Referral Process for Hospitals

Treating Family

BryLin Hospital accepts children, adolescents, and adults:

Children: ages 5-17 yrs

*All Insurances Accepted, including Medicaid.

Adults: ages 18 yrs and up

*Managed care products are accepted.

*Most commercial insurance accepted.

*Unable to accept straight Medicaid insurance between the ages of 21-64.

ECT is safe and effectiveSECTION I.  How to refer your patient from the Emergency Room to BryLin Hospital

STEP 1).  Contact BryLin Hospital Admissions Department –  Call (716) 886-8200 ext. 2264

STEP 2). Information to be faxed to BryLin Hospital Admissions Staff (Admissions Fax: 716-777-7666):

  1. Demographic information (name, dob, etc)
  2. Clinical (presenting crisis, need for hospitalization, etc)
  3. Type of Insurance and Insurance ID #

Step 3).  A Nurse to Nurse Report is done via phone to discuss current psychiatric and medical symptoms.

Step 4). Legal paperwork ((2) physician certificates & application which can be downloaded below) must be faxed to BryLin Admissions Department at (716) 885-4379, reviewed, and approved before transportation can be authorized.

Step 5).  Ambulance transfers are accepted from an Emergency Room following approval of appropriate legal paperwork by BryLin Hospitals’ Admissions Department.

psychiatric hospitalization

Waiting in Emergency department

SECTION II.  Who examines the Care Recipient at Time of Application & Legal Paperwork Needed:

1.  Voluntary Admission (9.13 of Mental Hygiene Law):

Staff MD of BryLin Hospital must confirm that the person meets the Voluntary Standard.

Once the Nurse to Nurse report (above under Section I, Step 3) is complete, criteria for admission is established, and insurance benefits are verified, the patient can be sent to BryLin Hospital with the understanding that they WILL be admitted, they are willing to be treated in a psychiatric hospital, and they have a safe means of transportation.

2.  Involuntary Admission (9.27 of Mental Hygiene Law):

[ALMOST ALL HOSPITAL REFERRALS FALL UNDER THIS CATEGORY]

Two MDs examine the patient using Involuntary Standard (above).

Usually done in a Hospital Emergency Room, Legal Paperwork [(2) Physician Certificates AND an Application for Involuntary Admission] must be completed and faxed to BryLin Hospital when completed. These forms MUST BE APPROVED by BryLin before the patient can be authorized for hospitalization.

– AND –

  • Application for Involuntary Admission can be completed by a family member, social worker, nurse, or NP (see below for more details). 
    • Application for Involuntary Admission (MHL 9.27): The following eleven parties may be applicants for a person’s involuntary admission: 1) someone residing with the person; 2) person’s father, mother, spouse, sibling, child or nearest relative; 3) committee of person; 4) officer of any public or well recognized charitable agency or home in whose institution the person resides; 5) DCS or Director of Social Services; 6) Director of hospital in which the person is hospitalized; 7) Director of a facility providing care to alcoholics, substance abusers or substance dependent persons; 8) Director of Division for Youth; 9) Social Services official or authorized agency with custody or guardianship of children over 16 years of age; 10) someone having custody of a child pursuant to Family Court Act §756 or §1055; or, 11) qualified psychiatrist who is either supervising the treatment of or treating person for a mental illness in a facility licensed or operated by OMH.

3.  Involuntary – Director of Community Services (DCS) or Designee (9.37 of Mental Hygiene Law)
Standard: same as Emergency Standard

DCS or Designee makes application. [Download Form OMH 475]

DCS or Designee using Emergency Standard. (See reverse ***) [Download Form OMH 475A/OMH 475B]

*** (MHL 9.37) A DCS or Designee authorized to certify persons pursuant to this provision includes: a) a DCS, if also a physician, b) a physician designated by the DCS and approved by the State Commissioner of Mental Health, or c) in counties with a population of less than 200,000, a DCS who is a licensed psychologist or certified social worker, if a §9.39 hospital is not located within 30 miles of the person and a designated physician is not immediately available. If a certificate of examination is completed by a DCS who is not a physician, the receiving hospital must have the patient evaluated by a second staff physician within 24 hours after admission (in addition to complying with all the other confirmation requirements).

SECTION III.  Mental Hygiene Law (MHL) Admission Standards:

A. Voluntary Admissions:

  • Voluntary (9.13) Standard: person has a mental illness for which care and treatment in a mental hospital is appropriate; person is suitable for admission on a voluntary basis.

B. Involuntary Admissions:

  • 9.27 Standard: person has a mental illness for which care & treatment in a mental hospital is essential to his/her welfare; person’s judgment is too impaired for him/her to understand the need for such care and treatment; as a result of his/her mental illness, the person poses a substantial threat of harm to self or others. (See below *)

* “Substantial threat of harm” may encompass (i) the person’s refusal or inability to meet his or her essential need for food, shelter, clothing or health care, or (ii) the person’s history of dangerous conduct associated with noncompliance with mental health treatment programs.

  • 9.37 Standard: reasonable cause to believe that the person has a mental illness for which immediate observation, care and treatment in a hospital is appropriate and which is likely to result in serious harm to him/ herself or others. “Likelihood of serious harm” means:
    1. a substantial risk of physical harm to the person as manifested by threats of or attempts at suicide or serious bodily harm or other conduct demonstrating that the person is dangerous to him/herself (See below **). or
    2. a substantial risk of physical harm to other persons as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm

** Such “other conduct” includes the person’s refusal or inability to meet his or her essential need for food, shelter, clothing or health care, provided that such refusal or inability is likely to result in serious harm if the person is not hospitalized immediately.

See complete Mental Hygiene Law – Transfers for Involuntary Admission to BryLin Hospital for more information – OR – see Mental Hygiene Law – Admissions Process.

If you have any questions, please call BryLin Hospitals’ admissions department at (716) 886-8200 ext. 2264.

 

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