New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 512 - Personalized Recovery Oriented Services › Section 512.5 - Service categories and requirements

Current through Register Vol. 46, No. 28, July 10, 2024
Each of the following services, offered by PROS providers in
				  accordance with their certification category, are provided face-to-face by PROS
				  staff members for the purpose of assisting individuals to overcome the barriers
				  caused by their mental illness that are preventing them from achieving their
				  chosen goals.
(a) Assessment is a
				service designed to review and determine an individual's level of functioning,
				the past benefits of participating in mental health services, and his or her
				ability to function in specific life roles. In addition, the assessment service
				should identify the individual's strengths as well as challenges and barriers
				encountered as a result of his or her psychiatric condition. The assessment
				service involves a comprehensive and continuous process, conducted within the
				context of the individual's self-identified needs, goals, and ethnic, religious
				and cultural identities. Each assessment must result in a summary of findings,
				within the context of the specific assessment focus, that addresses the
				individual's strengths, talents, and abilities, as well as the challenges and
				barriers presented by the individual's mental illness.
(b) Basic living skills training is a service
				designed to improve an individual's ability to perform the basic skills
				necessary to achieve maximum independence and acceptable community behaviors
				that are critical to his or her recovery. This service focuses on the
				acquisition of skills, as well as strategies for appropriate use of the skill,
				utilizing teaching interventions such as motivational, educational and
				cognitive-behavioral techniques. The service may include opportunities to
				practice, observe, reinforce and improve the individual's skill performance.
				The topics which may be covered include, but are not limited to: grooming and
				personal hygiene, nutrition, homemaking, building relationships, childcare,
				transportation, use of community resources, and engaging in social
				interactions.
(c) Benefits and
				financial management is a service designed to support an individual's
				functioning in the community through understanding and skill in handling his or
				her financial resources. The instruction may include counseling on budgeting,
				income and benefits, including incentives for returning to work as well as
				basic counseling on income maintenance, eligibility for benefits from relevant
				sources, and determination of the need for plans for additional support and
				assistance in managing personal finances.
(d) Clinical counseling and therapy is a
				service designed to provide goal-oriented verbal counseling or therapy,
				including individual, group and family counseling or therapy, for the purpose
				of addressing the emotional, cognitive and behavioral symptoms of a mental
				health disorder or for engaging, motivating and stabilizing persons with a
				co-occurring mental health and substance abuse (including alcohol) disorder,
				and the related effects on role functioning. Such service may also include
				cognitive behavioral therapy.
(e)
				Cognitive remediation is a set of techniques and interventions, such as drills,
				activities and exercises, designed to improve an individual's functioning by
				improving the cognitive skill that is the target of the remediation task. These
				skills include, but are not limited to: the ability to pay attention, remember,
				process information, solve problems, organize and reorganize information,
				communicate and act upon information. Cognitive remediation techniques work to
				improve mental capabilities necessary to learn academic subject matter, and
				more generally to function in daily life. Cognitive remediation is an optional
				PROS service, subject to prior review and written approval of the
				office.
(f) Community living
				exploration is a service designed to help an individual understand the demands
				of specific community life roles, in order to make decisions regarding
				participation in those roles. Community living exploration services can also be
				used to help motivate individuals who are not yet exhibiting active interest in
				more integrated community life roles, by increasing their knowledge of
				opportunities available in the community. Topics may include, but are not
				limited to: options for satisfactory experiences with living environments, work
				or career opportunities, educational opportunities, opportunities to connect to
				culturally-based community services, and resources for use of leisure time. It
				is expected that, to the extent possible, these services will be developed in
				natural community environments.
(g)
				Crisis intervention is a service designed to safely and respectfully
				de-escalate situations of acute distress or agitation which require immediate
				attention. Such service may include, but is not limited to, calming techniques
				to interrupt escalating behavior.
(h) Engagement is a service designed to reach
				out to individuals over time for the purpose of fostering a commitment on the
				part of an individual to enter into therapeutic relationships supportive of the
				individual's recovery. This service may include, but is not limited to,
				activities such as initial contacts with potential program participants, as
				well as ongoing efforts to engage individuals to participate in program
				services.
(i) Family
				psychoeducation/intensive family support is an intensive rehabilitation (IR)
				service designed to provide information, clinical guidance and support to
				collaterals and PROS participants when desired and appropriate, for the purpose
				of assisting and enhancing the capacity of a collateral to facilitate an
				individual's recovery. Specific examples of family psychoeducation/intensive
				family support include consumer-centered family consultation (CCFC),
				psychoeducational multiple family groups (MFGs), and behavioral family
				therapy.
(j) Health assessment is a
				service designed to gather data concerning an individual's medical history and
				any current signs and symptoms, and assess such data to determine his or her
				physical health status and need for referral. The assessment of the data shall
				be done by a nurse practitioner, psychiatric nurse practitioner, physician,
				physician's assistant, psychiatrist or registered professional nurse. Where
				indicated, this service shall include screening for metabolic syndrome,
				diabetes, and hypertension on a periodic basis.
(k) Individualized recovery planning is a
				continuous, dynamic process that engages each person as an active partner in
				developing, reviewing and modifying a course of care that supports his or her
				progress towards recovery. The course of care is based on an assessment process
				and the individual's personal preferences and desired life roles. The course of
				care is reflected in an individualized recovery plan (IRP), which includes the
				identification of medically necessary services and which supports the
				individual's goals and desires. The individualized recovery planning process
				also includes the development of a relapse prevention plan by the individual in
				partnership with the PROS practitioner and, when appropriate, an advance
				directive. The service may also involve activities designed to help identify
				and develop compensatory supports necessary to assist an individual during his
				or her recovery process.
(l)
				Information and education regarding self-help is a service designed to
				encourage individuals to participate in self-help and mutual aid groups. The
				service is designed to help an individual understand what self-help resources
				are available in the community and how to benefit from participating in them.
				The service may be conducted by people who have common experiences, and is
				intended to help the individual to learn how to share personal experiences with
				others who have had a common experience, to learn about the variety of
				available self-help groups, and to aid the individual in accessing the
				self-help options of his or her choice.
(m) Integrated treatment for dual disorders
				(IDDT) is an evidence-based practice designed to address the mental health and
				substance abuse needs of persons with co-occurring disorders simultaneously.
				Such service includes, but is not limited to, motivational,
				cognitive-behavioral and harm reduction approaches, wherein practitioners
				coordinate care with appropriate substance abuse providers when it is
				determined that the co-occurring disorder is acute or serious, and the
				recipient is ready to accept related treatment.
(n) Intensive rehabilitation goal acquisition
				is a service designed to assist an individual in identifying, attaining and
				retaining personally meaningful goals that will help the person to resume
				normal functioning in adult life roles. This service should be used to provide
				active support once an individual has made a commitment to achieving a new
				role, such as returning to work or school, returning to adult care giving or
				parenting roles, resuming roles as a spouse or significant other, obtaining a
				desired housing arrangement, and resuming a role as a community volunteer. Due
				to the urgency associated with the individual's readiness to attain and
				maintain a preferred life role, this service is not normally a long-term
				intervention.
(o) Intensive relapse
				prevention is a service designed to address an exacerbation of acute symptoms,
				or manage existing symptoms that are not responsive to the current service
				formulation. This may include the provision of targeted, intensive
				interventions necessary to address immediate risks such as relapse,
				hospitalization, loss of housing, or involvement with the criminal justice
				system. This service may also include the execution of a series of
				predetermined steps identified in the relapse prevention plan.
(p) Medication management is a service
				designed to prescribe or administer medication with the highest efficacy and
				lowest toxicity in treating the primary symptoms of an individual's psychiatric
				condition. This service is intended to include medication trials which are
				adequate in dose and duration, as well as assessments of the appropriateness of
				the individual's existing medication regimen through record reviews, ongoing
				monitoring, and consultation with the PROS participant and/or collateral. The
				purpose of such consultation is to determine personal preferences, as well as
				past and present experiences with medication, including related efficacy, side
				effects and compliance. Medication management may includes monitoring the side
				effects of prescribed medications, including, but not limited to,
				extrapyramidal, cardiac and metabolic side effects, and may include providing
				individuals with information concerning the effects, benefits, risks and
				possible side effects of a proposed course of medication.
(q) Ongoing rehabilitation and support is a
				service designed to provide ongoing counseling, mentoring, advocacy and support
				for the purpose of sustaining an individual's role in competitive, integrated
				employment. Such service does not include task-specific job training.
(r) Pre-admission screening is a service
				designed to include the initial process of contacting, engaging, interviewing
				and evaluating an individual to determine his or her need and desire for PROS
				services. The result of pre-admission screening is a determination of the
				individual's desire to participate in services and the program's
				appropriateness to meet the needs of the individual.
(s) Psychiatric assessment is a service
				designed to gather data concerning an individual's psychiatric history and
				current mental health symptoms, assess such data for determination of the
				individual's current mental health status, and identify the need for clinical
				treatment services. Assessment of the data shall be done by a psychiatrist or
				psychiatric nurse practitioner.
(t)
				Structured skill development and support is a service designed to assist
				individuals in developing instrumental skills for performing normative life
				roles associated with group membership, work, education, parenting or living
				environments. The focus of structured skill development is to develop skills
				through a process of teaching, practice, and feedback in community environments
				replicated at the program site. The modality for teaching these skills is a
				combination of individual, group and structured activities. It is often
				provided in structured club-like settings such as a work-ordered day or an
				activity-center format, where staff employ supportive counseling, mentoring and
				skill development techniques to assist the individual in completion of
				essential tasks.
(u) Symptom
				monitoring is a service designed to identify the ongoing effects of an
				individual's course of care. This service involves the continuous process of
				monitoring a recipient's symptoms of mental illness, as identified in his or
				her individualized recovery plan, and his or her response to treatment, within
				the context of other support and rehabilitation services. Such service may
				include consultation with identified collaterals. If this service is provided
				by a staff person other than a psychiatrist, nurse or nurse practitioner, it
				must include communication of observed symptoms and treatment responses to the
				physician or nurse.
(v) Wellness
				self-management (also known as illness management and recovery) is a service
				designed to develop or improve personal coping strategies, prevent relapse, and
				promote recovery. Such services may be provided to recipients and/or
				collaterals, and may include, but are not limited to:
(1) coping skills training which means
				teaching individuals strategies to address symptoms, manage stress and reduce
				exposure and vulnerability to stress;
(2) disability education which means
				instruction on the facts concerning mental illness and the potential for
				recovery. The intent of this service is to give individuals admitted to PROS
				programs and collaterals hope as well as practical information on prevention
				and recovery practices, including evidence-based practices;
(3) dual disorder education which means
				providing individuals admitted to PROS programs and/or collaterals with basic
				information on the nature of substance abuse disorders and how they relate to
				the symptoms and experiences of mental illness;
(4) medication education and self-management
				which means providing individuals admitted to PROS programs or collaterals with
				information on the individual's medications, including related efficacy, side
				effects and compliance issues. Individuals are supported in managing their
				medications and in learning about the effects of the medication on their mental
				health condition and in managing the side effects of medication through healthy
				life style changes such as smoking cessation, nutrition, and weight
				loss;
(5) problem-solving skills
				training which means a series of learning activities designed to assist
				individuals admitted to PROS programs and collaterals develop effective
				solutions for stressful responses to routine life situations. These activities
				may include, but are not limited to: role playing exercises, homework
				assignments or the mastery of specific principles and techniques; and
(6) relapse prevention planning which means a
				process to engage individuals admitted to PROS programs and collaterals in
				understanding factors which may trigger a recurrence of severe symptoms of
				mental illness and ways to cope with the potential for recurrence. Planning
				activities may include the development of an advance directives document and
				specific instructions on what steps need to be taken in the event of a
				relapse.