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Three-Year Accreditation

CARF Survey Report

for Brockton Area Multi-

Services, Inc.

Three-Year Accreditation

Organization Brockton Area Multi-Services, Inc. (BAMSI) 10 Christy’s Drive Brockton, MA 02301

Organizational Leadership Anthony Simonelli, Chief Executive Officer

Christopher Mundy, Vice President of Quality Management

Survey Dates December 4-6, 2013

Survey Team Walter A. Peake, LMSW, ACSW, Administrative Surveyor

Christine S. Walkons, LPC, CADC, CCS-M, Program Surveyor

Robert J. Melnick, Program Surveyor

Darlene J. Kratt, Program Surveyor

Andrzej Nowak, M.Ed., Program Surveyor

Denise Stuart, Program Surveyor

Alan J. Marken, Program Surveyor

Jill G. Bloom, RN, CPRP, Program Surveyor

Programs/Services Surveyed Community Housing: Mental Health (Adults) Day Treatment: Mental Health (Adults) Outpatient Treatment: Mental Health (Adults) Outpatient Treatment: Mental Health (Children and Adolescents) Supported Living: Mental Health (Adults)

Community Employment Services: Employment Supports Community Employment Services: Job Development Community Housing Community Housing (Medically Fragile) Community Integration Supported Living

Governance Standards Applied

Previous Survey December 1-3, 2010 Three-Year Accreditation

Survey Outcome

Three-Year Accreditation Expiration: January 2017

SURVEY SUMMARY

Brockton Area Multi-Services, Inc. (BAMSI), has strengths in many areas.

■ The work of the organization is guided by a board of directors, which has members of diverse backgrounds who bring years of experience, clear understanding of their roles and responsibilities, and a sense of passion and commitment that is evident in the solid structures and governance processes they have developed and implemented over the years.

■ Shared decision making, transparency, and clear communication are valued throughout the organization and are evident in initiatives, practices, and structures at every level. The organization has developed committee and meeting structures, including those associated with the Consumer Advisory Council, to ensure that the leadership hears, understands, and utilizes the input.

■ The work of the chief executive officer is recognized among internal and external stakeholders as key in the organization’s remarkable growth, development, success, and stability in the provision of high quality services in the community for almost 40 years.

■ The board of directors and its committees hold regular meetings throughout the year, including two meetings each year at selected program locations and an annual meeting with stakeholders, during which the many accomplishments of the organization, its programs, the staff members, and the persons served are recognized and celebrated. The leadership personnel and members of the board of directors describe the annual meeting as an exceptionally powerful experience that is valued, shared, and remembered by stakeholders for the quality of the production and the clarity with which the organization’s mission is communicated.

■ The organization has invested in the development of solid infrastructure and business practices, specifically designed to support and promote service delivery functions and related activities. Development and reliance on experts with specialized administrative roles continues to support the organization’s ability to ensure that program and clinical personnel can focus their considerable skills and efforts on the management and provision of services.

■ The work of the organization is guided by a meaningful strategic planning process. The process results in the development of a written strategic plan with meaningful goals and priorities that are reflected throughout business and service delivery functions. Strategic initiatives and progress in achievement of “smart goals” is tracked and reported using a clearly organized, straight forward spreadsheet that identifies the goal area, responsible person, target dates, and status.

■ BAMSI has engaged in ongoing planning associated with the use of technology in a variety of areas, including project management, communication with stakeholders, and the recent successful rollout of an electronic medical record. This is of particular note, given the complex service environment and multiple funding and regulatory requirements.

■ Planning processes have resulted in the development of a comprehensive executive succession strategy that includes provisions for short-term emergency situations or extended absences. This plan addresses specific roles and responsibilities and, along with its continuity of operations plans, positions the organization well to respond to urgent needs.

■ Individuals throughout the organization communicate a clear sense of mission and commitment to quality. Those associated with the organization describe a tremendous pride in their association with BAMSI and the delivery of services in an atmosphere of dignity and respect, for which the persons served are truly appreciative.

■ The organization’s commitment to quality and ongoing improvement in its operations is evident in a variety of structures and processes. In addition to the recent expansion of staffing in the quality improvement offices, this commitment is evident in the implementation of a Clinical Review process, during which challenging or complex service delivery issues are presented and discussed; the Medical Risk Committee, which includes stakeholders, consultants, and personnel with specialized skills and knowledge; and Clinical Best Practice forums with presentations by recognized experts. The Clinical Best Practice forums are scheduled a year in advance, and the organization has developed a process to have these events approved for professional continuing education credits that are available to staff members at no charge.

■ BAMSI continues to demonstrate a commitment and significant capacity in the management and use of technology, websites, social media, and publications for communicating its mission, sharing performance information, and managing its operations. In addition to the public website, the organization has developed secure web-based resources for the use of program personnel, the leadership staff members, and members of the board of directors. The public website is well designed, attractive, and easy to use and includes links to information about program access, performance information, and powerful videos that communicate the organization’s story and the many accomplishments of the persons served.

■ BAMSI demonstrates a clear commitment promoting personal growth and professional development of personnel throughout the organization. All personnel receive initial and ongoing training associated with their respective roles and responsibilities, and the organization has developed specialized training programs for leadership, management, administrative, and service delivery personnel.

■ The organization has undergone significant expansion in the scope, type, and communities served. This growth was made possible in part by the organization’s community reputation as the “go to” provider and recognition by stakeholders of the organization’s administrative and financial capacities. In addition, the organization has demonstrated the willingness and ability to develop new competencies, even in the face of uncertain or unclear financial supports.

■ The organization is to be recognized for the quality of the specifically designed housing options for individuals with multiple medical issues. Tastefully decorated, each house creatively balances the complex needs in a homelike setting that is personalized with the uniqueness of each person served.

■ In addressing the needs of individuals with complex medical issues and supporting the staff in these efforts, BAMSI provides comprehensive, ongoing training that exemplifies it as a leader in the field of community housing for the medically fragile.

■ The organization participates in ongoing research and studies that promote enhanced understanding and improvements. One example is the development of specific protocols and procedures for preventing hypothermia, while another addresses the needs of persons at risk for aspiration pneumonia. The results of this work include a reduction in hospitalizations and the promotion of well-being.

■ Generators are installed at all homes for medically fragile persons, and some of the vans are equipped to be able to accommodate oxygen and suction pumps.

■ The organization provides training and supervision to ensure that evidence-based treatment modalities are implemented appropriately and effectively throughout its programs.

■ Coordination of the crisis services is highly organized and responsive to the needs of the persons served.

■ A human rights advocate is designated at each location. This person has primary responsibility for the organization and oversight of rights-related processes at their respective locations.

■ Safety specialists are appointed throughout the organization, and these employees take the lead role in ensuring that systems to monitor environmental checks and safety drills are properly implemented and maintained.

■ Management team members report that the regularly occurring “cluster” meetings provide an excellent venue for sharing best practices that occur throughout the organization.

■ Stakeholders describe the employment program and the staff as “top notch” in providing support to the persons served and the employers. They regularly “go above and beyond.”

■ BAMSI understands the value of peer involvement in service provision and promotes opportunities for mentoring and supports for other individuals in service through Mentoring Mondays and peer partnering in the day habilitation programs.

■ The persons served attending the day habilitation program describe themselves as having a sense of pride as they attend the different activities that are organized by Yale, Princeton, and Harvard universities.

■ Brockton Employment Services takes a creative approach in finding the persons served competitive employment by utilizing the strengths of each staff member, providing a stepping stone for persons served as they move toward employment. With a 65 percent employment rate and a 95 percent retention rate, it is clear that this system has been effective for the persons served.

■ The organization is complimented for using the Mass in Motion program to promote healthy eating and physical fitness to the persons served in residential programs. Many examples were provided of how the persons benefit from the implementation of the program by being able to manage their medical conditions easier and in more natural way or by achieving better health. The persons served are involved in menu planning on a regular basis and are provided with

many opportunities for physical activities daily. Furthermore, the organization is applauded for having its 2013 Annual Conference focused on the Impact of Nutrition - Multi-Disciplinary Perspectives.

■ One of the aspects of the organization’s commitment to the “person-comes-first” philosophy and its promotion of the person-centered approach is the individualization of services. The persons served live in very personalized residences and work toward achieving goals based on their unique needs and strengths. The persons living in the same home attend different day programs on a full-time or part-time basis.

■ The residential services for persons with complex medical needs have been highly successful and could serve within the field as an example of an individualized, community-based model of services that reflects the organization’s commitment to quality of life of persons served. The persons residing in these homes are supported by teams of dedicated, passionate, and well-trained professionals who often go the extra distance to fulfill the mission of the organization. Homes visited during this survey are very functional and have been designed, built, and equipped to accommodate the unique needs and preferences of the future residents. The homes are spacious, well maintained, and equipped with modern fire suppression systems and back-up generators. Each person served has his or her own highly personalized bedroom. In addition, common areas, areas for visits or quiet time, and the three-season rooms have been designated. The residential and the office areas have been separated.

■ The holistic approach to the service delivery appears to result in good communication and collaboration among all professionals involved in the process and seems to have a positive effect on the quality of life of the persons served.

■ Interactions of the staff members and the persons served, and the interactions between the team members were positive, supportive, caring, respectful, and fully reflective of BAMSI’s mission statement, its values, and the code of ethics and professional conduct. The staff members describe themselves as a team working together for the benefit of the residents, or, as one of them expressed, to “make a difference in the lives of the persons served.”

BAMSI should seek improvement in the areas identified by the recommendations in the report. Consultation given does not indicate nonconformance to standards but is offered as a suggestion for further quality improvement.

On balance, BAMSI continues to demonstrate substantial conformance to the CARF standards and continues to provide high quality services across an extensive array of programs throughout a wide geographical area. The work of the organization is valued in the communities served, and stakeholders describe their ongoing appreciation and respect for the organization, its leadership, and the staff members. The ongoing success and growth of the organization, led by a talented and caring team, is reflective of the confidence of funders, referral sources, regulatory entities, and the persons/families served. Personnel throughout the organization communicate a shared sense of mission and a collective commitment to the promotion of the dignity, well-being, and inclusion of the persons served. There are a few opportunities for improvement. It is clear that the organization has the capacity and commitment to address these areas.

Brockton Area Multi-Services, Inc., has earned a Three-Year Accreditation. The board of directors, leadership, and staff members throughout the organization are congratulated for this achievement. The organization is encouraged to continue its longstanding practice of using the CARF standards and accreditation process in support of the continued improvement of its business functions and service delivery processes.

SECTION 1. ASPIRE TO EXCELLENCE®

A. Leadership Principle Statement CARF-accredited organizations identify leadership that embraces the values of accountability and responsibility to the individual organization’s stated mission. The leadership demonstrates corporate social responsibility.

Key Areas Addressed

■ Leadership structure

■ Leadership guidance

■ Commitment to diversity

■ Corporate responsibility

■ Corporate compliance

Recommendations A.6.a.(4)(f) Although the organization has developed codes of ethics and conduct, it is recommended that these codes be expanded to address service delivery, including the witnessing of documents.

B. Governance

Principle Statement The governing board should provide effective and ethical governance leadership on behalf of its owners’/stakeholders’ interest to ensure that the organization focuses on its purpose and outcomes for persons served, resulting in the organization’s long-term success and stability. The board is

responsible for ensuring that the organization is managed effectively, efficiently, and ethically by the organization’s executive leadership through defined governance accountability mechanisms. These mechanisms include, but are not limited to, an adopted governance framework defined by written governance policies and demonstrated practices; active and timely review of organizational performance and that of the executive leadership; and the demarcation of duties between the board and executive leadership to ensure that organizational strategies, plans, decisions, and actions are delegated to the resource that would best advance the interests and performance of the organization over the long term and manage the organization’s inherent risks. The board has additional responsibilities under the domain of public trust, and as such, it understands its corporate responsibility to the organization’s employees, providers, suppliers, and the communities it serves.

Key Areas Addressed ■ Ethical, active, and accountable governance

■ Board composition, selection, orientation, development, assessment, and succession

■ Board leadership, organizational structure, meeting planning, and management

■ Linkage between governance and executive leadership

■ Corporate and executive leadership performance review and development

■ Executive compensation

Recommendations There are no recommendations in this area.

C. Strategic Planning Principle Statement CARF-accredited organizations establish a foundation for success through strategic planning focused on taking advantage of strengths and opportunities and addressing weaknesses and threats.

Key Areas Addressed ■ Strategic planning considers stakeholder expectations and environmental impacts

■ Written strategic plan sets goals

■ Plan is implemented, shared, and kept relevant


D. Input from Persons Served and Other Stakeholders

Principle Statement CARF-accredited organizations continually focus on the expectations of the persons served and other stakeholders. The standards in this subsection direct the organization’s focus to soliciting, collecting, analyzing, and using input from all stakeholders to create services that meet or exceed the expectations of the persons served, the community, and other stakeholders.

Key Areas Addressed ■ Ongoing collection of information from a variety of sources

■ Analysis and integration into business practices

■ Leadership response to information collected


Consultation

■ It is suggested that the organization consider the development of a written plan, grid, or similar guide for obtaining input from stakeholders; addressing the identification of stakeholder groups; the type, source, timing, and method of collection; and the intended use of input in support of ongoing improvement plans and processes.

E. Legal Requirements

Principle Statement CARF-accredited organizations comply with all legal and regulatory requirements.

Key Areas Addressed ■ Compliance with all legal/regulatory requirements


Consultation

■ Although the organization has developed written procedures to guide personnel in responding to legal actions, it might be helpful to expand these procedures to describe actions taken by leadership once the action is brought to their attention. It might also be helpful to revise these

procedures to include, by reference, the organization’s expectations for the staff members to comply with any applicable codes of professional conduct and information about related laws, rules, and regulations.

F. Financial Planning and Management

Principle Statement CARF-accredited organizations strive to be financially responsible and solvent, conducting fiscal management in a manner that supports their mission, values, and annual performance objectives. Fiscal practices adhere to established accounting principles and business practices. Fiscal management covers daily operational cost management and incorporates plans for long-term solvency.

Key Areas Addressed ■ Budget(s) prepared, shared, and reflective of strategic planning

■ Financial results reported/compared to budgeted performance

■ Organization review

■ Fiscal policies and procedures

■ Review of service billing records and fee structure

■ Financial review/audit

■ Safeguarding funds of persons served


G. Risk Management

Principle Statement CARF-accredited organizations engage in a coordinated set of activities designed to control threats to their people, property, income, goodwill, and ability to accomplish goals.

Key Areas Addressed ■ Identification of loss exposures

■ Development of risk management plan

■ Adequate insurance coverage


H. Health and Safety

Principle Statement CARF-accredited organizations maintain healthy, safe, and clean environments that support quality services and minimize risk of harm to persons served, personnel, and other stakeholders.

Key Areas Addressed ■ Inspections

■ Emergency procedures

■ Access to emergency first aid

■ Competency of personnel in safety procedures

■ Reporting/reviewing critical incidents

■ Infection control

Recommendations H.6.a.(1) through H.6.d. Although each location conducts tests of emergency procedures for fires, it appears that some locations simply complete annual discussions of other emergency procedures during regularly scheduled staff meetings. It is recommended that unannounced tests of all emergency procedures be conducted at least annually on each shift at each location and be evidenced in writing. Tests should include complete actual or simulated physical evacuation drills. Tests should be analyzed for performance that addresses areas needing improvement, actions to be taken, results of performance improvement plans, and necessary education and training of personnel.

H.13.a. The organization has implemented multiple processes and structures that include the completion of comprehensive health and safety self-inspections of each location, but it does not appear that these inspections are completed on each shift. It is recommended that comprehensive health and safety

self-inspections be conducted at least semiannually on each shift. It might be helpful to include the completion of inspections on each shift on a comprehensive annual health and safety calendar, and monitor completion and results of these inspections as a part of existing health and safety meetings.

Consultation

■ Although the organization has developed written procedures to guide response to a variety of potential emergency situations, it is suggested that these procedures be revised to include step-by-step guidance tailored to specific program or administrative locations. It might be helpful to format these procedures to serve as a checklist that could be used in documenting and analyzing tests of each emergency plan.

■ It is suggested that, in addition to existing written procedures for evacuation from each location, the organization develop written procedures to guide personnel in sheltering-in-place.

■ BAMSI has adopted various policies and procedures addressing prevention, reporting, documentation, and remedial action for various types of critical incidents. However, there is not a single source or document that communicates a comprehensive list of the types of incidents to be reported. It might be helpful do develop an attachment or reference document to provide an at-a-glance resource that reflects all types of reportable incidents.

I. Human Resources

Principle Statement CARF-accredited organizations demonstrate that they value their human resources. It should be evident that personnel are involved and engaged in the success of the organization and the persons they serve.

Key Areas Addressed ■ Adequate staffing

■ Verification of background/credentials

■ Recruitment/retention efforts

■ Personnel skills/characteristics

■ Annual review of job descriptions/performance

■ Policies regarding students/volunteers, if applicable


Consultation

■ The organization completes annual reviews of all contract personnel to assess performance of their contracts and ensure conformance to applicable policies, procedures, and the CARF standards. It might be helpful to revise the existing letter or other documents associated with contract review and extension to specifically mention expectations as they relate to conformance to the applicable CARF standards.

J. Technology

Principle Statement CARF-accredited organizations plan for the use of technology to support and advance effective and efficient service and business practices.

Key Areas Addressed

■ Written technology and system plan


K. Rights of Persons Served

Principle Statement CARF-accredited organizations protect and promote the rights of all persons served. This commitment guides the delivery of services and ongoing interactions with the persons served.

Key Areas Addressed ■ Communication of rights

■ Policies that promote rights

■ Complaint, grievance, and appeals policy

■ Annual review of complaints


L. Accessibility

Principle Statement CARF-accredited organizations promote accessibility and the removal of barriers for the persons served and other stakeholders.

Key Areas Addressed ■ Written accessibility plan(s)

■ Status report regarding removal of identified barriers

■ Requests for reasonable accommodations


M. Performance Measurement and Management

Principle Statement CARF-accredited organizations are committed to continually improving their organizations and service delivery to the persons served. Data are collected and information is used to manage and improve service delivery.

Key Areas Addressed ■ Information collection, use, and management

■ Setting and measuring performance indicators


N. Performance Improvement

Principle Statement The dynamic nature of continuous improvement in a CARF-accredited organization sets it apart from other organizations providing similar services. CARF-accredited organizations share and provide the persons served and other interested stakeholders with ongoing information about their actual performance as a business entity and their ability to achieve optimal outcomes for the persons served through their programs and services.

Key Areas Addressed ■ Proactive performance improvement

■ Performance information shared with all stakeholders


Consultation

■ The organization has developed a variety of mechanisms to communicate performance information with its stakeholders. It might be helpful to reference these mechanisms on survey instruments or during input forums in order to ensure that the stakeholders understand how and where to access information about the results of performance processes and the use of input they may have provided.

SECTION 2. GENERAL PROGRAM STANDARDS Principle Statement For an organization to achieve quality services, the persons served are active participants in the planning, prioritization, implementation, and ongoing evaluation of the services offered. A commitment to quality and the involvement of the persons served span the entire time that the persons served are involved with the organization. The service planning process is individualized, establishing goals and objectives that incorporate the unique strengths, needs, abilities, and preferences of the persons served. The persons served have the opportunity to transition easily through a system of care.

A. Program/Service Structure

Principle Statement A fundamental responsibility of the organization is to provide a comprehensive program structure. The staffing is designed to maximize opportunities for the persons served to obtain and participate in the services provided.

Key Areas Addressed

■ Written program plan

■ Crisis intervention provided

■ Medical consultation

■ Services relevant to diversity

■ Assistance with advocacy and support groups

■ Team composition/duties

■ Relevant education

■ Clinical supervision

■ Family participation encouraged

Recommendations A.23.a. A.23.e. It is recommended that documented ongoing supervision of clinical or direct service personnel consistently address, when applicable, the accuracy of assessment and referral skills and issues of ethics, legal aspects of clinical practice, and professional standards, including boundaries.

B. Screening and Access to Services

Principle Statement The process of screening and assessment is designed to determine a person’s eligibility for services and the organization’s ability to provide those services. A person-centered assessment process helps to maximize opportunities for the persons served to gain access to the organization’s programs and services. Each person served is actively involved in, and has a significant role in, the assessment process. Assessments are conducted in a manner that identifies the historical and current information of the person served as well as his or her strengths, needs, abilities, and preferences. Assessment data may be gathered through various means including face-to-face contact, telehealth, or written material; and from various sources including the person served, his or her family or significant others, or from external resources.

Key Areas Addressed

■ Screening process described in policies and procedures

■ Ineligibility for services

■ Admission criteria

■ Orientation information provided regarding rights, grievances, services, fees, etc.

■ Waiting list

■ Primary and ongoing assessments

■ Reassessments


C. Person-Centered Plan

Principle Statement Each person served is actively involved in and has a significant role in the person-centered planning process and determining the direction of his or her plan. The person-centered plan contains goals and objectives that incorporate the unique strengths, needs, abilities, and preferences of the person served, as well as identified challenges and potential solutions. The planning process is person-directed and person-centered. The person-centered plan may also be referred to as an individual service plan, treatment plan, or plan of care. In a family-centered program, the plan may be for the family and identified as a family-centered plan.

Key Areas Addressed

■ Development of person-centered plan

■ Co-occurring disabilities/disorders

■ Person-centered plan goals and objectives

■ Designated person coordinates services


D. Transition/Discharge

Principle Statement Transition, continuing care, or discharge planning assists the persons served to move from one level of care to another within the organization or to obtain services that are needed but are not available within the organization. The transition process is planned with the active participation of each person served. Transition may include planned discharge, placement on inactive status, movement to a different level of service or intensity of contact, or a re-entry program in a criminal justice system.

The transition plan is a document developed with and for the person served and other interested participants to guide the person served in activities following transition/discharge to support the gains made during program participation. It is prepared with the active participation of person served when he or she moves to another level of care, after-care program, or community-based

services. The transition plan is meant to be a plan that the person served uses to identify the support that is needed to prevent a recurrence of symptoms or reduction in functioning. It is expected that the person served receives a copy of the transition plan.

A discharge summary is a clinical document written by the program personnel who are involved in the services provided to the person served and is completed when the person leaves the program (planned or unplanned). It is a document that is intended for the record of the person served and released, with appropriate authorization, to describe the course of services that the program provided and the response by the person served.

Just as the assessment is critical to the success of treatment, the transition services are critical for the support of the individual’s ongoing recovery or well-being. The organization proactively attempts to connect the persons served with the receiving service provider and contact the persons served after formal transition or discharge to gather needed information related to their post-discharge status. Discharge information is reviewed to determine the effectiveness of its services and whether additional services were needed.

Transition planning may be included as part of the person-centered plan. The transition plan and/or discharge summary may be a combined document as long as it is clear whether the information relates to transition or pre-discharge planning or identifies the person’s discharge or departure from the program.

Key Areas Addressed

■ Referral or transition to other services

■ Active participation of persons served

■ Transition planning at earliest point

■ Unplanned discharge referrals

■ Plan addresses strengths, needs, abilities, preferences

■ Follow-up for persons discharged for aggressiveness


E. Medication Use

Principle Statement Medication use is the practice of handling, prescribing, dispensing, and/or administering medications to persons served in response to specific symptoms, behaviors, and conditions for which the use of medications is indicated and deemed efficacious. Medication use may include self administration, or be provided by personnel of the organization or under contract with a licensed individual. Medication use is directed toward maximizing the functioning of the persons served while reducing their specific symptoms and minimizing the impact of side effects.

Medication use includes prescribed or sample medications, and may, when required as part of the treatment regimen, include over-the-counter or alternative medications provided to the person served. Alternative medications can include herbal or mineral supplements, vitamins, homeopathic remedies, hormone therapy, or culturally specific treatments.

Medication control is identified as the process of physically controlling, transporting, storing, and disposing of medications, including those self administered by the person served.

Self administration for adults is the application of a medication (whether by injection, inhalation, oral ingestion, or any other means) by the person served, to his/her body; and may include the organization storing the medication for the person served, or may include staff handing the bottle or blister-pak to the person served, instructing or verbally prompting the person served to take the medication, coaching the person served through the steps to ensure proper adherence, and closely observing the person served self-administering the medication.

Self administration by children or adolescents in a residential setting must be directly supervised by personnel, and standards related to medication use applied.

Dispensing is considered the practice of pharmacy; the process of preparing and delivering a prescribed medication (including samples) that has been packaged or re-packaged and labeled by a physician or pharmacist or other qualified professional licensed to dispense (for later oral ingestion, injection, inhalation, or other means of administration).

Prescribing is evaluating, determining what agent is to be used by and giving direction to a person served (or family/legal guardian), in the preparation and administration of a remedy to be used in the treatment of disease. It includes a verbal or written order, by a qualified professional licensed to prescribe, that details what medication should be given to whom, in what formulation and dose, by what route, when, how frequently, and for what length of time.

Key Areas Addressed

■ Individual records of medication

■ Physician review

■ Policies and procedures for prescribing, dispensing, and administering medications

■ Training regarding medications

■ Policies and procedures for safe handling of medication


F. Nonviolent Practices

Principle Statement Programs strive to be learning environments and to support persons served in the development of recovery, resiliency, and wellness. Relationships are central to supporting individuals in recovery and wellness. Programs are challenged to establish quality relationships as a foundation to supporting recovery and wellness. Providers need to be mindful of developing cultures that create healing, healthy and safe environments, and include the following:

■ Engagement

■ Partnership—power with, not over

■ Holistic approaches

■ Respect

■ Hope

■ Self-direction

Programs need to recognize that individuals may require supports to fully benefit from their services. Staff are expected to access or provide those supports wanted and needed by the individual. Supports may include environmental supports, verbal prompts, written expectations, clarity of rules and expectations, or praise and encouragement.

Even with supports, there are times when individuals may show signs of fear, anger, or pain, which may lead to aggression or agitation. Staff members are trained to recognize and respond to these signs through de-escalation, changes to the physical environmental, implementation of meaningful and engaging activities, redirection, active listening, etc. On the rare occasions when these interventions are not successful and there is imminent danger of serious harm, seclusion or restraint may be used to ensure safety. Seclusion and restraint are never considered treatment interventions; they are always considered actions of last resort. The use of seclusion and restraint must always be followed by a full review, as part of the process to eliminate the use of these in the future.

The goal is to eliminate the use of seclusion and restraint in behavioral health, as the use of seclusion or restraint creates potential physical and psychological dangers to the persons subject to the interventions, to the staff members who administer them, or those who witness the practice. Each organization still utilizing seclusion or restraint should have the elimination thereof as an eventual goal.

Restraint is the use of physical force or mechanical means to temporarily limit a person’s freedom of movement; chemical restraint is the involuntary emergency administration of medication, in immediate response to a dangerous behavior. Restraints used as an assistive device for persons with physical or medical needs are not considered restraints for purposes of this section. Briefly holding a person served, without undue force, for the purpose of comforting him or her or to prevent self-injurious behavior or injury to self, or holding a person’s hand or arm to safely guide him or her from one area to another, is not a restraint. Separating individuals threatening to harm one another, without implementing restraints, is not considered restraint.

Seclusion refers to restriction of the person served to a segregated room with the person’s freedom to leave physically restricted. Voluntary time out is not considered seclusion, even though the voluntary time out may occur in response to verbal direction; the person served is considered in seclusion if freedom to leave the segregated room is denied.

Seclusion or restraint by trained and competent personnel is used only when other less restrictive measures have been found to be ineffective to protect the person served or others from injury or serious harm. Peer restraint is not considered an acceptable alternative to restraint by personnel. Seclusion or restraint is not used as a means of coercion, discipline, convenience, or retaliation.

In a correctional setting, the use of seclusion or restraint for purposes of security is not considered seclusion or restraint under these standards. Security doors designed to prevent elopement or wandering are not considered seclusion or restraint. Security measures for forensic purposes, such as the use of handcuffs instituted by law enforcement personnel, are not subject to these standards. When permissible, consideration is made to removal of physical restraints while the person is receiving services in the behavioral health care setting.

Key Areas Addressed

■ Training and procedures supporting nonviolent practices

■ Policies and procedures for use of seclusion and restraint

■ Patterns of use reviewed

■ Persons trained in use

■ Plans for reduction/elimination of use


G. Records of the Persons Served

Principle Statement A complete and accurate record is developed to ensure that all appropriate individuals have access to relevant clinical and other information regarding each person served.

Key Areas Addressed

■ Confidentiality

■ Time frames for entries to records

■ Individual record requirements

■ Duplicate records


H. Quality Records Management

Principle Statement The organization has systems and procedures that provide for the ongoing monitoring of the quality, appropriateness, and utilization of the services provided. This is largely accomplished through a systematic review of the records of the persons served. The review assists the organization in improving the quality of services provided to each person served.

Key Areas Addressed

■ Quarterly professional review

■ Review current and closed records

■ Items addressed in quarterly review

■ Use of information to improve quality of services

Recommendations H.4.h.(1) H.4.h.(2) The organization conducts and documents the completion of routine quality records review processes. It is recommended that the process consistently address, when applicable, whether a transition plan and discharge summary have been completed.

MENTAL HEALTH Core programs in this field category are designed to provide services for persons with or who are at risk for psychiatric disabilities/disorders or have other mental health needs. These programs encompass a wide variety of therapeutic settings and intervention modalities. Core programs in this field category may also provide services to persons with co-occurring disabilities/disorders, such as mental illness and a developmental disability.

SECTION 3. BEHAVIORAL HEALTH CORE PROGRAM STANDARDS Principle Statement The standards in this section address the unique characteristics of each type of core program area. Behavioral health programs are organized and designed to provide services for persons who have or who are at risk of having psychiatric disorders, harmful involvement with alcohol or other drugs, or other addictions or who have other behavioral health needs. Through a team approach, and with the active and ongoing participation of the persons served, the overall goal of each program is to improve the quality of life and the functional abilities of the persons served. Each program selected for accreditation demonstrates cultural competency and relevance. Family members and significant others are involved in the programs of the persons served as appropriate and to the extent possible.

D. Community Housing

Principle Statement Community housing addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of the persons served, regardless of the home in which they live and/or the scope, duration, and intensity of the services they receive. The residences in which services are provided may be owned, rented, leased or operated directly by the organization, or a third party, such as a governmental entity. Providers exercise control over these sites.

Community housing is provided in partnership with individuals. These services are designed to assist the persons served to achieve success in and satisfaction with community living. They may be temporary or long term in nature. The services are focused on home and community integration and engagement in productive activities. Community housing enhances the independence, dignity, personal choice, and privacy of the persons served. For persons in alcohol and other drug programs, these services are focused on providing sober living environments to increase the likelihood of sobriety and abstinence and to decrease the potential for relapse.

Community housing programs may be referred to as recovery homes, transitional housing, sober housing, domestic violence or homeless shelters, safe houses, group homes, or supervised independent living. These programs may be located in rural or urban settings and in houses, apartments, townhouses, or other residential settings owned, rented, leased, or operated by the organization. They may include congregate living facilities and clustered homes/apartments in multiple-unit settings. These residences are often physically integrated into the community, and every effort is made to ensure that they approximate other homes in their neighborhoods in terms of size and number of residents.

Community housing may include either or both of the following:

■ Transitional living that provides interim supports and services for persons who are at risk of institutional placement, persons transitioning from institutional settings, or persons who are homeless. Transitional living is typically provided for 6 to 12 months and can be offered in congregate settings that may be larger than residences typically found in the community.

■ Long-term housing that provides stable, supported community living or assists the persons served to obtain and maintain safe, affordable, accessible, and stable housing.

The residences at which community housing services are provided must be identified in the Intent to Survey. These sites will be visited during the survey process and identified in the survey report and accreditation outcome as a site at which the organization provides a Community Housing program.


J. Day Treatment

Principle Statement Day treatment programs are time-limited, medically-monitored programs that offer comprehensive, intensive, individually planned, coordinated, and structured services.

A day treatment program consists of a scheduled series of structured, face-to-face therapeutic sessions organized at various levels of intensity and frequency in order to assist the persons served in achieving the goals identified in their individual treatment plans. Day treatment programs are offered four or more days per week, typically with some availability in the evenings and on weekends. Such a program functions as a step-down or alternative to inpatient care or partial hospitalization, as transitional care following an inpatient or partial hospitalization stay in order to facilitate return to the community or to prevent or minimize the need for a more intense or restrictive level of treatment. Day treatment programs are more intensive than outpatient treatment and serve persons who need a structured behavioral health setting for daytime activities.


T. Outpatient Treatment

Principle Statement Outpatient treatment programs provide services that include, but are not limited to, individual, group, and family counseling and education on recovery and wellness. These programs offer comprehensive, coordinated, and defined services that may vary in level of intensity. Outpatient programs may address a variety of needs, including, but not limited to, situational stressors, family relations, interpersonal relationships, mental health issues, life span issues, psychiatric illnesses, addictions (such as alcohol or other drugs, gambling, and internet), eating or sexual disorders, and the needs of victims of abuse, domestic violence, or other trauma.


Y. Supported Living

Principle Statement Supported living addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of persons living in their own homes (apartments, townhouses, or other residential settings). Supported living services are generally long term in nature, but may change in scope, duration, intensity, or location as the needs and preferences o individuals change over time.

Supported living refers to the support services provided to the person served, not the residence in which these services are provided. A sampling of these sites will be visited as part of the interview process of the person served. Although the residence will generally be owned, rented, or leased by the person who lives there, the organization may occasionally rent or lease an apartment when the person served is unable to do so. Typically, in this situation the organization would cosign or in other ways guarantee the lease or rental agreement; however, the person served would be identified as the tenant. The home or individual apartment of the person served, even when the organization holds the lease or rental agreement on behalf of the person served, is not included in the intent to survey or identified as a site on the accreditation outcome.


SECTION 4. BEHAVIORAL HEALTH SPECIFIC POPULATION DESIGNATION STANDARDS

B. Children and Adolescents

Outpatient Treatment: Mental Health

Principle Statement Programs for children and adolescents consist of an array of behavioral health services designed specifically to address the treatment needs of children and adolescents. Such programs tailor their services to the particular needs and preferences of children and adolescents and are provided in a setting that is both relevant to and comfortable for this population.


SECTION 5. COMMUNITY AND EMPLOYMENT SERVICES

A. Program/Service Structure

Principle Statement A fundamental responsibility of the organization is to provide a comprehensive program structure. The staffing is designed to maximize opportunities for the persons served to obtain and participate in the services provided.

Key Areas Addressed

■ Services are person centered and individualized

■ Persons are given information about the organization’s purposes and ability to address desired outcomes

■ Documented scope of services shared with stakeholders

■ Service delivery based on accepted field practices

■ Communication for effective service delivery

■ Entrance/exit/transition criteria

Recommendations A.3.b. It is recommended that the organization consistently document its transition criteria, based on the scope of each service provided.

B. Individual-Centered Service Planning, Design, and Delivery

Principle Statement Improvement of the quality of an individual’s services/supports requires a focus on the person and/or family served and their identified strengths, abilities, needs, and preferences. The organization’s services are designed around the identified needs and desires of the persons served, are responsive to their expectations and desired outcomes from services, and are relevant to their maximum participation in the environments of their choice.

The person served participates in decision making, directing, and planning that affects his or her life. Efforts to include the person served in the direction or delivery of those services/supports are evident.

Key Areas Addressed

■ Services are person centered and individualized

■ Persons are given information about the organization’s purposes and ability to address desired outcomes


C. Community Services Principle Standards

Key Areas Addressed

■ Access to community resources and services

■ Enhanced quality of life

■ Community inclusion

■ Community participation

Recommendations C.2. Although the persons served participate in community activities, it is recommended that individualized service plans consistently address community inclusion activities, as desired by the person served.

D. Employment Services Principle Standards

Principle Statement An organization seeking CARF accreditation in the area of employment services provides individualized services and supports to achieve identified employment outcomes. The array of services and supports may include:

■ Identification of employment opportunities and resources in the local job market.

■ Development of viable work skills that match workforce needs within the geographic area.

■ Development of realistic employment goals.

■ Establishment of service plans to achieve employment outcomes.

■ Identification of resources and supports to achieve and maintain employment.

■ Coordination of and referral to employment-related services and supports.

The organization maintains its strategic positioning in the employment sector of the community by designing and continually improving its services based on input from the persons served and from employers in the local job market, and managing results of the organization’s outcomes management system. The provision of quality employment services requires a continuous focus on the persons served and the personnel needs of employers in the organization’s local job market.

Key Areas Addressed

■ Goals of the persons served

■ Personnel needs of local employers

■ Community resources available

■ Economic trends in the local employment sector


E. Medication Monitoring and Management

Key Areas Addressed

■ Current, complete records of medications used by persons served

■ Written procedures for storage and safe handling of medications

■ Educational resources and advocacy for persons served in decision making

■ Physician review of medication use

■ Training and education for persons served regarding medications


H. Community Housing

Principle Statement Community housing addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of the persons served, regardless of the home in which they live and/or the scope, duration, and intensity of the services they receive. The residences in which services/supports are provided are typically owned, rented, leased, or operated directly by the organization, or may be owned, rented, or leased by a third party, such as a governmental entity. Providers exercise control over these sites in terms of having direct or indirect responsibility for the physical conditions of the facility.

Community housing is provided in partnership with individuals. These services/supports are designed to assist the persons served to achieve success in and satisfaction with community living. They may be temporary or long-term in nature. The services/supports are focused on home and community integration and engagement in productive activities. Community housing enhances the independence, dignity, personal choice, and privacy of the persons served. For persons in alcohol and other drug programs, these services/supports are focused on providing sober living environments to increase the likelihood of sobriety and abstinence and to decrease the potential for relapse.

Community housing programs may be referred to as group homes, halfway houses, three-quarter way houses, recovery residences, sober housing, domestic violence or homeless shelters, and safe houses. These programs may be located in rural or urban settings and in houses, apartments, townhouses, or other residential settings owned, rented, leased, or operated by the organization. They may include congregate living facilities and clustered homes/apartments in multiple-unit settings. These residences are often physically integrated into the community, and every effort is made to ensure that they approximate other homes in their neighborhoods in terms of size and number of individuals.

Community housing may include either or both of the following:

■ Transitional living that provides interim supports and services for persons who are at risk of institutional placement, persons transitioning from institutional settings, or persons who are homeless. Transitional living is typically provided for six to twelve months and can be offered in congregate settings that may be larger than residences typically found in the community.

■ Long-term housing that provides stable, supported community living or assists the persons served to obtain and maintain safe, affordable, accessible, and stable housing.

The residences in which Community Housing services are provided must be identified in the Intent to Survey. These sites will be visited during the survey process and identified in the survey report and accreditation outcome as a site at which the organization provides a Community Housing program.

Key Areas Addressed ■ Safe, secure, private location

■ In-home safety needs

■ Options to make changes in living arrangements

■ Support to persons as they explore alternatives

■ Access as desired to community activities

■ System for on-call availability of personnel


I. Community Integration

Principle Statement Community integration is designed to help persons to optimize their personal, social, and vocational competency to live successfully in the community. Persons served are active partners in determining the activities they desire to participate in. Therefore, the settings can be informal to reduce barriers between staff members and persons served. An activity center, a day program, a clubhouse, and a drop-in center are examples of community integration services. Consumer-run programs are also included.

Community integration provides opportunities for the community participation of the persons served. The organization defines the scope of these services and supports based on the identified needs and desires of the persons served. This may include services for persons who without this option are at risk of receiving services full-time in more restrictive environments with intensive levels of supports such as hospitalization or nursing home care. A person may participate in a variety of community life experiences or interactions that may include, but are not limited to:

■ Leisure or recreational activities.

■ Communication activities.

■ Spiritual activities.

■ Cultural activities.

■ Vocational pursuits.

■ Development of work attitudes.

■ Employment activities.

■ Volunteerism.

■ Educational and training activities.

■ Development of living skills.

■ Health and wellness promotion.

■ Orientation, mobility, and destination training.

■ Access and utilization of public transportation.

■ Interacting with volunteers from the community in program activities.

■ Community collaborations and social connections developed by the program (partnerships with community entities such as senior centers, arts councils, etc.).

Key Areas Addressed ■ Opportunities for community participation


Consultation

■ Many great strides have been made regarding advocacy in the organization. It is suggested that the organization explore avenues to promote greater access to this opportunity for those who wish to participate. Video conferencing could help facilitate this process.

■ Although the organization is making great strides in vocational development and employment for the persons served, it is suggested that the organization research the Social Security Ticket to Work Program and the application of Social Security work incentives. A couple of good websites to utilize could be www.db101.org, www.ssa.gov, or search for “ticket-to-work.”

M. Supported Living

Principle Statement Supported living addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of persons usually living in their own homes (apartments, townhouses, or other residential settings). Supported living services are generally long-term in nature but may change in scope, duration, intensity, or location as the needs and preferences of individuals change over time.

Supported living refers to the support services provided to the person served, not the residence in which these services are provided. A sampling of people receiving services/supports in these sites will be visited as part of the interview process. Although the residence will generally be owned, rented, or leased by the person who lives there, the organization may occasionally rent or lease an apartment when the person served is unable to do so. Typically, in this situation the organization would co-sign or in other ways guarantee the lease or rental agreement; however, the person served would be identified as the tenant.

Supported living programs may be referred to as supported living services, independent living, supportive living, semi-independent living, and apartment living; and services/supports may include home health aide and personal care attendant services. Typically there would not be more than two or three persons served living in a residence, no house rules or structure would be applied to the living situation by the organization, and persons served can come and go as they please. Service planning often identifies the number of hours and types of support services provided.

The home or individual apartment of the person served, even when the organization holds the lease or rental agreement on behalf of the person served, is not included in the intent to survey or identified as a site on the accreditation outcome.

Key Areas of Addressed

■ Safe, affordable, accessible housing chosen by the individual

■ In-home safety needs

■ Support personnel available based on needs

■ Supports available based on needs and desires

■ Living as desired in the community

■ Persons have opportunities to access community activities


N. Community Employment Services

Principle Statement Community employment services assist persons to obtain successful community employment opportunities that are responsive to their choices and preferences. Through a strengths-based approach the program provides person-directed services/supports to individuals to choose, achieve, and maintain employment in integrated community employment settings.

Work is a fundamental part of adult life. Individually tailored job development, training, and support recognize each person’s employability and potential contribution to the labor market. Persons are supported as needed through an individualized person-centered model of services to choose and obtain a successful employment opportunity consistent with their preferences, keep the employment, and find new employment if necessary or for purposes of career advancement.

Such services may be described as individual placements, contracted temporary personnel services, competitive employment, supported employment, transitional employment, mobile work crews, contracted work groups, enclaves, community-based SourceAmerica™ (formerly NISH) contracts, and other business-based work groups in community-integrated designs. In Canada employment in the form of bona fide volunteer placements is possible.

Individuals may be paid by community employers or by the organization. Employment is in the community.

The following service categories are available under Community Employment Services:

■ Job Development (CES:JD)

■ Employment Supports (CES:ES)

■ Personnel Services to Employers (CES:PSE)

Key Areas Addressed

■ Integrated employment choice

■ Integrated employment obtainment

■ Integrated employment retention

■ Pays wages at or above minimum wage

■ Providers a benefits package

■ Employment provided in regular business settings

■ Provides career advancement resources

■ Business plan is used to design service


Standards from the 2013 Employment and Community Services Standards Manual were also applied during this survey. The following sections of this report reflect the application of those standards.

SECTION 2. QUALITY INDIVIDUALIZED SERVICES AND SUPPORTS

I. Medically Fragile Specific Population Designation

Community Housing

Principle Statement Medically Fragile is a specific population designation that can be added at the option of the organization to a service being surveyed if it specializes in serving persons with a serious ongoing illness or a chronic health condition that requires daily monitoring and ongoing medical treatments and may include the routine use of a medical device or assistive technology. Persons with such needs require overall care planning to achieve optimum health and developmental status and to achieve community integration to the maximum extent possible. Services augment and support independence, empowerment, and dignity of persons served through the provision of flexible and efficient services.

A program specializing in serving persons with medically specific needs assists the persons served in achieving or maintaining an optimal state of health through developmentally appropriate care to have an enhanced quality of life throughout their life span. This may include achieving optimal functionality according to their physical capacities.

Service design is based on the needs, desires, and expectations of the person served and includes consideration of age, medical acuity, medical stability, impairments, activity limitations, participation restrictions, psychological status, behavioral status, cultural diversity, family/caregivers, and long-term outcomes expectations. Appropriate medical consultation occurs specific to each person served in addition to medical consultation related to policies and procedures.

The services support transitions in a person’s life and are changed as necessary to meet the identified needs and desires of the persons served and their families/caregivers.

Key Areas Addressed

■ Competencies of staff

■ Medical consultation

■ Collaboration with healthcare providers to support persons

■ Safety of persons including equipment maintenance

■ Initial and ongoing assessments guide services

■ Transition planning

■ Decision-making role of persons served in all aspects of services

■ Inclusive integrated living environment


PROGRAMS/SERVICES BY LOCATION Brockton Area Multi-Services, Inc. 10 Christy’s Drive Brockton, MA 02301

Administrative Location Only

Governance Standards Applied

Easton Day Habilitation 406 Turnpike Street South Easton, MA 02375

Community Integration

Adult Day Treatment 330 Crescent Street Brockton, MA 02302

Day Treatment: Mental Health (Adults)

Whitman Counseling Center 288 Bedford Street Whitman, MA 02382

Outpatient Treatment: Mental Health (Adults) Outpatient Treatment: Mental Health (Children and Adolescents)

Stoughton Day Habilitation 531 Washington Street Stoughton, MA 02072


Plymouth Outreach and Community Day Supports 225 Water Street, Suite B 236 Plymouth, MA 02360


Brockton Employment Services 795 Pleasant Street Brockton, MA 02301

Community Employment Services: Employment Supports Community Employment Services: Job Development

Lakeville Day Habilitation 62 Main Street Lakeville, MA 02347


North Brockton Day Habilitation 430 Howard Street Brockton, MA 02302


BAMSI 755 Bedford Street Bridgewater, MA 02324


West Roxbury Day Habilitation 1895 Centre Street West Roxbury, MA 02132


Worcester Day Habilitation 350 Plantation Street Worcester, MA 01604


BAMSI 552 Centre Street Brockton, MA 02302

Community Housing: Mental Health (Adults)

BAMSI 15 Heritage Circle Bridgewater, MA 02324


BAMSI 32 Berglund Avenue Brockton, MA 02301


BAMSI 270 Spring Street Brockton, MA 02301

Community Housing

BAMSI 24 Mercedes Road Brockton, MA 02301

Community Housing (Medically Fragile)

BAMSI 1983 Central Street Stoughton, MA 02072

Community Housing

BAMSI 79 East Main Street, Apartments 1 and 2 Norton, MA 02766

Community Housing

BAMSI 134 Auburn Street Brockton, MA 02301

Community Housing

BAMSI 679 West Main Street Avon, MA 02322


BAMSI 11 Bow Street Carver, MA 02330

Community Housing

BAMSI 397 Pleasant Street Bridgewater, MA 02324

Community Housing

BAMSI 323 Court Street Brockton, MA 02301

Community Housing

BAMSI 72 Dondi Road Brockton, MA 02301

Community Housing

BAMSI 7 Ida Road Braintree, MA 02184

Community Housing

BAMSI 95 Lothrop Street Taunton, MA 02780

Community Housing

BAMSI 45 Cross Street Foxboro, MA 02035

Community Housing

BAMSI 237 Pembroke Street Kingston, MA 02364


BAMSI 1427 Main Street Weymouth, MA 02190-1819


BAMSI 66 Montauk Road Brockton, MA 02301

Community Housing

BAMSI 7 Nessralla Drive Brockton, MA 02302

Community Housing

BAMSI 728 North Warren Avenue Extension Brockton, MA 02301

Community Housing

BAMSI 165 1/2 Quincy Street Brockton, MA 02302


BAMSI 40 Reservoir Street, Apartments 101, 107, and 108 Brockton, MA 02301

Community Housing

BAMSI 110 Rockland Street Brockton, MA 02301

Community Housing

BAMSI 380 South Elm Street West Bridgewater, MA 02379

Community Housing

BAMSI 916 West Street Attleboro, MA 02703

Community Housing

BAMSI 72 Tina Avenue Brockton, MA 02302

Community Housing

BAMSI 39 Trafalgar Street Brockton, MA 02301

Community Housing

BAMSI 20 Starr Lane Attleboro, MA 02703

Community Housing

BAMSI 19 May Street Brockton, MA 02301


BAMSI 23 Oak Ridge Drive West Brockton, MA 02301


BAMSI 79 Indian Head Road Framingham, MA 01701

Community Housing

BAMSI 16 Center Hill Road Kingston, MA 02364

Community Housing

BAMSI 105 Brookside Drive Middleboro, MA 02346


BAMSI 108 Harvey Street Norton, MA 02766

Community Housing

BAMSI 27 New Taunton Street Norton, MA 02766

Community Housing

BAMSI 8 Mirimichi Street, Apartments 1 & 2 Plainville, MA 02762

Community Housing

BAMSI 2 Priscilla Road, Unit B South Easton, MA 02375

Community Housing

BAMSI 5 Thomas Circle West Bridgewater, MA 02379

Community Housing

Quincy Day Habilitation 1515 Hancock Street, Suite 105 Quincy, MA 02169


BAMSI 44 Prospect Street East Bridgewater, MA 02333


BAMSI 15 Larkin Road Berlin, MA 01503


BAMSI 77 Farm Street Millis, MA 02146


BAMSI 17 South Meadow Road Carver, MA 02330


BAMSI 5 Shaw Road Carver, MA 02330


BAMSI 9 Sun Terrace Easton, MA 02367


BAMSI 14 Colchester Road Plympton, MA 02367


BAMSI 34 Morse Avenue Brockton, MA 02301

Community Housing

BAMSI 564 North Main Street Randolph, MA 02766

Community Housing

BAMSI 123 Plain Street Mansfield, MA 02048

Community Housing

BAMSI 2 Butterworth Drive Attleboro, MA 02703

Community Housing

BAMSI 300 Battles Street Brockton, MA 02301

Supported Living

BAMSI 375 Westgate Drive Brockton, MA 02301

Supported Living: Mental Health (Adults)

BAMSI 604 Torrey Street Brockton, MA 02301


BAMSI 15 Union Court Brockton, MA 02301


BAMSI 182 East Street Sharon, MA 02067

Community Housing

BAMSI 43 Dunster Road Holliston, MA 01746


BAMSI 140 Mixter Road Holden, MA 01520


BAMSI 150 West Street East Bridgewater, MA 01520


BAMSI 130 Old Center Street Middleboro, MA 02349


BAMSI 188 Main Street Carver, MA 02330


BAMSI 695 South Precinct East Taunton, MA 02780


BAMSI 187 Bates Road Brockton, MA 02301


BAMSI 7 West Fairhill Road Holden, MA 01520


BAMSI 37 Dona Drive Middleboro, MA 02346


BAMSI 181 Wapping Road Kingston, MA 02364


BAMSI 3 Spring Lane Holbrook, MA 02343


BAMSI 20 Independence Avenue Hanson, MA 02341


BAMSI 1240 West Street Stoughton, MA 02072

Community Housing

BAMSI 241 Elm Street Halifax, MA 02338

Community Housing

Middleboro Day Habilitation Program 547 West Grove Street Middleboro, MA 02346


BAMSI 351 Salisbury Street Worcester, MA 01609


BAMSI 401 Highland Street Dedham, MA 02026


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