Operation of Psychiatric Inpatient Units of General Hospitals
14 NYCRR Parts 580, 582, and 587
Adoption

14 NYCRR Parts 580, 582, and 587
Express Terms

1.  Part 580 of Title 14 NYCRR Is amended to read as follows:

Part 580
OPERATION OF PSYCHIATRIC INPATIENT UNITS OF GENERAL HOSPITALS
(Statutory Authority:  Mental Hygiene Law, §§ 7.09, 9.39, 7.21, 29.15, 29.29, 31.02, 31.04, 45.19; Social Services Law §365-m)

(d)  Section 365-m of the Social Services Law authorizes the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services, in consultation with the Department of Health, to contract with regional behavioral health organizations to provide administrative and management services for the provision of behavioral health services. 

(b)  Behavioral Health Organization or BHO means an entity selected by the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services pursuant to Section 365-m of the New York State Social Services Law to provide administrative and management services for the purposes of conducting concurrent review of Behavioral Health admissions to inpatient treatment settings, assisting in the coordination of Behavioral Health Services, and facilitating the integration of such services with physical health care. 

(e)  Concurrent Review means the review of the clinical necessity for continued inpatient Behavioral Health Services, resulting in a non-binding recommendation regarding the need for such continued inpatient services.

580.11  Behavioral health organizations.

The facility shall cooperate with designated regional behavioral health organizations.  Such cooperation shall include, but not be limited to:

(a)  notifying the appropriate behavioral health organization of an admission for a behavioral health condition for which coverage  is provided by Medicaid on a fee-for-service basis to an individual who is not also enrolled in the Medicare program.  Such notification shall be provided within 24 hours of such admission or, for an admission occurring on a Friday, Saturday, Sunday or public holiday, by 5:00 p.m. on the next business day following such admission.  When Medicaid coverage cannot be determined at the time of admission, notification shall be provided as soon as practicably possible after confirmation of Medicaid eligibility, but in no event more than 24 hours after such confirmation or, for a confirmation made on a Friday, Saturday, Sunday or public holiday, later than 5:00 p.m. of the next business day following such confirmation ;

(b)  cooperating with concurrent review activities;

(c)  ensuring that the discharge plan for such an individual includes consideration of physical health needs and services;

(d)  notifying such behavioral health organization within 24 hours of the discharge of such an individual or, for a discharge occurring on a Friday, Saturday, Sunday or public holiday, by 5:00 p.m. on the next business day following such discharge;

(e)  receiving and providing physical and mental health information, pursuant to Section 33.13 (d) of the Mental Hygiene Law; and

(f)  seeking to obtain, as needed, such individual’s consent to receive and provide information regarding such individual’s substance use problems. 

Part 582
OPERATION OF HOSPITALS FOR PERSONS WITH MENTAL ILLNESS
(Statutory Authority:  Mental Hygiene Law, §§ 7.09, 7.21, 29.15, 29.29, 31.04(a), 31.35, 45.19;
 Social Services Law §365-m)

(e)  Section 365-m of the Social Services Law authorizes the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services, in consultation with the Department of Health, to contract with regional behavioral health organizations to provide administrative and management services for the provision of behavioral health services. 

(b)  Behavioral Health Organization or BHO means an entity selected by the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services pursuant to Section 365-m of the New York State Social Services Law to provide administrative and management services for the purposes of conducting concurrent review of Behavioral Health admissions to inpatient treatment settings, assisting in the coordination of Behavioral Health Services, and facilitating the integration of such services with physical health care. 

(e)  Concurrent Review means the review of the clinical necessity for continued inpatient Behavioral Health Services, resulting in a non-binding recommendation regarding the need for such continued inpatient services.

582.11  Behavioral health organizations.

The facility shall cooperate with designated regional behavioral health organizations.  Such cooperation shall include, but not be limited to:

(a)  notifying the appropriate behavioral health organization of an admission for a behavioral health condition for which coverage  is provided by Medicaid on a fee-for-service basis to an individual who is not also enrolled in the Medicare program. Such notification shall be provided within 24 hours of such admission or, for an admission occurring on a Friday, Saturday, Sunday, or public holiday, by 5:00 p.m. on the next business day following such admission. When Medicaid coverage cannot be determined at the time of admission, notification shall be provided as soon as practicably possible after confirmation of Medicaid eligibility, but in no event more than 24 hours after such confirmation or, for a confirmation made on a Friday, Saturday, Sunday or public holiday, later than 5 p.m. of the next business day following such confirmation;

(b)  cooperating with concurrent review activities;

(c)  ensuring that the discharge plan for such an individual includes consideration of physical health needs and services;

(d)  notifying such behavioral health organization no later than 24 hours subsequent to the discharge of such an individual or by 5:00 p.m. the next business day following Friday, Saturday, Sunday and public holiday discharges;

(e)  receiving and providing physical and mental health information, pursuant to Section 33.13 (d) of the Mental Hygiene Law; and

(f)  seeking to obtain, as needed, such individual’s consent to receive and provide information regarding such individual’s substance use problems.

PART 587
OPERATION OF OUTPATIENT PROGRAMS
(Statutory Authority:  Mental Hygiene Law, §§ 7.07, 7.09, 7.15, 7.31, 31.02, 31.04, 31.92, 31.94, 43.02; Social Services Law §§ 364(3), 364-a(1), 365-m)

(j)  Section 365-m of the Social Services Law authorizes the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services, in consultation with the Department of Health, to contract with regional behavioral health organizations  to provide administrative and management services for the provision of behavioral health services.

(b) Program definitions.

587.14  Behavioral health organizations.

Providers shall cooperate with the designated regional behavioral health organizations and shall be authorized pursuant to Section 33.13(d) of the Mental Hygiene Law to exchange clinical information concerning clients with such organizations.  Information so exchanged shall be limited to the minimum necessary in light of the reason for the disclosure.  Such information shall be kept confidential and any limitations on the release of such information imposed on the party giving such information shall apply to the party receiving such information.

580.582.587.text.3.5.12