Notice of Public Hearing (Published 6/9/2023)
Division of Medical Assistance
Commonwealth of Massachusetts Office of Medicaid
Under the provisions of M.G.L. c. 30A and pursuant to the regulatory authority found in St. 2006, c. 58, the Commonwealth Health Insurance Connector Authority (“Connector”) will conduct a public hearing for the purpose of gathering comments, ideas, and information concerning the following proposed amendments to existing regulations:
956 CMR 5.00 Minimum Creditable Coverage
The purpose of the amendments to existing regulation 956 CMR 5.00 is to ensure that Massachusetts residents who are seeking to satisfy the Commonwealth’s individual mandate, which requires them to enroll in health insurance meeting minimum creditable coverage standards if it is affordable or pay a penalty on their state income tax returns, enroll in coverage that includes a complete and medically appropriate set of preventive services without any cost-sharing.
The hearing will be held online at the following date and time, and can be accessed using the below information:
Thursday, June 22, 2023, 10:00 a.m.
Zoom Meeting
https://us06web.zoom.us/j/84336421193?pwd=cGFpaUZGQllpM25ESGxJeWZpZFArZz09
Meeting ID:843 3642 1193
Passcode:706794
One tap mobile
+13052241968, 84336421193# US
+13092053325, 84336421193# US
These proposed amended regulations were approved by the Connector Board on May 11, 2023, and filed with the Secretary of the Commonwealth on or before May 26, 2023. A copy of the proposed amended regulations and hearing rules may be obtained from the Commonwealth Health Insurance Connector Authority, 100 City Hall Plaza, 6th Floor, Boston, MA 02108 during normal business hours or on the web at www.mahealthconnector.org, by hovering the cursor over “About” and selecting “Rules & Regulations” from the drop down menu. All persons desiring to be heard on these matters should appear for the online hearing at the designated time. Written comments in advance of the hearing and at the hearing are welcome and if mailed, should be sent to the same address - Attention to Andrew R. Egan: Public Comments, or emailed to connector-legal@state.ma.us.
Written Comments will be accepted until June 23, 2023 at 4 P.M.
956 CMR 5.00 Public Impact Statement
Via Electronic and Hand Delivery
May 25, 2023
Office of the Secretary of the Commonwealth
State Publication & Regulations Division
One Ashburton Place, Room 1613
Boston, MA 02108
Re: Notice of Public Hearing and Small Business Impact Statement
To Whom it May Concern:
Enclosed, please find a “Notice of Public Hearing” for amendments to existing regulation 956
CMR 5.00 – “Minimum Creditable Coverage”. These proposed regulations were approved by the
Health Connector Board on May 11, 2023. Please also find, enclosed, a “Small Business Impact
Statement” addressing the impact, if any, of the proposed amendments to 956 CMR 5.00 on small
businesses in the Commonwealth.
The purpose of the amendments to existing regulation 956 CMR 5.00 is to ensure that Massachusetts residents who are seeking to satisfy the Commonwealth’s individual mandate, which requires them to enroll in health insurance meeting minimum creditable coverage standards if it is affordable or pay a penalty on their state income tax returns, enroll in coverage that includes a complete and medically appropriate set of preventive services without any cost-sharing. Because these regulations concern the level or value of health insurance such residents must have in order to satisfy the state’s health coverage requirement there is no anticipated impact on small businesses, including that there is no projected reporting, recordkeeping, or other administrative cost required for compliance with the proposed amendments.
Because there is no impact on small businesses, there is no distinction between performance standards or design standards. Further, there are no other regulations of the Commonwealth Health Insurance Connector Authority, or any other state agency, which may duplicate or conflict with the proposed regulation.
The Commonwealth Health Insurance Connector Authority does not expect that these proposed amendments will be likely to have any effect on the formation of new business in the state. The Commonwealth Health Insurance Connector Authority respectfully requests that the enclosed “Notice of Public Hearing” be published in the next Register. If you have any questions regarding the enclosed “Notice of Public Hearing” or “Small Business Impact Statement”, please do not hesitate to call. Thank you for your attention to this matter.
Sincerely,
Andrew R. Egan, Esq.
General Counsel
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205 CMR 255.00 Gaming Commission, Massachusetts
Notice is hereby provided that in accordance with G.L. c. 30A § 2, the Massachusetts Gaming Commission (“Commission”) will convene a public hearing for purposes of gathering comments, ideas, and information relative to the proposed adoption of regulations. The proposal was developed pursuant to G.L. c. 23N § 4, as part of the Commission’s regulation promulgation process, and concerns the following regulation:205 CMR 255.00: Play Management
The regulation sets forth the types of play management limitations that must be offered by Sports Wagering Operators. It also outlines how a patron may enroll in them, and lastly, outlines the responsibilities of the sports wagering operator with respect to the play management system.
Scheduled hearing date and time
Tuesday, June 20, 2023, at 9:30 AM EST
Given the unprecedented circumstances, Governor Charles Baker issued an order to provide limited relief from certain provisions of the Open Meeting Law to protect the health and safety of the public and individuals interested in attending public meetings during the global Coronavirus pandemic. In keeping with the guidance provided, the Commission will conduct this hearing utilizing remote collaboration technology.
Conference Call Number: 646-741-5292
Participant Code: 111 353 2562
A complete copy of the draft regulation referenced above may be downloaded by visiting www.massgaming.com, clicking on ‘Regulations and Compliance’ and selecting the ‘Proposed Rulemaking’ Section. Anyone wishing to offer comments on this regulation can email Judith.Young@massgaming.gov and request the virtual hearing link to appear and speak. Alternatively, written comments may also be submitted to the same email address with ‘Regulation Comment’ in the subject line.
Comments must be received by 5:00PM EST on June 19, 2023.
Additionally, please find the accompanying Small Business Impact Statement in accordance with M.G.L. c. 30A, § 2 below.
205 CMR 255.00 Business Impact Statement
The Massachusetts Gaming Commission (“Commission”) hereby files this Small Business Impact Statement in accordance with G.L. c. 30A, §2, relative to the proposed promulgation of 205 CMR 255 PLAY MANAGEMENT.
This regulation is being promulgated as part of the process of promulgating regulations governing sports wagering in the Commonwealth, and is primarily governed by G.L. c. 23N, § 4. It sets forth the requirement that sports wagering operators offer play management pogroms to patrons engaging in sports betting on mobile applications and digital platforms in the Commonwealth.
The proposed 205 CMR 255 applies to potential sports wagering operators and the Commission. Accordingly, this regulation is unlikely to have an impact on small businesses. Under G.L. c.30A, §2, the Commission offers the following responses to the statutory questions:
- Estimate of the number of small businesses subject to the proposed regulation:
This regulation is unlikely to have an impact on small businesses. - State the projected reporting, recordkeeping, and other administrative costs required for
compliance with the proposed regulation:
There are no projected reporting, recordkeeping, or other administrative costs required for small businesses to comply with this regulation. - State the appropriateness of performance standards versus design standards:
No standards applicable to small businesses are set forth. - Identify regulations of the promulgating agency, or of another agency or department of
the Commonwealth, which may duplicate or conflict with the proposed regulation:
There are no conflicting regulations in 205 CMR, and the Commission is unaware of any conflicting or duplicating regulations of any other agency or department of the Commonwealth. - State whether the proposed regulation is likely to deter or encourage the formation of new
businesses in the Commonwealth:
This amendment is unlikely to have any impact on the formation of new businesses in the Commonwealth.
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101 CMR 356.00 Health and Human Services, Executive Offices of
Under the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, the Executive Office of Health and Human Services (EOHHS) will hold a remote public hearing on Friday, June 16, 2023, at 10:00 a.m. relative to the adoption of amendments to the following regulation.
101 CMR 356.00: Rates for Money Follows the Person Demonstration Services
The proposed regulation contains rates effective for dates of service on or after March 1, 2023. There is no fiscal impact on cities and towns.
Pursuant to M.G.L. Chapter 118E, Section 13D, EOHHS is required to establish, by regulation, rates to be paid by governmental units to providers of health services, which include the rates referenced in this regulation. In accordance with this statutory requirement, EOHHS is proposing amendments to 101 CMR 356.00: Rates for Money Follows the Person Demonstration Services. Proposed amendments include the following.
- Establish the rate for Assistive Technology as the rate established in 101 CMR 322.00: Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment
- Establish the rate for Community Engagement Navigation at the rate established in 101 CMR 423.00: Rates for Certain In-Home Basic Living Supports
- Establish the rate for Transitional Assistance at individual consideration
- Updates to the definitions to align with MFP Demonstration services
- Updates to conform to EOHHS rate regulations for other MassHealth programs, including provisions related to cost reporting and payment limitations, as well as formatting
The total CY2023 estimated spending for MFP Demonstration services and administration is $44,058,470. The proposed amendments to rates contained in 101 CMR 356.00 apply for dates of service provided on or after March 1, 2023.
To register to testify at the hearing and to get instructions on how to join the hearing online, go to www.mass.gov/service-details/executive-office-of-health-and-humanservices-public-hearings.
To join the hearing by phone, call (646) 558-8656 and enter meeting ID 935 397 8200# when prompted.
You may also submit written testimony instead of, or in addition to, live testimony. To
submit written testimony, please email your testimony to ehs-regulations@mass.gov as
an attached Word or PDF document or as text within the body of the email with the
name of the regulation in the subject line. All written testimony must include the
sender’s full name, mailing address, and organization or affiliation, if any. Individuals
who are unable to submit testimony by email should mail written testimony to:
EOHHS
c/o D. Briggs
100 Hancock Street, 6th Floor
Quincy, MA 02171
Written testimony will be accepted through 5:00 p.m. on Friday, June 16, 2023.
EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealth-covered services.
To review the current draft of the proposed regulation, go to www.mass.gov/servicedetails/ executive-office-of-health-and-human-services-public-hearings or request a copy in writing from MassHealth Publications, 100 Hancock Street, 6th Floor, Quincy, MA 02171.
Special accommodation requests may be directed to the Disability Accommodations Ombudsman by email at ADAAccommodations@mass.gov or by phone at (617) 847-3468 (TTY: (617) 847-3788 for people who are deaf, hard of hearing, or speech disabled). Please allow two weeks to schedule sign language interpreters. EOHHS may adopt a revised version of the proposed regulation taking into account relevant comments and any other practical alternatives that come to its attention.
In case of inclement weather or other emergency, hearing cancellation announcements
will be posted on the MassHealth website at www.mass.gov/service-details/executiveoffice-
of-health-and-human-services-public-hearings.
May 26, 2023
CMR No: 101 CMR 356.00: Rates for Money Follows the Person Demonstration Services
Small Business Impact Statement
(As required by M.G.L. c. 30A §§ 2, 3 & 5)
Estimate of the Number of Small Businesses Impacted by the Regulation: MFP Demonstration providers are yet to be enrolled.
Will small businesses have to create, file, or issue additional reports?
No. This regulation does not require small businesses to create, file, or issue additional reports.
Will small businesses have to implement additional recordkeeping procedures?
No. This regulation does not require small businesses to implement additional recordkeeping procedures.
Will small businesses have to provide additional administrative oversight?
No. This regulation does not require small businesses to provide additional administration oversight as a result of the proposed amendments.
Will small businesses have to hire additional employees in order to comply with the proposed regulation?
No. This regulation does not require small businesses to hire additional employees to remain compliant.
Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?
No. This regulation does not require small businesses to hire other professionals.
Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?
No. This regulation does not require small businesses to purchase any particular product or make any capital investments.
Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?
(Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)
No. The regulation is required by statute under M.G.L. Chapter 118E, § 13D, and establishes the rates to be paid by governmental units to providers of MFP Demonstration services.Do any other regulations duplicate or conflict with the proposed regulation?
No regulations duplicate or conflict with this regulation.
Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?
Yes. The regulation requires providers to periodically file cost data to enable EOHHS to develop rates for certain HCBS Waiver services. This cost reporting requirement is applied uniformly to all providers and is necessary to enable EOHHS to develop accurate rates that reflect cost data from all providers
Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?
No. This regulation does not require small businesses to provide educational services to keep up to date with the regulatory requirements.
Is the regulation likely to deter the formation of small businesses in Massachusetts?
No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts.
Is the regulation likely to encourage the formation of small businesses in Massachusetts?
No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts.
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?
No. The regulation is not likely to provide for less stringent compliance or reporting requirements for small businesses.
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?
No. The regulation contains requirements to report cost data to EOHHS to enable EOHHS to develop rates for MFP Demonstration services. The timeframe for cost reporting is applied uniformly to all providers to enable EOHHS to develop accurate rates in a timely manner that reflect cost data from all providers.
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?
No. The agency did not consolidate or simplify compliance or reporting requirements for small businesses. The requirement to report cost data to EOHHS is applied uniformly to enable EOHHS to develop accurate rates in a timely manner that reflect cost data from all providers.
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?
No. The establishment of rates for certain providers of MFP Demonstration services by regulation is a statutory requirement under M.G.L. Chapter 118E, § 13D.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?
No. The regulation does not have an adverse impact on small businesses. The regulation establishes rates by which certain providers of MFP Demonstration services are to be paid when governmental units purchase services. The establishment of rates for these MFP Demonstration services by regulation is a statutory requirement under M.G.L. Chapter 118E, § 13D.
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322 CMR 6.00 Marine Fisheries, Division of
Notice of Public Hearing and Comment Period: Recreational Slot Limit for Striped Bass
Under the provisions of G.L. c. 30A and pursuant to the authority found at G.L. c. 130 § 17, the Division of Marine Fisheries (DMF) is taking public comment on recently enacted emergency regulations amending 322 CMR 6.07 to adjust the recreational striped bass slot limit. Effective May 26, 2023, the emergency regulations decreased the maximum length limit from 35 inches to 31 inches resulting in a new slot size of 28 inches to less than 31 inches. Full text of the emergency regulations may be found on DMF’s website along with additional relevant background information.
Public Hearing and Comment Schedule
DMF will host a virtual public hearing on Wednesday, June 21, 2023 at 6PM. To attend the virtual public hearing you must pre-register here: https://shorturl.at/uCLW1. Additionally, DMF will accept written public comment through 5PM on Friday June 30, 2023. Please submit written comments to Director Daniel McKiernan by e-mail (marine.fish@mass.gov).
CMR No: 322 CMR 6.00
Initial Small Business Impact Statement
Estimate of the Number of Small Businesses Impacted by the Regulation: There were 828 for-hire permit holders in Massachusetts in 2022 and DMF anticipates a similar number of permits will be issued in 2023. These entities may be affected by this adjustment to the recreational striped bass maximum size.
Will small businesses have to create, file, or issue additional reports?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in additional paperwork or reporting.
Will small businesses have to implement additional recordkeeping procedures?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in additional record keeping.
Will small businesses have to provide additional administrative oversight?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in additional administrative oversight.
Will small businesses have to hire additional employees in order to comply with the proposed regulation?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in having to hire additional employees for purposes of compliance.
Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in having to hire professional services for purposes of compliance.
Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not require capital investment.
Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?
(Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.Do any other regulations duplicate or conflict with the proposed regulation?
No. There are no other duplicative or conflicting state regulations.
Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?
All audits and inspections are done in accordance with M.G.L. c. 130. No additional inspections are required under this emergency amendment.
Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?
This rule adjusts the state’s recreational striped bass maximum size for 2023. This will not result in having to provide educational services.
Is the regulation likely to deter the formation of small businesses in Massachusetts?
Recreational fishing rules are one of a number of limiting factors that may impact the formation of new for-hire fishing businesses in Massachusetts. Accordingly, this action alone does not discourage the formation of new for-hire businesses.
Is the regulation likely to encourage the formation of small businesses in Massachusetts?
Recreational fishing rules are one of a number of limiting factors that may impact the formation of new for-hire fishing businesses in Massachusetts. Accordingly, this action alone will not encourage the formation of new for-hire businesses.
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
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130 CMR 456.000 Medical Assistance, Division of
Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Friday, June 16, 2023, at 1 p.m. relative to the adoption of amendments to the following regulation.
130 CMR 456.000: Long Term Care Services
The proposed regulation is expected to be effective October 1, 2023. There is no fiscal impact on cities and towns.
Proposed amendments to 130 CMR 456.000 would implement the migration from MMQ to a Case-mix classification system (such as MDS) for nursing facility data collection and rate setting purposes; update important requirements for nursing facilities; clarify and improve sections such as clinical authorization, and codify EOHHS’s authority to enter facilities for any lawful purpose; remove sections that are no longer applicable; and make other changes to conform with other updated MassHealth rules and regulations.
To register to testify at the hearing and to get instructions on how to join the hearing online, go to www.mass.gov/service-details/masshealth-public-hearings. To join the hearing by phone, call (646) 558-8656 and enter meeting ID: 935 397 8200# when prompted.
You may also submit written testimony instead of, or in addition to, live testimony. To
submit written testimony, please email your testimony to
masshealthpublicnotice@mass.gov as an attached Word or PDF document or as text
within the body of the email with the name of the regulation in the subject line. All written
testimony must include the sender’s full name, mailing address, and organization or
affiliation, if any. Individuals who are unable to submit testimony by email should mail
written testimony to:
EOHHS
c/o D. Briggs
100 Hancock Street
6th Floor
Quincy, MA 02171.
Written testimony will be accepted through 5:00 p.m. on Friday, June 16, 2023.
The Division specifically invites comments as to how the amendments may affect beneficiary access to care.
To review the current draft of the proposed regulation, go towww.mass.gov/servicedetails/masshealth-public-hearings or request a copy in writing from:
MassHealth Publications
100 Hancock Street
6th Floor
Quincy, MA 02171.
Special accommodation requests may be directed to the Disability Accommodations Ombudsman by email at ADAAccommodations@mass.gov or by phone at (617) 847-3468 (TTY: (617) 847-3788 for people who are deaf, hard of hearing, or speech disabled). Please allow two weeks to schedule sign language interpreters.
The Division may adopt a revised version of the proposed regulation taking into account relevant comments and any other practical alternatives that come to its attention. In case of inclement weather or other emergency, hearing cancellation announcements will be posted on the MassHealth website at www.mass.gov/service-details/masshealthpublic-hearings.
May 26, 2023
CMR No: 130 CMR 456.000: Long Term Care Services
Small Business Impact Statement
Estimate of the Number of Small Businesses Impacted by the Regulation: SBA database searches conducted according to the instructions in the Overview and Guidelines section of this document returned 28 results for NAICS code 623110 (“Nursing Care Facilities”) and no results for 623311 (“Continuing Care Retirement Communities”).
Will small businesses have to create, file, or issue additional reports?
No, small businesses will not have to create, file, or issue additional reports.
Will small businesses have to implement additional recordkeeping procedures?
The regulation does not require small businesses to implement additional recordkeeping procedures, as the nursing facilities are already required to keep records.
Will small businesses have to provide additional administrative oversight?
The regulation does not require additional administrative oversight.
Will small businesses have to hire additional employees in order to comply with the proposed regulation?
Compliance does not require hiring additional employees.
Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?
Compliance does not require hiring other professionals.
Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?
The regulation does not require purchases or capital investments.
Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?
(Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)
Performance standards are not more appropriate than design or operational standards.Do any other regulations duplicate or conflict with the proposed regulation?
No other regulations duplicate or conflict with the proposed regulation.
Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?
The regulation requires all nursing facilities to comply with audits, but this is not a new requirement.
Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?
The regulation does not require small businesses to provide educational services to keep up to date with regulatory requirements.
Is the regulation likely to deter the formation of small businesses in Massachusetts?
The regulation updates the existing program requirements for Medicaid nursing facilities in Massachusetts and is unlikely to encourage or deter the formation of small businesses.
Is the regulation likely to encourage the formation of small businesses in Massachusetts?
The regulation updates the existing program requirements for Medicaid nursing facilities in Massachusetts and is unlikely to encourage or deter the formation of small businesses.
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?
The regulation does not distinguish between small and other businesses.
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?
The regulation does not distinguish between small and other businesses.
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?
Not applicable. The prescribed regulations are required by and designed to comply with interstate mandates and overarching federal law at 16 U.S.C. 5100.
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?
Distinguishing small businesses from other businesses would not be practicable for this regulation.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?
No. EOHHS must amend the nursing facility regulations in order to update program requirements.
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105 CMR 430.000 Public Health, Department of
Notice is hereby given pursuant to M.G.L. c. 30A, §2, that the Department of Public Health will hold a public hearing and comment period on proposed amendments to 105 CMR 430.000: Minimum Standards for Recreational Camps for Children (State Sanitary Code, Chapter IV).
The purpose of these amendments is to implement the requirements of Section 90 of the FY2021 Budget, Medical Specialty Camp Medication Administration, which will authorize certain unlicensed individuals at medical specialty camps to administer diabetes medications. The amendments will also clarify requirements for high-risk activities and update other regulatory standards.
The public hearing will be held on Tuesday, June 27, 2023, at 10:00 a.m.
The hearing will be conducted on a moderated conference call. The information for the moderated conference call is:
Dial in number: 888-390-5007
Participant passcode: 3516389
To Testify Press: *1
A copy of the proposed amendments to 105 CMR 430.000 may be viewed on the Department’s website at www.mass.gov/dph/proposed-regulations or upon request by calling the Office of the General Counsel at 617-624-5220.
Speakers who testify at the public hearing are requested to provide a copy of their oral comments. The
Department encourages all interested parties to submit comments electronically
to Reg.Testimony@mass.gov or by mail to:
William Anderson,
Office of the General Counsel,
Department of Public Health,
250 Washington Street, Boston, MA 02108.
All submissions must include the sender’s full name and address.
When electronically submitting comments, type “Recreational Camps for Children” in the subject line and attach a Word document with your comments or type your comments in the body of your email. The Department will post all testimony that complies with these instructions on its website.
All comments must be submitted by 5:00 p.m. on Friday, June 30, 2023.
All comments received by the Department may be released in response to a request for public records.
If you are deaf or hard of hearing, or are a person with a disability who requires accommodation, please contact Sofie Daley at least 5 days before the hearing at sofie.daley@mass.gov.
CMR No: 105 CMR 430.000, Minimum Standards for Recreational Camps for Children (State Sanitary Code,
Chapter IV)
Small Business Impact Statement
Estimate of the Number of Small Businesses Impacted by the Regulation: DPH’s database of licensed camps as reported by municipalities for 2022 indicates approximately 1415 recreational camps for children statewide.
Will small businesses have to create, file, or issue additional reports?
Yes. The regulations require camp operators to file reports of camper injury or death and reports of child abuse or neglect, which under the proposed regulation must be in writing. The proposed amendments also require reporting of injuries or incidents resulting from the administration of medications including diabetes care and health care providers or camp directors to comply with the reporting requirements of M.G.L. c. 94c as well as 105 CMR 700.
Will small businesses have to implement additional recordkeeping procedures?
Yes. The proposed amendments require camps to maintain written authorizations for emergency medical care for all adult staff or volunteers, develop and maintain written plans to prepare for and respond to disease outbreaks, maintain written policies outlining what is required of individuals authorized to administer insulin at medical specialty camps, and develop a written boating safety plan for camps that conduct watercraft activities.
Will small businesses have to provide additional administrative oversight?
Yes. The proposed regulations require health care consultants at medical specialty camps to train individuals authorized to administer insulin, monitor blood sugar, and epi-pen auto-injections on how to correctly do so and requires the administration of insulin to be under the direct supervision of the camp’s health care provider. Additional training for medication administration for oral and topical prescription medications is required and training specific to watercraft activities being overseen. Medical specialty camps will have to meet these requirements to ensure the safety of youth in their care.
Will small businesses have to hire additional employees in order to comply with the proposed regulation?
Yes. Camps that provide on-site aquatics activities are required to ensure that an experienced water safety professional is at the camp. While most camps already have these employees, some may have to hire additional staff to comply. In other areas, camps would have to perform additional trainings for current staff on the administration of insulin and trainings to comply with first aid/CPR/lifeguard/watercraft safety requirements. As a result, camps could simply train current staff rather than hire additional staff.
Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?
No. Compliance with this regulation requires additional trainings to be provided to current staff. The proposed regulations do not add additional requirements.
Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?
No. There are no requirements to purchase particular products or make other capital investments, but small businesses may have to make some capital investments to comply with the State Sanitary Code, or other codes, e.g., Building, Plumbing, and Fire Safety.
Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?
(Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)
In this case no; this regulation sets forth uniform procedures for camp requirements and for local boards of health to enforce the Sanitary Code.Do any other regulations duplicate or conflict with the proposed regulation?
Yes. Several other agencies in Massachusetts have involvement in issues related to recreational camps for children (e.g., the Department of Public Safety, the Board of Fire Prevention Regulations, the Board of Electrical Examiners, the Board of Building Regulations and Standards, the Board of Plumbers and Gasfitters, the Architectural Access Board, the Department of Environmental Protection, and the Department of Conservation and Recreation). However, the Department of Public Health's regulations are unique in that they set forth minimum standards for operating a recreational camp for children and inspection, licensing, hearing and procedures to be followed in enforcement of the State Sanitary Code and, where building code requirements overlap, contain no grandfathering clause.
Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?
Yes. The current regulations require regulated entities to cooperate with audits and inspections as needed, as well as with re-inspections pending orders to correct issued by a local board of health. The proposed amendments do not include additional requirements outlined above.
Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?
Yes. The proposed amendments would require staff delegated responsibility to administer insulin at medical specialty camps complete a training provided by the camp’s health care consultant and a test of competency. This is consistent with DPH-regulated policies and procedures for medication administration in schools.
Is the regulation likely to deter the formation of small businesses in Massachusetts?
No. The current regulations and proposed amendments provide uniform expectations for camp operators, including those operating in multiple municipalities, and consistent licensing, enforcement, and due process activities by local boards of health across the Commonwealth. The regulation and proposed changes are not expected to deter the formation of small businesses. It is not expected that small businesses will be deterred from operating in MA due to these amendments, but the impact is difficult to predict.
Is the regulation likely to encourage the formation of small businesses in Massachusetts?
No. The current regulations and proposed amendments provide uniform expectations for camp operators, including those operating in multiple municipalities, and consistent licensing, enforcement, and due process activities by local boards of health across the Commonwealth. The regulation and proposed changes are not expected to encourage the formation of small businesses.
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?
No. The regulation ensures uniform enforcement and due process by local boards of health across the Commonwealth. It does provide for an opportunity for the regulated party to request a variance from the local board of health for less stringent compliance and reporting requirements, but the proposed regulation limits the circumstances to ensure that camper safety is paramount.
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?
No. Reporting requirements are the same regardless of camp size to ensure safety of all children.
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?
No. The regulation establishes a minimum standard for health and safety to children in recreational camps in Massachusetts. The compliance and reporting requirements are the same regardless of camp size to ensure safety of all children.
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?
No. In this case no; this regulation sets forth procedures to enforce minimum standards for public health. These procedures (and the health standards they address) protect conditions that are critical to public health.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?
Alternative regulatory methods (e.g., establishment of municipal-specific standards) would inflict adverse impact on small businesses.