9.51 - Residential treatment facilities for children and youth; admissions.

§ 9.51 Residential   treatment   facilities   for  children  and  youth;           admissions.    (a) The director of a residential treatment facility for children  and  youth may receive as a patient a person in need of care and treatment in  such  a  facility  who  has  been  certified as needing such care by the  pre-admission  certification  committee  serving  the  facility  and  in  accordance  with priorities for admission established by such committee,  as provided by this section. Subject to the provisions of this  section,  the provisions of this article shall apply to admission and retention of  patients to residential treatment facilities for children and youth.    (b)  Persons  admitted  as  in-patients  to  hospitals operated by the  office of mental health upon the application  of  the  director  of  the  division  for  youth  pursuant  to  section  five  hundred  nine  of the  executive law or 353.4 of the family court act who are not subject to  a  restrictive placement pursuant to section 353.5 of the family court act,  may, if appropriate, and subject to the provisions of subdivision (d) of  this  section,  be  transferred  to a residential treatment facility for  children and youth. The director of the  division  for  youth  shall  be  notified  of  any  such  transfer. When appropriate, the director of the  residential treatment facility may arrange the return of  a  patient  so  transferred  to  the  hospital  or  the transfer of a patient to another  hospital or, in accordance with subdivision four of section five hundred  nine of the executive law, to the division for youth.    (c)  The  commissioner  shall  designate  pre-admission  certification  committees for defined geographic areas to evaluate each person proposed  for  admission  or  transfer  to  a  residential  treatment facility for  children and youth. When designating persons to serve  on  pre-admission  certification  committees,  the  commissioners  shall  assure  that  the  interests of the people residing in  the  area  to  be  served  by  each  committee  are  represented.  Such  committees  shall  include  a person  designated by the office of mental health, a person  designated  by  the  state  commissioner  of  social  services and a person designated by the  state commissioner of education. The commissioner of mental health shall  consult with the conference of local mental hygiene  directors  and  the  commissioner  of social services shall consult with county commissioners  of social services in the area to be served  by  a  committee  prior  to  designating  persons  to  serve  on  a  committee. The commissioners may  designate persons who are not state employees to serve on  pre-admission  certification  committees.  Membership  of  pre-admission  certification  committees shall be limited to persons licensed in accordance  with  the  education  law  to  practice  medicine, nursing, psychology, or licensed  clinical social work. In the event the persons originally designated  to  a  committee  by  the  commissioners  do  not  include  a physician, the  commissioner shall designate a  physician  to  serve  as  an  additional  member  of  the  committee.  Each  pre-admission certification committee  shall designate five persons representing local  governments,  voluntary  agencies,  parents  and  other  interested persons who shall serve as an  advisory board to the committee. Such board  shall  have  the  right  to  visit  residential treatment facilities for children and youth served by  the committee and shall  have  the  right  to  review  clinical  records  obtained by the pre-admission certification committee and shall be bound  by the confidentiality requirements of section 33.13 of this chapter.    (d)  All  applications for admission or transfer of an individual to a  residential treatment facility for children and youth shall be  referred  to  a  pre-admission certification committee for evaluation of the needs  of the  individual  and  certification  of  the  individual's  need  for  treatment  in  a  residential treatment facility for children and youth.  Applications  shall  include   an   assessment   of   the   individual'spsychiatric,  medical  and  social  needs  prepared in accordance with a  uniform  assessment  method  specified  by  the   regulations   of   the  commissioner.  The committee may at its discretion refer an applicant to  a  hospital  or other facility operated or licensed by the office for an  additional assessment. In the event of such an additional assessment  of  the  individual's  needs,  the  facility conducting the assessment shall  attempt to receive all third party insurance  or  federal  reimbursement  available as payment for the assessment. The state shall pay the balance  of  the  fees  which  may  be charged by the provider in accordance with  applicable provisions of law. In addition, if necessary,  in  accordance  with  section four thousand five of the education law, the pre-admission  certification committee shall obtain an evaluation  of  the  educational  needs  of  the child by the committee on special education of the school  district of residence. The pre-admission certification  committee  shall  review  all requests for evaluation and certification within thirty days  of receipt of a complete application and any additional  assessments  it  may  require  and,  using  a  uniform  assessment  method  specified  by  regulation of the commissioner, evaluate the  psychiatric,  medical  and  social  needs of the proposed admittee and certify: (i) the individual's  need for services in a residential treatment facility for  children  and  youth  and  (ii)  the  immediacy of that need, given the availability of  such services in the area and the needs of other children  evaluated  by  the  committee  and certified as eligible for admission to a residential  treatment facility for children and youth who have not yet been admitted  to such a facility. A pre-admission certification  committee  shall  not  certify an individual for admission unless it finds that:    (1)   Available   ambulatory  care  resources  and  other  residential  placements do not meet the treatment needs of the individual;    (2)  Proper  treatment  of  the  individual's  psychiatric   condition  requires  in-patient  care  and  treatment  under  the  direction  of  a  physician; and    (3) Care  and  treatment  in  a  residential  treatment  facility  for  children   and   youth   can  reasonably  be  expected  to  improve  the  individual's condition or prevent further regression  so  that  services  will  no  longer  be needed, provided that a poor prognosis shall not in  itself constitute grounds for a denial of certification if treatment can  be expected to effect a  change  in  prognosis.  All  decisions  of  the  committee to recommend admission or priority of admission shall be based  on  the  unanimous  vote of those present. The decision of the committee  shall be reported to the applicant. In the event a committee evaluates a  child who is the subject of a proceeding currently pending in the family  court, the committee shall report its decision to the family court.    No residential treatment facility for children and youth shall admit a  person who has not been certified as suitable for such admission by  the  appropriate pre-admission certification committee. Residential treatment  facilities  shall  admit  children  in  accordance  with  priorities for  admission  of  children  most  immediately  in  need  of  such  services  established  by  the  pre-admission  certification committee serving the  facility in accordance with standards established by the commissioner.    (e) Notwithstanding any inconsistent provision of law,  no  government  agency  shall  make  payments  pursuant to title nineteen of the federal  social security act or articles five and six of the social services  law  to  a  residential treatment facility for children and youth for service  to a person whose need for care and treatment in such a facility was not  certified pursuant to this section.    (f) No person shall be admitted to a  residential  treatment  facility  for  children  and  youth  who  has  a  mental  illness which presents a  likelihood of serious harm to others; "likelihood of serious harm" shallmean a substantial risk of physical harm to other persons as  manifested  by recent homicidal or other violent behavior by which others are placed  in reasonable fear of serious physical harm.    (g)   Notwithstanding   any  other  provision  of  law,  pre-admission  certification committees shall be entitled to  review  clinical  records  maintained  by  any  person  or entity which pertain to an individual on  whose behalf an application is  made  for  admission  to  a  residential  treatment facility for children and youth. Any clinical records received  by a pre-admission certification committee and all assessments submitted  to  the  committee  shall  be  kept  confidential in accordance with the  provisions of  section  33.13  of  the  mental  hygiene  law,  provided,  however,  that the commissioner may have access to and receive copies of  such  records  for  the  purpose  of  evaluating   the   operation   and  effectiveness of the committee.    Confidentiality  of  clinical  records  of  treatment of a person in a  residential  treatment  facility  for  children  and  youth   shall   be  maintained as required in section 33.13 of this chapter. That portion of  the  clinical  record maintained by a residential treatment facility for  children and youth operated by an authorized agency specifically related  to medical care and treatment shall not be considered part of the record  required to be maintained by such authorized agency pursuant to  section  three  hundred  seventy-two  of the social services law and shall not be  discoverable in a proceeding under section three  hundred  fifty-eight-a  of  the  social  services  law  or article ten-A of the family court act  except upon order of the family court; provided, however, that all other  information required by a local social services district or  the  office  of  children  and family services for purposes of sections three hundred  fifty-eight-a, four hundred nine-e and four hundred nine-f of the social  services law and  article  ten-A  of  the  family  court  act  shall  be  furnished  on request, and the confidentiality of such information shall  be safeguarded as provided in section four hundred sixty-e of the social  services law.