N.Y. Comp. Codes R. & Regs. tit. 14 § 594.8

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

Section 594.8 - Admission and discharge criteria

(a) Each program governed pursuant to this Part shall maintain written admission and discharge criteria which are consistent with its goals and objectives and which are subject to the approval of the Office of Mental Health.

(b) The admission criteria must, at a minimum, provide that the youth meet each of the following criteria:

(1) attainment of at least the 5th birthday but not the 18th, provided, however, that in the CREDIT program, the admission criteria must provide that the youth has attained at least the 12th birthday but not the 19th;

(2) a designated mental illness diagnosis which, for purposes of the CREDIT program, must include a diagnosis of an eating disorder, as such term is defined in this Part;

(3) substantial problems in social functioning due to a serious emotional disturbance within the past year;

(4) serious problems in family relationships, peer/social interaction or school performance. In a CREDIT program, serious problems in the family relationship/support system shall include circumstances in which:

(i) the family members and/or support systems demonstrate behaviors that are inconsistent with the goals of treatment, such that treatment at a lower level of care is unlikely to be successful; or

(ii) the family members and/or support systems do not possess the requisite skills to effectively manage the disease such that treatment at a lower level of care is unlikely to be successful;

(5) serious and persistent symptoms of cognitive, affective and personality disorders;

(6) a level of service need which requires multi-agency intervention and involvement; and

(7) in a community residence that is a CREDIT program, admission criteria shall also include documentation that the child demonstrates an inability to be managed at a lower level of care but does not require acute inpatient level of care.

(c) The provider of a teaching family home or community residence that is not a CREDIT program must establish an intake committee to review the applications of children and adolescents referred for admission to the program from the youth's home single point of access process (or similar successor process) and determine the eligibility for admission to such program. The intake committee shall, at a minimum, include appropriate representation from the residential program and other agencies impacting the care and treatment of the child such as, but not limited to, the local governmental unit, social service district, school district, and family and consumer representation.

(d) A referral for admission to a teaching family home or community residence program that is not a CREDIT program shall be submitted to the provider from the youth's home single point of access process (or similar successor process). Each referral must contain the following documents, and all assessments must have occurred within the last 90 days, except for the educational assessment which must have occurred within the last year:

(1) an updated medical report;

(2) a psychosocial assessment;

(3) a psychiatric evaluation;

(4) an educational assessment;

(5) a signed, parental/guardian informed consent form for admission;

(6) a description of the child's current behaviors and significant strengths and problems; and

(7) documentation that potentially less restrictive community, home and/or extended nonresidential services have been reasonably explored and are either not available or have not been successful.

(e) A referral for admission to a community residence that is a CREDIT program shall be received from a Comprehensive Care Center for Eating Disorders, or from the child's primary care physician or mental health provider. All assessments must have occurred within the last 30 days. Each referral must include the following documents:

(1) an updated medical report;

(2) a psychosocial assessment;

(3) a psychiatric evaluation;

(4) an educational assessment;

(5) a signed, parental/guardian informed consent form for admission;

(6) a description of the child's current behaviors and significant strengths and problems;

(7) documentation that potentially less restrictive community, home and/or extended non-residential services have been reasonably explored and are either not available or have not been successful;

(8) nutritional screening for eating disorder behaviors and nutritional status;

(9) psychological testing as needed; and

(10) assessment of the family system when appropriate by direct involvement with the family members.

(f) Prior to placement, each youth referred to a teaching family home or community residence, including a CREDIT program, shall be afforded at least one pre-placement visit to the teaching family home or community residence. Where appropriate, the family shall also be afforded such opportunity.

(g) Determination of eligibility for acceptance in the teaching family home or community residence, including a CREDIT program, must be made, once all intake materials have been received, within 10 working days.

(h) If the child is not accepted into the teaching family home or community residence that is not a CREDIT program, the provider shall send a notice of rejection to the youth's home single point of access committee (or similar successor process entity) and the child or adolescent's parent or guardian, accompanied by an explanation of the rejection and suggestion for other treatment alternatives. If the child is not accepted into a CREDIT program, the CREDIT program will send the notice of rejection to the referral source in a timely manner, but in no event not later than seven days after request has been made.

(i) Each provider shall develop a discharge policy and specific discharge criteria. The discharge policy shall indicate that the provider will begin discharge planning upon a child or adolescent's admission to the program. Although discharge planning shall begin prior to the youth's 18th birthday, the youth may remain in the program for up to one year following the 18th birthday, if clinically appropriate. The discharge plan must set forth the resident's functional levels and family and community supports needed to enable the youth to move home or live independently. Additionally, the discharge plan must identify goals for the youth to work towards which will strengthen his or her success upon discharge.

(j) As part of the discharge planning process, for both planned and unplanned discharges, the provider shall ensure that each child or adolescent and family is linked with the appropriate services needed for the youth to successfully transition into the community or other appropriate alternative. Attempts should be made to ensure that the discharge process allows for gradual transition to the child's discharge living environment.

(k) Teaching family homes and community residences, including CREDIT programs, shall maintain contact with youth and family for up to 90 days after discharge for the purpose of providing support during transition to the discharge living environment.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 594.8