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Title 14 of the Official Compilation of Codes, Rules and Regulations of the State of New York is amended by adding a new Part 800 as follows:

CHEMICAL DEPENDENCE SERVICES GENERAL PROVISIONS

Effective August 7, 2002

[Statutory Authority: Mental Hygiene Law Sections 19.07(e), 19.09(b), 32.01, 32.07(a)]

Notice: The following regulations are provided for informational purposes only. The Office of Alcoholism and Substance Abuse Services makes no assurance of reliability. For assured reliability, readers are referred to the Official Compilation of Rules and Regulations.

Sec.
800.1 Legal base
800.2 Definitions
800.3 Waiver 
800.4 Severability

Section 800.1 Legal base

(a) Section 19.07(e) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt standards including necessary rules and regulations pertaining to chemical dependence services.

(b) Section 19.09(b) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations necessary and proper to implement any matter under his or her jurisdiction.

(c) Section 32.01 of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt any regulation reasonably necessary to implement and effectively exercise the powers and perform the duties conferred by Article 32 of the Mental Hygiene Law.

(d) Section 32.07(a) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations to effectuate the provisions and purposes of Article 32 of the Mental Hygiene Law.

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Section 800.2 Definitions

(a) For purposes of all of the Part 800 series chemical dependence regulations of this Title, the following terms are defined as follows:

(1) "Activities therapies" means the evaluation and treatment of physical and psychosocial dysfunctions through the use of creative, manual, occupational, social, recreational, educational and self-management activities.

(2) "Chemical dependence" means the repeated use of alcohol and/or one or more substances to the extent that there is evidence of physical or psychological reliance on alcohol and/or substances, the existence of physical withdrawal symptoms from alcohol and/or one or more substances, a pattern of compulsive use, and/or impairment of normal development or functioning due to such use in one or more of the major life areas including but not limited to the social, emotional, familial, educational, vocational, and physical. The term "chemical dependence" shall mean and include alcoholism and/or substance dependence. Chemical dependence is identified through the substance dependence diagnostic criteria set forth in either the International Classification of Diseases, Ninth Revision or another Office-approved protocol.

(3) "Chemical dependence services" means examination, evaluation, diagnosis, care, treatment, rehabilitation, or training of persons suffering from alcohol and/or substance abuse and/or dependence. The term "chemical dependence services" shall mean and include alcoholism and/or substance abuse services. Education regarding the effects of alcohol and substances on significant others may also be provided to such persons as a component of chemical dependence services.

(4) "Clinical staff member" means an individual employed by the governing authority who is regularly supervised, receives regularly scheduled inservice training, and provides clinical services as required by this Part. The program director of a Part 819 residential service may be deemed to be a clinical staff member only if he or she receives regularly scheduled inservice training and provides clinical services as required by Part 819.

(5) "Commissioner" means the Commissioner of the Office of Alcoholism and Substance Abuse Services.

(6) "Facility" means any place where chemical dependence services are provided which is, or according to law is required to be, certified by the Office of Alcoholism and Substance Abuse Services.

(7) "Governing authority" means the overall policy-making authority, whether an individual or a group, that is responsible for general direction over the affairs of a provider of service and establishes policies concerning its operation.

(8) "Habilitative procedures" mean the delivery systems for education and training services which address basic life skills and social competencies that have not been acquired by the resident due to psychosocial deprivation and/or addictive behavior.

(9) "Medical director" means a physician who is responsible for the medical services provided by the service, is responsible for the overall direction of the medical procedures provided, and supervises the medical staff.

(10) "Medical services" means services provided by medical staff in accordance with the terms and conditions of their respective authorizing licenses and may include but are not limited to:

(i) a physical examination for the purpose of identifying the nature and extent of chemical dependence;

(ii) a physical examination to determine the nature and extent of any physical disease or disabling condition either related or unrelated to the individual's chemical dependence; and

(iii) ongoing care and treatment of physical conditions including prescribing and administering of medication.

(11) "Medical staff" means physicians, nurse practitioners, registered physician's assistants, registered nurses, and licensed practical nurses licensed and certified by the State Education Department practicing within the scope of, and in accordance with, the terms and conditions of such licenses and certifications, and working with, or under the supervision of, a physician, if required by law.

(12) "Multi-disciplinary team" means a team of health professional staff including, at a minimum, one medical staff member (where applicable) as defined in this section, one credentialed alcoholism and substance abuse counselor (CASAC) and one other staff member who is a qualified health professional as defined in this section in a discipline other than alcoholism and substance abuse counseling.

(13) "Office" means the New York State Office of Alcoholism and Substance Abuse Services.

(14) "Provider of chemical dependence services" or "provider of services" means an individual, association, partnership, corporation, public or private agency, other than an agency or department of the state, which provides chemical dependence services.

(15) "Qualified Health Professional" means any of the professionals listed below, who are in good standing with the appropriate licensing or certifying authority, as applicable, with a minimum of one year of experience in the treatment of alcoholism or substance abuse and/or chemical dependence, or satisfactory completion of a training program in the treatment of alcoholism or substance abuse and/or chemical dependence:

(i) a credentialed alcoholism and substance abuse counselor who has a current valid credential issued by the Office, or a comparable credential, certificate or license from another recognized certifying body as determined by the Office;

(ii) a certified social worker licensed and currently registered as such by the New York State Education Department;

(iii) a certified nurse practitioner licensed and currently registered by the New York State Education Department as both a professional nurse and a certified nurse practitioner;

(iv) an occupational therapist licensed and currently registered as such by the New York State Education Department;

(v) a physician licensed and currently registered as such by the New York State Education Department;

(vi) a physician's assistant licensed and currently registered as such by the New York State Education Department and whose practice is in conformity with Section 3701 of the Public Health Law;

(vii) a registered professional nurse currently licensed and registered as such by the New York State Education Department;

(viii) a psychologist licensed and currently registered as such by the New York State Education Department;

(ix) a rehabilitation counselor certified by the Commission of Rehabilitation Counselor Certification;

(x) a therapeutic recreation therapist who holds a baccalaureate degree in a field allied to therapeutic recreation and, either before or after receiving such degree, has five years of full-time, paid work experience in an activities program in a health care setting or an equivalent combination of advanced training, specialized therapeutic recreation education and experience, or is a recreational therapist certified by the National Council on Therapeutic Recreation or the American Therapeutic Recreation Association;

(xi) a family therapist who is currently accredited as such by the American Association for Marriage and Family Therapy (AAMFT); or

(xii) a counselor certified by and currently registered as such with the National Board for Certified Counselors.

(16) "Quality improvement" means an ongoing process by which a chemical dependence service systematically assesses the adequacy and appropriateness of the chemical dependence services provided to patients and provides recommendations for improvement.

(17) "Rehabilitative procedures" mean the provision of education and training which address the restoration of skills and competencies that have been lost due, at least in part, to chemical dependence.

(18) "Significant other" means an individual who is related to, a close friend of, associated with, or directly affected by, a chemically dependent person. Chemical dependence treatment should include services to the significant others of those who are chemically dependent or abusing, in recognition that addiction has a significant negative impact on such individuals.

(19) "Social services" means various services as indicated by a psychosocial evaluation of individual, familial, interpersonal and environmental strengths and needs. Such services may include, but not be limited to, assistance in enhancing skills of daily living, interpersonal, parenting, and community competency skills, as well as addressing identified financial, residential, educational, employment and/or vocational needs.

(20) "Utilization review" means a process by which a service systematically monitors the appropriateness of admissions, the need for continued stay, and the necessity for an alternative level of care.

(21) "Voluntary contribution" means a donation or other voluntary payment made directly or indirectly to a provider of services as defined pursuant to Section 1.03(5) of the Mental Hygiene Law.

(22) "The International Classification of Diseases, Ninth Revision" means the International Classification of Diseases, Ninth Revision, Sixth Edition, Clinical Modification document dated October 2001 and which is in the public domain.

(23) "The OASAS Level of Care for Alcohol and Drug Treatment Referral Protocol" or "LOCADTR" means the Guidelines for Level of Care Determination 2.0 dated April 1, 2001, published by the Office and which is in the public domain.

(24) "21 Code of Federal Regulations Part 1301.72" means 21 Code of Federal Regulations Part 1301.72 current through March 13, 2000.

(25) "42 Code of Federal Regulations Part 2" means 42 Code of Federal Regulations Part 2 et seq. current through May 5, 1995.

(26) "The Medicare Provider Reimbursement Manual" or "HIM 15" means the document published by the U.S. Department of Health and Human Services' Centers for Medicaid and Medicare Services current through December 15, 1998. The HIM 15 document is available from:

Centers for Medicaid and Medicare Services
Division of Communication Services
Production and Distribution Branch
Room 577, East High Rise Building
6325 Security Boulevard
Baltimore, MD 21207.

(27) "Level I Executive Schedule" means the Level I Executive Schedule current through January 2001 and published by the United States Office of Personnel Management.

(28) All of the aforementioned documents may be reviewed in person during regular business hours at the NYS Department of State, 41 State Street, Albany, NY 12207; or by appointment at the NYS Office of Alcoholism and Substance Abuse Services, Office of the Counsel, 1450 Western Avenue, Albany, New York 12203. Copies of all of the aforementioned documents are available by writing to the NYS Office of Alcoholism and Substance Abuse Services, Office of the Counsel, 1450 Western Avenue, Albany, New York 12203.

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Section 800.3 Waiver

(a) The Commissioner may grant a waiver of a Part 800-series chemical dependence regulatory requirement not specifically required by law, if the Commissioner determines that:

(1) meeting the requirement would impose an unreasonable hardship;

(2) the health and safety of patients/residents would not be diminished; and

(3) the best interests of the patients/residents and the service would be served.

(b) In considering a request for a waiver, the Commissioner will consider such factors as the special needs of the population(s) to be served, geographic distances and transportation problems, staff availability, long range plans of the chemical dependence service, alternatives, and any other relevant information.

(c) A request for a waiver must be submitted in writing, must contain substantial documentation to support the need for the waiver, and must include such other information as the Commissioner may require.

(d) Special limits, conditions or restrictions may be established by the Commissioner in granting a waiver.

(e) A waiver shall be in effect for no longer than the duration of the operating certificate held by the facility for which such waiver is granted.

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Section 800.4 Severability

If any provision of this Part or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of this Part which can be given effect without the invalid provisions or applications, and to this end the provisions of this Part are declared to be severable.