2019 New York Laws
MHY - Mental Hygiene
Title E - General Provisions
Article 31 - Regulation and Quality Control of Services for the Mentally Disabled
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  psychiatric  emergency
services  provided  in  an  emergency  room  located  within  a  general
hospital,  which  shall  include 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; extended observation beds; and other on-site psychiatric
emergency services.
  (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.
  (4) "Crisis residence services" means an outpatient service  operating
twenty-four   hours   per   day   which   provides  residential,  crisis
stabilization and other necessary support services to persons  who  have
recently  experienced  a  psychiatric  crisis,  who are in need of acute
psychiatric symptom reduction, and who  are  in  need  of  a  controlled
non-inpatient  residential  setting  in  order to restore such person to
their pre-crisis  level  of  functioning.  Such  services  may  also  be
provided  to  persons  who are clinically determined to be at risk of an
emerging  psychiatric  crisis  and  other  persons   deemed   clinically
appropriate  pursuant  to  standards  developed  by  the commissioner of
mental health.
  (5) "Extended observation bed" means an inpatient bed which is  in  or
adjacent  to  an  emergency  room  located  within  a  general hospital,
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.
  (8) "Rural  area"  shall  have  the same meaning as defined in section
four hundred eighty-one of the executive 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.
  (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,
crisis residence 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 crisis intervention
services, crisis outreach services, crisis residence 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.
  (i)  For the purpose of addressing unique rural service delivery needs
and conditions, the commissioner shall provide technical  assistance  to
assist  in  the  establishment  of  comprehensive  psychiatric emergency
programs otherwise  approved  under  the  provisions  of  this  section,
including   technical   assistance   to   promote   and  facilitate  the
establishment  of  such  programs  in  rural  areas  in  the  state   or
combinations of rural counties.
  * NB Repealed July 1, 2020