The Plan required under 104 CMR 27.13(6)(f)5 (the “6f5 Plan”)

 SECTION 1.  Section 23 of chapter 123 of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by inserting after clause (e) the following clause:-
         (f)  reasonable daily access to the outdoors, as weather conditions reasonably permit, at inpatient facilities in a manner consistent with the person’s clinical condition and safety as determined by the treating clinician and with the ability of the facility to safely provide access.  The department shall promulgate regulations defining what shall constitute reasonable access and regulations implementing sufficient precautions to ensure the safety of staff members charged with accompanying patients outdoors.

Prior to 2015, the

The 2015 Fresh Air law added an additional Human Right was signed by Gov. Deval Patrick in 2015. The law sa Regulators then had to interpret the law to ensure that it would be followed.

Then the question arisesLaws are passed. Then the question arises as to how they will be enforced. How

To ensure compliance with the Fresh Air law, the Commonwealth of Massachusetts required facilities

Subpart (f) (i.e., the 6th of these enumerated rights) is the Fresh Air right.

Subpart 5 under (f) is the part that requires a plan.

Writing a 6f5 Plan requires a facility’s leadership to take seriously the Fresh Air right, including whether any capital improvements are required. If leadership thinks they cannot meet the plan, they have to specify why—and DMH has to approve.

Here is the 6f5 language:

5. The facility shall have a written plan to implement its obligation to provide patients access to the outdoors.

a. The plan shall include the following: … procedures, including staffing and other safety requirements, to allow for access to [either (i) secure or (ii) nonsecure] outdoor space

b. Reasonable efforts to safely provide access to outdoor space may include, but shall not be limited to:

i. reasonable capital expenditures to develop, construct or otherwise acquire outdoor space;

ii. reasonable modifications of staffing patterns to permit staff escorts; or

iii. reasonable modifications to building access policies to permit patient access to common areas of the facility or proximate to the facility not normally dedicated as patient areas.

c. If the facility determines that it cannot safely provide secure outdoor access due to staffing or physical plant limitations, it shall:

i. identify and document such limitations in the plan; and

ii. identify what actions the facility will take to address these limitations and the time frame for the actions.

If the facility determines that the limitations cannot be reasonably remedied, the facility shall identify the reasons for such determination. Such reasons shall be documented with sufficient detail to enable the Department to determine whether they constitute reasonable justification.

d. Upon request of the Department, but no less frequently than in its application for licensure or license renewal, the facility shall demonstrate to the Department’s satisfaction that its plan is current and that it has identified, considered and implemented all reasonable actions to safely provide access to outdoor space.