Code of Massachusetts Regulations
104 CMR - DEPARTMENT OF MENTAL HEALTH
Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES
Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES
Section 27.15 - Absence without Authorization
Universal Citation: 104 CMR 27.00 MA Code of Regs 27.15
Current through Register 1531, September 27, 2024
(1) Classification as AWA. Any patient admitted or committed to a Department facility pursuant to M.G.L. c. 123, §§ 7, 8, 10, 11, 12, 15, 16, 17 or 18, who leaves the facility grounds or an off-grounds program or activity without permission and fails to return within a reasonable time, or any patient who, having left the facility with permission, fails to return at the designated time or within a reasonable time thereafter, shall be classified by the facility director as "absent without authorization" (AWA).
(2) Classification as AWA: Action to Be Taken.
(a)
Immediate
Classification. A patient who is admitted or committed pursuant to
M.G.L. c. 123, §§ 7, 8, 10, 11 or 12 and who is at a high risk of
harm to self or others or a patient who is committed pursuant to M.G.L. c. 123,
§§ 15, 16, 17 or 18 who leaves the facility grounds or an off-grounds
program or activity without permission shall be immediately classified as
AWA.
(b)
Classification
by Midnight Census. A patient who does not meet the criteria of
104 CMR 27.15(2)(a) shall be classified as AWA if he or she has not returned
within a reasonable time based on clinical judgment or by the midnight census,
whichever is earlier.
(c) The
facility shall take prompt and vigorous measures to secure the patient's
return.
(d) When a patient is
classified as AWA, the facility director or designee shall immediately notify
the following parties:
1.
Local
and State Police. The police shall be provided with the patient's
description, other information that would assist the police in locating the
patient, and information of the patient's tendencies to be assaultive,
homicidal, suicidal or to use weapons;
2. the district attorney of the county in
which the facility is located;
3.
the patient's next of kin;
4. the
patient's legally authorized representative;
5. any person known to be placed at risk
because the patient has left the facility; and
6. designated individuals within the
Department.
(3) Return from AWA: Action to Be Taken.
(a) A patient who had
been admitted pursuant to M.G.L. c. 123, §§ 10 and 11 or committed
pursuant to M.G.L. c. 123, §§ 7 and 8, and who has not been
discharged from the facility as provided in 104 CMR 27.15(4), may return or be
returned to the facility under the original legal status within six months of
being classified as AWA; provided however, if a patient was hospitalized
pursuant to an order of commitment under M.G.L. c. 123, §§ 7 and 8
that has expired. Such patient may not be retained involuntarily unless he or
she is assessed and admitted in accordance with the requirements of M.G.L. c.
123, § 12, and
104 CMR
27.07.
(b) A patient who was committed to a
Department facility pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18
may return or be returned to the facility under the original legal status;
provided however, that a patient who was committed after a finding of
incompetence to stand trial whose charges have been dismissed, and whose
commitment has expired, may not be retained involuntarily unless he or she is
assessed and admitted in accordance with the requirements of M.G.L. c. 123,
§ 12, and
104 CMR
27.07.
(c) All parties who were notified at the time
of a patient's classification as AWA, shall be notified of the patient's return
to the facility by the facility director or designee.
(4) Discharge of Patients on AWA: Action to Be Taken.
(a) Six
months after being classified as AWA, a patient on AWA who is not committed
pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18 may be discharged from
the facility upon authorization by the facility director after review by senior
clinical staff; provided however, that a patient who was committed after a
finding of incompetence to stand trial whose charges have been dismissed may be
so discharged; provided further, that the facility director, in consultation
with senior clinical staff, may discharge a patient on AWA status at an earlier
date.
(b) Except for a patient who
was committed after a finding of incompetence to stand trial whose charges have
been dismissed, there shall be no discharge of a person on AWA status who has
been committed to a Department facility pursuant to M.G.L. c. 123, §§
15, 16, 17 or 18.
(c) All parties
who were notified at the time of a patient's classification as AWA, shall be
notified of the facility's decision to discharge the patient pursuant to 104
CMR 27.15(4)(a).
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