Consumers' Rights When Applying to Licensed Mental Health Housing: Part One
(Column: Ask the Housing Experts)
All supportive housing programs that serve people with mental illness operate under rules and regulations. However, different sets of regulations apply to different models of housing, depending on who licenses or funds the program. Part 595 of the New York State Mental Hygiene Law establishes the regulations that apply to all housing programs licensed by the New York State Office of Mental Health (OMH). Of the different types of supportive housing here in New York City, five are required to follow the 595 regulations (595's): the Supervised Community Residence, the MICA Community Residence, Apartment Treatment programs, the Community Residence/Single Room Occupancy (CR/SRO), and the Residential Care Center for Adults (RCCA).
The 595's establish the rules by which a mental health residential program must operate, and they define both the rights of applicants to the program, and the rights of residents in these programs. This article is the first in a two part series about the 595 regulations; in this part, we will be focusing on an individual's rights when they apply to one of the above mentioned models of supportive housing. In the second part, we will look at a resident's rights regarding discharge from the program where they live.
Consumers who would like to apply for supportive housing need to submit an application packet (the HRA 1995) to the NYC Human Resources Administration/Office of Health and Mental Health (HRA/OHMHS). HRA/OHMHS determines whether or not a consumer is eligible for supportive housing. Consumers must meet specific eligibility criteria: applicants must be 18 years of age or older, and have an Axis I diagnosis of a serious and persistent mental illness. In addition, they must meet one of three additional criteria:
1) They must receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) due to a mental illness OR;
2) They must demonstrate extended impairment in functioning due to a mental illness OR;
3) They must demonstrate an ongoing reliance on psychiatric treatment, rehabilitation and supports.
Once a consumer has been determined to be eligible for licensed housing, and applies to a residential program regulated by the 595's, the residential program must make available written information describing their program and their application process. If the program does not offer this information in writing, consumers are encouraged to request written descriptions. The regulations state that this information should, at a minimum, include:
Admission and exclusion criteria (who is eligible and who is not eligible)
Information regarding what documentation is required for each applicant " A description of the admission process
Information about the types of living accommodations available (e.g. shared versus single rooms, etc.)
A description of the services to be provided by the housing program
Clear information about the fees required for the program
A copy of the residency agreement, house rules and/or resident rights
A copy of the policy describing what happens if a resident needs to be hospitalized
A description of the discharge planning process
According to the regulations, once an applicant has been interviewed, the housing program must make a decision regarding admission within 15 working days. Housing providers must provide a written explanation to the applicant/referring agency if a decision has not been reached in the specified time frame, or if the client's application is rejected. Rejection notices should include information about what steps would be needed in order for the person to be reconsidered for admission to the program. Consumers who do not receive written rejection/delay notices are encouraged to request them.
Housing programs regulated under the 595's are required to have a rehabilitative focus, meaning they are required to provide services that help residents learn new skills and become more independent. Programs are also required to provide the services that are compatible with the resident's "desire, tolerance, and capacity to participate." Services must have the goal of integrating the resident into the surrounding community and are required to allow for individual choice. To this end, the regulations require programs to include residents in the development and implementation of a service plan that is tailored to their individual needs and goals.
Residential programs regulated under the 595's can only require residents to participate in on-site or outside services, like a continuing day treatment program, skill development groups, or substance use treatment under two specific circumstances. First, if participation in a program or service is indicated for the resident under an AOT order (Assisted Outpatient Treatment, also known as Kendra's Law), the residential program can require program attendance and/or service participation. Second, a residential program can require participation in on-site and/or outside services "if the services are critical to the rehabilitation goals of such an individual, are consistent with the individual's service plan and are stipulated and agreed upon within the residency agreement." In practice, the programs regulated under the 595's are geared towards people who are agreeable to participating in a structured day activity.
Other program rules and requirements, regarding curfew, guests, drug and/or alcohol testing, pets, etc., are required to be in the Residential Agreement and/or House Rules. Consumers are encouraged to inquire about these requirements and read the Residential Agreement/House Rules prior to move-in.
In the next issue of New York City Voices, we will conclude this two part series by reviewing a resident's rights and a program's responsibilities regarding discharge.