Section 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,  mental  retardation  and  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 or unified 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, 2012