Massachusetts State Laws and Regulations - Summary
Frequently Asked Questions
Addiction Treatment Centers
- What types of chemical dependency services are offered in Massachusetts?
- What does it mean to be “licensed,” “certified,” or “accredited” in this industry?
- What kind of licensure and certifications are required to operate a chemical dependency treatment program in Massachusetts?
- How can the licensing and credentialing agencies in Massachusetts be reached?
- How does a treatment facility obtain a license?
- How does a treatment facility renew, amend, or terminate its license?
- What kinds of inspections might there be for licensure determination?
- How can a facility prepare for inspections, on-site reviews, and audits?
- Under what circumstances will the Department deny, suspend, modify, or revoke licensure?
- Under what circumstances can a facility challenge the Department’s decision to deny, suspend, modify, or revoke licensure?
- What kinds of information must a facility submit to the Department?
- What kinds of internal policies and procedures must a licensed substance abuse facility have?
- What are the requirements for client records for licensed substance abuse facilities?
- What kind of governance must a licensed substance abuse facility have?
- What personnel requirements exist for licensed facilities?
- What other operational requirements are there for licensed facilities?
- What are the protections afforded to small group homes used for the purpose of residential substance abuse treatment?
- Are there any proximity restrictions regulating how close treatment centers may be to each other? Can an operator open a residential treatment center right next to one that is already there?
- What are the basic physical plant requirements for treatment facilities?
- What information must be disclosed to the client during intake and what must a licensed facility put in its admissions agreement?
- What other documentation must be provided to clients?
- How does a facility decide whether a client meets criteria for placement in a particular level of care?
- What staffing must be offered at each level of care?
- What services must be offered by each type of program?
- What are the requirements of a chemical dependency assessment?
- What must be included in an individual treatment plan?
- What rules govern administration of client medications in a licensed facility?
- What requirements are there to start an opioid treatment facility?
- What other requirements apply to medication assisted opioid treatment?
- How can an opioid treatment facility discharge a patient?
- What rights are guaranteed to clients?
- When policies and procedures must be in place to address behavior management?
- What termination and discharge policies need to be in place?
- What grounds are needed in order to dismiss a client from a program?
- If a facility needs to discharge a client that relapsed, is the facility at risk if the client overdoses tonight? If so, how can the facility protect itself?
- What needs to be done if a patient dies while in treatment?
- How must clients’ privacy be protected?
- How can a facility respond to clients who are unable to pay the required deductibles? Can the facility waive a program participant’s financial responsibility?
- What are the key issues insurers raise to demand recoupment of fees from chemical dependency treatment programs?
- What marketing practices are prohibited?
- What are the limits of gift giving to potential referral sources?
- What kind of benefits can a facility offer existing or new clients?
- What is alcohol and drug free housing?
- Is a license or certification required to open alcohol and drug free housing?
- How can alcohol and drug free housing facilities demonstrate their commitment to meeting minimum quality standards?
- What kind of services can alcohol and drug free housing offer?
- What are the protections afforded by federal law to small group homes used for the purpose of sustained recovery?
- Can local governments put special restrictions on alcohol and drug free housing?
- What other aspects should an operator consider before choosing a location for alcohol and drug free housing?
- What are alcohol and drug free housing operators’ obligations to residents?
- What kind of agreement should alcohol and drug free housing operators ask residents to sign?
- Can an alcohol and drug free house insist on drug tests and searches?
- Can alcohol and drug free housing bill insurance for required and/or random drug testing?
- Can an alcohol and drug free house make clients’ obligations contractually enforceable?
- What kind of ownership and staffing structures are common with alcohol and drug free housing?
- Are there any other organizations from which alcohol and drug free housing operators could find more information?
The following types of treatment services may be offered in Massachusetts with appropriate licensure:
A license means that a facility or professional may operate or may deliver services with the advance and continuous authorization of a designated government agency, which is done to ensure protection of public health, safety, and welfare. Read More
Licensing & Certification
Facilities must be licensed to operate programs that provide treatment services. Certification is generally optional; however, alcohol and drug free housing must be in order to obtain referrals from state agencies. Read More
Bureau of Substance Abuse Services
Department of Public Health
250 Washington Street Read More
Applicants for an initial license or approval must submit an application to the Department on an approved form obtained from the Department, together with any other documents and materials that the Department deems appropriate. Read More
Applicants for renewal must submit completed forms and fees required by the Department at least 60 days prior to the expiration of the current license or approval. Read More
The Department or its agents may visit at any time without prior notice and inspect the facility, its staff, activities, and records to determine compliance with the licensing regulations and applicable state and federal laws. Read More
Facilities must ensure that staff are well-trained and ready to answer questions that may be asked of them by the Department, reflecting knowledge of compliance and operational requirements. Read More
If a facility does not comply with the licensure process, licensing regulations, or other applicable laws, an initial license may be denied. Read More
The regulations specify that the Department may hold hearings if an applicant wishes to challenge a decision to deny, suspend, or revoke licensure. Read More
Pursuant to applicable regulations, certain incidents must be reported to the Department as follows: Read More
Licensed facilities must also have a set of written policies and procedures made available to staff, clients, and Department inspectors. These written policies must address, at a minimum, the following: Read More
Facilities must maintain separate records for each client in a secure and confidential manner, which is discussed in further detail in the Privacy Section below. Read More
Licensed facilities must have a governing body that is responsible for the policies and activities of the service. The governing body must consist of persons with expertise in management, finance, and substance abuse treatment. Read More
Licensed facilities must have a set of written personnel policies and practices made available to all staff members. These written policies must address, at a minimum, the following: Read More
Licensees must have general and professional liability insurance, and be able to demonstrate compliance with workers’ compensation insurance requirements. Read More
The regulation of land use and zoning is traditionally reserved to state and local governments, except to the extent that it conflicts with requirements imposed by the Fair Housing Act, the protections of the ADA, or other federal laws. Read More
There is no statewide rule or regulation preventing multiple facilities from operating in close proximity. Notwithstanding the lack of legal or regulatory prohibitions... Read More
Please note, these regulations concern the physical requirements for licensure and certification and do not constitute all environmental requirements. Read More
Prior to admission, or in the case of an intoxicated client, as soon as stabilization occurs, basic information about treatment services must be provided, in simple, non-technical terms and in the client’s primary language. Read More
Licensed facilities must create and maintain a current policy manual for clients. Topics that must be covered in the manual include: Read More
To make a determination on whether the services offered by the facility are an appropriate fit to meet the treatment needs of the client, the facility must carry out an assessment of the client’s treatment and rehabilitation needs and goals. Read More
Requirements by Program Type
Substance abuse treatment facilities must meet the needs of admitted clients, as identified during the admission assessment process. Read More
There are minimum treatment service requirements for all licensed facilities. Certain services must be provided directly by the licensee, while others may also be provided by QSOs. Read More
In addition to the requirements set forth above based on types and levels of care, all licensed facilities must complete an initial assessment for each client that includes the following elements: Read More
For each client admitted, licensed facilities must complete an individual treatment plan based on the client’s treatment, medical, psychiatric, and social histories. The treatment plan must address the following elements: Read More
Medication & Medication Assisted Treatment
Licensees providing medically managed or medically monitored detoxification services shall ensure that management, storage, and administration of medication comply with requirements established by... Read More
As an initial matter, opioid treatment programs must comply with all applicable laws, including Massachusetts state laws governing controlled substances and federal regulations promulgated by... Read More
In addition to the general requirements for licensed facilities, the admissions and staffing regulations specific to opioid facilities described above, and the special application process described above, there are specific licensing rules that must be satisfied to provide medication assisted opioid treatment. Read More
Discharge depends on the circumstances. Clients who are undergoing medically supervised withdrawal as a planned goal in a maintenance program may request a blind dosage reduction, i.e. a gradual decrease of dosage without prior notice to the client of the decrease. Read More
Facilities must protect the legal and civil rights of each client at all times during treatment and discharge from treatment. Read More
Facilities must establish and maintain written policies and procedures for managing disruptive behavior, including aggression, harm or threats of harm to self or others, destruction of property, and refusal to comply with program policies. Read More
Licensed facilities must have written termination and discharge policies and procedures and make these available to prospective clients at the time of admission. Read More
Generally, there are four types of discharge. First, successful completion of the program means that the client has met the goals of his or her recovery plan. Read More
The discharge of a client must be handled carefully given the risks if a client suffers negative health consequences in the aftermath of discharge. Read More
The facility must develop procedures to be followed in the event of the death of a patient. These procedures must conform with laws governing the report of death to local authorities. Read More
Replace preview sentence with “Client confidentiality is an important issue covered by both federal and state laws. These laws set forth specific requirements regarding how and when patient information may be shared and the protections that must be in place to safeguard confidentiality. Read More
Clients seeking drug and alcohol rehabilitative services often face financial difficulties, whether because of the consequences of their addiction or the expense of multiple, prior failed treatment programs. Read More
Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws. Read More.
By law, advertising cannot: (1) be false, deceptive or misleading; (2) have the effect of intimidating or exerting undue pressure; (3) guarantee a cure; and/or (4) make claims of professional superiority that a licensee cannot substantiate. Read More
Federal and state laws prohibit the exchange of items of value to induce referrals for health-related services. As a result, the exchange of any item of value, whether it is cash or in kind, must be carefully monitored. Read More
Providers must avoid giving a patient or prospective patient anything of value or benefit. For example, facilities must avoid giving gifts to clients or referral sources because these may violate anti-kickback laws and rules against inducements and patient brokering. Read More
Alcohol and Drug Free Housing
Alcohol and drug free housing, also known as sober living facilities, are transitional alcohol and drug free residential settings with rules, peer-led groups, activities and/or other structured operations. Read More
Licensing & Certification
Alcohol and drug free housing are unlicensed facilities, which can offer sober housing with rules, peer-led groups, staff activities and/or other structured operations for persons in early recovery... Read More
Sober homes may devise their own quality standards. NARR provides a Code of Ethics that is used by sober homes in many states and is available here: Read More
Alcohol and drug free housing provides a structured alcohol and drug free environment for congregate living that offers regularly scheduled peer-led or community gatherings (self-help groups, etc.) Read More
Zoning and Land Use
A recovery house with six or fewer people is generally exempt from zoning and land use regulations based on federal and state law, and need not seek municipal approval to operate. Read More
This area of law is complex and evolving. It is well settled that state and federal law prohibit local governments from discriminating against or treating the residents of sober living homes differently... Read More
In siting alcohol and drug free housing, attention should be paid to potential hostility from neighbors. While federal and state law protect the right to operate sober living residences of six or fewer people in any residential community... Read More
Residents’ Rights and Responsibilities
In general, operators of sober living houses should agree to the following: (1) to enforce that the premises remain safe and free of intoxicant use; (2)... Read More
As a general matter, the housing agreement should include: (1) a pledge from the client to live by the house rules, including to abstain from drug and alcohol use and... Read More
As a general matter, alcohol and drug free housing does not have the right to impose testing or searches without consent. Read More
Alcohol and drug free housing sometimes rely on the drug screening that takes place when the resident attends outpatient services, although they may make use of drug testing equipment... Read More
Yes, as long as the obligations are enforceable under Massachusetts law in general and any applicable laws relating to landlord and tenants. Read More
Governance and Staffing
Alcohol and drug free housing may be structured as a nonprofit corporation, a for-profit corporation, limited liability company, partnership, or a sole owner arrangement. Read More