Attachment D_Mobile Crisis Guidelines for BC_07.2025.pdf

Broome County

Mental Health Department

GUIDELINES

Mobile Crisis

Issued: July 2025

Broome County Mental Health Department MOBILE CRISIS - Guidelines

Issued: 07/2025 Page 2 of 17

Table of Contents A. Introduction

B. Purpose

C. Vision & Goals

D. Provider Designation and Oversight

E. Definitions

F. Updates to Guidelines and Reference Documents

G. Funding - Billable Services - Financial Sustainability

H. Program Overview and Scope of Work

I. Program Operations - Service Components - Deliverables

J. Data Collection & LGU Oversight

K. Staffing Standards & Training

L. Implementation and Strategic Planning

M. Administrative Requirements

N. Telephonic Triage Service Delivery and Documentation

O. Mobile Crisis Intervention and Documentation

P. Follow up Crisis Services and Documentation

Q. Reference / Guidance Documents:

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A. Introduction

The Broome County Mental Health Department (BCMHD), in its role as the Local Government Unit (LGU)1 pursuant to NYS Mental Hygiene Law, strategically plans, develops and oversees the Behavioral Health System of Care (SOC). The SOC serves individuals with mental health concerns, intellectual and developmental disabilities, and substance use disorders. In accordance with New York State Mental Hygiene Law, the BCMHD is tasked to plan for the provision of services to improve availability, access and accountability within the SOC.

Together with providers and stakeholders, and in alignment with the Local Services Plan, crisis response services have been identified as a need for Broome County. To address this need, in July 2025, the BCMHD released a Request for Proposals (RFP) - and this guidance for Mobile Crisis services for Broome County.

Mobile Crisis services are a critical component of an effective behavioral health crisis response system.

These services provide timely, community-based intervention for individuals experiencing a mental health or substance use crisis. Mobile Crisis services aim to de-escalate situations, reduce unnecessary hospitalizations or law enforcement involvement, and connect individuals to appropriate ongoing care and supports.

B. Purpose

The purpose of the MOBILE CRISIS GUIDELINES [hereafter referenced to as “Guidelines”] is to establish a standardized framework for the delivery of Mobile Crisis services that ensures safety, responsiveness, cultural competence, and continuity of care. These Guidelines support providers, system partners, and stakeholders in implementing best practices that align with statewide and national models for crisis intervention. By following these standards, communities can enhance access to quality crisis care, reduce disparities, and promote recovery-oriented outcomes.

C. Vision & Goals

The Mobile Crisis service will be a trusted and integral resource, helping individuals maintain stability through timely intervention, support, and connection to ongoing care. By embedding this service into the local crisis continuum, it will play a critical role in fostering long-term resilience, reducing the need for higher levels of care.

1. The VISION is to deliver a person-centered, trauma-informed, culturally responsive, evidence-informed/based response in the community for behavioral health crises. Mobile Crisis service aims to:

a. Increase accessibility to crisis response.

b. Provide direct connections for individuals to prevention, treatment, and recovery services and supports.

c. Reduce the impact to emergency rooms resulting from visits associated with behavioral health crises that can be better treated in the community.

1 NYS Mental Hygiene Law: § 41.05 – Local Governmental Unit.

https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-41-05/ https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-41-05/

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2. The GOALS of Mobile Crisis services are engagement, symptom reduction, and stabilization. Services can be provided to individuals who appear to be experiencing, or are at imminent risk of experiencing, a behavioral health (psychiatric or substance use) crisis, regardless of age or ability to pay. These services are designed to interrupt or ameliorate a crisis by:

a. Providing crisis response in the community where individuals live, work, learn, and socialize.

b. Supporting timely crisis resolution and de-escalation, and development of a crisis or safety plan.

c. Delivering services directly to the individuals and/or their identified collaterals within the context of a potential or actual behavioral health crisis.

d. Aid in the diversion of an emergency room visit or inpatient admissions, if appropriate.

e. Providing services that are culturally and linguistically responsive, person-centered and trauma-informed to determine level of safety, risk, and to plan for the next level of services emphasizing symptom reduction, restoring individuals to a previous level of functioning, and preventing crises in the future.

f. Engaging individuals and their families and support systems in mental health and substance use assessments and tools.

g. Providing short-term care coordination, service planning, safety planning, individual, family and collateral supportive counseling, family advocacy and/or peer support services; and

h. Ensuring services include family-focused engagement, integration of natural supports and other collaterals while ensuring all services including family or other collaterals are for the direct benefit of the beneficiary.

D. Provider Designation and Oversight

The NYS Office of Mental Health (OMH), in consultation with the NYS Office of Addiction Services and Supports (OASAS), counties, and the City of New York, designates all Mobile Crisis providers eligible to deliver Mobile Crisis Services under the Crisis Intervention Benefit.

OMH and OASAS have shared oversight of Mobile Crisis services and coordinate with other NYS agencies as applicable. Counties provide oversight of those agencies/providers consistent with current operations (e.g., could include site visits or outcome reports) and ensure coordination of existing crisis services.

NYS OMH/OASAS reserves the right to make oversight visits and rescind provider approvals to deliver Mobile Crisis services.

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E. Definitions

988 – Suicide and Crisis Lifeline – Federal Public Law established 9-8-8 as the universal telephone number for a national suicide prevention and mental health crisis hotline. 9-8-8 administration is overseen by the NYS Office of Mental Health, establishing Regional Crisis Contact Centers/Hubs.

Behavioral Health (BH) Crisis2 is an acute psychological or emotional change which results in a marked increase in personal distress, requires a rapid response, and exceeds the abilities and the resources of the individual and those involved to effectively resolve.

• Broome County includes in this definition, a situation in which a person’s thoughts, emotions, and behaviors have the potential to result in [1] harm to themselves, [2] harm others, or [3] “other conduct which shall include the person’s refusal or inability to meet their essential needs for food, shelter, clothing, or health care provided that such refusal or inability is likely to result in serious harm if there were no immediate intervention,” [4] or could result in hospitalization.

Behavioral Health Crisis Intervention (BHCI)3 is defined as the activity (service) and modality (component), provided to an individual, to interrupt or ameliorate the individual's BH crisis.

CPEP - Comprehensive Psychiatric Emergency Program. Mental Hygiene Law § 9.404 and 14 NYCRR Part 5905

High-Risk Individuals: Persons at elevated risk for psychiatric decompensation, suicidal ideation or behavior, overdose, violence toward self or others, or significant instability that may compromise their ability to remain safely in the community without additional intervention or supports.

In-Person: Being present physically in the same location when a service is delivered.6

Licensed Practitioner of the Healing Arts (LPHA) – 14 NYCRR Part 511-1.4.7 Licensed Practitioner of the Healing Arts (LPHA) means the following professional staff:

(1) Marriage and Family Therapist, which means an individual who is currently licensed as a Marriage and Family Therapist by the New York State Education Department.

(2) Mental Health Counselor, which means an individual who is currently licensed as a Mental Health Counselor by the New York State Education Department.

(3) Nurse Practitioner, which means an individual who is currently certified as a Nurse Practitioner by the New York State Education Department.

(4) Nurse Practitioner in Psychiatry, which means an individual who is currently certified as a Psychiatric Nurse Practitioner by the New York State Education Department. For purposes of this Part, Nurse Practitioner in Psychiatry shall have the same meaning as Psychiatric Nurse Practitioner, as defined by the New York State Education Department.

2 NYS Crisis Intervention Benefit: Mobile Crisis Component. Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health. 02/2025.

3 NYS Crisis Intervention Benefit: Mobile Crisis Component. Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health. 02/2025.

4 NYS Mental Hygiene Law § 9.40 – Emergency observation, care, and treatment in Comprehensive Psychiatric Emergency Programs.

5 14 NYCRR Part 590 – Operation of Comprehensive Psychiatric Emergency Programs.

6 Telehealth Services Guidance for OMH Providers. NYS Office of Mental Health. 04/2023.

7 Licensed Practitioner of the Healing Arts (LPHA). 14 NYCRR Part 511 1.4.

https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-9-40/ https://regulations.justia.com/states/new-york/title-14/chapter-xiii/part-590/ https://govt.westlaw.com/nycrr/Document/I0e379eb7d4c611e987f6e182c2fa7ecc?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default) https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-9-40/ https://regulations.justia.com/states/new-york/title-14/chapter-xiii/part-590/ https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf https://govt.westlaw.com/nycrr/Document/I0e379eb7d4c611e987f6e182c2fa7ecc?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)

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(5) Physician, which means an individual who is currently licensed as a Physician by the New York State Education Department or possesses a permit from the New York State Education Department.

(6) Physician’s Assistant, which means an individual who is currently registered as a Physician Assistant or a Specialist's Assistant by the New York State Education Department.

(7) Psychiatrist, which means 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.

(8) Psychoanalyst, which means an individual who is currently licensed as a Psychoanalyst by the New York State Education Department.

(9) Psychologist, which means an individual who is currently licensed as a Psychologist by the New York State Education Department.

(10) Registered Professional Nurse, which means an individual who is currently licensed as a Registered Professional Nurse by the New York State Education Department; and

(11) Social Worker, which means an individual who is currently licensed as a Master Social Worker or Clinical Social Worker by the New York State Education Department.

Mobile Crisis Outreach Teams - Mobile Crisis services are specific therapeutic and supportive activities delivered by a NYS-approved Mobile Crisis Provider, pursuant to Mental Hygiene Law § 9.588.

Operational Period – Specific days of the week, and hours of the day the program is operational for deployment/activation.

Qualifying Behavioral Health Crisis Intervention (BHCI) Episode9 begins with the provider’s initial contact with the individual. The end of the crisis episode is defined by the amelioration of the individual’s presenting symptoms or, if clinically indicated, when the person is transferred to the recommended level of care.

Supportive Crisis Stabilization Center (SCSC) – Mental Hygiene Law § 36.0110 and § 36.0211.

Telephonic - the use of telephone and other audio-only technologies to deliver services synchronously.12

8 Mobile Crisis Outreach Teams – Mental Hygiene Law § 9.58 9 NYS Crisis Intervention Benefit: Mobile Crisis Component. Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health. 02/2025.

10 NYS Mental Hygiene Law § 36.01 – Crisis Stabilization Centers.

11 NYS Mental Hygiene Law § 36.02 – Referral to Crisis Stabilization Centers.

12 Telehealth Services Guidance for OMH Providers. NYS Office of Mental Health. 04/2023.

https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-9-58/ https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-36-01/ https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-36-02/ https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-9-58/ https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-36-01/ https://codes.findlaw.com/ny/mental-hygiene-law/mhy-sect-36-02/ https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf

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F. Updates to Guidelines and Reference Documents

1. The Mobile Crisis service provider operating in Broome County must be able to meet – and remain in compliance with – all guidance and programmatic implementation and billing requirements as issued by Broome County, Office of Mental Health (OMH), NYS Office Addiction Services and Supports (OASAS), and NYS Department of Health (DOH).

2. It is the intention of the Broome County Mental Health Department (BCMHD) / Local Government Unit (LGU) these Guidelines - and associated Guidance documents issued by NYS and federal agencies referred to throughout this publication - are catalogued in the REFERENCE DOCUMENTS section of these Guidelines and maintained in a digital reference repository hosted on the Department’s website. Updates to these Guidelines will be communicated to appropriate programs/providers and posted to the Department’s website.

G. Funding - Billable Services - Financial Sustainability

1. The funding model for Mobile Crisis services in Broome County is designed to support an integrated and responsive approach to crisis intervention, ensuring individuals receive timely and effective care.

Consisting of a blend of funding from Office of Mental Health (OMH) State Aid, Office of Addiction Services and Supports (OASAS) Opioid Settlement Funds (OSF) via targeted Regional Abatement Funds (RAF), Broome County support, federal Medicaid13 managed care revenue, and private insurance payor revenue. This braided funding model underscores the expectation that the Mobile Crisis services will provide a consistent, high-quality crisis response, within a payor-blind framework.

2. Mobile Crisis will be funded through a performance-based contract with a specified set of deliverables subject to the oversight and monitoring by the Broome County Mental Health Department, Local Government Unit.

3. Direct funding to the selected provider for the Mobile Crisis proposal herein is expected to be one-million dollars ($1M) annually, beginning January 2026, for a period of January 2026 – December 2030.

4. Once approved as NYS Mobile Crisis provider, they are expected to bill insurance payors for Mobile Crisis service components consistent with the most recent edition of New York State Crisis Intervention Benefit and Billing Guidance14 and therefore, must have the capability to consistently seek claims for eligible provision of services.

13 Rates available under: “Crisis Services: Mobile & Telephonic” at this NYS OMH website: https://omh.ny.gov/omhweb/medicaid_reimbursement/ 14 NYS Crisis Intervention Benefit: Mobile Crisis Component. Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health.02/2025.

https://omh.ny.gov/omhweb/medicaid_reimbursement/ https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/medicaid_reimbursement/ https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf

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H. Program Overview and Scope of Work

Mobile Crisis will provide services - in accordance with standards as put forth by the NYS Offices of Mental Health (OMH), Addiction Services and Supports (OASAS), and Department of Health (DOH) – which utilize therapeutic communication, interactions and supporting resources to interrupt and/or ameliorate acute behavioral health distress and associated behaviors.

1. Mobile Crisis Service will:

a. Be comprised of a credentialed, comprehensively trained team of clinicians, peers and care managers – to deliver person-centered, trauma-informed, culturally-responsive, high-quality and effective behavioral health interventions, strategies, and supports to those in the community experiencing a behavioral health crisis.

b. Assist individuals to safely remain in the community, reduce unnecessary emergency room visits, inpatient mental health and/or substance use hospitalizations, and reduce the risk of future crisis.

c. Establish interoperability with the Broome County Office of Emergency Services 911 Dispatch Center.

d. Establish workflows and adopt practices to facilitate seamless call transfers, ensuring timely intervention for individuals in crisis, within the scope of available personnel and resources, with a targeted effort to respond within one (1) clock hour of deployment.

e. Actively engage in the Broome County Behavioral Health System of Care - inclusive of inpatient and outpatient treatment services and community/peer supports - and active planning and coordination with the Broome County Mental Health Department / Local Government Unit.

f. Maintain staffing capacity for in-person response. Ensure capacity and coverage of credentialed personnel to respond during the specified operational period.

g. Collaborate, educate, and partner with local law enforcement and other First Responders – outlining deployment and response expectations of the Mobile Crisis service – ensuring cooperative and coordinated efforts with law enforcement or other crisis response entities.

h. Work closely with all behavioral health programs within Broome County’s crisis continuum of care including - but not limited to - local hospital emergency departments, the existing Comprehensive Psychiatric Emergency Program (CPEP) located at United Health Services, Binghamton General Hospital, the planned Supportive Crisis Stabilization Center (SCSC), the region’s 988 – Suicide and Crisis Lifeline provider, and the Broome County Mental Health Department.

i. Be available to all individuals who - at the time of the Qualifying Behavioral Health Crisis Intervention Episode [see Definitions] - are geographically located within Broome County, regardless of age or ability to pay.

j. Ensure compliance with all current – and future – regulatory requirements.

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I. Program Operations - Service Components - Deliverables

1. Location and Modality of Service Delivery

Mobile Crisis services are delivered in-person, or telephonically, for the direct benefit of the individual in crisis.

a. Telehealth

As of the publication date of this document, NYS Office of Mental Health (OMH) has not authorized the use of Telehealth services for the New York State Crisis Intervention Benefit: Mobile Crisis Component Guidance.

b. Service Delivery: In-Person vs. Telephonic

Deciding whether a Behavioral Health Crisis Intervention should be delivered in-person or telephonically is unique to each situation. Telephonic services are expected to complement, not replace, in-person engagement whenever possible.

NYS OMH published Telehealth Services Guidance for OMH Providers. While the guidance was constructed for “Telehealth Services”, Section 3: General Implementation Guidance outlines Considerations for Use of Telehealth Services including (1) General Standards15 and (2) Specific Services.16 This resource should be consulted when creating triage/assessment and follow-up strategies.

2. Service Components

As outlined in OMH guidance, Mobile Crisis services are grouped in the Activity (SERVICE) and Modality (COMPONENT), provided to an individual, to interrupt or ameliorate the individual's BH crisis.

a. Mobile Crisis SERVICES17 are provided within the following response methods to individuals, based on need, in the community:

1) Telephonic Triage and Response

2) Telephonic Crisis Follow Up

3) Mobile Crisis Response

4) Mobile Crisis Follow Up

b. Mobile Crisis service COMPONENTS18 include:

1) Mental Health and Substance Use Assessments

2) Crisis Planning

3) Safety Planning

4) Individual and Family Counseling

5) Care Coordination

6) Peer / Family Peer Support

15 Telehealth Services Guidance for OMH Providers. NYS Office of Mental Health. 04/2023. Pages 6-9.

16 Telehealth Services Guidance for OMH Providers. NYS Office of Mental Health. 04/2023. Pages 9-10.

17 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health. 02/2025.

18 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health 02/2025.

https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf

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3. Licensed Practitioner of the Healing Arts (LPHA) Recommendation

Mobile Crisis Services must be recommended by an LPHA operating within their licensed scope of practice, who may or may not be part of the Mobile Crisis program. The recommendation must be documented in the individual’s case record for every crisis episode. LPHA recommendations are valid throughout an individual’s episode of care. Individuals previously discharged and re-engaging in a Mobile Crisis service will need a new LPHA recommendation. Additional information on the LPHA recommendation can be found in the Mobile Crisis Program Guidance1920.

4. Program Deliverables

a. Mobile Crisis services will provide engagement, intervention, and follow-up support to help individuals gain access to and/or remain connected with treatment providers.

b. Mobile Crisis services will include:

1) Assessment: Determining the appropriate prevention, intervention and/or treatment strategy to best meet the needs of the presenting situation. Evidenced-based suicide risk assessment tools must be utilized during the initial assessment, administered by licensed mental health professionals who are trained to provide - and interpret - the assessment.

2) Crisis Intervention: Immediate, short-term counseling and support to de-escalate a behavioral health crisis from resulting in harm to the individual, harm to others, and to divert from emergency room as appropriate. The development and documentation of safety plans should be prioritized to support ongoing stabilization and effective crisis response.

3) Supportive Counseling: Services that allow for a therapeutic alliance to reduce/alleviate symptoms of a behavioral health crisis, to improve resiliency and response to crisis-like situations, reinforcing a person’s ability to cope with life stressors and presenting challenges.

4) Information and Referrals: Linkages and information for prevention, treatment, and recovery services may include, but are not limited to, mental health, substance use, intellectual/developmental disabilities, employment, housing, transportation, childcare, and/or trauma response advocacy and support. Educational and outreach materials will provide resources to individuals currently being served, and those who may be part of historically underserved communities.

5) Interoperability with the Crisis Continuum of Care: With support and collaboration with the Broome County Mental Health Department, construction of workflows and decision-trees creating a streamlined county-wide process for consistent, comprehensive, and compassionate response to individuals and families experiencing a behavioral health crisis. This includes warm hand-offs to community providers to facilitate smooth transitions and ensure individuals receive timely and appropriate care.

6) Community Engagement and Awareness: Efforts to increase awareness of crisis services will include strategic outreach, engagement with community stakeholders, and the use of promotional materials, presentations, and direct connections with provider across the community. These initiatives aim to improve knowledge and understanding of available resources, ensuring individuals, including those in underserved communities, are aware of crisis response services and how to access them.

19 NYS OMH Mobile Crisis Program Guidance. NYS Office of Mental Health (OMH). 09/20/2019.

20 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health. 02/2025.

https://omh.ny.gov/omhweb/bho/docs/mobile_crisis_program_guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile_crisis_program_guidance.pdf

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J. Data Collection & LGU Oversight

1. As this project is supported via a braided fiscal model – which includes local, state, federal and health insurance/payor sources - data collection and submission is required by both Broome County and the NYS Office of Mental Health (OMH).

2. The Mobile Crisis provider will meet regularly with the Broome County Mental Health Department (BCMHD) / Local Government Unit (LGU) to review service utilization and data. Data associated with Mobile Crisis services will be used to assess programmatic impact, determine systemic barriers impacting the provision of service(s), and to contribute to Broome County’s planning of the Behavioral Health System of Care.

3. Data associated with the project will be submitted monthly with the purpose of assessing programmatic impact, determining systemic barriers impacting the provision of service(s), and to contribute to County-wide planning for the mental hygiene system of care. Data points will include, but is not limited to, the following:

a. Demographic & Case Characteristics

1) Unique individuals served

2) Gender of individuals served

3) Other social determinants of health

4) Address or location of service delivery

5) Language

b. Referral & Service Access

1) Referral source (or source of the call)

2) Presenting problem

3) Call, outreach attempts, in-community services provided by age range

4) Response time

c. Service Utilization & Outcomes

1) Responses resulting in transport to the hospital for further assessment

2) Responses resulting in de-escalation in-community

3) Responses resulting in referral to alternative levels of care

4) Individuals served with short-term care management services or follow-up care

5) Duplication of services for complex case review

6) FTE statuses associated with the project

d. Billable Services

1) Number of billable services provided per month

2) Rate codes, procedures codes and modifiers utilized for reimbursement

3) Reimbursement rate, including the percentage of total billed revenue that has been received

4) Funding / Revenue (Medicaid, Medicare, etc.)

5) Crisis Response & System Coordination

6) Diversion (from 911, law enforcement)

7) Law enforcement involvement

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K. Staffing Standards & Training

1. Mobile Crisis services are to be provided by qualified personnel in accordance with all current – and future

- guidance212223 inclusive of the following categories:

a. Crisis Intervention PROFESSIONAL – NYS Licensed personnel.

b. Crisis Intervention STAFF – Unlicensed, Bachelor’s degree

c. Qualified PEERS

2. Mobile Crisis services must be recommended by a Licensed Practitioner of the Healing Arts (LPHA).

Guidance for staffing standards, including approved professional licensures qualified to conduct this assessment, are found in this OMH document: NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance.24 [02/2025].

3. To ensure effective intervention, the Mobile Crisis must always ensure adequate staffing capacity of credentialed personnel to respond during the specified operational period, including licensed professionals with commensurate education and experience that meet NYS OMH criteria for Qualified Mental Health Professional eligible to complete involuntary transport orders executed pursuant to Mental Hygiene Laws § 9.45 and/or §9.58.

4. Supervision of all personnel associated with Mobile Crisis shall be conducted by qualified, licensed personnel – on a regular, consistent basis - and documented accordingly.

5. Mobile Crisis services are equipped to provide comprehensive and integrated care. Training should address the diverse needs of individuals experiencing mental health challenges, substance use disorders and/or co-occurring conditions.

6. Training will ensure the staff designated to provide Mobile Crisis services are equipped to provide comprehensive and integrated care. Training should address the diverse needs of individuals experiencing mental health challenges, substance use disorders and/or co-occurring conditions including ASIST or similar training, training on crisis-related screening and assessment tool(s), evidenced based and trauma informed care and de-escalation strategies, SBIRT, administration of Naloxone, harm reduction strategies, safety plan development, training on regional resources, and HIPAA, Privacy and Security.

7. Mobile Crisis programs will work with the NYS Office of Mental Health and the Broome County Mental Health Department to build a robust training protocol staff.

21 NYS OMH Mobile Crisis Program Guidance. NYS Office of Mental Health (OMH). 09/20/2019.

22 State Plan Amendment Updates to Mobile Crisis Services. NYS Office of Mental Health (OMH). 02/01/2024.

23 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health.02/ 2025.

24 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health 02/ 2025.

https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://newyork.public.law/laws/n.y._mental_hygiene_law_section_9.58 https://newyork.public.law/laws/n.y._mental_hygiene_law_section_9.58 https://omh.ny.gov/omhweb/bho/docs/mobile_crisis_program_guidance.pdf https://omh.ny.gov/omhweb/bho/docs/state-plan-amendment-updates-to-mobile-crisis-services.pdf

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L. Implementation and Strategic Planning

Mobile Crisis providers must meet regularly with the Broome County Mental Health Department (BCMHD) / Local Government Unit (LGU) to develop and execute an Implementation Plan that will address program objectives, activities/strategies, expected outcomes, timeframe and individuals or organization responsible.

M. Administrative Requirements

Seamless integration into the existing System of Care – will necessitate close collaboration and planning. The following list illustrates many of the myriad administrative tasks/requirements to be accomplished enroute to successful program implementation.

1. Active strategic planning and program implementation in collaboration with the Broome County Mental Health Department (BCMHD) / Local Government Unit (LGU) to address program objectives, activities/strategies, expected outcomes, timeframe and individuals or organization responsible.

2. Completion of the NYS application by the provider organization with specific information about the organization and the services.

3. Designation by the State with letter to be provided to Medicaid Managed Care Organizations (MCOs) for contracting. Medicaid Provider Enrollment with NYS DOH for Medicaid reimbursement and contracting with MCOs.

4. Completion and incorporation of written policies and procedures for each crisis service designated to provide with principles of diversity, equity, including, and trauma-informed care.

5. Development of decision-making workflows and procedures for managing Protected Health Information (PHI) and data sharing.

6. Development and maintenance of documentation ensuring Mobile Crisis staff have the qualifications and training required to deliver crisis services.

7. Development of an Emergency Response Plan for handling emergencies and unforeseen situations and determine how these will be communicated to all crisis staff.

8. Development of administrative oversight of day-to-day operations to include scheduling and regular team meetings/huddles for the crisis team to debrief from crisis services and discuss caseload/care plans for individuals requiring follow-up.

9. Development of collaborative relationships with regional hospital, behavioral health provider organizations, MHOTRS, CCBHCs, schools, primary care clinics, FQHCs, community organizations, 988, law enforcement agencies (state, county, local) and county 911 dispatch center to potentially involve Memorandum of Understandings (MOUs) between the crisis services provider and collaborating entities to outline the role and expectations of each organization in an event of a crisis.

10. When available and if applicable, participate in Statewide learning collaboratives, councils, and/or pilot programs for mobile crisis and incorporate standardized crisis protocols and/or best practices.

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N. Telephonic Triage Service Delivery and Documentation

Mobile Crisis providers will conduct activities to provide telephonic crisis triage service to include:

1. Provide telephonic crisis triage services to include therapeutic communication and interaction, development of a safety plan, referrals and linkages to appropriate behavioral health and community services, collection of insurance information and verbal consent to provide telephonic follow up services.

2. Ensuring coverage of the identified method of communication (e.g., phone, direct phone line, even when a team is deployed primarily with a licensed practitioner of the healing arts who will conduct an initial assessment, determine the need for further evaluation, and make treatment recommendations/referrals.

When necessary, the person providing telephonic triage will coordinate cohesively with the deployment team as well as law enforcement and 911 dispatch.

3. Documentation in the individual’s Electronic Medical Record/Electronic Health Record (EHR) should be completed in accordance with guidance from the NYS Office of Mental Health. 25 At a minimum, documentation must include:

a. Date, time, description, and duration of each service.

b. Aggregate demographics of the calls to include, at minimum, age, gender, and town/zip code.

c. Disposition of the call (i.e. caller de-escalated, safety plan developed, mobile crisis services deployed, etc.).

d. If the individual consented to follow-up services.

O. Mobile Crisis Intervention and Documentation

Mobile Crisis providers will conduct activities in the community to include:

1. Mobile Crisis services are, primarily, an in-person response utilizing a recommendation by a Licensed Professional of the Healing Arts (LPHA) to assess mental health needs, substance use disorder needs, conduct a clinical assessment, provide support and develop care plans. This role may be filled by a NYS licensed professional who, within their scope of practice, is permitted to provide this level of care and that meets OMH guidance inclusive of billable standards.

2. The in-person response may also include unlicensed personnel to support individuals in crisis based on lived experience with mental health or substance use disorder. These personnel can support individuals in crisis by offering empathy, understanding and practical advice and can assist the licensed provider with the development of safety plans and connect individuals to supports and link to community services.

This role may be filled with certified peer specialists, credentialed alcoholism and substance abuse counselor (CASAC), certified recovery peer advocate (CRPA), qualified peer advocates or other qualified non-licensed staff.

25 NYS Crisis Intervention Benefit: Mobile Crisis Component Medicaid Managed Care Benefit and Billing Guidance. NYS Office of Mental Health 02/2025.

Issued: 07/2025 Page 15 of 17

3. Provide Mobile Crisis services to include:

a. Initial or ongoing assessment (if already started telephonically) of behavioral health symptoms including the use of an evidenced based tool for assessment.

b. Involvement of identified family/friends to support resolution the individual’s crisis.

c. Therapeutic communication and interaction to alleviate psychiatric or substance use symptoms.

d. Development of a Safety Plan (e.g., Stanley-Brown model or similar).

e. Referral and linkage to appropriate behavioral health community services.

f. Facilitate access to higher levels of care, if required. Should a higher level of care be required, the Mobile Crisis Team will work with law enforcement, utilizing Mental Hygiene Law parts §9.45 and/or §9.58 to transport an individual to CPEP, if needed.

g. Collection of medical insurance information.

h. Written and verbal consents [verbal consent to provide telephonic follow-up services] to facilitate continued stabilization/recovery.

4. Documentation within an individual’s Electronic Medical Record (EMR) / Electronic Health Record (EHR) as required by issued OMH/DOH/CMS guidance, within the prescribed time to include:

a. Date, time, description, and duration of each intervention.

b. Aggregate demographics of the calls to include, at minimum, age, gender, and town/zip code.

c. Rationale for mobile crisis response.

d. Source of the referral and cause for concern.

e. Presenting problem and precipitating factors.

f. Alert history and psychosocial history, if available.

g. Collaterals on scene participating in the behavioral health crisis resolution.

h. Mental status examination of the individual of concern.

i. History of psychiatric and/or substance use disorder treatment.

j. History of medical, emotional and/or social needs.

k. Review of prescribed medications and compliance.

l. Identification of current treatment providers with contact information.

m. Identification of supports/resources, individual and family strengths and coping skills.

n. Suicide and safety assessment and safety planning.

o. Consents / Authorization to release information.

p. Copy of Safety Plan, if applicable.

q. Aggregate demographic data of mobile deployments including age, zip code/town.

r. Result of the intervention (e.g., individual de-escalated, required transport to CPEP or SCSC).

s. If the individual consented to follow-up services.

Issued: 07/2025 Page 16 of 17

P. Follow up Crisis Services and Documentation

Mobile Crisis providers will conduct activities to provide crisis follow-up services and behavioral health wellness checks after an initial crisis including:

1. Therapeutic communication and interactions to maintain stabilization following a crisis episode and prevent escalation of behavioral health symptoms.

2. Facilitation of engagement in outpatient behavioral health services, care coordination, medical health or basic needs related to the original crisis service.

3. Confirmation with service providers of connections to care and support to the recipient in the community while they are awaiting initiation or resumption of services.

4. Contact with the individuals existing primary care and behavioral health treatment providers, Adult or Children’s Single Point of Access (SPOA) where applicable, and/or care coordinator of the developed crisis plan.

5. Contact with the individuals natural support network with consent.

6. Referral and engagement/re-engagement with care management/care coordination and/or appropriate behavioral health community and peer services.

7. Follow-up with the individual and the individual’s family-support network to confirm enrollment in care coordination, outpatient treatment, or other community services has occurred or is scheduled.

8. Documentation within an individual’s Electronic Medical Record (EMR) / Electronic Health Record (EHR) as required by issued OMH/DOH/CMS guidance, within the prescribed time to include:

a. Date, time, description, and duration of each intervention

t. Aggregate demographic information including, at minimum, age, gender, and town/zip code.

b. Content of follow-up between the Mobile Crisis staff and existing and/or anticipated service providers and identified supports. This information should be documented within 24 hours of the initial crisis or by the next business day.

c. If consents are in place, information to be shared with referral agencies.

d. Progress notes related to the service summary for every individual receiving services and collateral contact, signed by the staff member who provided the service.

e. Documentation of (re) linkage to identified services and supports.

f. Identification of barriers to linkage, if applicable.

g. Additional information necessary to complete and/or update the case record and/or service summary. This information may be obtained from program staff, the referral source, and/or outside medical and psychiatric staff including the individuals most recent mental health and/or substance use disorder service provider, upon consent.

h. Result of follow-up interaction – include follow-up attempts that were unsuccessful.

Issued: 07/2025 Page 17 of 17

Q. Reference / Guidance Documents:

2019.09.20 - Mobile Crisis Program Guidance. NYS Office of Mental Health. 09/20/2019.

2023.04 – Telehealth Services Guidance for OMH Providers. NYS Office of Mental Health. 04/2023.

2024.02.01 – State Plan Amendment Updates to Mobile Crisis Services. NYS Office of Mental Health.

02/01/2024.

2025.02 – New York State Crisis Intervention Benefit: Mobile Crisis Component. Medicaid Managed Care Benefit and Billing Guidance. NYS Offices of Addiction Services and Supports, Mental Health, and NYS Department of Health. 02/2025.

2025.06.30 – Medicaid Reimbursement Rates. Crisis Services: Mobile & Telephonic. NYS Office of Mental Health website. Updated periodically. 06/30/2025.

https://omh.ny.gov/omhweb/bho/docs/mobile_crisis_program_guidance.pdf https://omh.ny.gov/omhweb/guidance/telehealth-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/state-plan-amendment-updates-to-mobile-crisis-services.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/bho/docs/mobile-crisis-benefit-and-billing-guidance.pdf https://omh.ny.gov/omhweb/medicaid_reimbursement/