New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 590 - Operation Of Comprehensive Psychiatric Emergency Programs
Section 590.4 - Definitions
Universal Citation: 14 NY Comp Codes Rules and Regs ยง 590.4
Current through Register Vol. 46, No. 39, September 25, 2024
(a) General.
(1) Commissioner means the Commissioner of
Mental Health.
(2) General hospital
shall be defined as in article 28 of the Public Health Law.
(3) Rural areas, for the purposes of this
Part, means any city, town, village, community, organization or other group in
a county with a population under 200,000.
(4) Voluntary agency shall be defined as in
article 41 of the Mental Hygiene Law.
(b) Services.
(1) Collaterals means an individual who is a
member of the patient's family or household, or other individual who interacts
with the patient and is directly affected by or has the capability of affecting
their condition and is identified in the comprehensive psychiatric emergency
plan as having a role in treatment and/or is necessary for participation in the
evaluation and assessment of the recipient prior to admission.
(2) Crisis outreach means face to face
psychiatric emergency services provided outside an emergency room setting which
includes evaluation, assessment and stabilization services. Crisis outreach
services include but are not limited to therapeutic communication, coordination
with identified supports, psychiatric consultation, safety planning, referral,
linkage, peer services. Crisis outreach services may be provided outside the
emergency room of the hospital, in the community or in other clinical areas
within the hospital, for purposes of face to face visits with individuals
discharged from the comprehensive psychiatric emergency program. Crisis
outreach does not have to result in a visit or admission to the comprehensive
psychiatric emergency program. For individuals discharged from the
comprehensive psychiatric emergency program, crisis outreach includes face to
face contact with a mental health professional for purposes of facilitating an
individual's community tenure prior to engagement or re-engagement with
community-based providers.
(3)
Extended observation bed means a bed located in or adjacent to the emergency
room of a comprehensive psychiatric emergency program designed to provide, for
a period up to 72 hours, a safe environment for an individual who, in the
opinion of the examining physicians, requires extensive evaluation, assessment,
or stabilization of the person's acute psychiatric symptoms.
(4) Full emergency visit means a face to face
interaction between a patient and a psychiatrist and other clinical staff as
necessary to determine a patient's current psychosocial and medical condition.
It must include a psychiatric diagnostic examination; psychosocial assessment;
and medical examination; which results in a comprehensive psychiatric emergency
treatment plan and a discharge plan when comprehensive psychiatric emergency
program services are completed. It may include other examinations and
assessments as clinically indicated by the patient's presenting problems. Full
emergency visit should be provided to patients whose presenting symptoms are
initially determined to be serious and where the clinical staff determine
commencement of treatment should begin immediately, and/or where staff are
evaluating a person for retention in an extended observation bed or admission
to a psychiatric inpatient unit.
(5) Medical examination means an examination
conducted as part of a comprehensive psychiatric emergency program's full
emergency visit, conducted by an appropriately credentialed professional
employed by the comprehensive psychiatric emergency program or emergency
department. Such medical examination shall include:
1. A History and Physical which may be
obtained either from the individual or systems including but not limited to the
Psychiatric Services and Clinical Knowledge Enhancement System (PSYCKES) or
Electronic Health Records (EHR) and includes at a minimum:
a. past medical history,
b. review of systems (physical systems), c.
review of medications and allergies, and d. assessment of vital
signs.
2. Where
clinically indicated:
a. a targeted physical
exam, and
b. orders for laboratory
and other diagnostic studies.
(6) On duty means the professional is
physically present in the building and accessible.
(7) Received means the individual has
completed all required registration materials upon entry to the comprehensive
psychiatric emergency program, and a record has been created for such
individual.
(8) Restraint means the
term restraint as such term is defined in section
526.4 of
this Title.
(9) 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. A satellite facility at
minimum must provide crisis intervention services including triage and referral
and full emergency visits and/or extended observation bed services.
(10) Seclusion means the term seclusion as
such term is defined in section
526.4 of
this Title.
(11) Triage means a
determination upon presentation by a staff member that an individual should
receive an evaluation, or when appropriate, referral to other nonmental health
services.
(12) Triage and referral
means a face to face interaction between a patient and a staff physician,
preferably a psychiatrist, or psychiatric nurse practitioner to determine the
scope of emergency service required. This interaction should include a
psychiatric diagnostic examination. It may result in further comprehensive
psychiatric emergency program evaluation or treatment activities on the
patient's behalf or discharge from the comprehensive psychiatric emergency
program. For those persons who are discharged from the comprehensive
psychiatric emergency program and who require additional mental health services
triage and referral must include a discharge plan.
(c) Staffing.
(1) Clinical staff are all staff members who
provide services directly to patients. Students and trainees may qualify if
they are participating in a program leading to a degree or certificate
appropriate to the goals, objectives and services of the comprehensive
psychiatric emergency program and are supervised in accordance with the
policies governing the training program and are included in the staffing plan
approved by the Office of Mental Health.
(2) Professional staff, for the purpose of
this Part, are individuals who are qualified by credentials, training and
experience to provide supervision and direct service related to the treatment
of mental illness in a comprehensive psychiatric emergency program and may
include the following:
(i) Creative arts
therapist is an individual who is currently licensed as a creative arts
therapist by the New York State Education Department or possesses a creative
arts therapist permit from the New York State Education Department.
(ii) Credentialed alcoholism and substance
use counselor is an individual who is credentialed by the New York State
Division of Alcoholism and Alcohol Abuse.
(iii) Licensed practical nurse is an
individual who is currently licensed as a licensed practical nurse by the New
York State Education Department or possesses a licensed practical nurse permit
from the New York State Education Department
(iv) Licensed psychoanalyst is an individual
who is currently licensed as a psychoanalyst by the New York State Education
Department or possesses a permit from the New York State Education Department.
(v) Marriage and family therapist
is an individual who is currently licensed as a marriage and family therapist
by the New York State Education Department or possesses a permit from the New
York State Education Department.
(vi) Mental health counselor is an individual
who is currently licensed as a mental health counselor by the New York State
Education Department or possesses a permit from the New York State Education
Department.
(vii) Nurse
practitioner is an individual who is currently certified as a nurse
practitioner by the New York State Education Department or possesses a permit
from the New York State Education Department.
(viii) Nurse practitioner in psychiatry
(referred to as Psychiatric Nurse Practitioner in statute) is an individual who
is currently certified as a nurse practitioner with an approved specialty area
of psychiatry (NPP) by the New York State Education Department or possesses a
permit from the New York State Education Department.
(ix) Physician is an individual who is
currently licensed as a physician by the New York State Education
Department.
(x) Physician assistant
is an individual who is currently registered as a physician assistant by the
New York State Education Department or possesses a permit from the New York
State Education Department. (xi) Psychiatrist is an individual who is currently
licensed as a physician by the New York State Education Department and who is
certified by, or eligible to be certified by, the American Board of Psychiatry
and Neurology.
(xii) Psychologist
is an individual who is currently licensed as a psychologist by the New York
State Education Department.
(xiii)
Registered professional nurse is an individual who is currently licensed as a
registered professional nurse by the New York State Education
Department.
(xiv) Rehabilitation
counselor is an individual who has either a master's degree in rehabilitation
counseling from a program approved by the New York State Education Department
or current certification by the Commission on Rehabilitation Counselor
Certification.
(xv) Social worker
is an individual who is either currently licensed as a licensed master social
worker or as a licensed clinical social worker by the New York State Education
Department or has a master's degree in social work from a program approved by
the New York State Education Department.
(3) Certified peer specialist means an
individual who is credentialed as a peer in New York State.
(4) Other professional disciplines may be
included as professional staff, provided that the discipline is approved as
part of the staffing plan submitted to the Office of Mental Health. The
discipline shall be from a field related to the treatment of mental illness.
For rural areas, individuals who have obtained at least a master's degree in
psychology may be considered professional staff for the purposes of calculating
professional staff but may not be assigned supervisory
responsibility.
Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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