14 CRR-NY 690.1NY-CRR
14 CRR-NY 690.1
14 CRR-NY 690.1
690.1 Background and applicability.
(a) The Federal Social Security Act authorizes Federal financial participation to an approved State plan for Medicaid services authorizing payment for the costs of medical and remedial care for persons whose income and resources are insufficient to meet the costs of such services.
(b) The Medical Assistance Program in New York State is administered by the Department of Social Services in cooperation with the New York State Department of Health, the Education Department, and the Office for People With Developmental Disabilities (hereinafter referred to as OPWDD).
(c) This Part establishes the programmatic, administrative and funding standards for the certification and operation of day treatment facilities or services (see glossary) for persons with developmental disabilities (see glossary). The certification and recertification of day treatment facilities also requires demonstrated substantial compliance with Parts 624, 633, and 635 of this Title.
(d) For meeting the needs of persons (see glossary) with developmental disabilities, day treatment is intended to be a planned combination of diagnostic, treatment and habilitative services provided to persons with developmental disabilities in need of a broad range of clinically supported and structured habilitation services.
(1) Persons provided day treatment services in a free-standing certified site or approved satellite (see glossary) site, will attend for periods in excess of three hours if reimbursement is to be claimed. A reimbursable half-day visit covers a period of three to five hours. A full-day reimbursable visit covers a period of five hours or more.
(2) Persons who attend a certified day treatment facility which is collocated on the same site as a day training or sheltered program (a.k.a., "collocated day treatment"; see also section 635-7.1(a)(8) and (9)(ii)(d) of this Title), for the purposes of receiving needed active treatment based, pre-vocational/independent living activities, shall participate for periods of at least 90 minutes as the minimum unit of service.
(3) Day treatment facilities may vary widely in the services offered, the level of disability of persons served, the staffing plan, the program goals and the types and numbers of cooperative agency relationships. However, at its very essence, is the direct and meaningful involvement of the person as service recipient, and his/her parent, guardian or correspondent/advocate (as applicable), in the program planning and review process.
(4) A day treatment facility is eligible to participate as a provider in the Medical Assistance Program only if the provider is certified as a day treatment facility by OPWDD to provide services based at a specific inspected and certified site. Said requirement shall not preclude operation of a satellite site, if the location(s) of said satellite(s) have been inspected, meet the appropriate physical plant requirements, and are listed on the primary facility's operating certificate.
(e) Sections 690.3, 690.4, 690.5 and 690.6 of this Part are organized in a format consisting of principles of compliance and standards of certification. In reviewing the continued eligibility of a day treatment facility for an operating certificate, OPWDD shall survey for compliance with all "standards of certification," herein and any other applicable requirements. OPWDD may evaluate non-compliance with the applicable "principles of compliance." The detailed premises for the principles of compliance and standards of certification format may be found in Part 633.2 of this Title.
(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.
(f) The OPWDD certification process defined in subdivision (e) of this section is superseded by requirements in Part 619 of this Title, effective on the effective date of these regulations.
(g) OPWDD expects ongoing compliance with both principles of compliance and standards of certification included in this Part. Therefore, such compliance shall be the responsibility of the agency and shall be necessary for continued participation as a certified facility or funding as an approved program or service.
(h) As used herein, the terms, person(s)/people, shall be understood to refer to those who have been admitted to and are receiving allowable day treatment services.
14 CRR-NY 690.1
Current through June 30, 2021
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