Standards for Placement Services

(1) In selecting the care provider the placement agency shall comply with the following: (a) The placement agency shall assess the personal characteristics of the care provider and, where applicable, other members of the household who will be providing supervision or services with respect to their ability and appropriateness to serve the individual as determined through interviews, review of any prior service assessments, and information from at least two personal references. The placement agency shall also inquire of the care provider and the personal references as to whether any reports have been filed against the provider under M.G.L. c. 119 regarding the abuse, mistreatment, or neglect of children; under M.G.L. c. 19C, regarding abuse of adults with disabilities; under M.G.L. c. 19A, regarding abuse of elders; or under M.G.L. c. 111, regarding abuse of a resident in a facility licensed or certified by the Department of Public Health. (b) In assessing the care provider's ability to provide supports and services to individuals, the placement agency shall consider the following factors: 1. motivation for application; 2. characteristics, number, and age of the individuals the care provider can adequately serve; 3. geographical location of the care provider's home in relation to the needs of the individual the placement agency intends to serve; 4. ability to adjust to family changes which will occur when the individual is placed; 5. capacity to integrate the individual into daily routines and patterns of living without undue disruption; 6. flexibility to meet the individual's changing needs; 7. ability to accept the individual's relationship with his or her natural parents and other family members; 8. ability, if and when appropriate, to assist an individual to make the transition to a more independent living arrangement; and 9. previous work experience, competencies, or training in providing supports and services to persons with intellectual disability or other disabilities, and relevant personal experiences. (c) The placement agency shall assure that the minimum age for a person providing residential supports to an individual eligible for the Department's services in the care provider's own home is 21 years of age, except that a person 18 of age or older may provide such services if the person works under the direct supervision of someone 21 years of age or older and through training or experience exhibits the knowledge and competencies as set forth in 115 CMR 7.11(2)(a) prior to the provision of services. The age of any care provider shall be considered in determining the appropriateness of placing specific individuals with that person based on the individual's ISP. (d) The placement agency shall assess whether the care provider's employment, if any, outside the home will decrease the provider's capacity to meet the requirements of 115 CMR 7.00 and that adequate provision exists for the care and supervision of individuals during any such absences. (e) The placement agency shall assess the composition of the care provider's household to ensure that the number and characteristics of other members of the household do not adversely affect either the capacity of the provider to give adequate time, energy, and attention to individuals served or the appropriateness of the environment for specific individuals in accordance with their needs. (f) The placement agency shall assure that a care provider is serving only individuals 18 years of age or older unless there is prior approval by the area director. The approval shall be based on the area director's consideration of the circumstances and relationships of all individuals who will be supported in the home and the capacity of the care provider to meet their needs. (g) The placement agency shall conduct and document a review of the home of the person who may be selected as the care provider in accordance with the standards set forth in 115 CMR 7.07(1) and (3) through (7). (2) The placement agency shall assure that care providers shall have sufficient pre-service and in-service training to assure that they have the information and skills necessary to meet the needs of individuals to be supported. (a) Prior to the delivery of services, the placement agency shall assure that the care provider demonstrates knowledge and competence in at least the following areas: the current value base of service delivery; the nature and treatment of individuals with developmental disabilities; relevant principles of care, treatment, and the provision of supports; first aid; CPR; seizure care; and fire and safety considerations. (b) The placement agency shall assure that the care provider annually receives sufficient ongoing in-service training to continue to meet the needs of individuals served. (3) The placement agency shall execute a written agreement with the person indicating that the care provider will: (a) comply with all applicable state laws, standards, and regulations; (b) report any changes of location, household composition, or other conditions that may affect the person's continued suitability and ability to provide supports prior to such changes or as soon thereafter as practicable, but no later than 24 hours after such changes; (c) permit on-site review of the home; (d) permit a representative of the placement agency and an employee of the Department authorized to conduct surveys under 115 CMR 8.03(3): Survey Team to visit the home, as often as deemed necessary by the placement agency or the Department, to monitor compliance with the Department's regulations. Such visits may be made at any time, with or without notice, but should ordinarily be made with prior notice and at normal hours, giving due regard to the privacy of the individuals supported in the home, family members and other residents, and to any disruption that the visit may cause; (e) cooperate with the placement agency and the Department in maintaining liability insurance coverage, where applicable; and (f) arrange for emergency medical treatment of the individual and for notification of the placement agency and the individual's physician, family, and guardian, if any, and service coordinator of emergencies or symptoms reasonably appearing to require medical attention. (4) The placement agency shall conduct an annual assessment of the skills of the care providers, with such assessment made available to the Department. (5) The placement agency should determine whether the care provider is the sole provider of residential supports or whether there will be shared responsibility with a spouse or other adult members of the provider's family. If there is shared responsibility, the additional person(s) must be identified and determined appropriate as a care provider in accordance with the requirements of 115 CMR 7.11(1) through (4) and all other applicable regulations. (6) The placement agency shall, prior to placement, determine and document the appropriateness of the placement in relation to the needs and age of the individual and the capacity and other characteristics of the care provider and of the home. (7) Prior to placement, except in emergencies in which case as soon after placement as possible, the placement agency shall furnish the care provider with sufficient personal, medical, legal, and behavioral information to enable the care provider to care for the individual. Such information shall include, at least: (a) information on medication, special diets, allergies and other pertinent medical needs and the name(s) and telephone number(s) of the person(s) designated by the placement agency for the care provider to contact in the event of a medical or other emergency involving the individual; (b) information on the individual's work, training, school, or other supports; and (c) information on the individual's legal status with respect to custody (if a minor) or guardianship, and, if applicable, the name, address, and telephone number of the guardian, and specific authority, limitations, and rights of the individual in relation to custody or the guardianship. (8) Except in emergencies, a representative of the placement agency shall participate in the first meeting of the care provider and the individual. (9) After a placement is made, the placement agency shall visit the individual at the home to ensure its continuing appropriateness. The frequency of visits and the length of time over which visits are conducted may vary depending on the individual circumstances, but in no event shall the placement agency visit each home where residential or 24 hour respite supports are provided less frequently than once monthly, unless otherwise instructed in writing by the Department. (10) The placement agency shall, within a week after such supports initially have been provided, and at least quarterly thereafter if the supports continue to be provided, contact the individual and his or her family or other primary care provider to obtain a written evaluation of the arrangement. The evaluation shall include an assessment of the individual's and family's satisfaction with the supports and services provided by the placement agency and the care provider and with the degree to which the services meet the individual's needs.