senate Bill S4525

Amended

Authorizes nurse practitioners to admit mentally ill patients

download pdf

Sponsor

Co-Sponsors

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
view actions

actions

  • 11 / Apr / 2011
    • REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 06 / Jun / 2011
    • 1ST REPORT CAL.1003
  • 07 / Jun / 2011
    • 2ND REPORT CAL.
  • 13 / Jun / 2011
    • AMENDED 4525A
  • 13 / Jun / 2011
    • ADVANCED TO THIRD READING
  • 16 / Jun / 2011
    • AMENDED ON THIRD READING 4525B
  • 24 / Jun / 2011
    • COMMITTED TO RULES
  • 04 / Jan / 2012
    • REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 23 / Jan / 2012
    • 1ST REPORT CAL.89
  • 24 / Jan / 2012
    • 2ND REPORT CAL.
  • 30 / Jan / 2012
    • ADVANCED TO THIRD READING
  • 14 / Feb / 2012
    • PASSED SENATE
  • 14 / Feb / 2012
    • DELIVERED TO ASSEMBLY
  • 14 / Feb / 2012
    • REFERRED TO MENTAL HEALTH
  • 05 / Mar / 2012
    • RECALLED FROM ASSEMBLY
  • 05 / Mar / 2012
    • RETURNED TO SENATE
  • 05 / Mar / 2012
    • VOTE RECONSIDERED - RESTORED TO THIRD READING
  • 05 / Mar / 2012
    • AMENDED ON THIRD READING 4525C
  • 25 / Apr / 2012
    • REPASSED SENATE
  • 25 / Apr / 2012
    • RETURNED TO ASSEMBLY
  • 25 / Apr / 2012
    • REFERRED TO HIGHER EDUCATION

Summary

Authorizes nurse practitioners to admit a patient to an inpatient mental health unit on a voluntary or involuntary basis.

do you support this bill?

Bill Details

See Assembly Version of this Bill:
A1603
Versions:
S4525
S4525A
S4525B
S4525C
Legislative Cycle:
2011-2012
Current Committee:
Assembly Higher Education
Law Section:
Mental Hygiene Law
Laws Affected:
Amd ยงยง1.03, 9.05, 9.27, 9.40, 9.55, 9.57 & 9.60, Ment Hyg L
Versions Introduced in 2009-2010 Legislative Cycle:
A11650, A11650

Votes

9
0
9
Aye
0
Nay
1
aye with reservations
0
absent
0
excused
0
abstained
show Mental Health and Developmental Disabilities committee vote details

Sponsor Memo

BILL NUMBER:S4525

TITLE OF BILL:
An act
to amend the mental hygiene law, in relation to authorizing nurse
practitioners to admit a patient to an inpatient mental health unit on
a voluntary or involuntary basis

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of his legislation is to
allow a nurse practitioner, acting within their lawful scope of
practice, to admit a patient to an inpatient mental health unit on a
voluntary or involuntary basis.

SUMMARY OF SPECIFIC PROVISIONS:
Section 1.03 of the mental hygiene law is
amended by adding a new subdivision 9-a which defines "nurse
practitioner". The section heading, the opening paragraph of
subdivision (a) and subdivision (b) of section 9.05 of the mental
hygiene law, as renumbered by chapter 978 of the laws of 1977, is
amended to include nurse practitioners as having the authority to
admit a patient to an inpatient mental health unit.

JUSTIFICATION:
Most inpatient admissions currently occur through a
psychiatrist. However, since there is a shortage of psychiatrists in
certain areas of the State, trained nurse practitioners in the
specialty of psychiatry should have the ability to admit patients on
a voluntary or involuntary basis. This legislation would allow nurse
practitioners, acting within their lawful scope of practice, to admit
a patient to an inpatient mental health unit on a voluntary or
involuntary basis.

PRIOR LEGISLATIVE HISTORY:
None.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately, with provisions.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4525

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 11, 2011
                               ___________

Introduced  by Sen. McDONALD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Mental Health and Develop-
  mental Disabilities

AN ACT to amend the mental hygiene law, in relation to authorizing nurse
  practitioners to admit a patient to an inpatient mental health unit on
  a voluntary or involuntary basis

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 1.03 of the mental hygiene law is amended by adding
a new subdivision 9-a to read as follows:
  9-A.  "NURSE PRACTITIONER" MEANS A CERTIFIED NURSE PRACTITIONER ACTING
WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE.
  S 2. The section heading, the opening paragraph of subdivision (a) and
subdivision (b) of section 9.05 of the mental hygiene law, such  section
as  renumbered  by chapter 978 and the laws of 1977, are amended to read
as follows:
  Examining physicians and NURSE PRACTITIONERS AND medical certificates.
  A person is disqualified from acting  as  an  examining  physician  OR
NURSE PRACTITIONER in the following cases:
  (b)  A  certificate,  as  required by this article, must show that the
person is mentally ill and shall be  based  on  an  examination  of  the
person alleged to be mentally ill made within ten days prior to the date
of  admission.  The  date  of  the certificate shall be the date of such
examination. All certificates shall contain the facts and  circumstances
upon which the judgment of the physicians OR NURSE PRACTITIONER is based
and shall show that the condition of the person examined is such that he
OR SHE needs involuntary care and treatment in a hospital and such other
information as the commissioner may by regulation require.
  S  3.  Subdivision (a) of section 9.27 of the mental hygiene law, such
section as renumbered by chapter 978 of the laws of 1977, is amended  to
read as follows:
  (a)  The  director  of  a hospital may receive and retain therein as a
patient any person alleged to be mentally ill and in need of involuntary
care and treatment upon the certificates of two examining physicians  OR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03971-01-1

S. 4525                             2

NURSE  PRACTITIONERS, accompanied by an application for the admission of
such person. The examination may be conducted jointly but each examining
physician OR NURSE PRACTITIONER shall execute a separate certificate.
  S  4.   Subdivisions (b) and (c) of section 9.40 of the mental hygiene
law, as added by chapter 723 of the laws of 1989, are amended to read as
follows:
  (b) The director shall cause examination of such persons to be  initi-
ated  by  a staff physician OR NURSE PRACTITIONER of the program as soon
as practicable and in any event within six hours  after  the  person  is
received  into the program's emergency room. Such person may be retained
for observation, care and treatment and further examination  for  up  to
twenty-four hours if, at the conclusion of such examination, such physi-
cian OR NURSE PRACTITIONER determines that such person may have a mental
illness for which immediate observation, care and treatment in a compre-
hensive psychiatric emergency program is appropriate, and which is like-
ly to result in serious harm to the person or others.
  (c)  No person shall be involuntarily retained in accordance with this
section for more than twenty-four hours, unless (i) within that time the
determination of the examining staff physician OR NURSE PRACTITIONER has
been confirmed after examination by another physician OR  NURSE  PRACTI-
TIONER  who is a member of the psychiatric staff of the program and (ii)
the person is admitted to an extended observation bed, as such  term  is
defined in section 31.27 of this chapter. At the time of admission to an
extended  observation  bed,  such  person  shall  be served with written
notice of his status and rights as a patient under  this  section.  Such
notice shall contain the patient's name. The notice shall be provided to
the  same  persons and in the manner as if provided pursuant to subdivi-
sion (a) of section 9.39 of this article.  Written  requests  for  court
hearings  on  the  question  of need for immediate observation, care and
treatment shall be made, and court hearings shall be scheduled and held,
in the manner provided pursuant to subdivision (a) of  section  9.39  of
this  article, provided however, if a person is removed or admitted to a
hospital pursuant to subdivision (e) or (f) of this section the director
of such hospital shall be substituted for the director of the comprehen-
sive psychiatric emergency program in all  legal  proceedings  regarding
the continued retention of the person.
  S 5. Section 9.55 of the mental hygiene law, as amended by chapter 598
of the laws of 1994, is amended to read as follows:
 S 9.55 Emergency  admissions for immediate observation, care and treat-
           ment; powers of qualified psychiatrists OR NURSE  PRACTITION-
           ERS.
  A qualified psychiatrist OR NURSE PRACTITIONER shall have the power to
direct  the  removal of any person, whose treatment for a mental illness
he or she is either supervising or providing in a facility  licensed  or
operated by the office of mental health which does not have an inpatient
psychiatric service, to a hospital approved by the commissioner pursuant
to subdivision (a) of section 9.39 of this article or to a comprehensive
psychiatric  emergency program, if he or she determines upon examination
of such person that such person appears to have  a  mental  illness  for
which  immediate observation, care and treatment in a hospital is appro-
priate and which is likely to result  in  serious  harm  to  himself  or
herself  or  others.  Upon the request of such qualified psychiatrist OR
NURSE PRACTITIONER,  peace  officers,  when  acting  pursuant  to  their
special  duties,  or  police  officers, who are members of an authorized
police department or force or of a sheriff's department shall take  into
custody  and  transport any such person. Upon the request of a qualified

S. 4525                             3

psychiatrist OR NURSE PRACTITIONER an ambulance service, as  defined  by
subdivision  two of section three thousand one of the public health law,
is authorized to transport any such person.  Such  person  may  then  be
admitted to a hospital in accordance with the provisions of section 9.39
of  this  article or to a comprehensive psychiatric emergency program in
accordance with the provisions of section 9.40 of this article.
  S 6. Section 9.55 of the mental hygiene law, as amended by chapter 847
of the laws of 1987, is amended to read as follows:
 S 9.55 Emergency admissions for immediate observation, care and  treat-
           ment;  powers of qualified psychiatrists OR NURSE PRACTITION-
           ERS.
  A qualified psychiatrist OR NURSE PRACTITIONER shall have the power to
direct the removal of any person, whose treatment for a  mental  illness
he  OR  SHE is either supervising or providing in a facility licensed or
operated by the office of mental health which does not have an inpatient
psychiatric service, to a hospital approved by the commissioner pursuant
to subdivision (a) of section 9.39 of this article, if he OR SHE  deter-
mines upon examination of such person that such person appears to have 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
himself OR HERSELF or others, as defined in section 9.39 of  this  arti-
cle.  Upon  the  request of such qualified psychiatrist OR NURSE PRACTI-
TIONER, peace officers, when acting pursuant to their special duties, or
police officers, who are members of an authorized police  department  or
force or of a sheriff's department shall take into custody and transport
any  such  person. Upon the request of a qualified psychiatrist OR NURSE
PRACTITIONER an ambulance service, as  defined  by  subdivision  two  of
section  three  thousand  one of the public health law, is authorized to
transport any such person. Such person may then be admitted  in  accord-
ance with the provisions of section 9.39 of this article.
  S 7. Section 9.57 of the mental hygiene law, as amended by chapter 598
of the laws of 1994, is amended to read as follows:
 S 9.57 Emergency  admissions for immediate observation, care and treat-
           ment; powers of emergency room physicians  OR  NURSE  PRACTI-
           TIONERS.
  A  physician  OR  NURSE  PRACTITIONER  who has examined a person in an
emergency room or provided  emergency  medical  services  at  a  general
hospital,  as  defined in article twenty-eight of the public health law,
which does not have an inpatient psychiatric service, or a physician  OR
NURSE  PRACTITIONER who has examined a person in a comprehensive psychi-
atric emergency program shall be authorized to request that the director
of the program or hospital,  or  the  director's  designee,  direct  the
removal of such person to a hospital approved by the commissioner pursu-
ant  to  subdivision (a) of section 9.39 of this article or to a compre-
hensive psychiatric emergency program, if the physician OR NURSE PRACTI-
TIONER determines upon examination  of  such  person  that  such  person
appears  to have a mental illness for which immediate care and treatment
in a hospital is appropriate and which is likely to  result  in  serious
harm  to  himself  or others. Upon the request of the physician OR NURSE
PRACTITIONER, the director of the program or hospital or the  director's
designee,  is  authorized to direct peace officers, when acting pursuant
to their special duties, or police  officers,  who  are  members  of  an
authorized  police  department  or force or of a sheriff's department to
take into custody and transport any such person. Upon the request of  an
emergency  room  physician, A NURSE PRACTITIONER, or the director of the
program or hospital, or the director's designee, an  ambulance  service,

S. 4525                             4

as  defined  by  subdivision  two  of  section three thousand one of the
public health law, is authorized to take into custody and transport  any
such  person.  Such person may then be admitted to a hospital in accord-
ance with the provisions of section 9.39 of this article or to a compre-
hensive  psychiatric emergency program in accordance with the provisions
of section 9.40 of this article.
  S 8. Section 9.57 of the mental hygiene law, as amended by chapter 847
of the laws of 1987, is amended to read as follows:
S 9.57 Emergency admissions for immediate observation, care  and  treat-
           ment;  powers  of  emergency room physicians OR NURSE PRACTI-
           TIONERS.
  A physician OR NURSE PRACTITIONER who has  examined  a  person  in  an
emergency  room  or  provided  emergency  medical  services at a general
hospital, as defined in article twenty-eight of the public  health  law,
which  does  not have an inpatient psychiatric service, shall be author-
ized to request that the director of the hospital, or his OR HER  desig-
nee,  direct  the  removal  of such person to a hospital approved by the
commissioner pursuant to subdivision (a) of section 9.39 of  this  arti-
cle,  if the physician OR NURSE PRACTITIONER determines upon examination
of such person that such person appears to have  a  mental  illness  for
which  immediate  care  and  treatment  in a hospital is appropriate and
which is likely to result in serious  harm  to  himself  OR  HERSELF  or
others,  as defined in section 9.39 of this article. Upon the request of
the physician OR NURSE PRACTITIONER, the director of the hospital or his
OR HER designee, is authorized to direct  peace  officers,  when  acting
pursuant to their special duties, or police officers, who are members of
an authorized police department or force or of a sheriff's department to
take  into custody and transport any such person. Upon the request of an
emergency room physician, A NURSE PRACTITIONER, or the director  of  the
hospital,  or  his  OR HER designee, an ambulance service, as defined by
subdivision two of section three thousand one of the public health  law,
is  authorized  to take into custody and transport any such person. Such
person may then be admitted in accordance with the provisions of section
9.39 of this article.
  S 9. Subparagraph (v) of paragraph 1 and paragraphs 3 and 4 of  subdi-
vision (e) and subdivisions (h), (i), (k) and (n) of section 9.60 of the
mental  hygiene  law,  as  amended and paragraph 4 of subdivision (e) as
added by chapter 158 of the  laws  of  2005,  are  amended  to  read  as
follows:
  (v)  a  qualified  psychiatrist  OR  NURSE  PRACTITIONER who is either
supervising the treatment of or treating the subject of the petition for
a mental illness; or
  (3) The petition shall be accompanied by an affirmation  or  affidavit
of  a  physician OR NURSE PRACTITIONER, who shall not be the petitioner,
stating either that:
  (i) such physician OR NURSE PRACTITIONER has personally  examined  the
subject of the petition no more than ten days prior to the submission of
the  petition,  recommends assisted outpatient treatment for the subject
of the petition, and is willing and able to testify at  the  hearing  on
the petition; or
  (ii)  no  more than ten days prior to the filing of the petition, such
physician OR NURSE PRACTITIONER or his or her designee has  made  appro-
priate attempts but has not been successful in eliciting the cooperation
of  the subject of the petition to submit to an examination, such physi-
cian OR NURSE PRACTITIONER has reason to suspect that the subject of the
petition meets the criteria for assisted outpatient treatment, and  such

S. 4525                             5

physician  OR  NURSE  PRACTITIONER  is  willing  and able to examine the
subject of the petition and testify at the hearing on the petition.
  (4)  In counties with a population of less than seventy-five thousand,
the affirmation or affidavit required by paragraph three of this  subdi-
vision  may  be  made  by  a  physician  OR NURSE PRACTITIONER who is an
employee of the office.  The office is authorized to make available,  at
no  cost  to the county, a qualified physician OR NURSE PRACTITIONER for
the purpose of making such affirmation or affidavit consistent with  the
provisions of such paragraph.
  (h) Hearing. (1) Upon receipt of the petition, the court shall fix the
date for a hearing. Such date shall be no later than three days from the
date  such  petition  is  received  by  the  court, excluding Saturdays,
Sundays and holidays. Adjournments shall  be  permitted  only  for  good
cause shown. In granting adjournments, the court shall consider the need
for  further  examination  by  a  physician OR NURSE PRACTITIONER or the
potential need to provide assisted outpatient  treatment  expeditiously.
The  court  shall  cause  the  subject of the petition, any other person
receiving notice pursuant to subdivision (f) of this section, the  peti-
tioner, the physician OR NURSE PRACTITIONER whose affirmation or affida-
vit  accompanied  the  petition, and such other persons as the court may
determine to be advised of such date. Upon such date, or upon such other
date to which the proceeding may be  adjourned,  the  court  shall  hear
testimony and, if it be deemed advisable and the subject of the petition
is available, examine the subject of the petition in or out of court. If
the  subject  of the petition does not appear at the hearing, and appro-
priate attempts to elicit the attendance of the subject have failed, the
court may conduct the hearing in the subject's absence.  In  such  case,
the  court  shall set forth the factual basis for conducting the hearing
without the presence of the subject of the petition.
  (2) The court shall not order assisted outpatient treatment unless  an
examining  physician  OR  NURSE  PRACTITIONER,  who  recommends assisted
outpatient treatment and has personally  examined  the  subject  of  the
petition no more than ten days before the filing of the petition, testi-
fies  in  person  at  the  hearing. Such physician OR NURSE PRACTITIONER
shall state the facts and  clinical  determinations  which  support  the
allegation  that  the subject of the petition meets each of the criteria
for assisted outpatient treatment.
  (3) If the subject of the petition has refused to  be  examined  by  a
physician  OR  NURSE  PRACTITIONER, the court may request the subject to
consent to an examination by a physician OR NURSE PRACTITIONER appointed
by the court. If the subject of the petition does not  consent  and  the
court  finds  reasonable  cause  to  believe that the allegations in the
petition are true, the court may order peace officers,  acting  pursuant
to  their  special  duties,  or  police  officers  who are members of an
authorized police department or force, or of a sheriff's  department  to
take  the  subject of the petition into custody and transport him or her
to a hospital for examination by a physician. Retention of  the  subject
of the petition under such order shall not exceed twenty-four hours. The
examination  of  the  subject  of  the  petition may be performed by the
physician OR NURSE PRACTITIONER whose affirmation or affidavit  accompa-
nied the petition pursuant to paragraph three of subdivision (e) of this
section,  if  such physician OR NURSE PRACTITIONER is privileged by such
hospital or otherwise authorized by such hospital  to  do  so.  If  such
examination is performed by another physician OR NURSE PRACTITIONER, the
examining physician OR NURSE PRACTITIONER may consult with the physician
OR  NURSE  PRACTITIONER  whose  affirmation or affidavit accompanied the

S. 4525                             6

petition as to whether the  subject  meets  the  criteria  for  assisted
outpatient treatment.
  (4)  A physician OR NURSE PRACTITIONER who testifies pursuant to para-
graph two of this subdivision shall state: (i) the facts  which  support
the  allegation that the subject meets each of the criteria for assisted
outpatient treatment, (ii) that the treatment is the  least  restrictive
alternative,  (iii)  the  recommended assisted outpatient treatment, and
(iv) the rationale for the recommended assisted outpatient treatment. If
the recommended assisted outpatient treatment includes medication,  such
physician's  OR  NURSE PRACTITIONER'S testimony shall describe the types
or classes of medication which should be authorized, shall describe  the
beneficial  and  detrimental physical and mental effects of such medica-
tion, and shall recommend whether such medication should be  self-admin-
istered or administered by authorized personnel.
  (5)  The  subject  of the petition shall be afforded an opportunity to
present evidence, to call witnesses on his or her behalf, and to  cross-
examine adverse witnesses.
  (i)  Written  treatment  plan.  (1) The court shall not order assisted
outpatient treatment unless a physician OR NURSE PRACTITIONER  appointed
by  the appropriate director, in consultation with such director, devel-
ops and provides to the court a proposed  written  treatment  plan.  The
written  treatment plan shall include case management services or asser-
tive community treatment team services to provide care coordination. The
written treatment plan also shall include all categories of services, as
set forth in paragraph one of subdivision (a)  of  this  section,  which
such  physician OR NURSE PRACTITIONER recommends that the subject of the
petition receive. All service  providers  shall  be  notified  regarding
their  inclusion in the written treatment plan. If the written treatment
plan includes medication, it shall state whether such medication  should
be  self-administered or administered by authorized personnel, and shall
specify type and dosage range of medication most likely to provide maxi-
mum benefit for the subject. If  the  written  treatment  plan  includes
alcohol  or  substance  abuse  counseling  and  treatment, such plan may
include a provision requiring relevant testing  for  either  alcohol  or
illegal  substances  provided  the  physician's  OR NURSE PRACTITIONER'S
clinical basis for recommending such plan provides sufficient facts  for
the  court  to  find  (i)  that  such person has a history of alcohol or
substance abuse that is clinically related to the  mental  illness;  and
(ii)  that  such  testing  is  necessary to prevent a relapse or deteri-
oration which would be likely to result in serious harm to the person or
others. If a director is the  petitioner,  the  written  treatment  plan
shall  be provided to the court no later than the date of the hearing on
the petition. If a person other than a director is the petitioner,  such
plan  shall  be  provided to the court no later than the date set by the
court pursuant to paragraph three of subdivision (j) of this section.
  (2) The physician OR NURSE PRACTITIONER appointed to develop the writ-
ten treatment plan shall provide the following persons with an  opportu-
nity  to  actively  participate  in  the  development  of such plan: the
subject of the petition; the treating physician OR  NURSE  PRACTITIONER,
if any; and upon the request of the subject of the petition, an individ-
ual  significant  to the subject including any relative, close friend or
individual otherwise concerned with the welfare of the subject.  If  the
subject  of the petition has executed a health care proxy, the appointed
physician OR NURSE PRACTITIONER shall consider any  directions  included
in such proxy in developing the written treatment plan.

S. 4525                             7

  (3)  The  court shall not order assisted outpatient treatment unless a
physician OR NURSE PRACTITIONER appearing on behalf of a director testi-
fies to explain the written proposed treatment plan. Such  physician  OR
NURSE  PRACTITIONER  shall  state  the categories of assisted outpatient
treatment recommended, the rationale for each such category, facts which
establish that such treatment is the least restrictive alternative, and,
if  the  recommended assisted outpatient treatment plan includes medica-
tion, such physician OR NURSE PRACTITIONER  shall  state  the  types  or
classes  of medication recommended, the beneficial and detrimental phys-
ical and mental effects of such medication, and whether such  medication
should  be  self-administered  or  administered by an authorized profes-
sional. If the subject of the petition has executed a health care proxy,
such physician OR NURSE PRACTITIONER shall state the consideration given
to any directions included in  such  proxy  in  developing  the  written
treatment  plan.  If a director is the petitioner, testimony pursuant to
this paragraph shall be given at the  hearing  on  the  petition.  If  a
person  other than a director is the petitioner, such testimony shall be
given on the date set by the court pursuant to paragraph three of subdi-
vision (j) of this section.
  (k) Petition for additional periods of treatment. Within  thirty  days
prior  to  the  expiration of an order of assisted outpatient treatment,
the appropriate director or the current petitioner, if the current peti-
tion was filed pursuant to subparagraph (i) or (ii) of paragraph one  of
subdivision  (e) of this section, and the current petitioner retains his
or her original status pursuant  to  the  applicable  subparagraph,  may
petition  the court to order continued assisted outpatient treatment for
a period not to exceed one year from the expiration date of the  current
order.  If the court's disposition of such petition does not occur prior
to the expiration date of the current order,  the  current  order  shall
remain  in  effect  until such disposition. The procedures for obtaining
any order pursuant to this subdivision shall be in accordance  with  the
provisions  of the foregoing subdivisions of this section; provided that
the time restrictions included in paragraph four of subdivision  (c)  of
this section shall not be applicable. The notice provisions set forth in
paragraph  six  of  subdivision (j) of this section shall be applicable.
Any court order requiring periodic blood tests  or  urinalysis  for  the
presence  of  alcohol  or illegal drugs shall be subject to review after
six months by the physician OR  NURSE  PRACTITIONER  who  developed  the
written treatment plan or another physician OR NURSE PRACTITIONER desig-
nated by the director, and such physician OR NURSE PRACTITIONER shall be
authorized  to  terminate such blood tests or urinalysis without further
action by the court.
  (n) Failure to comply with assisted outpatient treatment. Where in the
clinical judgment of a physician OR NURSE PRACTITIONER, (i) the assisted
outpatient, has failed or refused to comply with the assisted outpatient
treatment, (ii) efforts were made to solicit compliance, and (iii)  such
assisted  outpatient may be in need of involuntary admission to a hospi-
tal pursuant to section 9.27 of this article or  immediate  observation,
care  and  treatment  pursuant  to section 9.39 or 9.40 of this article,
such physician OR NURSE PRACTITIONER may request the director of  commu-
nity  services, the director's designee, or any physician OR NURSE PRAC-
TITIONER designated by the director of community  services  pursuant  to
section  9.37  of  this  article, to direct the removal of such assisted
outpatient to an appropriate hospital for an examination to determine if
such person has a mental illness for which hospitalization is  necessary
pursuant  to section 9.27, 9.39 or 9.40 of this article. Furthermore, if

S. 4525                             8

such assisted outpatient refuses to take medications as required by  the
court order, or he or she refuses to take, or fails a blood test, urina-
lysis,  or  alcohol  or  drug  test as required by the court order, such
physician  OR  NURSE  PRACTITIONER  may consider such refusal or failure
when determining whether the assisted outpatient is in need of an  exam-
ination  to  determine  whether he or she has a mental illness for which
hospitalization is necessary. Upon the  request  of  such  physician  OR
NURSE PRACTITIONER, the director, the director's designee, or any physi-
cian  OR  NURSE PRACTITIONER designated pursuant to section 9.37 of this
article, may direct peace officers, acting  pursuant  to  their  special
duties,  or  police  officers  who  are  members of an authorized police
department or force or of a sheriff's department to  take  the  assisted
outpatient into custody and transport him or her to the hospital operat-
ing the assisted outpatient treatment program or to any hospital author-
ized by the director of community services to receive such persons. Such
law  enforcement  officials  shall  carry  out  such directive. Upon the
request of such physician  OR  NURSE  PRACTITIONER,  the  director,  the
director's  designee,  or any physician OR NURSE PRACTITIONER designated
pursuant to section 9.37 of  this  article,  an  ambulance  service,  as
defined  by  subdivision two of section three thousand one of the public
health law, or an approved mobile crisis outreach  team  as  defined  in
section  9.58  of  this article shall be authorized to take into custody
and transport any such person to the  hospital  operating  the  assisted
outpatient treatment program, or to any other hospital authorized by the
director  of community services to receive such persons. Any director of
community services, or designee,  shall  be  authorized  to  direct  the
removal of an assisted outpatient who is present in his or her county to
an  appropriate  hospital,  in  accordance  with  the provisions of this
subdivision, based upon a determination of the appropriate  director  of
community  services  directing  the  removal of such assisted outpatient
pursuant to this subdivision. Such person may be retained  for  observa-
tion,  care and treatment and further examination in the hospital for up
to seventy-two hours to permit a  physician  OR  NURSE  PRACTITIONER  to
determine  whether  such  person  has a mental illness and is in need of
involuntary care and treatment in a hospital pursuant to the  provisions
of  this  article.  Any continued involuntary retention in such hospital
beyond the initial seventy-two hour period shall be in  accordance  with
the provisions of this article relating to the involuntary admission and
retention of a person. If at any time during the seventy-two hour period
the  person  is  determined  not  to  meet the involuntary admission and
retention provisions of this article, and does not agree to stay in  the
hospital as a voluntary or informal patient, he or she must be released.
Failure  to  comply with an order of assisted outpatient treatment shall
not be grounds for involuntary civil commitment or a finding of contempt
of court.
  S 10. This act shall take effect immediately; provided, however, that
  1. The amendments to subdivisions (b) and (c) of section 9.40  of  the
mental hygiene law made by section four of this act shall not affect the
repeal of such section and shall be deemed repealed therewith;
  2.  The amendments to sections 9.55 and 9.57 of the mental hygiene law
made by sections five and seven of this act  shall  be  subject  to  the
expiration  and  reversion  of  such  sections pursuant to section 21 of
chapter 723 of the laws of 1989, as amended, when  upon  such  date  the
provisions of sections six and eight of this act shall take effect;

S. 4525                             9

  3.  The  amendments  to section 9.60 of the mental hygiene law made by
section nine of this act shall not affect the repeal of such section and
shall be deemed repealed therewith.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.