New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 594 - Operation Of Licensed Housing Programs For Children And Adolescents With Serious Emotional Disturbances
Section 594.4 - Definitions

(1) Admission criteria means factors which are identified for use by the provider of services in determining a youth's eligibility for admission to a licensed housing program.

(2) Child, adolescent, or youth means:

(3) Collaterals means members of the child or adolescent's family or household, or significant others other than staff members of mental health programs, who regularly interact with the child or adolescent and are directly affected by or have the capability of affecting the child's or adolescent's condition and are identified in the service plan as having a role in treatment.

(4) Community Residence Program (CR) means a program which provides a therapeutic environment for six to eight children and adolescents with serious emotional disturbances whose individual treatment issues preclude family settings or who may need to prepare for independent living. The focus of the program is to develop and implement a plan with the youth and family on how to live successfully and productively in a community, attend school or prepare for employment and develop the skills needed to return to more normative environments. The program emphasizes consumer and family-driven integration in the community, collaboration with other service providers, consumer input and family involvement, and development of community life roles and natural supports.

(5) Community Residence for Eating Disorder Integrated Treatment Program (CREDIT program) is a subclass of community residence program for children and adolescents who have been diagnosed with an eating disorder, whose individual treatment issues preclude family settings or other less restrictive alternatives.

(6) Crisis residence means a program which provides a short-term (1-21 day) crisis residential option for children and adolescents experiencing a crisis which threatens psychiatric stability and provides crisis supports to the youth, the family and/or to the service provider. The goal of the program is to stabilize the crisis situation; support the family's or service provider's efforts to maintain the child or adolescent in his or her current residence, and to decrease the inappropriate use of an inpatient facility or other out-of-home placements.

(7) Designated mental illness diagnosis means that the youth currently meets the criteria for a psychiatric diagnosis in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), or has a diagnosis of an eating disorder as defined in this section, but excluding alcohol or drug disorders, organic brain syndromes, developmental disabilities or social conditions (V-codes). ICD-9-CM categories and codes that do not have an equivalent in DSM-III-R are also not included as designated mental illness diagnosis.

(8) Discharge planning means the continuing process of planning for termination of services from a licensed housing program through the utilization of an individual's strengths in the identification of residential or other community resources and natural supports needed for the transition of the resident to another residential option or return to the family and making the necessary referrals, including linkages for treatment, rehabilitative and support services.

(9) Eating disorder shall have the same meaning as defined in section 2799-e of the Public Health Law and shall include, but not be limited to, conditions such as anorexia nervosa, bulimia and binge eating disorder, identified as such in the most current edition of the International Classification of Disease or the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, or other medical and mental health diagnostic references generally accepted for standard use by the medical and mental health fields.

(10) Family-centered care means the degree to which a service is oriented toward meeting the needs of the family rather than requiring the family to conform to the nature of the program.

(11) Provider of service means the entity which is responsible for the operation of a program. Such entity may be an individual, partnership, association or corporation.

(12) Qualified mental health staff person means:

(13) Teaching family home program (TFHP) means a program which provides an individually tailored treatment-oriented residential environment for children and adolescents with serious emotional disturbances. Each individual home can serve up to four children and adolescents. The program utilizes carefully selected and trained teaching parents and child care staff who provide services, support and education to the youth and their families. The youths' mental health-related challenges may preclude them from the closeness of a family setting and are best addressed in a small group setting. The focus of the program is to provide the necessary supports and teaching to ensure that each youth will be able to live successfully in a family or independently, can meet with success in school or vocational activities, and live productively in the community. The program emphasizes integration in the community, collaboration with other service providers, consumer input and family involvement.

(1) Behavior support (also known as 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. In the CREDIT program, "behavioral support" includes specific attention towards managing the secondary issues which may accompany an eating disorder such as depression, anxiety and substance abuse.

(2) Case management means the process of linking the youth and family, where appropriate, to the community service system and coordinating the provision of services with the objective of continuity of care and service. Case management includes the following components:

(3) Counseling services means the use of individual or group therapeutic modalities which provide an environment for assisting in clarifying future direction, developing meaningful goals, identifying personal strengths, identifying mental health-related behaviors or feelings that assist or interfere with the achievement of goals, and integrating into the community. Such modalities shall also foster the development of skills which assist in the reinforcing and generalizing of newly learned positive behaviors to school, home, employment and other community situations outside of the program structure. In the CREDIT program, counseling services includes specific emphasis on assisting children and adolescents in developing appropriate body image as well as wellness self-management techniques for maintaining this progress.

(4) 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. In the CREDIT program, daily living skills training includes specific emphasis on the planning, preparation and consumption of nutritious meals.

(5) Educational-vocational support services means activities which include training, practice and supervision to promote regular attendance at school or work, including completion of homework or work assignments, while encouraging accuracy and neatness in homework assignments, development of time management and prioritization of tasks and facilitation of positive teacher/supervisor relations.

(6) Family support services means activities which are needed to maintain and/or develop a positive relationship with one's family. Such activities shall provide training in skills needed for success in the discharge living environment such as implementation of a safety plan which includes ongoing family support and for maintaining a positive relationship with family. Opportunities to practice and develop skills should be provided in addition to establishing an ongoing linkage to treatment, rehabilitative and support services in the discharge living environment.

(7) 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 to make choices regarding their health and welfare, 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. In the CREDIT program, health services may also include assistance and monitoring of the youth's activities relating to food, meals, and weight management.

(8) Independent living skills training means activities which assist with the integration of developmentally responsible behaviors and generalization of skills for the purpose of completing educational and vocational requirements, meeting citizenship 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.

(9) 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.

(10) Medication monitoring means activities performed by staff which relate to storage, monitoring, recordkeeping and supervision associated with the use of medication. Such activities include reviewing the appropriateness of an existing regimen by staff with the prescribing physician. Prescribing medication is not an activity included under this service.

(11) Respite means the provision of brief temporary care to children and youth with serious emotional disturbances, with the primary purpose of providing relief to families or caretakers. Such care may occur while the child is out of home or in home.

(12) 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 direct skill teaching, modeling, individual and group counseling and behavioral interventions in a variety of settings with both adults and peers.