New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 591 - Medical Assistance Payments For Comprehensive Psychiatric Emergency Programs
Section 591.3 - Definitions

(a) Crisis outreach means face to face psychiatric emergency services provided outside an emergency room setting which includes clinical 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.

(b) 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 or mental health 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 or services are completed. It may include other examinations and assessments as clinically indicated by the patient's presenting problems. Full emergency visits 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.

(c) 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:

(d) 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.