Provision of Services

(A) At the time of admission, the Licensed or Approved Provider shall determine that Family Residential Substance Use Disorder Treatment Services are appropriate based upon the following criteria: (1) The parent or legal guardian: (a) is 18 years old or older; (b) has a substance use disorder or a mental or behavioral disorder due to psychoactive substance use and is not intoxicated and is not currently at risk of experiencing withdrawal symptoms requiring medical monitoring; (c) is not currently experiencing acute symptoms of physical illness or mental health conditions, and does not pose a risk to self or others; (d) is open to recovery and can understand relapse; (e) requires a 24-hour per day structured and supportive environment in order to maintain gains; (f) has custody of at least one child or reunification with at least one child is planned within 30 calendar days of admission, or is pregnant; and (g) is capable of recognizing physical danger, including when such danger requires immediate egress from the residence, and is able to follow a prescribed procedure for egress, as demonstrated by completion of a self-preservation test. The determination may consider whether the family is homeless and is eligible for Emergency Assistance (EA) through the Department of Housing and Community Development as determined by the DHCD pursuant to the standards of 760 CMR 67.00: Eligibility for Emergency Assistance (EA); or the family has housing resources located in a community or social environment that is unsupportive of recovery or constitutes a risk to maintenance of abstinence. (B) Assessment. Licensed or Approved Provider may initiate patient treatment prior to completion of the assessment required by 105 CMR 164.072, provided sufficient information to initiate treatment for the presenting complaint or problem on that day of services is obtained and that the assessment is completed in a reasonable timeframe. The Licensed or Approved Provider shall complete the following in a reasonable timeframe: an assessment as required in 105 CMR 164.072 for each adult family member in the program; assessments of the physical and mental health needs of all family members in the program; and (3) evaluations, physical examinations, immunizations, and/or consultations by qualified professionals, as indicated by the assessments required under 105 CMR 164.432(B)(1) and (2). (C) Treatment Plan. The Licensed or Approved Provider shall develop an Individual Treatment Plan as required by 105 CMR 164.073 for each family member residing in the program. In addition to substance use disorders, the treatment plan shall address mental health disorders, trauma, domestic violence, child welfare, parent- or legal guardian-child relationships and family life. (D) Substance Use Disorder Treatment Services. In addition to the Minimum Treatment Services Requirements specified in 105 CMR 164.074, the Licensed or Approved Provider shall provide the following services for adults and adolescents: Monthly case review or consultation meetings between the Licensed or Approved Provider's staff and any Qualified Service Organizations providing services for a family under a QSOA; (2) 24-hour per day crisis intervention services; (3) Engage in the Plan of Safe Care (POSC) process with all pregnant residents, and work collaboratively with other involved providers provided appropriate releases of information are in place; Offer group and individual education and counseling specific to pregnancy and parenting for all pregnant, postpartum, and parenting residents whether or not they currently have custody; and Help pregnant and postpartum residents prepare for and navigate any Department of Children and Families (DCF) involvement, and assist them in the DCF process, including collaborating with DCF and other involved providers, with the resident's written consent and participation whenever feasible. (E) Mental Health Services. The Licensed or Approved Provider shall establish QSOAs with licensed Mental Health Providers in order to provide the following for adults and children: A mental health assessment that includes a history of mental health concerns or disorders and treatment, psychosocial, family and medical history, and a psychopharmacological assessment; and (2) Individual and/or group counseling for mental health issues such as childhood or adult sexual abuse, depression, domestic violence and traumatic stress symptoms. (F) Parenting and Life Skills Education. The Licensed or Approved Provider shall provide, either directly or through a QSOA, the following adult services: (1) Weekly, on-site parenting education and parenting skill building; and Counseling and clinical monitoring to promote successful involvement in regular, productive daily activity, such as work or school, and, as indicated, successful reintegration into family and community living. (G) Transitional Assistance and Employment. The Licensed or Approved Provider shall provide advocacy services to assist the family in applying for transitional assistance through the DTA. (H) Services for Children Residing in the Program. The Licensed or Approved Provider shall: (1) Obtain parent(s)' or legal guardian(s)' consent prior to referring a child for services or consulting with service providers: (a) Refer children from birth to age three for a Developmental Assessment through an Early Intervention Program (EIP) certified by the Department; (b) Consult with other service providers or institutions providing services to children, e.g., courts, schools, Early Intervention Program, Department of Youth Services, Department of Social Services, etc.; (c) Ensure that children receive medical examinations in accordance with recommended schedules of pediatric care; and (d) Ensure that children's immunizations are up to date in accordance with the recommendations of the Department, unless the child's parent or legal guardian has stated in writing that vaccinations or immunizations conflict with his or her sincere religious beliefs or if the child's practitioner has stated in writing that the vaccination or immunization is medically contraindicated. Assist parent(s) or legal guardian(s) in obtaining child care services, including after school child care for school-age children; Assist parents or legal guardian in ensuring school age children are registered in and attending school; and Provide on-site services and activities for children who are not in community-based child care programs or in school. Such services shall be designed to promote the child's development and shall be available for children of all ages, including adolescents. (I) Aftercare. In addition to requirements in 105 CMR 164.076 and 164.077, the Licensed or Approved Provider shall provide the following aftercare services: (1) Assistance to obtain housing, child-care, employment, continued health care and other social services that the family has received while in the program. (2) Follow-up services for up to three months following the family's discharge; and Directly connect the family to another family residential program through policy established by the Department if the family is discharged before completion of treatment.