Standards Of Care For Substance Use Disorder Facilities In Massachusetts
Out of all 50 states, Massachusetts has one of the most thorough and developed programs for standards of care for substance use disorder treatment programs and providers.
The Bureau of Substance Use Services (BSAS) has a strategic plan that includes nine principles of care for prevention, treatment, and recovery. The principles of care are aspirational, as this example shows:
“Substance-related disorders are complex: physical, social, spiritual and emotional. Treatment and prevention must respond to the whole person.”
Vendors (substance use disorder service providers) are required to know BSAS standards of care and adhere to state contract requirements. The state also specifies that vendors must be “actively engaged with other agencies and communities in supporting BSAS goals.”
Licensing Requirements For Treatment Programs In Massachusetts
Licensing requirements for treatment programs in Massachusetts are governed by the Licensure of Substance Use Treatment code of the Commonwealth of Massachusetts: 105 CMR 164.00.
Massachusetts also specifies that all healthcare providers be trained in and offer Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocols for referring patients to treatment.
Following referral to treatment, Massachusetts’ BSAS System of Care encompasses the following levels of service:
- Acute Treatment
- Stabilization and Transitional Outpatient Services
- Driver Alcohol Education
- Early Intervention Services
- Medication-Assisted Treatment (MAT)
- Residential Rehabilitation Services
- Driving Under The Influence Services
All services are offered to youth, young adults, adults with families, and individuals in custody.
Treatment plans and monitoring must be developed with criteria established by the American Society of Addiction Medicine (ASAM).
Program Licensing In Massachusetts
No facility can provide substance use disorder treatment in Massachusetts without a license provided by the Department of Mental Health (BSAS). Programs must make applications for each facility, including satellite or medication units.
Massachusetts state code specifies that licensed drug and alcohol treatment programs can be inspected “at any time” to determine if the facility, staff, and records meet state regulations and comply with the Commonwealth’s 105 CMR 164.00 code.
Facilities or programs operating without a license in Massachusetts may be subject to penalties of $500 for the first offense and up to $1,000 for each additional offense, as well as imprisonment for not more than two years (or both).
Licensed facilities must submit an audit and provide a financial report to the Department of Mental Health (DMH) each year on or before the 15th day of the fifth month at the end of the facility’s fiscal year.
Massachusetts drug and alcohol program licensees must also adopt and maintain a written statement of purpose including goals, objectives, and program philosophy. The statement must be reviewed each year and modified when the program or clients served change.
Addiction Treatment Centers Must Notify DMH Of Incidents
Licensees are also responsible to notify Massachusetts DMH of the death, serious illness, or accidents involving program enrollees within one business day of learning of the incident. This provision affects outpatient licensees as well as residential programs.
Programs are also required to immediately notify DMH orally, and follow up within one business day in writing, of any complaints regarding use or neglect of any individual enrolled in the program.
Interruptions in essential services, such as heat and water, must also be reported immediately via phone services, and also within one business day in writing.
Laws And Policies Affecting Addiction Treatment In Massachusetts
In October 2019, Massachusetts’ Department of Public Health revised its treatment protocols for the state’s Department of Corrections programs and facilities. The new treatment protocols require voluntary, informed consent for patients in custody who will receive medication-assisted treatment (MAT) for opioid use disorders.
Program physicians must inform patients in custody of the use of opioids for medication-assisted treatment (MAT) and their individual opioid use disorder (OUD) diagnosis.
Qualified program physicians must explain the nature of the FDA-approved medication that is recommended, and must ensure that patients understand the health benefits and risks.
Patients must also be provided with alternative treatment options, as well as the approximate individualized treatment program length that providing physicians are recommending.
Massachusetts Bureau of Substance Addiction Services—Protocol for Consent to Treatment with Medications for Opioid Use Disorder in Correctional Facilities
Massachusetts Bureau of Substance Addiction Services—Information for Substance Addiction Providers
Massachusetts Department of Public Health—05 CMR 164.000: Licensure of Substance Use Treatment Programs
Massachusetts Department of Public Health—Bureau of Substance Addiction Services