(A)
Required Services. Each center must have services
available to treat a wide range of behavioral health disorders, including
co-occurring substance use disorders. All services must be clinically
determined to be medically necessary and appropriate and must be delivered by
qualified staff in accordance with
130
CMR 448.415, and as part of the treatment
plan in accordance with
130
CMR 448.412(A)(3). A center
must have the capacity to provide at least the services set forth in
130
CMR 448.412(A). In certain
rare circumstances, the MassHealth agency may waive the requirement that the
center directly provide one or more of these services if the center has a
written referral agreement with another source of care to provide such services
and makes such referrals according to the provisions of
130
CMR 448.412(A)(7).
(1)
Intake Services.
Intake services must be completed on the initial date of service. Intake must
include
(a) a brief assessment to determine
appropriate services; and
(b)
triage to appropriate services.
(2)
Diagnostic Evaluation
Services.
(a) Diagnostic
Evaluation Services that may occur on a member's initial date of service or
over subsequent visits to complete the diagnostic evaluation, develop a
treatment plan, and substantiate treatment rendered, must include
1. an assessment of the current status and
history of the member's physical and psychological health, including any
current or former substance use;
2.
current and former behavioral health disorder treatment, or any other related
treatment, including pharmacotherapy or substance use disorder treatment;
and
3. current and former social,
economic, developmental, and educational functioning, describing both strengths
and needs.
(b) As
treatment progresses, further diagnostic information must be gathered and
documented to inform longitudinal treatment planning.
(c) For members younger than 21 years old, a
CANS assessment must be completed during the initial behavioral health
assessment before the initiation of therapy and be updated at least every 90
days thereafter by a CANS-certified provider.
(3)
Treatment Planning
Services.
(a) Each center must
complete a treatment plan for every member receiving ongoing treatment by the
later of the member's fourth visit or 30 days after the initiation of
treatment. Where an existing written treatment plan has been completed by a
different provider prior to the member's initiation of treatment with the
center, the center may rely on such treatment plan, provided that the treatment
plan satisfies the requirements of
130
CMR 448.412(A)(3), and that
the center reviews the treatment plan and updates the treatment plan as
clinically appropriate upon initiation of treatment.
(b) The member's written treatment plan must
be appropriate to the member's presenting complaint or problem and based on
information gathered during the intake and diagnostic evaluation
process.
(c) The treatment plan
must be in writing, and must include at least the following information, as
appropriate to the member's presenting complaint or problem:
1. identified problems and needs relevant to
treatment and discharge expressed in behavioral, descriptive terms;
2. the member's strengths and
needs;
3. measurable treatment
goals addressing identified problems, with time guidelines for accomplishing
goals and working towards discharge;
4. identified clinical interventions,
including pharmacotherapy, to obtain treatment goals;
5. evidence of member's input in formulation
of the treatment plan, for example, the member's stated goals, and direct
quotes from the member;
6. clearly
defined staff responsibilities and assignments for implementing the
plan;
7. the date the plan was last
reviewed or revised; and
8. the
signatures and licenses or degrees of staff involved in the review or
revision.
(d) Treatment
plans must be updated at least every six months or sooner in the event of a
significant change in clinical presentation or treatment needs, which may
include, but is not limited to, admission to inpatient level of care or
initiation of psychopharmacology or therapy services.
(e) Upon the member meeting the goals and
objectives within the treatment plan, a written discharge summary must be
completed by the clinician that describes the member's response to the course
of treatment and referrals to aftercare and other resources.
(4)
Case and Family
Consultation and Therapy Services. These services must include
case and family consultation, individual, group, couple, and family therapies
provided by or supervised by the mental health professionals identified in
130
CMR 448.413.
(5)
Pharmacotherapy
Services.
(a) Pharmacotherapy
services must include, but are not limited to, an assessment of the patient's
1. psychiatric symptoms and
disorders;
2. health status
including medical conditions and medications;
3. use or misuse of alcohol or other
substances; and
4. prior experience
with psychiatric medications.
(b) Pharmacotherapy services must include
medication prescribing, reviewing, and monitoring.
(c) Pharmacotherapy services must be provided
by an appropriately licensed individual with the authority to prescribe
medications.
(d) Pharmacotherapy
services may be provided by a provider that is not employed by the center, who
is operating under a documented agreement with the center.
(e) These requirements do not preclude the
one-time administration of a medication in an emergency in accordance with a
prescribing practitioner's order.
(f) Storage and administration of medications
must be limited to the scope of the center's DPH clinic licensure referred to
in 105 CMR 140.357 and
105
CMR 140.520: Adequate Mental Health
Services.
(g) The center
must have the capacity to conduct medical monitoring of pharmacotherapy for
behavioral health conditions and must address requests such as prescription
refills and/or medication questions related to behavioral health. These
activities will include documentation of
1.
vital signs;
2. updated medication
lists;
3. reviewing side
effects;
4. performing medication
adjustment;
5. prescribing of
a. Buprenorphine, including for same-day
induction, bridging, and maintenance for members 16 years of age or older,
including treatment referral services for follow-up treatment;
b. Oral Naltrexone. Storage and
administration of medications must be limited to the scope of the center's DPH
clinic licensure; providers are encouraged to check MassPAT prior to
prescribing MOUD; and
c.
Antipsychotic medications that require monitoring.
(h) The center must provide access
to and distribution of Naloxone. The center must have a Massachusetts
Controlled Substance Registration to store Naloxone on-site. The center must
have at least one staff member trained in the administration of Naloxone onsite
24/7. Distribution or administration of Naloxone must be documented in the
member's medical record.
(6)
Crisis Intervention
Services. Each center must provide clinic coverage to respond to
members experiencing a crisis 24 hours per day, seven days per week, 365 days
per year.
(a) During business hours, clinic
coverage must include, at minimum, crisis evaluation by a qualified
professional and triage to appropriate services for the member's presenting
crisis.
(b) After hours crisis
intervention services must include live telephonic access to qualified
professionals and, if indicated, triage in real-time to an appropriate provider
to determine whether a higher level of care and/or additional diversionary
services are necessary. A pre-recorded message will not fulfill the requirement
for access to a qualified professional.
(c) During standard hours of operation, each
center must provide individual and family crisis counseling.
(7)
Mobile Crisis
Intervention Services. Each center must provide the following
mobile crisis intervention services 24 hours per day, seven days per week, 365
days per year.
(a)
Adult Mobile
Crisis Intervention (AMCI). AMCI must utilize a multi-disciplinary
team, and AMCI services must include
1.
capacity to screen for substance intoxication or withdrawal, and to provide
access to medications for opioid use disorder for induction and urgent
psychopharmacology;
2. adherence to
the Expedited Psychiatric Inpatient Admissions (EPIA) protocol;
3. telehealth services as requested and
clinically appropriate;
4.
continued crisis intervention and stabilization services, including follow-up
care, as clinically indicated, for up to 72 hours after the initial day of
service;
5. a disposition plan that
includes referrals to the least-restrictive, clinically appropriate levels of
care, and follow-up instructions and when a member requires 24-hour level of
care, AMCI teams will facilitate admission to such levels of care;
and
6. care coordination with
existing medical and behavioral health providers and existing social service
providers, as clinically indicated.
(b)
Youth Mobile Crisis
Intervention (YMCI). YMCI must utilize a multi-disciplinary team,
and YMCI services must include
1. capacity to
screen for substance intoxication or withdrawal, and to provide access to
medications for opioid use disorder for induction and urgent
psychopharmacology;
2. capacity to
assess for parent/guardian/caregiver strengths and resources to identify how
such strengths and resources impact their ability to care for the youth's
behavioral health needs;
3.
adherence to the Expedited Psychiatric Inpatient Admissions (EPIA)
protocol;
4. telehealth services as
clinically appropriate and agreed upon by the member;
5. continued crisis intervention and
stabilization services, including follow-up care, as clinically indicated, for
up to seven days after the initial day of service;
6. a disposition plan that includes referrals
to appropriate levels of care, and follow-up instructions, and when a member
requires 24-hour level of care, YMCI teams will facilitate admission to such
levels of care; and
7. care
coordination with existing medical and behavioral health providers and existing
social service providers, as clinically indicated.
(8)
Community Crisis
Stabilization Services. Each center must provide access to the
following community crisis stabilization services 24 hours per day, seven days
per week, 365 days per year.
(a)
Adult Community Crisis Stabilization (Adult CCS). Each
center providing Adult CCS must utilize a multi-disciplinary team, and Adult
CCS services must include
1. crisis
stabilization and treatment;
2.
care coordination;
3. induction for
FDA-approved medications for opioid use disorder;
4. psychiatric evaluation and medication
management;
5. peer support and/or
other recovery-oriented services;
6. daily re-evaluation and assessment of
readiness for discharge; and
7.
psychoeducation, including information about recovery, wellness, and crisis
self-management.
(b)
Youth Community Crisis Stabilization (YCCS). Each
center providing YCCS must utilize a multi-disciplinary team, and YCCS services
must include
1. Intensive Therapeutic Milieu
(1:3 minimum Direct Care: youth ratio);
2. comprehensive assessment;
3. pharmacological evaluation and treatment
(including daily medication reconciliation);
4. treatment planning that develops a youth-
and family-centered treatment plan that specifies the goals and actions to
address the medical, social, therapeutic, educational, and other strengths and
needs of the youth;
5. daily
wellness and therapy services focused on skills building and
stabilization;
6. parent/caregiver
contact and involvement; and
7.
development of behavioral plans and crisis/safety plans.
(9)
Referral
Services.
(a) Each center must
have written policies and procedures for addressing a member's behavioral
health disorder needs that exceed the scope of services provided by the center,
including but not limited to substance use disorder needs. Policies and
procedures must minimally include personnel, referral, coordination, and other
procedural commitments to address the referral of members to the appropriate
health care providers.
(b) When
referring a member to another provider for services, each center must ensure
continuity of care, exchange of relevant health information, such as test
results and records, and avoidance of service duplication between the center
and the provider to whom a member is referred. Each center must also ensure
that the referral process is completed successfully and documented in the
member's medical record.
(c) In the
case of a member who is referred to services outside of the center, the
rendering provider must bill the MassHealth agency directly for any services
rendered to a member. The rendering provider may not bill through the referring
community behavioral health center.
(10)
Medical
Services.
(a) Each center must
conduct withdrawal management for individuals with opioid use disorder who do
not meet inpatient level of care, with or without extended onsite monitoring in
a stable environment that ensures patient confidentiality, dignity, and privacy
for members. These services must be in compliance with requirements referred to
in 130 CMR 418.000: Substance Use Disorder Treatment Services
and 105 CMR 164.000: Substance Use Disorder Treatment
Programs.
(b) Each center
must offer on-site toxicology screenings including collection and testing of
specimens using CLIA-waived testing procedures, including rapid or
point-of-care testing, at all locations to support medication initiation,
withdrawal management, and ongoing treatment for both mental health and
substance use disorders.
(c) Each
center must conduct screenings for health indicators based on member
presentation and refer members to primary care and/or specialized providers for
further assessment or treatment as clinically appropriate.
(11)
Certified Peer Specialist
(CPS) Services. The MassHealth agency will pay for CPS services
that promote empowerment, self-determination, self-advocacy, understanding,
coping skills, and resiliency through a specialized set of activities and
interactions when provided by a qualified Certified Peer Specialist to an
individual with a mental health disorder.
(12)
Peer Recovery Coach
Services. The MassHealth agency will pay for peer recovery coach
services delivered by centers in conformance with all applicable sections of
130 CMR 418.000: Substance Use Disorder Treatment
Services.
(13)
Recovery Support Navigator Services. The MassHealth
agency will pay for recovery support navigator services delivered by centers in
conformance with all applicable sections of 130 CMR 418.000: Substance
Use Disorder Treatment Services.
(14)
Community Support Program
(CSP). The MassHealth agency will pay for community support
program services delivered by centers in conformance with all applicable
sections of 130 CMR 461.000: Community Support Program
Services.
(B)
Optional Services. The below services are reimbursed
by the MassHealth agency and are intended to complement the required services
set forth in
130
CMR 448.421(A). The
following services set forth in
130
CMR 448.421(B) are billable
services and are allowed but not required to be provided by a center. All
optional services provided by the center will be set forth and documented in a
member's Treatment Plan developed pursuant to
130
CMR 448.421(A)(2).
(1)
Psychological
Testing. The MassHealth agency will pay for Psychological Testing
services delivered by centers in conformance with all applicable sections of
130 CMR 411.000: Psychologist Services.
(2)
Structured Outpatient
Addiction Program (SOAP). The MassHealth agency will pay for SOAP
services delivered by centers in conformance with all applicable sections of
130 CMR 418.000: Substances Use Disorder Treatment
Services.
(3)
Enhanced Structured Outpatient Addiction Program
(E-SOAP). The MassHealth agency will pay for E-SOAP services
delivered by centers in conformance with all applicable sections of 130 CMR
418.000: Substance Use Disorder Treatment Services.
(4)
Intensive Outpatient Program
(IOP). The MassHealth agency will pay for IOP services delivered
by centers in conformance with all applicable sections of 130 CMR 429.000:
Mental Health Center Services.