N.Y. Mental Hygiene Law § 31.27: Comprehensive psychiatric emergency programs

** § 31.27 Comprehensive psychiatric emergency programs.

(a) As used in this section:

(1) "Commissioner" means the commissioner of mental health.

(2) "Crisis intervention services" means services provided in an

emergency room located within a general hospital, which shall include

but not be limited to: psychiatric and medical evaluations and

assessments; prescription or adjustment of medication, counseling, and

other stabilization or treatment services intended to reduce symptoms of

mental illness when appropriate.

(3) "Crisis outreach services" means psychiatric emergency services

provided outside an emergency room setting including evaluation,

assessment and stabilization services; crisis reduction services;

referral services; and other psychiatric emergency services.

(5) "Extended observation bed" means an inpatient bed which is in or

adjacent to an emergency room located within a general hospital or

satellite facility approved by the commissioner, designed to provide a

safe environment for an individual who, in the opinion of the examining

physician, requires extensive evaluation, assessment, or stabilization

of the person's acute psychiatric symptoms, except that, if the

commissioner determines that the program can provide for the privacy and

safety of all patients receiving services in a hospital, he or she may

approve the location of one or more such beds within another unit of the

hospital.

(6) "General hospital" shall be defined as in article twenty-eight of

the public health law.

(9) "Psychiatric emergency services" means services designed to

stabilize and, when possible, reduce acute psychiatric symptoms of an

individual who appears to be mentally ill and in crisis.

(10) "Triage and referral services" means services designed to provide

preliminary diagnosis, assessment and evaluation of individuals served

by a comprehensive psychiatric emergency program in order to direct such

person to those services which appropriately address their needs.

(11) "Voluntary agency" shall be defined as in section 41.03 of this

chapter.

(12) "Satellite facility" means a medical facility providing

psychiatric emergency services that is managed and operated by a general

hospital who holds a valid operating certificate for a comprehensive

psychiatric emergency program and is located away from the central

campus of the general hospital.

(b) (1) The commissioner may license the operation of comprehensive

psychiatric emergency programs by general hospitals which are operated

by state or local governments or voluntary agencies. The provision of

such services in general hospitals may be located either within the

state or, with the approval of the commissioner and the director of the

budget and to the extent consistent with state and federal law, in a

contiguous state. The commissioner is further authorized to enter into

interstate agreements for the purpose of facilitating the development of

programs which provide services in another state. A comprehensive

psychiatric emergency program shall serve as a primary psychiatric

emergency service provider within a defined catchment area for persons

in need of psychiatric emergency services including persons who require

immediate observation, care and treatment in accordance with section

9.40 of this chapter. Each comprehensive psychiatric emergency program

shall provide or contract to provide psychiatric emergency services

twenty-four hours per day, seven days per week, including but not

limited to: crisis intervention services, crisis outreach services,

extended observation beds, and triage and referral services.

(2) The commissioner of mental health shall require that each

comprehensive psychiatric emergency program submit a plan. The plan must

be approved by the commissioner prior to the issuance of an operating

certificate pursuant to this article. Each plan shall include: (i) a

description of the program's catchment area; (ii) a description of the

program's psychiatric emergency services, including but not limited to

crisis intervention services, crisis outreach services, extended

observation beds, and triage and referral services, whether or not

provided directly or through agreement with other providers of services;

(iii) agreements or affiliations with hospitals, as defined in section

1.03 of this chapter, to receive and admit persons who require inpatient

psychiatric services; (iv) agreements or affiliations with general

hospitals to receive and admit persons who have been referred by the

comprehensive psychiatric emergency program and who require medical or

surgical care which cannot be provided by the comprehensive psychiatric

emergency program; (v) a description of local resources available to the

program to prevent unnecessary hospitalizations of persons, which shall

include agreements with local mental health, health, substance abuse,

alcoholism or alcohol abuse, developmental disabilities, or social

services agencies to provide appropriate services; (vi) a description of

the program's linkages with local police agencies, emergency medical

services, ambulance services, and other transportation agencies; (vii) a

description of local resources available to the program to provide

appropriate community mental health services upon release or discharge,

which shall include case management services and agreements with state

or local mental health and other human service providers; (viii) written

criteria and guidelines for the development of appropriate discharge

planning for persons in need of post emergency treatment or services;

(ix) a statement indicating that the program has been included in an

approved local services plan developed pursuant to article forty-one of

this chapter for each local government located within the program's

catchment area; and (x) any other information or agreements required by

the commissioner.

(c) Each comprehensive psychiatric emergency program shall have at

least one physician, who is a member of the psychiatric staff of the

program, on duty and available at all times, provided, however, the

commissioner may promulgate regulations to permit the issuance of a

waiver of this requirement when the volume of service of a program does

not require such level of staff coverage.

(d) The commissioner shall promulgate regulations to establish a

maximum number and location of extended observation beds which may be

provided in a program, including provisions to maximize the privacy and

safety of all patients receiving services in the hospital in which such

extended observation beds are located.

(e) The commissioner may prevent new presentations and admissions from

entering a comprehensive psychiatric emergency program when the

commissioner concludes that the ability of the program to deliver

quality services would be jeopardized. Before reaching such a

conclusion, the commissioner shall consider the effect presenting new

presentations and admissions may have on other hospital emergency rooms

which provide psychiatric emergency services, and the commissioner shall

review the continued necessity for such prevention at least once every

twenty-four hours.

(f) The commissioner and the commissioner of health shall enter into a

cooperative agreement to govern the operation of comprehensive

psychiatric emergency programs including visitation, inspection and

supervision of such programs, enforcement of the conditions of operating

certificates issued by the office of mental health and the department of

health, and the protection of the confidentiality of clinical

information regarding patients at such programs.

(g) The office of mental health, the department of social services and

the department of health shall establish a uniform system by which

general hospitals which operate comprehensive psychiatric emergency

programs shall report the cost of operating such programs.

(h) Notwithstanding any other provision of law, nothing in this

section shall be interpreted to create an entitlement for any individual

to receive psychiatric emergency services in a comprehensive psychiatric

emergency program.

** NB Repealed July 1, 2027