1. (A) Staff Supervision Requirements

   1. (1) Unlicensed or Not Independently Licensed Staff. All professionals who are unlicensed, who are in a profession without licensure, or who are not independently licensed or certified as a peer supervisor must receive direct and continuous supervision. Direct and continuous supervision may be provided using telehealth technology.
   2. (2) Independently Licensed and Certified Peer Supervisor Staff. All independently licensed professionals and certified peer supervisors must receive supervision in accordance with center policy. Supervision may be provided using telehealth technology.
   3. (3) The supervising clinician is primarily responsible for the care of the member. For any care delivered by a professional under supervision there must be documentation in the clinical chart that the chart was reviewed by the supervising clinician.
   4. (4) All supervision must be documented in files accessible for review by the MassHealth agency. Supervision notes must, at a minimum, contain information regarding frequency of supervision, format of supervision, supervisor’s signature and credentials, and general content of supervision session.

2. (B) Staff Training. Centers must provide staff with specific training to provide services to members, including but not limited to training on

   1. (1) assessing and treating mental health disorders, which may include co-occurring substance use disorders including the clinical and psychosocial needs of the target population using evidence-based practices (e.g., staff treating children must have specialized training and experience in children’s services);

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1. (2) Culturally and Linguistically Appropriate Services (CLAS) to ensure the content and process of all services are informed by knowledge, respect for, and sensitivity to culture, and are provided in the individual’s preferred language and mode of communication. Training must include recognition and respect for the characteristics of the members served, such as behaviors, ideas, values, beliefs, and language;
2. (3) maintaining a trauma-informed facility and upholding standards of trauma-informed care, including fostering trauma-informed environments;
3. (4) currently available resources and services, including those in the community, and how to make appropriate referrals based on the needs of the member;
4. (5) crisis prevention and de-escalation, risk management and safety planning, and conflict resolution; and
5. (6) overdose prevention and response.
6. (C) Child and Adolescent Needs and Strengths Assessment (CANS). Any clinician who provides individual, group, or family therapy to members younger than 21 years of age must be certified every two years to administer the CANS, according to the process established by EOHHS.
7. (D) Staff Professional Standards. Any staff of any discipline operating in the center must comport with the standards and scope of practice delineated in their professional licensure and be in good standing with their board of professional licensure, as applicable. Each center must notify the MassHealth agency of any staff who are censured by DPH or sanctioned by their board of licensure as set forth in 130 CMR 429.406.
8. (E) Staffing Plan. Centers must maintain a staffing plan that includes policies and procedures to ensure all staffing and supervision requirements pursuant to 130 CMR 429.423.

429.424: Qualifications of Staff Authorized to Render Billable Services

A center may bill only for medically necessary services provided by a professional or paraprofessional staff member qualified as follows.

1. (A) Psychiatrists and Medical Professionals

   1. (1) At least one staff psychiatrist must meet the requirements in 130 CMR 429.422.
   2. (2) Additional psychiatrists must be licensed physicians in their second year of a psychiatric residency program accredited by the Accreditation Council for Graduate Medical Education.
   3. (3) Psychiatrists and prescribers must have the appropriate Drug Enforcement Administration (DEA) and DPH registrations for the prescribing of controlled substances.

2. (B) Nursing Staff

   1. (1) All nurse practitioners, registered nurses, psychiatric nurses, and psychiatric clinical nurse specialists must be licensed by the Board of Registration in Nursing pursuant to M.G.L.
   2. c. 112, § 80B and 244 CMR 4.00: Advanced Practice Registered Nursing.
   3. (2) Psychiatric Clinical Nurse Specialists. All psychiatric clinical nurse specialists in the center who are engaged in prescriptive practice with FDA-approved medications for the treatment of opioid use disorders must have completed specialized training and be qualified to prescribe buprenorphine as pharmacotherapy for substance use disorder under state and federal law.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

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Provider Manual Series (130 CMR 429.000)

Transmittal Letter Date

Mental Health Center Manual

MHC-53 9/1/2025

1. (C) Psychologists

   1. (1) Psychologists must be licensed as set forth in 130 CMR 429.422.

   2. (2) Unlicensed psychology trainees must meet the following requirements:

      1. (a) Post-Doctoral Fellows. Post-doctoral fellows must have a minimum of a doctoral degree in clinical or counseling psychology or a closely related specialty from an accredited educational institution and must meet the professional experience and supervisory requirements in 251 CMR 3.00: Registration of Psychologists.
      2. (b) Psychology Interns. Psychology interns must be enrolled in a structured, clinical, or counseling American Psychological Association (APA)-approved doctoral program.

   3. (D) Social Workers

      1. (1) Social workers may be independently licensed as set forth in 130 CMR 429.422.

      2. (2) Social workers without independent licensure must meet the following requirements:

         1. (a) Licensed Clinical Social Workers (LCSW). LCSWs must have received a master's degree in social work and completed two years of full-time supervised clinical work in an organized graduate internship program.
         2. (b) Post-Graduate, Unlicensed Social Workers. Unlicensed social workers must have received a master's degree in social work from a college or university accredited by the Council on Social Work Education.
         3. (c) Social Work Interns. Social work interns must be a second-year, clinical-track student in a structured field practicum that is a component of a masters of social work program, fully accredited by the Council on Social Work Education.

   4. (E) Mental Health Counselors

      1. (1) Mental health counselors may be licensed as set forth in 130 CMR 429.422.

      2. (2) Mental health counselors must meet the following requirements:

         1. (a) Post-master’s Mental Health Counselors. Post-master’s mental health counselors must have a master’s degree, or above, in a mental health field from an accredited educational institution, and must have completed one year of supervised clinical work in an organized graduate internship program.
         2. (b) Mental Health Counselor Interns. Interns must be in a second-year, clinical-track structured field placement that is a component of a master’s degree in mental health counseling or counseling psychology that is accepted by the Board of Allied Mental Health and Human Services Professions.

   5. (F) Alcohol and Drug Counselors

      1. (1) Licensed Alcohol and Drug Counselors (LADC). LADCs may be licensed as a LADC I, as set forth in 130 CMR 429.422.
      2. (2) LADC II or LADC Assistants. LADC IIs or LADC assistants must be licensed and must support LADC Is in the delivery of services, but may not provide direct services.

   6. (G) Marriage and Family Therapists

      1. (1) Marriage and family therapists may be licensed, as set forth in 130 CMR 429.422.

      2. (3) Marriage and family therapists must meet the following requirements.

         1. (a) Post-master’s Marriage and Family Therapists. Post-master’s marriage and family therapists must have a master’s degree, or above, in a mental health field from an accredited educational institution and must have completed one year of supervised clinical work in an organized graduate internship program.
         2. (b) Marriage and Family Therapy Interns. Interns must be in a second-year, clinical-

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   MassHealth 4. Program Regulations

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   Transmittal Letter Date

   Mental Health Center Manual

   MHC-53 9/1/2025

   track structured field placement that is a component of a master’s degree in marriage and family therapy or a related field that is accepted by the Board of Allied Mental Health and Human Services Professions.

   1. (G) Other Staff

      1. (1) Billing providers of Structured Outpatient Addiction Programs (SOAP) and Enhanced Structured Outpatient Addiction Programs (E-SOAP) services must comply with the requirements of 130 CMR 429.000 and all applicable sections of 130 CMR 418.000: Substance Use Disorder Treatment Services.
      2. (2) Billing peer and paraprofessional providers of certified peer specialist services, peer recovery coach services, and recovery support navigator services must comply with the requirements of 130 CMR 429.000. Further, centers must staff peer recovery coaches and recovery support navigators in conformance with the requirements of all applicable sections of 130 CMR 418.000: Substance Use Disorder Treatment Services.

(130 CMR 429.425 through 429.432 Reserved)

429.433: Coordination of Care

1. (A) Coordination of Medical Care. A mental health center must coordinate behavioral health

   disorder treatment with medical care for MassHealth members. If a member has not received a physical exam within 12 months of the date of intake, the mental health center must advise the member that one is needed. If the member does not have an existing relationship with a physician, the mental health center must assist the member in contacting the MassHealth agency’s customer service center to receive help in selecting a physician. If the member declines a physical examination, the member’s record must document their preference and any stated reason for that preference.

2. (B) Coordination of Behavioral Health Care. Centers designated as BHUC providers must

   have a qualified service organization agreement with at least one opioid treatment program provider furnishing services in accordance with 105 CMR 164.000: Licensure of Substance Use Disorder Treatment Programs and 130 CMR 418.000: Substance Use Disorder Treatment Services. Designated BHUC providers must have relationships with organizations and partners in the community that provide behavioral health services, inclusive of, but not limited to, community behavioral health centers, skilled nursing facilities, primary care providers, opioid treatment programs, emergency departments, schools, and hospitals.