(b) Crisis intervention services shall be provided in the emergency room 24 hours per day, seven days per week and shall include psychiatric and medical evaluations and assessments which are used to determine the appropriateness of admission to and retention in the comprehensive psychiatric emergency program.

1. (1) Triage and referral services shall be performed as soon as practicable and in any event within six hours after an individual is admitted into the comprehensive psychiatric emergency program's emergency room.
2. (2) Full emergency visit services shall be performed as soon as is practicable after an individual is determined to need such services. If a triage and referral visit is not conducted, a full emergency visit must be initiated within six hours.
3. (3) In any case, an individual shall not be retained in the comprehensive psychiatric emergency program emergency room for more than 24 hours at which point they must be admitted to an extended observation bed or a psychiatric inpatient bed.

(c) Crisis outreach shall be provided seven days per week, during at least the day and evening hours pursuant to a staffing plan approved by the Office of Mental Health.

1. (1) Such services may be provided directly by the comprehensive psychiatric emergency program or through written agreement with a provider of service approved by the Office of Mental Health.

2. (2) Crisis outreach means face to face psychiatric emergency services provided outside an emergency room setting which includes evaluation, assessment and stabilization services. Crisis outreach services may be provided outside the emergency room of the hospital, in the community or in other clinical areas within the hospital, for purposes of face to face visits with individuals discharged from the comprehensive psychiatric emergency program. Crisis outreach does not have to result in an admission to the comprehensive psychiatric emergency program. For individuals discharged from comprehensive psychiatric emergency programs, crisis outreach includes face to face contact with a mental health professional for purposes of facilitating an individual’s community tenure prior to engagement or re-engagement with a community-based provider.

   1. (i) Crisis outreach services include but are not limited to assessment, therapeutic communication, coordination with identified supports, psychiatric consultation, safety planning, referral, linkage, peer services.
   2. (ii) Crisis outreach referrals can be made through internal referrals, external referrals or through comprehensive psychiatric emergency program discharge referrals.