Code of Massachusetts Regulations
606 CMR - DEPARTMENT OF EARLY EDUCATION AND CARE
Title 606 CMR 3.00 - Standards for the Licensure or Approval of Residential Programs Servicing Children and Teen Parents
Section 3.05 - Intake, Service and Discharge Planning

(a) Each temporary shelter shall be available at all times for emergency admissions (i.e., 24 hours each day, seven days each week).

(b) Each licensee shall establish written eligibility criteria for admission, as required in 606 CMR 3.04(1)(b) and shall make such criteria available upon request.

(c) The program shall only admit a resident whose needs it believes can be met by the program.

(d) Programs offering temporary shelter may admit residents on their own request for up to 72 hours. In order to provide services to a child beyond 72 hours, a program must obtain written consent of the parent having custody of the child or a legal guardian, a court order, or a written agreement with a placement agency.

(e) Programs serving teen parents and transition to independent living programs may serve a resident who is younger than 18 years old upon a self-referral if the program assesses the resident to be a mature minor.

(f) Whenever possible, the licensee shall not admit a prospective resident to a program without evidence in the referral that placement in a residential program is the most appropriate plan for the resident. The licensee shall seek information from the referral source which includes evidence of attempts to provide preventive services and an examination of possible alternatives to such placement, or a statement by the referring agency as to why placement is warranted without such attempts being made.

(g) Except in cases of emergency, the licensee shall admit only those prospective residents who have had evaluations by qualified professionals covering physical, emotional, social and intellectual factors relevant to the prospective residents' situations.

(h) The licensee shall seek and document recommendations from any prior placements regarding effective and ineffective behavior de-escalation methods.

(i) For emergency admissions or admissions for purposes of evaluation, the licensee shall make appropriate and adequate provisions to meet the requirements of 606 CMR 3.05(1)(f),(g) and (h) as soon as possible after admission, provided that the licensee shall initiate the admission evaluation within one week after admission.

(j) A Shelter program shall have a written plan for providing referral services to children who cannot be admitted because the program has reached its licensed capacity or because characteristics of the child or the shelter make it inappropriate to admit the child. The plan shall provide for referral to another licensed or approved program, or placement agency.

(a) Except in cases of emergency, the licensee shall, prior to admission, provide the resident and his or her parents or guardian an opportunity to visit the program and the living unit in which the resident is likely to be placed.

(b) The licensee shall, prior to admission, (or in the case of emergency admission, within 72 hours) provide the following written materials to the resident and his or her parents or guardian(s). If the resident objects to his or her parent receiving such information the program shall not be required to provide such materials but shall maintain written documentation of the objection in the resident's file. Information required by 606 CMR 3.05(2)(b)1. through 9. shall be provided to the resident, consistent with his or her capacity to understand.

(c) The licensee shall establish procedures to prepare the staff and residents for the new resident's arrival and shall provide staff with appropriate information to receive the new resident and assist in his or her adjustment. This information shall include at a minimum, reason for placement, medical condition, information related to the residents strengths, skills and hobbies, and specific instructions related to the individual needs of the resident, including the need for an individualized restraint method, if appropriate.

(d) For residents in care longer than 72 hours, the licensee shall enter into an agreement with the placement agency referring the resident, the purchaser of services and the parent or guardian. The placement agreement shall make clear the following responsibilities:

(e) In programs serving teen parents, a placement agreement shall be maintained on file for both the teen parent and her or his child as follows:

(a) Upon admission, the licensee shall designate and prepare sleeping quarters and space for the admitted resident's personal belongings.

(b) The licensee shall assign at least one adult to help orient a newly admitted resident to the program and to the services available to the resident.

(c) The following intake services shall be provided immediately upon the admission of a child:

(d) The following services shall be provided within 24 hours of admission:

(a) All service plans, service plan reviews and discharge plans shall be developed by a team which includes those personnel of the program responsible for implementing the service plan on a daily basis. At least one member of the team shall have an advanced degree from an accredited school in social work, psychology, psychiatry or a related field, or be a certified Massachusetts school psychologist and experienced in providing direct treatment services to residents. The team shall include at least one child care worker who will be implementing the plan with the resident, the case manager and a person who has knowledge of the resident's educational program. The team shall request a representative from the referral source to participate in the development of the service plan and document notification of such meetings. Consistent with any court order and requirements of the referral source, parents shall be invited to attend service planning meetings. If parents are not invited, the reasons shall be documented.

(b) The team shall consult with the resident in developing his or her service plan, consistent with the resident's capacity to understand.

(c) The plan shall identify the child's needs, the services to be provided and the staff person responsible for providing or arranging for the services while the child is in care. The plan shall include the following areas: educational, vocational, health (including medical, dental and ancillary services); behavior support (including specific individual modifications of the restraint plan, if necessary), life skills, and social services (including family work, psychological and psychiatric services and counseling). For programs serving teen parents, the team shall include an assessment of the resident's parenting skills.

(d) If a resident has an Individual Education Plan (IEP) developed as a result of a M.G.L. c. 71B, Chapter 766 Team Evaluation, the IEP may be used to meet the requirements of part, but not necessarily all of the resident's service plan.

(e) The licensee shall explain all service plans, reviews and discharge plans to all child care personnel responsible for implementing the service plan on a daily basis, to the child's family or guardian, as appropriate, and to the resident in a manner consistent with her or his maturity and capacity to understand.

(f) The licensee shall provide a copy of all service plans, reviews and discharge plans to the referral source.

(g) Exceptions for Shelter Placement.

(a) The licensee shall review the progress, needs and service plan of each resident as often as necessary, but no less frequently than every six months. The team shall evaluate the child's progress and shall re-assess the child's needs in the areas required by 606 CMR 3.05(4)(c). For children whose placement extends longer than 45 days, the team shall specifically consider the child's legal status and need for guardianship, if any, and shall make recommendations regarding appropriate alternatives to residential placement.

(b) For children in shelter placement, service plan review and discharge planning meetings shall be held within 15 days of admission, or within a shorter period of time if appropriate, and every 15 days thereafter until discharge from the program. Each service plan review shall include specific recommendations for appropriate discharge planning, including anticipated date of discharge, recommended placement and identification of persons responsible for implementation of the plan.

(a) The licensee may request an extension of time in placement in a shelter program when, due to unforeseen or extreme circumstances, a long-term plan for the care of the child cannot be implemented in 45 days. For a child placed in a secure detention facility, an extension need not be requested unless the placement extends longer than 90 days.

(b) Requests for extensions will not be required for any child who is detained, on dual status or with outstanding charges to the Department of Youth Services and who is in care as the result of a specific court order.

(c) Specific requests for extensions shall be made to the Department in the following manner:

(d) Except in extenuating circumstances, extensions may be granted for a two week period or less.

(e) The licensee shall inform the Department of the actual discharge date and/or progress toward discharge.

(f) The licensee shall maintain a record of extensions requested through the Department and indicate whether or not these extensions were approved.

(a) For each child in care less than 45 days, a discharge summary shall be developed which includes a summary of services provided, the resident's behaviors which required the use of physical restraint and the individualized restraint method which the resident required, if applicable, the child's location after discharge and the person(s) responsible for the child's care.

(b) For each child in care longer than 45 days, the licensee shall assess the resident's needs and prepare a discharge plan at least 30 working days prior to the resident's discharge, except in the case of an emergency. In programs serving teen parents, one discharge plan may be completed for the family unit. The discharge plan shall include:

(c) Except in an emergency, the licensee shall permit transfer of a resident to another facility only with the consent of the parent or the person other than a parent who has legal custody of the child as applicable.

(d) In the case of an unplanned or emergency discharge, the licensee shall prepare a discharge summary which explains the circumstances of the discharge.

(e) The licensee shall identify in the resident's record her or his location immediately after discharge including the name, address, telephone number and relationship of the persons responsible for the resident's care.