§ 22.09 Emergency services for persons intoxicated, impaired, or

incapacitated by alcohol and/or substances.

(a) As used in this article:

1. "Intoxicated or impaired person" means a person whose mental or
physical functioning is substantially impaired as a result of the
presence of alcohol and/or substances in his or her body.

2. "Incapacitated" means that a person, as a result of the use of
alcohol and/or substances, is unconscious or has his or her judgment
otherwise so impaired that he or she is incapable of realizing and
making a rational decision with respect to his or her need for
treatment.

3. "Likelihood to result in harm" or "likely to result in harm" means
(i) a substantial risk of physical harm to the person as manifested by
threats of or attempts at suicide or serious bodily harm or other
conduct demonstrating that the person is dangerous to himself or
herself, or (ii) 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.

4. "Emergency services" means immediate physical examination,
assessment, care and treatment of an incapacitated person for the
purpose of confirming that the person is, and continues to be,
incapacitated by alcohol and/or substances to the degree that there is a
likelihood to result in harm to the person or others.

5. "Treatment facility" means a facility designated by the
commissioner which may only include a general hospital as defined in
article twenty-eight of the public health law, or a medically managed or
medically supervised withdrawal, inpatient rehabilitation, or
residential stabilization treatment program that has been certified by
the commissioner to have appropriate medical staff available on-site at
all times to provide emergency services and continued evaluation of
capacity of individuals retained under this section or a crisis
stabilization center licensed pursuant to article 36.01 of this chapter.

(b) 1. An intoxicated or impaired person may come voluntarily for
emergency services to a chemical dependence program or treatment
facility authorized by the commissioner to provide such emergency
services. A person who appears to be intoxicated or impaired and who
consents to the proffered help may be assisted by any peace officer
acting pursuant to his or her special duties, police officer, or by a
designee of the director of community services to return to his or her
home, to a chemical dependence program or treatment facility, or to any
other facility authorized by the commissioner to provide such emergency
services. In such cases, the peace officer, police officer, or designee
of the director of community services shall accompany the intoxicated or
impaired person in a manner which is reasonably designed to assure his
or her safety, as set forth in regulations promulgated in accordance
with subdivision (d) of this section.

2. A person who appears to be incapacitated by alcohol and/or
substances to the degree that there is a likelihood to result in harm to
the person or to others may be taken by a peace officer acting pursuant
to his or her special duties, or a police officer who is a member of the
state police or of an authorized police department or force or of a
sheriff's department or by the director of community services or a
person duly designated by him or her to a treatment facility for
purposes of receiving emergency services. Every reasonable effort shall
be made to protect the health and safety of such person, including but
not limited to the requirement that the peace officer, police officer,
or director of community services or his or her designee shall accompany
the apparently incapacitated person in a manner which is reasonably
designed to assure his or her safety, as set forth in regulations
promulgated in accordance with subdivision (d) of this section.

3. A person who comes voluntarily or is brought without his or her
objection to any such facility or program in accordance with this
subdivision shall be given emergency care and treatment at such place if
found suitable therefor by authorized personnel, or referred to another
suitable facility or treatment program for care and treatment, or sent
to his or her home.

4. The director of a treatment facility may receive as a patient in
need of emergency services any person who appears to be incapacitated as
defined in this section.

5. A person who comes voluntarily or is brought with his or her
objection to a treatment facility shall be examined as soon as possible
but not more than twelve hours after arriving at such treatment facility
by an examining physician. If such examining physician determines that
such person is incapacitated by alcohol and/or substances to the degree
that there is a likelihood to result in harm to the person or others, he
or she may be retained to receive emergency services and shall be
regularly reevaluated to confirm continued incapacity by alcohol and/or
substances to the degree that there is a likelihood to result in harm to
the person or others. If the examining physician determines at any time
that such person is not incapacitated by alcohol and/or substances to
the degree that there is a likelihood to result in harm to the person or
others, he or she must be released. Notwithstanding any other law, in no
event may such person be retained against his or her objection beyond
whichever is the shorter of the following: (i) the time that he or she
is no longer incapacitated by alcohol and/or substances to the degree
that there is a likelihood to result in harm to the person or others or
(ii) a period longer than seventy-two hours.

6. Every reasonable effort must be made to obtain the person's consent
to give prompt notification of a person's retention in a facility or
program pursuant to this section to his or her closest relative or
friend, and, if requested by such person, to his or her attorney and
personal physician, in accordance with federal confidentiality
regulations.

7. A person may not be retained pursuant to this section beyond a
period of seventy-two hours without his or her consent. Persons suitable
therefor may be voluntarily admitted to a chemical dependence program or
facility pursuant to this article.

(c) Discharge procedures. 1. The discharge procedure process shall
begin as soon as the patient is admitted to the treatment facility and
shall be considered a part of the treatment planning process. The
discharge plan shall be developed in collaboration with the patient and
any significant other(s) the patient chooses to involve. If the patient
is a minor, the discharge plan must also be developed in consultation
with his or her parent or guardian, unless the minor is being treated
without parental consent as authorized by section 22.11 of this chapter.

2. No patient shall be discharged without a discharge plan which has
been completed and reviewed by the multi-disciplinary team prior to the
discharge of the patient. This review may be part of a regular treatment
plan review. The portion of the discharge plan which includes the
referrals for continuing care shall be given to the patient upon
discharge. This requirement shall not apply to patients who refuse
continuing care planning, provided, however, that the treatment facility
shall make reasonable efforts to provide information about the dangers
of long term substance use as well as information related to treatment
including, but not limited to, the OASAS HOPELINE and the OASAS Bed
Availability Dashboard.

3. The discharge plan shall be developed by the responsible clinical
staff member, who, in the development of such plan, shall consider the
patient's self-reported confidence in maintaining abstinence and
following an individualized relapse prevention plan. The responsible
clinical staff member shall also consider an assessment of the patient's
home and family environment, vocational/educational/employment status,
and the patient's relationships with significant others. The purpose of
the discharge plan shall be to establish the level of clinical and
social resources available to the patient upon discharge from the
inpatient service and the need for the services for significant others.
The discharge plan shall include, but not be limited to, the following:

(i) identification of continuing chemical dependence services
including management of withdrawal or continuing stabilization and any
other treatment, rehabilitation, self-help and vocational, educational
and employment services the patient will need after discharge;

(ii) identification of the type of residence, if any, that the patient
will need after discharge;

(iii) identification of specific providers of these needed services;
and

(iv) specific referrals and initial appointments for these needed
services.

4. A discharge summary which includes the course and results of care
and treatment must be prepared and included in each patient's case
record within twenty days of discharge.

(d) The commissioner shall promulgate all rules and regulations, after
consulting with representatives of appropriate law enforcement and
chemical dependence providers of services, establishing procedures for
taking intoxicated or impaired persons and persons apparently
incapacitated by alcohol and/or substances to their residences or to
appropriate public or private facilities for emergency services and for
minimizing the role of the police in obtaining treatment of such persons
necessary to implement the provisions of this section, including but not
limited to establishing procedures for transporting incapacitated
persons to a treatment facility for emergency services.