14 CRR-NY 671.1NY-CRR

14 CRR-NY 671.1
14 CRR-NY 671.1
671.1 Background and intent.
(a) This Part establishes standards for the delivery of community residential habilitation services (see section 671.5 of this Part) to persons (see glossary) with developmental disabilities (see glossary) who require such services in order to assist the person to reach his/her best possible functional level and/or to prevent the loss of skills or capacity due to aging or the presence of a degenerative condition.
(b) The expressed treatment goal of community residential habilitation services shall be to assist the person to reach his/her best functional level. The overall goal of all community residential habilitation services shall be to promote and encourage independence, integration, individualization and productivity (see section 671.6[a][5][ii] of this Part).
(c) Community residential habilitation services, as governed by this Part shall be delivered by providers (see glossary) authorized by OPWDD to provide such services in supervised and supportive community residences. The requirements of this Part constitute the program planning and service delivery standards applicable in this facility class.
(d) Allowable (see glossary) services by an authorized provider (see glossary) are those appropriately supervised (see glossary) activities interventions and therapies which are designed and implemented for the maximum reduction of functional and/or behavioral deficits associated with the person's developmental disability and/or a concurrent medical condition.
(e) This Part establishes standards for reimbursement and financial reporting under the medical assistance program for home and community-based services waiver community residential habilitation services delivered in community residences by providers of services (see section 1.03[5] of the New York State Mental Hygiene Law) to eligible persons with developmental disabilities. The standards of reimbursement in section 671.7 of this Part shall be in effect as long as continued Federal financial participation is available. Absent Federal financial participation, other sources of reimbursement will be utilized.
(f) This Part establishes standards for service planning and review for the delivery of community residential habilitation services reimbursed under the medical assistance program or other sources, and substitutes and supersedes the existing program planning and associated review regulatory requirements in certified community residences.
(g) As used herein, the terms people and person(s) shall be understood to refer to those who are eligible to receive, and are receiving services from an authorized provider.
(h) The OPWDD certification process described below is superseded by requirements in Part 619 of this Title, effective on the effective date of these regulations. This Part (with the exception of sections 671.1, 671.2, 671.3, 671.7 and 671.99 of this Part) is organized in a format consisting of principles of compliance and standards of certification. In reviewing the continued eligibility of a facility for an operating certificate, OPWDD (see glossary) shall survey for compliance with all “standards of certification” herein and any other applicable requirements. OPWDD may make inquiries into and evaluate evidence of noncompliance with the applicable “principles of compliance”. The detailed premises for the principles of compliance and standards of certification format may be found at section 633.2 of this Title. However, in general:
(1) Principles of compliance set forth the basic conditions for the operation of a facility. Facilities will not be routinely examined against principles of compliance at surveys for recertification. OPWDD reserves the right to monitor compliance with any applicable requirements at any time pursuant to the responsibilities of the commissioner (see glossary) under the Mental Hygiene Law.
(2) Standards of certification are criteria specified by OPWDD as necessary for compliance in order for a facility to demonstrate on a regular and ongoing basis that it can and will continue providing the appropriate environment to assure an adequate level of quality of care, welfare, individual rights, safety, and fiscal accountability. Surveys are conducted for the purpose of documenting compliance with standards of certification. Compliance with all applicable statutes and regulations, or an acceptable plan of correction, is a basis for issuing an operating certificate and/or renewing an operating certificate.
(i) Nothing herein shall be interpreted to preclude a person from being eligible for and, receiving the HCBS waiver services set forth at Subpart 635-10 in section 635-10.4(b)(2) and (c)-(f) of this Title in different authorized facilities, or from more than one provider of services as long as the providers coordinate the development of the person's plan(s) of services and take steps to ensure that there is no duplication of payment for the same service delivered at the same time by the same staff. The latter shall not be interpreted to mean that the person may not receive comparable services targeted toward achievement of similar outcomes (see glossary) in different authorized facility classes or locations, or using similar activities, interventions, or therapies.
(j) Community residential habilitation services to eligible persons shall be delivered in the environment(s) most conducive to promoting effective training and skill generalization. Thus, while such services are authorized for delivery by a specifically designated certified authorized provider, it is presumed and encouraged that, where feasible and appropriate, the activities, interventions and therapies associated with the services, shall make appropriate use of community environments which allow for interaction with those without disabilities.
(k) Every person approved for receipt of community residential habilitation services shall be assisted by a specific case manager chosen by him or herself or his/her advocate (see glossary), regardless of the type or amount of community residential habilitation service(s) received.
(1) The chosen case manager is responsible for assisting the person and/or his/her advocate, as needed, in creating and sustaining an individualized service environment by developing, implementing, reviewing and revising the person's plan of service. To the extent possible, providers of case management services shall attempt to ensure the avoidance of a conflict of interest between the provision of case management services and other services in which the person is participating or receiving.
(2) Appropriate case management services activities include the following areas as defined further in 10 NYCRR 505.16:
(i) development of a comprehensive case management plan which shall incorporate the provisions of the person's community residential habilitation services' plan of services developed pursuant to this Part;
(ii) intake and screening;
(iii) assessment and reassessment;
(iv) coordination of the case management plan;
(v) implementation of the case management plan;
(vi) crisis intervention;
(vii) monitoring and follow-up; and
(viii) counseling for exit planning.
(l) The receipt of community residential habilitation services shall not preclude a person from receiving generic or OPWDD authorized personal care services, or comprehensive Medicaid case management services, or Part 679 of this Title certified clinic treatment services at the facility/setting where the community residential habilitation services are delivered.
(m) Nothing herein shall be interpreted as precluding the applicability of Parts 604, 624, 633, 635 and 636 of this Title to each setting as specified pursuant to each Part. In the event that there is a conflict between the requirements contained herein and any other applicable law or regulation, OPWDD will resolve issues relative to the conflicting requirements.
(n) OPWDD expects ongoing compliance with both principles of compliance and standards of certification included in this Part. Therefore, such compliance is the responsibility of the agency and is necessary for continued participation as a certified facility or funding as an approved program or service.
14 CRR-NY 671.1
Current through June 30, 2021
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