OMH-32-12-00019-P Operation of Psychiatric Inpatient Units of General Hospitals and Operation of Hospitals for Persons with Mental Illness

8/8/12 N.Y. St. Reg. OMH-32-12-00019-P

NEW YORK STATE REGISTER

VOLUME XXXIV, ISSUE 32

August 08, 2012

RULE MAKING ACTIVITIES

OFFICE OF MENTAL HEALTH

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. OMH-32-12-00019-P

Operation of Psychiatric Inpatient Units of General Hospitals and Operation of Hospitals for Persons with Mental Illness

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

Amendment of Parts 580 and 582 of Title 14 NYCRR.

Statutory authority:

Mental Hygiene Law, sections 7.09, 29.15 and 31.04

Subject:

Operation of Psychiatric Inpatient Units of General Hospitals and Operation of Hospitals for Persons with Mental Illness.

Purpose:

To establish provisions prohibiting the discharging of patients to transitional adult homes.

Text of proposed rule:

1. A new subdivision (c) is added to Section 580.6 of Title 14 NYCRR to read as follows:

(c) Discharges.

(1) All discharges shall be in accordance with the provisions of section 29.15 of the Mental Hygiene Law, in a form and format designed by the Office.

(2) A hospital shall be prohibited from discharging any patient to a transitional adult home, as defined in regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization.

2. A new subdivision (c) is added to Section 582.6 of Title 14 NYCRR to read as follows:

(c) Discharges.

(1) All discharges shall be in accordance with the provisions of section 29.15 of the Mental Hygiene Law, in a form and format designed by the Office.

(2) A hospital shall be prohibited from discharging any patient to a transitional adult home, as defined in regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization.

Text of proposed rule and any required statements and analyses may be obtained from:

Sue Watson, NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

Regulatory Impact Statement

1. Statutory authority: Sections 7.09 and 31.04 of the Mental Hygiene Law grant the Commissioner of the Office of Mental Health the authority and responsibility to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction and to set standards of quality and adequacy of facilities, equipment, personnel, services, records and programs for the rendition of services for persons with mental illness pursuant to an operating certificate.

Section 29.15 of the Mental Hygiene Law establishes requirements for the discharge or conditional release of patients from hospitals operated by the Office of Mental Health (Office) or from psychiatric inpatient services subject to licensure by such Office.

2. Legislative objectives: Articles 7 and 31 of the Mental Hygiene Law reflect the Commissioner's authority to establish regulations regarding mental health programs. The proposed rule furthers the legislative policy of providing high quality mental health services to individuals with mental illness in a safe and secure environment by establishing provisions prohibiting the discharge of patients with mental illness to transitional adult homes.

3. Needs and benefits: The proposed amendments to 14 NYCRR Part 580 and 14 NYCRR Part 582 prohibit the discharge of a patient to a transitional adult home, as defined in the regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization. The Office is charged with the responsibility of providing care and treatment for persons with serious mental illness with the goal of supporting and assisting individuals toward integration into the community.

Mixed use, larger scale congregate housing is an important and viable form of community living. However, certain settings where there are a significant number of individuals with serious mental illness may not be conducive to recovery for the residents. The Office has issued a clinical advisory prohibiting the discharge of patients from OMH-licensed or operated psychiatric hospitals to transitional adult homes, formerly known as impacted adult homes unless they were admitted to the psychiatric hospital from the transitional adult home. Transitional adult homes are defined by the Commissioner of Health as adult homes with a certified capacity of 80 beds or more in which at least 25 percent of the resident population or 25 residents, whichever is less, are persons (a) with serious mental illness, or (b) who are receiving or have received within the past five years services from a mental health provider which is licensed, operated or funded by the Office.

Transitional adult homes are not designed to effectively serve large numbers of people with serious mental illness, are not licensed by the Office, nor are they under the clinical quality control of the Office. In addition, the transitional adult home model does not foster independent living, with the use of congregate meals, ritualized medication administration and programming that may not be tailored to the individual needs of the residents. Further, the absence of specifically designed rehabilitation and recovery oriented programs is not conducive to the goal of integration into the community.

4. Costs:

(a) cost to State government: These regulatory amendments will not result in any additional costs to State government.

(b) cost to local government: These regulatory amendments will not result in any additional costs to local government.

(c) cost to regulated parties: These regulatory amendments will not result in any additional costs to regulated parties.

5. Local government mandates: These regulatory amendments will not result in any additional imposition of duties or responsibilities upon county, city, town, village, school or fire districts.

6. Paperwork: No increased paperwork is anticipated as a result of the amendments to Parts 580 and 582.

7. Duplication: These regulatory amendments do not duplicate existing State or federal requirements.

8. Alternatives: The only alternative to the regulatory amendment that was considered was inaction. Since inaction would be contrary to good clinical practice with the goal of patients being integrated into the community, that alternative was necessarily rejected.

9. Federal standards: The regulatory amendments do not exceed any minimum standards of the federal government for the same or similar subject areas.

10. Compliance schedule: The regulatory amendments are effective immediately upon adoption.

Regulatory Flexibility Analysis

The proposed rule adds provisions to 14 NYCRR Parts 580 and 582 that prohibit the discharge of a patient to a transitional adult home, as defined in the regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization. This proposal is consistent with a clinical advisory issued by the Office of Mental Health. The amendments will not impose any adverse economic impact on small businesses or local governments; therefore, a Regulatory Flexibility Analysis is not submitted with this notice.

Rural Area Flexibility Analysis

The amendments to 14 NYCRR Parts 580 and 582 of Title 14 NYCRR prohibit the discharge of a patient to a transitional adult home, as defined in the regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization. This proposal is consistent with a clinical advisory issued by the Office of Mental Health. The amendments will not impose any adverse economic impact on rural areas; therefore, a Rural Area Flexibility Analysis is not submitted with this notice.

Job Impact Statement

A Job Impact Statement is not submitted with this notice because the purpose of this rule making is to prohibit the discharge of a patient to a transitional adult home, as defined in the regulations of the Commissioner of Health, unless the patient was a resident of the home immediately prior to his or her current period of hospitalization. This proposal is consistent with a clinical advisory issued by the Office of Mental Health. There will be no adverse impact on jobs and employment opportunities as a result of the proposed amendments to 14 NYCRR Parts 580 and 582.