N.Y. Comp. Codes R. & Regs. tit. 14 § 587.5

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

Section 587.5 - Certification

(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.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 587.5

Amended, New York State Register, Volume XXXVI, Issue 22, effective 6/4/2014