(1)
A center must maintain member records in accordance with 130 CMR 450.000:
Administrative and Billing Regulations and 105 CMR 140.000:
Licensure of Clinics, in addition to applicable recordkeeping
requirements for clinics under M.G.L. c. 111 § 70. When a member is
referred to any other provider, each center will maintain the original member
record and forward a copy to the other provider.
(2) Member records must be complete,
accurate, and properly organized.
(3) The member's record will include at least
the following information:
(a) the member's
name and case number, MassHealth identification number, address, telephone
number, gender identity, date of birth, marital status, next of kin, school or
employment status (or both), and date of initial contact;
(b) the place of service;
(c) a report of a physical examination
performed within 12 months of the date of intake, including documentation the
physical examination informed the treatment plan, or documentation that the
member did not want to be examined and any stated reason for that
preference;
(d) the name and
address of the member's primary care physician or, if not available, another
physician who has treated the member;
(e) the member's description of the problem,
and any additional information from other sources, including the referral
source, if any;
(f) the events
precipitating the member's contact with the center;
(g) the relevant medical, psychosocial,
educational, and vocational history;
(h) a comprehensive assessment of the member
initiated at intake;
(i) the
clinical impression of the member and a diagnostic formulation, including a
specific diagnosis using standard nomenclature;
(j) short- and long-range goals that are
measurable, realistic and obtainable, and a timeframe for their
achievement;
(k) the proposed
schedule of therapeutic activities, both in and out of the center, necessary to
achieve such goals and objectives and the responsibilities of each individual
member of the interdisciplinary team;
(l) a schedule of dates for utilization
review to determine the member's progress in accomplishing goals and
objectives;
(m) the name,
qualifications, and discipline of the therapist primarily responsible for the
member;
(n) a written record of
semi-annual reviews (every six months) by the primary therapist, which relate
to the short and long range goals;
(o) progress notes, including those related
to the defined treatment plan goals on each visit written and signed by the
primary therapist that include the therapist's discipline and degree;
(p) a treatment plan for the member signed by
the primary therapist, or the supervisor of an unlicensed primary therapist,
pursuant to
130
CMR 448.412(A)(3);
(q) all information and correspondence
regarding the member, including appropriately signed and dated consent
forms;
(r) a drug-use profile (both
prescribed and other);
(s) when the
member is discharged, a discharge summary, including a brief summary of the
member's condition and response to treatment, achievement of treatment and
recovery goals, and recommendations for any future appropriate services;
and
(t) for members younger than 21
years old, a CANS completed during the initial behavioral health assessment and
updated at least every 90 days thereafter.
(4) A brief history is acceptable for
emergency or walk-in visits when the treatment plan does not call for extended
care.