New York's OMH Operating Certificate

New York regulates mental health and substance use programs through two separate offices. The Office of Mental Health (OMH) licenses mental health programs; the Office of Addiction Services and Supports (OASAS) certifies substance use programs. Both call their license an operating certificate, and a program offering both kinds of care can need one from each.

OMH puts the rule simply: "Service providers must have an operating certificate (license) from OMH before the operation of facilities and programs that are subject to regulatory jurisdiction." And to get one, "providers must go through the Prior Approval Review process."

Which programs need an OMH operating certificate?

OMH's Licensed Program Type Definitions page lists them. Licensed outpatient program types include Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS), partial hospitalization, continuing day treatment, children's day treatment, Personalized Recovery Oriented Services (PROS), Assertive Community Treatment and Youth ACT, intensive and supportive crisis stabilization centers, and the hospital-based Comprehensive Psychiatric Emergency Program. Licensed residential programs include community residences, crisis residences, teaching family homes and service-enriched single room occupancy programs, and inpatient programs are licensed too. OMH notes that it also authorizes some residential and non-residential programs that do not require licensure, so check the definitions before assuming either way.

Crisis stabilization centers are a special case: OMH and OASAS jointly license them under Mental Hygiene Law Article 36, and those applications go through the state's NYSE-CON portal rather than OMH's own system.

What is Prior Approval Review?

Prior Approval Review (PAR) is OMH's process for approving a project before it opens, changes or closes. The rules are in 14 NYCRR Part 551, which OMH says sets "minimum standards to ensure that entities providing mental health services that seek an operating certificate from OMH meet appropriate criteria for quality, safety, and fiscal viability." Applications are submitted through OMH's Mental Health Provider Data Exchange (MHPD) system, and the PAR page lists supplemental forms including prior consultation forms, budget tools and an NFPA 101 Life Safety Code checklist.

Comprehensive PAR or E-Z PAR?

Part 551.6 sorts projects into two review tracks.

• Comprehensive review applies to, among other things, a new program from an applicant that is not currently licensed by OMH or has been licensed for less than six months; a change of sponsor to someone new to OMH licensing; and capital projects over a set threshold. A brand-new provider opening its first clinic is on this track.
• E-Z PAR review applies to outpatient projects from applicants that already operate OMH-licensed programs, such as a new outpatient program or satellite, relocating a program or satellite to another county, a substantial change in caseload, population, services or program type, or closing an outpatient program.

OMH or the local governmental unit can move an E-Z PAR project to comprehensive review if it will have a significant local impact, is unusually complex or uses substantial public resources (551.9(c)).

Who do you consult before applying?

Consultation is required, not optional. The applicant must consult the local governmental unit through its director of community services before submitting, and for E-Z PAR must include a letter of support from that unit with the application (551.5(c)). Applicants must also make good faith efforts to consult OMH staff first (551.5(d)), and OMH's PAR page says the local Director of Community Services and the OMH Field Office should be consulted before any application, with the Field Office identifying the application type and supporting documents. The rule also advises an applicant planning an extensive and expensive project to check public need in the county before applying (551.5(b)).

What standards does OMH apply?

Section 551.7(a) lists what the review weighs. Among the most consequential:

1. whether the board members, officers, owners, partners, LLC members and stockholders have the character, experience, competence and standing to manage the organization responsibly, considering the criminal history of any natural person operator;
2. whether there is public need for the project at the time and place proposed, and whether alternatives exist;
3. whether the project fits local or unified services plans and links to the wider system of care;
4. whether funds are reasonably assured for operations and for any construction or renovation;
5. whether the facility will be safe and appropriate and the program will meet operating certificate requirements; and
6. for a management or clinical services contract, whether the operator keeps effective control of the program.

The public need standard is the one out-of-state operators often do not expect. A New York application has to make the case that the county needs the program, not just that the applicant can run it.

Are there deadlines inside the review?

Part 551.9 sets the early deadlines. For E-Z PAR, OMH reviews completeness within three business days, tells the applicant what is missing within five, and the applicant has 10 business days to respond. For comprehensive PAR, the figures are five, seven and 20 business days. A missed response deadline counts as withdrawing the application. Local and other reviewers then have 20 business days (comprehensive) or 10 (E-Z PAR) to comment, and silence counts as no objection. Comprehensive projects also go to the Mental Health Services Council for recommendations before the Commissioner decides.

If the project involves construction or substantial renovation, the applicant submits building, safety and design information within four months of approval, OMH may rescind approval if there is no substantial progress within six months, and OMH may inspect the site before the program starts (551.10). A leased site needs specific lease language acknowledging that the landlord's reentry rights do not let it operate the facility (551.10(b)).

How do crisis stabilization center applications work?

Crisis stabilization centers follow a different path because OMH and OASAS license them jointly under Mental Hygiene Law Article 36. According to OMH's PAR page, the applicant first completes a prior consultation form and sends it to the local governmental unit, the OMH Field Office and the OASAS Regional Office to request a prior consultation meeting, and collects the required signatures at that meeting. The application itself goes through the state's NYSE-CON portal with a set of schedules: entity, site and service information, a policies and procedures attestation, and resource allocation. Providers not currently licensed by either office also submit a governing authority questionnaire, a character and competence review and fingerprinting consent forms. After submission, all communication runs through the portal.

How is an operating certificate renewed?

OMH's Bureau of Inspection and Certification issues and renews operating certificates, with Field Office staff conducting the licensing surveys. "An unannounced inspection occurs before the renewal of the operating certificate," and if the program is in substantial compliance, the certificate is renewed. The certificate identifies the provider, the program type, the location and the effective and renewal dates.

How is the OASAS side different?

For substance use programs, Mental Hygiene Law 32.05 says no provider may operate a residential program, or a program of outpatient or non-residential chemical dependence services, without an OASAS operating certificate, with exceptions that include licensed professionals practicing within their own license. OASAS has its own application process under 14 NYCRR Part 810. The New York page covers both offices.

Can we prepare an OMH application?

We prepare the PAR application and supporting forms, draft the program description and the public need narrative, help you prepare for the local consultation, assemble the character and competence information for every principal, and get the site ready for OMH's inspection. Your authorized officer signs and submits through your own MHPD account, which stays yours. The State License package is $1,995 for an outpatient program at one site, and a Facility Readiness Review ($149, credited toward a package) is the right first step if you are deciding whether to open in New York at all. Licensed social workers relocating to staff the program can read White Glove Social Work's New York LCSW by endorsement guide.