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. 39, September 25, 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.

(b) Reimbursement related definitions.

(1) Blended ICM/SCM program shall mean a program that provides case management services to persons with a serious mental illness and which allows case managers to deliver services through a team approach and shared caseloads.

(2) Client month shall mean a calendar month in which an enrolled client or appropriate collateral receives the required number of face- to-face contacts with a case manager.

(3) Commissioner shall mean the Commissioner of Mental Health.

(4) Intensive case management program means services provided by a designated intensive case manager to promote managed care by coordinating all aspects of services needed by persons with a serious mental illness and enrolled for such services with a provider of services, for as long as necessary.

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

(6) Shared case management staff means staff which are employed under the auspice of the Office of Mental Health while assigned to other than a State-operated psychiatric center.

(7) Supportive case management program (SCM) means a variant of the intensive case management program which provides services to individuals who require less support than ICM clients.

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