As used in 101 CMR 426.00, unless the context requires otherwise, terms have the meanings in 101 CMR 426.02.

Client. An individual who receives certain adult community mental health services purchased by a governmental unit.

Cost Report. The document used to report costs and other financial and statistical data. The Uniform Financial Statements and Independent Auditor's Report (UFR) is used when required.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Governmental Unit. The Commonwealth, any board, commission, department, division, or agency of the Commonwealth and any political subdivision of the Commonwealth.

Group Living Environment (GLE). This temporary setting provides a clinically oriented environment and structure in which staff is present on a planned staffing schedule. The setting provides increased treatment and engagement interventions to enable the client to develop the skills necessary to live in a more independent setting. Clients residing in GLEs can also receive supervision and support from an Integrated Team. Certain GLE staff members are part of the

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Final Adoption

Date Published in Mass. Register: October 25, 2024

101 CMR 426.00: RATES FOR CERTAIN ADULT COMMUNITY MENTAL HEALTH SERVICES

Integrated Team and perform the duties and responsibilities of the direct care staff members of the Team for clients residing in the GLEs.

Integrated Team. A multi-disciplinary team of clinical, direct care, and peer staff providing clinical interventions, housing services, and peer and family support to facilitate engagement, support functioning and community living skill development, and maximize self-management consistent with the treatment plan.

Intensive Group Living Environment Services. This group living setting provides clients with the service components and specific clinical interventions particular to a defined service model for which they are referred. The Intensive Group Living Environment Service locations will be designated by the purchasing governmental unit. The following are the intensive GLE services.

1. (a) Medically Intensive Group Living Environment. Provides daily medical management that may be complicated by symptoms and/or behaviors related to the client’s mental health. In addition to medical management and other rehabilitative services, clients receive support and supervision services as their needs indicate.
2. (b) Intensive Behavioral Group Living Environment. Provides increased therapeutic interventions and supervision that focus on identifying triggers and precipitant behaviors, coping skills, improving communication skills, addressing issues around substance use, and identifying and resolving barriers to more independent community living and employment. Other rehabilitative, support, and supervision services are provided to clients as their needs indicate.
3. (c) Intensive Behavioral Assessment Group Living Environment. Provides an intensive level of supervision, including one to one (line of sight) coaching on a consistent basis throughout the day. Coaching interventions focus on identifying and practicing pro-social communication and community engagement. Rehabilitation and other support services are provided to clients as their needs indicate.
4. (d) Intensive Fire Safety Group Living Environment. Provides enhanced supervision and monitoring for fire setting behavior, therapeutic interventions to address individually identified risk behaviors assessed in the Fire Setting Behavior Evaluation, and a special physical setting to minimize the risk of fire. Rehabilitative, support, and supervision services are provided to clients as their needs indicate.
5. (e) Clinically Intensive Group Living Environment. Delivers rapid response to a client’s emerging clinical needs including, but not limited to, symptom management, de-escalation strategies, or one-to-one assistance. Clients enrolled in this program require either an experience of a length of stay in a Department of Mental Health (DMH) Continuing Care Hospital for two years or more or prior histories of multiple failed efforts in standard DMH community services. The program is designed to develop, implement, and monitor person centered clinically intensive care. Other rehabilitative, support, and supervision services are provided to clients as their needs indicate.

6. (f) Intensive Dialectical Behavioral Therapy Group Living Environment. Delivers therapeutic interventions to increase awareness of emotional triggers, manage personal safety, coach emotional regulation skills, and improve skills for social interactions. Intensive Dialectical Behavioral Therapy supports clients to meet the community integration goals, including employment, education, and independent housing. Other rehabilitative, support, and supervision services are provided to clients as their needs indicate.

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   Final Adoption

   Date Published in Mass. Register: October 25, 2024

101 CMR 426.00: RATES FOR CERTAIN ADULT COMMUNITY MENTAL HEALTH SERVICES

1. (g) Enhanced Medical Group Living Environment. Provides a variety of skilled health care and supportive services, including nursing and hands-on personal care to clients with serious mental illness in addition to compounding medical needs. These services are designed to meet and support the daily needs of clients with chronic medical conditions, terminal illnesses, and/or disabilities that are impacted by their significant mental illness.

Lease Management. A lease management function responsible for managing client leasing requirements for those clients enrolled in Adult Community Clinical Services (ACCS) who are benefitting from sponsor-based rental assistance. Covered lease management activities include those leasing arrangements where the ACCS provider is directly involved in the category of sponsor-based leasing.

Provider. Any individual, group, partnership, trust, corporation, or other legal entity that offers services for purchase by a governmental unit and that meets the conditions of purchase or licensure that have been adopted by a purchasing governmental unit.

Reporting Year. The provider's fiscal year for which costs incurred are reported to the Operational Services Division on the Uniform Financial Statements and Independent Auditor's Report (UFR).

Supported Independent Environment (SIE). This setting provides clinical outreach and treatment in an environment with individual or shared units and staff present on a planned schedule within the setting, generally within an office or separate unit. Clients residing in SIEs can also receive supervision and support from an Integrated Team. Certain SIE staff members are part of the Integrated Team and perform the duties and responsibilities of the direct care staff members of the team for clients residing in the SIEs.