Medical Services Required on Site

A CHC must provide on site the medical services specified in 130 CMR 405.408. It is not necessary that all of these services be available during all hours of the CHC's operation, but all must be available to members on a regularly scheduled basis with sufficient frequency to ensure access to care and continuity of care. If the CHC does not serve patients of a particular age group, upon the prior written approval of the MassHealth agency, the CHC will not be required to provide pediatric or obstetrical/gynecological services or both (see 130 CMR 405.408(A) and (C)). (A) Pediatric Services. A CHC must provide pediatric services. (B) Internal Medicine. A CHC must provide internal medicine services. (C) Obstetrics/Gynecology. A CHC must provide obstetrical and gynecological services. When a family practitioner is employed in place of a specialist in obstetrics/gynecology, the family practitioner must have admitting privileges to a hospital for delivery and obstetrical and gynecological backup. (D) Health Education. A CHC must provide health education designed to prepare members for their participation in and reaction to specific medical procedures, and to instruct members in self-management of medical problems and in disease prevention. Health education may be provided by any health practitioner or by any other individual approved by the professional services director as possessing the qualifications and training necessary to provide health education to members. (E) Medical Social Services. A CHC must provide medical social services designed to assist members in their adjustment to and management of social problems resulting from medical treatment, specific disease episodes, or chronic illness. Medical social services must be provided by a clinical social worker who is licensed by the Massachusetts Board of Registration. This individual must be on site sufficient hours and with sufficient frequency to provide medical social services to members. (F) Nutrition Services. A CHC must provide counseling in the purchase, preparation, and consumption of proper nutrients to members who have been determined to require such counseling because of their health problems or because they have a high potential for developing health problems that might be avoided or made less severe through proper nutrition. Each CHC must employ either a nutrition professional with a bachelor's or master's degree in public health nutrition, community nutrition, or human nutrition; or a dietitian who is currently registered by the Commonwealth of Massachusetts Subchapter Number and Title Academy of Nutrition and Dietetics. This individual is responsible for planning, directing, and evaluating the nutrition services provided at the CHC; for educating the CHC's staff about nutrition; for supervising any nutrition aides; for consulting with practitioners and other staff members of the CHC; and for counseling members referred for nutrition information. The nutrition professional or registered dietitian must be on site at least one day per calendar month.