N.Y. Comp. Codes R. & Regs. Tit. 14 §§ 511-2.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 511-2.4 - Definitions

For Purposes of this Part:

(a)Child means a person no more than 21 years of age.

(b)Collateral means a person who is a member of the child's family or household, or other individual who regularly interacts with the recipient and is directly affected by or has the capability of affecting his or her condition, and is identified in the treatment plan as having a role in treatment and/or is necessary for participation in the evaluation and assessment of the recipient prior to admission.

(c)Commissioner refers to the Commissioner of the New York State Office of Mental Health.

(d)Crisis episode means an acute psychological/emotional change a child or family member is experiencing which results in a marked increase in personal distress and which exceeds the abilities and the resources of those involved (e.g., provider, family member) to effectively resolve it.

(e)EPSDT means the Federal Early and Periodic Screening, Diagnostic, and Treatment benefit, which is a primary component of New York State's Medicaid program for children and adolescents. It affords a comprehensive array of preventive health care and treatments for Medicaid recipients from birth up until age 21 years.

(f)Family means a child's primary caregiving unit, and is inclusive of a wide diversity of primary caregiving units such as birth, foster, adoptive, grandparents, siblings, other kinship caregivers, or a self-created unit of people with significant attachment to one another.

(g)Licensed Practitioner of the Healing Arts (LPHA) means the following professional staff:

(1) Licensed Creative Arts Therapist operating within their scope of practice defined by the New York State Education Department;

(2) Licensed Marriage and Family Therapist operating within their scope of practice defined by the New York State Education Department;

(3) Licensed Mental Health Counselor operating within their scope of practice defined by the New York State Education Department;

(4) Licensed Nurse Practitioner operating within their scope of practice defined by the New York State Education Department;

(5) Licensed Nurse Practitioner in psychiatry certified as a psychiatric nurse practitioner by the New York State Education Department. For purposes of this Part, nurse practitioner in psychiatry shall have the same meaning as psychiatric nurse practitioner, as defined by the New York State Education Department;

(6) Licensed Physician operating within their scope of practice defined by the New York State Education Department or possesses a permit from the New York State Education Department;

(7) Licensed Physician's Assistant operating within their scope of practice defined by the New York State Education Department;

(8) Licensed Psychiatrist operating within their scope of practice defined by the New York State Education Department and who is certified by, or eligible to be certified by, the American Board of Psychiatry and Neurology;

(9) Licensed Psychoanalyst operating within their scope of practice defined by the New York State Education Department;

(10) Licensed Psychologist operating within their scope of practice defined by the New York State Education Department;

(11) Licensed Registered Professional Nurse operating within their scope of practice defined by the New York State Education Department; and

(12) Licensed Social Worker as a master social worker or clinical social worker, operating within their scope of practice defined by the New York State Education Department

(h)Medical Necessity means that the medical, dental, and remedial care, services, and supplies are necessary to prevent, diagnose, correct, or cure conditions in the person that cause acute suffering, endanger life, result in illness or infirmity, interfere with such person's capacity for normal activity, or threaten some significant handicap and which are furnished an eligible person in accordance with state law.

(i)Mental illness means an affliction with a mental disease or mental condition which is manifested by a disorder or disturbance in behavior, feeling, thinking or judgment such an extent that the person afflicted requires care, treatment and rehabilitation.

(j)Non-physician Licensed Behavioral Health Practitioner (NP-LBHP) means the following practitioners licensed to practice:

(1) Licensed Psychoanalyst operating within their scope of practice defined by the New York State Education Department;

(2) Licensed Clinical Social Worker operating within their scope of practice defined by the New York State Education Department.

(3) Licensed Marriage and Family Therapist operating within their scope of practice defined by the New York State Education Department;

(4) Licensed Mental Health Counselor operating within their scope of practice defined by the New York State Education Department;

(5) Licensed Master Social Worker operating within their scope of practice defined by the New York State Education Department and providing services under the supervision of a Licensed Clinical Social Worker, Licensed Psychologist, or Psychiatrist.

(k)Office means the Office of Mental Health.

(l)Provider of Service is the entity that is legally responsible for the operation of a program. Such entity may be an individual, partnership, association, limited liability corporation, or corporation

(m)Rehabilitative Services means therapeutic interventions and services intended to help a child maintain, restore, or improve developmentally-appropriate skills and functional abilities necessary for daily living, including skills related to communication, that have been lost or impaired due to a child's disability.

N.Y. Comp. Codes R. & Regs. Tit. 14 §§ 511-2.4

Adopted New York State Register July 17, 2019/Volume XLI, Issue 29, eff. 7/17/2019