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Subcommittee carries over crisis-stabilization-unit rules after dispute over child-bed placement and 24/7 nurse requirement
Summary
The Medical Affairs Subcommittee carried over proposed licensing standards for Crisis Stabilization Units after lawmakers and the Department of Mental Health questioned rules allowing minors to be admitted and sharing sleeping quarters with adults and debated a 24/7 on‑site registered‑nurse requirement.
The subcommittee carried over proposed licensing standards for Crisis Stabilization Units (CSUs) (regulation document 53-50, tab 5) after members and Department of Mental Health (DMH) officials questioned several provisions: expanding admission to children as young as 5, allowing individuals 14 and older to share sleeping rooms with adults in some circumstances, and a proposed requirement that a registered nurse be physically on-duty at the facility at all times.
DPH told the committee the statutory change extends CSU admissions downward so facilities may treat individuals ages 5–17 as clinically appropriate. DPH proposed a rule prohibiting children 13 and under from sharing a bed in the same room with an adult and requiring direct supervision in common areas for those 14 and older. DMH Deputy Director Deborah Blaylock testified that the existing CSUs have served adults only and that DMH would not place children and adults in the same unit; she said the single existing CSU in Charleston has historically worked under an arrangement where a nurse must be able to respond within 30 minutes and that requiring a nurse 24/7 could force temporary closures if staffing gaps occurred.
Blaylock said Charleston’s CSU reopened in 2017 and typically averages short stays (about three to six days), with roughly 3 percent of patients sent to an emergency department (64 of about 1,800 patients cited since 2017). She told the committee, “I prefer children and adults to be separated,” and warned that requiring a nurse physically on-site around the clock could lead to service interruptions if a nurse calls out.
Senators asked the agencies to reconcile language about whether children may share sleeping quarters with adults and to propose compromise staffing language. The subcommittee voted to carry the rule over and asked DPH and DMH to present revised, reconciled wording and stakeholder input at a follow-up meeting.
