N.Y. Comp. Codes R. & Regs. tit. 14 § 584.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 584.4 - Definitions pertaining to this part

(a) General

(1) Admission criteria are those factors of psychopathology, activities of daily living skills, age, gender, and intelligence quotient, in addition to the office's eligibility criteria for access to residential treatment facility services, which are identified for use by a specific residential treatment facility to determine whether to accept a child or youth's application for admission or transfer.

(2) Alternate care determination is a decision made by the Office of Mental Health or the commissioner's designee, that a child or youth who has been receiving residential treatment facility services no longer meets medical necessity for continued access to residential treatment facility services.

(3) Case records are those reports which contain information on all matters relating to the admission, legal status, assessment, treatment planning, treatment and discharge of the resident, and shall include all pertinent documents relating to the resident.

(4) Child or youth is an individual who has passed at least their 5th birthday, and who has not yet reached their 22nd birthday.

(5) Clinical staff are all staff members who provide services directly to residents and their families or legal guardian. Clinical staff shall include professional staff, paraprofessional staff and other nonprofessional staff.

(6) Continued stay criteria are those factors of psychopathology, activities of daily living skills and age which are identified for use in determining the eligibility and medical necessity of a resident's continued access to residential treatment facility services. These factors shall provide the basis for determining that the resident continues to meet the admission criteria of the residential treatment facility. Such evidence shall be directly observed and documented by staff of the residential treatment facility or be documented in reports of hospital or therapeutic leaves.

(7) Designated mental illness means a disruption of cognitive, emotional, or behavioral functioning, which can be classified and diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM), or the International Classification of Diseases (ICD) as incorporated by reference in Part 800 of this Title, other than:

(i) substance use disorders in the absences of other mental health conditions defined in the DSM or ICD;

(ii) neurodevelopmental disorders in the absence of other mental health conditions;

(iii) major neurocognitive disorders in the absence of other mental health conditions defined in the DSM or ICD except Attention-Deficit/Hyperactivity Disorder or Tic Disorders; or

(iv) other conditions that may be a focus of clinical attention (commonly described with Z codes), except Parent-Child Relational Problem (V61.20/Z62.820) for child or youth.

(8) Education records means those reports which contain information on all matters relating to the education of the resident, and shall include all pertinent documents. For children or youth determined to have an educational disability classification by a committee on special education, the education record shall contain the individualized education program. Education records shall be separate and distinct from the case record.

(9) Eligibility criteria means personal attributes and characteristics that an individual needs to have in order to access residential treatment facility services.

(10) Medical necessity criteria shall refer to criteria for access to residential treatment facility services set forth by the office or commissioner's designee, where minimally, outpatient, community-based, and other out of home interventions available, do not meet the treatment needs of the child or youth, the child or youth is experiencing a severity of psychiatric need which requires proper care and treatment of the child or youth's psychiatric condition on an inpatient basis in a residential treatment facility under the direction of a physician, and care and treatment provided by residential treatment facility services can reasonably be expected to improve the child or youth's condition or prevent further regression so that residential treatment facility services will no longer be needed.

(11) Provider of services means the organization that is legally responsible for the operation of a program, licensed by the office. The organization may be an individual, partnership, association, corporation, public agency, or a psychiatric center or institute operated by the Office of Mental Health.

(12) Residential treatment facility is an inpatient psychiatric facility which is family centered and provides active care and treatment under the direction of a physician for children or youth who are under 21 years of age and is issued an operating certificate pursuant to this Part.

(13) Restraint means "restraint" as such term is defined in section 526.4(a) of this Title.

(14) Seclusion means "seclusion" as such term is defined in section 526.4(a) of this Title.

(15) Serious emotional disturbance means a child or youth has a designated mental illness diagnosis according to the most current Diagnostic and Statistical Manual of Mental Disorders (DSM) and has experienced functional limitations due to emotional disturbance over the past 12 months on a continuous or intermittent basis. The functional limitations must be moderate in at least two of the following areas or severe in at least one of the following areas:

(i) ability to care for self (e.g., personal hygiene; obtaining and eating food; dressing; avoiding injuries); or

(ii) family life (e.g., capacity to live in a family or family like environment; relationships with parents or substitute parents, siblings and other relatives; behavior in family setting); or

(iii) social relationships (e.g., establishing and maintaining friendships; interpersonal interactions with peers, neighbors and other adults; social skills; compliance with social norms; play and appropriate use of leisure time); or

(iv) self-direction/self-control (e.g., ability to sustain focused attention for a long enough period of time to permit completion of age-appropriate tasks; behavioral self-control; appropriate judgment and value systems; decision-making ability); or

(v) ability to learn (e.g., school achievement and attendance; receptive and expressive language; relationships with teachers; behavior in school).

(16) Time-out means "time out" as such term is defined in section 526.4(a) of this Title.

(b) Services.

(1) Case coordination services are activities to assure the full integration of all services provided to each resident. Case coordination activities include, but are not limited to, monitoring the resident's daily functioning to assure the continuity of service in accordance with the resident's treatment plan and ensuring that all clinical staff responsible for the care and delivery of services actively participate in the development and implementation of the resident's treatment plan.

(2) Dietetic services are services designed to meet the nutritional needs of all residents. Dietetic services include, but are not limited to: ensuring that each resident on a special diet receives the prescribed diet; ensuring food storage and preparation in a safe and sanitary manner; directing the nutritional aspects of resident care; and providing planned menus that reflect the food acceptance of the residents.

(3) Educational and vocational services are those activities the purpose of which is to assist the resident in the acquisition or development of academic and occupational skills.

(4) Medication therapy is the reviewing of the appropriateness of the resident's existing medication regimen through review of the resident's medication record and consultation with the resident and, as appropriate, their family or guardian; prescribing and/or administering medication; and monitoring the effects and side effects of the medication on the resident's mental and physical health.

(5) Physical health services is a comprehensive program of preventive, routine and emergency medical and dental care, and an age-appropriate program of health education.

(6) Task and skill training is a nonvocational activity whose purpose is to enhance a resident's age-appropriate skills necessary to facilitate the resident's ability to care for themself and to function effectively in community settings. Task and skill training activities include, but are not limited to: homemaking; personal hygiene; budgeting; shopping; and the use of community resources.

(7) Therapeutic recreation services are planned therapeutic activities whose purposes are: the acquisition or development of social and interpersonal skills; the improvement of the psychomotor and cardiovascular abilities of the residents; the enhancement of the self concept of the residents; the development of healthy, lifelong activities toward participation in recreation and physical activity; and the improvement or maintenance of a resident's capacity for social and/or recreational involvement by providing opportunities for the application of social and/or recreational skills.

(8) Verbal therapies are planned activities whose purpose is to provide formal, individual, family, and group therapies. These therapies include, but are not limited to, psychotherapy and other face-to-face verbal contacts between staff and the resident which are planned to enhance the resident's psychological and social functioning as well as to facilitate the resident's integration into a family unit. Verbal contacts that are incidental to other activities are excluded from this service. Verbal therapy shall include play therapy and other forms of expressive therapy.

(c) Staff qualifications.

(1) Dentist is an individual who is currently licensed as a dentist by the New York State Education Department.

(2) Dietitian is an individual who is either currently registered or eligible for registration by the Commission on Dietetic Registration; or has the documented equivalent in education, training and experience, with evidence of relevant continuing education.

(3) Limited permit physician is an individual who has received from the New York State Education Department a current permit to practice medicine which is limited as to eligibility, practice and duration.

(4) Nurse is an individual who is currently licensed as a registered professional nurse by the New York State Education Department.

(5) Occupational therapist is an individual who is currently licensed as an occupational therapist by the New York State Education Department.

(6) Physician is an individual who is currently licensed to practice medicine by the New York State Education Department.

(7) Psychiatrist is an individual who is currently licensed as a physician by the New York State Education Department and who is certified by, or eligible to be certified by, the American Board of Psychiatry and Neurology as a psychiatrist or a child psychiatrist.

(8) Psychologist is an individual who is currently licensed as a psychologist by the New York State Education Department.

(9) Rehabilitation counselor is an individual who either has a master's degree in rehabilitation counseling from a program approved by the New York State Education Department, or is currently certified by the Commission on Rehabilitation Counselor Certification.

(10) Social worker is an individual who is either currently licensed as a licensed master social worker or as a licensed clinical social worker by the New York State Education Department, or has a master's degree in social work from a program approved by the New York State Education Department.

(11) Speech pathologist is an individual who either has a master's degree in speech pathology or speech and/or language therapy, and who is currently licensed as a speech pathologist by the New York State Education Department.

(12) Therapeutic recreation specialist is an individual who either has a master's degree in therapeutic recreation or in recreation with emphasis in therapeutic recreation from a program approved by the New York State Education Department, or is currently registered as a therapeutic recreation specialist by the National Therapeutic Recreation Society.

(13) Teacher is an individual who is currently licensed as a teacher by the New York State Education Department.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 584.4

Amended New York State Register August 17, 2016/Volume XXXVIII, Issue 33, eff. 8/17/2016

Amended New York State Register July 3, 2024/Volume XLVI, Issue 27, eff. 7/3/2024