New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 593 - Medical Assistance Payments For Community Rehabilitation Services Within Residential Programs For Adults And Children And Adolescents
Section 593.4 - Definitions

(1) In residence means currently admitted to and residing in a program governed by this Part and not on leave as an inpatient of any hospital for any reason or temporarily residing in any other licensed residential facility.

(2) Qualified mental health staff person means:

(3) A congregate residence, for the purpose of this Part, means a group living design requiring supervisory staff on-site 24 hours per day.

(4) An apartment, for the purpose of this Part, means a program organized as a self- contained unit requiring an appropriate level of staff support.

(5) A residential program for children and adolescents, for the purpose of this Part, means teaching family home and community residence programs licensed pursuant to Part 594 of this Title.

(6) Downstate, for the purpose of this Part, means New York City and Nassau, Suffolk and Westchester Counties.

(7) Upstate, for the purpose of this Part, means all other counties not included in paragraph (6) of this subdivision.

(8) Approved costs, for the purpose of this Part, means the prospective annual expenditures approved by the Office of Mental Health and the Division of the Budget for each provider of rehabilitation services.

(1) Assertiveness/self advocacy training means training which is designed to promote the individual's ability to assess his or her needs to make a life status change and to increase self-awareness about his or her values and preferences. Training will also increase an individual's ability to respond to medical, safety and other personal problems. Activities are also intended to improve communication skills and facilitate appropriate interpersonal behavior.

(2) Community integration services/resource development means activities which are designed to help individuals to identify skills and community supports necessary for specific environments, to assess their skills strengths and deficits in relationship to environmental demands, to assess resources available to help the individuals, and to develop a natural support system by accessing social, educational and recreational opportunities.

(3) Daily living skills training means activities which focus on the acquisition of skills and capabilities to maintain primary activities of daily life. Services are provided by addressing areas of functioning in categories such as: dressing, personal hygiene and grooming, selection and/or preparation of food, cleaning and washing of clothes, maintenance of environment, budgeting and money management. Training is intended to increase those competencies needed by the individual to live in his or her goal environment.

(4) Health services means training to maximize independence in personal health care by increasing the individual's awareness of his or her physical health status and the resources required to maintain physical health, including regular medical and dental appointments, basic first aid skill and basic knowledge of proper nutritional habits and family planning. Also included is training on topics such as AIDS awareness.

(5) Medication management and training means the storage, monitoring, recordkeeping and supervision associated with the self-administration of medication. This does not include prescribing, but does include a certain degree of reviewing the appropriateness of the residents' existing regimen with his or her physician. Activities which focus on educating residents about the role and effects of medication in treating symptoms of mental illness and training in the skill of self-medication are also included.

(6) Parenting training means structured activities intended to promote positive family functioning and enable residents to assume parenting responsibilities. Activities include peer support groups to foster skills around effective parenting, assistance in selecting and obtaining housing appropriate for families, and linkage with the children's service system. Psycho-education programs on parenting skills, single parenting issues, child care and the nature of mental illness and its effect on the family are also included.

(7) Rehabilitation counseling means a therapeutic modality which includes assisting the individual in clarifying future directions and the potential to achieve rehabilitation goals, identifying and specifying behaviors that impede goal setting, improving awareness of the influence of environmental stress, and helping an individual to generalize newly learned behaviors to housing and other situations outside the program structure.

(8) Skill development services means activities which assist clients to gain and utilize the skills necessary to undertake employment or pursue educational opportunities. This may include skills related to securing appropriate clothing, scheduling, work-related symptom management, and work readiness training.

(9) Socialization means activities which are intended to diminish tendencies toward isolation and withdrawal by assisting residents in the acquisition or development of social and interpersonal skills. Socialization is an activity meant to improve or maintain a resident's capacity for social involvement by providing opportunities for application of social skills. This occurs through resident and staff interaction in the program and through exposure with staff to opportunities in the community. Modalities used in socialization include individual and group counseling and behavior intervention.

(10) Substance abuse services means services provided to increase the individual's awareness of alcohol and substance abuse and reduction or elimination of its use: such services shall include verbal and medication therapies, psycho-educational approaches and relapse prevention techniques, but shall not include acupuncture without prior Office of Mental Health approval.

(11) Symptom management, for the purpose of this Part, means activities which are intended to achieve a maximum reduction of psychiatric symptoms and increased functioning. This includes the ongoing monitoring of residents' mental illness symptoms and response to treatment, interventions designed to help residents manage their symptoms and assisting residents to develop coping strategies to deal with internal and external stressors. Services range from providing guidance around everyday life situations to addressing acute emotional distress through crisis management and behavior intervention techniques.

(1) Behavior management training means activities which provide guidance and training in behavior intervention techniques and practice of skills to increase the capacity to manage one's behavior from everyday life situations to acute emotional stress. Such activities shall focus on interventions which assist in identifying internal or external stressors and developing coping strategies to address such stressors.

(2) Counseling services means the use of individual or group therapeutic modalities which provide an environment for assisting in clarifying future direction, identifying personal potential, identifying behaviors or feelings that assist or interfere with the achievement of goals; identifying and working through internal issues that interfere with daily functioning. Such modalities shall also foster the development of skills which assist in the reinforcing and generalizing of newly-learned positive behaviors to school, home and other community situations outside of the program structure.

(3) Daily living skills training means activities which focus on the acquisition of skills and capabilities to perform primary activities of daily life. The activities which are provided address areas of functioning such as: dressing, personal hygiene and grooming, selection and preparation of food, cleaning and washing of clothes, maintenance of the environment, and budgeting and money management. Such activities shall increase the responsibility needed to maintain the primary activities of daily life.

(4) Family support services means activities which are needed to maintain a relationship with one's family. Such activities shall provide training in skills needed for success in the discharge living environment and for maintaining a relationship with family. Opportunities to practice and develop skills should be provided in addition to establishing an ongoing linkage to the discharge living environment.

(5) Health services means activities which increase developmentally appropriate independence in personal health care and maintenance. Such activities include but are not limited to addressing values clarification regarding one's body and health, helping youth make choices regarding one's body and health, increasing awareness of personal physical health, basic nutrition, the dangers of substance abuse, sexual development, sexually transmitted diseases and HIV/AIDS, the role of exercise and sleep, as well as identifying practices and resources necessary to maintain physical health.

(6) Independent living skills training mean activities which assist with the integration of developmentally responsible behaviors and generalization of skills for the purpose of completing educational requirements, meeting citizen requirements, setting up and managing a household, seeking and maintaining an educational placement or job, identifying and accessing positive supports, and responsible decisionmaking in the community.

(7) Medication management and training means activities which provide information to ensure appropriate management of medication through understanding the role and effects of medication in treatment, identification of side effects of medication and discussion of potential dangers of consuming other substances while on medication. Training in self medication skills is also an appropriate activity, when developmentally and clinically indicated.

(8) Socialization means activities which assist in the development and practice of age appropriate social and interpersonal skills. Such activities shall promote the capacity to identify and participate in positive social situations and to develop and practice appropriate communication skills. Modalities used to reinforce the development of socialization skills may include modeling, individual and group counseling and behavioral interventions in a variety of settings with both adults and peers.