1. (A) A professional staff member must conduct a comprehensive evaluation of each member prior to initiation of therapy. For members under the age of 21, a CANS must be completed during the initial behavioral-health assessment before initiation of therapy and updated at least every 90 days thereafter by a CANS-certified provider, as described in 130 CMR 434.426(B).
2. (B) The psychiatric inpatient hospital must accept for treatment, refer for treatment elsewhere, or both, any member for whom the intake evaluation substantiates a mental or emotional disorder.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-11

Provider Manual Series (130 CMR 434.000)

Transmittal Letter Date

Psychiatric Outpatient Hospital Manual

POH-4 12/26/08

1. (C) The psychiatric inpatient hospital will ensure that one professional staff member (the primary therapist) assumes primary responsibility for each member. This responsibility includes

   1. (1) within four member visits, preparation of a comprehensive written treatment plan that is based on the initial evaluation, incorporates short- and long-term treatment goals, and establishes criteria for determining when termination of treatment is appropriate;
   2. (2) ongoing care management;
   3. (3) review of each case at termination of treatment and preparation of a termination summary that describes the course of treatment and any aftercare program or resources in which the member is expected to participate; and
   4. (4) ensuring that a CANS-certified provider, as described in 130 CMR 434.426(B) completes the CANS in accordance with 130 CMR 434.427(A).
2. (D) The psychiatric inpatient hospital must make provisions for responding to persons needing services on a walk-in basis.
3. (E) The psychiatric inpatient hospital must take appropriate steps to facilitate uninterrupted and coordinated member care whenever it refers a member elsewhere for concurrent or subsequent treatment.
4. (F) Before referring a member elsewhere, the psychiatric inpatient hospital must, with the member's consent, send a summary of or the actual record of the member to that referral provider.