1. Statutory Authority: Sections 7.09 and 31.04 of the Mental Hygiene Law grant the Commissioner of the Office of Mental Health the authority and responsibility to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction.

Section 43.02 of the Mental Hygiene Law grants the Commissioner the authority to request operators of facilities licensed by the Office of Mental Health to submit financial, statistical and program information as the Commissioner may deem to be necessary.

Chapter 676 of the Laws of 2007, as amended by Chapter 24 of the Laws of 2008, creates Section 31.25 of the Mental Hygiene Law, which requires the Commissioner of the Office of Mental Health to establish, pursuant to regulation, licensed residential providers of treatment and/or supportive services to individuals with eating disorders.

2. Legislative Objectives: Articles 7 and 31 of the Mental Hygiene Law reflect the Commissioner's authority to establish regulations regarding mental health programs. Section 2799-e of the Public Health Law establishes Comprehensive Care Centers for Eating Disorders, and requires that they include within their scope of services a licensed residential component.

3. Needs and Benefits: This regulation clarifies that services that are provided by Community Residences for Eating Disorder Integrated Treatment (CREDIT) programs do not qualify as rehabilitative services under this Part, and are, therefore, not eligible for Medical Assistance (Medicaid) payments. Residential rehabilitative services are intended for individuals who have severe deficits in various life skills, and who require an intermediate to long-term period of residential care. The CREDIT program is designed for individuals who do require residential care, and who do have impairment in life skills, but not typically to the extent and duration anticipated in the design of the rehabilitative services program. Further, the CREDIT program is a new model of service. In a time of extremely limited resources, the commitment of scarce Medicaid dollars to this model is premature. Individuals with eating disorders who receive Medicaid continue to be eligible to receive the full panoply of services available under the Medicaid State Plan to address their needs.

4. Costs: No additional costs are anticipated as a result of the adoption of this regulation.

5. Paperwork: This rule should not substantially increase the paperwork requirements of those affected.

6. Local Government Mandates: This regulatory amendment will not result in any additional imposition of duties or responsibilities upon county, city, town, village, school or fire districts.

7. Duplication: There are no duplicate, overlapping or conflicting mandates which may affect this rule.

8. Alternative Approaches: The only alternative would be to include services provided in the CREDIT program as rehabilitative services for which Medicaid reimbursement is available. This alternative is not being pursued for two major reasons. First, residential rehabilitative services are intended for individuals who have severe deficits in various life skills, and who require an intermediate to long-term period of residential care. The CREDIT program is designed for individuals who do require residential care, and who do have impairment in life skills, but not typically to the extent and duration anticipated in the design of the rehabilitative services program. Second, the CREDIT program is a new model of service. In a time of extremely limited resources, the commitment of scarce Medicaid dollars to this model is premature. Therefore, this alternative was necessarily rejected.

9. Federal Standards: The regulatory amendment does not exceed any minimum standards of the federal government for the same or similar subject areas.

10. Compliance Schedule: The regulatory amendment would be effective immediately upon adoption.

Because it is evident from the nature of the proposed rule that there will be no adverse economic impact on small businesses or local governments, a regulatory flexibility analysis is not submitted with this notice.

A Rural Area Flexibility Analysis is not submitted with this notice because the proposed rule will not impose any adverse economic impact on rural areas. The amendment merely clarifies that services provided by Community Residences for Eating Disorder Integrated Treatment (CREDIT) programs do not qualify as rehabilitative services under Part 593 and are, therefore, not eligible for Medical Assistance (Medicaid) payments.

A Job Impact Statement is not submitted with this notice because the proposed rule will not have any adverse impact on jobs and employment opportunities. This amendment simply clarifies that services provided by Community Residences for Eating Disorder Integrated Treatment (CREDIT) programs do not qualify as rehabilitative services under this Part and are, therefore, not eligible for Medical Assistance (Medicaid) payments.