N.Y. Comp. Codes R. & Regs. tit. 14 § 590.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 590.4 - Definitions

(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.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 590.4

Amended New York State Register August 17, 2016/Volume XXXVIII, Issue 33, eff.8/17/2016

Amended New York State Register May 19, 2021/Volume XLIII, Issue 20, eff. 5/5/2021