistent with the client's strengths, preferences, service
			 needs and goals as identified in the comprehensive assessment of needs, as it
			 may have been revised;
(b)
			 determine whether there has been progress toward attainment of goals and
			 objectives stated in the client's individual service plan;
(c) ensure services continue to be, to the
			 maximum extent possible, consistent with the client's strengths, preferences,
			 service needs, and goals; and where appropriate, the strengths, preferences,
			 service needs, and goals of the client's family, and with the goals of the
			 individual service plan and are provided in the least restrictive
			 setting;
(d) to reassess, if
			 appropriate, the client's need for a guardian, or other fiduciary;
			 and
(e) ensure the client's
			 community service plans, if any, continue to be compatible with the individual
			 service plan and to determine if service goals have been met.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.10 - Modification of the Individual Service Plan

Current through Register 1525, July 5, 2024
(1)
			 Requests for modification of an individual service plan may be initiated by the
			 client, the client's legally authorized representative, the client's DMH
			 community service provider(s), or the client's case manager.
(2) Modifications shall be made in an
			 individual service plan whenever it is determined at an annual review or at any
			 other time, in accordance with the service planning procedures required by
			 104 CMR
			 29.00, that such a change will permit the client to
			 receive more appropriate or less restrictive services consistent with the
			 client's strengths, preferences, service needs and goals, or that the client no
			 longer needs a service or services.
(3) No modification of an individual service
			 plan shall be made without the acceptance of the client or the client's legally
			 authorized representative unless it is determined that the modification is
			 required:
(a) to comply with state contracting
			 requirements (
e.g
., that compliance with state purchase of
			 service regulations or other applicable contracting requirements requires a
			 change in a service provider); or
(b) to avoid a serious or immediate threat to
			 the health, mental health or safety of the client or other persons.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.11 - Community Service Plans

Current through Register 1525, July 5, 2024
(1) Each client who
			 receives a DMH community service shall have a community service plan that is
			 consistent with applicable service standards. The plan shall be developed by
			 the program that provides the service, together with the client, and the
			 client's legally authorized representative and family members, if appropriate,
			 and in collaboration with other service providers, if applicable.
(2)
General
			 Provisions
.
(a) In accordance
			 with applicable service standards:
1.
			 Community service plans are based on assessments, including clinical
			 assessments, conducted or arranged for by the program that provides the
			 community service, as appropriate.
2. To the maximum extent possible, community
			 service plans should reflect the strengths, preferences, service needs and
			 goals of the client and family, as appropriate.
3. Community service plans contain measurable
			 criteria for the completion of the service and anticipated transition
			 plan.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.12 - Acceptance or Rejection of the Community Service Plan

Current through Register 1525, July 5, 2024
(1) Once the written community service plan
			 is complete, it shall be given to the client or the client's legally authorized
			 representative for acceptance or rejection.
(a) Upon acceptance by the client or the
			 client's legally authorized representative, the community service plan shall be
			 implemented.
(b) If the client, or
			 the client's legally authorized representative, does not object to the
			 community service plan within 20 days of receipt, the plan shall be deemed to
			 be accepted.
(c) If the client, or
			 the client's legally authorized representative, rejects some or all of the
			 community service plan, the program shall inform the client's of the right to
			 meet to discuss the community service plan and to discuss possible
			 modifications.
(d) If agreement
			 regarding any such modifications is not reached and the client or the client's
			 legally authorized representative continues to reject the proposed plan, the
			 client or the client's legally authorized representative may appeal the plan
			 pursuant to
			 104
			 CMR 29.16.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.13 - Review of the Community Service Plan

Current through Register 1525, July 5, 2024
(1) All
			 community service plans are reviewed by the provider together with the client
			 and the client's legally authorized representative at least annually, or at
			 intervals determined by the applicable service standards, as needs change, or
			 upon the request of the client, or the client's legally authorized
			 representative. The purpose of this review is to:
(a) evaluate the client's progress and
			 current status in meeting the goals set forth in the community service plan;
			 and
(b) evaluate whether the
			 services, goals, objectives, and interventions continue to be consistent with
			 the client's strengths, preferences, service needs, goals and individual
			 service plan, if any, and to modify the community service plan as appropriate,
			 and to determine if service goals have been met.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.14 - Transition from DMH Services to Other Levels of Service

Current through Register 1525, July 5, 2024
(1) If upon redetermination in accordance
			 with 104 CMR 29.04, the Area
			 Director or designee determines that the client no longer meets the clinical
			 criteria for DMH services or no longer needs such services, a date will be set
			 for transition planning to other levels of service, as appropriate. The Area
			 Director or designee shall:
(a) notify the
			 client and the client's legally authorized representative of the basis for the
			 determination and, the date that transition planning will begin;
(b) notify the client and the client's
			 legally authorized representative of the right to appeal the determination
			 based on clinical criteria pursuant to
			 104
			 CMR 29.16(3)  or based on
			 need for DMH services pursuant to
			 104
			 CMR 29.16(4);
(c) note the determination in the applicable
			 community record;
(d) engage the
			 client in transition planning to the fullest extent possible and state on the
			 individual plan, if applicable, a transition plan with appropriate follow-up
			 services, the name and contact information of the agency or person, if any,
			 responsible for the provision of future services to the individual, or state
			 that no further services are currently needed.
Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals › Section 29.15 - Requests for Discharge from Services; Disengagement from Services

Current through Register 1525, July 5, 2024
(1) If a client or the client's legally
			 authorized representative requests discharge from DMH services, the request
			 will be referred to the Area Director or designee for review.
(a) If the Area Director or designee concurs
			 with the request, the client shall be discharged.
(b) If such request is against the advice of
			 the Area Director or designee, the Department shall direct efforts, for a
			 reasonable period of time, to encourage the client or the client's legally
			 authorized representative to continue such services. If, notwithstanding such
			 efforts, the client or the client's legally authorized representative still
			 requests discharge, the client shall be discharged. Efforts to encourage
			 continued participation and discharge from services shall be documented in the
			 client's record.