MHOTRS Standards of Care and Program Guidance

July 19, 2023

See below and 2 docs (attached) from OMH. Don’t forget to review highlighted content (below) in red (I added the highlights)

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Subject: MHOTRS Standards of Care and Program Guidance

The New York State Office of Mental Health (OMH) has updated two documents specific to Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS):

The updated Standards of Care replaces “clinic” with “MHOTRS program” throughout, includes the addition of NPP signatures for Initial Treatment Plans and flexibilities for the provision of optional and off-site services. Additionally, Exemplary standards have been added to support Peer Support Services, when available. The Standards of Care can be found on the OMH Website NYS Bureau of Inspection and Certification MHOTRS Program Standards of Care Anchor Element July 2023.

Article 31 MHOTRS Program Guidance has been updated to address the changes in Part 599 regulations, that were approved in November 2022 to allow more flexibilities, since moving under the Rehab State Plan Amendment.  The Program Guidance also contains updated language and formatting since the last guidance revisions. The following is a summary of the guidance updates:

  1. Separated Program Guidance from Billing Guidance into two documents, billing guidance can be found here.
  2. Explanation of program name change to MHOTRS
  3. Addition of Off-site Services allowances for all services and age ranges
  4. Addition of Co-Enrollment allowances
    1. Defining co-enrollment between two MHOTRS programs
    2. Defining co-enrollment between MHOTRS programs and other programs
  5. Defining PA credentials needed to provide psychiatric assessments and medication services
  6. Expanding Crisis services definition to match regulations
  7. Addition of examples of Complex Care Management into guidance, eliminating appendix
  8. Addition of Peer Support Services definition and guidance that align with the Guidance for Peer Support Services
  9. Reorganization of information:
    1. Assessment now includes Health Screening
    2. Health Monitoring now includes Tobacco Use Disorder and Health Physical
    3. Removal of Telepsychiatry guidance, released as separate Telehealth guidance
  10. Addition of Neurobehavioral Status Examination definition and guidance
  11. IOP
    1. Added definition and guidance
    2. Elimination of a waiver requirement, instead allowing an AA for authorization
  12. Staffing definitions and requirements
    1. Supervisory guidance
    2. Definition of Peer Support Specialists/Advocates
    3. Removal of requirement of Board Certification for Psychiatrists but identifying definition of Psychiatrist, including completing ACGME-accredited programs
    4. Definition of the role and responsibilities of a Medical Director
  13. Outline of Policies and procedures required, highlighting changes needed to programs’ policies and procedures from regulation revisions
  14. Inclusion of AOT recipients and individuals transitioning from ACT in the populations prioritized for admission/services in MHOTRS programs
  15. Changes to Utilization Review requirements reducing provider burden
  16. Addition of NPPs able to sign treatment plans
  17. Updated definitions list

Program Guidance can be found on the OMH Website Part 599 Clinic Program (

OMH expects providers to rapidly review and come into compliance with this guidance. We will begin incorporating the terms of the updated Standards of Care and Program Guidance in OMH’s certification reviews effective August 1st, 2023. Correspondingly, OMIG will be informed of this date to use for future audits.

Questions regarding the Standards of Care can be directed to

Questions regarding the MHOTRS Program Guidance can be directed to for adult services, and for child/adolescent services.