BILL NUMBER: S9954
SPONSOR: HOYLMAN-SIGAL
 
TITLE OF BILL:
An act to amend the mental hygiene law, in relation to the hospitaliza-
tion, care coordination, and assisted outpatient treatment for persons
with mental illness by qualified clinical examiners or qualified mental
health professionals
 
PURPOSE OR GENERAL IDEA OF BILL:
Authorize psychologists, psychiatric nurse practitioners, and licensed
clinical social workers to ev aluate an individual's need for psychiat-
ric hospitalization or AOT. Require psychiatric hospitals to coordinate
with community mental health institutions and local mental health offi-
cials upon intake and discharge.
 
SUMMARY OF PROVISIONS:
Section 1: Provides for the law to be known as the Harness Expertise of
Licensed Professionals Act
Section 2: Amends Section 9.01 of the Mental Hygiene Law to add the
definition of qualified clinical examiner, which will include psy chia-
tric nurse practitioner, psychologist, or licensed clinical social work-
er
Section 3: Amends Section 9.05 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 4: Amends Section 9.27 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 5: Amends Section 9.29 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 6: Amends Section 9.31 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 7: Amends Section 9.33 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 8: Amends Section 9.37 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 9: Amends Section 9.39 to add clinical examiners as those eligi-
ble alongside physicians to make decisions regarding involunta ry hospi-
talization
Section 10: Amends Section 9.40 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involunt ary
hospitalization
Section 11: Amends Section 9.47 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involunt ary
hospitalization
Section 12: Amends Section 9.55 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involunt ary
hospitalization
Section 13: Creates Section 9.56 which allows Physicians or mental
health professionals to request that a director of an adult care f acil-
ity remove a patient that is acting in a way that presents serious harm
to themselves or others. A facility director may request law enforcement
to transfer a patient to a hospital. Patients transported to a hospital
retain their status as a resident of the adult care facility unless
admitted to the hospital for treatment.
Section 14: Amends Section 9.57 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involuntary
hospitalization
Section 15: Amends Section 9.58 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involuntary
hospitalization
Section 16: Amends Section 9.60 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involuntary
hospitalization
Section 17: Amends Section 9.60 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involuntary
hospitalization
Section 18: Amends Section 9.60 to add clinical examiners as those
eligible alongside physicians to make decisions regarding involunt ary
hospitalization
Section 19: Amends Section 9.64 to require that when a patient is admit-
ted into a psychiatric hospital that community health providers that
have treated said patient are promptly notified
Section 20: Amends Section 29.15 of the Mental Hygiene Law to add clin-
ical examiners as those eligible alongside physicians to make decisions
regarding involuntary hospitalization
Section 21: Amends Section 29.15 to require that when a patient is
discharged from a psychiatric hospital that community health providers
that have treated said patient and state and local social services
commissioners are promptly notified
Section 22: Amends Section 41.09 to add qualified clinical examiners as
those eligible to be directors of a psychiatric institution e ligible to
make involuntary hospitalization determinations
Section 23: Requires that this bill take effect immediately, except for
section seven of this act, which is subject to the expiration and rever-
sion of such subdivision pursuant to section 21 of chapter 723 of the
laws of 1989
 
JUSTIFICATION:
The H.E.L.P. Act aims to address New York City's mental health crisis by
expanding the pool of mental health professionals authorized to perform
clinical evaluations and direct treatment for individuals who may pose a
threat of serious harm to themselves or others. This legislation would
allow not only physicians to perform a clinical evaluation of a person's
need for involuntary hospitalization, but also psychiatric nurse practi-
tioners, psychologists, and clinical social workers. The current
restrictions prevent the system from making use of other mental health
profes sionals who are equally qualified to perform these evaluations,
exacerbating a systemic staffing shortage, and diverting physicians'
time from patient care. The bill does not expand the powers of police or
adjust the standards required for commitment in any way.
CPEPs (Comprehensive Psychiatric Emergency Programs) are already heavily
reliant on Psychiatric Nurse Practitioners (PNPs) to fill th e gap left
by the psychiatrist shortage and are highly trained clinicians fully
capable of performing most basic functions of a CPEP, including whether
patients meet admission criteria. With the relatively small number of
psychiatrists on duty in CPEPs, the result i s often a backlog of
patients waiting to be assessed, and making it harder for patients to
get careful assessments. Allowing CPEPs to operate more efficiently will
lead to higher quality, more careful assessments that take account of
the person's treatment history, behavior that led to the removal, and
other factors.
The psychiatrist shortage is an underappreciated major contributing
factor to New York's inpatient psychiatric bed shortage. Hospitals can
only open as many beds as they have the personnel to staff. Empowering
fully qualified clinicians in significantly greater supply to perform
these functions will allow hospitals to open more inpatient psychiatric
beds and relieve pressure on the system to reserve the beds they have
for those thought to be at highest risk.
The H.E.L.P. Act also requires that hospital administrators notify
community mental health providers who have treated a patient previ ously
when they are admitted to a hospital. This will help ensure better
continuity of care and coordination between different layers of the
healthcare system. Additionally, community healthcare providers, along
with mental health government officials, must be notif ied upon
discharge of a patient who was involuntarily committed.
 
PRIOR LEGISLATIVE HISTORY:
New Bill
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None to State
 
EFFECTIVE DATE:
this act shall take effect immediately