Section 458.411 - Staffing Requirements(A) Minimum Staffing Requirements. medical respite provider staff must meet the minimum staff composition requirements outlined in 130 CMR 458.411 for each service location to adequately provide the required scope of services set forth in 130 CMR 458.410.(B)Minimum Staff Composition.(1) The medical respite provider shall arrange for at least two medical respite provider staff to be available on-site 24 hours per day, seven days per week to ensure the safety of staff and members, provide oversight, manage building issues, provide meal services, and address non-clinical program concerns.(2) The medical respite provider shall: (a) Make available an adequate level of Massachusetts-licensed and appropriately credentialed staff necessary to provide the services set forth in 130 CMR 458.410;(b) When clinical staff are not on-site at the medical respite service location, engage an on-call nurse line or medical support service to provide clinical coverage up to 24-hours a day for non-emergency medical issues; and(c) Designate a specific staff person to serve as the program director who is qualified by education, training, or experience to direct and evaluate the provision of medical respite services. The person in this role must supervise the other staff persons providing medical respite services and must ensure that treatment and care are both adequate and appropriate to the needs of members and in compliance with 130 CMR 458.000.(3)Case Management. The medical respite provider shall engage a case manager responsible for the case management services in 130 CMR 458.410(A)(5) whose on-site and off-site availability ensures that members have reasonable access to case management supports. A staff person in the case manager role can fulfill the requirements of 130 CMR 458.411(B)(1) in support of on-site staff coverage.(4)Admissions Staffing. The medical respite provider must provide staffing to support admissions into the medical respite service location at least 28 hours per week over at least five calendar days including Friday, including coordinating access to clinical staff to assess and address immediate clinical needs for members in accordance with 130 CMR 458.410(B)(2). Providers must flexibly schedule admission staff and other provider staff to minimize delays to members seeking admission and align with typical discharge timeframes from referring organizations.(5)Staff Experience. The medical respite provider should: (a) incorporate individuals with relevant lived experience as staff or volunteers, where possible; and(b) engage staff with experience working with:1. residents in a shared living environment; and2. individuals experiencing homelessness; or3. a history of mental health and substance use disorders.Adopted by Mass Register Issue 1538, eff. 1/3/2025.