Establishes peer crisis diversion homes; requires the commissioner to establish or contract for no less than six peer crisis diversion homes within one year.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A185
SPONSOR: Cunningham TITLE OF BILL:
An act to amend the mental hygiene law, in relation to establishing peer
crisis diversion homes
PURPOSE OR GENERAL IDEA OF BILL:
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-en-
ter 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-en-
ter 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.
JUSTIFICATION:
Our nation's psychiatric emergency system is in crisis. Community mental
health resources across the nation have become progressively more scarce
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.it 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. Hospital officials then reorganized
parts of the emergency department to speed up patient flow, to incorpo-
rate ExpressCare clinic to provide faster urgent care.
To support the community integration of people with psychiatric disabil-
ities 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 psychiat-
ric emergencies. These peer-operated homes will be designed to assist
people with psychiatric disabilities in diverting from psychiatric
distress which would otherwise have led 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 resi-
dents 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 diversion 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 of ten chronic unnecessary, inef-
fective and expensive hospitalizations.
PRIOR LEGISLATIVE HISTORY:
2023-24: A2110/S5274 - Referred to Mental Health
2021-22: A.9982/5.4657 - Referred to Mental Health
2019-20: A.2267/S.4381 Disabilities Referred to Mental Health and Devel-
opmental
2017-18: A.1109/S.3256 Disabilities Referred to Mental Health and Devel-
opmental
2015-16: A.8589/S.1894 Disabilities Referred to Mental Health and Devel-
opmental
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
Minimal with savings as expensive ER visits are averted.
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
185
2025-2026 Regular Sessions
IN ASSEMBLY(Prefiled)
January 8, 2025
___________
Introduced by M. of A. CUNNINGHAM -- read once and referred to the
Committee on Mental Health
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:
1 Section 1. The mental hygiene law is amended by adding a new section
2 31.34 to read as follows:
3 § 31.34 Peer crisis diversion homes.
4 (a) For the purposes of this section:
5 (1) "commissioner" shall mean the commissioner of mental health;
6 (2) "crisis diversion services" shall mean services designed to
7 provide a person who has behavioral health disorders and who is experi-
8 encing symptoms, a safe, supportive and affirming home-like, temporary
9 residence where the person may begin the recovery process, understand
10 the meaning of what the person is experiencing and regain equilibrium
11 and the ability to relate effectively to other people. Crisis diversion
12 services include peer support with an emphasis on relationship-building
13 and personal choice;
14 (3) "peer support specialist" shall mean a person who has previously
15 experienced urgent behavioral health needs and has recovered and who has
16 successfully completed training that has been approved by the commis-
17 sioner, qualifying that person to work with a resident;
18 (4) "resident" shall mean an adult who has experienced urgent behav-
19 ioral health needs but does not require hospitalization and who volun-
20 tarily resides for a short term stay in a peer crisis diversion home;
21 (5) "peer crisis diversion home" shall mean a home-like environment
22 that offers crisis diversion services by temporarily housing voluntary
23 residents who engage in routine activities of daily living and learn
24 about tools for recovery through experience and peer support. The
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00015-01-5
A. 185 2
1 governing body of such home shall consist of current or former recipi-
2 ents of mental health services and shall control the decision making
3 processes of the organization, including control of all budget and
4 personnel management related to the peer crisis diversion home.
5 (b) The commissioner shall provide formal guidelines for training and
6 credentialing of a peer support specialist, provided that each peer
7 support specialist shall personally have experienced urgent behavioral
8 health needs and shall be certified as completing training in de-escala-
9 tion techniques, cultural competency, race relations, the recovery proc-
10 ess, substance abuse, and avoidance of aggressive confrontation prior to
11 working at a peer crisis diversion home.
12 (c) The commissioner shall, within one year of the effective date of
13 this section, establish or contract for the establishment of no less
14 than six peer crisis diversion homes, three of which shall be in urban
15 settings and three of which shall be in rural communities. Such homes
16 shall be recipient-run homes and may be associated with comprehensive
17 psychiatric emergency programs established pursuant to section 31.27 of
18 this article.
19 (d) A peer crisis diversion home, as authorized by this section, shall
20 offer crisis diversion services that:
21 (1) serve residents regardless of income;
22 (2) are staffed twenty-four hours a day by two or more peer support
23 specialists;
24 (3) employ a licensed clinician full time and a psychiatric consultant
25 at least part time;
26 (4) include peer support in helping residents perform daily public
27 living skills and reentry into independent living;
28 (5) offer a mix of therapeutic services, including nontraditional
29 tools for wellness and traditional behavioral health services;
30 (6) accept a resident on a first-come, first-served basis for a tempo-
31 rary stay provided they have alternate long term housing options avail-
32 able;
33 (7) use interpersonal relationship and connection to the community as
34 primary modalities of care;
35 (8) base length of stay on the psychological state of residents,
36 provided that such stay shall be short term with the understanding they
37 are able and willing to live in more independent settings and to resume
38 their desired roles in the community; and
39 (9) are a part of a system of care continuum in the community and
40 state aimed at diverting individuals experiencing behavioral health
41 crisis from more intensive hospital based care and treatment by provid-
42 ing peer support services in a home-like setting for short term, tempo-
43 rary stays.
44 (e) As early as possible, a peer support specialist shall assist a
45 resident of a peer crisis home with accessing a service provider who may
46 coordinate care and otherwise provide support for such resident upon the
47 completion of such resident's stay at a peer crisis diversion home.
48 (f) Peer crisis diversion homes shall consult with community stake-
49 holders, including those who use the behavioral health system and their
50 family members, providers of behavioral health services, whether tradi-
51 tional or alternative, advocates, and others with subject matter exper-
52 tise, as part of the planning and development of peer crisis diversion
53 homes.
54 (g) Peer crisis diversion homes shall participate in county and commu-
55 nity planning activities annually, and as needed, in order to partic-
56 ipate in local community service planning processes to ensure, maintain,
A. 185 3
1 improve or develop community services that demonstrate recovery
2 outcomes. These outcomes include, but are not limited to, quality of
3 life, socio-economic status, entitlement status, social networking,
4 coping skills and reduction in use of crisis services.
5 § 2. This act shall take effect immediately.
