N.Y. Comp. Codes R. & Regs. tit. 14 § 679.99

Current through Register Vol. 46, No. 45, November 2, 2024
Section 679.99 - Glossary
(a)Administrator.

That party, by whatever title known, designated in an agency's administrative structure with responsibility for:

(1) the day-to-day operation of the clinic treatment facility;
(2) ensuring the conformance of the facility and its services to the requirements of all applicable statutes and regulations;
(3) ensuring that arrangements are made for the timely delivery of treatments to persons admitted to the facility; and
(4) ensuring adherence to the overall policies of the agency/facility as approved by the governing body.
(b)Agency/facility.

As used in this Part, a term used to indicate that the stated requirement needs to be considered in relation to the administrative structure of both the agency and the site- specific facility and acted upon accordingly. The term agency used alone means the agent or operator of a facility operated or certified by OPWDD. In the case of State-operated facilities, the Developmental Disabilities State Operations Office (DDSOO) is considered to be the agency.

(c)Arts, licensed practitioner of the healing.

Anyone who holds licensure/certification appropriate to his or her discipline in medicine, dentistry, and/or physical or mental health-related disciplines as identified at section 679.3(j) of this Part or otherwise authorized by this Part.

(d)Body, governing.

The policymaking authority that exercises general direction over the affairs of one or more certified facilities in the same class, and establishes policies concerning the operation of such facility or facilities for the welfare of the persons served.

(1) The governing body of a clinic treatment facility operated by a voluntary, not-for-profit corporation is the board of directors as empowered by the agency's articles of incorporation, consisting of at least three persons.
(2) The governing body of a proprietary clinic treatment facility is the proprietor(s) of the clinic.
(3) The governing body of a State-operated clinic treatment facility is the central office administration of OPWDD and includes the administration by the Developmental Disabilities State Operations Office (DDSOO) director and his/her delegate(s).
(e)Care, managed health.

The use of a service delivery management system for medical care (see section 679.3[k] of this Part) delivered by the Part 679 certified facility, designed to minimize the need for accessing hospital emergency room services and the length of stay for inpatient hospital care as well as ensuring access to appropriate health care. Nothing herein shall preclude a person's access to emergency medical care as appropriate, solely because of his or her disability or because he or she is receiving medical care from a Part 679 clinic. It includes the following components applicable to every person admitted for and receiving medical care as his or her principal source of health care in an OPWDD certified clinic treatment facility:

(1) An individually assigned primary care physician, responsible for coordinating all aspects (including access to emergency medical care) of a person's medical care for the purposes of maintaining continuity of care and developing an individualized managed health care plan.
(2) Access to specialty medical care by a referral by the primary care physician. Referrals for a second opinion also shall be made by the primary care physician.
(3) Provision of treatment coordination (internal to the clinic facility) of the clinic's services by a designated clinic staff member for persons receiving services from the facility.
(4) After office hours, weekend and holiday service or phone availability. Availability of a back-up physician in circumstances where the assigned primary care physician is unavailable.
(f)Collateral.

A party or parties:

(1) having a care-giving relationship with the person receiving services; and
(2) who needs ancillary support and reinforcement to maximize the potential benefit the relationship may bring to the person.

For the purposes of this Part, a collateral may only be a member of the family, defined as biological/adoptive family, guardian, foster care parent, or family care provider of a person who is receiving services; or, a nonrelated party who has an established long term care-giving relationship with the person. The purpose of said services to a collateral shall be limited to those which contribute to meeting the identified needs of the admitted person with developmental disabilities.

(g)Commissioner.

The commissioner of the New York State Office for People With Developmental Disabilities, or his or her designee.

(h)Coordinator, treatment.

The single professional or otherwise qualified (i.e., holding at least a baccalaureate degree or a license as a registered nurse) staff member, by whatever name known at the clinic, designated for each person receiving services to coordinate the provision of all treatments, activities, experiences, or therapies as prescribed through the clinic's admission process and by the treating professionals in the person's treatment plan. In this circumstance, "coordinate" includes (as appropriate to the person in question), but is not limited to, checking on maintenance of appointments; obtaining information to address any recipient questions; transmitting information to referral sources, the person's outside case manager, and/or other interested and appropriate parties; ensuring progress notes are up-to-date in the clinical record; following-up on outside referrals by the clinic for ancillary services and ensuring that any resulting information is transmitted to the treating clinician and is entered into the record in a timely manner; evaluating the person's/collateral's satisfaction with the services(s); reviewing the clinical record with the person and providing explanations of its content; bringing any concerns of the person to the attention of appropriate clinical personnel and following-up to ensure resolution; being aware of other services outside the clinic received by the person and ensuring that there is no duplication service; ensuring that the person's annual reassessment by the physician and any other assessment information contained in the clinical record continues to document the need for the clinic service(s) provided, etc. The treatment coordinator also functions as the facility's liaison to the person's comprehensive Medicaid case manager, if applicable, and to other providers of service.

(i)Director, medical/dental.

Any New York State licensed physician or dentist by whatever title known, delegated with the overall responsibility for the delivery of professional services.

(j)Disability, developmental.

A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law.

(k)Facility.

Any place certified or operated by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities in accordance with the provisions of the applicable facility class regulation. See also "Facility, clinic treatment".

(l)Facility, clinic treatment.

A certified physical space or setting and/or its services including any certified satellite location(s) and providing clinical services pursuant to this Part, principally to persons with developmental disabilities, where such services are provided on an outpatient (i.e., nonresidential) basis. For clinics authorized to deliver services on an exclusively off-site basis (as allowed prior to April 1, 2016), the term facility includes the headquarters for administration, management (including clinical records management), and clinician office space which holds an appropriate certificate of occupancy in accordance with the requirements of the locality having jurisdiction.

(m)Intake, clinic.

A preliminary clinical interview/assessment of the potential admittee, his/her collateral, and/or the referral source conducted by a licensed professional and/or other authorized party pursuant to this Part for the purpose of determining the appropriateness of admission to the clinic treatment facility.

(n)OPWDD.

The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions.

(o)Off-site services.

Prior to April 1, 2016, allowed clinic services (see subdivision [s] of this section) delivered by practitioners of the healing arts (see subdivision [c] of this section) at any location(s) other than the clinic's main certified site or a certified clinic satellite site (see subdivision [t] of this section). This may have included delivery of authorized clinic services from a mobile van that met appropriate Department of Transportation vehicular requirements and was suitably equipped and staffed. Off-site services are not allowable clinic treatment services, effective on April 1, 2016.

(p)Party, authorized.

Someone who:

(1) holds licensure/certification appropriate to a discipline recognized by this Part; or
(2) holds the qualifications and functions as the facility's administrator pursuant to section 679.3(g) of this Part; or
(3) holds the qualifications and functions as a treatment coordinator at the facility pursuant to section 679.3(m) of this Part; or
(4) meets the definition of professional as set forth at subdivision (r) of this section; or
(5) meets the designation of student-in-training as set forth at section 679.3(l)(2) of this Part.
(q)Policies/procedures or policy/procedure.

As used in this Part, the term indicating the need for appropriate written guidance for staff, whether such guidance is in a form of a policy statement, a policy statement with accompanying procedures, or procedures only. Determination of the nature and wording of the material's content is that of the agency/facility.

(r)Professional.

For the purposes of this Part, anyone who by virtue of training, licensure, certification and/or applicable State law and/or regulation (including this Part), has the authority to perform those activities granted or presumed pursuant to community practice standards by the professional discipline in question. For State-operated clinics, it also includes those who meet the Civil Service qualifications at the professional level appropriate to their discipline. In addition, it shall include the following clinical and professional treatment areas with their associated qualifications:

(1) Applied behavioral sciences specialist-someone having a master's degree in a clinical and/or treatment field of psychology from an accredited institution, who has training in assessment techniques and behavioral program development and who functions under the supervision of a licensed psychologist.
(2) Rehabilitation counselor-someone who holds the following qualifications:
(i) a master's degree in rehabilitation counseling from an accredited institution of higher education whose program includes supervised clinical experience in a vocational setting of at least six months; or
(ii) a bachelor's degree in a human services discipline from an accredited institution of higher learning and three years supervised experience in providing rehabilitation services in a vocational setting.
(s)Services.

Allowable services by a clinic include those delivered by a practitioner of the healing arts and reasonably classified as:

(1)Diagnostic. Any medical/clinical procedures or supplies recommended by a physician or other licensed practitioner of the healing arts, within the scope of his or her practice under State law, to enable him or her to identify the existence, nature or extent of illness, injury, primary developmental disability, or other health condition in the person.
(2)Palliative. Services provided by a physician or other practitioner of the healing arts focused on reducing the severity of a disease or condition; to cause to lessen or abate; to ease without curing.
(3)Preventative. Services provided by a physician or other licensed practitioner of the healing arts within the scope of his or her practice under State law to:
(i) treat and prevent disease, disability, and other health conditions or their progression;
(ii) prolong life; and
(iii) promote physical and mental health and efficiency.
(4)Rehabilitative/habilitative. Any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts, within the scope of his/her practice under State law, for a maximum reduction of the effects of physical or mental disability and restoration of the person to his or her best possible functional level. It includes the fitting, training and modification of assistive devices by licensed practitioners or trained others under their direct supervision.
(t)Site, satellite.

A physical location or dedicated space meeting the physical plant and environmental standards of Subpart 635-7 of this Title appropriate to a clinic treatment facility, where the clinic regularly or periodically delivers Part 679 authorized services.

(1) A satellite site must occupy either:
(i) dedicated space, which is used exclusively for provision of article 16 clinic treatment services; or
(ii) designated space, which is multi-purpose space that can be used by other programs or services based on a written arrangement, including a schedule that identifies the days and times when the space is used for provision of article 16 clinic treatment services.
(2) A satellite site may be co-located with another OPWDD certified or funded non-residential program or service in accordance with the provisions of this subdivision.
(3) Effective on April 1, 2016, no space co-located in an educational setting serving students in any grades from preschool through grade 12 will be certified as an article 16 clinic satellite site. However, OPWDD will not revoke or refuse to renew the certification of such a co-located space solely because it is located in an educational setting, if the space was certified by OPWDD prior to April 1, 2016.
(4) Services delivered at a satellite site must be available, by appointment, to any individual who is eligible to receive such services.
(5) Every satellite site must be specifically approved, periodically inspected, and listed by address as a satellite clinic on the article 16 clinic operating certificate issued by OPWDD.
(u)Specialist, applied behavioral sciences.

A person with a master's degree from an accredited program in a clinical and/or treatment field of psychology and/or a New York State license in mental health counseling, who has training in assessment techniques and behavioral program development and who functions under the supervision of a licensed psychologist.

(v)Supervision.

Authoritative procedural guidance by a professional for the accomplishment of a function or activity within his/her sphere of competence (as defined in the State Education Department licensing/certifying regulations), with initial direction and periodic inspection of the actual act of accomplishing the function or activity. Unless otherwise stated in regulations, the supervision must be on the premises if the party does not meet the assistant-level qualifications specified.

(w)Telehealth.

The use of electronic information and communication technologies by a health care provider to deliver health care services to an individual while such individual is located at a site that is different from the site where the health care provider is located.

(x)Treatment, ongoing.

Approved and recommended therapies or interventions provided on a routine schedule over a period of time exceeding three months.

(y)Verify.

Any means including, but not limited to, observation, interview, and the written word that provides OPWDD with a basis for being reasonably assured that a requirement has been met.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 679.99

Amended New York State Register March 30, 2016/Volume XXXVIII, Issue 13, eff.4/1/2016
Amended New York State Register April 20, 2016/Volume XXXVIII, Issue 16, eff.4/20/2016
Amended New York State Register September 21, 2016/Volume XXXVIII, Issue 38, eff. 9/21/2016
Amended New York State Register November 8, 2017 /Volume XXXIX, Issue 45, eff.11/8/2017
Amended New York State Register December 12, 2018/Volume XL, Issue 50, eff. 12/12/2018