Mental Health Services: Staffing Requirements

(A) Provider Responsibilities. (1) The hospital outpatient department must employ a multidisciplinary staff to furnish mental health services under the direction of a licensed psychiatrist. (2) The hospital outpatient department must designate a professional staff member as director of clinical services and a licensed psychiatrist as medical director. (3) A licensed psychiatrist must be on call during all hours of operation. (4) Although the MassHealth agency does not require that the hospital outpatient department employ mental health professionals from all the disciplines listed in 130 CMR 410.475(B), staff members who provide services to members must be qualified as set forth in 130 CMR 410.475(B) for their respective disciplines. (B) Staff Qualifications. (1) Psychiatrist. At least one staff psychiatrist must be either currently certified by the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry or eligible for such certification. Any additional psychiatrists must be, at the minimum, licensed physicians in their second year of a psychiatric residency program accredited by the Council on Medical Education of the American Medical Association. Such physicians must be under the direct supervision of a licensed psychiatrist. Any psychiatrist or psychiatric resident who provides individual, group, or family therapy to members younger than 21 years old must be certified every two years to administer the CANS, according to the process established by the Executive Office of Health and Human Services (EOHHS). (2) Psychologist. At least one staff psychologist must be licensed by the Massachusetts Board of Registration of Psychologists with a specialization listed in clinical or counseling psychology or a closely related specialty. Additional staff members trained in the field of clinical or counseling psychology or a closely related specialty must (a) have a minimum of a master's degree or the equivalent graduate study in clinical or counseling psychology or a closely related specialty from an accredited educational institution; (b) be currently enrolled in or have completed a doctoral program in clinical or counseling psychology or a closely related specialty; (c) have had two years of full-time supervised clinical experience subsequent to obtaining a master's degree in a multidisciplinary mental health setting (one year of supervised clinical work in an organized graduate internship program may be substituted for each year of experience); and (d) for any psychologist who provides individual, group, or family therapy to members younger than 21 years old, be certified every two years to administer the CANS, according to the process established by EOHHS. (3) Social Worker. (a) At least one staff social worker must be licensed or have applied for and have a license pending as an independent clinical social worker by the Massachusetts Board of Registration of Social Workers. (b) Any additional social workers on the staff must provide services under the direct and continuous supervision of an independent clinical social worker. Such additional social workers must be licensed or applying for licensure as certified social workers by the Massachusetts Board of Registration of Social Workers and have received a master's degree in social work and completed two years of full-time supervised clinical work in an organized graduate internship program. (c) Any social worker who provides individual, group, or family therapy to members younger than 21 years old must be certified every two years to administer the CANS, 4. Program Regulations according to the process established by EOHHS. (4) Psychiatric Nurse. At least one psychiatric nurse must be currently registered by the Massachusetts Board of Registration in Nursing and must have a master's degree in nursing from an accredited National League of Nursing graduate school with two years of full-time supervised clinical experience in a multidisciplinary mental health setting and be eligible for certification as an Adult Psychiatric-Mental Health Clinical Nurse Specialist, Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist, or Psychiatric Mental Health Nurse Practitioner by the American Nurses Association. Any other nurses must have a bachelor's degree from an educational institution accredited by the National League of Nursing and two years of full-time supervised skilled experience in a multidisciplinary mental health setting subsequent to that degree, or a master's degree in psychiatric nursing. Any Adult Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC), Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC) or, Psychiatric Mental Health Nurse Practitioner- Board Certified (PMHNP-BC) who provides individual, group, or family therapy to members younger than 21 years old must be certified every two years to administer the CANS, according to the process established by the Executive Office of Health and Human Services (EOHHS). Nurses who are not board certified as PMHCNS-BC or PMHNP-BC are not eligible to administer the CANS. (5) Counselor. A counselor must have a master's degree in counseling education, counseling psychology, or rehabilitation counseling from an accredited educational institution and two years of full-time supervised clinical experience in a multidisciplinary mental health setting subsequent to obtaining the master's degree (one year of supervised clinical work in an organized graduate internship program may be substituted for each year of full-time experience). Any counselor who provides individual, group, or family therapy to members under the age of 21 must be certified every two years to administer the CANS, according to the process established by EOHHS. (6) Occupational Therapist. An occupational therapist must be currently licensed by the Massachusetts Division of Registration of Allied Health Professions and registered by the American Occupational Therapy Association and must have either (a) a master's degree in occupational therapy from an accredited program in occupational therapy; or (b) a bachelor's degree in occupational therapy from an accredited program in occupational therapy and a master's degree in a related field such as psychology, social work, or counseling.