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The 193rd General Court of the Commonwealth of Massachusetts

Section 51E: Applications by clinical specialists in psychiatric and mental health nursing for staff membership or clinical privileges; discrimination

Section 51E. When considering and acting on applications of certified clinical specialists in psychiatric and mental health nursing for staff membership and clinical privileges, no by-law, rule, regulation or practice of a health care facility, regulated by chapter one hundred and eleven, shall prohibit a certified clinical specialist in psychiatric and mental health nursing from being granted clinical privileges and appointed to staff membership at such facilities, as defined in section twenty-five B that offer services that can be performed by certified clinical specialists in psychiatric and mental health nursing. Clinical privileges shall be determined on an individual basis and shall be commensurate with an applicant's education, training and experience as established herein. In implementing these criteria, said facility shall formulate and apply reasonable, nondiscriminatory standards for the evaluation of the credentials of a certified clinical specialist in psychiatric and mental health nursing. As part of its responsibility for the operation of such facility, the governing body, or designated persons so functioning, shall ensure that decisions on clinical privileges and staff membership are based on an objective evaluation of an applicant's credentials, free of anti-competitive intent or purpose. The credentials committee and other staff who evaluate and determine the qualifications of applicants for clinical privileges and staff membership shall include, whenever possible, certified clinical specialists in psychiatric and mental health nursing.

In determining the qualifications for staff membership or clinical privileges, the facility shall not consider the following factors in its deliberations:

(1) an applicant's membership or lack of membership in a professional society or association;

(2) an applicant's decision to advertise, reduce fees or engage in other competitive acts intended to generate business;

(3) an applicant's participation in prepaid group health plans, salaried employment or any other manner of delivering health services on other than a fee-for-service basis;

(4) an applicant's support for, training of or participation in a private group practice with members of a particular classification of health professional;

(5) an applicant's willingness to testifying in malpractice suits, disciplinary actions or other proceedings; and

(6) an applicant's willingness to send a specified amount of patients or clients who are in need of the services of a facility to a particular facility; provided, however, that this last restriction shall not apply to public facilities or agencies.

Whenever a certified clinical specialist in psychiatric and mental health nursing submits a completed application for staff membership or clinical privileges to such facility, such facility shall have one hundred and twenty calendar days to grant or deny such application. Such facility shall not deny such application without providing the applicant with the same procedural rights as are provided to all physician applicants included, but not limited to, the following:

(1) a contemporaneous written explanation containing the explicit reasons for denial of such application;

(2) reasonable advance notice of the right to a fair hearing which would afford the applicant the opportunity to prepare an adequate rebuttal to the stated reasons for denial of such application;

(3) a fair hearing, including the right to present evidence and to call witnesses on his behalf; and

(4) a written decision containing the explicit reasons for taking the action including, but not limited to, any evidence upon which the decision was based.

Nothing in this section shall prohibit any certified clinical specialist in psychiatric and mental health nursing from working as a salaried employee or consultant in a health care facility. No classification of a health care facility by the department of public health or department of mental health, nor any other classification of said facility on quality or service or otherwise, by any person, body or agency of the commonwealth or any subdivision thereof, shall be affected by use of such facility by certified clinical specialists in psychiatric and mental health nursing; nor shall any such classification be affected by the subjection of the certified clinical specialist in psychiatric and mental health nursing to the rules and regulations of the organized professional staff. No classification of such health care facility by any agency of the commonwealth or any subdivision thereof, for the purposes of ascertaining eligibility for compensation, reimbursement, or other benefit for treatment of patients, shall be affected by the use of such facility by certified clinical specialists in psychiatric and mental health nursing; nor shall any such classification be affected by the subjection of the certified clinical specialist in psychiatric and mental health nursing to the rules and regulations of the organized professional staff which govern the certified clinical specialist in psychiatric and mental health nursing's use of the facilities.

Notwithstanding any other provisions of this section, the exercise of privileges in such health care facility may be limited, restricted or revoked for reasons including, but not limited to, the violation of such health care facility's rules, regulations or procedures which are applied in good faith, in a nondiscriminatory manner, to all practitioners in such health care facilities exercising such privileges or entitled to exercise such privileges.