New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 551 - Prior Approval Review For Quality And Appropriateness
Section 551.12 - Additional criteria for inpatient projects
Universal Citation: 14 NY Comp Codes Rules and Regs ยง 551.12
Current through Register Vol. 46, No. 39, September 25, 2024
(a) In addition to the criteria of sections 551.7 and 551.10 of this Part, applications for inpatient projects shall be reviewed against criteria in this section.
(b) No application for the issuance of an operating certificate of a psychiatric inpatient unit of a hospital licensed pursuant to article 28 of the Public Health Law, which is applying for an operating certificate pursuant to Part 580 of this Title, shall be granted unless the applicant hospital is, or will be, approved to admit individuals in emergencies pursuant to section 9.39 of the Mental Hygiene Law, except as or provided pursuant to the authority granted in section 31.04 (a)(4) of the Mental Hygiene Law and as outlined below.
(1) The
commissioner shall waive this requirement for a period of two years upon
determination that:
(i) there is no public
need for additional beds for emergency psychiatric admission in the service
area. In determining such need, the factors which the commissioner shall
consider include, but shall not be limited to:
(a) the current and projected population
characteristics of the service area, including the prevalence of mental illness
in the population;
(b) the current
patterns of utilization of psychiatric services and the service demands of the
service area; and
(c) the existence
and availability of psychiatric resources available in the community;
(ii) the hospital lacks the
physical capacity to reasonably accommodate such emergency admissions without
extensive structural changes. For the purpose of this section, extensive
structural changes shall consist of any project for which the costs of
accommodating emergency admissions will unreasonably increase the psychiatric
inpatient rate of the hospital;
(iii) the hospital does not and reasonably
could not provide the scope of services necessary to assure adequate and
appropriate psychiatric care and treatment for patients in emergency
situations; or
(iv) the hospital
has agreed to accept referrals of involuntary psychiatric patients under an
emergency admissions system which has been approved by the commissioner. In
determining whether such a proposed system should be approved, the
commissioner, in consultation with the local governmental unit, shall consider
whether such proposal:
(a) defines the
specific area to be served;
(b)
provides for sufficient beds for emergency psychiatric admissions to meet the
public needs identified for the service area pursuant to subparagraph (i) of
this paragraph;
(c) describes the
manner in which the patterns of admission in the service areas will be
altered;
(d) projects the number of
admissions that will occur at the hospital covered under the proposal;
and
(e) effectively addresses the
availability of emergency psychiatric admissions to meet the projected public
needs.
(2) No
hospital without an on-site emergency room shall be required to accept patients
in need of emergency observation, care and treatment. No application for the
issuance of an operating certificate for a psychiatric inpatient unit of such
hospital shall be accepted until the hospital has agreed to accept referrals of
involuntary psychiatric patients under an emergency admission system which has
been approved by the commissioner, except the commissioner may waive this
requirement for a period of two years pursuant to paragraph (1) of this
subdivision.
(3) Nothing in this
Part shall prevent the commissioner from requiring a hospital to admit patients
under section 9.39 of the Mental Hygiene Law on an
emergency basis if the health or welfare of the public so requires.
(4) Prior to granting a waiver to a hospital,
the commissioner shall consider the comments of the director of the local
governmental unit of the specific service area.
(c) In reviewing projects for inpatient beds, the Office of Mental Health shall consider:
(1) the advice and recommendations of the
local governmental unit;
(2)
current or anticipated psychiatric treatment alternatives to acute psychiatric
inpatient care which lessen the need for inpatient care;
(3) whether the project improves the network
of services available to patients in the service area;
(4) for projects serving children and
adolescents:
(i) conformance with admission
and utilization review practices which emphasize the shortest lengths of stay
clinically appropriate in order to prevent the child's or adolescent's
estrangement from family and community;
(ii) conformance with discharge practices
which emphasize planning for discharge from the time of admission, prevention
of family or community estrangement, and post discharge follow-up
responsibility for all patients; and
(iii) conformance with the policy of
developing smaller, specialized children/adolescents units that serve children
and adolescents as close to their own communities as possible. Specifically,
the Office of Mental Health will consider location of beds, number of beds,
travel distances to obtain service in the proposed service area, public
transportation, other access factors, and service area plans for children and
adolescent beds.
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