Standards for Services and Supports

(1) All providers shall provide supports and services in ways that promote the following outcomes within the context and location of those supports and services and in accordance with the individual's ISP, the provider's mission statement, the Department's mission statement, and 115 CMR: (a) Protection and Affirmation of Rights and Dignity. Protection and affirmation of the rights and dignity of individuals, including, but not limited to, respect of the individual, support of an individual's culture and religion, freedom of movement at home and in the workplace or day program, privacy, appropriate and timely assistance to the individual with decision-making, support of the individual in exercising his or her rights, and provision of safeguards whenever limitations are imposed. (b) Individual Choice and Control. Opportunities for exercising choice and control in all aspects of an individual's life by providing the education and supports to enable the individual to make informed decisions, and by promoting an environment and culture where the individual's opinions are listened to and treated seriously. (c) Community Membership. Opportunities to participate in, be integrated into, and contribute to the life of their community through: 1. education and supports to assist individuals to participate in recreational, social, and leisure activities outside of the home in integrated settings with neighbors, other people in the community, and consistent with the needs, desires, and choices of each individual; 2. access to the same services and resources used by neighbors and other people in the community; 3. a home offered by a residential supports provider that is part of a neighborhood, village, or community and with general design features, layout, and style of decor that would not stigmatize or devalue the individual. The home should offer the individual safety, refuge, rest, satisfaction, and enable the individual to exercise control and be at ease in the home; and 4. work in settings arranged by the provider of employment supports that maximize integration with other people in the community and with general design features that do not emphasize the supports' separateness or difference. (d) Relationships. Supports that help individuals to develop and sustain varied and meaningful relationships with family, friends, neighbors and co-workers. The supports shall include education and assistance to help the individuals form friendships, express intimacy and sexuality in an appropriate, healthy and safe manner, and prepare individuals to receive visitors. (e) Skill Acquisition and Accomplishments. Assessment, training, education, supports and services necessary for the individual to meet the goals in the individual's ISP, to acquire skills that increase self-reliance and that are necessary to achieve desired and valued outcomes 1. For providers of residential supports and individualized home supports, the supports and services include skills training and supports to maximize an individual's independence and performance of household activities and routines, participation in community recreational, cultural and leisure activities, and opportunities to maintain or expand their relationships with family and friends. 2. For providers of employment supports, the supports and services include supports to explore and develop work skills, to obtain and maintain paid work in integrated work settings, and the supports to help individuals on a pathway to employment by developing the skills to secure work. 3. For providers of day supports, the services and supports include help that will enable the individual to explore their work, leisure, and community interests, and to participate in their preferred activities. (f) Health, Safety, and Economic Security. That the sites where supports and services are provided are safe; individuals are protected from abuse, neglect and mistreatment; health care services meet the needs of the individual; personal funds of individuals are safeguarded; and the individual is assisted in maximizing economic resources to meet his or her needs. Included are the requirements that the provider: 1. promote optimal health of the individual by arranging for coordinated routine, preventive, specialty, and emergency health care, professional clinical services; make first-aid supplies available; and assure prompt and appropriate response by staff to emerging health care issues; 2. comply with the Department's requirements governing the storage and use of prescription and over the counter medication as specified in 115 CMR 5.00: Standards to Promote Dignity and the Department's guidelines; 3. store, prepare and serve food in a clean, safe, nutritious, tasteful, and appetizing manner and for each individual to have regularly nourishing and well-balanced meals. The meals must be provided at least three times a day including one in the morning, one in the afternoon and one in the evening and be chosen by the individual unless there is documentation from a physician that the frequency, amount, texture or type of meal is medically contraindicated for the individual; 4. provide for the safety and well-being of individuals in both home, day and work environments, including implementation of the safety plan in accordance with 115 CMR 7.06; 5. provide site based supports and services in a physical setting that meets all applicable local, state, and federal requirements pertaining to building construction, sanitation, health, safety, occupational health, and zoning; 6. comply with the applicable environmental requirements of 115 CMR 7.07; 7. prevent abuse and neglect, and comply with all applicable local, state, and federal reporting requirements; 8. comply with state and federal wage-hour requirements when individuals engage in any work which must be compensated; and 9. support each individual to obtain personal possessions, including an adequate supply of fashionable, seasonal clothing as necessary for the individual's health and comfort and consistent with the individual's choice and preferences, and assist each individual to maintain his or her clothing in a clean and well-kept manner.