N.Y. Comp. Codes R. & Regs. tit. 14 § 822.5

Current through Register Vol. 46, No. 24, June 12, 2024

Section 822.5 - Definitions

As used in this Part, unless otherwise indicated, the following terms shall be applicable all programs providing outpatient services:

(a) "Accrediting Body" means an entity approved by the federal Substance Abuse Mental Health Services Administration (SAMHSA) to accredit all programs pursuant to 42 CFR Part 8.1 through 8.6 using opioid full agonist treatment medications.

(b) "Active treatment" is the period from pre-admission through discharge.

(c) "Admission assessment" is a service between a prospective patient and clinical staff for the purpose of determining a preliminary diagnosis, appropriateness for service, person-centered initial plan of treatment, including type(s) of services and frequency of services.

(d) "Ancillary withdrawal" is a service whereby patients in mild to moderate or persistent withdrawal receive symptom relief and/or addiction medications after an assessment of the level of withdrawal determined using a standardized assessment instrument. Providers must receive Office approved designation to provide this service.

(e) "Approved medications" means any medication approved by state or federal authorities for the treatment of substance use disorder.

(f) "Brief intervention" is a service between a prospective patient and clinical staff when screening results indicate at risk behavior. The brief intervention educates patients about their substance use, alerts them to possible consequences, and is intended to encourage healthier choices.

(g) "Brief treatment" is a service between an active patient and clinical staff and must include a target behavior or health need and an evidence-based or clinical practice upon which the treatment is based. Brief treatment may be used throughout the course of treatment to meet specific goals, motivate patients or support medicated supported recovery.

(h) "Central registry system" means the central registry established and maintained by the Office pursuant to section 19.16 of the Mental Hygiene Law.

(i) "Collateral person" is a member of a patient's family or household, significant others, or persons who are directly affected by regular interaction with the patient, or who have the capability to affect both the patient's substance use disorder and recovery.

(j) "Collateral visit" is a service between a clinical staff member and a collateral person for the purpose of providing an intervention in the service of the primary patient's progress in treatment.

(k) "Complex care coordination" is an ancillary service provided to a patient when a critical event occurs, or the individual's condition requires significant coordination with other service providers. Complex care coordination is distinguished from routine case coordination activities.

(l) "Continuing care treatment" is a treatment protocol that offers clinical support for the ongoing substance use management needs of patients. Patients have either completed the goals of active treatment and are discharged with referral to continuing care or opt for continuing care any time after discharge.

(m) "Group counseling" is a service between one or more clinical staff and multiple patients at the same time, to be delivered consistent with patient treatment/recovery plans, their development or emergent issues. Group counseling sessions must be structured in size and duration to maximize therapeutic benefit for each participant. Program policies must include a process for determining group size, group purpose, monitoring patient experience, and assessing group efficacy.

(n) "Individual counseling" is a service between a clinical staff member and a patient focused on the needs and goals of the patient to be delivered consistent with the treatment/recovery plan, its development or emergent issues.

(o) "Initial services or pre-admission services" are services prior to admission as the first step in developing a treatment/recovery plan, focusing on issues that need to be addressed to ensure successful engagement and admission into treatment and any other urgent or emergent issues. Initial/pre-admission services address priority goals based on presenting problem(s) identified during the patient's assessment and provide focus for the critical period of treatment engagement. Services which may be delivered preadmission will be identified by the Office.

(p) "Intensive outpatient services" (IOS) is an outpatient treatment service provided by a team of clinical staff for patients who require a time-limited, multi-faceted array of services, structure, and support to achieve and sustain recovery. Programs that offer intensive outpatient treatment must make available individual and group counseling, family counseling when appropriate, skills to mitigate reoccurrence, and coping skills training, including as appropriate, Dialectical and Behavioral Therapy (DBT), Motivational Enhancement Therapy (MET), Cognitive Behavioral Therapy (CBT) and increased connections to recovery supports and other evidence based practices as proven effective in meeting patient needs.

(q) "Medication administration and observation" is face-to-face administration or dispensing of a medication by medical staff, to be delivered in conjunction with observation of the patient prior to the administration and after, as appropriate to the medication and patient's condition.

(r) "Medication for addiction treatment" (MAT) means treatment of substance use disorder i.e., substance use disorder and concomitant conditions with medications requiring a prescription or order from an authorized prescribing professional with counseling and behavioral therapies, as clinically appropriate.

(s) "Medication management" is a service with a prescribing professional for one of the following purposes:

(1) evaluation, monitoring, observation or dosage change to a patient's medication;

(2) a comprehensive medication review of a new patient or any patient who requires a more extensive review; or

(3) the induction of a patient to a new medication requiring a period of patient observation.

(t) "Naloxone emergency overdose prevention kit" means a kit as prescribed pursuant to state law and is used to reverse an opioid overdose.

(u) "Opioid medical maintenance" is a designated Office-based opioid treatment ("OBOT") program limited to patients who meet specific criteria as described in this Part.

(v) "Opioid taper" means a medical treatment protocol that, after a period of stabilization, utilizes approved medications in gradually decreasing doses to the point of 0 milligrams (no dose) followed by continuing care treatment as described in this Part, or discharge.

(w) "Patient" for purposes of this Part is an individual including a significant other who meets with clinical and/or peer staff for the purpose of engagement, assessment or treatment. "Active patient" means a patient who is admitted to a program and has an active treatment/recovery plan.

(x) "Peer support service" is provided by a peer advocate as defined in Part 800 of this Title. Peer support services are services for the purpose of outreach for engaging an individual to consider entering treatment, reinforcing current patients' engagement in treatment, and connecting patients to community-based recovery supports consistent with treatment/recovery and discharge plans.

(y) "Person centered care"is a collaborative care approach to individualized treatment resulting in the development of treatment/recovery plan goals and service provision that is respectful of the patient's needs and choices. It is guided by patients and produced in partnership with care providers for treatment and recovery. Person and family centered care planning is strength-based and focuses on individual capacities, preferences and goals. It supports patient preferences and a recovery orientation and is developed within the professional responsibilities of providers and care teams.

(z) "Progress note" is documentation of each service delivered and serves as the treatment/recovery plan as it evolves to support person centered goals and ongoing service and care planning. Progress notes identify patient's clinical status, type of services, and may also include updates to goals, methods of treatment and types of services provided and includes challenges and achievements identified.

(aa) "Screening" is a pre-admission service with a clinical staff member for the purpose of identifying patients who have problems with substance use. Screening results must be shared by the clinical staff with the patient.

(ab) "Specialized opioid services"are those not defined in this Part and are generally research-oriented in nature. Such specialized services shall be reviewed and approved by the Office prior to implementation and operation in accordance with Office policy, procedures, and requirements.

(ac) "Substance use disorder outpatient rehabilitation services"(outpatient rehabilitation services) are services offered by programs which have been certified to provide outpatient rehabilitation services; such services are designed to assist individuals with more chronic conditions as further defined in this Part who are typically scheduled to attend the outpatient rehabilitation program three to five days per week for at least two hours per day.

(ad) "Substance use disorder outpatient program"is an Office certified program which provides outpatient services that assist individuals with a substance use disorder and their family members and/or significant others and may also provide outpatient rehabilitation services and/or intensive outpatient services (IOS); and sites where addiction medications are administered to treat opioid use disorder, as well as other SUDs following one or more medical treatment protocols as defined in this Part. This term encompasses medical and comprehensive support services including counseling, educational and vocational rehabilitation. The term also includes the Narcotic Treatment Program (NTP) as defined by the federal Drug Enforcement Agency (DEA) in 21 CFR Section 1301. An NTP or Opioid Treatment Program (OTP) requires federal and state approval.

(ae) "Transfer"is an intra-program function (i.e., between outpatient and outpatient rehabilitation within the same provider or between different Program Reporting Units (PRUs) of the same provider); and may also be an inter-program function (i.e., between two different providers).

(af) "Treatment/recovery plan" is the plan developed by clinical staff with the patient and based on the admission assessment and initial services and includes goals, type and frequency of services and methods. Treatment/recovery plans shall be regularly updated using progress notes.

(ag) "Visit" means one or more services provided to a patient and/or collateral person on a single day.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 822.5

Adopted New York State Register December 9, 2015/Volume XXXVII, Issue 49, eff. 11/20/2015

Amended New York State Register December 6, 2017/Volume XXXIX, Issue 49, eff. 12/6/2017

Adopted New York State Register March 27, 2019/Volume XLI, Issue 13, eff. 3/27/2019

Amended New York State Register January 27, 2021/Volume XLIII, Issue 04, eff. 1/27/2021

Amended New York State Register September 14, 2022/Volume XLIV, Issue 37, eff. 10/1/2022