Current through Register Vol. 46, No. 39, September 25, 2024
(a) A provider of
service intending to operate an outpatient program must obtain an initial
operating certificate issued by the Office of Mental Health in accordance with
procedures established in Part 551 of this Title. Renewals of such operating
certificates shall be issued for terms of up to three years, unless the Office
of Mental Health shall deem that a term less than three years is
appropriate.
(b) Each outpatient
program site shall be authorized by a separate operating certificate. The
operating certificate shall specify for each site:
(1) the program type to be
operated;
(2) the location of the
program;
(3) the hours of operation
of the program;
(4) the program
capacity for continuing day treatment, partial hospitalization and intensive
psychiatric rehabilitation treatment programs;
(5) the population to be served;
(6) the term of the operating certificate;
and
(7) any approved optional
services to be provided.
(c) Each outpatient program authorized by an
operating certificate pursuant to this Part shall be clearly identifiable. Each
outpatient program shall have separately identifiable staff, space and program
policies and procedures.
(d) The
county director of community services shall be responsible for identifying
specific licensed clinic treatment programs to be designated by the
commissioner as interim specialty clinic programs serving children in
accordance with the identified need within the county. In making such
identification, the county director of community services shall use the
following criteria:
(1) All licensed
satellites of a recommended provider in the same county shall be included if so
designated by the commissioner. New York City is one county for such
purposes.
(2) A county with less
than one percent of children in New York State, as defined in accordance with
section
587.4(a)(4) and
(8) of this Part, may have up to two
designated providers. If only one licensed clinic is included on the
recommended list, the county director of community services may recommend a
second licensed clinic without recent Medicaid experience serving children. The
Office of Mental Health may approve these recommendations based upon competence
of a licensed clinic treatment program to serve such children and upon
accessibility to the clinic by such children. Accessibility shall be based upon
a geographic area rather than a catchment area of the recommended licensed
clinic treatment program.
(3) A
county with at least one percent and less than three percent of the projected
number of children in New York State, as defined in accordance with section
587.4(a)(4) and
(8) of this Part, may recommend up to six
licensed clinic treatment programs including all licensed satellites of such
recommended providers.
(4) A county
with at least three percent and less than eight percent of the children in New
York State, as defined in accordance with section
587.4(a)(4) and
(8) of this Part, may recommend up to 10
licensed clinic treatment programs.
(5) The City of New York may recommend up to
85 licensed clinic treatment programs.
(6) New York City may reallocate the total
number of licensed clinics of the five boroughs which appear on the recommended
list amongst the five boroughs. However, no more than the total number of
licensed clinic treatment programs which appear on the list for the five
boroughs shall be designated as interim specialty clinic treatment programs
serving children.
(e)
The commissioner shall designate a licensed clinic treatment program to provide
interim specialty children's services to children as defined in accordance with
section
587.4(a)
of this Part. A clinic treatment program so designated shall be authorized to
provide, and be reimbursed for providing, clinic treatment services to children
notwithstanding the child's enrollment in a Medicaid managed care program. Such
a clinic shall be designated as an interim specialty clinic treatment program
serving children and shall operate in accordance with section
587.9
of this Part and Part 588 of this Title. An interim specialty clinic treatment
program serving children shall be determined to meet at least one of the
following criteria:
(1) In a county with less
than three percent of the projected population of children in New York State,
as defined in section
587.4(a)
of this Part, the criteria for inclusion as a designated interim specialty
clinic treatment program serving children includes:
(i) any licensed clinic treatment program,
including all licensed satellite locations within the county, that had total
Medicaid visits by children exceeding 400 visits annually for the most recent
completed State fiscal year; or
(ii) any one licensed clinic treatment
program location which had more than 200 Medicaid visits by children
representing more than 75 percent of total Medicaid volume of visits at that
location; or
(iii) all licensed
clinic treatment programs in a county with two or fewer clinic treatment
programs serving children; or
(iv)
all county-operated clinic treatment programs serving children.
(2) In a county with three percent
or more of the projected population of children in New York State, as defined
in section
587.4(a)(4) and
(8) of this Part, the criteria for inclusion
as a designated interim specialty clinic treatment program serving children
includes:
(i) any licensed clinic treatment
program, including all licensed satellites within the county or the City of New
York, which had total Medicaid visits by children exceeding 700 visits annually
for the most recent completed State fiscal year; or
(ii) any one licensed clinic treatment
program location which had more than 300 Medicaid visits by children
representing more than 50 percent of total Medicaid volume of visits at that
location; or
(iii) all licensed
clinic treatment programs primarily serving physically handicapped or
non-English speaking children; or
(iv) all county operated clinic treatment
programs.
(3) In a
county with one percent or more of the projected population of children in New
York State, as defined in accordance with section
587.4(a)(4) and
(8) of this Part, the commissioner shall not
designate a clinic treatment program as an interim specialty clinic treatment
program serving children which is not on the list recommended by the county
director of community services, even if the list contains less than the maximum
number of recommended clinic treatment programs as provided by the county
director of community services with the exception of clinic treatment programs
primarily serving special populations, including, but not limited to,
physically handicapped or non-English speaking children. Such clinic treatment
programs may be added to the list of recommended clinic treatment programs. Any
additions made to the list of recommended licensed clinic treatment programs
shall not increase the total number of programs to be designated as interim
specialty clinic treatment programs serving children in a county.
(f) Outpatient programs may
provide services at off-site locations. To the extent that such services are
provided in a given location on a regularly and routinely scheduled basis (full
or part time), such site shall be considered a satellite location and shall be
in compliance with subdivision (g) of this section. In determining the regular
and routine nature of services at a given site, the Office of Mental Health
shall take into consideration the volume of services, the number of recipients
receiving services, the number of staff assigned, the range of services
provided, and whether the site will be utilized on a permanent or temporary
basis.
(g) Off-site locations which
are determined by the Office of Mental Health to be satellite locations of a
primary program shall meet the following requirements:
(1) the satellite must be approved and
certified by the Office of Mental Health in accordance with procedures
established in Part 551 of this Title prior to operation;
(2) there shall be an explicit clinical and
administrative linkage between the satellite and the primary program which
includes, but is not limited to, methods of staff supervision, treatment
planning, review of treatment plans, maintenance of recipients' records and
utilization review;
(3) there shall
be adequate and sufficient staff to provide services at the satellite. The full
range of the primary program's services must be available as clinically
appropriate to recipients who utilize the satellite location; and
(4) satellite locations must meet the
physical plant requirements for program space set forth in section
587.19 of
this Part.
(h)
Establishment of a new program or changes to the operating certificate, other
than changes in the hours of operation, require prior approval of the Office of
Mental Health in accordance with Part 551 of this Title. Such changes include
the following:
(1) changes in the physical
space or location, use of additional sites, and change in capacity;
(2) termination of the program; or
(3) changes in the powers or purposes set
forth in the certificate of incorporation of the provider of service.
(i) Changes in the hours of
operation of a program may be made upon notification to the Office of Mental
Health and the Office of Mental Health's determination that the changes will
not negatively affect the program and will not increase the program's total
Medical Assistance revenue.
(j) An
operating certificate may be limited, suspended or revoked by the Office of
Mental Health pursuant to Part 573 of this Title. The operating certificate is
the property of the Office of Mental Health and as such shall be returned to
the Office of Mental Health if it should be revoked.
(k) The commissioner may reduce the capacity
of a program when it is determined that such program is not serving its
certified capacity at a reasonable level.
(l) The provider of service shall frame and
display the operating certificate within the outpatient program site in a
conspicuous place which is readily accessible to the public.
(m) The provider of service shall cooperate
with the Office of Mental Health during any review or inspection of the
outpatient program.
(n) The
commissioner shall have the authority to designate and approve demonstration
projects for purposes of examining innovative program and administrative
configurations; regulatory flexibility and alternative funding
methodologies.
