DEPARTMENT OF PUBLIC HEALTH

M.G.L. pt. Part I, tit. Title II, ch. c. 17

in effect

M.G.L. c. 17, § 1 Composition of department

c. 17, § 1. Composition of department Section 1. There shall be a department of public health, consisting of a commissioner of public health and a public health council.

M.G.L. c. 17, § 2 Commissioner; qualifications; appointment and term; salary

c. 17, § 2. Commissioner; qualifications; appointment and term; salary Section 2. At the time of appointment, the commissioner shall be a graduate of an accredited four-year college or university and shall have had (a) not less than eight years of administrative experience of which at least three years shall have been in the organization, management or delivery of health care services; or (b) a doctorate or other degree beyond the level of baccalaureate in the field of business, economics, education, government, law, medicine, psychology, public administration, public health, public policy, social work, urban planning, or a field substantially related to one or more of the foregoing, and not less than five years of administrative experience of which at least two years shall have been in the organization, management or delivery of health care services. For the purposes of this section administrative experience shall mean service in a management or supervisory capacity. The secretary of health and human services, with the approval of the governor, shall appoint the commissioner who shall serve at the pleasure of the secretary and may be removed by the secretary at any time, subject to the approval of the governor. The position of commissioner shall be classified in accordance with section forty-five of chapter thirty and the salary shall be determined in accordance with section forty-six C of said chapter thirty and, such commissioner shall devote his full time during business hours to the duties of his office. He shall be the executive and administrative head of the department.

M.G.L. c. 17, § 2A Powers of commissioner upon declaration of emergency

c. 17, § 2A. Powers of commissioner upon declaration of emergency Section 2A. Upon declaration by the governor that an emergency exists which is detrimental to the public health, the commissioner may, with the approval of the governor and the public health council, during such period of emergency, take such action and incur such liabilities as he may deem necessary to assure the maintenance of public health and the prevention of disease. The commissioner, with the approval of the public health council, may establish procedures to be followed during such emergency to insure the continuation of essential public health services and the enforcement of the same. Upon declaration by the governor that such emergency has terminated, all powers granted to and exercised by the commissioner under this section shall terminate.

M.G.L. c. 17, § 3 Public health council

c. 17, § 3. Public health council Section 3. (a) There shall be a public health council to advise the commissioner of public health and to perform other duties as required by law. The council shall consist of the commissioner of public health as chairperson and 14 members appointed for terms of 6 years under this section. The commissioner may designate 1 of the members as vice chairperson and may appoint subcommittees or special committees as needed. (b) Four of the members shall be appointed by the governor: 1 shall be appointed from among the chancellor of the University of Massachusetts Medical School and a list of 3 nominated by said chancellor; 1 shall be appointed from among the dean of the University of Massachusetts Amherst School of Public Health or Health Sciences and a list of 3 nominated by said dean; 1 shall be appointed from among the heads of the non-public schools of medicine in the commonwealth or their nominees; and 1 shall be appointed from among the heads of the non-public schools or programs in public health in the commonwealth or their nominees. (c) Four of the appointed members shall be providers of health services, appointed by the governor: 1 of whom shall have expertise in acute care hospital management; 1 of whom shall have expertise in long term care management; 1 of whom shall have expertise in home or community-based care management, and 1 of whom shall have expertise in the practice of primary care medicine or public health nursing. (d) Six of the appointed members shall be non–providers: 1 shall be appointed by the secretary of aging and independence; 1 shall be appointed by the secretary of veterans' services; 1 shall be appointed by the governor from a list of 3 nominated by Health Care For All, Inc.; 1 shall be appointed by the governor from a list of 3 nominated by the Coalition for the Prevention of Medical Errors, Inc.; 1 shall be appointed by the governor from a list of 3 nominated by the Massachusetts Public Health Association; and 1 shall be appointed by the governor from a list of 3 nominated by the Massachusetts Community Health Worker Network. Whenever an organization nominates a list of candidates for appointment by the governor under this subsection, the organization may nominate additional candidates if the governor declines to appoint any of those originally nominated. (e) For purposes of this section, ''non-provider'' shall mean a person whose background and experience indicate that he is qualified to act on the council in the public interest; who, and whose spouse, parents, siblings or children, have no financial interest in a health care facility; who, and whose spouse has no employment relationship to a health care facility, to a nonprofit service corporation established under chapters 176A to 176E, inclusive, or to a corporation authorized to insure the health of individuals; and who, and whose spouse, is not licensed to practice medicine. (f) Upon the expiration of the term of office of an appointive member, his successor shall be appointed in the same manner as the original appointment, for a term of 6 years and until the qualification of his successor. The members shall be appointed not later than 60 days after a vacancy. The council shall meet at least once a month, and at such other times as it shall determine by its rules, or when requested by the commissioner or any 4 members. The appointive members shall receive $100 per day that the council meets, and their reasonably necessary traveling expenses while in the performance of their official duties.

M.G.L. c. 17, § 4 Other divisions; directors; civil service

c. 17, § 4. Other divisions; directors; civil service Section 4. There shall be in the department a division of sanatoria, a division of communicable and venereal diseases, a division of food and drugs, a division of alcoholism, a division of drug rehabilitation, a division of organ transplants and such other divisions as the commissioner, with the approval of the public health council, may from time to time determine. Each division shall be in charge of a director. The director of a division, other than the divisions of alcoholism and drug rehabilitation, shall be appointed by the commissioner, subject to the approval of the public health council. The director of the division of alcoholism shall be appointed by the commissioner, with the approval of the secretary of health and human services. The director of the division of drug rehabilitation shall be appointed by the commissioner, with the approval of the secretary of health and human services. The director of each division, other than divisions of alcoholism and drug rehabilitation, shall be subject to chapter thirty-one. The director of the division of alcoholism shall be a physician with special training or experience in the treatment of behavioral disorders or medico-social problems, or a person qualified by training and experience in the treatment of behavioral disorders or medico-social problems or, in the organization or administration of treatment services for persons suffering from behavioral disorders or medico-social problems. The provisions of chapter thirty-one shall not apply to the director of the division of alcoholism nor to physicians and psychiatrists therein who have full medical or psychiatric responsibilities, as opposed to administrative responsibilities, or to nurses. The provisions of chapter thirty-one shall not apply to the director of the division of drug rehabilitation. Whenever, as a condition of receiving federal grants for the purpose and programs of chapter one hundred eleven B, the federal government requires that such director of physicians and psychiatrists be subject to the civil service law, the exemption of such officer or employee from the operation of the civil service law shall not apply. There shall also be in the department a registry of vital records and statistics which may be located within such division as the commissioner determines to be appropriate. The commissioner shall appoint a registrar, subject to the approval of the public health council. The registrar shall be subject to chapter thirty-one and shall, under the supervision of the commissioner, enforce all laws relative to the registry and return of births, marriages and deaths, and may prosecute in the name of the commonwealth any violations thereof. The department may, after public hearing, promulgate regulations to insure the uniform administration of all laws relative to the registry and return of births, marriages and deaths. Proposed regulations shall be prepared for the department by the registrar and by the majority of the members of a seven person committee which shall include the registrar, no less than four town clerks as defined in subsection (e) of section one E of chapter forty-six, a genealogist to be chosen from a list of three to be submitted by the Massachusetts Historical Genealogical Society, and a historian to be chosen from a list of three to be submitted by the Massachusetts Historical Commission to be appointed by the registrar. Said regulations shall not unduly restrict access to said records by qualified genealogists and historians. The committee shall meet annually, no later than March first each year. At least twenty-one days prior to any public hearing held pursuant to section two of chapter thirty A, the commissioner shall send notice of such hearing to all city and town clerks. Said notice shall be published at least once, at least twenty-one days prior to said public hearing in the major newspapers throughout the commonwealth. The responsibility of the division of communicable and venereal diseases shall include, but not be limited to, the prevention and control of communicable and venereal diseases and the provision of diagnostic and treatment care of those having or suspected of having a venereal disease, or any program relating thereto. The commissioner may require that a physician who is to be appointed a director be certified as to his qualifications by one of the physicians specialty boards approved by the Council on Medical Education and Hospitals of the American Medical Association. There shall be within the division of food and drugs a furniture and bedding inspection section, a drugs control section, a poultry inspection section, a fish inspection section and such other sections as the director, with the approval of the department, may from time to time determine.

M.G.L. c. 17, § 4A Poison information and control center

c. 17, § 4A. Poison information and control center Section 4A. There shall be in the department a poison information and control center to accept inquiries and provide comprehensive, full-time, centralized professional information to cities and towns of the commonwealth. The department may through agencies of the commonwealth or by contract with private hospitals, institutions, agencies, individuals or groups provide for such facilities and services as may be necessary to carry out the purposes of this section.

M.G.L. c. 17, § 5 Deputy commissioners

c. 17, § 5. Deputy commissioners Section 5. The commissioner may, with the approval of the public health council, designate the director of one or more, but not more than three, divisions as deputy commissioners, who shall perform such duties as may be prescribed by the commissioner, and he may, with like approval, designate one of the deputy commissioners to perform the duties of the commissioner during his absence or disability.

M.G.L. c. 17, § 6 Assistant directors, treasurers, superintendents, inspectors and other employees

c. 17, § 6. Assistant directors, treasurers, superintendents, inspectors and other employees Section 6. The commissioner may, with the approval of the public health council, appoint assistant directors of divisions and epidemiologists, inspectors and other necessary employees. Persons appointed hereunder shall be subject to chapter thirty-one. The commissioner may require that a physician to be appointed under this section be certified as to his qualifications by one of the physicians' specialty boards approved by the Council on Medical Education and Hospitals of the American Medical Association. The commissioner, with the approval of the public health council, may appoint a treasurer for each institution, who shall give bond for the faithful performance of his duties, and may appoint a superintendent, physicians, registered nurses, licensed practical nurses, student nurses and other employees necessary for the proper administration of the affairs of the institution under the jurisdiction of the department and may incur all expenses necessary for the maintenance of the institutions. Subject to the bylaws of an institution under the control and supervision of the department, the commissioner may admit to the medical staff thereof physicians and other providers of health care who are not compensated by the commonwealth as either salaried employees or consultants. Such physicians and other providers of health care may directly bill patients and their health insurers or other third-party payors for the clinical services they furnish to patients at such institutions. The superintendent of each hospital or other institution established in the department may act on behalf and in the place of the appointing authority for any action taken under the provisions of sections fifty-three to fifty-seven, inclusive, of chapter thirty and for any action taken under sections nine A, nine B and nine D of chapter thirty and sections forty-three, forty-five and forty-six A of chapter thirty-one, relative to the discharge, removal, suspension and lay-off of a person. For all other purposes, the commissioner shall be the appointing authority; provided, however, that he may delegate preliminary authority to negotiate collective bargaining agreements and other matters relative to the right of employees to organize, negotiate and bargain with employers under section five of chapter one hundred and fifty A and section one hundred and seventy-eight F of chapter one hundred and forty-nine and other applicable statutes.

M.G.L. c. 17, § 6A Training programs for residents in medical specialties; fellowships

c. 17, § 6A. Training programs for residents in medical specialties; fellowships Section 6A. Under the supervision of the commissioner, superintendents of hospitals under the control and supervision of the department may establish programs for the training of residents in medicine, and in such other specialties and subspecialties of medicine as he may deem necessary. The persons undergoing such training shall be designated as fellows and shall be eligible for training grants from the commonwealth, which grants shall be exempt from the provisions of chapter sixty-two. Recipients of said grants shall not be subject to the provisions of chapter thirty-one and shall not be deemed to be employees of the commonwealth. Approval of said training program by the personnel administrator shall be required in accordance with the provisions of section twenty-eight of chapter seven.

M.G.L. c. 17, § 6B Hearings officer

c. 17, § 6B. Hearings officer Section 6B. The commissioner shall appoint a hearings officer who shall be an attorney and who shall not be subject to chapter thirty-one. He shall hold hearings as provided in chapter one hundred and eleven.

M.G.L. c. 17, § 7 District health officers

c. 17, § 7. District health officers Section 7. The commissioner, with the approval of the public health council, shall appoint a district health officer for each health district provided in section four of chapter one hundred and eleven. Such officers shall be graduates of incorporated medical schools, admitted to practice in the commonwealth, or shall have had at least five years' experience in public health duties and sanitary science, shall give their entire time to the performance of their duties, and shall be subject to chapter thirty-one.

M.G.L. c. 17, § 7A Public health officers; eligibility; salaries

c. 17, § 7A. Public health officers; eligibility; salaries Section 7A. The commissioner, with the approval of the secretary of health and human services, may designate certain physicians and dentists employed by the department as public health officers; provided, however, that there shall be not more than ten public health officers in the department at any one time. In order to be eligible to be designated as a public health officer, an employee shall have received a doctor of medicine, doctor of dental medicine or equivalent degree from an accredited medical or dental school, and shall be fully registered to practice medicine or dentistry in the commonwealth, and shall be serving in a management position classified as a program manager specialist allocated to Job Group M–VII, M–VIII, M–IX, M–X, M–XI or M–XII in the management salary schedule in section forty-six C of chapter thirty. The salaries of the positions in which public health officers are serving shall, however, be determined in accordance with the provisions of paragraph (5A) of said section forty-six C and shall not be subject to paragraph (4) of section forty-five of said chapter thirty.

M.G.L. c. 17, § 11 Commission on hypertension

c. 17, § 11. Commission on hypertension Section 11. There shall be in the department, but in no manner subject to its control, a commission on hypertension, hereinafter called the commission. The commission shall consist of three persons to be appointed by the governor, with the advice and consent of the council, who shall be members of the medical profession experienced in the fields of cardiovascular disease or public health, to serve for terms of one, two and three years, respectively, as he may designate. Upon the expiration of the term of a member, his successor shall be appointed in like manner for a term of three years. The members shall serve without compensation, but shall receive necessary expenses incurred in the discharge of their duties. The chairman of the commission shall be elected by the members. Said commission shall keep informed of the research program relative to high blood pressure and its control established in the Lemuel Shattuck hospital, and may recommend any legislation it deems necessary to assist and promote said program.

M.G.L. c. 17, § 13 Drug formulary commission

c. 17, § 13. Drug formulary commission Section 13. (a) There shall be in the department a drug formulary commission consisting of 16 members. The commission shall include: the commissioner of public health or a designee, who shall serve as the chair of the commission; the director of Medicaid or a designee; the commissioner of insurance or a designee; and 13 members appointed by the governor, which shall include: a clinical pharmacist; a pharmaceutical chemist; a clinical pharmacologist; a retail pharmacist; a person with experience in insurance pharmacy benefit design; 2 persons with experience in pharmaceutical manufacturing, 1 of whom shall have experience with biologics; 4 practicing physicians, 1 of whom shall specialize in addiction medicine and 1 of whom shall specialize in the treatment of chronic pain; and 2 persons who are not involved in the delivery of health services who shall be representatives of the public. One of the 2 public appointees by reason of age, training, experience and affiliation shall represent the interests of the elderly. None of the members may be employed by a pharmaceutical manufacturing company or private insurer. Members shall serve for a term of 3 years, but a person appointed to fill a vacancy shall serve only for the unexpired term. (b) The commission shall prepare a drug formulary of interchangeable drug products which shall be adopted by regulations of the department. Said formulary shall be based on assessment and evaluation of the United States Pharmacopeia and its supplements, additional pertinent listings of the Department of Health, Education, and Welfare, Food and Drug Administration, other state formularies, formularies of various hospitals of the commonwealth, as well as data submitted by manufacturers. The commission shall assess and evaluate chemical and laboratory testing data, clinical proof of bioequivalence, and therapeutic equivalence where available. The commission shall also adopt for inclusion in said formulary the list of drugs determined by the regulation of the Food and Drug Administration to be therapeutically equivalent and interchangeable when said list becomes available. The commission shall also prepare a drug formulary of chemically equivalent substitutions for drugs that are opiates, as defined in section 1 of chapter 94C, and contained in schedule II or III of section 3 of said chapter 94C that the commission has determined have a heightened level of public health risk due to the drugs' potential for abuse and misuse. The department shall adopt this drug formulary, as prepared by the commission, by regulation. The formulary shall include formulations of drugs that the commission has determined may be appropriately substituted and that incorporate any of the following abuse deterrent properties: (1) a physical or chemical barrier that (i) prevents chewing, crushing, cutting, grating, grinding, melting or other physical manipulations that enable abuse or (ii) resists extraction of the opioid by common solvents such as water, alcohol or other organic solvents; (2) an agonist or antagonist combination that interferes with, reduces or defeats the euphoria associated with abuse; (3) an aversion quality that produces an unpleasant effect if the dosage form is manipulated or altered or a higher dose than directed is used; (4) a delivery system that, under United States Food and Drug Administration guidance, offers resistance to abuse; (5) a prodrug technique that limits opioid activity until transformed in the gastrointestinal tract; or (6) any other technique, as may be identified or recommended by the United States Food and Drug Administration, that offers significant abuse deterrence. In preparing the formulary, the commission shall consider information contained in drug applications approved by the United States Food and Drug Administration and other regulatory and guidance documents distributed by the United States Food and Drug Administration. A determination of substitution between 2 drug products shall not require that both products incorporate the same methods of abuse deterrence. Inclusion of a drug on the formulary shall not be the basis for a labeling or marketing claim of abuse deterrence potential, unless the United States Food and Drug Administration authorizes such a claim. In considering whether a drug is a chemically equivalent substitution the commission shall consider: the accessibility of the drug and its proposed substitute; whether the drug's substitute is cost prohibitive; the effectiveness of the substitution; and whether, based upon the current patterns of abuse and misuse, the drug's substitute incorporates abuse deterrent technology that will be an effective deterrent to such abuse and misuse. In conducting its analysis, the commission may request an insurance benefit review by the center for health information and analysis. Said formularies shall not include drugs which are the subject matter of patent rights issued by the United States Patent Office nor shall it include those drug products for which bioequivalence is considered essential, but for which bioequivalence has not been established by the Food and Drug Administration. The commission shall provide for distribution copies of such formularies and revisions thereto amongst physicians and pharmacists licensed to practice within the commonwealth and to other appropriate individuals and shall supply a copy to any person on request upon payment of the cost of printing. Said formularies shall be revised from time to time but in no event less frequently than once a year so as to include new pertinent information on drugs approved for inclusion or drugs to be deleted and to reflect current information as to the therapeutic efficacy of drugs and pharmaceuticals. (c) The department, in cooperation with the commission, shall promulgate rules and regulations to insure public education regarding the provisions of this section. Any person or party in interest aggrieved by a finding or report of the commission shall be entitled to a judicial review thereof as provided in section fourteen of chapter thirty A. (d) For purposes of this subsection, the term ''extended release long-acting opioids'' shall mean a drug that is subject to the United States Food and Drug Administration's risk evaluation and mitigation strategy for extended release and long-acting opioid analgesics and the term ''non-abuse deterrent opioid'' shall mean an opioid drug product that is approved for medical use but does not meet the requirements for listing as a chemically equivalent substitute pursuant to this section. The commission shall also identify drugs that are extended release long-acting opioids and non-abuse deterrent opioids, contained in schedule II or III of section 3 of chapter 94C, that the commission has determined have a heightened level of public health risk due to the drugs' potential for abuse and misuse for which no adequate chemically equivalent substitute is available and shall notify the commissioner of public health that such drugs pose a threat to the public's health. (e) The commission shall also identify and publish a list of non-opioid drug products that have been approved by the United States Food and Drug Administration that are effective pain management alternatives and have a lesser potential for abuse than an opioid drug product contained in Schedules II and III of section 3 of chapter 94C. The commission shall provide for distribution, including electronic distribution, of copies of the list and revisions to the list among all prescribers and dispensers licensed to practice in the commonwealth and to other appropriate individuals and shall supply a copy to any person on request and upon payment of the cost of printing. The list shall be revised not less frequently than annually to include new pertinent information on non-opioid drug products approved for inclusion or non-opioid drug products to be deleted and to reflect current information as to the therapeutic efficacy of drugs and pharmaceuticals.

M.G.L. c. 17, § 15 Advisory council on organ and tissue transplants and donations

c. 17, § 15. Advisory council on organ and tissue transplants and donations Section 15. (a) There shall be an advisory council on organ and tissue transplants and donations which shall consist of the commissioner of public health; the registrar of motor vehicles; the director of organ transplants; the president of the Massachusetts Medical Society; and at least 6 persons to be appointed by the governor with experience in the field of organ and tissue transplants and donations, at least 1 of whom shall be a representative of a federally-designated organ procurement organization serving the commonwealth, at least 1 of whom shall be a physician experienced in organ and tissue transplantation, at least 1 of whom shall be a physician experienced in pediatric organ and tissue transplantation, at least 1 of whom may be a donated organ or tissue recipient, at least 1 of whom may be a pediatric donated organ or tissue recipient and at least 1 of whom may be an organ or tissue donor or a family member of an organ or tissue donor. Members shall be appointed for terms of 3 years and no member shall be appointed to serve for more than 2 consecutive terms. Upon the expiration of the term of an appointed member, a successor shall be appointed in like manner for a term of 3 years. (b) The governor shall annually designate the chairperson of the council from among its members. The council shall meet at least 2 times annually, and shall convene special meetings at the call of the chairperson, a majority of the members of the council, the commissioner of public health or the director of organ transplants. The director of organ transplants shall serve as the executive secretary of the council and shall attend all meetings. The council shall make an annual report to the governor, which shall include an account of all actions taken to further adult and pediatric organ and tissue donor registration, and shall file a copy of the report with the state secretary and the clerks of the senate and house of representatives. Members of the council shall serve without compensation. (c) The advisory council shall: (1) assist the commissioner of public health and the director of organ transplants in coordinating the efforts of all public and private agencies within the commonwealth concerned with the donation and transplantation of human organs and tissue; (2) advise the commissioner of public health and the director of organ transplants on policy and priority of needs for a comprehensive program relative to organ and tissue donations and transplants; (3) assist the director of organ transplants in developing strategies to increase adult and pediatric organ and tissue donor registration and awareness with a special focus upon the need for increased pediatric organ and tissue donation; provided, however, that funding to support any such strategies shall be made available from the Organ and Tissue Donor Registration Fund established in section 35E1/2 of chapter 10; (4) assist the director of organ transplants in establishing a website that provides general information relative to adult and pediatric organ and tissue donor registration and awareness, which shall include, but not be limited to, information that the council and director consider beneficial in increasing public knowledge about the need for organ and tissue donation, particularly pediatric organ and tissue donation, and a means by which the public may donate to the Organ and Tissue Donor Registration Fund; (5) facilitate and assist in the establishment of a program by which employers can match the donations of their employees to the Organ and Tissue Donor Registration Fund; (6) establish goals for increasing both adult and pediatric organ and tissue donation rates, which shall include a baseline account of current organ and tissue donation rates and periodic benchmarks for success; and (7) assist the director of organ transplants in establishing regulations which shall set forth standards and guidelines by which the director shall select individuals to receive funds from the Organ Transplant Fund established in section 35E of said chapter 10 and determine the amount each such individual shall receive.

M.G.L. c. 17, § 16 Office of violence prevention; duties

c. 17, § 16. Office of violence prevention; duties Section 16. There shall be in the department an office of violence prevention whose purpose shall be to coordinate and expand violence prevention activities, to reduce the incidences of interpersonal violence and intentional injury. The duties of said office shall consist of the following: (1) To integrate a violence prevention focus within the department of public health and those agencies which receive funding from the department; (2) To develop collaborative relationships with other state agencies which are interested or active in the reduction of interpersonal violence including child abuse, youth violence, domestic violence, sexual assault and elderly abuse; (3) To integrate violence prevention education into substance use and abuse prevention programs; (4) To support the development of comprehensive community-based violence prevention initiatives within cities and towns across the state; and (5) To develop sources of funding to maintain the office and expand its activities.

M.G.L. c. 17, § 17 Advisory council on quality of care in nursing homes; members; duties

c. 17, § 17. Advisory council on quality of care in nursing homes; members; duties Section 17. There shall be an advisory council on quality of care in nursing homes to consist of the commissioner of public health, the commissioner of medical assistance, the secretary of aging and independence, the director of the Commonwealth Corporation and 11 persons to be appointed by the governor, 2 of whom shall be representatives of the nursing home industry, 2 of whom shall be direct care workers who are certified as nurse's aides, 1 of whom shall be a registered nurse, 1 of whom shall be a licensed practical nurse, 1 of whom shall be a member of a consumer advocacy organization, 1 of whom shall be a nursing home ombudsman, 1 of whom shall be an expert in labor recruitment and issues relative to the health care workforce, 1 of whom shall be a representative of a labor organization representing nursing home direct care workers recommended by the president of the Massachusetts AFL–CIO and 1 of whom shall be a family member of a nursing home resident. The duties of the advisory council shall consist of the following: (a) to propose regulations to the department of public health establishing appropriate staffing levels for long–term care facilities to ensure quality of care for residents. In developing such regulations, the council shall consider the staffing ratios recommended by the National Citizens' Coalition for Nursing Home Reform and staffing levels established in other states; (b) to evaluate, annually, the required minimum staffing levels for nursing and ancillary nursing personnel set forth in department of public health's long–term care facility regulations and to make recommendations to ensure adequate staffing; (c) to submit a report, annually, to the governor and file a copy of the report with the state secretary, the clerks of the senate and house of representatives reflecting any legislative, budgetary and policy recommendations necessary to support and improve quality of care in nursing homes; and (d) to study the status of the healthcare workforce in the commonwealth and develop legislative, budgetary and policy recommendations on labor recruitment and retention, including workforce development, compensation and benefits for staff of long term–care facilities. In developing such recommendations, the council shall consult with individuals and organizations with expertise in the area of labor recruitment and workforce issues. Members of the council shall choose the chairperson of the council. The council shall meet at least 4 times each year and shall convene special meetings at the call of the chairperson, a majority of the members of the council or the commissioner of public health. Members of the council shall be appointed for terms of 2 years and no member shall be appointed to serve more than 2 consecutive terms. Upon the expiration of the term of an appointed member, a successor shall be appointed in like manner for a term of 2 years. Members of the council shall serve without compensation but shall be reimbursed, subject to appropriation, for expenses actually and necessarily incurred in the discharge of their duties.

M.G.L. c. 17, § 18 Bureau of substance addiction services; telephone helpline; website

c. 17, § 18. Bureau of substance addiction services; telephone helpline; website Section 18. (a) There shall be a bureau of substance addiction services within the department. (b) The bureau shall establish and advertise a free, anonymous and confidential toll-free telephone helpline that provides comprehensive, accurate and current information and referrals related to addiction treatment and prevention services. The helpline shall inform adult and juvenile callers on: (i) acute treatment service facilities and transitional support service facilities that have open beds; (ii) outpatient resources; and (iii) community-based services. The helpline shall be a resource for emergency departments, health centers, families, social workers and medical professionals to obtain information on how to get treatment for an individual who is addicted to drugs or alcohol. The administration of the helpline shall be coordinated with other departments and agencies to prevent the duplication of similar services. The operation of the helpline may be contracted to third parties; provided, however, that any such contracts shall be performance-based and subject to approval by the commissioner. (c) The bureau shall establish a website that informs the public of acute treatment service facilities and transitional support service facilities that have open beds. The bureau shall update the website daily. The website shall provide the following information about each facility that has an open bed: (i) the name, address, telephone number and website of the facility; (ii) information about the types of payment that the facility accepts; and (iii) a description of the types of programs and services provided at the facility. The website shall also provide information about services available in each region of the commonwealth including, but not limited to, alcohol and drug free housing as defined in section 18A, outpatient services and community-based services.

M.G.L. c. 17, § 18A Voluntary training and accreditation program for operators of alcohol and drug free housing

c. 17, § 18A. Voluntary training and accreditation program for operators of alcohol and drug free housing Section 18A. (a) As used in this section, the following words shall have the following meanings unless the context clearly requires otherwise: ''Alcohol and drug free housing'', a residence, commonly known as a sober home, that provides or advertises as providing, an alcohol and drug free environment for people recovering from substance use disorders; provided, however, that, ''Alcohol and drug free housing'' shall not include a halfway house, treatment unit or detoxification facility or any other facility licensed pursuant to section 7 of chapter 111E. ''Bureau'', the bureau of substance addiction services established in section 18. ''Certified alcohol and drug free housing'', alcohol and drug free housing that has been accredited by the bureau pursuant to this section. ''Director'', the director of substance addiction services. ''Operator'', the lawful owner of alcohol and drug free housing or a person employed and designated by the owner to have primary responsibility for the daily operation of such housing and for maintaining standards and conditions in such housing that create an environment supportive of substance use disorder recovery. (b) The bureau shall establish and provide for the administration of a voluntary training and accreditation program for operators of alcohol and drug free housing seeking certification under subsection (d). (c) The accreditation program established pursuant to this section shall maintain nationally-recognized standards and practices that: (i) uphold industry best practices and support a safe, healthy and effective recovery environment; (ii) evaluate the ability to assist persons in achieving long-term recovery goals; (iii) provide for appropriate training for the operators and staff and ensure satisfactory completion of such training; (iv) protect occupants of alcohol and drug free housing against unreasonable and unfair practices in setting and collecting rent payments; and (v) verify good standing with regard to local, state and federal laws and any regulations and ordinances including, but not limited to, building, maximum occupancy, fire safety and sanitation codes. (d) The bureau shall include a residence on a list of certified alcohol and drug free housing as described in subsection (f) upon receipt and review of: (i) the completion of training as described in subsection (c); (ii) a deed, trust document, articles of incorporation, lease or other document acceptable to the director evidencing that the individual or entity seeking certification is the lawful owner or lessee of the parcel where the housing shall be located; and (iii) a certificate issued pursuant to section 23 of chapter 60 indicating that there are no taxes or other assessments that constitute liens on the parcel of real estate upon which the housing shall be located. (e) The director shall periodically evaluate the quality of training being provided to operators seeking certification and the integrity and efficacy of the accreditation program. (f) The bureau shall prepare, publish and disseminate a list of alcohol and drug free housing certified pursuant to this section; provided, however, that the list shall be updated bimonthly. The list shall be disseminated to the director of the division of drug rehabilitation and to each state agency or vendor with a statewide contract that provides substance use disorder treatment services. The commissioner of probation shall inform all district and superior court probation officers and the chief justice of the trial court shall inform all district and superior court judges on how to access the list. The list shall also be posted on the website established pursuant to section 18. (g) The department, in consultation with the bureau, shall promulgate rules and regulations to implement this section that shall include a process for receiving complaints against certified alcohol and drug free housing and criteria by which the director may exclude a residence from the list prepared under subsection (f) if the frequency and severity of complaints received supports a determination that the alcohol and drug free housing in question does not maintain standards or provide an environment that appropriately supports the recovery goals of its residents. (h) A state agency or vendor with a statewide contract that is providing treatment or services to a person, or a state agency or officer setting terms and conditions for the release, parole or discharge of a person from custody or treatment, shall not refer that person to alcohol and drug free housing and shall not otherwise include in such terms and conditions a referral to alcohol and drug free housing unless the alcohol and drug free housing is certified pursuant to this section. Nothing in this section shall prohibit a residence that has not received certification from operating or advertising as alcohol and drug free housing or from offering residence to persons recovering from substance use disorders.

M.G.L. c. 17, § 19 Regulations relative to coordination of care and management; discharge planning for substance use disorder treatment programs

c. 17, § 19. Regulations relative to coordination of care and management; discharge planning for substance use disorder treatment programs Section 19. The department shall promulgate regulations relative to coordination of care and management that includes effective discharge planning for substance use disorder treatment programs subject to licensure or approval under sections 24 and 24D of chapter 90, sections 6 and 6A of chapter 111B and section 7 of chapter 111E. The regulations shall include, but not be limited to, a requirement that such substance use disorder treatment providers shall: (1) provide enhanced care coordination and management, which shall include effective discharge planning that engages and educates the patient and the patient's outpatient medical and psychiatric providers to ensure continuity of care; (2) provide a discharge plan to each client leaving a licensed substance use disorder treatment program, which shall include recommended follow-up treatment, contact information for certified alcohol and drug free housing pursuant to section 18A, additional resources for substance use disorder treatment, including information on United States Food and Drug Administration-approved medication assisted-treatment and the availability of such treatments in each geographic region of the commonwealth, resources for workforce options, information and links to community and social supports and information on family support services; (3) provide patient specific treatment that is individualized based on the patient's past history of treatment, medical history, psychiatric history and social history; (4) facilitate transitions from more intensive to less intensive treatment based on the patient's needs and response to treatment; (5) upon admission, acquire informed consent from each patient regarding the risk and benefit of all medication assisted treatment options, as well as the risk and benefit of not receiving treatment; (6) provide information to the patient prior to discharge about the patient's option to file a voluntary non-opiate directive form pursuant to section 18B of chapter 94C; and (7) provide regular monitoring of patients' behavior and addressing relapse risks. A discharge plan shall not include a referral or recommendation to alcohol and drug free housing unless such housing is certified pursuant to section 18A.

M.G.L. c. 17, § 20 Domestic and Sexual Violence Prevention and Victim Assistance Fund

c. 17, § 20. Domestic and Sexual Violence Prevention and Victim Assistance Fund Section 20. There shall be established and placed within the department of public health a fund to be known as the Domestic and Sexual Violence Prevention and Victim Assistance Fund, in this section referred to as the fund, to support innovative practices to prevent domestic and sexual violence and provide assistance to victims of domestic violence in the commonwealth. The fund shall be credited any appropriations, bond proceeds or other monies authorized by the general court, which may properly be applied in furtherance of the objectives of the fund, domestic and sexual violence prevention and victim assistance assessments, as specified in section 8 of chapter 258B, and any other monies which may be available for the purposes of the fund from any other source or sources. Any revenues, deposits, receipts or funds received shall be deposited in the fund and shall be available for the purposes described in this section, without further appropriation. Money remaining in the fund at the end of the year shall not revert to the General Fund. The fund shall be under the control of the department of public health and not subject to appropriation. The fund shall be used for innovative practices, which shall include, but not be limited to: (i) community-based domestic and sexual violence prevention and assistance programs and service providers; (ii) multi-disciplinary teams addressing victims of domestic and sexual violence at high risk of homicide or fatality; and (iii) other programs and service providers that support victims of domestic and sexual violence.

M.G.L. c. 17, § 21 Promulgation of regulations relative to patient access to hospital emergency rooms or departments requiring hospitals to meet minimum criteria and standards that ensure safe, timely and accessible patient access to hospital emergency rooms or departments at all times

c. 17, § 21. Promulgation of regulations relative to patient access to hospital emergency rooms or departments requiring hospitals to meet minimum criteria and standards that ensure safe, timely and accessible patient access to hospital emergency rooms or departments at all times Section 21. The department of public health shall promulgate regulations relative to patient access to hospital emergency rooms or departments that would require all hospitals in the commonwealth to meet minimum criteria and standards that ensure safe, timely and accessible patient access to hospital emergency rooms or departments at all times. The regulations shall include, but not be limited to: (a) criteria and standards related to: (1) legible indoor and outdoor signage; (2) indoor and outdoor lighting; (3) best-practice wayfinding signage; and (4) security and monitoring of all emergency department access points; (b) minimum requirements for proper security monitoring of any prominent hospital door or entrance that is locked at night and through which a patient may try to enter; and (c) any other safety feature that the department deems necessary to ensure daytime or nighttime entry to an emergency room or department. In promulgating the regulations, the department shall: (a) ensure that all patients, including patients at all levels of physical, sensory and brain-based function, are able to access hospital emergency rooms or departments; and (b) consider the most-current published industry standards and best practices, including, but not limited to, standards under the federal Americans with Disabilities Act, local codes, regulations, including regulations promulgated by the architectural access board, and any guidance or resources from the Facility Guidelines Institute Inc. and the International Association for Healthcare Security and Safety.

M.G.L. c. 17, § 22 Standards for a certified training program for schools; certifying documentation; review of certifying documentation; evaluation of the integrity and efficacy of training programs; preparation, publishing, dissemination and annual update a list of certified schools

c. 17, § 22. Standards for a certified training program for schools; certifying documentation; review of certifying documentation; evaluation of the integrity and efficacy of training programs; preparation, publishing, dissemination and annual update a list of certified schools Section 22. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings: ''Certified school'', a school certified by the department pursuant to subsection (c). ''Certified training program'', a training program certified by the department pursuant to subsection (b). ''Operation House Call'', a program developed by the Arc of Massachusetts that teaches health care professionals skills to enhance the treatment and care of persons with autism and other intellectual and developmental disabilities. ''School'', an accredited institution of higher education that provides a course of study for students in: (i) health care, including, but not limited to, medical schools, nursing schools and dental schools; or (ii) other related fields, including, but not limited to, physician assistants, dieticians, nutritionists, physical therapists, dental hygienists, allied mental health and human services professionals. ''Training program'', training for students that focuses on instruction and best practices for the treatment and care of patients with intellectual and developmental disabilities, including, but not limited to, autism spectrum disorders. (b) The department, in consultation with the department of developmental services and the Arc of Massachusetts, shall establish standards for a certified training program for schools. A training program, to be certified by the department as a certified training program, shall: (i) be modeled on Operation House Call; (ii) be offered by schools to participating students on a voluntary basis separate from the students' required course of study; and (iii) maintain recognized standards and practices that provide instruction to students that: (A) uphold industry standards for instructing students pursuing a health care profession on best practices for the treatment and care for individuals with intellectual and developmental disabilities, including, but not limited to, autism spectrum disorders; and (B) include not less than 6 hours of training consisting of didactic classroom instruction, experiential learning and online learning. (c) The department shall certify that a school offers a certified training program, as described in subsection (b), upon receipt and review of documentation demonstrating that: (i) the school has successfully delivered the training program to a sufficient number of participating students, as mutually agreed upon by the school and the provider of the training; and (ii) the training program meets the minimum standards and practices pursuant to subsection (b). (d) The director of the bureau of family health and nutrition shall periodically evaluate the integrity and efficacy of the training programs offered at schools seeking certification. (e) The department shall prepare, publish, disseminate and annually update a list of certified schools. The list of certified schools shall be published in a location that is accessible to prospective students seeking to apply to attend a school in a health care or related field.

Source: Massachusetts General Court (malegislature.gov)URL: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter17Fetched: 10/20/2026