OMH-09-09-00002-A Operation of Residential Programs for Adults

5/20/09 N.Y. St. Reg. OMH-09-09-00002-A

NEW YORK STATE REGISTER

VOLUME XXXI, ISSUE 20

May 20, 2009

RULE MAKING ACTIVITIES

OFFICE OF MENTAL HEALTH

NOTICE OF ADOPTION

 

I.D No. OMH-09-09-00002-A

Filing No. 495

Filing Date. May. 05, 2009

Effective Date. May. 20, 2009

Operation of Residential Programs for Adults

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:

Action taken:

Amendment of Part 595 of Title 14 NYCRR.

Statutory authority:

Mental Hygiene Law, sections 7.09 and 31.04

Subject:

Operation of Residential Programs for Adults.

Purpose:

To amend Part 595 to include a new class of community residences for treatment of eating disorders.

Substance of final rule:

Summary

This rule will amend 14 NYCRR Part 595, Operation of Residential Programs for Adults, by establishing a new sub-class of community residence for individuals over the age of 18 who have been diagnosed as having an eating disorder such as anorexia nervosa, bulimia, binge eating disorder, or other eating disorder identified as such in generally accepted medical or mental health diagnostic references.

Overview

The new category of community residences will be known as Community Residences for Eating Disorder Integrated Treatment (CREDIT), and will address the needs of adults who have been referred by a provider who is a participant in a Comprehensive Care Center for Eating Disorders (CCCED) designated by the State Department of Health or by the individual's primary care physician or mental health provider, and whose individual treatment issues preclude being served in a family setting or other less restrictive residential alternative.

Requirements

CREDIT programs will be required to have written affiliation agreements with CCCED providers, which must include referral and admission procedures, as well as procedures for crisis clinical back-up. The agreements will be subject to approval by the Office of Mental Health, and will be required to assure continuity and integration of care with the CCCED. The agreements will provide, at a minimum, for the following:

• The performance of a psychiatric assessment;

• The development of an integrated service plan;

• The performance of a medical examination;

• The supervision of meal, bathroom and exercise time;

• Family participation, as appropriate.

CREDIT programs will be required to have sufficient staff to meet the special needs of individuals residing in a community residence who have been diagnosed with an eating disorder. Services will be required to be provided pursuant to an initial service plan developed by program staff with the resident and family and/or any collateral identified for participation within three days of admission, and a more extensive plan to be developed within four weeks of admission. The CREDIT program will be required to complete progress notes weekly.

Non-substantive changes to previous rulemaking

The non-substantive changes in the final version of the rulemaking serve to specify the appropriate chapter of the Life Safety Code (LSC) for new and existing residences. The changes clarify that newly constructed residences shall be governed by the LSC chapter on new construction and that existing buildings which are converted to use as residential programs shall be governed by the chapter on the LSC on existing construction.

Final rule as compared with last published rule:

Nonsubstantive changes were made in section 595.15(a)(2).

Text of rule and any required statements and analyses may be obtained from:

Joyce Donohue, NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, [phone], email: [e-mail]

Revised Regulatory Impact Statement

A revised regulatory impact statement is not submitted with this notice because the non-substantive changes in the final version of the rulemaking merely serve to specify the appropriate chapter of the Life Safety Code (LSC) for new and existing residences. The changes clarify that newly constructed residences shall be governed by the LSC chapter on new construction and that existing buildings which are converted to use as residential programs shall be governed by the chapter of the LSC on existing construction.

Revised Regulatory Flexibility Analysis

Because it is evident from the nature of the non-substantive changes in the final version of the rulemaking that there will be no adverse economic impact on small businesses or local governments, a regulatory flexibility analysis is not submitted with this notice. The changes merely serve to specify the appropriate chapter of the Life Safety Code (LSC) for new and existing residences. The changes clarify that newly constructed residences shall be governed by the LSC chapter on new construction and that existing buildings which are converted to use as residential programs shall be governed by the chapter of the LSC on existing construction.

Revised Rural Area Flexibility Analysis

A Rural Area Flexibility Analysis is not submitted with this notice because the non-substantive changes in the final version of the rulemaking merely serve to specify the appropriate chapter of the Life Safety Code (LSC) for new and existing residences. The changes clarify that newly constructed residences shall be governed by the LSC chapter on new construction and that existing buildings which are converted to use as residential programs shall be governed by the chapter of the LSC on existing construction. There is no adverse economic impact on rural areas.

Revised Job Impact Statement

A Job Impact Statement is not submitted with this notice because the non-substantive changes in the final version of the rulemaking merely serve to specify the appropriate chapter of the Life Safety Code (LSC) for new and existing residences. The changes clarify that newly constructed residences shall be governed by the LSC chapter on new construction and that existing buildings which are converted to use as residential programs shall be governed by the chapter of the LSC on existing construction.

Assessment of Public Comment

The agency received two letters in support of the adoption of Part 595 of Title 14 NYCRR. The letters indicated that the rate of eating disorders among all age groups continues to rise both in New York State and throughout the country. In addition, eating disorders can have severe effects on a patient's physical and mental health, and effective treatment requires an integrated team approach involving a physician, mental health provider, dietitian and supportive therapies. There are patients who require more than outpatient services to manage their eating disorder, and a structured treatment program offered in a residential setting may be needed to facilitate recovery. Since a residential component for the treatment of eating disorders has not previously been available in New York State, many patients are forced to go out of state to access this level of care. The CREDIT program will help to alleviate this problem and allow therapeutic work to be done with the patient and his/her family.