(1) No
application for the renewal of an operating certificate for a psychiatric
inpatient unit of a hospital licensed pursuant to article 28 of the Public
Health Law and Part 580 of this Title shall be accepted until the applicant
hospital is granted approval to admit patients pursuant to section 9.39 of the Mental Hygiene Law, except that
the commissioner shall waive this requirement for a period of two years upon
his or her determination that:
(i) there is
no public need for additional beds for emergency psychiatric admission in the
subregional service area. In determining such need, the factors which the
commissioner shall consider shall include, but 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;
(c) the existence and
availability of psychiatric resources available in the community; and
(d) acute bed needs of the service area as
identified in the acute bed needs methodology set forth in the Office of Mental
Health's five-year plan for mental health services required by section 5.07 (h) of the Mental
Hygiene Law;
(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
approved 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;
(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 subregional service area pursuant to
subparagraph (i) of this paragraph;
(c) describes the manner in which the
patterns of admission in the service area will be altered; and
(d) projects the number of admissions that
will occur at the hospitals covered under the proposal.
The commissioner shall also consider the way in which the
proposed system would affect the availability of emergency psychiatric services
in other service areas, and the ability of such areas to provide for sufficient
beds for emergency psychiatric admissions to meet the projected public
needs.
(2) No hospital without an onsite emergency
room shall be required to accept patients in need of emergency observation,
care and treatment. No application for the renewal of an operating certificate
for psychiatric inpatient units of such hospitals 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. The
commissioner shall specify in writing the nature and reasons for such
determination.
(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 subregional
service area. The commissioner shall forward a copy of the waiver request to
the director of the local governmental unit, who shall have 30 days within
which to respond.