DEPARTMENT OF MENTAL HEALTH

M.G.L. pt. Part I, tit. Title II, ch. c. 19

in effect

M.G.L. c. 19, § 1 Creation; powers of department and commissioner; safety symposium

c. 19, § 1. Creation; powers of department and commissioner; safety symposium Section 1. There shall be a department of mental health, in this chapter called the department, and a commissioner of mental health who shall have and shall exercise supervision and control of the department. All action of the department shall be taken by the commissioner, or under the direction of said commissioner, by such agents or subordinate officers as he shall determine. The department shall take cognizance of all matters affecting the mental health of the citizens of the commonwealth; provided, that the primary mission of the department shall be to provide for services to citizens with long-term or serious mental illness, early and ongoing treatment for mental illness, and research into the causes of mental illness. The department shall have supervision and control of all public facilities, for mentally ill persons and of all persons received into any of said facilities and shall have general supervision of all private facilities for such persons; provided, however, that this sentence shall not be deemed to interfere with or supersede any other provision of general or special law which grants or confers supervision and control of certain public facilities for mentally ill persons and persons admitted to such facilities or which grants or confers supervision over certain private facilities for such persons, to any other department of the commonwealth or to any political subdivision. The department shall have supervision and control of all hospitals, comprehensive centers and clinics, and other mental health facilities established within the department and, subject to appropriation, may further develop additional state hospitals, comprehensive centers and clinics, or other mental health facilities under commonwealth operation or, subject to appropriation, may contract with any private hospital, institution, nonprofit charitable corporation, partnership, collaborative or other agency furnishing community or complementary mental health services to pay it the ordinary and reasonable compensation for such services actually rendered or furnished to persons in need thereof. Such agreements may provide for the retention of all revenues resulting from all billings and third party reimbursements by the contracting agency, provided that the expenditure of such funds is made in conformance with applicable state and federal law and subject to the approval of the commissioner. The department shall designate those facilities to which persons may be committed or admitted as patients under the provisions of chapter one hundred and twenty-three. The department shall periodically inform the courts as to the available facilities to which persons may be committed or admitted as patients or residents. The department shall be a corporation for the purpose of taking, holding and administering in trust for the commonwealth any grant, devise, gift or bequest made either to the commonwealth, to it, or to any state hospital or other mental health facility of the department, for the use of persons under its control in any mental health facility of the department, or for the use of such hospital or facility, or if the acceptance of such trust is approved by the governor, for expenditure upon any work which the department is authorized to undertake. The department shall select the site of any new state mental health facility and any land to be taken or purchased by the commonwealth for the purposes of any new or existing state mental health facility. The department of highways shall construct and maintain roads on the grounds of property of a state mental health facility; and expenses so incurred shall be paid from appropriations for the maintenance of such facility. The department may make contracts with the federal government relative to receiving persons in the United States armed forces for care and treatment in departmental facilities and for support of such persons. The department shall, on an annual basis, conduct a safety symposium known as the Stephanie Moulton Safety Symposium, which shall be a forum to discuss topics including, but not limited to, best safety practices and policies and risk management for community-based services.

M.G.L. c. 19, § 2 Commissioner; appointment; qualifications; appointments by commissioner; report; salary

c. 19, § 2. Commissioner; appointment; qualifications; appointments by commissioner; report; salary Section 2. The secretary of health and human services shall appoint, with the approval of the governor, a commissioner of mental health 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. Such commissioner shall have such educational qualifications and such administrative and other experience, including education or experience in a field related to human services, as the secretary of health and human services determines are necessary for the performance of the duties of the commissioner. The commissioner shall appoint and may remove such agents and subordinate officers as the commissioner may deem necessary, and may establish such divisions or regional management systems in the department as the commissioner deems appropriate from time to time. Except as otherwise provided by law all offices and positions shall be subject to the provisions of chapter thirty-one; provided, however, the provisions of chapter thirty-one shall not apply to physicians and psychiatrists with full medical-psychiatric responsibility as opposed to administrative responsibility, to community mental health area directors appointed under the provisions of section thirteen, to nurses employed as such by the department, or to attorneys acting as legal counsel; and provided further, however, and notwithstanding the preceding provision or any other provision of law, all offices and positions which as a condition of receiving federal grants for programs and activities to which the federal standards for a merit system of personnel administration relate and make necessary the application of the provisions of the civil service law, shall be subject to the provisions of chapter thirty-one if such federal standards are uniform in all states. At the end of each fiscal year, the commissioner shall make an annual report of the activities of the department, and of each facility, clinic, or unit under its control, the cost of operating the same, the initiation of new programs, and the progress made in providing services and facilities for mental health in the commonwealth. 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. Prior to undertaking any activity or implementing any policy which would affect expenditures for medical assistance under chapter one hundred and eighteen E, involving the delivery of services reimbursable under said chapter, certification and licensure of providers of services under said chapter, or identifying individuals eligible for such assistance under said chapter, the commissioner shall assure that such activity or policy is reviewed by the commissioner of medical assistance.

M.G.L. c. 19, § 3 Deputy commissioner; appointment; duties; qualifications

c. 19, § 3. Deputy commissioner; appointment; duties; qualifications Section 3. The commissioner shall appoint, with the approval of the secretary of health and human services, a person qualified to serve as deputy commissioner of mental health. Said deputy commissioner shall perform such duties as the commissioner may determine and shall, in the case of a vacancy in the office of the commissioner, and during said commissioner's absence or disability, exercise the powers and perform the duties of the office of the commissioner. Said deputy commissioner may be allowed such professional affiliations as the commissioner approves, subject to the provisions of chapter two hundred and sixty-eight A. The deputy commissioner shall have such educational qualifications and such administrative and other experience, including education or experience in a field related to human services, as the commissioner determines are necessary for the performance of the duties of the deputy commissioner. The commissioner or a deputy commissioner shall be a diplomate in psychiatry of the American Board of Psychiatry and Neurology, Inc.

M.G.L. c. 19, § 4 Assistant, deputy or associate commissioners; appointment; duties; qualifications

c. 19, § 4. Assistant, deputy or associate commissioners; appointment; duties; qualifications Section 4. The commissioner shall appoint, subject to appropriation, such other assistant, deputy or associate commissioners as the commissioner may determine to be necessary or desirable to carry out the work of the department. Assistant, deputy and associate commissioners shall be assigned areas of responsibility to be specified by the commissioner. At the time of appointment, they shall possess such qualifications as the commissioner shall determine. Persons appointed to such positions shall serve at the pleasure of the commissioner. Chapter thirty-one and section nine A of chapter thirty shall not apply to said positions.

M.G.L. c. 19, § 5 Legal counsel

c. 19, § 5. Legal counsel Section 5. The commissioner shall appoint a member of the Massachusetts bar to serve as legal counsel to the commissioner. Such legal counsel shall devote full time to his duties. Such legal counsel shall have been a member of the bar for not less than six years and shall have been actively engaged in the practice of law.

M.G.L. c. 19, § 6 Program for training of residents in psychiatry and other professional disciplines

c. 19, § 6. Program for training of residents in psychiatry and other professional disciplines Section 6. The commissioner may establish a program for the training of residents in psychiatry and any other professional disciplines as required by departmental programs. Such residents shall be eligible for training grants from the commonwealth. Recipients of said grants shall be exempt from the provisions of chapter thirty-one and shall not be deemed employees of the commonwealth; provided, however, that such recipients shall be deemed public employees under chapter two hundred and fifty-eight. Such grants shall not be deemed income under chapter sixty-two. Approval of such training programs by the personnel administrator shall be required in accordance with the provisions of section twenty-eight of chapter seven.

M.G.L. c. 19, § 7 State facilities under department control; admission

c. 19, § 7. State facilities under department control; admission Section 7. The state facilities under the control of the department shall be such state hospitals, mental health centers and other mental health facilities as the commissioner from time to time shall designate in the regulations of the department, including any facilities or portions thereof which the department may, subject to appropriation, construct or develop for use as homes or facilities for aging persons who are not mentally ill. Admissions of patients to said facilities or homes for aging persons shall be voluntary and not by commitment and said facilities or homes, although under the supervision and control of said department, shall be deemed to be public medical institutions within the meaning of section two of chapter one hundred and eighteen E.

M.G.L. c. 19, § 8 Superintendents or directors; vacancies; appointments; qualifications; officers

c. 19, § 8. Superintendents or directors; vacancies; appointments; qualifications; officers Section 8. When a vacancy occurs in the positions of superintendent of a state hospital of the department or director of any other mental health facility of the department, the commissioner shall appoint to such a vacancy a person who has such educational qualifications and such administrative and other experience, including education or experience in the care, treatment or education of the mentally ill, as the commissioner determines are necessary for the performance of the duties of superintendent or director. The superintendent with the approval of the commissioner shall appoint and may remove a treasurer and assistant treasurer in each state hospital, each of whom shall give bond for the faithful performance of this duties. The provisions of section forty-nine of chapter thirty-one shall apply to the appointment of such treasurers and assistant treasurers. The superintendent with the approval of the commissioner shall appoint and may remove assistant physicians and necessary subordinate officers and other persons. The superintendent may require that a physician who is to be so appointed 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.

M.G.L. c. 19, § 8A Boards of trustees for Taunton state hospital and Worcester recovery center and hospital

c. 19, § 8A. Boards of trustees for Taunton state hospital and Worcester recovery center and hospital Section 8A. The governor shall appoint a board of trustees for the Taunton state hospital and for the Worcester recovery center and hospital. A majority of the members of each such board of trustees shall be consumers and their guardians or family members. Said board shall visit and familiarize itself with its state hospital, and may from time to time make suggestions to the department as to improvements therein, especially such as will make the administration thereof more effective, economical and humane. Said board shall serve without compensation, but each member shall be reimbursed by the commonwealth for all expenses incurred in the performance of his duties.

M.G.L. c. 19, § 10 Crimes committed by or upon persons on facility premises or persons in care of facility

c. 19, § 10. Crimes committed by or upon persons on facility premises or persons in care of facility Section 10. The superintendent of any state hospital or the director of any mental health facility of the department, who has reason to believe that a crime which is punishable by imprisonment in the state prison has been committed by or upon any person on the premises of the particular facility or by or upon any person in the care of the particular facility but not on the premises thereof, shall, no later than one week from the date of the commission of such crime, report the same to the district attorney of the district within which the crime was committed.

M.G.L. c. 19, § 11 Mental health advisory council

c. 19, § 11. Mental health advisory council Section 11. There shall be a mental health advisory council consisting of fifteen persons to be appointed by the secretary of health and human services, with the approval of the governor, eight of whom shall be members of community mental health area boards, and of the remaining seven, one shall be a professional in the field of children's mental health and at least four shall be appointed to represent one of the following professions and groups: state level medical, psychological, nursing, educational, social work, occupational therapy, or bar associations, associations for mental health, industrial and labor groups and the clergy. Upon the expiration of the term of office of any member, his successor shall be appointed for a term of three years. No member shall be appointed to serve more than two consecutive three-year terms. The councils shall elect a chairman annually. The council shall serve without compensation, but each member shall be reimbursed by the commonwealth for all expenses incurred in the performance of his official duties. Said advisory council shall have the following duties: (a) It shall advise the commissioner on policy, program development, and priorities of need in the commonwealth for comprehensive programs in mental health; (b) It shall participate with the department in holding a regular series of public hearings throughout the commonwealth to obtain the views of the area boards and other citizens concerning the programs of the department and the needs of the people for mental health services; (c) It shall review the annual plans and the proposed annual budget of the department, and shall make recommendations to the commissioner in regard thereto; (d) It shall hold at least three meetings per year and shall convene special meetings at the call of the chairman of the council, a majority of the council, or the commissioner.

M.G.L. c. 19, § 11A Disclosure of financial interest in department contracts by human rights advisory committee members

c. 19, § 11A. Disclosure of financial interest in department contracts by human rights advisory committee members Section 11A. Nothing in section 7 of chapter 268A shall prevent a person who has a financial interest, directly or indirectly, in a contract made by the department of mental health from serving as a member of the department's human rights advisory committee. Members of such committee shall disclose their financial interest, if any, in a department contract by notifying in writing the commissioner and the state ethics commission.

M.G.L. c. 19, § 12 Community mental health services

c. 19, § 12. Community mental health services Section 12. The department shall establish a comprehensive program of community mental health services which shall include state hospitals, clinics, comprehensive centers and other facilities of the department, and to promote such programs the department shall divide the commonwealth into service areas for the conduct of said mental health services, and shall establish standards for the development of said community programs. Each area shall be drawn so as to include and to allow for the development of mental health services and facilities, as needed, which shall be readily accessible to the people in the area, taking into consideration such factors as geographic boundaries, roads and other means of transportation, population concentration, city, town and county lines, other relevant community services, and community economic and social relationships.

M.G.L. c. 19, § 13 Community mental health area directors

c. 19, § 13. Community mental health area directors Section 13. The commissioner shall, after consultation with the area board, appoint in each community mental health area an area director. Such area director shall have such educational qualifications and such administrative and other experience, including education or experience in a field related to human services, as the commissioner determines are necessary for the performance of the duties of area director. The area director shall perform such duties as are described in this chapter and any other law and such other duties as are assigned by the department. Where there is established within the area a comprehensive center operated by the department and designated as a comprehensive center by the commissioner, the area director may also serve by appointment of the commissioner as head of such center. The area board shall also serve as the citizen board for such center and no other board shall be formed or designated for such center. The area director, subject to departmental regulations, shall supervise all employees within such center. Salaries for area directors shall be fixed under and in accordance with sections forty-five to fifty, inclusive, of chapter thirty, taking into account those individual cases where an area director is also superintendent of a state hospital or a comprehensive center.

M.G.L. c. 19, § 14 Community mental health area boards

c. 19, § 14. Community mental health area boards Section 14. In each area established under section twelve there shall be a community mental health area board, hereinafter called the area board, which shall be an agency of the commonwealth, and shall serve in the department. The area board shall consist of not fewer than 15 members, who shall be appointed by the commissioner. Two thirds of the members shall live within the area for which they are appointed, and the remaining members shall either live or work within said area. The commissioner shall seek to provide proper geographical representation in the membership of the board. Two thirds of such members shall be persons other than employees of the commonwealth. No member shall be an employee of the department. Upon the expiration of the term of any member of the area board, a successor shall be appointed, in like manner, for a term of three years. In the event of vacancy, the commissioner may, in like manner, appoint a member who shall serve for the remainder of the unexpired term. Members of the board shall serve without compensation, and shall be sworn to the faithful performance of their duties. The area board shall suggest for consideration by the commissioner one or more names for each such expiring term or vacancy. No member shall be appointed for more than two consecutive three-year terms.

M.G.L. c. 19, § 15 Duties and powers of area boards

c. 19, § 15. Duties and powers of area boards Section 15. The area board shall have the following duties and powers: (a) to act as the representative of the citizens of the area; (b) to advise regarding local needs and resources in the development of comprehensive mental health services; (c) to advise in the recruitment and selection of the area director to be appointed by the commissioner, provided that, where the area director will also be an executive head of a facility which is integrated with a university medical center or medical school or with a hospital, the university, medical school, or hospital authorities shall advise in the recruitment and selection of such director; provided, that the commissioner may designate a person to act as area director in any case in which such office shall be vacant; (d) to review and make recommendations concerning the annual budget for the comprehensive mental health services of the area; (e) to review programs and services which are a part of the program of the area but which are not conducted within commonwealth-operated facilities; (f) to consult with the commissioner in personnel recruitment and appointment policies, in the establishment of program priorities for the area, in admission policies for all facilities and services, and in policies regarding relationships with other agencies and organizations; (g) to communicate with the mental health advisory council, established under section eleven, to discuss any matters concerning the area program; (h) to receive and administer any gift or bequest of personal property or funds in trust or any grant or devise of lands made to its use in trust in the interest of the area program of mental health services, or for any special purpose as indicated in the gift or grant in trust, and may invest the proceeds thereof in notes, bonds or property secured by sufficient mortgages; (i) to hold regular meetings in each year and to convene special meetings on the call of the president, or ten members of the board, or the area director, or the commissioner. The area director shall be notified of, and may participate in, all meetings, but shall not vote; (j) to elect from their members annually a president and such other officers as they deem appropriate. The area board shall adopt rules for its proper organization and for procedures at meetings. Such rules and any subsequent amendments thereto shall be submitted to the commissioner for approval.

M.G.L. c. 19, § 16 Development and maintenance of community mental health services

c. 19, § 16. Development and maintenance of community mental health services Section 16. The department shall develop and maintain, subject to appropriation, and in accordance with its standards, a comprehensive, area-based system to provide community mental health services, including specialized services for both children and adults. Major consideration shall be given to the development of (a) inpatient services; (b) outpatient services; (c) emergency services on a twenty-four hour basis; (d) partial hospitalization services for day care and night care; (e) mental health consultation and educational services to community agencies and professional personnel practicing in the area; (f) employment opportunities for patients; and (g) support services to enable patients to live in apartment housing in the community. Mental health services shall include case management services, the primary purpose of which is to assure continuity of care for a patient's medical or psychiatric needs, but which shall include a determination of eligibility for existing federal, state, and municipal programs to provide for social and economic needs as well. The department shall issue rules and regulations which shall govern the provision of such management services, to be implemented and adhered to by each area, provided, however, that each patient shall have the right to confidentiality of all records and communications to the extent provided by chapter one hundred and twenty-three. Mental health services shall also, where applicable, include: (a) diagnostic services; (b) rehabilitative services; (c) preventive, precare, and aftercare services within the area; and (d) research programs including evaluation of effectiveness and efficiency of the various programs operating within the area. The services described in this section may, unless otherwise provided in this chapter or by departmental regulations, be developed for each area through commonwealth-operated facilities or, subject to appropriation, by contracts for services. Programs and services may also be developed in cooperation with facilities or other resources located in other community mental health areas of the commonwealth or operated regionally, subject to appropriation. In arranging cooperative services between or among areas, or on a regional basis, provision should be made to ensure continuity of services to clients. The department may also receive funds under contracts or other agreements from community sources, including municipalities as authorized by clause (40C) of section five of chapter forty for the rendering of services in collaboration with such municipal or other community or private agencies providing cooperative or complementary services. Those eligible for participation in any one service must be eligible for and have access to other services made available in the area. Services shall be offered without discrimination to all people in the area except where specialized programs are developed such as for children or the aging, provided that within such specialized categories the services shall be equally available to all such persons in the area. Notwithstanding any provision of law to the contrary, all revenues received by the community mental health facilities operated by the department shall be deposited in one or more trust funds in the state treasury of which the commissioner shall be trustee and may be expended by the department for the operation and maintenance of such community mental health facilities and may be further expended for the management, stabilization, and delivery of mental health services by and through such community mental health facilities and other affiliated service providing agencies; provided, that all expenditures from said trust funds so made shall conform to standard state accounting procedures and such further requirements as prescribed by the comptroller; provided further, that the commissioner in his capacity as trustee shall report monthly to the commissioner of administration and to the house and senate committees on ways and means such revenues and reimbursements received and expenditures made; and provided further, that whenever any such trust fund ceases to be operative, all monies remaining in such fund shall accrue to the General Fund.

M.G.L. c. 19, § 16A Program to provide remote mental health consultations

c. 19, § 16A. Program to provide remote mental health consultations Section 16A. (a) Subject to appropriation, the department shall operate a statewide program to provide remote mental health consultations available for a at least 5 days a week to pediatricians, family physicians, nurse practitioners and primary care practices for persons under the age of 19 who exhibit a possible mental health or substance use disorder and to health care providers of women who are presenting with signs of postpartum depression. (b) Expenditures on the program by the department that are related to services provided on behalf of commercially-insured clients shall be assessed by the commissioner on surcharge payors as defined in section 64 of chapter 118E.

M.G.L. c. 19, § 17 Area advisory committees

c. 19, § 17. Area advisory committees Section 17. The area board may appoint such advisory committees as it may from time to time deem necessary. The members of such committees shall serve for such terms as the area board may determine.

M.G.L. c. 19, § 18 Rules and regulations

c. 19, § 18. Rules and regulations Section 18. The department may from time to time adopt such rules and regulations as it deems necessary to carry out the provisions of this chapter, and may amend or repeal the same.

M.G.L. c. 19, § 19 Inpatient psychiatric, residential or day care services; licenses

c. 19, § 19. Inpatient psychiatric, residential or day care services; licenses Section 19. (a) The department shall issue for a term of 2 years, and may renew for like terms, a license, subject to revocation by the department for cause, to any private, county or municipal facility or department or unit of any such facility that: (i) offers to the public inpatient psychiatric, residential or day care services; (ii) is represented as providing treatment of persons with a mental illness; and (iii) meets the department's applicable licensure standards and requirements, set forth in regulations of the department; provided, however, that: (1) the department may issue a license to those facilities, departments or units providing care but not treatment of persons with a mental illness; and (2) licensing by the department shall not be required where such residential or day care treatment is provided within an institution or facility licensed by the department of public health pursuant to chapter 111, unless such services are provided on an involuntary basis. Whether or not a license is issued under clause (1), the department shall make regulations for the operation of such facilities, departments or units. The department may issue a provisional license to a facility, department or unit that has not previously operated, or is operating but is temporarily unable to meet applicable standards and requirements. No original license shall be issued to establish or maintain a facility, department or unit subject to licensure under this section, unless there is determination by the department, in accordance with its regulations, that there is need for such a facility, department or unit, as described in subsection (c). The department may grant the type of license that it deems suitable for the facility, department or unit. The department shall fix reasonable fees for licenses and renewal of licenses. In order to be licensed by the department under this section, a facility, department or unit shall provide services to commonwealth residents with public health insurance on a non-discriminatory basis and shall report the facility's payer mix to the department on a quarterly basis. (b) Each facility, department or unit licensed under the provisions of this section shall maintain and make available to the department such statistical and diagnostic data as may be required by the department. (c) Each facility, department or unit licensed by the department shall be subject to supervision, visitation and inspection by the department. The department shall inspect each facility, department or unit prior to granting or renewing a license pursuant to this section. The department shall establish regulations to administer licensing standards and to provide operational standards for such facilities, departments or units, including, but not limited to, the standards or criteria that an applicant shall meet to demonstrate the need for an original license; provided, however, that those standards or criteria shall be reviewed by the department every 2 years and shall be limited to: (i) the health needs of persons with a mental illness in the commonwealth, including underserved populations and persons with co-occurring mental illness and substance use disorder; and (ii) the demonstrated ability and history of a prospective licensee to meet the needs of those persons. The regulations promulgated by the department pursuant to this section shall provide that no facility, department or unit shall discriminate against an individual, qualified within the scope of the individual's license, when considering or acting on an application of a licensed independent clinical social worker for staff membership or clinical privileges. The regulations shall further provide that each application shall be considered solely on the basis of the applicant's education, training, current competence and experience. Each facility, department or unit shall establish, in consultation with the director of social work or, if none, a consulting licensed independent clinical social worker, the specific standards, criteria and procedures to admit an applicant for staff membership and clinical privileges. Such standards shall be available to the department upon request. (d) The department may refuse to grant, suspend, revoke, limit or restrict the applicability of or refuse to renew a license granted under this section, subject to the procedural requirements of section thirteen of chapter thirty A, for any violation of its regulations or standards concerning such facilities, department or unit, including the denial or conditional issuance of an original license if an application does not meet the department's standards or criteria for demonstrating need, as described in subsection (c). The department may temporarily suspend a license prior to a hearing in cases of emergency if it deems that such suspension would be in the public interest; provided, however, that upon request of an aggrieved party, a hearing pursuant to section thirteen of chapter thirty A shall be held after the license is suspended. Any party aggrieved by a decision of the department under this section may appeal in accordance with the provisions of section fourteen of chapter thirty A. (e) The department may conduct surveys and investigations to enforce compliance with this section and any rule or regulation promulgated pursuant to this section. The department may examine the books and accounts of any facility, department or unit if it deems such examination necessary for the purposes of this section. If upon inspection or through information in its possession, the department finds that a facility, department or unit licensed by the department is not in compliance with a requirement established under this section, the department may order the facility, department or unit to correct the deficiency by providing the facility, department or unit a deficiency notice in writing of each deficiency. The notice shall specify a reasonable time, not more than 60 days after receipt of the notice, by which time the facility, department or unit shall remedy or correct each deficiency cited in the notice; provided, however, that in the case of a deficiency which, in the opinion of the department, is not capable of correction within 60 days, the department shall require that the facility, department or unit submit a written plan for correction of the deficiency in a reasonable manner. The department may modify a nonconforming written plan for correction upon notice in writing to the facility, department or unit. Not more than 7 days after the receipt of notice of such a modification of a written plan for correction, the affected facility, department or unit may file a written request with the department for administrative reconsideration of the modified plan for correction or any portion thereof. Nothing in this section shall be construed to prohibit the department from enforcing a rule, regulation, deficiency notice or plan for correction, administratively or in court, without first affording formal opportunity to make correction, or to seek administrative reconsideration under this section, where, in the opinion of the department, the violation of such rule, regulation, deficiency notice or plan for correction jeopardizes the health or safety of patients or the public or seriously limits the capacity of a facility, department or unit to provide adequate care, or where the violation of such rule, regulation, deficiency notice or plan for correction is the second or subsequent such violation occurring during a period of 12 months. If a facility, department or unit fails to remedy or correct a cited deficiency by the date specified in the written deficiency notice or fails to remedy or correct a cited deficiency by the date specified in a plan for correction, as accepted or modified by the department, the department may: (i) suspend, limit, restrict or revoke the license of the facility, department or unit; (ii) impose a civil fine upon the facility, department or unit; (iii) pursue any other sanction as the department may impose administratively upon the facility, department or unit; or (iv) impose any combination of the penalties set forth in clauses (i) to (iii), inclusive, of this paragraph. A civil fine imposed pursuant to this subsection shall not exceed $1,000 per deficiency for each day the deficiency continues to exist beyond the date prescribed for correction. (f) No facility, department or unit, for which a license is required under subsection (a), shall provide inpatient psychiatric, residential or day care services for the treatment or care of persons with a mental illness, unless it has obtained a license under this section. The superior court sitting in equity shall have jurisdiction, upon petition of the department, to restrain any violation of this section or to take such other action as equity and justice may require. Whoever violates this section shall be punished for the first offense by a fine of not more than $500 and for subsequent offenses by a fine of not more than $1,000 or by imprisonment for not more than 2 years, or both. (g) No patient at a facility, department or unit subject to licensure under this section shall be commercially exploited. No patient shall be photographed, interviewed or exposed to public view without the express written consent of the patient or the patient's legal guardian. (h) Notwithstanding subsections (a) to (g), inclusive, a child care center, family child care home, family child care system, family foster care or group care facility, as defined in section 1A of chapter 15D, shall not be subject to this section. (i) As used in this section, ''original license'' shall mean a license, including a provisional license, issued to a facility, department or unit not previously licensed, or a license issued to an existing facility, department or unit in which there has been a change in ownership or location or a change in class of license or specialized service as provided in regulations of the department.

M.G.L. c. 19, § 20 Mental health facility employees; civil service exemption

c. 19, § 20. Mental health facility employees; civil service exemption Section 20. Stationary engineers, steam firemen, school teachers and head farmers employed in mental health facilities of the department and, except as otherwise provided by the civil service law and rules, the classified labor service of the department, shall be exempt from chapter thirty-one; provided, however, that whenever, as a condition of receiving federal grants for programs and activities to which the federal standards for a merit system of personnel administration relate, federal requirements make necessary the application of the civil service law and rules to any such position, or to the classified labor service or any portion thereof, said positions or service shall be subject to chapter thirty-one; provided, further, such federal requirements are uniform in all states.

M.G.L. c. 19, § 21 Interagency agreements with developmental services department

c. 19, § 21. Interagency agreements with developmental services department Section 21. Subject to approval by the secretary of health and human services, the commissioner may enter into interagency agreements with the commissioner of developmental services for the coordinated regulation of or for the coordinated or joint management of certain services that are required or that must be provided by both the department of developmental services and the department of mental health. Such agreements may be entered where it is determined by the commissioners of said departments that the services require coordinated regulation to ensure development of substantially similar standards consistent with certain shared needs of mentally ill and persons with an intellectual disability or that the services will be more efficiently and effectively provided by a single, unified management system than by two separate management systems. Such services may include, without limitation, transportation, laundry, data processing, certain services to mixed populations of mentally ill and mentally retarded individuals with common needs for care and treatment or to individuals who are diagnosed as both persons with an intellectual disability and mentally ill, research activities and program monitoring. Coordinated regulation of such services may include, without limitation, such issues as restraint, charges for care, investigations and case management. Pursuant to such agreements the department of mental health may assume responsibility for the provision of such services to the department of developmental services. Such agreements may delegate responsibility to the department of developmental services to provide such services for the department of mental health. Such agreements may provide for the expenditure of appropriated funds consistent with such joint management service systems and may further provide for assignment of certain staff to such joint management service systems. Such agreements shall not, however, conflict with the department of developmental services' primary responsibility for persons with an intellectual disability regardless of whether such persons are also mentally ill.

M.G.L. c. 19, § 22 Consultation of commissioner for behavioral health services for children

c. 19, § 22. Consultation of commissioner for behavioral health services for children Section 22. The commissioner of mental health shall be consulted on the design and implementation of the commonwealth's behavioral health services for children, under guidelines established by the secretary of health and human services under section 16S of chapter 6A.

M.G.L. c. 19, § 23 Children's behavioral research center; powers and duties; annual report

c. 19, § 23. Children's behavioral research center; powers and duties; annual report Section 23. There shall be, within the department of mental health, a children's behavioral health research center, the primary mission of which shall be to ensure that the workforce of clinicians and direct care staff providing children's behavioral health services are highly skilled and well trained, the services provided to children in the commonwealth are cost-effective and evidence-based, and that the commonwealth continues to develop and evaluate new models of service delivery. Subject to appropriation, the center shall conduct activities as the commissioner may direct in furtherance of its primary mission, which may include: (i) collecting quarterly data from state agencies, the juvenile court, the commissioner of probation, service providers and insurance providers relative to children's behavioral health services; (ii) researching the best practices for the identification and treatment of children's behavioral health needs; (iii) evaluating the demand for and the availability, cost and quality of, children's behavioral health services provided by the commonwealth; (iv) publishing annual progress reports, including the estimated costs and benefits of implementing new programs or practices, the status of racial and ethnic disparities, and the capacity of the behavioral health system to meet clinically appropriate inpatient, residential and community-based service demands; and (v) providing information on a regular basis to the children's behavioral health advisory council, established by section 16Q of chapter 6A. The center shall publish an annual report including: (i) narrative and statistical information about service demand, delivery and cost, and identified service gaps during the prior year; (ii) the effectiveness of the services delivered during the prior year; and (iii) review of research analyzed or conducted during the prior year. The center shall submit the annual report by February 1st to the governor, the children's behavioral health advisory council, the child advocate and the general court, by filing it with the clerks of the senate and the house of representatives, the joint committee on mental health and substance abuse, the joint committee on children, families and persons with disabilities, the joint committee on health care financing and the senate and the house committees on ways and means.

M.G.L. c. 19, § 24 Notification of parent or guardian of child receiving inpatient psychiatric services

c. 19, § 24. Notification of parent or guardian of child receiving inpatient psychiatric services Section 24. If the department is notified that a child who is eligible for department services is receiving inpatient psychiatric services, the department shall contact the child's parents or guardians and a member of the child's treatment team within 3 business days of being so notified, shall maintain weekly contact with them until the child is discharged, and shall, with the consent of the child's parent or guardian, immediately begin discharge planning, with the priority of returning the child to his home or to a community placement. Not later than 5 business days after being notified that continued hospitalization is no longer clinically appropriate, the department shall determine the appropriate type of placement for the child and, with the consent of the child's parent or guardian, shall immediately initiate the placement referrals. The department shall document its activities in assisting with discharge placement, including identification of available resources for home-based, community or alternative residential placements, and the barriers, if any, to discharge to the most clinically-appropriate setting. If the initial placement shall not be deemed to be the most clinically appropriate, the department shall continue to seek an appropriate placement. Not longer than 30 days after being notified that continued hospitalization is no longer clinically appropriate, the department shall refer the child to the interagency team established pursuant to section 16R of chapter 6A. The department shall submit a monthly report to the secretary of health and human services detailing the activities undertaken pursuant to this section, including the length of time required to place each such child in a clinically-appropriate, post-discharge setting.

M.G.L. c. 19, § 25 Center for responsive training in crisis intervention

c. 19, § 25. Center for responsive training in crisis intervention Section 25. (a) Subject to appropriation, within the department of mental health, there shall be a center for responsive training in crisis intervention, in this section hereinafter referred to as the center. The center shall serve as a source for cost-effective, evidence-based mental health and substance use crisis response training programs for municipal police and other public safety personnel throughout the commonwealth. The center shall conduct activities as the advisory council, pursuant to subsection (e), directs, which shall include: (i) supporting the establishment and availability of community policing and behavioral health training curricula for law enforcement personnel, particularly in interventions that provide alternatives to arrest and incarceration; (ii) serving as a clearinghouse for best practices in police interactions with individuals suffering from mental illness and substance use disorders; (iii) developing and implementing crisis intervention training curricula for all veteran and new recruit officers; (iv) providing technical assistance to cities and towns by establishing collaborative partnerships between law enforcement and human services providers that maximize referrals to treatment services; and (v) establishing metrics for success and evaluation of outcomes of these programs. (b) The center shall be funded with revenue from appropriations or other money authorized by the general court and specifically credited to the center, and revenue from private sources including, but not limited to, grants, both state and federal, gifts and donations received by the commonwealth that are specifically credited to the center. (c)(1) The center shall: (i) establish regional training opportunities for municipal police as needed throughout the commonwealth; (ii) develop and maintain curricula that is updated with the latest research on best practices in community policing and behavioral health; (iii) recruit, reimburse and support trainers with experience in community policing and behavioral health crisis intervention; (iv) ensure the training is targeted to meet specific local needs of participating cities and towns and the commonwealth; (v) support police departments in implementing improved behavioral health responses through responsive policies and procedures and partnerships with community behavioral health providers; (vi) assist municipal police departments to cover backfill costs incurred in sending staff to training; provided, however, that reimbursement shall not exceed the actual cost of the sending department's backfill; (vii) promote the use and adequate resourcing of trained community-based crisis response resources to assist residents when an exclusive police response is not best suited to address the concerns raised or is inappropriate or unnecessary; and (viii) stipulate that each municipal police department receiving reimbursement provide information necessary for the center to evaluate the goals described in paragraph (3), including the percentage of the municipality's police sergeants, lieutenants and other officers who directly oversee patrol officers who have received the center's recommended training and the percentage of the municipality's patrol officers who have received the center's recommended training. (2) Training shall include, but not be limited to, information on: (i) the signs and symptoms of mental illnesses and substance misuse; (ii) mental health treatment; (iii) co-occurring disorders; (iv) responding to a mental health or substance use crisis; (v) best practices, including efforts to prioritize de-escalation tactics and techniques in crisis response situations; (vi) institutional and structural racism and implicit bias; (vii) best practices for responding to mass gatherings or protests that shall emphasize de-escalation and minimizing the necessity for use of force; and (viii) community policing principles. (3) The center shall develop and ensure sufficient training resources and opportunities to enable each municipality in the commonwealth to obtain the center's recommended training for not less than 25 per cent of their police sergeants, lieutenants and other officers who directly oversee patrol officers, and not less than 50 per cent of their patrol officers within a time determined by the community policing and behavioral health advisory council as described in subsection (e). (d) The center shall publish an annual report including: (i) narrative and statistical information about training demand, delivery, cost and identified service gaps during the prior year; (ii) the effectiveness of the services delivered during the prior year; (iii) the communities that participated in the training; (iv) the number of officers, and their ranks, that participated in the training; (v) the progress each municipality has made in reaching the goals described in subsection (c)(3), including the percentage of each municipality's police sergeants, lieutenants and other officers who directly oversee patrol officers who have received the center's recommended training, and the percentage of each municipality's patrol officers who have received the center's recommended training; and (vi) a review of research analyzed or conducted during the prior year. The center shall submit the annual report not later than February 1 to the governor, the secretary of health and human services, the commissioner of mental health, the secretary of public safety and security, the clerks of the house of representatives and the senate, the joint committee on mental health, substance use and recovery, the joint committee on public safety and homeland security and the house and senate committees on ways and means. (e) There shall be a community policing and behavioral health advisory council, in this section called the council, consisting of 11 members: the secretary of health and human services or the secretary's designee, and the secretary of public safety and security or the secretary's designee who shall serve as co-chairs of the council; the commissioner of the department of mental health or the commissioner's designee; the commissioner of the department of public health or the commissioner's designee; the executive director of the municipal police training committee or the director's designee; a representative of a mental health consumer advocacy group, as appointed by the secretary of health and human services; 2 community members who are consumers of behavioral health services, appointed by the secretary of health and human services; and 3 municipal police chiefs or commanding officers to be selected by the executive director of the Massachusetts Chiefs of Police Association, which shall include 1 police chief or commanding officer employed by a community with fewer than 10,000 residents; 1 police chief or commanding officer employed by a community with 10,000 or more residents and fewer than 60,000 residents; and 1 police chief or commanding officer employed by a community with 60,000 or more residents. Members of the council shall be appointed for a term of 3 years, and may be reappointed for consecutive 3–year terms. Each member shall be reimbursed by the commonwealth for all expenses incurred in the performance of their official duties. The council shall advise the chairs in directing the activities of the center consistent with subsection (c), and shall receive ongoing reports from the center concerning its activities. The council shall solicit public comment in the area of community policing and behavioral health, and in so doing may convene public hearings throughout the commonwealth. The council shall hold not less than 2 meetings per year and may convene special meetings at the call of the chair or a majority of the council.

M.G.L. c. 19, § 26 Expedited psychiatric inpatient admission advisory council; members; annual report; expedited psychiatric inpatient admissions protocol

c. 19, § 26. Expedited psychiatric inpatient admission advisory council; members; annual report; expedited psychiatric inpatient admissions protocol Section 26. (a) There shall be an expedited psychiatric inpatient admission advisory council within the department which shall investigate and recommend policies and solutions regarding the emergency department boarding of patients seeking mental health and substance use disorder services. The advisory council shall: (i) implement the expedited psychiatric inpatient admissions protocol, as established by the department; (ii) collect data on the number of patients boarding in emergency departments and the reasons for extended wait times, including capacity constraints; and (iii) make recommendations for measures to reduce the wait times for admissions. (b) The advisory council shall consist of the following members: the commissioner of mental health or a designee, who shall serve as chair; the commissioner of public health or a designee; the director of the office of Medicaid or a designee; the commissioner of insurance or a designee; a representative from the Massachusetts Association of Health Plans, Inc.; a representative of Blue Cross and Blue Shield of Massachusetts, Inc.; a representative of the Massachusetts Health and Hospital Association, Inc.; a representative of the Massachusetts College of Emergency Physicians, Inc.; a representative of the Association for Behavioral Healthcare, Inc.; a representative of the National Alliance on Mental Illness of Massachusetts, Inc.; a representative of the Massachusetts Association of Behavioral Health Systems, Inc.; a member representing emergency services providers; and a consumer representative with lived experience boarding in an emergency department. (c) Annually, not later than December 31, the advisory council shall file a report with the secretary of health and human services, the joint committee on mental health, substance use and recovery and the joint committee on health care financing. The report shall: (i) summarize the data collected on the number of patients boarding in emergency departments identified by age, gender identity, race, ethnicity, insurance status, diagnosis and reason for the delay in admission; and (ii) include recommendations for reducing boarding in emergency departments and any suggested legislative or regulatory action to implement those recommendations, which shall include, but not be limited to, requirements for the delivery system to operate on a 24 hours a day, 7 days a week basis for admissions and discharges and penalties for noncompliance. (d) Notwithstanding any general or special law to the contrary, the expedited psychiatric inpatient admissions protocol established by the department shall: (i) require, for patients under the age of 18, notification by the hospital emergency department to the department in order to expedite placement in or admission to an appropriate treatment program or facility within 48 hours of boarding or within 48 hours of being assessed to need acute psychiatric treatment and having been determined by a licensed health care provider to be medically stable without the need for urgent medical assessment or hospitalization for a physical health condition; (ii) include, within the escalation protocol, patients who initially had a primary medical diagnosis or primary presenting problem requiring treatment on a medical-surgical floor, who have been subsequently medically cleared and are boarding on a medical-surgical floor for an inpatient psychiatric placement; and (iii) include, for patients under the age of 18, notification upon discharge from the emergency department, satellite emergency facility or medical-surgical floor to the patient's primary care physician or treating behavioral health clinician, if known.

Source: Massachusetts General Court (malegislature.gov)URL: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter19Fetched: 10/20/2026