Staffing Standards

(1) All providers of supports and services unless specifically exempted by law or regulations, shall be subject to the following requirements: (a) Screening of Provider Staff and Care Providers. 1. All providers shall comply with applicable federal and state labor laws and not engage in discriminatory employment practices. 2. All providers shall comply with all required Criminal Offender Record Checks. 3. All providers arranging or providing professional services or consultation shall assure that such professionals are licensed, certified or registered as required by law to provide such professional services to the public. (2) Staff Qualifications. All providers shall assure that the number, organization and qualifications of staff meet the training, care, support, health, safety, and evacuation needs of the individuals supported by the provider. This shall be determined by all of the following: (a) The provider's ability to meet the objectives in the ISP of each individual while promoting independence and skill development. (b) The provider's ability to assist each individual to achieve the stated outcomes as set forth in his or her ISP. (c) The provider's ability to meet environmental, safety, administrative, and service delivery requirements as set forth in 115 CMR 7.07. (d) The provider's ability to develop and competently execute safety plans for all individuals at the location(s) where supports and services are provided as required in 115 CMR 7.06. (3) Supervision and Evaluation. All providers shall have adequate staff as determined by all of the following: (a) The skills demonstrated by staff in helping individuals to achieve outcomes identified in the individual's ISP, the provider's mission statement, and the mission statement, regulations, and standards of the Department. (b) The level of ongoing supervision that supports staff in increasing their skills and ability to assist individuals supported by the provider. (c) The ongoing staff development and training activities that are provided. (d) Training activities that are tied to the specific needs of individuals supported by the provider. (e) Access to technical and clinical consultation to enhance staff's ability to meet individuals' needs and desires. (4) All providers shall have current staff job descriptions that describe the education, skills, and experience required of staff to meet the standards set forth in 115 CMR 7.04. (5) All providers shall develop and utilize staff performance evaluations to enhance supports and services to individuals. (a) Evaluations of staff performance shall be competency-based and shall assess the degree to which requirements of the employee's job description are achieved by the employee subject to the evaluation. Comments from individuals, families or guardians of individuals, and relevant external agencies shall be included in the evaluation of staff performance. (b) Staff performance evaluations shall occur at least annually. (c) The results of staff performance evaluations shall be used by the provider to produce continued improvement in the skills needed by staff to enhance the lives of the individuals they support. (6) Training. All providers shall meet the following training requirements for staff, relief staff and care providers except as otherwise noted in 115 CMR 7.05(6). (a) Training in the reporting of actual or suspected abuse, neglect, or omission as specified in M.G.L. c. 19C and 115 CMR 9.00: Investigations and Reporting Responsibilities. (b) Training in the reporting of incidents as required in 115 CMR, (c) Training in the implementation of positive behavioral supports and the requirements in 115 CMR 5.00: Standards to Promote Dignity. (d) For staff, relief staff and care providers who may be expected to use restraint, training on the requirements in 115 CMR 5.11: Seclusion, Locked Buildings, and Emergency Restraint and on the appropriate use of restraint using a curriculum approved by the Department. (e) For non-licensed staff who will be administering medication at a site that is required to be registered as a Medication Administration Program (MAP) site, training on the requirements of 115 CMR 5.15: Medication and on the safe administration of medications and are MAP certified. (f) Training in first aid. (g) Training in cardiopulmonary resuscitation (CPR) for all staff at every site providing 24 hour residential supports, employment supports, day supports or 24 hour site based respite supports. 115 CMR 7.05(6)(g) shall not apply to residential sites providing less than 24 hour supports. (h) Training in all aspects of the safety plan for sites required to have safety plans under 115 CMR 7.06(3). (i) At least one staff person trained in fire safety by an approved fire safety training agency, local fire department or from the Department shall be present at every site where residential supports, day supports or 24 hour site based respite services are provided. All other staff and care providers are trained in basic fire safety. (7) Staffing Requirements. (a) Providers of residential supports, including care providers, shall assure the presence of staff whenever an individual is present in the home, unless the individual: 1. has an ISP that expressly provides that he or she can be home alone for a defined period of time; and 2. is 18 years of age or older; and 3. is capable of evacuating from the home within 2½ minutes without assistance. The Department's approval of an arrangement for any individual to remain in the home alone for a defined period of time does not change the residential supports into a different service that does not require 24 hour staffing. (b) Providers of residential supports, care providers, and providers of 24 hour site-based respite shall develop a staffing pattern that is sufficient to enable all individuals to evacuate, with or without assistance, within 2½ minutes in accordance with professionally accepted fire safety procedures. 1. Assistance from any staff who evacuates and re-enters the building cannot be considered in determining sufficiency of staffing pattern. 2. Evacuation times may be extended only when an evaluation using the National Fire Protection Association's Fire Safety Evaluation System ("FSES") has been conducted and the results based on physical site adaptation, staffing patterns, characteristics of the individuals in the home, and other relevant factors, demonstrate that the extended evacuation times are within accepted fire safety standards. Until such time as there is an approved waiver from the Department, the provider must have sufficient staff to evacuate all individuals in the home within 2½ minutes. The provider shall ensure that staffing is sufficient to meet the conditions and evaluation time set in the waiver approved pursuant to 115 CMR 7.05(7)(b)2. (c) Providers of residential supports, including care providers and providers of 24 hour site based respite supports shall have at least one person on duty and present in the home (including overnight) when any individual is present at the home except as otherwise provided in 115 CMR 7.05(7)(a). (d) Successful performance on fire drills required by 115 CMR 7.06(3)(b)7. shall be a factor in determining the adequacy of the provider's staffing.