Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 413.00 - Payments for Youth Intermediate-term Stabilization Services › Section 413.02 - Definitions

Current through Register 1525, July 5, 2024
As used in 101 CMR 413.00, unless the context requires
				otherwise, terms have the meanings in
				101
				CMR 413.02.
Add-on Rate
. A rate that is intended
				to provide an additional, necessary programmatic or client specific service,
				not included in the current programmatic model, which will be instituted at the
				discretion of the purchasing governmental unit.
Adjudicated Youth Residential
				Treatment
. Post-assessment programs that are either hardware-or
				staff-secure for clients 12 through 20 years of age committed by the juvenile
				court to the care and custody of the Department of Youth Services (DYS). These
				programs are characterized by physical (by means of both staffing and hardware)
				and behavior management, clinical and health services, education, recreation,
				and family support. These programs also undertake community transition
				assistance, among other services, in a fully integrated manner with the goal of
				reducing risk and/or need and preparing the client for reentry into the
				community.
Client
. A child, adolescent, or young
				adult receiving youth intermediate-term stabilization services purchased by a
				governmental unit.
Clinically Intensive Residential Treatment Program
				(CIRT)
. Residential care that is a comprehensive strength-based,
				trauma-informed, skill-oriented treatment.
Clinically Intensive Youth Residential Substance
				Use Disorder Treatment
. Residential programs for clients 13
				through 17 years of age that include gender specific services for medically
				stable youth with substance use disorders. Each youth participates in highly
				structured, developmentally appropriate individual, group, and family clinical
				services in addition to having his or her medical and psychiatric needs
				addressed.
Community-based Services
. Treatment
				options provided in a community setting where the client and his or her family
				typically live, work, or recreate.
Community Services Network (CSN)
.
				Regional community services teams that effectively integrate the DYS casework
				staff with provider agency support staff in a combined effort to deliver high
				quality, individualized, and culturally responsive services and supports to the
				youth and families served by DYS. CSN programs provide service locations for
				youth who have completed residential stays and are returning to their home
				communities. Services provided by CSN include education, clinical treatment,
				and accountability (rewards and sanctions), as well as recreational activities
				and community service.
Community Treatment Residence
. A
				residential service that provides clients with moderate behavioral health needs
				a therapeutic milieu for receiving individualized treatment, rehabilitation,
				training in life skills, and supportive services to promote permanency in a
				family-based environment or, as developmentally appropriate, community living
				with permanency.
Continuum/Intensive Home-based Therapeutic
				Care
. This program is an integrated and intensive array of
				community-based therapeutic interventions designed in partnership with youth
				and families to meet their unique needs. A goal of treatment is to support
				youth in their home and community, but when clinically indicated and
				authorized, short-term therapeutic group care is integrated into the
				Continuum/Intensive Home-based Therapeutic Care treatment plan.
				Continuum/Intensive Home-based Therapeutic Care treatment continues during
				periods of hospitalization or out-of-home placement.
Cost Report
. The document used to
				report costs and other financial and statistical data. The Uniform Financial
				Statements and Independent Auditor's Report (UFR) is used when required.
Emergency Residence
. A residential
				service, available for immediate 24/7 access, for clients requiring placement
				in a therapeutic milieu providing individualized treatment, rehabilitation,
				training in life skills, and supportive services to promote transition from the
				emergency setting to a treatment setting, to permanency in a family-based
				environment or, as developmentally appropriate, to community living with
				permanency.
Enhanced Residential Treatment Program
				(ERTP)
. The federal Family First Prevention Services Act of 2017
				introduced this term. An ERTP meets the following five requirements:
(a) accreditation by an accrediting body
			 named in the Family First Prevention Services Act of 2017 or subsequently
			 approved by the U.S. Secretary of Health and Human Services;
(b) operation within a trauma-informed
			 treatment model that creates a culture of delivering trauma-informed care and
			 treatment;
(c) provision of 24/7
			 access to licensed or registered nursing staff and other licensed clinical
			 staff;
(d) facilitation, in
			 accordance with the child's best interest, of family members', including
			 siblings', connections with the child and involvement in the child's treatment
			 plan and programs; and
(e)
			 provision of discharge planning and family-based aftercare support.
EOHHS
. The Executive Office of Health
				and Human Services, established under M.G.L. c. 6A.
Extraordinary Circumstances/Flex
				Funding
. A method whereby, subject to availability, a purchasing
				governmental unit may provide resource allocations to a client and/or provider
				across the state. Flexible funding may be provided through a number of means
				including, but not limited to, reimbursement to the client for specific support
				services or funds directed to a qualified provider for extraordinary
				circumstances.
Full-time Equivalent (FTE)
. A staff
				position equivalent to a full-time employee.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth, and
				any political subdivision of the Commonwealth.
Group Home Program
. Residential
				services that provide flexible individualized treatment, rehabilitation, and
				support/supervision services that vary in intensity based upon individual youth
				and family needs. The Group Home Program includes the following four service
				models:
(a) Intensive Group Home
			 programs with a 1:3 direct care staffing ratio;
(b) Group Home 1:4 programs with a 1:4 direct
			 care staffing ratio;
(c)
			 Pre-independent Living programs with a 1:5 direct care staffing ratio;
			 and
(d) Independent Living programs
			 with no live-in staff and that occur in an apartment setting
Individual Consideration (I.C.)
.
				Payment rates for certain services are designated as individual consideration
				(I.C.). Where I.C. rates are designated, the purchasing governmental unit will
				determine the appropriate payment as the actual cost of the item or service as
				evidenced by invoice, published tuition amount, or other price reasonably
				obtained by a competitive market for the product or service.
Intensive Emergency Residence
. A
				residential service, available for immediate 24/7 access, for clients with
				severe behavioral health needs requiring placement in a therapeutic milieu
				providing individualized treatment, rehabilitation, training in life skills,
				and supportive services to promote transition from the emergency setting to a
				treatment setting, to permanency in a family-based environment or, as
				developmentally appropriate, to community living with permanency.
Intensive 1:1 Supported Living
. A
				specialty community-based residential treatment service for young adults 18
				through 22 years of age with a range of significant developmental needs. This
				service provides individualized 1:1 supervision and support services for all
				clients.
Intensive 1:2 Group Home
. A specialty
				service that provides flexible individualized treatment, rehabilitation, and
				support/supervision services at a more intensive 1:2 direct care staff ratio,
				based upon individual youth and family needs.
Intensive Group Home with Expanded
				Nursing
. Intensive Group Home with Expanded Nursing provides
				out-of-home treatment services that are integrated with community-based
				transitional support services. These services are designed for youth who
				present with complex medical needs and their families.
Intensive Residential Treatment Program
				(IRTP)
. Residential programs that are class VII facilities,
				licensed by the Department of Mental Health (DMH), and designed for adolescents
				who have completed a thorough and aggressive course of acute psychiatric
				care.
Intensive Transitional Independent
				Living
. Programs for clients 16 through 20 years of age who are
				preparing to live independently upon release or who have been determined to
				need more intensive transitional and community support services as they return
				to the community. The programs are staff secure and provide monitoring and
				supervision, as well as individualized services that reduce risk and/or need
				and develop independent living skills and experiences in the community and
				community-based support systems.
Intensive Treatment Residence
. A
				residential service that provides clients with severe behavioral health needs a
				therapeutic milieu that includes expertise about severe behavioral health
				conditions, individualized treatment, rehabilitation, training in life skills
				and self-regulation, and supportive services to promote permanency in a
				family-based environment or, as developmentally appropriate, to community
				living with permanency.
Intensive Treatment Residence Emergency Intake
				Add-on
. An add-on service to support additional costs associated
				with achieving an emergency placement, within 24 to 48 hours of referral, into
				an Intensive Treatment Residence.
Medically Complex Behavioral
				Residence
. A residential service for clients with complex medical
				needs that require out-of-home nursing services to meet their health-care needs
				and require individualized treatment to meet their behavioral health
				needs.
Medically Complex Needs Group Home
.
				Specialty service for children/youth and young adults with complex medical
				needs that require intensive out-of-home nursing services in order to meet
				their health-care needs.
Medically Complex Residence
. A
				residential service for clients with complex medical needs that require
				out-of-home nursing services to meet their health-care needs.
Non-enhanced Residential Treatment Program
				(Non-ERTP)
. A program that does not meet all five requirements of
				an Enhanced Residential Treatment Program (ERTP).
See
the
				definition of an Enhanced Residential Treatment Program.
Per Diem
. Service
				unit based on a 24-hour period of care.
Programmatic Add-on Rate
. A rate that
				is intended to provide an additional, necessary service to all clients, that is
				not included in the current programmatic model, and that will be instituted at
				the discretion of the purchasing governmental unit.
Provider
. Any individual, group,
				partnership, trust, corporation, or other legal entity that offers youth
				intermediate-term stabilization services for purchase by a governmental unit
				and that meets the conditions of purchase or licensure that have been adopted
				by a purchasing governmental unit.
Provider Leased
. The building housing
				an Adjudicated Youth Residential Treatment program that is leased by the
				provider.
Provider Owned
. The building housing
				an Adjudicated Youth Residential Treatment program that is owned by the
				provider.
Recovery, Engagement, and Alliance with DYS Youth
				(READY, formerly MassSTART)
. A community-based program serving
				high-risk DYS-involved youth who are struggling with substance use and related
				behavioral health problems. Services provide ongoing engagement and
				psycho-education around substance use, increased support for education and
				employment, enhanced family engagement, expanded social support, out-of-school
				activities, one-on-one mentoring, behavioral incentives, and advocacy within
				DYS regarding the correlation between substance use and delinquent
				behavior.
Residential Schools
. Special education
				programs with rates established by the Operational Services Division.
Residential Services
. A setting away
				from the home that offers both housing and treatment.
Specialty Treatment Residence
. A
				residential service that provides clients who would benefit from specialized
				treatment (
e.g
., individuals with intellectual disabilities;
				transgender individuals) with a therapeutic milieu that includes expertise
				about the specialty population, individualized treatment, rehabilitation,
				training in life skills, and supportive services to promote permanency in a
				family-based environment or, as developmentally appropriate, community living
				with permanency.
Specialty Treatment Residence for Commercially
				Sexually Exploited Children (CSEC)
. A residential service designed
				to meet the particular behavioral-health needs of clients who have been
				sexually exploited. Services are delivered within a therapeutic milieu that
				includes expertise about the CSEC population, individualized treatment,
				rehabilitation, training in life skills, and supportive services to promote
				permanency in a family-based environment or, as developmentally appropriate, to
				community living with permanency.
Short-term Assessment and Rapid Reintegration
				Program (STARR)
. A flexible, residential service designed to meet
				the service needs of the child/youth and family. All children/youth referred
				receive stabilization services, while some children/youth require additional
				assessment and treatment services.
Specialty Services
. Specifically
				designed, low-incidence models of care.
State College Preparatory Program
. A
				specialty service designed to serve as a crucial support in building permanency
				for young people by helping them achieve self-sufficiency, strengthen
				supportive relationships, and identify and access community support services
				and resources by combining intensive academic and support services that prepare
				the youth for college and adulthood.
State Funding
. The aggregate state
				fiscal year amount of payments to a provider by a governmental unit for
				services purchased at rates established in
				101 CMR 413.00. State
				funding does not include any amounts attributable to federal funding or grant
				funds.
State Owned Co-located
. The building
				housing an Adjudicated Youth Residential Treatment program that is owned by the
				state and is connected in any way to or on the same campus as another
				state-owned building.
State Owned Separate
. The building
				housing an Adjudicated Youth Residential Treatment program that is owned by the
				state and is a stand-alone structure in that it is not connected in any way to
				or on the same campus as another state-owned building.
Stepping Out Program
. Community-based
				individualized support provided to youth who have transitioned to living
				independently after receiving pre-independent living and independent living
				services. Service continuity is a critical feature of Stepping Out. In order to
				ensure continuity, Stepping Out services are provided by the case manager who
				has already been working with the youth.
Summer Teacher Add-on Rate
. An add-on
				rate for a licensed teaching position receiving a stipend to provide education
				in residential programs for the summer session, totaling six weeks during the
				months of July and August.
Teen Parenting Emergency Beds (E-beds)
				Program
. An add-on rate to support additional costs associated
				with providing emergency beds (E-beds), which include transportation, food,
				diapers, and other emergency incidentals, and monthly assessment reimbursement
				for teen parents. The add-on rate is utilized for young parents needing an
				emergency bed and services until a regular placement can be made.
Teen Parenting Program
. Programs
				designed to help teens develop a support system for themselves and their
				children including ensuring continuing contact with the baby's father, teen's
				parent(s), family members, paternal family members, and other supports through
				a residential setting. The Teen Parenting Program includes the following four
				service models:
(a) Enhanced programs
			 with a 1:4 direct care staff ratio;
(b) Teen Living Programs (TLP) with a 1:5
			 direct care staff ratio;
(c) House
			 Parent programs with a 1:5 direct care staff ratio; and
(d) Supportive Teen Parent Education and
			 Employment Program (STEP), which has no live-in staff and is provided in an
			 apartment setting.
Therapeutic Group Care
. A 24/7
				out-of-home treatment service that provides flexible, individualized treatment
				and assessment with the goal of reintegrating youth to their families and
				communities; also provides short-term, planned respite.
Transition to Intensive Foster Care (IFC)
				Add-on
. Specialty service for transition to Intensive Foster Care.
				Serves as an add-on to a residential model.
Transitional Age Youth Program
. A
				specialty program for young adults, 18 through 25 years of age, designed to
				promote health and wellness and recovery through person-centered services and
				supports that enable individuals to live, work, and participate in their
				communities. The Transitional Age Youth Program includes the following two
				service models.
(a) The Transitional
			 Aged Young Adult Continuum is an integrated array of services that includes
			 both residential and community-based treatment.
(b) The Young Adult Group Living Environment
			 includes services provided in a group home or supported housing residential
			 setting.
Transitional Independent Living
.
				Programs for clients 16 through 20 years of age who are preparing to live
				independently upon release or who have been determined to need more
				transitional and community support services as they return to the community.
				The programs provide monitoring and supervision, as well as individualized
				services that reduce risk and/or need and develop independent living skills and
				experiences in the community and in community-based support systems.
Utilization
. The proportion of a
				program's capacity that is filled by clients on a regularly measured basis,
				expressed as a percentage.
Workforce Initiatives
. Funds directed
				to a provider for workforce development.
Youth Intermediate-term Stabilization
.
				Programs that provide a child, adolescent, or young adult temporary housing in
				a specialized residential or hospital setting to provide comprehensive
				services, and to promote stabilization and transition to
(a) a less-restrictive setting;
(b) a permanent family home;
(c) independence; or
(d) another type of adult program.
Youth Residential Substance Use Disorder
				Treatment
. Residential programs for clients 16 through 19 years of
				age with moderate-to-severe substance use disorders that include intake and
				assessment, mental health counseling, case management and service coordination;
				psycho- and health education; life skills enhancement and
				vocational/educational support; recovery support and aftercare; and discharge
				planning.
Youth and Young Adult Group Residence
. A residential service that provides older adolescents or young adults with a
				supportive environment where there are opportunities for individualized
				treatment, training in life skills development, vocational and career planning,
				linkages with community services, and supportive services to promote community
				living with permanency.
Youth and Young Adult Supported Living
				Community
. Residential services offered to older adolescents or
				young adults living in multi-occupancy units (
e.g
.,
				apartments, townhomes) that provide opportunities for linkages to
				community-based services, support with life skills development, vocational and
				career planning, and supportive services to promote community living with
				permanency.
Young Adult Supported Living
.
				Services, with no live-in staff, offered to young adults living independently
				in scattered apartments that provide opportunities for linkages to
				community-based services, support with life skills, vocational and career
				planning, and supportive services to promote community living with
				permanency.
Young Parent Living Program
. A
				residential service to support young parents in learning to care for themselves
				and their children, in developing positive support systems that include family
				members, extended kin, and friends, and in connecting with community-based
				supports.
Young Parent Residence Add-on
. An
				add-on rate to support additional costs associated with a one-time assessment
				of young parents upon intake to a young parent residence.
Young Adult Therapeutic Care
. This
				program is for young adults, 18 through 25 years of age, and is designed to
				promote health, wellness, and recovery through person-centered services and
				supports that enable individuals to live, work, and participate in their
				communities. This service provides multiple levels of intensity in order to
				meet the individual needs, including the following.
(a)
Staffed
			 Apartments
. 24/7 group living with onsite staff support.
(b)
Supported
			 Apartments
. 24/7 individual apartments with intermittent onsite
			 staff support.
(c)
Outreach
. Community, team-based support for young
			 adults living at home.