Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Section 164.005 - Definitions

Current through Register 1525, July 5, 2024
The following definitions shall apply to
				105 CMR 164.000, unless an
				alternative interpretation is specifically provided:
24-hour Diversionary Withdrawal Management
				Service
. 24-hour substance use disorder treatment services
				provided in freestanding or hospital-based settings with 24-hour, seven-day per
				week nursing and medical supervision that include withdrawal symptom management
				as part of medically supervised withdrawal and/or induction onto maintenance
				treatment.
Accreditation
. The process of
				evaluation and approval by an accrediting body.
Accreditation Survey
. An on-site
				review and evaluation of a substance use disorder treatment program by an
				accrediting body.
Accrediting Body
. An independent,
				not-for-profit organization or governmental entity that has been approved by
				the Commissioner to accredit substance use disorder treatment programs.
Acupuncture Withdrawal Treatment
				Services
. A treatment program providing acupuncture services for
				individuals experiencing the dysfunctional effects of the use of alcohol and/or
				other drugs, whose primary need is to manage withdrawal symptoms, and
				thereafter, support services for maintenance of sobriety.
Acupuncturist
. An individual licensed
				by the Board of Registration in Medicine in accordance with M.G.L. c. 112,
				§§ 150 through 156.
Administrator
. The Executive Director,
				Program Director or other individual responsible for the day-to-day operations
				of a facility or program.
Adolescent
. A child 13 through 17
				years of age.
Advanced Practice Registered Nurse
. An
				individual licensed by the Massachusetts Board of Registration in Nursing in
				accordance with M.G.L. c. 112, § 80B.
Advertisement
. In accordance with
				Consumer Protection regulations
				940 CMR
				6.00:
Retail Advertising
(including
				the terms Advertise and Advertising), any oral, written, graphic, or pictorial
				representation made by a Licensed or Approved Provider in the course of the
				solicitation of consumers of services or which encourages a person to utilize
				services. Advertisement includes any representation made in any media including
				digital or electronic media, newspaper, magazine, or other publication or on
				radio or television or contained in any notice, handbill, sign, billboard,
				banner, poster, display, circular, pamphlet, catalog, or letter, or printed on
				or contained in any tag or label, which is attached to or accompanies any
				product offered for sale. Advertisement includes any representation
				disseminated within Massachusetts if the advertisement is directed to consumers
				in Massachusetts.
Aftercare Coordinator
. An individual
				responsible for identifying appropriate continuing care and post discharge
				services and resources while working to ensure a smooth transition to the next
				phase in the adolescent's or transition age youth's recovery plan.
Alcohol and Drug-free Housing
or
ADF Housing
. A form of group housing, also known as a
				sober home or recovery residence, that provides an environment free from
				alcohol and drugs for individuals recovering from a substance use disorder who,
				as a condition of occupancy, agree not to use alcohol or other substances. ADF
				housing does not include a halfway house, residential rehabilitation unit,
				treatment unit, withdrawal management facility, or other facility licensed by
				the Department under
				105 CMR 164.000.
American Psychiatric Association
. A
				professional organization of psychiatrists which defines and codifies
				psychiatric conditions for purposes of diagnosis.
American Society of Addiction Medicine
or
ASAM
. A medical society of physicians engaged in
				addiction treatment, education, research and program improvement.
Applicant
. Anyone requesting or
				renewing a license or approval from the Department to operate a substance use
				disorder treatment program.
Application
. Any application for
				initial or renewal licensure, approval, amendment or closure.
Approval
. A certification, in writing,
				whether full or provisional, issued by the Department to a provider to operate
				within a facility or program licensed by the Department, or to a department,
				agency or institution of the Commonwealth or subdivision thereof, or to a penal
				facility, which authorizes it to operate a program subject to
				105 CMR 164.000.
Approved Provider
. Any entity holding
				an approval from the Department to operate a substance use disorder treatment
				program.
Audit
. A professional independent
				review, examination and verification of financial and accounting records and
				supporting documents by a professional, such as a Certified Public Accountant,
				to verify their accuracy and render an opinion as to their fairness,
				consistency, and conformity with Generally Accepted Accounting Principles
				(GAAP) and to recommend necessary changes in controls, policies, or
				procedures.
Bureau
. The Bureau of Substance
				Addiction Services of the Department of Public Health, including its
				staff.
Business Day
. A day on which the
				offices of the Commonwealth are open for regular business.
Case Aide
. An individual responsible
				for daily management within a 24-hour structured Substance Use Disorder
				treatment program.
Case Manager
or
Core
				Coordinator
. An individual responsible for assisting patients or
				residents to obtain needed services by providing information, referral
				coordination and follow-up.
Case Record
. A unified, comprehensive
				collection of documentation concerning a patient or resident in a substance use
				disorder treatment program.
Central Registry System
. A centralized
				database for the collection and maintenance of records for the purposes of
				preventing multiple concurrent enrollments, ensuring accurate dosage delivery,
				and facilitating disaster management in Opioid Treatment Programs licensed in
				Massachusetts.
Certified Alcohol and Drug-free
				Housing
. ADF housing provided by persons or entities trained and
				certified by a certifying body.
Chain of Custody
. A process of
				monitoring possession of samples, such as saliva, urine or blood, to prevent
				tampering with the sample or the results. Chain of custody begins with
				collection of the sample, and continues through final reporting of test
				results.
Child
. Any person younger than 18
				years old.
Children's Services Assistant
. A
				person with, at minimum, an Associate in Arts or equivalent education and
				training in child development, child psychology, and childhood education and at
				least three years of experience working with families and children, substance
				use and mental health disorders who works under the supervision of the Child
				Service Coordinator and assists in developing the children's part of the
				service plan, overseeing the children's activities, parenting classes, and
				educational needs of the children.
Children's Services Coordinator
. A
				person with, at minimum, a Bachelor's degree in Early Childhood Education,
				Special Education, Psychology, or a related field, or a Bachelor's degree in an
				unrelated field with four courses or 12 credits in Early Childhood Education,
				Special Education, Psychology, or a related field who has experience or
				knowledge of parent-child dyadic work.
Clinical Supervision
. A regular and
				specified time set aside to provide training, education and guidance to direct
				care staff and to oversee the provision of patient and resident services.
				Supervision must be delivered by a staff member qualified to deliver
				supervision, preferably in the discipline of the supervisee; must be sufficient
				to meet the needs of supervised staff, patients, and residents; and may be
				provided on an individual or group basis.
Clinician
. An individual with a
				minimum of:
(1) a master's degree in one of the following disciplines or a
				closely related field: clinical psychology, education-counseling, medicine,
				psychology, psychiatric nursing, rehabilitative counseling, social work, and
				who has a minimum of one year of supervised substance use disorder counseling
				experience; or
(2) a bachelor's degree in any of the listed disciplines and a
				minimum of two years of supervised substance use disorder counseling
				experience; or
(3) a recognized certification or licensure including 4,000
				hours of clinically supervised counseling of individuals with substance use
				disorders including at least 220 documented hours of supervision.
Commissioner
. Commissioner of
				Massachusetts Department of Public Health or his or her designee.
Commonwealth
. Every executive office,
				department, board, commission, division or authority of the Massachusetts state
				government or political sub-division of any of the foregoing.
Consultation
. The presentation of
				specific patient cases to clinicians of equal or greater expertise for the
				purpose of feedback, direction and guidance.
Continuum of Care
. A principle of
				substance use disorder treatment that includes a range of substance use
				disorder treatment services based on six dimensions established by the American
				Society of Addiction Medicine: alcohol intoxication/withdrawal potential;
				biomedical conditions and complications; emotional/behavioral conditions and
				complications; treatment acceptance/ resistance; relapse continued use
				potential; and recovery environment.
Co-occurring Disorders
. Diagnosis of
				both a substance use disorder and one or more mental health disorders in one
				individual.
Co-occurring Enhanced
. A program
				provided in a 24-hour, safe, structured environment, located in the community,
				which supports residents' recovery from addiction and moderate to severe mental
				health conditions as they reintegrate into the community and return to social,
				vocation/employment, and/or educational roles.
Counselor
. An individual who has a
				minimum of a high school diploma or equivalent and a minimum of one year
				supervised counseling experience in substance use disorder treatment or a
				closely related field.
Day Treatment
. An intensive outpatient
				program providing direct patient services through group, individual, and family
				substance use disorder counseling a minimum of 3.5 hours per day three to seven
				days per week based upon patient needs.
Deemed Status
. The acceptance by the
				Department of accreditation as evidence of compliance with one or more
				requirements of
				105 CMR 164.000.
Department
. The Massachusetts
				Department of Public Health.
Direct Care Staff
. Personnel who
				provide direct individual, group, educational, clinical or case management
				services to patients or residents of substance use disorder treatment
				programs.
Disability
. A physical or mental
				impairment that substantially limits one or more of the major life activities
				of an individual; a record of such an impairment; or being regarded as having
				such an impairment (28 CFR §
									35.104,
				and M.G.L. c. 151B, § 1).
Educational Coordinator
. An individual
				responsible for coordinating the educational progress of adolescents or
				transition age youth during treatment, who acts as a liaison between school
				districts or placements and the adolescents or transition age youth residents
				of residential treatment program, to ensure the residents are receiving and
				completing work and who support the residents in completing this educational
				work while at the residential treatment program.
Emergency
. A sudden, calamitous event
				that seriously disrupts the functioning of a community or society and causes
				human, material, and economic or environmental losses that exceed the
				community's or society's ability to cope using its own resources.
Executive Director
. The individual
				duly appointed by the governing body of the Licensed or Approved Provider, who
				is responsible for the overall operations of the Licensed or Approved Provider
				providing substance use disorder treatment services.
Facility
. A substance use disorder
				intervention or treatment provider that is publicly or privately owned,
				for-profit or not-for-profit which is not part of or located at a penal
				institution and which is not operated by the federal government.
Family Therapist
. An individual
				licensed by the Massachusetts Board of Registration of Allied Mental Health
				Professions in accordance with M.G.L. c. 112, § 165.
First Offender Driver Alcohol
or
Controlled Substance Education Services
. An outpatient
				program providing psycho-educational and counseling interventions for
				individuals adjudicated by a court as first offenders of laws prohibiting
				driving under the influence of intoxicating liquor or controlled
				substances.
Food Service Personnel
. Staff who
				prepare and serve meals, oversee food storage, and are responsible for sanitary
				care of food preparation and serving equipment.
Full-time Equivalent
or FTE. A minimum
				of 35 hours per week per each staff position.
Induction
. The process of initial
				dosing with medication for OUD treatment, until the patient reaches a state of
				stability; also called initiation.
Intensive 24-hour Diversionary Withdrawal
				Management
. 24-hour substance use disorder treatment services
				provided in hospital-based settings that include daily medical management and
				primary nursing interventions with 24-hour, seven-day per week nursing and
				medical supervision that include withdrawal symptom management as part of
				medically supervised withdrawal and/or induction onto maintenance
				treatment.
Interim Maintenance Treatment
.
				Maintenance treatment provided in an opioid treatment program in conjunction
				with appropriate medical services while a patient is awaiting transfer to a
				program that provides comprehensive maintenance treatment.
License
. Authorization, in writing,
				issued by the Department upon its determination that the applicant is
				responsible and suitable to operate a substance use disorder treatment
				program.
Licensed Alcohol and Drug Counselor
				(LADC)
. An individual who has applied for and has been deemed
				qualified under applicable sections of
				105 CMR 168.000:
Licensure of Alcohol and Drug Counselors
and duly licensed by
				the Department to provide treatment for individuals with a substance use
				disorder as a Licensed Alcohol Drug Counselor I (LADC I), Licensed Alcohol Drug
				Counselor II (LADC II) or Licensed Alcohol Drug Counselor (LADC)
				Assistant.
Licensed Practical Nurse
. An
				individual licensed by Massachusetts Board of Registration in Nursing in
				accordance with M.G.L. c. 112, § 74A.
Licensed Provider
. Any entity,
				including its controlling parent (corporation) holding a license from the
				Department to operate a substance use disorder treatment program. In the case
				of a Licensed Provider which is not a natural person, the term
Licensed Provider
shall also mean any shareholder
				owning 5% or more of the outstanding stock; any limited partner owning 5% or
				more of the partnership interests and any general partner of a partnership
				Licensed Provider; any trustee of any trust Licensed Provider; any receiver or
				trustee in bankruptcy; any manager of a Limited Liability Company and any
				member of a Limited Liability Company with a 5% or more membership interest;
				any sole proprietor of any Licensed Provider which is a sole proprietorship;
				any mortgagee in possession; and any executor or administrator of any Licensed
				Provider which is an estate.
Limited Liability Company
. An
				unincorporated organization formed under M.G.L. c. 156C.
Maintenance Treatment
. Providing
				medications to achieve and sustain clinical remission of signs and symptoms of
				substance use disorder including, but not limited to, opioid use disorder, and
				support the individual process of recovery without a specific endpoint.
Massachusetts Prescription Awareness Tool
				(MassPAT)
. The online prescription monitoring program database
				created pursuant to M.G.L. c. 94C, § 24A.
Medical Clearance
. Determination by
				the Provider's physician, nurse practitioner, physician assistant, registered
				nurse, or a licensed practical nurse duly licensed/certified in the
				Commonwealth of Massachusetts that treatment by the Provider is appropriate
				based upon an individual's condition, and that the individual is not exhibiting
				withdrawal or other medical symptoms that would require a higher level of
				care.
Medical Director
. A physician licensed
				to practice medicine in the Commonwealth of Massachusetts, with specialized
				training in addiction medicine, who assumes responsibility for administering
				all medical services performed by the program, either by performing them
				directly or by delegating specific responsibility to authorized program
				physicians and qualified healthcare professionals functioning under the medical
				director's direct supervision.
Medically Supervised Withdrawal
.
				Dispensing, administering, or prescribing of an FDA-approved medication for the
				treatment of substance use disorder including, but not limited to, opioid use
				disorder, in gradually decreasing doses to alleviate adverse physical or
				psychological effects incident to withdrawal from the continuous or sustained
				use of opioid drugs. The purpose of medically supervised withdrawal is to bring
				a patient maintained on maintenance medication to a medication-free state
				within a target period.
Medication for Addiction Treatment
.
				Use of a medication approved by the federal Food and Drug Administration (FDA)
				for the treatment of a substance use disorder.
Medication for Treatment of Opioid Use
				Disorder
. Use of a medication approved by the FDA for the
				treatment of an opioid use disorder.
Medication Unit
. A component of an OTP
				that is geographically separate from a brick-and-mortar OTP. As such, a
				medication unit engages in the treatment of opioid use disorder, including
				maintenance and/or detoxification treatment with narcotic drugs in Schedules
				II-V, at a location or locations remote from, but within the State as, the
				licensed, certified, and registered OTP, and operates under the licensure and
				certification of the Brick-and-Mortar OTP.
Mental and Behavioral Disorders Due to Psychoactive
				Substance Use
. The variety of disorders defined by the World
				Health Organization which are attributable to the use of one or more
				psychoactive and/or addictive substances.
Mental Health
. Any condition
				pertaining to mental health as defined by the current edition of the Diagnostic
				and Statistical Manual of Mental Disorders.
Mental Health Service
. A separate,
				identifiable service providing diagnosis and treatment to individuals seeking
				treatment for mental health conditions, which may integrate treatment for
				co-occurring substance use disorder, and their families.
Mobile Opioid Treatment Program (Mobile
				OTP)
. An OTP operating from a motor vehicle that serves as a
				mobile component of the brick-and-mortar OTP. As such, a mobile OTP engages in
				the treatment of opioid use disorder, including maintenance and/or
				detoxification treatment with narcotic drugs in Schedules II-V, at a location
				or locations remote from, but within Massachusetts as, the licensed, certified,
				and registered OTP, and operates under the licensure, certification, and
				registration of the OTP. The Mobile OTP is described in DEA regulation 21 CFR
				Part 1300.
Office Based Addiction Treatment
				(OBAT)
. A type of outpatient service not subject to
				105 CMR 164.000 providing
				medication for addiction that is provided outside of licensed or approved SUD
				treatment programs by appropriately licensed clinicians to patients with
				addiction. Includes, but is not limited to, MAT in a primary care office, MAT
				in a hospital clinic setting, and office based opioid treatment serving under
				300 patients.
Office Based Opioid Treatment (OBOT)
.
				A type of Office Based Addiction Treatment provided by a corporate entity,
				other than a hospital or clinic licensed under M.G.L. c. 111, § 51, or an
				opioid treatment program licensed under M.G.L. c. 111E, doing business in the
				Commonwealth, which has more than 300 patients receiving treatment for
				treatment of opioid dependence with an FDA-approved narcotic medication used
				for withdrawal management or maintenance by a qualified health care
				professional who is registered with the U.S. Department of Justice Drug
				Enforcement Agency, as required by
				21 U.S.C. §
									823(g) (known as DATA 2000),
				in a health care professional's office setting or in a primary care center, and
				is associated with the corporate entity by contract, fee for service, or other
				arrangement other than as members of the practice.
Opioid Treatment Program (OTP)
. A
				SAMHSA-certified program, usually comprised of a facility, staff,
				administration, patients, and services, that engages in supervised assessment
				and treatment, using approved medications, of individuals who are addicted to
				opioids.
Original License
. A license, including
				a provisional license, issued to a facility not previously licensed; or a
				license issued to an existing facility, in which there has been a change in
				ownership or location.
Outpatient Counseling
. An outpatient
				substance use disorder treatment service designed to help patients achieve
				changes in alcohol and/or drug use and addictive behaviors and often address
				issues that have the potential to undermine the patient's ability to cope with
				life tasks without the addictive use of alcohol, other drugs, or both.
				Outpatient counseling services may offer several therapies and service
				components, including individual and group counseling, motivational
				enhancement, family therapy, educational groups, occupational and recreational
				therapy, psychotherapy, MAT, or other skilled treatment services.
Outpatient Withdrawal Treatment
				Service
. A program of ambulatory substance use disorder treatment
				that provides clinical management of withdrawal symptoms through medical,
				ancillary treatment, treatment with FDA-approved medications for the treatment
				of addiction, and may include counseling.
Patient
. A person applying for
				admission or admitted to a program providing acute or ambulatory substance use
				disorder services.
Penal Facility
. An institution, or any
				part thereof, other than an institution, or any part thereof operated by the
				federal government, for the detention or confinement of persons accused or
				convicted of crime including, but not limited to, jails, prisons, houses of
				correction and correctional institutions, providing services especially
				designed for the treatment of drug dependent persons.
Pharmacist
. An individual registered
				by the Massachusetts Board of Registration in Pharmacy in accordance with
				M.G.L. c. 112, § 24.
Physician
. An individual licensed by
				the Massachusetts Board of Registration in Medicine in accordance with M.G.L.
				c. 112, § 2.
Physician Assistant
. An individual who
				is registered by the Board of Registration of Physician Assistants in
				accordance with M.G.L. c. 112, § 9I.
Practitioner
. A Physician, Physician
				Assistant, or Advanced Practice Registered Nurse as those terms are defined in
				105 CMR 164.005, acting within applicable scope of service and pursuant to
				state and federal law.
Program
. A substance use disorder
				treatment program.
Program Director
. The individual
				employed by the Licensed or Approved Provider who is responsible for the
				administrative and programmatic day-to-day operations of a program of substance
				use disorder treatment services and may provide supervision of all non-clinical
				staff.
Program Sponsor
. The person
				responsible for the operation of an opioid treatment program.
Provider
. A substance use disorder
				treatment program, including units within a facility or program licensed by the
				Department of Mental Health or the Department, located within a penal facility,
				or operated by a department, agency or institution of the Commonwealth or
				subdivision thereof.
Provisional License
. A license or
				approval granted by the Department to an applicant for a period not to exceed
				six months, in accordance with provisions of
				105 CMR
				164.011(F).
Psychiatrist
. A physician licensed by
				the Massachusetts Board of Registration in Medicine and certified by the
				American Board of Psychiatry and Neurology or an equivalent body.
Psychologist
. An individual licensed
				by the Massachusetts Board of Registration of Psychologists in accordance with
				M.G.L. c. 112, §§ 118 through 121.
Qualified Health Care Professional
. A
				Practitioner, Registered Nurse, or Licensed Practical Nurse trained to do
				physical assessments, duly licensed, certified or registered as such in the
				Commonwealth of Massachusetts, and practicing within the scope of applicable
				Massachusetts and federal regulations.
Qualified Service Organization
. An
				individual, partnership, corporation, federal, state or local government
				agency, or any other legal entity, which:
(1) provides services to a Licensed or Approved Provider;
				and
(2) has entered into a written agreement with the Licensed or
				Approved Provider.
Qualified Service Organization Agreement
				(QSOA)
. A signed and dated document describing the agreed upon
				terms of a service relationship between the Licensed or Approved Provider and
				the qualified service organization, which meets the requirements of 42 CFR Part
				2.
Recovery Home
. A residential
				rehabilitation program that conforms to ASAM criteria for Medium-intensity
				Residential Services.
Recovery Specialist
. A staff person
				who completes the orientation requirements pursuant to
				105 CMR 164.044(B)(1)
				 and population-specific addiction treatment
				training requirements pursuant to
				105 CMR 164.004(B) (2)(f)
				 to provide guidance and direction to
				residents or patients, and oversees resident or patient activities to ensure
				conformance with program policies.
Referral
. A process through which a
				Licensed or Approved Provider directly refers a patient or resident for
				treatment or placement in a substance use disorder treatment program or other
				provider type upon securing the patient's or resident's treatment or placement
				in such a program or other provider type.
Registered Nurse
. An individual
				licensed by the Massachusetts Board of Registration in Nursing in accordance
				with M.G.L. c. 112, § 74.
Resident
. A person applying for
				admission or admitted to a Residential Rehabilitation program providing
				substance use disorder services.
Residential Rehabilitation
. A Licensed
				or Approved Provider that provides a therapeutic, planned regimen of substance
				addiction treatment and education services for persons in the early stages of
				recovery from addiction who require safe and stable living environments in
				order to develop recovery skills. Services are provided in a 24-hour live-in
				setting, with 24-hour per day staffing.
Satellite Office
. An office operating
				at a site physically separate from the main premises of a Licensed or Approved
				Provider that provides outpatient substance use disorder treatment services. A
				satellite office must be open to patients at least 20 hours per week and must
				offer a minimum of 40 staff hours a week of substance use disorder treatment
				services.
Second Offender Aftercare
. An
				educational and treatment program of a licensed outpatient facility for
				individuals who have been convicted of a second Driving While Under the
				Influence offense and who have completed, or are awaiting placement in, a
				14-day Driving Under the Influence (DUI) second offender residential
				program.
Senior Clinician
. An individual who is
				a LADC I, or other independently licensed individual who has at least a
				master's degree in one of the following disciplines or a closely related field:
				clinical psychology, education-counseling, medicine, mental health, psychology,
				psychiatric nursing, rehabilitative counseling, social work; and two years of
				supervised substance use disorder counseling experience; and at least one year
				full time equivalent year of clinical supervisory experience.
(1) Prior to January 1, 2026, Senior Clinicians may include an
				individual who possesses at least a master's degree in one of the following
				disciplines or a closely related field: clinical psychology,
				education-counseling, medicine, mental health, psychology, psychiatric nursing,
				rehabilitative counseling, social work; and two years of supervised substance
				use disorder counseling experience; at least one year full time equivalent year
				of clinical supervisory experience; and has acted as Senior Clinician for more
				than two years.
(2) This role may also be known as the Clinical Director or the
				Clinical Supervisor.
Social Model Recovery Home
. A
				Residential Rehabilitation program that conforms to the ASAM criteria for Low
				Intensity Residential Services.
State Opioid Treatment Authority
				(SOTA)
. Personnel of the Bureau authorized to approve requests for
				exceptions to limitations on take-home doses of methadone, and to review
				hearing decisions to terminate a patient from an opioid treatment
				program.
Substance Use Education Program
. An
				education program within a penal facility which focuses on reducing risk to
				recidivate and may include information about substance use prevention, misuse
				and addiction. Individuals enrolled in a Substance Use Education Program may
				simultaneously be enrolled in a Substance Use Disorder Treatment Program and/or
				receive individual medical treatment from a licensed provider for Substance Use
				Disorder management or treatment. Substance use education programs are not
				intended to provide treatment directly and therefore are not subject to
				licensure under
				105 CMR
				160.000.
Substance Use Disorder Treatment
. An
				evidence based practice intended to assess status, reduce symptoms, or mitigate
				the effects of substance misuse, substance use disorders, that may also treat
				co-occurring disorders; reduce risk of relapse and associated harm; or restore
				or establish well-being for individuals and families; provided, that said
				practice shall include, but not be limited to, care coordination, case
				management, medical, pharmacological, psychological, psycho-educational,
				rehabilitative, or social services and therapies.
Substance Use Disorder Treatment License for
				Department of Mental Health Licensed Facility
. Authorization, in
				writing, issued by the Department upon its determination that a mental health
				facility licensed by the Department of Mental Health (DMH) under M.G.L. c. 19,
				§ 19, meets applicable requirements of
				105 CMR 164.000 to ensure
				the safety and adequacy of the substance use disorder treatment program.
Substance Use Disorder Treatment
				Program
. An organized system of services containing a mission,
				philosophy and model of substance use disorder treatment designed to address
				the needs of patients or residents.
Substance Use Disorder
. Any condition
				pertaining to substance use disorder as defined by the current edition of the
				Diagnostic and Statistical Manual of Mental Disorders.
Supervision
. A regular and specified
				time set aside to provide non-clinical training, education and guidance to
				staff. Supervision must be sufficient to meet the needs of supervised staff,
				patients, and residents, and may be provided on an individual or group
				basis.
Therapeutic Community
. A Residential
				Rehabilitation program that conforms to ASAM criteria for High-intensity
				Residential Services.
Tobacco Free
. An environment free of
				tobacco use, including e-cigarettes and the use of smokeless tobacco, such as
				snuff and chewing tobacco.
Training
. Educational programs,
				workshops and other structured opportunities for staff aimed at improving
				skill, knowledge and service provision.
Transfer of Ownership
shall include,
				but not be limited to, the following:
(1) a transfer of a majority interest in the ownership of the
				substance use disorder treatment program;
(2) in the case of a for profit corporation, transfer of a
				majority of any class of the stock thereof;
(3) in the case of a partnership, transfer of a majority of the
				partnership interest;
(4) in the case of a trust, change of the trustee or a majority
				of trustees;
(5) in the case of a not-for profit corporation, such changes
				in the corporate membership and/or trustees as the Department determines to
				constitute a shift in control of the operation of the Licensed or Approved
				Provider; or
(6) where foreclosure proceedings have been instituted by a
				mortgagee in possession.
Transfer of Ownership
also means any
				change in the ownership interest or structure of a substance use disorder
				treatment program or the program's parent corporation(s) that the Commissioner
				determines to effect a change in control of the operation of the substance use
				disorder treatment program. The Commissioner may, in his or her discretion,
				determine a proposed transaction does not rise to the level of a transfer of
				ownership.
Transition Age Youth
. A young person
				16 through 25 years of age.
Transitional Support Service
. A
				short-term Residential Rehabilitation program.
Viral Hepatitis
. For purposes of
				105 CMR 164.000, viral
				hepatitis refers to Hepatitis A, Hepatitis B and Hepatitis C.
Withdrawal Symptom Management
. The
				process of initial dosing with FDA-approved medication for the treatment of
				addiction including, but not limited to, opioid use disorder, until the patient
				reaches a state of stability. Withdrawal Symptom Management may also be
				referred to as induction.
World Health Organization
. An agency
				of the United Nations which directs and coordinates UN authority on
				international public health, and which compiles classifications of diseases and
				disorders.
Written Notice
.
(1) a letter sent by registered or certified mail; or
(2) a written statement, receipt of which is documented by
				dated signature of both the individual sending and the individual receiving the
				notice. The period of time stated in the written notice shall be calculated
				beginning on the first business day following receipt of written notice.