Fillable MA Program application for new ADR program

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MA Program application for new ADR program

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U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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PROGRAM APPLICATION FOR NEW PROGRAMS
COVER SHEET
PROGRAM INFORMATION
Name: __________________________________________________________________
Address: __________________________________________________________________
Phone #: __________________________________________________________________
Fax #: __________________________________________________________________
E-Mail: __________________________________________________________________
Contact Person: ________________________________________________________________
Year Program Began: ____________________________________________________________
Number of Neutrals on Program Roster: _____________________________________________
CERTIFICATION
I certify the following with regard to the above-named program: that it qualifies as a “program” as
that term is used in Rule 2 of the Uniform Rules; that it agrees to comply with the Trial Court Policy
on Data Collection and Record Keeping set forth in Appendix A; that it agrees to comply with the
Trial Court Complaint Mechanism set forth in Appendix B; that it agrees to comply with the Trial
Court Policy on Evaluation of Dispute Resolution Services set forth in Appendix C; that it agrees to
comply with the standards set forth in Rule 7 of the Uniform Rules; that it agrees to comply with the
standards set forth in Rule 8 and the Guidelines for the implementation of Rule 8 to ensure that
neutrals on its roster meet applicable qualification standards; that it will follow the ethical standards
set forth in Rule 9 of the Uniform Rules; and that it is in compliance with all other applicable state
and federal laws.
All the information contained in this application is true to the best of my knowledge and belief.
_______________________________ _______________________________
Signature Print Name
_______________________________ ________________________________
Title E-Mail
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PROGRAM APPLICATION - NARRATIVE
1. Program information:
Indicate numbers and types of cases handled for each of the past three years. List all types of
ADR services provided. Describe in detail the services listed on the cover sheet which your
program has previously provided to a court. Describe any special expertise your program
offers based on experience or training of neutrals on your roster. To comply with the need for
foreign languages, American Sign Language or oral interpreting, list any related fluency on
the part of your neutrals. Describe the hours your program’s services are available.
2. Space:
If approved, where will you provide services? If space is not available in a courthouse, where,
specifically, would you provide services in each division? Is the space handicapped
accessible? Describe any guidelines you have for the type of space required.
3. Methodology:
Describe and attach your process and policies in accordance with Uniform Rule 7(a) for
receiving referrals, screening referrals for appropriateness, scheduling or canceling sessions,
distributing cases among neutrals on the roster and following up after sessions. Describe your
policies for assuring that clients are not subject to inappropriate pressure to settle.
4. Quality Control:
Describe in detail how you will evaluate your programs performance and how you will
monitor your neutrals. Describe any additional steps you take to ensure the quality of services
you provide. Describe your process for assembling and maintaining the roster of neutrals,
including the methods for adding and removing neutrals in accordance with Uniform Rule
7(c).
5. Record keeping:
Describe the types of records you keep and the types of data you collect.
6. Diversity:
Describe or attach any policies you have prohibiting discrimination against your staff, neutrals
or clients. Describe any policies which promote diversity as to race, gender, ethnicity,
experience, and training among your staff, your neutrals and your clients.
7. Fees:
If you plan to charge fees for any court-connected services, attach your fee schedule, including
specified criteria for fee waived or reduced fee services to be made available to indigent and
low income litigants. (Fees must be approved by the Chief Justice of the Department in which
services are provided.) Also, please see the new Fee Policy for Dispute Resolution Services
in the Appendixes as Appendix D and Section 4 of the Instructions for Program Application
regarding departmental implementation of that policy.
8. Affiliations:
Is your program, the parent or subsidiary of any other organization? If so, describe the
relationship. Does any officer or employee of the courts have an affiliation or relationship
with your program? If your program has a written policy for addressing conflicts of interest,
please attach it.
9. Divisions:
Please indicate each Trial Court Department in which your program seeks approval and each
Division within that Department in which you seek approval.
10. Roster:
Please describe the size and composition of your roster of neutrals including what percentage
meet the basic training requirements and the alternative methods requirement.
11. Neutral Qualifications:
Please list, describe and explain how each neutral on your roster satisfies the training,
mentoring and evaluation requirements in Rule 8 of the Uniform Rules on Dispute Resolution.
Please describe your policies, procedures and record keeping, which documents how all
neutrals on your roster satisfy the qualification requirements of Rule 8 (b) (v) of the Uniform
Rules on Dispute Resolution.
12. Continuing Education:
Please describe how your program intends to implement the ongoing continuing education
requirements in Rule 8 of the Uniform Rules on Dispute Resolution, and provide a copy of
your policy on continuing education.
13. Continuing Evaluation:
Please describe how your program intends to implement the ongoing continuing evaluation
requirements in Rule 8 of the Uniform Rules on Dispute Resolution, and provide a copy of
your continuing evaluation policy.
14. Court Orientation:
Please describe any court orientation your program provides to your roster of neutrals, and
provide a copy of your court orientation policy.
15. Personal Information:
Massachusetts General Laws Chapter 93 H provides that the judicial branch shall adopt rules
or regulations to safeguard certain personal information from being improperly or
inadvertently disclosed to diminish the risk of identity theft or fraud in the courts.
Accordingly, please see Supreme Judicial Court Rule 1:24, Protection of Personal Identifying
Information in Publicly Accessible Court Documents attached to the application material.
In addition, all programs shall protect the security and confidentiality of personal information
in their possession, protect against anticipated threats or hazards to the security or integrity of
such information and protect against unauthorized access or use of such information.
Please describe your policy on safeguarding personal information.
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MA Program application for new ADR program

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Completed 18 May 2020

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