Current through Register 1531, September 27, 2024
(1) All
providers of supports and services unless specifically exempted by law or
regulations, shall be subject to the following requirements:
(a)
Screening of Provider Staff
and Care Providers.
1. All
providers shall comply with applicable federal and state labor laws and not
engage in discriminatory employment practices.
2. All providers shall comply with all
required Criminal Offender Record Checks.
3. All providers arranging or providing
professional services or consultation shall assure that such professionals are
licensed, certified or registered as required by law to provide such
professional services to the public.
(2)
Staff
Qualifications. All providers shall assure that the number,
organization and qualifications of staff meet the training, care, support,
health, safety, and evacuation needs of the individuals supported by the
provider. This shall be determined by all of the following:
(a) The provider's ability to meet the
objectives in the ISP of each individual while promoting independence and skill
development.
(b) The provider's
ability to assist each individual to achieve the stated outcomes as set forth
in his or her ISP.
(c) The
provider's ability to meet environmental, safety, administrative, and service
delivery requirements as set forth in
115 CMR
7.07.
(d) The provider's ability to develop and
competently execute safety plans for all individuals at the location(s) where
supports and services are provided as required in
115 CMR
7.06.
(3)
Supervision and
Evaluation. All providers shall have adequate staff as determined
by all of the following:
(a) The skills
demonstrated by staff in helping individuals to achieve outcomes identified in
the individual's ISP, the provider's mission statement, and the mission
statement, regulations, and standards of the Department.
(b) The level of ongoing supervision that
supports staff in increasing their skills and ability to assist individuals
supported by the provider.
(c) The
ongoing staff development and training activities that are provided.
(d) Training activities that are tied to the
specific needs of individuals supported by the provider.
(e) Access to technical and clinical
consultation to enhance staff's ability to meet individuals' needs and
desires.
(4) All
providers shall have current staff job descriptions that describe the
education, skills, and experience required of staff to meet the standards set
forth in
115 CMR
7.04.
(5) All providers shall develop and utilize
staff performance evaluations to enhance supports and services to individuals.
(a) Evaluations of staff performance shall be
competency-based and shall assess the degree to which requirements of the
employee's job description are achieved by the employee subject to the
evaluation. Comments from individuals, families or guardians of individuals,
and relevant external agencies shall be included in the evaluation of staff
performance.
(b) Staff performance
evaluations shall occur at least annually.
(c) The results of staff performance
evaluations shall be used by the provider to produce continued improvement in
the skills needed by staff to enhance the lives of the individuals they
support.
(6)
Training. All providers shall meet the following
training requirements for staff, relief staff and care providers except as
otherwise noted in 115 CMR 7.05(6).
(a)
Training in the reporting of actual or suspected abuse, neglect, or omission as
specified in M.G.L. c. 19C and
115 CMR 9.00:
Investigations and Reporting Responsibilities.
(b) Training in the reporting of incidents as
required in 115 CMR,
(c) Training
in the implementation of positive behavioral supports and the requirements in
115
CMR 5.00: Standards to Promote
Dignity.
(d) For staff,
relief staff and care providers who may be expected to use restraint, training
on the requirements in
115 CMR
5.11: Seclusion, Locked Buildings,
and Emergency Restraint and on the appropriate use of restraint using
a curriculum approved by the Department.
(e) For non-licensed staff who will be
administering medication at a site that is required to be registered as a
Medication Administration Program (MAP) site, training on the requirements of
115 CMR 5.15:
Medication and on the safe administration of medications and
are MAP certified.
(f) Training in
first aid.
(g) Training in
cardiopulmonary resuscitation (CPR) for all staff at every site providing 24
hour residential supports, employment supports, day supports or 24 hour site
based respite supports. 115 CMR 7.05(6)(g) shall not apply to residential sites
providing less than 24 hour supports.
(h) Training in all aspects of the safety
plan for sites required to have safety plans under
115 CMR
7.06(3).
(i) At least one staff person trained in fire
safety by an approved fire safety training agency, local fire department or
from the Department shall be present at every site where residential supports,
day supports or 24 hour site based respite services are provided. All other
staff and care providers are trained in basic fire safety.
(7)
Staffing
Requirements.
(a) Providers of
residential supports, including care providers, shall assure the presence of
staff whenever an individual is present in the home, unless the individual:
1. has an ISP that expressly provides that he
or she can be home alone for a defined period of time; and
2. is 18 years of age or older; and
3. is capable of evacuating from the home
within 21/2 minutes without assistance.
The Department's approval of an arrangement for any individual
to remain in the home alone for a defined period of time does not change the
residential supports into a different service that does not require 24 hour
staffing.
(b)
Providers of residential supports, care providers, and providers of 24 hour
site-based respite shall develop a staffing pattern that is sufficient to
enable all individuals to evacuate, with or without assistance, within
21/2 minutes in accordance with professionally accepted fire safety
procedures.
1. Assistance from any staff who
evacuates and re-enters the building cannot be considered in determining
sufficiency of staffing pattern.
2.
Evacuation times may be extended only when an evaluation using the National
Fire Protection Association's Fire Safety Evaluation System ("FSES") has been
conducted and the results based on physical site adaptation, staffing patterns,
characteristics of the individuals in the home, and other relevant factors,
demonstrate that the extended evacuation times are within accepted fire safety
standards. Until such time as there is an approved waiver from the Department,
the provider must have sufficient staff to evacuate all individuals in the home
within 21/2 minutes. The provider shall ensure that staffing is sufficient
to meet the conditions and evaluation time set in the waiver approved pursuant
to 115 CMR 7.05(7)(b)2.
(c) Providers of residential supports,
including care providers and providers of 24 hour site based respite supports
shall have at least one person on duty and present in the home (including
overnight) when any individual is present at the home except as otherwise
provided in 115 CMR 7.05(7)(a).
(d)
Successful performance on fire drills required by
115 CMR
7.06(3)(b)7. shall be a
factor in determining the adequacy of the provider's staffing.