Establishes peer crisis diversion homes.
TITLE OF BILL: An act to amend the mental hygiene law, in relation to establishing peer crisis diversion homes
PURPOSE: To create peer crisis diversion homes which would provide short term peer support to individuals in psychiatric crisis who can be served outside of a hospital with the goal of helping them stabilize and re-enter into independent living.
SUMMARY OF PROVISIONS: Section 1 of the bill adds a new section 31.34 of the mental hygiene law directing the Commission of OMH to establish no less than 6 Peer Crisis diversion homes within one year of enactment, of which 3 shall be in rural areas and 3 in urban areas. The homes are designed to provide short term peer support to individuals in crisis who can be served outside of a hospital with the goal of helping them stabilize and re-enter into independent living. The services would be voluntary and provided by peer support specialists who have previously experienced urgent behavioral health needs and recovered and who have completed training approved by the Commissioner. Similarly, the governing body of such homes would consist of individuals who have previously experienced urgent behavioral health needs and recovered.
Section 2 of the bill provides for an immediate effective date.
EXISTING LAW: Since the late 1980's NYS has had the Comprehensive psychiatric emergency programs CPEP (Section 31.27 of the mental hygiene law) which was designed to manage psychiatric crisis and envisioned to include crisis residence services.
JUSTIFICATION: Our nation's psychiatric emergency system is in crisis. Community mental health resources across the nation have become progressively scarcer in the past several decades and people with psychiatric disabilities have increasingly turned towards emergency rooms (ERs) at a great cost to society both fiscally and socially.
Emergency rooms are stretched to the breaking point. There is limited physical space and limited staff and this has resulted in a dramatic increase in wait time in the ERs. A 2008 study in Health Affairs, The Policy Journal of The Health Sphere showed a 4.1% increase per year in ER wait time between 1997 and 2004, with ethnic minorities, women and patients in urban ERs waiting longer than other patients.
The tragic death of Ms. Esmin Green in 2008 at the Kings County Emergency Room in Brooklyn New York is an example of the consequences of such overcrowding.
To support the community integration of people with psychiatric disabilities and solve the problems defined above, experts have consistently called for innovative cost effective community based
alternatives to the crisis in our psychiatric emergency response system. Through the use of peer crisis diversion homes, New York State can become a national leader in the delivery of innovative crisis services for people with psychiatric emergencies. These peer-operated homes will be designed to assist people with psychiatric disabilities in diverting from psychiatric distress which would otherwise have lead to a hospitalization. Equipped with a variety of traditional self-help and proactive tools to maintain wellness, clinical staff and trained peer companions will assist residents in learning self-help tools with the underlying goal of avoiding future emergency room and inpatient hospitalizations.
For several years a not-for profit has run a hospital division program called Rose House for residents of Orange and Ulster Counties which is similar to the peer crisis diversion homes envisioned in this bill. This bill expands upon the Rose House model thus filling a gap in the mental health system and helping individuals break the cycle of often chronic unnecessary, ineffective and expensive hospitalizations.
LEGISLATIVE HISTORY: 2009-2010 S.5012/A.8165 - Referred to Finance
FISCAL IMPLICATIONS: Minimal with savings as expensive ER visits are averted.
EFFECTIVE DATE: Immediately.
STATE OF NEW YORK ________________________________________________________________________ 3017 2011-2012 Regular Sessions IN SENATE February 7, 2011 ___________Introduced by Sen. HUNTLEY -- read twice and ordered printed, and when printed to be committed to the Committee on Mental Health and Develop- mental Disabilities AN ACT to amend the mental hygiene law, in relation to establishing peer crisis diversion homes THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The mental hygiene law is amended by adding a new section 31.34 to read as follows: S 31.34 PEER CRISIS DIVERSION HOMES. (A) FOR THE PURPOSES OF THIS SECTION: (1) "COMMISSIONER" SHALL MEAN THE COMMISSIONER OF MENTAL HEALTH; (2) "CRISIS DIVERSION SERVICES" SHALL MEAN SERVICES DESIGNED TO PROVIDE A PERSON WHO HAS BEHAVIORAL HEALTH DISORDERS AND WHO IS EXPERI- ENCING SYMPTOMS, A SAFE, SUPPORTIVE AND AFFIRMING HOME-LIKE, TEMPORARY RESIDENCE WHERE THE PERSON MAY BEGIN THE RECOVERY PROCESS, UNDERSTAND THE MEANING OF WHAT THE PERSON IS EXPERIENCING AND REGAIN EQUILIBRIUM AND THE ABILITY TO RELATE EFFECTIVELY TO OTHER PEOPLE. CRISIS DIVERSION SERVICES INCLUDE PEER SUPPORT WITH AN EMPHASIS ON RELATIONSHIP-BUILDING AND PERSONAL CHOICE; (3) "PEER SUPPORT SPECIALIST" SHALL MEAN A PERSON WHO HAS PREVIOUSLY EXPERIENCED URGENT BEHAVIORAL HEALTH NEEDS AND HAS RECOVERED AND WHO HAS SUCCESSFULLY COMPLETED TRAINING THAT HAS BEEN APPROVED BY THE COMMIS- SIONER, QUALIFYING THAT PERSON TO WORK WITH A RESIDENT; (4) "RESIDENT" SHALL MEAN AN ADULT WHO HAS EXPERIENCED URGENT BEHAV- IORAL HEALTH NEEDS BUT DOES NOT REQUIRE HOSPITALIZATION AND WHO VOLUN- TARILY RESIDES FOR A SHORT TERM STAY IN A PEER CRISIS DIVERSION HOME; (5) "PEER CRISIS DIVERSION HOME" SHALL MEAN A HOME-LIKE ENVIRONMENT THAT OFFERS CRISIS DIVERSION SERVICES BY TEMPORARILY HOUSING VOLUNTARY RESIDENTS WHO ENGAGE IN ROUTINE ACTIVITIES OF DAILY LIVING AND LEARN ABOUT TOOLS FOR RECOVERY THROUGH EXPERIENCE AND PEER SUPPORT. THEEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01016-01-1 S. 3017 2
GOVERNING BODY OF SUCH HOME SHALL CONSIST OF CURRENT OR FORMER RECIPI- ENTS OF MENTAL HEALTH SERVICES AND SHALL CONTROL THE DECISION MAKING PROCESSES OF THE ORGANIZATION, INCLUDING CONTROL OF ALL BUDGET AND PERSONNEL MANAGEMENT RELATED TO THE PEER CRISIS DIVERSION HOME. (B) THE COMMISSIONER SHALL PROVIDE FORMAL GUIDELINES FOR TRAINING AND CREDENTIALING OF A PEER SUPPORT SPECIALIST, PROVIDED THAT EACH PEER SUPPORT SPECIALIST SHALL PERSONALLY HAVE EXPERIENCED URGENT BEHAVIORAL HEALTH NEEDS AND SHALL BE CERTIFIED AS COMPLETING TRAINING IN DE-ESCALA- TION TECHNIQUES, CULTURAL COMPETENCY, RACE RELATIONS, THE RECOVERY PROC- ESS, SUBSTANCE ABUSE, AND AVOIDANCE OF AGGRESSIVE CONFRONTATION PRIOR TO WORKING AT A PEER CRISIS DIVERSION HOME. (C) THE COMMISSIONER SHALL, WITHIN ONE YEAR OF ENACTMENT, ESTABLISH OR CONTRACT FOR THE ESTABLISHMENT OF NO LESS THAN SIX PEER CRISIS DIVERSION HOMES, THREE OF WHICH SHALL BE IN URBAN SETTINGS AND THREE OF WHICH SHALL BE IN RURAL COMMUNITIES. SUCH HOMES SHALL BE RECIPIENT-RUN HOMES AND MAY BE ASSOCIATED WITH COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAMS ESTABLISHED PURSUANT TO SECTION 31.27 OF THIS ARTICLE. (D) A PEER CRISIS DIVERSION HOME, AS AUTHORIZED BY THIS SECTION, SHALL OFFER CRISIS DIVERSION SERVICES THAT: (1) SERVE RESIDENTS REGARDLESS OF INCOME; (2) ARE STAFFED TWENTY-FOUR HOURS A DAY BY TWO OR MORE PEER SUPPORT SPECIALISTS; (3) EMPLOY A LICENSED CLINICIAN FULL TIME AND A PSYCHIATRIC CONSULTANT AT LEAST PART TIME; (4) INCLUDE PEER SUPPORT IN HELPING RESIDENTS PERFORM DAILY PUBLIC LIVING SKILLS AND REENTRY INTO INDEPENDENT LIVING; (5) OFFER A MIX OF THERAPEUTIC SERVICES, INCLUDING NONTRADITIONAL TOOLS FOR WELLNESS AND TRADITIONAL BEHAVIORAL HEALTH SERVICES; (6) ACCEPT A RESIDENT ON A FIRST-COME, FIRST-SERVED BASIS FOR A TEMPO- RARY STAY PROVIDED THEY HAVE ALTERNATE LONG TERM HOUSING OPTIONS AVAIL- ABLE; (7) USE INTERPERSONAL RELATIONSHIP AND CONNECTION TO THE COMMUNITY AS PRIMARY MODALITIES OF CARE; (8) BASE LENGTH OF STAY ON THE PSYCHOLOGICAL STATE OF RESIDENTS, PROVIDED THAT SUCH STAY SHALL BE SHORT TERM WITH THE UNDERSTANDING THEY ARE ABLE AND WILLING TO LIVE IN MORE INDEPENDENT SETTINGS AND TO RESUME THEIR DESIRED ROLES IN THE COMMUNITY; AND (9) ARE A PART OF A SYSTEM OF CARE CONTINUUM IN THE COMMUNITY AND STATE AIMED AT DIVERTING INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH CRISIS FROM MORE INTENSIVE HOSPITAL BASED CARE AND TREATMENT BY PROVID- ING PEER SUPPORT SERVICES IN A HOME-LIKE SETTING FOR SHORT TERM, TEMPO- RARY STAYS. (E) AS EARLY AS POSSIBLE, A PEER SUPPORT SPECIALIST SHALL ASSIST A RESIDENT OF A PEER CRISIS HOME WITH ACCESSING A SERVICE PROVIDER WHO MAY COORDINATE CARE AND OTHERWISE PROVIDE SUPPORT FOR SUCH RESIDENT UPON THE COMPLETION OF SUCH RESIDENT'S STAY AT A PEER CRISIS DIVERSION HOME. (F) PEER CRISIS DIVERSION HOMES SHALL CONSULT WITH COMMUNITY STAKE- HOLDERS, INCLUDING THOSE WHO USE THE BEHAVIORAL HEALTH SYSTEM AND THEIR FAMILY MEMBERS, PROVIDERS OF BEHAVIORAL HEALTH SERVICES, WHETHER TRADI- TIONAL OR ALTERNATIVE, ADVOCATES, AND OTHERS WITH SUBJECT MATTER EXPER- TISE, AS PART OF THE PLANNING AND DEVELOPMENT OF PEER CRISIS DIVERSION HOMES. (G) PEER CRISIS DIVERSION HOMES SHALL PARTICIPATE IN COUNTY AND COMMU- NITY PLANNING ACTIVITIES ANNUALLY, AND AS NEEDED, IN ORDER TO PARTIC- IPATE IN LOCAL COMMUNITY SERVICE PLANNING PROCESSES TO ENSURE, MAINTAIN, IMPROVE OR DEVELOP COMMUNITY SERVICES THAT DEMONSTRATE RECOVERYS. 3017 3
OUTCOMES. THESE OUTCOMES INCLUDE, BUT ARE NOT LIMITED TO, QUALITY OF LIFE, SOCIO-ECONOMIC STATUS, ENTITLEMENT STATUS, SOCIAL NETWORKING, COPING SKILLS AND REDUCTION IN USE OF CRISIS SERVICES. S 2. This act shall take effect immediately.