New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 583 - Residential Treatment Facilities For Children And Youth; Eligibility
Section 583.5 - Residential Treatment Facility (RTF) Eligibility and Authorization Requirements
Universal Citation: 14 NY Comp Codes Rules and Regs ยง 583.5
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Applications for an eligibility determination and authorization to access residential treatment facility services shall be in a form and format specified by the office or commissioner's designee.
(b) In order for a child or youth to be found eligible and authorized to access residential treatment services they must meet the following criteria:
(1) be
between the age of 5 years old and 20 years old;
(2) have an intelligence quotient equal to or
greater than 51;
(3) meet the criteria
for voluntary admission in accordance with section 9.13 of the Mental Hygiene
Law;
(4) have a current primary
diagnosis of a designated mental illness;
(5) meet criteria for serious emotional
disturbance; and
(6) meet all medical
necessity criteria for residential treatment facility services.
(i) Medical necessity criteria determinations
shall comply with the Code of Federal Regulations, title 42, section 441.153 as
incorporated by reference in Part 502.2 of this Title. Medical necessity criteria
shall also meet the CFR 42 section 441.152 Certification of Need requirements where
the child or youth is an applicant or recipient of medical assistance pursuant to
Social Services Law, title 11, article 5 as incorporated by reference in Part 502.2
of this Title.
(ii) Medical Necessity
criteria includes the following:
(a) outpatient,
community-based, and other out of home interventions available, do not meet the
treatment needs of the child or youth;
(b) 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;
(c)
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,
provided that a poor prognosis shall not in itself constitute grounds for a denial
of determination of eligibility if treatment in a residential treatment facility
offers can be expected to effect a change in prognosis.
(c) Eligibility criteria to obtain authorization
to access residential treatment facility services delivered by a residential
treatment facility developed in collaboration with the office and the Office for
People With Developmental Disabilities, to serve children or youth with a designated
mental illness and an intellectual and/or development disability, shall be exempt
from paragraphs (2) and (4) of subdivision (b) of this section.
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