Community Residential Care

(1) Community residential care is a form of substitute care which provides planned, temporary care in a licensed or approved residential facility on a 24 hour basis. (2) Community residential care shall be goal-directed, time limited, community-based, and in the least restrictive setting possible. Community residential care may be the placement of primary choice when a child's behavioral, emotional, or physical needs cannot be met in a less restrictive setting, i.e. in their own home, or in a foster/pre-adoptive home setting. (3) A community residential placement is an interim placement for a child with the long term goal(s) of either the child's return home, movement of the child to a less restrictive setting, or transitioning the child to another permanent placement, i.e. adoptive home, guardianship, or an independent living situation. (4) When the Department determines, in its clinical judgment, that a child's best interests would be served by placement into a community residential care facility, the Department shall select from the facilities available, which have a valid Department Community Residential Care Purchase Agreement, the one which best meets the child's needs, and place the child in the selected residential care facility. The Department may utilize the following kinds of facilities: (a) a facility licensed or approved by EEC; (b) a facility not subject to the jurisdiction of EEC, which is approved as a special education school by the Department of Elementary and Secondary Education (ESE); (c) a facility not included in 110 CMR 7.120(4)(a) or (b) if otherwise approved by the Department; or (d) a facility located outside of Massachusetts if the procedures of the Interstate Compact are utilized, and if the facility is licensed or approved by the applicable licensing/regulatory agency of that state. (5) The Department recognizes that certain children may occasionally require some degree of seclusion or restraint in order to enable staff to effectively implement the child's treatment plan and provide for his/her safety. Issues of seclusion and physical restraint, to the extent they are regulated by EEC or DMH or ESE, shall be governed by EEC's or DMH's or ESE's regulations and requirements. (See 102 CMR and 104 CMR and 603 CMR). In addition to and to the extent not inconsistent with EEC's and DMH's and ESE's regulations and requirements, the Department will permit providers of residential or group care to use the least restrictive effective amount of restraint or seclusion which enables staff to effectively implement the child's treatment plan and provide for his/her safety. Examples of permissible restraint or seclusion include: (a) physical restraint of child's arms and legs by staff members holding the child; (b) use of a "seclusion" or "cool off" or "time out" room, if the child is, at all times therein, accompanied by or in view of a staff member; (c) use of high staff: children ratio to create a "staff secure" environment. Use of greater amounts or types of restraint or seclusion by any provider, or use of any cruel or unusual punishment by any provider, is prohibited by the Department. Examples of such impermissible restraint or seclusion or punishment include: (d) use of "seclusion" room for excessive periods of time or without constant surveillance by a staff member; (e) food deprivation; (f) physical exercises when used solely as a means of punishment; (g) use of any type of drug for the purpose of restraining behavior, unless the administration of such drug is on an emergency basis, has been court-approved, or is administered with parental consent; and (h) use of any facility (except a mental health facility) which is wholly locked or barred at all times. Nothing in 110 CMR 7.000 shall affect or preclude the Department's use of mental health and mental retardation facilities, which are subject to the provisions of M.G.L. c. 123, and which may employ locked and/or barred facilities, and drug therapy, for placement of children who have been adjudicated mentally ill or incompetent and committed to such a facility by court order. (6) The Department shall conduct periodic evaluations of all community residential care providers under contract with the Department. Such evaluation shall be conducted jointly with the Department or ESE for all 766-approved providers. The Department's evaluation shall include a site visit to the provider. The Department shall maintain records of the evaluations it conducts. A copy of the written evaluation shall be provided to the director of each facility evaluated, and said director shall be afforded the opportunity to attach his/her comments concerning the evaluation.