Organizational Structure

(A) Program Director. (1) Requirement. A psychiatric day treatment program must designate a full-time professional as overall administrator and clinical director to be responsible for the program and charged with day-to-day responsibility over it. (2) Experience. The program director must have the following educational and work experience. (a) Educational Requirements. A program director must have one of the following college degrees: 1. a master’s degree in one of the disciplines set forth in 105 CMR 140.530(C): Personal Qualifications 2. a master's degree in a related health field (such as health administration or public health); or 3. a bachelor's degree in nursing (to become a registered nurse) or in occupational therapy, unless the basic preparation took place at a master's degree level. (b) Experience Requirements. A program director must have five years of full-time, supervised clinical experience in a multidisciplinary team treatment setting, and a familiarity with the principles of the rehabilitation and recovery model. Two years of this experience must be attained after the degree required in 130 CMR 417.422(A)(2)(a) has been received, except for registered nurses and occupational therapists with a bachelor's degree who must have the required five years of experience subsequent to receiving their degrees. Occupational therapists with a bachelor's degree in occupational therapy and a master's degree in a related health field, as described in 130 CMR 417.422(A)(2)(a)(2.), must have two years of the below experience subsequent to receiving their master's degree. Experience should be broken down as follows: 1. two years of work with a participant population similar to that receiving psychiatric day treatment program services; 2. one year (which may be concurrent with one of the foregoing two years) in another day treatment program; and 3. two years in an administrative/supervisory category. (3) Responsibilities. The program director's responsibilities include: (a) hiring and firing of clinical staff; (b) establishing and implementing a supervision protocol in consultation with the medical director and/or clinic director; (c) establishing policies and procedures for participant treatment; (d) accountability for adequacy and appropriateness of participant treatment; (e) coordinating staff activities to meet program objectives; (f) program evaluation; and (g) establishing and supervising in-service training and education (B) Medical Director. (1) The psychiatric day treatment program must designate a psychiatrist who meets the qualifications outlined in 130 CMR 417.423(A) as the medical director. The medical director is responsible for reviewing and approving all psychiatric day treatment medical policies and protocols and for supervising all psychiatric day treatment medical services provided by the staff. (2) The role of the medical director in the program, apart from any other duties assumed under 130 CMR 417.422(B)(1), must include the following: (a) participation in the ongoing multidisciplinary evaluation and review of each participant’s status; (b) review of physical examination reports on all participants participating in the program; (c) monitoring or supervising the participant’s medication regimen and prescribing medications as indicated and necessary upon consultation with the participant’s primary care provider; and (d) coordination of all aspects of the participant’s treatment plan that involve physicians outside the program. (3) The medical director may be either a staff member or a consultant, but must work on site for a minimum of four hours a week. In addition, arrangements must be made so that the medical director or another psychiatrist is available for telephone consultations every day the program is open. (4) If the medical director is a member of the treatment team, his or her responsibilities must include active involvement in all aspects of treatment planning and service delivery.