101 CMR 27.05
Referrals
(1) Parties Who May Refer Cases for Review. An individual’s case may be referred to the IRT
by
(a) an individual 16 years of age or older;
(b) a state agency or a representative of a state agency’s ombudsman’s office;
(c) a juvenile court in the Commonwealth of Massachusetts;
(d) a hospital or emergency service provider;
(e) a school district;
(f) an attorney representing the individual or the individual’s parent or guardian;
(g) the individual’s parent or guardian; or
(h) a physician or behavioral health care provider authorized to act on behalf of a parent or
guardian who is seeking access to services for the individual or the individual’s parent or
guardian.
(2) Documentation and Consents Required to Refer to the IRT.
(a) A person or entity identified in 101 CMR 27.05(1) seeking to refer an individual’s case to
the IRT must provide to the co-chairs the following:
1. an IRT form containing key information, developed and amended as necessary by the
co-chairs;
2. consent from the legal custodian, or from the individual if 18 years of age or older or
otherwise authorized by law, authorizing the IRT, the secretary of EOHHS, the
commissioner of DESE, and DALA to
a. obtain materials related to the individual’s case, including but not limited to
medical records, school records, and any evaluation or assessment of the individual;
and
b. discuss these materials and records related to the individual’s case with one
another and with other individuals directly addressing matters related to the
individual’s case.
3. documentation and any necessary description, demonstrating the individual presents a
complex case; and
4. the reason the individual’s case is being submitted to the IRT, the agencies currently
involved in the case, and a requested resolution.
(b) Authorizations for the disclosure of Protected Health Information or Substance Use
Treatment information submitted to the co-chairs must comply with applicable requirements
of HIPAA and 42 CFR Part 2.
(c) An individual between 16 and up to 18 years of age who seeks to refer themselves to the
IRT must submit all required documents, including the consents from their legal custodian or
the person authorized to provide consent to release their records as required in 101 CMR
27.05(2)(a)2.
(3) The co-chairs will assess the referral submission to determine if the submission is complete
and the case is eligible for IRT review. The co-chairs may request any additional records or
information necessary to complete the referral submission or assess eligibility. A case is referred
to the IRT only after the co-chairs determine the referral submission is complete and the case is
eligible.
(4) Withdrawal of Referral. The legal custodian or, if authorized by law, the individual, may
withdraw a referral at any time by notifying the co-chairs in writing.