Section 501.3(a)(7) of Title 14 NYCRR requires the Office of Mental Health (OMH) to post requests for regulation waivers, and the Commissioner’s decision regarding those requests.
Date: December 18, 2019
Waiver Request:
Provider requested to renew approval for a physician assistant to treat established adult clients at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this clinic will continue to be best served by receiving psychiatric services from this experienced physician assistant who has adequate and appropriate supervision by a psychiatrist.
Date: November 20, 2019
Waiver Request:
Hospital requested approval to allow psychiatric nurse practitioners (NPPs) to perform and bill Medicaid for Brief Emergency Visits in its CPEP.
Regulations at Issue:
14 NYCRR Sections 590.4, 590.9, 591.3, and 591.4
Commissioner’s Decision:
The waivers are approved as it has been determined that they will enable the CPEP to see patients far more expeditiously, as an NPP can treat and discharge patients who only need medication or other brief services without requiring those patients to wait to see a psychiatrist. All NPPs hired at the CPEP will work under the supervision of the psychiatrist onsite at the CPEP. NPPs who are qualified and competent to treat youth, per the hospital’s new policy for NPPs in the CPEP, will be able to do so.
Date: October 28, 2019
Waiver Request:
Provider requested approval for a physician assistant to treat new and existing adult clients at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this clinic will be best served by receiving psychiatric services from this experienced physician assistant, along with a psychiatrist and a psychiatric nurse practitioner. The physician assistant will have adequate and appropriate supervision by a psychiatrist.
Date: September 24, 2019
Waiver Request:
A Waiver is required for the new Children’s Mental Health Rehabilitation Services (CMHRS) Program to account for the phase in of available State Plan services under Children and Family Treatment and Support Services covered under the license.
Regulations at Issue:
14 NYCRR Section 511-2.5
Commissioner’s Decision:
The waiver was approved to recognize that licensed CMHRS programs may not be able to make all services available under the license due to a phase in of services and the expectation of the need for growth and availability of services on a statewide basis. This waiver, applying to all OMH licensed CMHRS programs, is effective beginning July 17, 2019 and is valid until July 17, 2020; at which time OMH will reevaluate the need for the waiver.
Date: September 16, 2019
Waiver Request:
Provider received approval on June 3, 2019 for a physician assistant to primarily treat established adult clients and occasionally new adult clients, at both of its clinic treatment programs. Provider requested an amendment to that approval, to allow the physician assistant to treat new and established adolescent and adult clients ages 15 and up.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The amendment is approved as it has been determined that the physician assistant has the experience and clinical supervision needed to treat new and established clients ages 15 and up at the two clinics.
Date: August 28, 2019
Waiver Request:
Provider requested to renew approval for a physician assistant to treat adult clients at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this clinic will continue to be best served by receiving psychiatric services from this experienced physician assistant who has adequate and appropriate supervision by a psychiatrist.
Date: July 15, 2019
Waiver Request:
Provider requested a waiver of the discharge age criteria for a Children & Youth Community Residence.
Regulations at Issue:
14 NYCRR Section 594.8(a) and 594.8(i)
Commissioner’s Decision:
The waiver was approved to allow the extended stay of a particular individual, one week past his 19th birthday, until the next identified placement was available for his transition, in October 2018. This waiver applies solely to the treatment of this individual, and any future requests to waive this provision must be submitted to OMH.
Date: July 10, 2019
Waiver Request:
Provider requested a renewal waiver to allow commingling of adolescents and adults in an eating disorder unit.
Regulations at Issue:
14 NYCRR Section 580.6(b)(4)
Commissioner’s Decision:
A renewal waiver is approved with conditions related to staffing, assessment, and therapeutic programming in commingled setting, as well as ensuring adequate supervision and programming for individuals who are not appropriate for commingled groups. The waiver is effective for 10 months, through the renewal date of the operating certificate.
Date: July 10, 2019
Waiver Request:
Provider requested to approve four psychiatric nurse practitioners to provide Clinical Treatment services to adults at a PROS program in lieu of a psychiatrist.
Regulations at Issue:
14 NYCRR Section 512.7(d)(7)(iv)(a) and 512.7(d)(7)(v)(a)
Commissioner’s Decision:
The request is approved as it has been determined that the waiver will enable the PROS program to meet its participants’ clinical needs in the same setting as other PROS services, until the provider can recruit a psychiatrist to replace the PROS psychiatrist who recently resigned. The psychiatric nurse practitioners will have adequate and appropriate supervision by a psychiatrist.
Date: June 25, 2019
Waiver Request:
Provider requested approval of a family nurse practitioner (FNP), who has a federal waiver to prescribe buprenorphine in office-based settings, to provide psychiatric and physical health services in addition to continuing to provide Medication Assisted Treatment (MAT) to OASAS clients through the Integrated Outpatient Service of Substance Use Disorder (lOS-SUD) at a county-operated clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9(d)
Commissioner’s Decision:
The provider was informed that OMH has no objection to the FNP continuing to provide MAT at the clinic, and the clinic may increase this FNP’s hours to provide MAT and physical health services only.
Date: June 24, 2019
Waiver Request:
Provider requested to renew its waiver of the maximum capacity of 8 beds at an adolescent Community Residence for Eating Disorder Integrated Treatment (CREDIT) program.
Regulations at Issue:
14 NYCRR Section 594.5(g)(2)
Commissioner’s Decision:
The waiver is approved through December 31, 2021. It has been determined that the rights, health and safety of youth will not be diminished by renewing this waiver.
Date: June 20, 2019
Waiver Request:
Provider requested to approve a physician assistant to treat adult clients at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this clinic will be best served by receiving backup psychiatric services from this experienced physician assistant, who is also the clinic’s director. The physician assistant has adequate and appropriate supervision by a psychiatrist.
Date: June 17, 2019
Waiver Request:
Provider requested to approve a psychiatric nurse practitioner to provide Clinical Treatment services to adults at a PROS program in lieu of a psychiatrist.
Regulations at Issue:
14 NYCRR Section 512.7(d)(7)(iv)(a) and 512.7(d)(7)(v)(a)
Commissioner’s Decision:
The request is approved as it has been determined that the waiver will enable the PROS program to meet its participants’ clinical needs in the same setting as other PROS services, following the resignation of the program’s psychiatrist, until the provider can recruit a new psychiatrist. The psychiatric nurse practitioner will have adequate and appropriate supervision by a psychiatrist.
Date: June 17, 2019
Waiver Request:
Provider requested a waiver to allow the Mobile Crisis Team to connect with a psychiatrist located at a distance via telepsychiatry to augment clinical decision-making.
Regulations at Issue:
14 NYCRR Section 597(b)(1)
Commissioner’s Decision:
The waiver is approved through August 31, 2020.
Date: June 17, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through December 31, 2019.
Date: June 4, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through September 30, 2021.
Date: June 4, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through September 30, 2021.
Date: June 3, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services, primarily to established adult clients and occasionally new adult clients, at one of its clinic treatment programs. Provider also requested initial approval for the same physician assistant to provide psychiatric services to the same population at its other clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at the two clinics will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with psychiatrists, psychiatric nurse practitioners, and other physician assistants. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: June 3, 2019
Waiver Request:
Provider requested a waiver renewal to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: June 3, 2019
Waiver Request:
Provider requested a waiver renewal to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: June 3, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services to new and established clients ages 15 and up at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of adolescents and adults at this clinic will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with psychiatrists, psychiatric nurse practitioners, and other physician assistants. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: June 3, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services to new and established clients of all ages at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of adolescents and adults at this clinic will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with psychiatrists, psychiatric nurse practitioners, and other physician assistants. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: May 10, 2019
Waiver Request:
Provider requested to approve a physician assistant to provide psychiatric services to patients in a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of patients at this clinic treatment program will be best served by allowing this physician assistant to provide psychiatric services to established adult patients, along with a psychiatrist and a psychiatric nurse practitioner. The physician assistant will receive adequate and appropriate clinical supervision and consultation by a psychiatrist.
Date: May 2, 2019
Waiver Request:
Provider requested the specific approval of the Office of Mental Health to allow two 3-bedded rooms in a Community Residence for Eating Disorder Integrated Treatment (CREDIT) program for adults. Such approval is necessary for the Office of Mental Health to approve the pending PAR Application to open the proposed program
Regulations at Issue:
14 NYCRR Section 595.15(b)(1)(i)(a)
Commissioner’s Decision:
The request is approved as the bedroom space per resident is adequate, and it has been determined that the rights, health and safety of residents will not be diminished by this approval.
Date: April 30, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through June 30, 2021.
Date: April 30, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through March 1, 2022.
Date: April 4, 2019
Waiver Request:
Provider requested a waiver to allow various practitioners to deliver services via telepsychiatry to clients at their home location or other clinically appropriate community location.
Regulations at Issue:
14 NYCRR Section 596.5(a) and 596.7(b)(1)(2)(3), and (5).
Commissioner’s Decision:
The waiver is approved through November 30, 2020.
Date: April 4, 2019
Waiver Request:
Provider requested a waiver renewal to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through August 31, 2021.
Date: April 4, 2019
Waiver Request:
Provider requested a waiver renewal to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through November 30, 2021.
Date: March 13, 2019
Waiver Request:
Provider requested a waiver of a Medicaid reimbursement requirement for a Comprehensive PROS program.
Regulations at Issue:
14 NYCRR Section 512.11(f)(3)(ii)
Commissioner’s Decision:
The waiver request is approved as it has been determined that the needs of participants at this PROS program will be best served by removing the clinical treatment component of the PROS program and receiving clinical treatment at the provider’s clinic treatment program.
Date: February 28, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through February 28, 2022.
Date: February 26, 2019
Waiver Request:
Provider requested to waive requirements for clinics approved to offer Integrated Outpatient Services - Substance Use Disorder, including required services, staffing, utilization review, eligibility, admission, and billing criteria, at a clinic treatment satellite.
Regulations at Issue:
14 NYCRR Section 598.9(c)(3)(ii)(a)(b), 14 NYCRR Section 598.9(c)(4)(iii), 14 NYCRR Section 598.11(a)(2)(iii)(e), 14 NYCRR Section 598.12(c)(2) (i)(a)(b)(c)(d), 14 NYCRR Section 599.6(l)(2)(i)(ii), 14 NYCRR Section 599.8(a), and 14 NYCRR Section 599.14(f)(1)
Commissioner’s Decision:
The request to waive Section 599.6(l)(2)(i)(ii) is disapproved as it has been determined that OMH is unable to deviate from our determination that a review of the need for continued treatment in a clinic treatment program within seven months after admission and every six months thereafter is required.
The request to waive all other referenced regulations is approved in furtherance of the unique model and acute nature of services to be provided. The provider will use an innovative approach to provide immediate access to integrated mental health and substance use disorder services during extended hours, with the intent to divert unnecessary hospital emergency department presentations.
Date: February 26, 2019
Waiver Request:
Provider requested to renew a waiver to allow commingling of adolescents and adults in an early psychosis unit.
Regulations at Issue:
14 NYCRR Section 580.6(b)(4)
Commissioner’s Decision:
The request is approved as the hospital has continued to meet conditions related to staffing, assessment, therapeutic programming, and patient safety in a commingled setting.
Date: February 26, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services to adults at a satellite of a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this site will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with a psychiatrist. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: February 22, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: February 22, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: February 22, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: February 22, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: February 22, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through January 31, 2022.
Date: February 13, 2019
Waiver Request:
Provider requested a waiver to place a 17-year-old in an adult outpatient clinic.
Regulations at Issue:
14 NYCRR Section 599.1(b) and 14 NYCRR Section 599.1(c)
Commissioner’s Decision:
The waiver is approved to allow this particular individual to be placed in a satellite of an Adult Outpatient Behavioral Health Clinic, despite her age, in order to receive the services that meet her needs. This individual will turn 18 in August 2019 and will then be considered an adult. This waiver applies solely to the treatment of this individual, and any future requests to waive this provision must be submitted to OMH.
Date: February 13, 2019
Waiver Request:
Provider requested to renew a waiver of the requirement to employ at least one full-time registered nurse in a crisis residence for youth.
Regulations at Issue:
14 NYCRR Section 594.12(g)
Commissioner’s Decision:
The waiver is approved through January 31, 2022. It has been determined that the rights, health and safety of youth will not be diminished by this waiver, because necessary and appropriate nursing services will continue to be provided by nurses from other programs, which are in close proximity to the crisis residence.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to allow one of their psychiatrists to deliver services via telepsychiatry from their home offices in New York and California.
Regulations at Issue:
14 NYCRR Section 596.5(a) and 596.6(a)(1)(v)
Commissioner’s Decision:
The waiver is approved through February 29, 2020.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through April 30, 2020.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through April 30, 2020.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to contract with a Telemedicine Company for the provision of telepsychiatry services.
Regulations at Issue:
14 NYCRR Section 596.7(b)(8)(iii)
Commissioner’s Decision:
The waiver is approved through April 30, 2020.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through April 30, 2019.
Date: February 6, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through November 30, 2019.
Date: January 24, 2019
Waiver Request:
HCBS Waiver Individualized Care Coordination (ICC) Agency requested to waive the requirement for licensure in order to provide Other Licensed Practitioner (OLP) and Community Psychiatric Supports and Treatment (CPST) services to assure continuity of care for Waiver-enrolled children.
Regulations at Issue:
14 NYCRR Section 511.1(d)
Commissioner’s Decision:
The request is approved as it has been determined that the waiver will enable the provider to continue to serve children enrolled in the OMH 1915c Waiver receiving comparable Home and Community Based Services (HCBS) as they transition to becoming State Plan Children and Family Treatment and Support Services (CFTSS) beginning January 1, 2019. The waiver will assure continued access to services and continuity of care and will remain effective for up to 90 days after the Part 511.2 regulations are promulgated.
Date: January 24, 2019
Waiver Request:
HCBS Waiver Individualized Care Coordination (ICC) Agency requested to waive the requirement for licensure in order to provide Other Licensed Practitioner (OLP) and Community Psychiatric Supports and Treatment (CPST) services to assure continuity of care for Waiver-enrolled children.
Regulations at Issue:
14 NYCRR Section 511.1(d)
Commissioner’s Decision:
The request is approved as it has been determined that the waiver will enable the provider to continue to serve children enrolled in the OMH 1915c Waiver receiving comparable Home and Community Based Services (HCBS) as they transition to becoming State Plan Children and Family Treatment and Support Services (CFTSS) beginning January 1, 2019. The waiver will assure continued access to services and continuity of care and will remain effective for up to 90 days after the Part 511.2 regulations are promulgated.
Date: January 17, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through December 31, 2019.
Date: January 16, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services to adults at a satellite of a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this site will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with a psychiatrist. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: January 10, 2019
Waiver Request:
Provider requested to renew approval of a physician assistant to provide psychiatric services to children and adolescents at a clinic treatment program.
Regulations at Issue:
14 NYCRR Section 599.9
Commissioner’s Decision:
The request is approved as it has been determined that the needs of clients at this clinic treatment program will be best served by continuing to receive psychiatric services from this experienced physician assistant, along with psychiatric nurse practitioners on site and a psychiatrist via telepsychiatry. The physician assistant has established professional and clinical relationships at this agency, as well as adequate and appropriate supervision by a psychiatrist.
Date: January 2, 2019
Waiver Request:
Provider requested a waiver to offer an Intensive Outpatient Program level of service.
Regulations at Issue:
14 NYCRR Sections 599.13(e) and 599.14(c)
Commissioner’s Decision:
The waiver is approved through April 30, 2019.
Date: January 2, 2019
Waiver Request:
Provider requested to use a Medical Assistant in place of an LPN to provide the Optional Service of Health Monitoring at its clinic treatment programs.
Regulations at Issue:
14 NYCRR Sections 599.9(b)(18), 599.9(d)
Commissioner’s Decision:
The request is disapproved as it has been determined that Section 599.9(b)(18) does not allow OMH to deviate from our determination that the Health Monitoring service can only be reimbursed by Medicaid if it is provided by a licensed medical professional.