This regulation establishes the organizational structure of the Massachusetts Department of Mental Health (DMH), designates specific state-operated facilities (state hospitals, community mental health centers, psychiatric units, and an addiction treatment program), and sets requirements for citizen advisory boards at various levels (statewide, area, site, and facility-specific). Facility operators under DMH oversight must be aware of the governance structures, board compositions, and advisory roles that apply to their facilities. The regulation does not set clinical operating standards but defines the administrative and citizen-participation framework within which DMH-designated facilities operate.
View official source104 CMR: DEPARTMENT OF MENTAL HEALTH 104 CMR 26.00: ORGANIZATIONAL STRUCTURE AND CITIZEN PARTICIPATION Section 26.01: Organization of the Department 26.02: Designation of Departmental Facilities 26.03: Citizen Advisory Boards 26.01: Organization of the Department The Department is authorized by M.G.L. c. 19, § 12, to establish a geographic structure for the organization and provision of mental health services. The Department’s organization shall include a Central Office, Area Offices, and such other offices as may be designated from time to time by the Commissioner. The Department shall from time to time issue a Resource Guide that describes the geographic structure of the Department and how to access community-based service delivery systems throughout the state. 26.02: Designation of Departmental Facilities (1) The Commissioner is authorized by M.G.L. c. 19, § 7 to designate the state facilities under the control of the Department. The following have been so designated by the Commissioner: (a) State Hospitals: Taunton State Hospital; Worcester Recovery Center and Hospital. (b) Community Mental Health Centers with Inpatient Units: Cape Cod and Islands Mental Health Center; Corrigan Mental Health Center; Dr. Solomon Carter Fuller Mental Health Center. (c) Community Mental Health Centers without Inpatient Units: Brockton Multi-Service Center; Massachusetts Mental Health Center; Erich Lindemann Mental Health Center; Dr. Harry C. Solomon Mental Health Center; Quincy Mental Health Center. (d) State Hospital Psychiatric Units: Hathorne Psychiatric Services of Tewksbury Hospital; Metro Boston Mental Health Units of Lemuel Shattuck Hospital. (e) The Recovery from Addictions Program, a facility for the treatment of Individuals committed pursuant to M.G.L. c. 123, § 35. (2) Specialized units operated by the Department directly or through contract in a Department facility that are subject to the facility’s governance structure shall be considered part of that facility. 26.03: Citizen Advisory Boards (1) Authority and General Requirements. (a) Authority. The Department is authorized by M.G.L. c. 19 to provide for and to cooperate with citizen advisory boards at its facilities and at each geographic level of the Department. 104 CMR 26.03, applies to the Mental Health Advisory Council, the board of trustees for a state hospital, Area Boards, the Human Rights Advisory Committee, Site Boards and such other citizen advisory boards as may be established by the Commissioner. (b) Special State Employees. Subject to the exception below, all appointed members of the Department’s citizen advisory boards, as well as all volunteers who may serve on a regular or ad hoc committee or subcommittee of a citizen advisory board, shall be special state employees and, as such, are subject to the conflict of interest law, M.G.L. c. 268A. Nothing in M.G.L. c. 268A, § 7 shall prevent a person who has a financial interest, directly or indirectly, in a contract made by the Department from serving as a member of a citizen advisory board. Members of such committee shall disclose any such financial interest by written notification to the Commissioner and the State Ethics Commission. (c) Waiver. With respect to any person nominated for appointment to a citizen advisory board, the qualification standards set forth in 104 CMR 26.03 may be waived by the appointing authority for good cause, except where such standards are otherwise required by law. (d) Application of Open Meeting Law. The meetings of any board established under M.G.L c. 19 or subject to 104 CMR 26.03 shall be subject to the provisions of M.G.L. c. 30A, §§ 18 through 25 concerning the meetings of governmental bodies. (Mass. Register #1457 11/26/21) 104 CMR: DEPARTMENT OF MENTAL HEALTH 26.03: continued (e) General Requirements. The following requirements apply to all citizen advisory boards subject to 104 CMR 26.03. 1. Membership requirements. a. No member may be an employee of the Department; b. No more than one third of the members may be employees of the state; c. Members shall represent the entire geographic area covered by the board; d. Members shall receive orientation and training upon their appointment; and e. Members shall serve without compensation, but each member shall be reimbursed by the state for all rea sonable expenses incurred in the perf ormance of his or he r duties; 2. Terms of Office. a. The term of office for citizen advisory boards is three years; b. In the event of a vacancy in the membership of a citizen advisory board where the term of a former member's appointment has not yet expired, the appointing authority for that board may appoint a member who shall serve for the r emainder of that unexpired term or may appoint a member to serve a full three year term; c. No membe r shall be a ppointed to serve mor e than two co nsecutive three year terms; d. A person must wait for at lea st one year after completing a second consecutive three year term before becoming eligible for reappointment. 3. Duties and Powers of Citizen Boards. a. To educate the public regarding the needs of individuals with mental illness and their families; b. To receive and review regular reports concerning the Department’s programs and services; c. To make recommendations to the Commissioner or designee based on the review of regular reports; d. To hold regular meetings as follows: i. An Area Board shall hold at least four re gular meetings in ea ch year, and convene special meetings on the call of the board’s president or ten members of the board, or by the Commissioner or designee. ii. All other Advisory Boards shall hold at least three regular meeting in each year, and convene special meetings on the ca ll of the board’ s president or a majority of members of the board. iii. A special mee ting of any Advisory Boa rd may be cal led by the Commissioner or de signee; provided that the Commi ssioner or de signee may participate in all meetings but may not vote. e. To appoint any permanent or ad hoc advisory committee that the board deems necessary, or as specified in the bylaws. The term of office for any member of such a committee shall be determined by the board, or as specified in the bylaws; f. To elect from its members annually a president and such other officers as it deems appropriate, or as required by law; g. To enact bylaws for its proper organization and procedures at meetings, provided that th e b ylaws a nd a ny s ubsequent a mendments mu st b e s ubmitted to the Commissioner or designee for approval. (2) Community Mental Health Area Boards. The Commissioner shall appoint in each Area, with the advice of the Area Director, a Community Mental Health Area Board (“Area Board”). In a ddition to t he g eneral r equirements lis ted at 104 CMR 26. 03(1)(e), the me mbership requirements, terms of office, and duties and powers of each Area Board shall be as follows: (a) Membership Requirements. 1. The Ar ea B oard sha ll consist o f no less than 15 members a ppointed by the Commissioner. Two thirds of the members must live within the Area and the remaining members must either live or work within the Area; 104 CMR: DEPARTMENT OF MENTAL HEALTH 26.03: continued 2. The Area Board should reflect the geographic and demographic diversity of the Area. When making a ppointments, the Comm issioner shall include, but not be limit ed to, persons who are or have been recipients of mental health services, including individuals between 18 and 25 y ears of age and adults 60 years of age or older; persons who a re family members or guardians of recipients of mental health services, including family members or guardians of children younger than 19 years old currently receiving services; and persons representing racial and cultural minorities; 3. The Area Board shall include one representative from the board of trustees of each state hospital located within the Area; 4. The Area Board shall include one representative from each Site Board located within the Area. (b) Appointment and Terms of Office. 1. The Commissioner shall appoint and may remove Area Board members who shall be sworn to the faithful performance of their duties. 2. Eac h Are a B oard, in c onjunction with the Area Direc tor, shall sug gest for consideration by the Commiss ioner one or more names for each e xpiring term or vacancy. (c) Duties and Powers of Area Boards. 1. To act as the representative of the citizens of the Area; 2. To take cognizance of the unique needs of the various sites within the Area; 3. To advise the Area Director regarding local needs and resources in the development of comprehensive mental health services in the Area and on matters of importance to the Area and the Department; 4. I n a manne r determined by the Commiss ioner, to consult in the re cruitment and selection of the Area Director to be appointed by the Commissioner; 5. To participate in the review of service program development, annual goals and annual budgets for the comprehensive mental health services of the Area; 6. To consult with the Commi ssioner or de signee in personne l rec ruitment and appointment policies and in the establishment of program priorities for the Area; 7. To consult with the Commissioner or designee on the admission policies for all facilities and se rvices, and policies re garding r elationships with other ag encies and organizations; 8. To review programs and services which are part of the program of the Area, including those which are not conducted with state-operated facilities; 9. To receive and administer any gift or bequest of personal property or funds in trust, or any grant or devise of lands made to its use in trust in the interest of the Area program of mental health services; 10. To communicate with the statewide Me ntal Health Advisory Council reg arding matters concerning the Area. (3) Site Boards. The Area Director shall appoint for each Site located within an Area, a Site Board. In addition to the general requirements listed at 104 CMR 26.03(1)(e), the membership requirements, terms of office, and duties and powers of each Site Board shall be as follows: (a) Membership Requirements. 1. Two thirds of the members must live within the geographic area served by the Site Board and the remaining members shall either live or work within the geographic area; 2. Me mbership of the Site B oard sh ould r eflect th e g eographic a nd de mographic diversity of the area. When making appointments, the Commissioner or designee shall include, but not be limited to, persons who are or have been recipients of mental health services, including individuals between 18 and 25 years of age and adults 60 years of age or older; persons who are family members or guardians of recipients of mental health services, including family members or guardians of children younger than 19 years old currently receiving services; and persons representing racial and cultural minorities. (b) Appointment of Members. 1. The Area Director shall appoint and may remove Site Board members. 2. Eac h Site Board may suggest for consideration by the Area Director one or more names for each expiring term or vacancy. 104 CMR: DEPARTMENT OF MENTAL HEALTH 26.03: continued (c) Duties and Powers of Site Boards. 1. To act as the representative of the citizens of the geographic area served by the Site Board; 2. To collabora te with and advise the Area Board and Area Director regarding local needs, resources, and matters of concern in the geographic area served by the Site Board; 3. To participate in the review of the Area's proposed annual budget; 4. To participate in the development of programs for the geographic area served by the Site Board; 5. To attend regularly scheduled meetings with program provider representatives in order to promote high quality programs and services. (4) Boards of Trustees for State Hospitals. I n addition to the ge neral requirements listed at 104 CMR 26.03(1)(e), the membership requirements, terms of office, and duties and powers of the State Hospital Boards of Trustees provided for by M.G.L. c. 19, § 8A, shall be as follows: (a) Membership Requirements. 1. Members shall be appointed or removed by the Governor; 2. A majority of the trustees shall be persons who are or have been recipients of mental health services and their guardians or family members. (b) Duties and Powers. 1. To visit and become f amiliar with the state hospital. This duty requires board members to personally visit, at least annually, all service delivery areas within the state hospital; 2. To interact with the Area Board in an effort to ensure coordination of the service delivery system in the Area; 3. I n a manne r determined by the Commiss ioner, to consult in the rec ruitment and selection of the facility director to be appointed by the Commissioner; 4. To review and make recommendations concerning the annual budget for the state hospital; 5. To review programs and services which are a part of the program of the state hospital and oversee the development, establishment and implementation of internal and external monitoring functions within the state hospital, including any monitoring activities carried out by interested citizens; 6. From time to time, to make suggestions to the Department for improvements in the state ho spital, especially those that will make its administration more eff ective, economical and humane. (5) Mental Health Advisory Council. In addition to the general requirements listed at 104 CMR 26.03(1)(e), the membership re quirements, ter ms of office , and duties and pow ers of the Statewide Mental Health Advisory Council provided for by M.G.L. c. 19, § 11, shall be a s follows: (a) Membership Requirements. 1. The Mental Health Advisory Council shall consist of 15 members appointed by the appointed or removed by the Secretary of Health and Human Services with the approval of the Governor; 2. There must be at least one member from each Area in the state; 3. Eight of the members must be citizens who are members of the Department's Area Boards across the state; 4. One member shall be a professional in the field of children's mental health; 5. At least four of the remaining members shall be appointed to represent one of the following p rofessions an d gro ups: s tate l evel m edical, p sychological, n ursing, educational, social work, oc cupational ther apy, or bar associations , associations for mental health, industrial and labor groups, and the clergy; 6. Membership of the Mental Health Advisory Council should reflect the geographic and demographic diversity of the state. When making appointments, the Secretary shall include, but not be limited to, persons who are or have been recipients of mental health services, including individuals between 18 and 25 years of age and adults 60 years of age or older; persons who are family members or guardians of recipients of mental health services, including family members or guardians of children younger than 19 years old currently receiving services; and persons representing racial and cultural minorities. 104 CMR: DEPARTMENT OF MENTAL HEALTH 26.03: continued (b) Duties and Powers. 1. To advise the Commissioner on policy, program development, and priorities of need in the Commonwealth for comprehensive programs in mental health; 2. To participate with the Department in holding a regular series of public hearings throughout the state to obtain the views of the Area Boards, and other citizens concerning the programs of the Department and the needs for mental health services; 3. To make recommendations to the Commissioner based on a review of the annual plan and the proposed annual budget of the Department. (6) Human Rights Advisory Committee. The Commissioner shall appoint a statewide Human Rights Ad visory Com mittee. I n a ddition to t he g eneral r equirements lis ted a t 10 4 CM R 26.03(1)(e), the membership requirements, terms of office, and duties and powers of the Human Rights Advisory Committee shall be as follows: (a) Membership Requirements. 1. A majority of the membership of the Committee shall be comprised of one or more of each of the following: past or present recipients of mental health services or their guardians; family members of such persons; representatives of advocacy organizations; psychologists; psychiatrists; and mental health service providers. 2. Membership of the Human Rights Advisory Committee should reflect the geographic and demographic diversity of the state. When making appointments, the Commissioner shall include, but not be limited to, persons who ar e or have been recipients of mental health services, including individuals between 18 and 25 years of age and adults 60 years of age or older; persons who are family members or guardians of recipients of mental health services, including family members or guardians of children younger than 19 years old currently receiving services; and persons representing racial and cultural minorities. (b) Appointment of Members. 1. The Commissioner shall appoint and may remove Committee members; 2. The Commit tee may suggest for consideration by the Commissioner one or more names for each expiring term or vacancy. (c) Duties and Powers. 1. To advise the Commissioner or d esignee regarding the human and c ivil rights of clients served by the Department; 2. To assist the Commissioner or designee in identifying the human and civil rights implications of existing and proposed Department policy and procedure; 3. To assist the Commissioner or designee in reviewing human rights training programs; 4. At the Commissioner’s request, to consult on the appointment of the Department’s Director of Human Rights. (d) Expectations and Limits of Advocacy. The Department, being mindful of the state conflict of interest law, M.G.L. c. 268A, sets forth and authorizes the following expectations and limits of advocacy by members of the Committee. A committee member's official duties do not prec lude re presentation of or advoc acy for a ny party , including the rec eipt of compensation f or su ch r epresentation o r a dvocacy, if the c ommittee me mber a cts i n accordance with 104 CMR 26.03. 1. General Rule. The Department expects that persons appointed to the Committee who are regularly advocates for the human rights of Department clients (whether or not such advocates are "representatives of advocacy organizations" as provided in 104 CMR 26.03(5)(a)1., whether they are legal advocates or otherwise, and whether paid or unpaid - hereafter referred to a s "outside a dvocates") will bring to their pa rticipation on the Committee the knowle dge, views a nd spirit of that outside advocacy , so that the Department may have the benefit of a diverse range of perspectives in order better to protect and respect the human rights of its clients. 2. Limitations on General Rule. If the Committee addresses any matter which involves the rig hts or obligations of a spe cific, know n person r eceiving se rvices from the Department, any member of the Committee who is such an outside advocate and who: 104 CMR: DEPARTMENT OF MENTAL HEALTH 26.03: continued a. has participated or is participating in the same matter as an outside advocate for any p arty to it, shall disclose to the Commit tee the r elevant fac ts as to such participation and shall have the opportunity to present to the Committee any information or argument pertaining to the matter, but may not thereafter participate in the d eliberations or votes of the Committee or in any advice provided to the Commissioner or other person within the Department regarding the matter. b. might ther eafter participate in the sa me matter as an outside advoc ate for any party to i t, shall, before, or as soon as, it i s addressed by the Committee, recuse himself or herself so that he or she does not lear n any information re garding the matter not otherwise available without membership on the Committee or otherwise participate in the deliberations, votes or advice of the Committee. Any information about t he ma tter g ained b y re ason o f t he me mber's p resence sh all b e ke pt i n confidence a nd not disclosed to any one outside the Committee. Howeve r, the member shall have the opportunity to present to the Committee any information or argument on any relevant general issue pertaining to the matter. REGULATORY AUTHORITY 104 CMR 26.00: M.G.L. c. 19, § 18.