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Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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| Jan 03, 2024 |
referred to mental health |
| Jun 15, 2023 |
referred to mental health |
Assembly Bill A7827
2023-2024 Legislative Session
Relates to hospitalization, care coordination, and assisted outpatient treatment for persons with mental illness
download bill text pdfSponsored By
BRAUNSTEIN
Current Bill Status - In Assembly Committee
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
co-Sponsors
Stacey Pheffer Amato
2023-A7827 (ACTIVE) - Details
- Current Committee:
- Assembly Mental Health
- Law Section:
- Mental Hygiene Law
- Laws Affected:
- Amd Ment Hyg L, generally
2023-A7827 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
7827
2023-2024 Regular Sessions
I N A S S E M B L Y
June 15, 2023
___________
Introduced by M. of A. BRAUNSTEIN -- read once and referred to the
Committee on Mental Health
AN ACT to amend the mental hygiene law, in relation to hospitalization,
care coordination, and assisted outpatient treatment for persons with
mental illness
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act shall be known and may be cited as "The Supportive
Interventions Act".
§ 2. Legislative findings. The legislature finds that with proper
support, the great majority of New Yorkers with severe mental illness
can thrive in outpatient settings as fully-integrated members of the
communities of our state.
The legislature further finds that a core function of our mental
health system is to help each person with severe mental illness maximize
their potential for a self-directed life. Fulfilling this responsibility
requires a flexible approach that acknowledges the challenges that indi-
viduals with severe mental illness may face at certain junctures in
recognizing their own illness and need for treatment. To empower a
person to gain command of their own mental health recovery in due
course, it is sometimes necessary to extend a lifeline through a period
of mandated treatment.
The legislature further finds that it is always preferable for an
individual in psychiatric crisis or at risk thereof to accept mental
health treatment voluntarily, and that care providers be encouraged to
make diligent efforts to exhaust such possibilities before resorting to
involuntary care.
The legislature further finds that while New York law appropriately
limits involuntary hospitalization to circumstances where a person's
mental illness is deemed "likely to result in serious harm," a lack of
statutory guidance has led to tragically narrow interpretations of this
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11722-01-3
A. 7827 2
standard. The serious harm likely to result from egregious self-neglect,
including psychiatric deterioration likely to result from an extended
period of untreated psychosis, is too often not considered in the clin-
ical evaluation of those in crisis.
The legislature further finds individuals not receiving essential
mental health care because they are unable to recognize their own need
for it may face "revolving door" hospitalization, and intolerable rates
of victimization and premature death.
The legislature further finds that while assisted outpatient treat-
ment, as established by "Kendra's Law" in 1999, has been highly effec-
tive in helping New Yorkers with severe mental illness live safely in
the community and avoid hospitalization and criminal justice involve-
ment, gaps and barriers in the law have prevented the participation of
many individuals who meet the legal eligibility criteria and stand to
benefit from this essential intervention.
The legislature intends and expects that the supportive interventions
facilitated by this act will save lives, raise the quality of life for
New Yorkers with severe mental illness and their loved ones, enhance
public safety, reduce criminalization of mental illness, and improve the
efficiency and cost-effectiveness of our public mental health system.
The legislature further finds that there is no choice to be made
between the reforms enacted herein and the additional need to increase
investments in community-based mental health. Ongoing efforts to expand
availability of mental health treatment and services, supportive hous-
ing, and opportunities for social connection must continue, and offer
great promise to reduce the need for the crisis response mechanisms
addressed in this act.
§ 3. Section 9.01 of the mental hygiene law, as amended by chapter 723
of the laws of 1989, the seventh undesignated paragraph as amended by
chapter 595 of the laws of 2000, is amended to read as follows:
§ 9.01 Definitions.
As used in this article:
"in need of care and treatment" means that a person has a mental
illness for which in-patient care and treatment in a hospital is appro-
priate.
"in need of involuntary care and treatment" means that a person has a
mental illness for which care and treatment as a patient in a hospital
is essential to such person's welfare and [whose] THAT SO IMPAIRS THE
PERSON'S judgment [is so impaired] that [he] THE PERSON is unable to
understand the need for such care and treatment. CARE AND TREATMENT IN A
HOSPITAL SHALL BE CONSIDERED ESSENTIAL TO A PERSON'S WELFARE IF, IN THE
ABSENCE OF SUCH CARE AND TREATMENT, THE PERSON'S MENTAL ILLNESS IS LIKE-
LY TO RESULT IN SERIOUS HARM TO SELF OR OTHERS.
["likelihood to result in serious harm" or] "likely to result in seri-
ous harm TO SELF OR OTHERS" means [(a)] PRESENTING a substantial risk
of: (A) physical OR PSYCHIATRIC harm to the person as manifested by: (I)
threats of or attempts at suicide or serious bodily harm; (II) SUBSTAN-
TIAL INABILITY OF THE PERSON TO MEET HIS OR HER BASIC NEED FOR FOOD,
CLOTHING, SHELTER OR MEDICAL CARE; or (III) other conduct demonstrating
that the person is dangerous to himself or herself, or (b) [a substan-
tial risk of] physical harm to other persons as manifested by homicidal
or other violent behavior OR THREATS by which others are placed in
reasonable fear of serious physical harm.
"need for retention" means [that] THE NEED OF a person who has been
admitted to a hospital pursuant to this article [is in need] FOR A
A. 7827 3
FURTHER PERIOD of involuntary care and treatment in a hospital [for a
further period].
"record" of a patient shall consist of admission, transfer or
retention papers and orders, and accompanying data required by this
article and by the regulations of the commissioner.
"director of community services" means the director of community
services for the mentally disabled appointed pursuant to article forty-
one of this chapter.
"qualified psychiatrist" means a physician licensed to practice medi-
cine in New York state who: (a) is a diplomate of the American board of
psychiatry and neurology or is eligible to be certified by that board;
or (b) is certified by the American osteopathic board of neurology and
psychiatry or is eligible to be certified by that board.
"QUALIFIED CLINICAL EXAMINER" MEANS A PSYCHIATRIC NURSE PRACTITIONER
CERTIFIED BY THE DEPARTMENT OF EDUCATION, A PSYCHOLOGIST LICENSED PURSU-
ANT TO ARTICLE ONE HUNDRED FIFTY-THREE OF THE EDUCATION LAW, OR A CLIN-
ICAL SOCIAL WORKER LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-FOUR
OF THE EDUCATION LAW.
"QUALIFIED MENTAL HEALTH PROFESSIONAL" MEANS A QUALIFIED CLINICAL
EXAMINER, A PROFESSIONAL NURSE REGISTERED PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THE EDUCATION LAW, OR ANY OF THE FOLLOWING WORK-
ING UNDER THE SUPERVISION OF A PHYSICIAN OR QUALIFIED CLINICAL EXAMINER:
A MASTER SOCIAL WORKER LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-
FOUR OF THE EDUCATION LAW, A MENTAL HEALTH COUNSELOR LICENSED PURSUANT
TO ARTICLE ONE HUNDRED SIXTY-THREE OF THE EDUCATION LAW, OR A MARRIAGE
AND FAMILY THERAPIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-
THREE OF THE EDUCATION LAW.
§ 4. The mental hygiene law is amended by adding a new section 9.04 to
read as follows:
§ 9.04 CLINICAL DETERMINATION OF RISK OF HARM.
A CLINICAL DETERMINATION OF WHETHER A PERSON'S MENTAL ILLNESS IS LIKE-
LY TO RESULT IN SERIOUS HARM TO SELF OR OTHERS SHALL TAKE ACCOUNT OF:
(A) ALL RELEVANT INFORMATION PRESENTED TO THE EVALUATING FACILITY'S
STAFF, INCLUDING CREDIBLE REPORTS OF THE PERSON'S RECENT BEHAVIOR AND
ANY KNOWN INFORMATION RELATED TO THE PERSON'S MEDICAL AND BEHAVIORAL
HISTORY;
(B) THE PERSON'S CURRENT ABILITY, WITH AVAILABLE SUPPORT, TO ADHERE TO
OUTPATIENT TREATMENT; AND
(C) THE EXPECTED LONG-TERM IMPACT ON THE PERSON'S HEALTH OR SAFETY OF
ACTIONS OR SELF-NEGLECT CAUSED BY MENTAL ILLNESS.
§ 5. Section 9.05 of the mental hygiene law, as renumbered by chapter
978 of the laws of 1977, is amended to read as follows:
§ 9.05 Examining physicians, QUALIFIED CLINICAL EXAMINERS, and medical
certificates.
(a) A person is disqualified from acting as an examining physician OR
QUALIFIED CLINICAL EXAMINER in the following cases:
1. if he OR SHE is a relative of the person applying for the admission
or of the person alleged to be mentally ill.
2. if he OR SHE is a manager, trustee, visitor, proprietor, officer,
director, or stockholder of the hospital in which the patient is hospi-
talized or to which it is proposed to admit such person, except as
otherwise provided in this chapter, or if he OR SHE has any pecuniary
interest, directly or indirectly, in such hospital, provided that
receipt of fees, privileges, or compensation for treating or examining
patients in such hospital shall not be deemed to be a pecuniary inter-
est.
A. 7827 4
3. if he OR SHE is on the staff of a proprietary facility to which it
is proposed to admit such person.
(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 QUALIFIED CLINICAL EXAMIN-
ERS 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.
§ 6. The section heading and subdivisions (a), (d), (e), and (i) of
section 9.27 of the mental hygiene law, section 9.27 as renumbered by
chapter 978 of the laws of 1977 and subdivision (i) as amended by chap-
ter 847 of the laws of 1987, are amended to read as follows:
Involuntary admission on [medical] CLINICAL certification.
(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,
TWO EXAMINING QUALIFIED CLINICAL EXAMINERS OR A COMBINATION OF AN EXAM-
INING PHYSICIAN AND AN EXAMINING QUALIFIED CLINICAL EXAMINER, accompa-
nied by an application for the admission of such person. The examination
may be conducted jointly but each examining physician OR QUALIFIED CLIN-
ICAL EXAMINER shall execute a separate certificate.
(d) Before an examining physician OR QUALIFIED CLINICAL EXAMINER
completes the certificate of examination of a person for involuntary
care and treatment, [he] THE PHYSICIAN OR QUALIFIED CLINICAL EXAMINER
shall consider alternative forms of care and treatment that might be
adequate to provide for the person's needs without requiring involuntary
hospitalization. If the examining physician OR QUALIFIED CLINICAL EXAM-
INER knows that the person he OR SHE is examining for involuntary care
and treatment has been under prior treatment, he OR SHE shall, insofar
as [possible] REASONABLE, consult with the physician or [psychologist]
QUALIFIED MENTAL HEALTH PROFESSIONAL furnishing such prior treatment
prior to completing [his] THE certificate. Nothing in this section shall
prohibit or invalidate any involuntary admission made in accordance with
the provisions of this chapter.
(e) The director of the hospital where such person is brought shall
cause such person to be examined forthwith by a physician OR QUALIFIED
CLINICAL EXAMINER who shall be a member of the psychiatric staff of such
hospital other than the original examining physicians OR QUALIFIED CLIN-
ICAL EXAMINER whose certificate or certificates accompanied the applica-
tion, and[,] if such person is found to be in need of involuntary care
and treatment, he OR SHE may be admitted thereto as a patient as herein
provided.
(i) After an application for the admission of a person has been
completed and both physicians OR QUALIFIED CLINICAL EXAMINERS have exam-
ined such person and separately certified that he or she is mentally ill
and in need of involuntary care and treatment in a hospital, either
physician OR QUALIFIED CLINICAL EXAMINER is authorized to request peace
officers, when acting pursuant to their special duties, or police offi-
cers[,] who are members of an authorized police department or force or
of a sheriff's department, to take into custody and transport such
person to a hospital for determination by the director whether such
person qualifies for admission pursuant to this section. Upon the
A. 7827 5
request of either physician OR QUALIFIED CLINICAL EXAMINER, an ambulance
service, as defined by subdivision two of section three thousand one of
the public health law, is authorized to transport such person to a
hospital for determination by the director whether such person qualifies
for admission pursuant to this section.
§ 7. The section heading and subdivision (a) of section 9.29 of the
mental hygiene law, section 9.29 as renumbered by chapter 978 of the
laws of 1977 and subdivision (a) as amended by chapter 789 of the laws
of 1985, are amended to read as follows:
Involuntary admission on [medical] CLINICAL certification; notice of
admission to patients and others.
(a) The director shall cause written notice of a person's involuntary
admission on an application supported by [medical] CLINICAL certif-
ication to be given forthwith to the mental hygiene legal service.
§ 8. The section heading and subdivision (a) of section 9.31 of the
mental hygiene law, section 9.31 as renumbered by chapter 978 of the
laws of 1977, subdivision (a) as amended by chapter 789 of the laws of
1985, are amended to read as follows:
Involuntary admission on [medical] CLINICAL certification; patient's
right to a hearing.
(a) If, at any time prior to the expiration of sixty days from the
date of involuntary admission of a patient on an application supported
by [medical] CLINICAL certification, [he] SUCH PATIENT or any relative
or friend, or the mental hygiene legal service gives notice in writing
to the director of A request for hearing on the question of need for
involuntary care and treatment, a hearing shall be held as herein
provided. The patient or person requesting a hearing on behalf of the
patient may designate the county where the hearing shall be held, which
shall be either in the county where the hospital is located, the county
of the patient's residence, or the county in which the hospital to which
the patient was first admitted is located. Such hearing shall be held in
the county so designated, subject to application by any interested
party, including the director, for change of venue to any other county
because of the convenience of parties or witnesses or the condition of
the patient upon notice to the persons required to be served with notice
of the patient's initial admission.
§ 9. Subdivision (a) of section 9.33 of the mental hygiene law, as
amended by chapter 789 of the laws of 1985, is amended to read as
follows:
(a) If the director shall determine that a patient admitted upon an
application supported by [medical] CLINICAL certification, for whom
there is no court order authorizing retention for a specified period, is
in need of retention and if such patient does not agree to remain in
such hospital as a voluntary patient, the director shall apply to the
supreme court or the county court in the county where the hospital is
located for an order authorizing continued retention. Such application
shall be made no later than sixty days from the date of involuntary
admission on application supported by [medical] CLINICAL certification
or thirty days from the date of an order denying an application for
patient's release pursuant to section 9.31 OF THIS ARTICLE, whichever is
later; and the hospital is authorized to retain the patient for such
further period during which the hospital is authorized to make such
application or during which the application may be pending. The director
shall cause written notice of such application to be given TO the
patient and a copy thereof shall be given personally or by mail to the
persons required by this article to be served with notice of such
A. 7827 6
patient's initial admission and to the mental hygiene legal service.
Such notice shall state that a hearing may be requested and that failure
to make such a request within five days, excluding Sunday and holidays,
from the date that the notice was given to the patient will permit the
entry without a hearing of an order authorizing retention.
§ 10. The section heading and subdivisions (a), (b), (c), (d), and (e)
of section 9.37 of the mental hygiene law, section 9.37 as renumbered by
chapter 978 of the laws of 1977, subdivision (a) as amended by chapter
723 of the laws of 1989, subdivision (c) as amended by chapter 230 of
the laws of 2004, and subdivision (d) as amended by chapter 357 of the
laws of 1991 and relettered by chapter 343 of the laws of 1996, and
subdivision (e) as relettered by chapter 343 of the laws of 1996, are
amended to read as follows:
Involuntary admission on certificate of a director of community
services or [his] DIRECTOR'S designee.
(a) The director of a hospital, upon application by a director of
community services or an examining physician OR QUALIFIED CLINICAL EXAM-
INER duly designated by [him or her] SUCH DIRECTOR, may receive and care
for in such hospital as a patient any person who, in the opinion of the
director of community services or the director's designee, has a mental
illness for which immediate inpatient care and treatment in a hospital
is appropriate and [which] THAT, WITHOUT TREATMENT, is likely to result
in serious harm to [himself or herself] SELF or others.
The need for immediate hospitalization shall be confirmed by a [staff]
physician OR QUALIFIED CLINICAL EXAMINER ON THE STAFF of the hospital
prior to admission. Within seventy-two hours, excluding Sunday and holi-
days, after such admission, if such patient is to be retained for care
and treatment beyond such time and he or she does not agree to remain in
such hospital as a voluntary patient, the certificate of another examin-
ing physician OR QUALIFIED CLINICAL EXAMINER who is a member of the
psychiatric staff of the hospital that the patient is in need of invol-
untary care and treatment shall be filed with the hospital. From the
time of his or her admission under this section the retention of such
patient for care and treatment shall be subject to the provisions for
notice, hearing, review, and judicial approval of continued retention or
transfer and continued retention provided by this article for the admis-
sion and retention of involuntary patients, provided that, for the
purposes of such provisions, the date of admission of the patient shall
be deemed to be the date when the patient was first received in the
hospital under this section.
(b) The application for admission of a patient pursuant to this
section shall be based upon a personal examination by a director of
community services or [his] THE DIRECTOR'S designee. It shall be in
writing and shall be filed with the director of such hospital at the
time of the patient's reception, together with a statement in a form
prescribed by the commissioner giving such information as [he] THE
COMMISSIONER may deem appropriate.
(c) Notwithstanding the provisions of subdivision (b) of [this]
section 41.09 OF THIS CHAPTER, in counties with a population of less
than two hundred thousand, a director of community services who is a
licensed psychologist pursuant to article one hundred fifty-three of the
education law or a licensed clinical social worker pursuant to article
one hundred fifty-four of the education law but who is not a physician
OR QUALIFIED CLINICAL EXAMINER may apply for the admission of a patient
pursuant to this section without [a medical] AN examination by a desig-
nated physician OR QUALIFIED CLINICAL EXAMINER, if a hospital approved
A. 7827 7
by the commissioner pursuant to section 9.39 of this article is not
located within thirty miles of the patient, and the director of communi-
ty services has made a reasonable effort to locate [a designated] AN
examining physician OR QUALIFIED CLINICAL EXAMINER DESIGNATED PURSUANT
TO SECTION 41.09 OF THIS CHAPTER but such [a] designee is not immediate-
ly available and the director of community services, after personal
observation of the person, reasonably believes that [he] SUCH PERSON may
have a mental illness [which] THAT is likely to result in serious harm
to [himself] SELF or others and inpatient care and treatment of such
person in a hospital may be appropriate. In the event of an application
pursuant to this subdivision, a physician OR QUALIFIED CLINICAL EXAMINER
of the receiving hospital shall examine the patient and shall not admit
the patient unless he or she determines that the patient has a mental
illness for which immediate inpatient care and treatment in a hospital
is appropriate and [which] THAT is likely to result in serious harm to
[himself] SELF or others. If the patient is admitted, the need for
hospitalization shall be confirmed by another [staff] physician OR QUAL-
IFIED CLINICAL EXAMINER ON THE STAFF OF THE HOSPITAL within twenty-four
hours. An application pursuant to this subdivision shall be in writing
and shall be filed with the director of such hospital at the time of the
patient's reception, together with a statement in a form prescribed by
the commissioner giving such information as [he] THE COMMISSIONER may
deem appropriate, including a statement of the efforts made by the
director of community services to locate a designated examining physi-
cian OR QUALIFIED CLINICAL EXAMINER prior to making an application
pursuant to this subdivision.
(d) After signing the application, the director of community services
or the director's designee shall be authorized and empowered to take
into custody, detain, transport, and provide temporary care for any such
person. Upon the written [request] DIRECTIVE of such director or the
director's designee it shall be the duty of peace officers, when acting
pursuant to their special duties, or police officers who are members of
the state police or of an authorized police department or force or of a
sheriff's department, to take into custody and transport any such person
as [requested and] directed by such director or designee. Upon the writ-
ten request of such director or designee, an ambulance service, as
defined in subdivision two of section three thousand one of the public
health law, is authorized to transport any such person.
(e) Reasonable expenses incurred by the director of community mental
hygiene services or [his] THE DIRECTOR'S designee for the examination
and temporary care of the patient and [his] SUCH PATIENT'S transporta-
tion to and from the hospital shall be a charge upon the county from
which the patient was admitted and shall be paid from any funds avail-
able for such purposes.
§ 11. Subdivisions (a) and (b) of section 9.39 of the mental hygiene
law, subdivision (a) as amended by chapter 789 of the laws of 1985 and
such section as renumbered by chapter 978 of the laws of 1977, are
amended to read as follows:
(a) The director of any hospital maintaining adequate staff and facil-
ities for the observation, examination, care, and treatment of persons
alleged to be mentally ill and approved by the commissioner to receive
and retain patients pursuant to this section may receive and retain
therein as a patient for a period of fifteen days any person alleged to
have a mental illness for which immediate observation, care, and treat-
ment in a hospital is appropriate and [which] THAT is likely to result
A. 7827 8
in serious harm to [himself] SELF or others. ["Likelihood to result in
serious harm" as used in this article shall mean:
1. substantial risk of physical harm to himself as manifested by
threats of or attempts at suicide or serious bodily harm or other
conduct demonstrating that he is dangerous to himself, 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.]
The director shall cause to be entered upon the hospital records the
name of the person or persons, if any, who have brought such person to
the hospital and the details of the circumstances leading to the hospi-
talization of such person.
The director shall admit such person pursuant to the provisions of
this section only if a [staff] physician OR QUALIFIED CLINICAL EXAMINER
ON THE STAFF of the hospital upon examination of such person finds that
such person qualifies under the requirements of this section. Such
person shall not be retained for a period of more than forty-eight hours
unless within such period such finding is confirmed after examination by
another physician OR QUALIFIED CLINICAL EXAMINER who shall be a member
of the psychiatric staff of the hospital. Such person shall be served,
at the time of admission, with written notice of [his] SUCH PERSON'S
status and rights as a patient under this section. Such notice shall
contain the patient's name. At the same time, such notice shall also be
given to the mental hygiene legal service and personally or by mail to
such person or persons, not to exceed three in number, as may be desig-
nated in writing to receive such notice by the person alleged to be
mentally ill. If at any time after admission, the patient, any relative,
friend, or the mental hygiene legal service gives notice to the director
in writing of request for court hearing on the question of need for
immediate observation, care, and treatment, a hearing shall be held as
herein provided as soon as practicable but in any event not more than
five days after such request is received, except that the commencement
of such hearing may be adjourned at the request of the patient. It shall
be the duty of the director upon receiving notice of such request for
hearing to forward forthwith a copy of such notice with a record of the
patient to the supreme court or county court in the county where such
hospital is located. A copy of such notice and record shall also be
given the mental hygiene legal service. The court [which] THAT receives
such notice shall fix the date of such hearing and cause the patient or
other person requesting the hearing, the director, the mental hygiene
legal service 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
examine the person alleged to be mentally ill, if it be deemed advisable
in or out of court, and shall render a decision in writing that there is
reasonable cause to believe that the patient has a mental illness for
which immediate inpatient care and treatment in a hospital is appropri-
ate and [which] THAT is likely to result in serious harm to [himself]
SELF or others. If it be determined that there is such reasonable cause,
the court shall forthwith issue an order authorizing the retention of
such patient for any such purpose or purposes in the hospital for a
period not to exceed fifteen days from the date of admission. Any such
order entered by the court shall not be deemed to be an adjudication
that the patient is mentally ill, but only a determination that there is
reasonable cause to retain the patient for the purposes of this section.
A. 7827 9
(b) Within fifteen days of arrival at the hospital, if a determination
is made that the person is not in need of involuntary care and treat-
ment, [he] SUCH PERSON shall be discharged unless [he] SUCH PERSON
agrees to remain as a voluntary or informal patient. If [he] SUCH PERSON
is in need of involuntary care and treatment and does not agree to
remain as a voluntary or informal patient, [he] SUCH PERSON may be
retained beyond such fifteen day period only by admission to such hospi-
tal or another appropriate hospital pursuant to the provisions governing
involuntary admission on application supported by [medical] CLINICAL
certification and subject to the provisions for notice, hearing, review,
and judicial approval of retention or transfer and retention governing
such admissions, provided that, for the purposes of such provisions, the
date of admission of the patient shall be deemed to be the date when the
patient was first received under this section. If a hearing has been
requested pursuant to the provisions of subdivision (a), the filing of
an application for involuntary admission on [medical] CLINICAL certif-
ication shall not delay or prevent the holding of the hearing.
§ 12. Subdivisions (a-1), (b), and (c) of section 9.40 of the mental
hygiene law, subdivisions (a-1) as added and (b) as amended by section 2
of part PPP of chapter 58 of the laws of 2020, and subdivision (c) as
added by chapter 723 of the laws of 1989, are amended to read as
follows:
(a-1) The director shall cause triage and referral services to be
provided by a psychiatric nurse practitioner or physician of the program
as soon as such person is received into the comprehensive psychiatric
emergency program. After receiving triage and referral services, such
person shall be appropriately treated and discharged, or referred for
further crisis intervention services including an examination by a
physician OR QUALIFIED CLINICAL EXAMINER as described in subdivision (b)
of this section.
(b) The director shall cause examination of such persons not
discharged after the provision of triage and referral services to be
initiated by a [staff] physician OR QUALIFIED CLINICAL EXAMINER ON THE
STAFF 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 physician OR QUALIFIED CLINICAL EXAMINER deter-
mines that such person may have a mental illness for which immediate
observation, care and treatment in a comprehensive psychiatric emergency
program is appropriate, and [which] THAT is likely to result in serious
harm to [the person] SELF 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 QUALIFIED CLINICAL
EXAMINER has been confirmed after examination by another physician OR
QUALIFIED CLINICAL EXAMINER 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 OR HER 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 subdivision (a) of section 9.39 of this article.
Written requests for court hearings on the question of need for immedi-
ate observation, care and treatment shall be made, and court hearings
A. 7827 10
shall be scheduled and held, in the manner provided pursuant to subdivi-
sion (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 comprehensive psychiatric emergency program in all
legal proceedings regarding the continued retention of the person.
§ 13. Subdivision (a) of section 9.41 of the mental hygiene law, as
amended by section 4 of part AA of chapter 57 of the laws of 2021, is
amended to read as follows:
(a) Any peace officer, when acting pursuant to his or her special
duties, or police officer who is a member of the state police or of an
authorized police department or force or of a sheriff's department may
take into custody any person who appears to be mentally ill and is
[conducting himself or herself] ACTING in a manner [which] THAT is like-
ly to result in serious harm to [the person] SELF or others. Such offi-
cer may direct the removal of such person or remove him or her to any
hospital specified in subdivision (a) of section 9.39 of this article,
or any comprehensive psychiatric emergency program specified in subdivi-
sion (a) of section 9.40 of this article, or pending his or her examina-
tion or admission to any such hospital or program, temporarily detain
any such person in another safe and comfortable place, in which event,
such officer shall immediately notify the director of community services
or THE DIRECTOR'S DESIGNEE, OR if there be [none] NO SUCH DIRECTOR OR
DESIGNEE, the health officer of the city or county of such action.
§ 14. Subdivision (a) of section 9.45 of the mental hygiene law, as
amended by section 6 of part AA of chapter 57 of the laws of 2021, is
amended to read as follows:
(a) The director of community services or the director's designee
shall have the power to direct the removal of any person, within his or
her jurisdiction, 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 pursuant to subdivision (a) of section
9.40 of this article, if the parent, adult sibling, spouse [or], DOMES-
TIC PARTNER AS DEFINED IN SECTION TWENTY-NINE HUNDRED NINETY-FOUR-A OF
THE PUBLIC HEALTH LAW, child of the person, COHABITANT OF THE PERSON'S
RESIDENTIAL UNIT, the committee or legal guardian of the person, a
licensed psychologist, registered professional nurse or certified social
worker currently responsible for providing treatment services to the
person, a supportive or intensive case manager currently assigned to the
person by a case management program, which program is approved by the
office of mental health for the purpose of reporting under this section,
a licensed physician, health officer, peace officer or police officer
reports to [him or her] THE DIRECTOR OR THE DIRECTOR'S DESIGNEE that
such person has a mental illness for which immediate care and treatment
is appropriate and [which] THAT is likely to result in serious harm to
[himself or herself] SELF or others. It shall be the duty of peace offi-
cers, when acting pursuant to their special duties, or police offi-
cers[,] who are members of an authorized police department, or force or
of a sheriff's department to assist representatives of such director to
take into custody and transport any such person. Upon the request of a
director of community services or the director's designee, an ambulance
service, as defined in subdivision two of section three thousand one of
the public health law, is authorized to transport any such person. Such
person may then be retained in a hospital pursuant to the provisions of
section 9.39 of this article or in a comprehensive psychiatric emergency
program pursuant to the provisions of section 9.40 of this article.
A. 7827 11
§ 15. Subdivision (b) of section 9.46 of the mental hygiene law, as
added by chapter 1 of the laws of 2013, is amended to read as follows:
(b) Notwithstanding any other law to the contrary, when a mental
health professional currently providing treatment services to a person
determines, in the exercise of reasonable professional judgment, that
such person is likely to engage in conduct that would result in serious
PHYSICAL harm to self or others, [he or she] THE MENTAL HEALTH PROFES-
SIONAL shall be required to report, as soon as practicable, to the
director of community services, or the director's designee, who shall
report to the division of criminal justice services whenever [he or she]
SUCH DIRECTOR OR DESIGNEE agrees that the person is likely to engage in
such conduct. Information transmitted to the division of criminal
justice services shall be limited to names and other non-clinical iden-
tifying information, which may only be used for determining whether a
license issued pursuant to section 400.00 of the penal law should be
suspended or revoked, or for determining whether a person is ineligible
for a license issued pursuant to section 400.00 of the penal law, or is
no longer permitted under state or federal law to possess a firearm.
§ 16. Paragraph 3 of subdivision (b) of section 9.47 of the mental
hygiene law, as amended by chapter 158 of the laws of 2005, is amended
to read as follows:
(3) filing of petitions for assisted outpatient treatment pursuant to
[paragraph] SUBPARAGRAPH (vii) OF PARAGRAPH ONE of subdivision (e) of
section 9.60 of this article, and documenting the petition filing date
and the date of the court order;
§ 17. Section 9.55 of the mental hygiene law, as amended by chapter
598 of the laws of 1994, is amended to read as follows:
§ 9.55 Emergency admissions for immediate observation, care and treat-
ment; powers of qualified psychiatrists AND QUALIFIED CLINICAL
EXAMINERS.
A qualified psychiatrist OR QUALIFIED CLINICAL EXAMINER 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 facili-
ty licensed or operated by the office of mental health [which] THAT 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 appropriate and [which] THAT is likely to
result in serious harm to [himself or herself] SELF or others. Upon the
[request] DIRECTIVE of such qualified psychiatrist[,] OR QUALIFIED CLIN-
ICAL EXAMINER, 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 psychia-
trist OR QUALIFIED CLINICAL EXAMINER, 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.
§ 18. The mental hygiene law is amended by adding a new section 9.56
to read as follows:
§ 9.56 TRANSPORT FOR EVALUATION; POWERS OF SPECIALIZED STAFF OF ADULT
CARE FACILITIES.
A. 7827 12
(A) A PHYSICIAN OR QUALIFIED MENTAL HEALTH PROFESSIONAL WHO HAS
COMPLETED TRAINING PURSUANT TO SUBDIVISION (C) OF THIS SECTION AND IS
EMPLOYED AS A CLINICAL STAFF MEMBER OR CLINICAL CONTRACTOR OF AN ADULT
CARE FACILITY AS DEFINED IN SECTION TWO OF THE SOCIAL SERVICES LAW SHALL
BE AUTHORIZED TO REQUEST THAT THE DIRECTOR OF SUCH FACILITY, OR SUCH
DIRECTOR'S DESIGNEE, DIRECT THE REMOVAL OF ANY RESIDENT OF SUCH FACILITY
WHO APPEARS TO BE MENTALLY ILL AND IS ACTING IN A MANNER THAT IS LIKELY
TO RESULT IN SERIOUS HARM TO SELF OR OTHERS, TO A HOSPITAL APPROVED BY
THE COMMISSIONER PURSUANT TO SUBDIVISION (A) OF SECTION 9.39 OR SECTION
31.27 OF THIS CHAPTER OR, WHERE SUCH PHYSICIAN OR QUALIFIED MENTAL
HEALTH PROFESSIONAL DEEMS APPROPRIATE AND THE PERSON VOLUNTARILY AGREES,
TO A CRISIS STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF THIS
CHAPTER.
(B) A FACILITY DIRECTOR OR DIRECTOR'S DESIGNEE WHO RECEIVES A REQUEST
FROM A PHYSICIAN OR QUALIFIED MENTAL HEALTH PROFESSIONAL PURSUANT TO
SUBDIVISION (A) OF THIS SECTION MAY DIRECT PEACE OFFICERS ACTING PURSU-
ANT 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 THE RESIDENT IDENTIFIED IN SUCH REQUEST.
UPON THE REQUEST OF SUCH FACILITY DIRECTOR OR DESIGNEE, AN AMBULANCE
SERVICE, AS DEFINED IN SUBDIVISION TWO OF SECTION THREE THOUSAND ONE OF
THE PUBLIC HEALTH LAW, IS AUTHORIZED TO TRANSPORT ANY SUCH PERSONS. SUCH
PERSONS MAY THEN BE EVALUATED FOR ADMISSION IN ACCORDANCE WITH THE
PROVISIONS OF SECTION 9.27, 9.39, 9.40 OR OTHER SECTIONS OF THIS ARTI-
CLE, PROVIDED THAT SUCH TRANSPORT SHALL NOT CREATE A PRESUMPTION THAT
THE PERSON SHOULD BE INVOLUNTARILY ADMITTED TO A HOSPITAL.
(C) THE COMMISSIONER SHALL DEVELOP STANDARDS RELATING TO THE TRAINING
REQUIREMENTS OF PHYSICIANS AND MENTAL HEALTH PROFESSIONALS AUTHORIZED TO
REQUEST TRANSPORT PURSUANT TO THIS SECTION. SUCH TRAINING SHALL, AT A
MINIMUM, HELP TO ENSURE THAT CRISIS AND EMERGENCY SERVICES ARE PROVIDED
IN A MANNER THAT PROTECTS THE HEALTH AND SAFETY, AND RESPECTS THE INDI-
VIDUAL NEEDS AND RIGHTS, OF PERSONS BEING EVALUATED OR TRANSPORTED
PURSUANT TO THIS SECTION.
(D) A PERSON REMOVED TO A HOSPITAL PURSUANT TO THIS SECTION SHALL
MAINTAIN HIS OR HER STATUS AS A RESIDENT OF THE ADULT CARE FACILITY
UNTIL ADMITTED AS A PATIENT AT SUCH HOSPITAL OR FOR TWENTY-FOUR HOURS
FOLLOWING SUCH PERSON'S RELEASE UPON A DETERMINATION BY A PHYSICIAN OR
QUALIFIED CLINICAL EXAMINER AT SUCH HOSPITAL TO NOT ADMIT THE PERSON AS
A PATIENT; PROVIDED THAT THIS SECTION SHALL NOT PREVENT THE ADULT CARE
FACILITY FROM CONTINUING SUCH PERSON'S RESIDENCY STATUS FOR A LONGER
PERIOD AT THE DISCRETION OF THE FACILITY DIRECTOR OR AS THE FACILITY MAY
OTHERWISE BE OBLIGATED. ANY PERSONAL PROPERTY OF SUCH PERSON LOCATED AT
THE FACILITY AT THE TIME OF REMOVAL SHALL BE SECURELY MAINTAINED BY THE
FACILITY FOR THE DURATION OF ANY RESULTING HOSPITALIZATION OR CRISIS
STABILIZATION, UNLESS TRANSFERRED TO ANOTHER PARTY UPON SUCH PERSON'S
REQUEST.
§ 19. The opening paragraph of section 9.57 of the mental hygiene law,
as amended by chapter 598 of the laws of 1994, is amended to read as
follows:
A physician OR QUALIFIED CLINICAL EXAMINER 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] THAT does not have an inpatient psychiatric service, or a physi-
cian OR QUALIFIED CLINICAL EXAMINER who has examined a person in a
comprehensive psychiatric emergency program shall be authorized to
request that the director of the program or hospital, or the director's
A. 7827 13
designee, direct the removal of such person 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 the
physician OR QUALIFIED CLINICAL EXAMINER 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]
THAT is likely to result in serious harm to [himself] SELF or others.
Upon the request of the physician OR QUALIFIED CLINICAL EXAMINER, 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 or the director of the program or hospital, or the direc-
tor's 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 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.
§ 20. Subdivisions (b), (c), and (d) of section 9.58 of the mental
hygiene law, subdivisions (b), (c) and (d) as added by chapter 678 of
the laws of 1994, and paragraph 2 of subdivision (d) as amended by chap-
ter 230 of the laws of 2004, are amended to read as follows:
(b) If the team physician or qualified mental health professional
determines that it is necessary to effectuate transport, he or she shall
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 persons identified in subdivision (a) of this section. Upon the
request of such physician or qualified mental health professional, an
ambulance service, as defined in subdivision two of section three thou-
sand one of the public health law, is authorized to transport any such
persons. Such persons may then be evaluated for admission in accordance
with the provisions of section 9.27, 9.39, 9.40 or other sections of
this article, provided that [such admission decisions shall be made
independent of the fact that the person was transported pursuant to the
provisions of this section and, provided further,] such transport shall
not create a presumption that the person should be involuntarily admit-
ted to a hospital.
(c) The commissioner shall be authorized to develop standards, in
consultation with the commissioner of the division of criminal justice
services, relating to the training requirements of teams established
pursuant to this section. Such training shall, at a minimum, help to
ensure that [the provision of] crisis and emergency services are
provided in a manner [which] THAT protects the health and safety and
respects the individual needs and rights of persons being evaluated or
transported pursuant to this section.
(d) As used in this section[:
(1) "Approved], "APPROVED mobile crisis outreach team" shall mean a
team of persons operating as part of a mobile crisis outreach program
approved by the commissioner of mental health, which may include mobile
crisis outreach teams funded pursuant to section 41.55 of this chapter.
[(2) "Qualified mental health professional" shall mean a licensed
psychologist, registered professional nurse, licensed clinical social
A. 7827 14
worker or a licensed master social worker under the supervision of a
physician, psychologist or licensed clinical social worker.]
§ 21. Subparagraph (iii) of paragraph 4 of subdivision (c) of section
9.60 of the mental hygiene law, as amended by section 2 of subpart H of
part UU of chapter 56 of the laws of 2022, is amended to read as
follows:
(iii) notwithstanding subparagraphs (i) and (ii) of this paragraph,
resulted in the issuance of a court order for assisted outpatient treat-
ment [which] THAT has expired within the last six months, and since the
expiration of the order, the person has experienced a substantial
increase in symptoms of mental illness [and such symptoms] THAT substan-
tially interferes with [or limits one or more major life activities as
determined by a director of community services who previously was
required to coordinate and monitor the care of any individual who was
subject to such expired assisted outpatient treatment order. The appli-
cable director of community services or their designee shall arrange for
the individual to be evaluated by a physician. If the physician deter-
mines court ordered services are clinically necessary and the least
restrictive option, the director of community services may initiate a
court proceeding] THE PERSON'S ABILITY TO MAINTAIN HIS OR HER HEALTH OR
SAFETY.
§ 22. Subparagraphs (ii) and (vi) of paragraph 1 of subdivision (e) of
section 9.60 of the mental hygiene law, as amended by chapter 158 of the
laws of 2005, is amended to read as follows:
(ii) the parent, spouse, DOMESTIC PARTNER, sibling eighteen years of
age or older, or child eighteen years of age or older of the subject of
the petition; or
(vi) a [psychologist, licensed pursuant to article one hundred fifty-
three of the education law, or a social worker, licensed pursuant to
article one hundred fifty-four of the education law,] QUALIFIED MENTAL
HEALTH PROFESSIONAL who is treating the subject of the petition for a
mental illness; or
§ 23. Paragraphs 3 and 4 of subdivision (e) of section 9.60 of the
mental hygiene law, paragraph 3 as amended by chapter 158 of the laws of
2005, and paragraph 4 as amended by chapter 382 of the laws of 2015, are
amended to read as follows:
(3) The petition shall be accompanied by an affirmation or affidavit
of a physician, OR QUALIFIED CLINICAL EXAMINER who shall not be the
petitioner, stating either that:
(i) such physician OR QUALIFIED CLINICAL EXAMINER has personally exam-
ined 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 QUALIFIED CLINICAL EXAMINER or his or her designee has made
appropriate attempts but has not been successful in eliciting the coop-
eration of the subject of the petition to submit to an examination, such
physician OR QUALIFIED CLINICAL EXAMINER has reason to suspect that the
subject of the petition meets the criteria for assisted outpatient
treatment, and such physician OR QUALIFIED CLINICAL EXAMINER is willing
and able to examine the subject of the petition and testify at the hear-
ing on the petition.
(4) In counties with a population of less than eighty thousand, the
affirmation or affidavit required by paragraph three of this subdivision
may be made by a physician OR QUALIFIED CLINICAL EXAMINER who is an
A. 7827 15
employee of the office. The office is authorized to make available, at
no cost to the county, a qualified physician OR QUALIFIED CLINICAL EXAM-
INER for the purpose of making such affirmation or affidavit consistent
with the provisions of such paragraph.
§ 24. Paragraphs 1, 2, 3, and 4 of subdivision (h) of section 9.60 of
the mental hygiene law, paragraphs 1, 3, and 4 as amended by chapter 158
of the laws of 2005, and paragraph 2 as amended by section 2 of subpart
H of part UU of chapter 56 of the laws of 2022, are amended to read as
follows:
(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 QUALIFIED CLINICAL EXAMINER or the poten-
tial need to provide assisted outpatient treatment expeditiously. The
court shall cause the subject of the petition, any other person receiv-
ing notice pursuant to subdivision (f) of this section, the petitioner,
the physician OR QUALIFIED CLINICAL EXAMINER whose affirmation or affi-
davit 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 appropriate 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 QUALIFIED CLINICAL EXAMINER 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[,]
testifies in person or by videoconference at the hearing. Provided
however, a physician OR QUALIFIED CLINICAL EXAMINER shall only be
authorized to testify by video conference [when it has been: (i) shown
that diligent efforts have been made to attend such hearing in person
and] UPON CONSENT OF the subject of the petition [consents to the physi-
cian testifying by video conference;] or [(ii) the court orders the
physician to testify by video conference] upon a finding of good cause.
Such physician OR QUALIFIED CLINICAL EXAMINER 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 treat-
ment.
(3) If the subject of the petition has refused to be examined by a
physician OR QUALIFIED CLINICAL EXAMINER, the court may request the
subject to consent to an examination by a physician OR QUALIFIED CLIN-
ICAL EXAMINER 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 OR
QUALIFIED CLINICAL EXAMINER. Retention of the subject of the petition
under such order shall not exceed twenty-four hours. The examination of
A. 7827 16
the subject of the petition may be performed by the physician OR QUALI-
FIED CLINICAL EXAMINER whose affirmation or affidavit accompanied the
petition pursuant to paragraph three of subdivision (e) of this section,
if such physician OR QUALIFIED CLINICAL EXAMINER is privileged by such
hospital or otherwise authorized by such hospital to do so. If such
examination is performed by another physician[, the examining physician]
OR QUALIFIED CLINICAL EXAMINER, SUCH PHYSICIAN OR QUALIFIED CLINICAL
EXAMINER may consult with the physician OR QUALIFIED CLINICAL EXAMINER
whose affirmation or affidavit accompanied the petition as to whether
the subject meets the criteria for assisted outpatient treatment.
(4) A physician OR QUALIFIED CLINICAL EXAMINER who testifies pursuant
to paragraph two of this subdivision shall state[: (i)] the facts AND
CONCLUSIONS which support the allegation that the subject meets each of
the criteria for assisted outpatient treatment[, (ii)] AND that [the]
ASSISTED OUTPATIENT 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 testimony shall describe the types or classes of medication
which should be authorized, shall describe the beneficial and detri-
mental physical and mental effects of such medication, and shall recom-
mend whether such medication should be self-administered or administered
by authorized personnel].
§ 25. Subdivision (i) of section 9.60 of the mental hygiene law, as
amended by chapter 158 of the laws of 2005, is amended to read as
follows:
(i) Written treatment plan. (1) The court shall not order assisted
outpatient treatment unless a physician OR PSYCHIATRIC NURSE PRACTITION-
ER appointed by the appropriate director, in consultation with such
director, develops and provides to the court a proposed written treat-
ment plan. The written treatment plan shall include case management
services or assertive community treatment team services to provide care
coordination. The written treatment plan also shall include all catego-
ries of services, as set forth in paragraph one of subdivision (a) of
this section, which such physician OR PSYCHIATRIC NURSE PRACTITIONER
recommends that the subject of the petition receive. All service provid-
ers 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 medica-
tion most likely to provide maximum 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 physi-
cian's OR PSYCHIATRIC NURSE PRACTITIONER'S clinical basis for recommend-
ing such plan provides sufficient facts for the court to find (i) that
such person has a history of alcohol or substance abuse that is clin-
ically related to the mental illness; and (ii) that such testing is
necessary to prevent a relapse or deterioration [which] THAT would be
likely to result in serious harm to [the person] SELF 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.
A. 7827 17
(2) The physician OR PSYCHIATRIC NURSE PRACTITIONER appointed to
develop the written treatment plan shall provide the following persons
with an opportunity to actively participate in the development of such
plan: the subject of the petition; the treating physician, if any; and
upon the request of the subject of the petition, an individual signif-
icant 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 PSYCHIATRIC NURSE PRACTITIONER shall consider any directions included
in such proxy in developing the written treatment plan.
(3) The court shall not order assisted outpatient treatment unless a
physician OR PSYCHIATRIC NURSE PRACTITIONER appearing on behalf of a
director testifies IN PERSON OR BY VIDEO CONFERENCE to explain the writ-
ten proposed treatment plan; PROVIDED THAT SUCH TESTIMONY SHALL ONLY BE
PERMITTED BY VIDEO CONFERENCE UPON CONSENT OF THE SUBJECT OF THE PETI-
TION OR UPON A FINDING OF GOOD CAUSE. Such physician OR PSYCHIATRIC
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 shall state] the types or classes of medication
recommended, the beneficial and detrimental physical and mental effects
of such medication, and whether such medication should be self-adminis-
tered or administered by an authorized professional. If the subject of
the petition has executed a health care proxy, such physician OR PSYCHI-
ATRIC 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 para-
graph 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 subdivision (j) of
this section.
§ 26. Paragraph 2 of subdivision (j) of section 9.60 of the mental
hygiene law, as amended by chapter 1 of the laws of 2013, is amended to
read as follows:
(2) If after hearing all relevant evidence, the court finds by clear
and convincing evidence that the subject of the petition meets the
criteria for assisted outpatient treatment, and there is no appropriate
and feasible less restrictive alternative, the court may order the
subject to receive assisted outpatient treatment for an initial period
[not to exceed] OF one year; PROVIDED THAT THE COURT MAY ORDER ASSISTED
OUTPATIENT TREATMENT FOR A SHORTER PERIOD UPON A SHOWING OF GOOD CAUSE
OR UPON THE REQUEST OF THE PETITIONER. In fashioning the order, the
court shall specifically make findings by clear and convincing evidence
that the proposed treatment is the least restrictive treatment appropri-
ate and feasible for the subject. The order shall state an assisted
outpatient treatment plan, which shall include all categories of
assisted outpatient treatment, as set forth in paragraph one of subdivi-
sion (a) of this section, which the assisted outpatient is to receive,
but shall not include any such category that has not been recommended in
both the proposed written treatment plan and the testimony provided to
the court pursuant to subdivision (i) of this section.
§ 27. Paragraph 2 of subdivision (k) of section 9.60 of the mental
hygiene law, as amended by chapter 1 of the laws of 2013, is amended to
read as follows:
A. 7827 18
(2) Within thirty days prior to the expiration of an order of assisted
outpatient treatment, the appropriate director or the current petition-
er, if the current petition 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 para-
graph 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 PSYCHI-
ATRIC NURSE PRACTITIONER who developed the written treatment plan or
another physician OR PSYCHIATRIC NURSE PRACTITIONER designated by the
director, and such physician OR PSYCHIATRIC NURSE PRACTITIONER shall be
authorized to terminate such blood tests or urinalysis without further
action by the court.
§ 28. Subdivision (n) of section 9.60 of the mental hygiene law, as
amended by chapter 1 of the laws of 2013, is amended to read as follows:
(n) Failure to comply with assisted outpatient treatment. Where in the
clinical judgment of a physician OR QUALIFIED CLINICAL EXAMINER, (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 hospital 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 QUALIFIED CLINICAL EXAMINER may request the
appropriate director of community services, the director's designee, or
any physician OR QUALIFIED CLINICAL EXAMINER 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 hospi-
tal 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 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, urinalysis, or alcohol or drug test as
required by the court order, such physician OR QUALIFIED CLINICAL EXAM-
INER may consider such refusal or failure when determining whether the
assisted outpatient is in need of an examination to determine whether he
or she has a mental illness for which hospitalization is necessary. Upon
the request of such physician OR QUALIFIED CLINICAL EXAMINER, the appro-
priate director, the director's designee, or any physician OR QUALIFIED
CLINICAL EXAMINER 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 operating the assisted
outpatient treatment program or to any hospital authorized by the direc-
tor of community services to receive such persons. Such law enforcement
officials shall carry out such directive. Upon the request of such
A. 7827 19
physician OR QUALIFIED CLINICAL EXAMINER, the appropriate director, the
director's designee, or any physician OR QUALIFIED CLINICAL EXAMINER
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 author-
ized by the appropriate 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 pres-
ent 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 OR DIRECTOR'S DESIGNEE
directing the removal of such assisted outpatient pursuant to this
subdivision. Such person may be retained for observation, care and
treatment and further examination in the hospital for up to seventy-two
hours to permit a physician OR QUALIFIED CLINICAL EXAMINER 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.
§ 29. Subdivision (s) of section 9.60 of the mental hygiene law, as
added by section 2 of subpart H of part UU of chapter 56 of the laws of
2022, is amended to read as follows:
(s) DISCLOSURES. (1) A director of community services or his or her
designee may require a provider of [inpatient psychiatric] services
operated or licensed by the office of mental health to provide [contem-
poraneous] information, including but not limited to relevant clinical
records, documents, and other information concerning [the person receiv-
ing assisted outpatient treatment pursuant to an active assisted outpa-
tient treatment order,] AN ASSISTED OUTPATIENT, A SUBJECT OF A CURRENTLY
PENDING PETITION PURSUANT TO THIS SECTION, OR A PERSON WHO IS THE
SUBJECT OF AN INVESTIGATION PURSUANT TO PARAGRAPH TWO OF SUBDIVISION (B)
OF SECTION 9.47 OF THIS ARTICLE, that is deemed necessary by such direc-
tor or designee [who is required to coordinate and monitor the care of
any individual who was subject to an active assisted outpatient treat-
ment order to appropriately] IN THE discharge OF their duties OF CARE
COORDINATION, CARE MONITORING, OR INVESTIGATION pursuant to section 9.47
of this article[, and where] OR TREATMENT PLAN DEVELOPMENT PURSUANT TO
SUBDIVISION (I) OF THIS SECTION; PROVIDED THAT such provider [of inpa-
tient psychiatric services] is [required] PERMITTED to disclose such
information pursuant to paragraph twelve of subdivision (c) of section
33.13 of this chapter and such disclosure is in accordance with PARA-
GRAPH TWO OF THIS SUBDIVISION AND all other applicable state and federal
confidentiality laws. None of the records or information obtained by the
director of community services OR THE DIRECTOR'S DESIGNEE pursuant to
this subdivision shall be public records, and the records shall not be
A. 7827 20
released by the director to any person or agency, except as already
authorized by law.
(2) A REQUIREMENT TO DISCLOSE INFORMATION PURSUANT TO THIS SUBDIVISION
SHALL BE IN WRITING AND SHALL BE ACCOMPANIED BY DOCUMENTATION DEMON-
STRATING THAT:
(I) THE IDENTIFIED PERSON CONSENTS TO SUCH DISCLOSURE; OR
(II) (A) THE DIRECTOR OF COMMUNITY SERVICES OR THE DIRECTOR'S DESIGNEE
PROVIDED OR MADE A GOOD FAITH ATTEMPT TO PROVIDE THE IDENTIFIED PERSON
WITH WRITTEN NOTICE OF THE DIRECTOR'S OR THE DIRECTOR'S DESIGNEE'S
INTENT TO SEEK SUCH DISCLOSURE; (B) SUCH NOTICE WAS SUFFICIENT TO
PROVIDE SUCH PERSON WITH A REASONABLE OPPORTUNITY TO CHALLENGE SUCH
DISCLOSURE IN COURT; AND (C) EITHER NO SUCH CHALLENGE WAS FILED OR THE
COURT RESOLVED SUCH CHALLENGE BY AUTHORIZING DISCLOSURE.
§ 30. The mental hygiene law is amended by adding a new section 9.64
to read as follows:
§ 9.64 NOTICE OF ADMISSION DETERMINATION TO COMMUNITY PROVIDER.
UPON A DETERMINATION BY A PHYSICIAN OR QUALIFIED CLINICAL EXAMINER
PURSUANT TO THE PROVISIONS OF THIS ARTICLE AS TO WHETHER A PERSON SHOULD
BE ADMITTED AS A PATIENT IN A HOSPITAL OR RECEIVED AS A PATIENT IN A
COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM, THE DIRECTOR OF SUCH HOSPI-
TAL OR PROGRAM SHALL ENSURE THAT REASONABLE EFFORTS ARE MADE TO IDENTIFY
AND PROMPTLY NOTIFY OF SUCH DETERMINATION ANY COMMUNITY PROVIDER OF
MENTAL HEALTH SERVICES THAT MAINTAINS SUCH PERSON ON ITS CASELOAD.
§ 31. Paragraph 1 of subdivision (e) of section 29.15 of the mental
hygiene law, as amended by chapter 408 of the laws of 1999, is amended
to read as follows:
1. In the case of an involuntary patient on conditional release, the
director may terminate the conditional release and order the patient to
return to the facility at any time during the period for which retention
was authorized, if, in the director's judgment, the patient needs in-pa-
tient care and treatment and the conditional release is no longer appro-
priate; provided, however, that in any such case, the director shall
cause written notice of such patient's return to be given to the mental
hygiene legal service. The director shall cause the patient to be
retained for observation, care and treatment and further examination in
a hospital for up to seventy-two hours if a physician OR QUALIFIED CLIN-
ICAL EXAMINER on the staff of the hospital determines that such person
may have a mental illness and may be in need of involuntary care and
treatment in a hospital pursuant to the provisions of article nine of
this chapter. Any continued retention in such hospital beyond the
initial seventy-two hour period shall be in accordance with the
provisions of this chapter 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 chapter, and does not agree to stay in the
hospital as a voluntary or informal patient, he or she must be released,
either conditionally or unconditionally.
§ 32. Subdivisions (f) and (m) of section 29.15 of the mental hygiene
law, subdivision (f) as amended by chapter 135 of the laws of 1993, and
subdivision (m) as added by chapter 341 of the laws of 1980, are amended
to read as follows:
(f) The discharge or conditional release of all clients at develop-
mental centers, patients at psychiatric centers or patients at psychiat-
ric inpatient services subject to licensure by the office of mental
health shall be in accordance with a written service plan prepared by
staff familiar with the case history of the client or patient to be
A. 7827 21
discharged or conditionally released and in cooperation with appropriate
social services officials and directors of local governmental units. In
causing such plan to be prepared, the director of the facility shall
take steps to assure that the following persons are interviewed,
provided an opportunity to actively participate in the development of
such plan and advised of whatever services might be available to the
patient through the mental hygiene legal service: the patient to be
discharged or conditionally released; A REPRESENTATIVE OF A COMMUNITY
PROVIDER OF MENTAL HEALTH SERVICES, INCLUDING A PROVIDER OF CASE MANAGE-
MENT SERVICES, THAT MAINTAINS THE PATIENT ON ITS CASELOAD; an authorized
representative of the patient, to include the parent or parents if the
patient is a minor, unless such minor sixteen years of age or older
objects to the participation of the parent or parents and there has been
a clinical determination by a physician that the involvement of the
parent or parents is not clinically appropriate and such determination
is documented in the clinical record and there is no plan to discharge
or release the minor to the home of such parent or parents; and upon the
request of the patient sixteen years of age or older, [a significant] AN
individual SIGNIFICANT to the patient including any relative, close
friend or individual otherwise concerned with the welfare of the
patient, other than an employee of the facility.
(m) It shall be the responsibility of the chief administrator of any
facility providing inpatient services subject to licensure by the office
of mental health to notify[, when appropriate, the local social services
commissioner and appropriate state and local mental health represen-
tatives] THE FOLLOWING PERSONS when an inpatient is about to be
discharged or conditionally released and to provide to such [officials]
PERSONS the written service plan developed for such inpatient as
required under subdivision (f) of this section: A REPRESENTATIVE OF A
COMMUNITY PROVIDER OF MENTAL HEALTH SERVICES, INCLUDING A PROVIDER OF
CASE MANAGEMENT SERVICES, THAT MAINTAINS THE PATIENT ON ITS CASELOAD; A
REPRESENTATIVE OF AN ADULT CARE FACILITY IN WHICH THE PATIENT RESIDED AT
THE TIME OF THE PATIENT'S ADMISSION; AND, WHEN APPROPRIATE, THE LOCAL
SOCIAL SERVICES COMMISSIONER AND APPROPRIATE STATE AND LOCAL MENTAL
HEALTH REPRESENTATIVES.
§ 33. Section 29.15 of the mental hygiene law is amended by adding a
new subdivision (f-1) to read as follows:
(F-1) PRIOR TO THE DISCHARGE OF A PATIENT FROM A PSYCHIATRIC CENTER OR
FROM PSYCHIATRIC INPATIENT SERVICES SUBJECT TO LICENSURE BY THE OFFICE
OF MENTAL HEALTH, THE STAFF OF SUCH FACILITY SHALL CONDUCT A REVIEW AS
TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ASSISTED OUTPATIENT TREAT-
MENT PURSUANT TO ARTICLE NINE OF THIS CHAPTER. BEFORE DISCHARGE, STAFF
SHALL RECORD IN THE PATIENT'S MEDICAL RECORD THE FINDING OF SUCH REVIEW,
THE BASIS OF THE FINDING, AND, FOR A PATIENT FOUND TO MEET THE CRITERIA
FOR ASSISTED OUTPATIENT TREATMENT, THE ACTIONS TAKEN TO INITIATE AN
ASSISTED OUTPATIENT TREATMENT PETITION OR REFERRAL. SUCH FACILITIES
SHALL REPORT ON A QUARTERLY BASIS TO THE OFFICE OF MENTAL HEALTH: THE
NUMBER OF PSYCHIATRIC INPATIENTS DISCHARGED; THE NUMBER OF SUCH PATIENTS
WHO WERE SCREENED FOR ASSISTED OUTPATIENT TREATMENT ELIGIBILITY; THE
NUMBER OF PATIENTS DETERMINED TO MEET THE CRITERIA FOR ASSISTED OUTPA-
TIENT TREATMENT; AND THE NUMBER OF PATIENTS DETERMINED TO MEET THE
CRITERIA FOR ASSISTED OUTPATIENT TREATMENT WHO WERE REFERRED OR PETI-
TIONED FOR ASSISTED OUTPATIENT TREATMENT. THE OFFICE OF MENTAL HEALTH
SHALL DEVELOP AN ELECTRONIC FORM TO FACILITATE SUCH REPORTING.
A. 7827 22
§ 34. Subdivision (b) of section 41.09 of the mental hygiene law, as
amended by chapter 588 of the laws of 1973 and such section as renum-
bered by chapter 978 of the laws of 1977, is amended to read as follows:
(b) Each director shall be a psychiatrist or other professional person
who meets standards set by the commissioner for the position. If the
director is not a physician OR QUALIFIED CLINICAL EXAMINER AS DEFINED IN
ARTICLE NINE OF THIS CHAPTER, [he] THE DIRECTOR shall not have the power
to conduct examinations authorized to be conducted by an examining
physician OR QUALIFIED CLINICAL EXAMINER or by a director of community
services pursuant to this chapter but [he] shall designate an examining
physician OR QUALIFIED CLINICAL EXAMINER who shall be empowered to
conduct such examinations on behalf of such director. A director need
not reside in the area to be served. The director shall be a full-time
employee except in cases where the commissioner has expressly waived the
requirement.
§ 35. The office of mental health shall conduct live training and
shall disseminate training materials on the changes to law included in
this act and their implications for professional practice. Such training
and materials shall be specifically tailored and directly provided to
multiple audiences, including mental health professionals, hospital
personnel, adult care facility personnel, law enforcement officers,
ambulance service personnel, and the general public.
§ 36. This act shall take effect on the ninetieth day after it shall
have become a law; provided, however, that:
a. the amendments to subdivision (a) of section 9.37 of the mental
hygiene law made by section ten of this act shall not affect the expira-
tion and reversion of such subdivision and shall be deemed to expire
therewith;
b. the amendments to section 9.40 of the mental hygiene law made by
section twelve of this act shall not affect the repeal of such section
and shall be deemed repealed therewith;
c. the amendments to sections 9.41 and 9.45 of the mental hygiene law
made by sections thirteen and fourteen of this act shall not affect the
expiration and reversion of such sections pursuant to section 21 of
chapter 723 of the laws of 1989, as amended, and shall expire and be
deemed repealed therewith;
d. the amendments to paragraph 3 of subdivision (b) of section 9.47 of
the mental hygiene law made by section sixteen of this act shall not
affect the repeal of such subdivision and shall be deemed to be repealed
therewith;
e. the amendments to sections 9.55 and 9.57 of the mental hygiene law
made by sections seventeen and nineteen of this act shall not affect the
expiration and reversion of such sections pursuant to section 21 of
chapter 723 of the laws of 1989, as amended, and shall be deemed
repealed therewith;
f. the amendments to section 9.60 of the mental hygiene law made by
sections twenty-one, twenty-two, twenty-three, twenty-four, twenty-five,
twenty-six, twenty-seven, twenty-eight and twenty-nine of this act shall
not affect the repeal of such section and shall be deemed repealed ther-
ewith; and
g. the amendments to subdivision (e) of section 29.15 of the mental
hygiene law made by section thirty-one of this act shall not affect the
expiration and repeal of such section pursuant to section 18 of chapter
408 of the laws of 1989, as amended and shall expire and be deemed
repealed therewith.
A. 7827 23
Effective immediately, the addition, amendment and/or repeal of any
rule or regulation necessary for the implementation of this act on its
effective date are authorized to be made and completed on or before such
effective date.
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