reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 503 - Adjudicatory Proceedings › Section 503.7 - Hearing procedures: issuance of a cease and desist order

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This section
				shall apply to hearings held pursuant to Mental Hygiene Law, section 31.19. W
				here a conflict exists between this section and any other section of this Part,
				the provisions of this section shall be controlling.
(b) The decision to issue a cease and desist
				order pursuant to the Mental Hygiene Law, section
				31.19 shall be final, unless the person
				charged with the violation files a written request for a hearing within 48
				hours of service of notice of the proposed action.
(c) If the person charged with a violation
				makes a timely and sufficient request for a hearing, the execution of any
				proposed action to issue a cease and desist order shall be stayed pending the
				commissioner's final determination. Nothing in this section shall prevent the
				commissioner from taking whatever action he deems necessary for the suspension,
				revocation or limitation of the operating certificate of a facility operator
				who has been charged with a violation of Mental Hygiene Law, section
				31.19, including but not limited to
				temporary suspension or limitation of an operating certificate as provided for
				in Mental Hygiene Law, section
				31.16(b), nor shall it
				prevent the commissioner from seeking a temporary restraining order or such
				other injunctive relief as may be permitted by Mental Hygiene Law, sections
				31.19 and
				31.21 under the circumstances stated
				therein.
(d) The hearing shall
				commence within 10 days from the receipt of the request for the hearing. The
				notice of hearing shall be served upon the person charged with a violation not
				less than 24 hours prior to the commencement of the hearing. Such service may
				be made in any manner permitted herein sufficient to provide the requisite
				24-hour notice. The person charged with a violation may serve an answer upon
				the Office of Mental Health at any time prior to the commencement of the
				hearing. No request for an adjournment shall be granted without the concurrence
				of all parties and the hearing officer.
(e) Unless otherwise agreed to by all
				parties, the hearing officer shall set forth his or her findings and
				recommendations for action by written report to the commissioner within 10 days
				of receipt of the entire transcript of the hearing. The record of the hearing,
				together with the hearing officer's report, shall be transmitted forthwith to
				the commissioner for final determination and order. The hearing officer shall
				also serve a copy of the report on all parties.
(f) The commissioner shall issue a ruling
				within 10 days after the receipt of the hearing officer's report. Submission of
				any responses or replies need not be considered.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 503 - Adjudicatory Proceedings › Section 503.8 - Hearing procedures: denial of request for rate revision

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This section
				shall apply to hearings held pursuant to any law or regulation giving a
				facility licensed by the Office of Mental Health the right to request a hearing
				to appeal a determination by the commissioner regarding the facility's request
				for revision of a certified rate of payment. Where a conflict exists between
				this section and any other section of this Part, the provisions of this section
				shall be controlling.
(b) If the
				commissioner denies some or all of the revisions to the rate requested by a
				provider, the determination shall be final unless, within 30 days of service of
				the notification of denial, the provider requests a hearing pursuant to this
				Part. The notification of denial, as served on the provider, shall be deemed to
				be the notice of proposed action under section
				503.4(a) 
				of this Part.
(c) If the
				commissioner approves the revisions to the rate requested by the provider and
				the State Division of the Budget denies the revision, the provider shall have
				no further right to administrative review pursuant to this Part.
(d) A request for a hearing pursuant to this
				section shall be sent to the commissioner by registered or certified mail and
				shall contain a statement of the factual issues in dispute.
(e) Upon receipt of a request for a hearing,
				the commissioner shall determine whether a hearable factual issue is in
				dispute. If it is determined that there is no factual issue in dispute, the
				request for a hearing shall be denied; no administrative appeal shall be
				available from this determination. When it is determined that there is a
				factual issue in dispute, the commissioner shall order an administrative
				hearing to be held.
(f) The burden
				of proof shall be on the provider to prove by clear and convincing evidence
				that findings of fact on which the determination was based are
				incorrect.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 503 - Adjudicatory Proceedings › Section 503.9 - Hearing procedures: revision of certified rate of payment pursuant to audit findings

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This section
				shall apply to hearings held pursuant to any law or regulation giving a
				facility licensed by the Office of Mental Health the right to request a hearing
				to appeal an agency audit finding which results in a proposed revision of a
				certified rate of payment. This section does not apply to hearings pursuant to
				audits conducted by the Department of Social Services, which shall be conducted
				in accordance with applicable regulations of the State Department of Social
				Services. Where a conflict exists between this section and any other section of
				this Part, the provisions of this section shall be controlling.
(b) If the commissioner affirms some or all
				of the Office of Mental Health's proposed revision of a certified rate of
				payment upon administrative review of the audit findings, the provider shall
				have a right to a hearing pursuant to this Part.
(c) The proposed revision of a certified rate
				of payment resulting from an audit finding, as adjusted in accordance with the
				determination after administrative review, shall be final unless, within 30
				days of service of the determination, the provider requests a hearing. The
				notice of the final audit findings, as served on the provider, shall be deemed
				to be the notice of proposed action under section
				503.4(a) 
				of this Part.
(d) A request for a
				hearing pursuant to this section shall be sent to the commissioner by
				registered or certified mail and shall contain a statement of the factual
				issues in dispute.
(e) Upon receipt
				of a request for a hearing, the commissioner shall determine whether a hearable
				factual issue is in dispute. If it is determined that there is no factual issue
				in dispute, the request for a hearing shall be denied; no administrative appeal
				shall be available from this determination. When it is determined that there is
				a factual issue in dispute, the commissioner shall order an administrative
				hearing to be held.
(f) The burden
				of proof shall be on the provider to prove by clear and convincing evidence
				that findings of fact on which the determination was based are
				incorrect.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Part
				establishes the process for determining and offering appropriate placement and
				services in programs licensed and operated by New York State to individuals
				with mental illness receiving transitional care funding.
(b) This Part establishes standards for an
				administrative review and informal hearing process should an objection to a
				placement, which results in a request for an administrative review, be
				made.
(c) The Office of Mental
				Health has a responsibility to assist in locating placements and/or services
				for individuals currently receiving transitional care funding and to complete
				such placements by January 1, 1999.
(d) The Office of Mental Health has
				responsibility to assist in locating placements and/or services for an
				individual reaching 21 years of age while attending a program or residential
				school which provides services to children, in order that no new transitional
				care placements occur after July 1, 1996.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Section 7.09  of the Mental Hygiene Law grants the
				Commissioner of Mental Health the power and responsibility to adopt regulations
				that are necessary and proper to implement matters under his/her
				jurisdiction.
(b) Sections 7.37 and
				7.38  of the Mental Hygiene Law grant the
				Commissioner of Mental Health the authority to set forth a process for
				placement of individuals in receipt of transitional care funding and to set
				standards which guarantee the right to administrative review and a hearing
				regarding placements of individuals receiving transitional care
				funding.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Part shall
				apply to those individuals with responsibility for the process of determining
				an appropriate placement for individuals who are currently receiving
				transitional care funding, the individual receiving transitional care funding,
				and the individual's guardian or another individual who has been actively
				involved in the care of the individual and who can represent the individual's
				interests.
(b) This Part shall
				apply to administrative review regarding placements of individuals who are
				currently receiving transitional care funding.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.4 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Administrative
				review for purposes of this regulation shall be by the Commissioner of Mental
				Health or his/her designee. Such review shall be conducted as a hearing
				pursuant to section
				504.6  of
				this Part.
(b) Appropriate
				placement and services means meeting an individual's needs for care and
				treatment, as determined by clinical staff exercising professional
				judgement.
(c) Commissioner means
				the Commissioner of Mental Health.
(d) Transitional care for purposes of this
				Part shall mean care and treatment of persons:
(1) who were placed in foster care by a
				social services district pursuant to Article 6 of chapter 600 of the Laws of
				1994 and who have become 21 years of age, or who were placed in a residential
				educational placement by a school district pursuant to article 89 of the
				Education Law and who are no longer eligible for free educational services
				because they have completed the school year in which they became 21;
(2) who were disabled and in need of
				residential care prior to becoming age 21 or prior to becoming ineligible for
				free education services and who have since remained continuously disabled and
				continuously in need of residential care;
(3) who became 21 or become ineligible for
				free educational services prior to July 1st, 1996;
(4) with respect to whom the Office of Mental
				Health, as appropriate, has approved a plan of continued out-of-home care for
				the person but has not yet identified a currently available appropriate
				placement within those care systems;
(5) whose residential needs can be met by the
				facility in which the persons resided prior to becoming age 21 or becoming
				ineligible for free educational services; and
(6) with respect to whom approved
				expenditures for transitional care currently are being made by a social
				services district pursuant to section 466(2) of the Social Services
				Law.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.5 - Placement process

Current through Register Vol. 46, No. 28, July 10, 2024
(a) An
				individual receiving transitional care funding shall be interviewed and his/her
				clinical records evaluated for purposes of making a determination regarding an
				appropriate placement and services for care and treatment.
(b) An appropriate placement and services
				will be sought which meet the individual's needs for care and treatment, as
				determined by appropriate clinicians exercising professional judgement. The
				Office of Mental Health shall also honor all requests for information regarding
				non-residential services, including but not limited to at-home family
				support.
(c) The individual, the
				individual's guardian, or another individual who has been actively involved in
				the care of the individual and who can represent the individual's interests,
				shall be notified in writing of a proposed placement(s) and services.
(d) A visit to the proposed placement(s)
				shall be arranged for the individual, the individual's guardian, or another
				individual who has been actively involved in the care of the individual and who
				can represent the individual's interests. Such preliminary visits are necessary
				for residential placement. Every effort shall be made to identify a convenient
				time for all concerned.
(e) A
				refusal to visit the proposed placement(s) and/or services shall constitute
				refusal of placement, at which time the commissioner or his/her designee shall
				notify the appropriate local department of social services which shall
				discontinue funding for transitional care for the individual.
(f) Following a visit to the proposed
				placement, the individual, the individual's guardian, or another individual who
				has been actively involved in the care of the individual and who can represent
				the individual's interests shall be notified in writing of the placement
				determined to be appropriate and the approximate date of transfer. Such
				notification shall include the program description and services to be provided
				and shall identify a person(s) to whom questions regarding the placement may be
				directed, an explanation of the administrative review process, and information
				regarding the availability of the Mental Hygiene Legal Service.
(g) An individual receiving transitional care
				funding, the individual's guardian or another individual actively involved in
				the care of the individual and who can represent the individual's interests may
				choose to remain in the current placement, or otherwise chose not to accept a
				placement identified as appropriate by the Office of Mental Health. The Office
				of Mental Health shall notify the local department of social services which
				shall discontinue funding for transitional care for the individual.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 504 - Placement Of Individuals Leaving Transitional Care Funding › Section 504.6 - Administrative review

Current through Register Vol. 46, No. 28, July 10, 2024
(a) An
				administrative appeal may be requested by the individual, the individual's
				guardian or another individual actively involved in the care of the individual
				and who can represent the individual's interests within 30 days of receipt of
				written notification of the placement determined to be appropriate. Such
				request shall be forwarded in writing to the commissioner.
(b) If a timely request is made, a hearing
				shall be conducted by the commissioner or his/her designee. Such hearing shall
				be presided over by an individual, designated by the commissioner, who has no
				interest or bias in the matter involved. Both sides may call witnesses and
				present relevant evidence.
(c) A
				hearing shall occur within 30 days of request for such appeal and every effort
				shall be made to hold the review in a county of the State convenient to the
				individual requesting the review.
(d) The commissioner or his/her designee
				shall issue a written determination within 30 days of the administrative
				review. The reasons supporting the determination shall be fully explained in
				the determination, which shall address all specific issues raised by the
				individual and his or her representatives. All clinical reports and other
				documents considered will be attached to the determination. If it is determined
				that the proposed placement is appropriate for the individual receiving
				transitional care funding, the Commissioner of Mental Health shall notify the
				local department of social services which shall discontinue funding for
				transitional care for such individual on the transfer date.
(e) If an administrative appeal is not
				requested within the 30 days stipulated in subdivision (a) of this section, the
				process for placement will begin and funding of the transitional care will
				terminate on the transfer date.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of this Part is to establish standards for the proper disclosure of HIV-related
				information.
(b) The purpose of
				this Part is to establish standards which limit the risk of discrimination and
				harm to an individual's privacy which unauthorized disclosure of HIV
				information can cause.
(c) The
				purpose of this Part is to establish standards which seek to enhance the safety
				of employees of facilities or programs operated or certified by the Office of
				Mental Health as well as other individuals.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Sections 7.09 and
				31.04  of the Mental Hygiene Law grant the
				Commissioner of Mental Health (commissioner) the power and responsibility to
				adopt regulations that are necessary and proper to implement matters under his
				or her jurisdiction, and to set standards of quality and adequacy of
				facilities, equipment, personnel, services, records and programs for the
				rendition of services for the mentally ill pursuant to an operating
				certificate.
(b) Section 2786  of the Public Health Law requires the
				commissioner to promulgate regulations which provide safeguards against
				discrimination, abuse and other adverse actions directed toward protected
				individuals; provide for the proper disclosure of HIV-related information;
				protect individuals in contact with protected individuals when such contact
				creates a significant risk of contracting or transmitting HIV infection and
				establish criteria for determining when it is reasonably necessary for a
				provider of a health or social service or a State agency or a local government
				agency to have or use confidential HIV-related information for supervision,
				monitoring, investigation or administration:
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Part
				applies to any provider of services which operates or proposes to operate a
				program certified or funded by the Office of Mental Health.
(b) This Part applies to facilities and
				programs operated by the Office of Mental Health.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.5 - Prevention of discrimination and abuse

Current through Register Vol. 46, No. 28, July 10, 2024
(a) No individual will be subjected to
				discrimination because that individual is or is thought to be HIV infected. All
				individuals shall be appropriately served by programs operated or certified by
				the Office of Mental Health according to the needs of the individual's current
				psychiatric condition.
(1) All programs
				operated or certified by the Office of Mental Health shall admit, place, treat
				and discharge patients in accordance with established clinical criteria and
				shall not be used to house or quarantine individuals who do not need the
				psychiatric services provided.
(2)
				An individual's predominant need for nonpsychiatric medical care, as determined
				by an appropriately qualified physician, may render the individual
				inappropriate for care in a psychiatric treatment setting.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.6 - Hiv-related testing

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Except as
				noted in paragraph (b)(2) of this section, no physician or other person
				authorized pursuant to law may order an HIV-related test without obtaining
				written informed consent.
(1) Informed consent
				shall consist of providing to the person to be tested or, if such person lacks
				capacity to consent, to the person lawfully authorized to consent to health
				care for such person:
(i) explanations
				regarding the nature of HIV infection and HIV-related illness, the accuracy of
				the HIV-related test, the significance and benefits of the test and its
				result;
(ii) information regarding
				discrimination problems which might occur as a result of unauthorized
				disclosure of HIV-related information and legal protections prohibiting such
				disclosures;
(iii) information on
				preventing exposure or transmission of HIV infection, including behavior which
				poses a risk of HIV transmission; and
(iv) information on the availability of
				anonymous HIV testing, including the location and telephone numbers of
				anonymous test sites, except that anonymous testing is not available to persons
				proposed for insurance coverage.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.8 - Protection of others at significant risk of infection

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Staff and patient protection. Since
				medical history and examination cannot reliably identify all patients infected
				with HIV or other blood-borne pathogens, blood and body fluid precautions shall
				be consistently used for all patients. This approach, referred to as "universal
				blood and body fluid precautions" or "universal precautions," shall be used in
				the care of all patients, particularly including those in emergency care
				settings in which the risk of blood exposure is increased and the infection
				status of the patient is usually unknown.
(b) Facilities and programs shall abide by
				any additional administrative guidelines regarding protective barriers or
				procedures as may be required by the Office of Mental Health.
(c) Staff will evaluate and educate
				individuals and utilize clinically appropriate methods to reduce the risk of
				HIV transmission through sexual contact.
(d) Each facility operated or certified by
				the Office of Mental Health shall:
(1)
				Implement and enforce a plan for the prevention of circumstances which could
				result in an employee or individual becoming exposed to blood or bodily fluids
				which could put the individual at risk for HIV infection, during the provision
				of services. Such a plan shall include:
(i)
				use of generally accepted protective barriers during the job-related activities
				which involve, or may involve, exposure to blood or body fluids. Such
				preventive action shall be taken by the employee with each client and shall
				constitute an essential element for the prevention of bi-directional spread of
				HIV;
(ii) use of generally accepted
				preventive practices during job-related activities which involve the use of
				contaminated instruments or equipment which may cause puncture
				injuries;
(iii) training at the
				time of employment and yearly staff development programs on the use of
				protective equipment, preventive practices, and circumstances which represent a
				risk for all employees whose job-related tasks involve, or may involve,
				exposure to blood or body fluids;
(iv) provision of personal protective
				equipment for employees which is appropriate to the tasks being performed;
				and
(v) a system for monitoring
				preventive programs to assure compliance and safety.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.9 - Contact notification

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A
				physician may disclose HIV-related information, without the protected person's
				consent, to a contact or to a public health officer when:
(1) the physician reasonably believes
				disclosure is medically appropriate and a significant risk of infection exists;
				and
(2) the protected person has
				been counseled to notify the contact and the physician reasonably believes the
				protected person will not inform the contacts.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 505 - Requirements Regarding Testing, Confidentiality And Precautions Concerning The Human Immunodeficiency Virus (hiv) And Acquired Immune Deficiency Syndrome (aids) › Section 505.10 - Monitoring

Current through Register Vol. 46, No. 28, July 10, 2024
Employees and agents of the Office of Mental Health,
				  Commission on Quality of Care and Advocacy for Persons with Disabilities, and
				  other Federal, State and local agencies responsible for monitoring, inspecting,
				  supervising, and investigating programs operated or certified by the Office of
				  Mental Health shall have access to confidential HIV information to the extent
				  necessary to discharge those responsibilities.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose
				of these regulations is to establish standards and methods for determining
				rates of payment made by government agencies pursuant to title 11 of article 5
				of the Social Services Law for case management services provided by intensive
				case management, supportive case management and blended ICM/SCM case management
				programs to active clients identified as persons with serious mental illness
				and enrolled with a provider of services.
(b) In order to be eligible for payments
				pursuant to title 11 of article 5 of the Social Services Law, an intensive case
				management, supportive case management or blended ICM/SCM case management
				program must meet the requirements of its agreement with the Office of Mental
				Health or the local governmental unit in addition to the requirements of title
				XIX of the Social Security Act as identified in section
				502.2(d) 
				of this Title and 18 NYCRR 505.16.
(c) The rates of payment established
				according to these regulations are intended to be adequate to meet the costs of
				an efficiently operated program.
(d) Notwithstanding any other provision of
				the law, case management services may be authorized by the designated case
				manager assigned to individuals comprising the populations as defined in
				section
				506.4 
				of this Part and pursuant to criteria established by the commissioner and
				approved by the Director of the Budget.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.2 - Legal base

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Section 7.09 (b)  of the Mental
				Hygiene Law gives the commissioner the power and responsibility to plan,
				establish and evaluate programs and services for the benefit of the individuals
				with mental illness, and to adopt regulations that are necessary and proper to
				implement matters under his or her jurisdiction.
(b) Section 43.02 (c)(ii)  of the
				Mental Hygiene Law provides that payments under the medical assistance program
				for services approved by the Office of Mental Health shall be at rates
				certified by the Commissioner of Mental Health and approved by the Director of
				the Budget.
(c) Section 364 (3)  of the Social
				Services Law provide that each office within the Department of Mental Hygiene
				shall be responsible for establishing and maintaining standards for medical
				care and services received in institutions operated by it or subject to its
				supervision pursuant to the Mental Hygiene Law.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.3 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Part
				applies to any provider of services which operates or proposes to operate an
				intensive case management, supportive case management or blended ICM/SCM case
				management program.
(b) This Part
				applies to the operation or proposed operation of an intensive case management,
				supportive case management or blended ICM/SCM case management program for a
				client identified as a person with a serious mental illness and enrolled with a
				provider of services as follows:
(1) an
				intensive case management, supportive case management or blended ICM/SCM case
				management program provided by a local government unit or voluntary agency;
				or
(2) an intensive case
				management, supportive case management or blended ICM/SCM case management
				program provided by a provider of service licensed pursuant to article 31 of
				the Mental Hygiene Law; or
(3) an
				intensive case management program operated by a State-operated psychiatric
				center.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.4 - Definitions pertaining to this part

Current through Register Vol. 46, No. 28, July 10, 2024
For the purposes of this Part:
(a) Client related definitions.
(1) Active client shall mean an enrolled
				client who receives four or more face-to-face contacts with an intensive case
				manager within one month or two or more face-to-face contacts with a supportive
				case manager within one month, except as otherwise provided in sections
				506.5(b),
				(f),
				506.6(d)
				 and
				506.7(c),
				(f)  of this Part.
(2) Collaterals means persons who are:
(i) members of a child's or adolescent's
				family or household, or significant others who regularly interact with the
				child or adolescent and are directly affected by or have the capability of
				affecting his or her condition; and
(ii) are identified in the treatment or
				psychiatric rehabilitation service plan as having a role in treatment and/or
				identified in the preadmission notes as being necessary for participation in
				the evaluation and assessment of the child or adolescent prior to
				admission.
(3) Enrolled
				client shall mean a person scheduled to receive intensive case management,
				supportive case management or blended ICM/SCM case management services from a
				designated provider of services and a designated intensive case manager or
				supportive case manager.
(4)
				Intensive case management recipients shall mean persons with a serious mental
				illness that is marked by impairment in self care, social functioning,
				activities of daily living, economic self sufficiency, self direction and
				concentration and which interferes with the ability to function independently,
				appropriately and effectively. Such recipients are identifiable within four
				subpopulations of persons with serious mental illness as follows:
(i) high-needs persons; and
(ii) extended care state psychiatric center
				patients; and
(iii) homeless
				persons; and
(iv) seriously and
				emotionally disturbed children and adolescents.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.5 - Standards pertaining to reimbursement for intensive case management services

Current through Register Vol. 46, No. 28, July 10, 2024
(a) In order
				to receive reimbursement for the provision of services, a provider of an
				intensive case management program shall provide services to a person identified
				as a person with a serious mental illness and who is also enrolled as a client
				of the provider of case management services.
(b) A provider of service must indicate to
				the Office of Mental Health which one of the following billing methodologies
				will be adopted by the program:
(1) a minimum
				of four face-to-face contacts within a month between an intensive case manager
				and an active client shall be considered a billable service; or
(2) a minimum of two face-to-face contacts
				within a month between an intensive case manager and an active client shall be
				considered a billable service, if the intensive case manager's aggregate
				monthly contacts average four face-to-face contacts per active
				client.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.6 - Standards pertaining to reimbursement for supportive case management services

Current through Register Vol. 46, No. 28, July 10, 2024
(a) In order
				to receive reimbursement for the provision of services, a provider of a
				supportive case management program shall provide services to persons who are
				enrolled as clients of the provider of services. Such individuals shall be in
				need of less intensive support than that provided in the intensive case
				management program.
(b) A minimum
				of two face-to-face contacts within a month between a supportive case manager
				and an active client shall be considered a billable service.
(c) A face-to-face contact between a
				supportive case manager and an active client shall be counted as a separate
				contact for purposes of reimbursement per patient day regardless of the number
				of face-to-face contacts provided or other outpatient programs in which the
				active client participates in a single day.
(d) While awaiting discharge from the
				supportive case management program, a client shall be considered on
				transitional status and may receive one contact per month for a period of two
				months prior to discharge. The one contact per month during this time period is
				a billable service.
(e) Each
				provider of services shall furnish any and all information and records
				concerning the provision of supportive case management services which may be
				requested by the Office of Mental Health. Such information and records shall be
				provided as the Office of Mental Health may prescribe including but not limited
				to, the program of services, individual client specific services and
				statistical, administrative and fiscal operations carried out under the
				agreement.
(f) Collateral contacts
				shall not be counted as a billable service for the supportive case management
				program.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.7 - Standards pertaining to reimbursement for blended icm/scm services

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The blended
				ICM/SCM program allows case managers to deliver services through a team
				approach and shared caseloads. The blended options for ICM/SCM are as follows:
(1) one ICM case manager and one SCM case
				manager;
(2) one ICM case manager
				and two SCM case managers;
(3) two
				ICM case managers and one SCM case manager; and
(4) any multiple of the options presented in
				paragraph (1), (2) or (3) of this subdivision.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.8 - Audits

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each provider
				of intensive case management, supportive case management or blended ICM/SCM
				case management services shall maintain the records which formed the basis of
				the statistical and financial reports submitted to the commissioner for six
				years from the date on which the reports were submitted to the commissioner, or
				for such longer period as may be required under Federal law.
(b) All such records shall be subject to
				audit for a period of six years from the date on which all required reports
				were filed with the commissioner or the date on which such reports were due,
				whichever is later
(c) On-site
				audits or desk audits shall be conducted by the commissioner at a time and
				place and in a manner to be determined by the commissioner.
(d) The commissioner may enter into
				agreements with other organizations or agencies having audit responsibilities
				to audit the financial and statistical records of any provider of intensive
				case management, supportive case management or blended ICM/SCM case management
				services.
(e) At the conclusion of
				the audit, the provider of intensive case management, supportive case
				management or blended ICM/SCM case management services shall be afforded an
				opportunity to submit additional documentation to the commissioner. After
				receipt and review of such additional documentation, a copy of the audit
				findings and notice of any proposed rate revision shall be sent to the provider
				of intensive case management, support case management or blended ICM/SCM case
				management services.
(f) Any
				proposed rate revisions resulting from the implementation of audit findings
				shall be final unless within 30 days of receipt of the proposed rate revision
				the provider of intensive case management, supportive case management or
				blended ICM/SCM case management services requests a hearing on factual issues.
				Requests for hearing, and the conduct of such hearings, shall be pursuant to
				Part 503 of this Title.
(g)
				Revisions to rates determined in accordance with the provisions of this section
				shall be retroactive to the rate year covered by the audit. Any resulting
				overpayment shall be satisfied by either retroactive adjustments of the
				provisional rate paid, based on the period audited, or prospective adjustment
				of the current certified rate at the discretion of the commissioner.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.9 - Rates of payment

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Rates of
				payment shall be established on a prospective basis.
(b) Each rate of payment under this section
				shall be a regional monthly fee.
(c) Rates of payment established pursuant to
				this section shall be reviewed by the Department of Health.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.10 - Case management services in inpatient facilities

Current through Register Vol. 46, No. 28, July 10, 2024
Individuals who have been admitted to discrete psychiatric
				  units of hospitals licensed pursuant to article 28 of the Public Health Law,
				  residential treatment facilities for children and youth, or individuals 21
				  years of age of less or 65 years of age or older who are receiving services at
				  State-operated psychiatric facilities or hospitals licensed pursuant to article
				  31 of the Mental Hygiene Law and who have an anticipated discharge within 90
				  days or less, may receive case management services. Such services shall be
				  billed pursuant to the standards established in sections
				  506.5,
				  506.6
				  and
				  506.7 
				  of this Part, if such services are required in order to facilitate the process
				  of transition to community services and to enable the individual to gain access
				  to needed medical, social, educational, and other services in the
				  community.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.11 - Individuals enrolled in assisted outpatient treatment

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each provider of services approved or
				licensed to provide intensive care management services, supportive case
				management services or blended ICM/SCM services shall establish mechanisms to
				ensure priority access by individuals who have been referred to the provider
				and who are enrolled in an assisted outpatient treatment program established
				pursuant to section 9.60  of the Mental Hygiene Law.
(b) Such provider of services shall cooperate
				with the local governmental unit or the commissioner, or their authorized
				representatives, to ensure priority access by such individuals, and in the
				development, review, and implementation of treatment plans for them.
(c) Prior to discharge from an intensive case
				management, supportive case management or blended ICM/SCM program of an
				individual who is also enrolled in an assisted outpatient treatment program,
				the provider of services shall notify the director of the assisted outpatient
				treatment program and, if appropriate, the individual's case manager.
(d) Any and all related information, reports,
				and data which may be requested by the commissioner or the local governmental
				unit in connection with an individual who is also enrolled in an assisted
				outpatient treatment program shall be furnished by the provider of
				services.
(e) Any requests for
				clinical records regarding persons who are the subject of, or who are under
				consideration for, a petition for an order authorizing assisted outpatient
				treatment, from persons or entities authorized pursuant to section 33.13 or
				33.16  of the Mental Hygiene Law, shall be
				given priority attention and responded to without delay.
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 506 - Medical Assistance Rates Of Payment For Intensive Case Management Services (icm), Supportive Case Management (scm) And Blended Icm/scm Case Management Services › Section 506.12 to 506.13

Current through Register Vol. 46, No. 28, July 10, 2024
New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 507 - Community Based Service System For Children › Section 507.1 - Background and intent

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Chapter 499
				of the Laws of 1989 authorized the establishment of funding for community based
				services for children with serious emotional disturbance.
(b) The purpose of a community based system
				of mental health services for children with serious emotional disturbance is to
				provide services which are responsive to children and families within their
				community so as to avoid unnecessary institutionalization and separation of
				children from their families and communities.
(c) The purpose of these regulations is to
				establish standards for the use of the authorized funding for purposes of
				developing a comprehensive community based service system within the community
				for children with serious emotional disturbance.
(d) These regulations provide for the
				establishment of an interagency group that has responsibility for monitoring
				the system of services, identifying gaps in the service system, recommending
				the development of services as appropriate and providing technical assistance
				to the member agencies.