Current through Register Vol. 46, No. 39, September 25, 2024
(a) A comprehensive
psychiatric emergency program shall continuously employ an adequate number of
staff and an appropriate staff composition to carry out its goals and
objectives as well as to ensure the continuous provision of sufficient ongoing
and emergency supervision. Each comprehensive psychiatric emergency program
shall submit a staffing plan which includes the qualifications and duties of
each staff position by title. The staffing plan and its rationale shall be
subject to approval by the Office of Mental Health. The Office of Mental Health
must be notified of and approve any long-term deviations from the approved
staffing plan.
(b) An adequate
proportion of the clinical staff hours shall be provided by full-time
employees.
(c) The comprehensive
psychiatric emergency program shall, at a minimum, employ the following types
and numbers of staff:
(1) except as provided
in subdivision (e) of this section, at least one full-time equivalent
psychiatrist who is a member of the psychiatric staff of the program shall be
on duty and available at all times;
(2) at least one full-time equivalent
registered nurse shall be on duty at all times and shall be responsible for the
supervision of the nursing care and treatment provided in the extended
observation beds of the comprehensive psychiatric emergency program;
(3) at least one full-time equivalent
licensed master social worker or licensed clinical social worker shall be on
duty and available, at a minimum, during the day and evening hours;
(4) a sufficient number of security personnel
shall be on duty and available at all times;
(5) at least one full-time equivalent
credentialed alcoholism and substance use disorder counselor or clinical staff
person with experience in the counseling or treatment of individuals with a
substance use disorder shall be available or on call 24 hours a day;
(6) the extended observation beds component
of the comprehensive psychiatric emergency program shall be staffed by at least
one clinical staff person, who is supervised by the registered nurse supervisor
indicated in paragraph (2) of this subdivision, 24 hours per day, seven days
per week; and
(7) when providing
crisis outreach at a site other than the emergency room of the comprehensive
psychiatric emergency program at least two staff of the crisis outreach team,
one of whom is a member of the professional staff, shall be present at all
times.
(e) The
commissioner may waive the requirement that one full time equivalent
psychiatrist be on duty and available during the night hours, if:
(1) the comprehensive psychiatric emergency
program can demonstrate that the volume of service does not require such level
of staff coverage; and
(2) the
comprehensive psychiatric emergency program can demonstrate that it can provide
adequate coverage by other professional disciplines; and
(3) the comprehensive psychiatric emergency
program can demonstrate the availability of a psychiatrist on call for
consultation and supervision.
(f) For comprehensive psychiatric emergency
programs which are within rural areas and which have 3,000 or less
presentations per year, the commissioner may waive the requirement that one
full-time equivalent psychiatrists be on duty and available if:
(1) the comprehensive psychiatric emergency
program can demonstrate that the volume of service does not require such level
of staff coverage;
(2) the
comprehensive psychiatric emergency program can demonstrate that it can provide
adequate 24-hour coverage by other professional staff; and
(3) the comprehensive psychiatric emergency
program can demonstrate the availability of a psychiatrist on-call for
face-to-face interaction, consultation, supervision, an admission to or
discharge from an extended observation bed.
(i) In order to assure that individuals
admitted to the comprehensive psychiatric emergency program are adequately
supervised and are cared for in a safe and therapeutic manner, the
comprehensive psychiatric emergency program shall meet each of the following
requirements:
(1) appropriate professional
staff shall be available to assist in emergencies on at least an on-call basis
at all times.
