104 CMR, § 29.13

Current through Register 1533, October 25, 2024

Section 29.13 - Review of the Community Service Plan

(1) All community service plans are reviewed by the provider together with the client and the client's legally authorized representative at least annually, or at intervals determined by the applicable service standards, as needs change, or upon the request of the client, or the client's legally authorized representative. The purpose of this review is to:

(a) evaluate the client's progress and current status in meeting the goals set forth in the community service plan; and

(b) evaluate whether the services, goals, objectives, and interventions continue to be consistent with the client's strengths, preferences, service needs, goals and individual service plan, if any, and to modify the community service plan as appropriate, and to determine if service goals have been met.

(2) If a community service plan is modified as a result of a review conducted pursuant to 104 CMR 29.13, the modified community service plan will be given to the client and the client's legally authorized representative for acceptance or rejection as provided in 104 CMR 29.12.

(3) If after reviewing the community service plan, the DMH community service provider recommends the client no longer receive a DMH community service, including attainment of the goals of the service as reflected in the community service plan, the service provider will notify the Area Director or designee for appropriate action, which may include a redetermination of whether the client continues to meet the clinical criteria for DMH services in accordance with 104 CMR 29.04. Action on any such redetermination shall be subject to 104 CMR 29.04 and 104 CMR 29.13 or 104 CMR 29.14, as applicable, and shall be subject to appeal pursuant to 104 CMR 29.16.

(4) The Department may conduct utilization review activities to determine whether the client's community service plan is meeting the service needs and addressing the goals of the client.

(5) If the DMH community service provider determines the client has not met the client's responsibility, to the extent of the client's ability, to respect the rights of other clients and staff in the program or residential site of the program, or to conform to reasonable operational rules of the program or residential site of the program, there shall be a review of the client's community service plan. The program director, or designee, shall document the situation, including any known precipitating factors and efforts at resolution; and in conjunction with the client and the client's legally authorized representative, shall develop a plan to address the situation;

(a) If the plan does not resolve the situation, the client may be asked to leave the program or residential site of the program; provided however, that any modification of an community service plan necessitated by such request shall be governed by the provisions of 104 CMR 29.13;

(b) No client shall be discriminated against or asked to leave a program due to the exercise of any right set forth in 104 CMR 28.00: Licensing and Operational Standards for Community Services;

(c) The program director shall notify the Department before a client is asked to leave a program or residential site of a program;

(d) A client who is asked to leave a program or residential site of a program may request a review of that decision by the Human Rights Committee or by the Area Director or designee;

(e) Clients may have additional remedies, including the protections enumerated under the Community Residence Tenancy Law, M.G.L. c. 186, § 17A.