View Adobe Acrobat Version | Download Adobe Acrobat Reader
0320 � On site Rehabilitation (Non Licensed Program)
The objective is to assist individuals disabled by mental illness who live in adult congregate care settings, supervised or supported living arrangements to achieve their treatment and community living rehabilitation goals. Services include one or a combination of: (1) consumer self help and support interventions: (2) community living; (3) academic and/or social leisure time rehabilitation training and support services. These services are typically provided either at the residential location of the resident or in the natural or provider operated community settings which are integral to the life of the residents. These on site rehabilitation services are provided by a team that is either located at the residential site or which functions as a mobile rehabilitation team traveling from site to site.
Units of Service:
Brief Day Visit: less than 3 hours.
Half day visit: 3 but less than 5 hours.
Full day visit: 5 hours or more.
Total Units of Service: Add weighted visits by category to calculate a total.
0340 - Sheltered Workshop/Satellite Sheltered Workshop (Non Licensed Program)
The objective is to provide vocational assessment, training, and paid work in a protective and non integrated work environment for individuals disabled by mental illness. Services are provided according to wage and hour requirements specified in the Fair Labor Standards Act administered by the Department of Labor.
Units of Service:
Half day visit: 3 but less than 5 hours
Full day visit: 5 hours or more
Total Units of Service: Add weighted visits by category to calculate a total.
0380 - Transitional Employment Placement (TEP) (Non Licensed Program)
The objective is to strengthen the individual's work record and work skills toward the goal of achieving assisted or unassisted competitive employment at or above the minimum wage paid by the competitive sector employer. TEP's provide time limited employment and on the job training in one or more integrated employment settings as an integral part of the individual's vocational rehabilitation growth.
Direct staff hours: The number of staff hours spent by staff in providing case management services face to face or by telephone directly to Consumers or collaterals.
Indirect staff hours: The number of staff hours spent by staff in providing case management services on behalf of Consumers other than face to face or by telephone directly with Consumers or collaterals.
Units of Service: Count the total number of staff hours (combine direct and indirect).
0670 � Transportation (Non Licensed Program)
The provision of transportation to and from facilities or resources specified in the Consumer's individual treatment plan as a necessary part of his/her service for mental disability. This includes all necessary supportive services for full and effective integration of the Consumer into community life. A Consumer trip is the one way transportation of a Consumer from one place to another. For example, transportation of one Consumer from home to the facility and back is counted as two trips; transportation of two Consumers to and from is counted as four trips.
Units of Service: Count the number of trips.
0690 � Outreach (Non Licensed Program)
Outreach programs/services are intended to engage and/or assess individuals potentially in need of mental health services. Outreach programs/services are not crisis services. Examples of applicable services are socialization, recreation, light meals, and provision of information about mental health and social services. Another type of service within this program code includes off site, community based assessment and screening services. These services can be provided at forensic sites, a consumer�s home, other residential settings, including homeless shelters, and the streets. �This program code should not be used for services that are provided by a licensed outpatient program. For unlicensed crisis type services use program code 2680 Crisis Intervention.
Units of Service: Total the number of contacts.
0770 - Psychosocial Club (Non Licensed Program)
The objective is to assist individuals disabled by mental illness to develop or reestablish a sense of self esteem and group affiliation, and to promote their recovery from mental illness and their reintegration into a meaningful role in community life through the provision of two or more of the following: (1) consumer self help and empowerment interventions; (2) community living: (3) academic; (4) vocational and/or (5) social leisure time rehabilitation, training and support services.
Units of Service: Count each Consumer visit as one unit (no more than one unit of service per Consumer per day unless the Consumer returns for a planned evening program in which case count as two (2) units).
0800 - Assertive Community Treatment (ACT) Program (Licensed Program)
ACT Teams provide mobile intensive treatment and support to people with psychiatric disabilities. The focus is on the improvement of an individual's quality of life in the community and reducing the need for inpatient care, by providing intense community based treatment services by an interdisciplinary team of mental health professionals. Building on the successful components of the Intensive Case Management (ICM) program, the ACT program has low staff outpatient ratios; 24 hour a day, seven day per week availability; enrollment of consumers, and flexible service dollars. Treatment is focused on individuals who have been unsuccessful in traditional forms of treatment.
Units of Service: Intensive Program Full Payment: Six or more face to face contacts per individual per month (may include 3 collateral visits) count as one unit.
Intensive Program - Partial Payment: Between 2 and 5 face to face contacts per individual per month count as one unit. �Supportive Program: 2 or more face to face contacts per individual per month count as one unit.
Total Units of Service: Total the number of contacts.
0810 - Case Management (Non Licensed Program)
Activities aimed at linking the Consumer to the service system and at coordinating the various services in order to achieve a successful outcome. The objective of case management in a mental health system is continuity of care and service. Services may include linking, monitoring and case specific advocacy. Linking: The process of referring or transferring a Consumer to all required internal and external services that include the identification and acquisition of appropriate service resources. Monitoring: Observation to assure the continuity of service in accordance with the consumer's treatment plan. Case Specific Advocacy: Interceding on behalf of a Consumer to assure access to services required in the individual service plan. Case management activities are expediting and coordinative in nature rather than the primary treatment services ordinarily provided by a therapist. Case management services are provided to enrolled Consumers for whom staff are assigned a continuing case management responsibility. Thus, routine referral would not be included unless the staff member making the referral retains a continuing active responsibility for the Consumer throughout the system of service.
Direct staff hours: The number of staff hours spent by staff in providing case management services face to face or by telephone directly to Consumers or collaterals.
Indirect staff hours: The number of staff hours spent by staff in providing case management services on behalf of Consumers other than face to face or by telephone directly with Consumers or collaterals.
Units of Service: Count the total number of staff hours (combine direct and indirect).
Note: Use Program Code 2100 (Clinic Treatment) if the Case Management services are affiliated with a licensed Clinic Treatment program. Please refer to Codes 1810, 6810 and 0820 for more Case Management service codes for applicability.
0820 � Blended Case Management (Non Licensed Program)
This program will facilitate a team approach to case management services by combining the caseloads of multiple Intensive Case Managers (ICMs) and/or Supportive Case Managers (SCMs).
Units of Service: Two face to face contacts per individual, per month (may include 1 collateral visit for children per month) counted as one unit. Count the total number of contacts.
0910 � Crisis Residence (Licensed Program)
A licensed residential (24 hours/day) stabilization program, which provides services for acute symptom reduction and the restoration of patients to pre crisis level of functioning. These programs are time limited for persons until they achieve stabilization (generally up to 30 days). Crisis residences serve persons experiencing rapid or sudden deterioration of social and personal conditions such that they are clinically at risk of hospitalization but may be treated in this alternative setting.
This program is licensed for adults as defined in 14NYCRR589 and for children and adolescents as defined in 14NYCRR594.
Units of Service: One resident day.
1310 - Continuing Day Treatment (Licensed Program)
A continuing day treatment program shall provide active treatment and rehabilitation designed to maintain or enhance current levels of functioning and skills, to maintain community living and to develop self awareness and self esteem through the exploration and development of patient strengths and interests. A continuing day treatment program shall provide the following services: assessment and treatment planning, discharge planning, medication therapy, medication education, case management, health screening and referral, psychiatric rehabilitation readiness development, psychiatric rehabilitation readiness determination and referral and symptom management. The following additional services may also be provided: supportive skills training, activity therapy, verbal therapy, crisis intervention services and clinical support services.
Units of Service:
Regular: shall be at least one hour and up to five hours
Collateral: shall be at least 30 minutes but not more than 120 minutes.
Group Collateral: shall be at least one hour and up to two hours.
Count the total number of service hours.
1340 - Enclave in Industry (Non Licensed Program)
The objective is to provide vocational assessment, training, and transitional or long term paid work for individuals with severe disabilities in an integrated employment environment. An enclave consists of a small group of approximately five to eight individuals who work in an industrial or other economic enterprise either as individuals or as a crew. Individuals in enclaves are provided with training, supervision and ongoing support by a job coach/supervisor assigned to the work site by the rehabilitation service agency.
Direct staff hours: The number of staff hours spent by staff in providing case management services face to face or by telephone directly to Consumers or collaterals.
Indirect staff hours: The number of staff hours spent by staff in providing case management services on behalf of Consumers other than face to face or by telephone directly with Consumers or collaterals.
Units of Service: Count the total number of staff hours (combine direct and indirect).
1380 - Assisted Competitive Employment (Non Licensed Program)
The objective is to assist individuals in choosing, finding, and maintaining satisfying jobs in the competitive employment market at minimum wage or higher. When appropriate, ACE provides these individuals with job related skills training as well as long term supervision and support services, both at the work site and offsite.
Direct staff hours: The number of staff hours spent by staff in providing case management services face to face or by telephone directly to Consumers or collaterals.
Indirect staff hours: The number of staff hours spent by staff in providing case management services on behalf of Consumers other than face to face or by telephone directly with Consumers or collaterals.
Units of Service: Count the total number of staff hours (combine direct and indirect).
1400 Single Point Of Access (SPOA) (Non Licensed Program)
A SPOA is a process, led by a SPOA Coordinator, that helps Local Governmental Units achieve community based mental health systems that are cohesive and well coordinated in order to serve those individuals most in need of services. There are three types of SPOAs: Children�s, Adult Case Management and Adult Housing. The SPOA process provides for the identification of individuals most in need of services, and manages service access and utilization.
This program code should not be used for services that are provided by a licensed outpatient program.
Units of Service: Not applicable.
1410 - Geriatric Demo Gatekeeper (Non Licensed Program
The Gatekeeper Program is designed to proactively identify at risk older adults in the community who are not connected to the service delivery system. Gatekeepers are non traditional referral sources who come into contact with older adults through their everyday work activities. They are specifically trained to look for signs and symptoms that may indicate the older adult is in need of assistance. The program increases public awareness of the needs of the older adults before a crisis occurs. Upon identification of an older adult in need, a trained Gatekeeper makes a phone call to trained staff which initiates the individual's assessment and a variety of in home supportive services. The program is designed to keep at risk seniors in their own homes, and prevent premature out of home placement. This program code should not be used for services provided by a licensed outpatient program, or for services provided by another active OMH funded program.
Units of Service: Count the total number of contacts.
1680 � CPEP Crisis Outreach (Non Licensed Program - Associated with a Licensed CPEP Program)
A mobile crisis intervention component of the CPEP offering crisis outreach and interim crisis service visits to individuals outside an emergency room setting, in the community in natural (e.g. homes), structured (e.g., residential programs), or controlled (e.g., instructional) environments. Crisis outreach service visits are emergency mental health services provided outside an emergency room which include clinical assessment and crisis intervention treatment. Interim crisis service visits are mental health services provided to individuals who are released from a CPEP for the purpose of facilitating the individual�s community tenure while waiting for the first post CPEP visit with a community based mental health provider.
CPEP crisis outreach and interim crisis service visits are Medicaid reimbursable. This program is one of four program components which, when provided together, form the OMH licensed Comprehensive Psychiatric Emergency Program (CPEP). The other program components of the CPEP are: CPEP Crisis Intervention (3130), CPEP Extended Observation Beds (1920) and CPEP Crisis Beds (2600).
Units of Service:
Crisis Outreach Visit
Interim Crisis Visit.
Count the total number of visits.
1760 � Advocacy/Support Services (Non Licensed Program)
Advocacy/support services may be individual advocacy or systems advocacy (or a combination of both. Examples are warm lines, hot lines, teaching daily living skills, providing representative payee services, and training in any aspect of mental health services. Individual advocacy assists consumers in protecting and promoting their rights, resolving complaints and grievances, and accessing services and supports of their choice. Systems advocacy represent the concerns of a class of consumers by identifying patterns of problems and complaints and working with program or system administrators to resolve or eliminate these problems on a systemic, rather than individual basis.
Units of Service: Count the total number of contacts.
1770 � Drop In Center (Non Licensed Program)
The objective of a Drop In Center program is to identify and engage persons who may choose not to participate in more structured programs or who might not otherwise avail themselves of mental health services, and to provide services and supports in a manner which these individuals would accept. These programs are low demand, flexible and relatively unstructured, and responsive to individual need and circumstance.
Units of Service: Count the total number of units. Count each Consumer visit as one unit (no more than one unit of service per Consumer, per day, unless the Consumer returns for a planned evening program, in which case, count as two (2) units).
1810 - Intensive Case Management (Non Licensed Program)
In addition to the program description for Case Management (Code 0810), ICM services are services which are operated under a fidelity structure defined in 18 NYCRR, Section 505 and a memorandum of understanding between OMH and the NYS Department of Health. Federal Individuals with Disabilities Education Act Funds
Units of Service: Four or more face to face contacts per individual per month (may include 1 collateral visit for children per month) count as one unit. Note: If the service provider chooses the "Flexible ICM Model" as defined in Section 8 of the New Initiative Guidelines, a minimum of two (2) face to face contacts per individual, per month count as one unit.
Count the number of total units.
1920 � CPEP Extended Observation Beds (Non Licensed Program - Associated with a Licensed CPEP Program)
Beds operated by the Comprehensive Psychiatric Emergency Program which are usually located in or adjacent to the CPEP emergency room, are available 24 hours per day, seven days per week to provide extended assessment and evaluation as well as a safe and comfortable environment for up to 72 hours for persons, who in the opinion of the examining physicians, require extensive evaluation, assessment, or stabilization of their acute psychiatric symptoms. Extended observation bed services are reimbursed at the inpatient psychiatric rate of the hospital where the CPEP is located. This program is one of four program components which, when provided together, form the OMH licensed Comprehensive Psychiatric Emergency Program (CPEP). The other program components of the CPEP are: CPEP Crisis Intervention (3130), CPEP Crisis Outreach (1680) and CPEP Crisis Beds (2600).
Units of Service: One (psychiatric) inpatient day.
1970 � Transition Management (TM) Services (Non Licensed Program)
Transition Management Services (discharge planning) programs provide support for improved community service linkages and timely filing of Medicaid applications for seriously and persistently mentally ill (SPMI) consumers being released from local correctional facilities. The TM focus will be in obtaining post release services for these consumers. TM can only be used with funding source code 170B.
Units of Service: The number of staff hours.
1990 � Bridger Services (Non Licensed Program)
Health service to a less restrictive mental health service. The services provide supports to link consumers to appropriate community services and to ease their transition from, inpatient care.
Units of Service: The number of staff hours.
2070 - Transient Housing (THP, Some PHP and some S+C) (Non Licensed Program)
Housing and Urban Development (HUD) funds: Several federally funded programs contribute housing assistance specifically targeted to the homeless mentally ill. When funds do not flow through OMH, but are sent directly to the provider, the funds are reported under this program code and funding code 090 (non funded) on the DMH-3. Federal Programs which fall into this category are Transitional Housing Program (THP), Supported Housing Demonstration Program (SHDP), and some Shelter Plus Care grants. Funds may be used for: the acquisition and/or rehabilitation of a program site; operating expenses; support services; and administrative expenses. These funds flow directly to the not for profit provider agencies from the federal agency; organizations in receipt of these funds report the funds in a separate program column with the program code indexed if necessary. These grants are made for five years at a time.
Units of Service: Not applicable.
2320 - Intensive Psychiatric Rehabilitation Treatment (IPRT) (Licensed Program)
An intensive psychiatric rehabilitation treatment program is time limited, with active psychiatric rehabilitation designed to assist a patient in forming and achieving mutually agreed upon goals in living, learning, working and social environments; to intervene with psychiatric rehabilitation technologies, to overcome functional disabilities and to improve environmental supports. An intensive psychiatric rehabilitation treatment program shall provide the following services: psychiatric rehabilitation readiness determination, psychiatric rehabilitation goal setting, psychiatric rehabilitation functional and resource assessment, psychiatric rehabilitation service planning, psychiatric rehabilitation skills and resource development and discharge planning.
Units of Service: Total service hours.
2340 - Affirmative Business/Industry (Non Licensed Program)
The objective is to provide vocational assessment, training, transitional or long term paid employment, and support services for persons disabled by mental illness in a less restrictive/more integrated employment setting than sheltered workshops. Affirmative programs may include mobile contract services, small retail or wholesale outlets, and manufacturing and service oriented businesses.
Units of Service: Count the total number of Consumer hours.
2600 � CPEP Crisis Beds (Non Licensed Program)
A residential (24 hour/day) stabilization component of the CPEP, which provides supportive services for acute symptom reduction and the restoration of patients to pre crisis level of functioning. These programs are time limited (up to five days) for patients until they achieve stabilization. Crisis beds serve persons experiencing rapid or sudden deterioration of social and personal conditions such that they are clinically at risk of hospitalization but may be treated in this alternative setting. CPEP crisis bed services are neither funded by OMH nor Medicaid reimbursable, but are purchased from the facility operating these beds.� This program is one of four program components which, when provided together, form the OMH licensed Comprehensive Psychiatric Emergency Program (CPEP). The other program components of the CPEP are: CPEP Crisis Intervention (3130), CPEP Crisis Outreach (1680) and CPEP Extended Observation Beds (1920).
Units of Service: One resident day.
2680 Crisis Intervention (Non Licensed Program)
Crisis intervention services, applicable to adults, children and adolescents, are intended to reduce acute symptoms and restore individuals to pre crisis levels of functioning. Examples of where these services may be provided include emergency rooms and residential settings. Provision of services may also be provided by a mobile treatment team, generally at a consumer�s residence or other natural setting (not at an inpatient or outpatient treatment setting). Examples of services are screening, assessment, stabilization, triage, and/or referral to an appropriate program or programs. This program type does not include warm lines or hot lines. Use Advocacy/Support 1760 for such services. �This program code should not be used for services that are provided by a licensed outpatient program.
Units of Service: Count the total staff hours.
2770 - Self Help Program (Non Licensed Program)
To provide rehabilitative and support activities based on the principle that people who share a common condition or experience can be of substantial assistance to each other. These programs may take the form of mutual support groups and networks, or they may be more formal self help organizations that offer specific educational, recreational, social or other program opportunities.
Direct staff hours: The number of staff hours spent by staff in providing case management services face to face or by telephone directly to Consumers or collaterals.
Indirect staff hours: The number of staff hours spent by staff in providing case management services on behalf of Consumers other than face to face or by telephone directly with Consumers or collaterals.
Units of Service: Count the number total number of staff hours (combine direct and indirect)
2810 � Intensive Case Management (ICM) Services Dollars Management �(Part of the Intensive Case Management Program)
Direct costs of support provided by the county or agency for contracted management expenses.
Units of Service: Not applicable.
2820 � Consumer Service Dollars (Non ICM/SCM/BCM/ACT) (Non Licensed Program)
Consumer Service Dollars (also known as "wrap around" dollars) may be used for any service(s) that address a consumer�s basic needs and assist the consumer in living, working and/or socializing in a community environment. Authorizations and the detail of use for Consumer Service Dollars must be kept and available for field audit. Providers must have internal controls in place to limit the use of these funds. Examples of eligible expenses include: food, security deposits, lodging, respite, clothing, payment of a utility bill to prevent shut off, medical care, transportation, crisis specialist, educational services, vocational services, leisure time activities, homemakers and escorts. A fuller description of the uses and requirements for these funds is located in the annual "Contracting and Policy Guidelines." This definition does not apply to ICM, SCM or ACT teams.
Units of Service: Each authorization to use these funds.
2830 - Intensive Case Management/Supportive Case Management/Blended Case Management Emergency and Non Emergency Service Dollars (Non Licensed Program)
Services consistent with a consumers treatment plan, designed to be flexible and responsible to current individual needs. These services may include emergency services, both immediate and not immediate. The emergency dollars aimed at meeting immediate basic needs of the consumer to include transportation, medical/dental care, shelter/respite/hotel, food/meals, clothing, escort and other. Service dollars may also include furnishings, utilities, tuition, job related costs, job coaching, education, vocational services, leisure time services and others. This program does not include agency administration. Agency administrative costs allocated to the operating costs of this program via the Ratio Value allocation methodology are redistributed to other OMH programs in the CFR.
Units of Service: Not applicable.
3130 � CPEP Crisis Intervention (Licensed Program)
This licensed, hospital based psychiatric emergency program establishes a primary entry point to the mental health system for individuals who may be mentally ill to receive emergency observation, evaluation, care and treatment in a safe and comfortable environment. Emergency visit services include provision of triage and screening, assessment, treatment, stabilization and referral or diversion to an appropriate program. Brief emergency visits require a psychiatric diagnostic examination and may result in further CPEP evaluation or treatment activities, or discharge from the CPEP program. Full emergency visits, which result in a CPEP admission and treatment plan, must include a psychiatric diagnostic examination, psychosocial assessment and medication examination. Brief and full emergency visit services are Medicaid reimbursable.
CPEP Crisis Intervention is one of four program components which, when provided together, form the OMH licensed Comprehensive Psychiatric Emergency Program (CPEP), and the code to which the license is issued. The other program components of the CPEP are: CPEP Extended Observation Beds (1920), CPEP Crisis Outreach (1680) and CPEP Crisis Beds (2600).
Units of Service:
Brief Emergency Visit
Full Emergency Visit
Count the total number of visits.
3340 - Work Program (Non Licensed Program)
The objective is to provide vocational assessment, training and transitional or long term paid work in institutional or community job sites for individuals disabled by mental illness. Paid by the vocational services provider.
Units of Service: Count the total number of staff hours.
3990 - Multicultural Initiatives (Non Licensed Program)
Funds will support activities related to the development and operation of outreach interventions in underserved communities and to address disparities based upon culture, ethnicity, age, or gender. Efforts by service providers will include the cultural and linguistic competence of their programs, management and staff.
Units of Service: Count the total number of staff hours.
4340 - Ongoing Integrated Supported Employment Services (Non Licensed Program)
These funds are intended for ongoing job maintenance services including job coaching, employer consultation, and other relevant supports needed to assist an individual in maintaining a job placement. These services are intended to complement VESID time limited supported employment services.
Units of Service: Count the total number of staff hours.
6340 - Comprehensive PROS with Clinic (Licensed Program)
Personalized Recovery Oriented Services (PROS) is a comprehensive recovery oriented program for individuals with severe and persistent mental illness. The goal of the program is to integrate treatment, support and rehabilitation in a manner that facilitates the individual's recovery. Goals for individuals in the program are to: improve functioning, reduce inpatient utilization, reduce emergency services, reduce contact with the criminal justice system, increase employment, attain higher levels of education and secure preferred housing. There are four service components" in the program: Community Rehabilitation and Support (CRS), Intensive Rehabilitation (IR), Ongoing Rehabilitation and Support (ORS) and Clinical Treatment.
Units of Service: Count the number of direct care hours.
6810 - Supportive Case Management (SCM) (Non Licensed Program)
In addition to the program description for Case Management (Code 0810), SCM services are services which are operated under a fidelity structure defined in 18 NYCRR, Section 505 and a memorandum of understanding between OMH and the NYS Department of Health.
Units of Service: Count two or more face to face contacts per month as one unit. Report total contacts.
7340 - Comprehensive PROS without Clinic (Licensed Program)
Personalized Recovery Oriented Services (PROS) is a comprehensive recovery oriented program for individuals with severe and persistent mental illness. The goal of the program is to integrate treatment, support and rehabilitation in a manner that facilitates the individual's recovery. Goals for individuals in the program are to: improve functioning, reduce inpatient utilization, reduce emergency services, reduce contact with the criminal justice system, increase employment, attain higher levels of education and secure preferred housing. There are four "service components" in the program: Community Rehabilitation and Support (CRS), Intensive Rehabilitation (IR), Ongoing Rehabilitation and Support (ORS) and Clinical Treatment. This program does not include the optional Clinic Treatment component.
Units of Service: Direct Care Hours.
8810 � Assertive Community Treatment (ACT) Program Service Dollars (Associated with the licensed Assertive Community Treatment (ACT) program, Program Code 0800)
Individual services aimed at meeting basic needs of the consumer. These services may include emergency services as well as job coaching, education, leisure time services and others. Agency administrative costs allocated to the operating costs of this program via the Ratio Value allocation methodology are redistributed to other OMH programs in the CFR.
Units of Service: Not applicable.