** § 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, 2024