§ 29.15 Discharge and conditional release of patients to the community.

(a) A patient may be discharged or conditionally released to the
community by the director of a department facility, if, in the opinion
of staff familiar with the patient's case history, such patient does not
require active in-patient care and treatment.

(b) A patient may be conditionally released, rather than discharged,
when in the opinion of staff familiar with the patient's case history,
the clinical needs of such patient warrant this more restrictive
placement, provided, however, that

1. an involuntary patient may be conditionally released only for the
remainder of the authorized retention period; and

2. except as provided in subdivision (d) of this section, a voluntary
patient may be conditionally released only for a twelve month period,
provided however that (i) a voluntary patient under sixteen years of age
may be conditionally released only after consultation with the parent,
legal guardian, or next-of-kin of such patient; (ii) a voluntary patient
over sixteen and under eighteen years of age may be conditionally
released only with his consent or with the consent of the parent, legal
guardian, or next-of-kin of such patient; (iii) a voluntary patient
eighteen years of age or older may be conditionally released only with
his consent.

(c) The director of a department facility from which any patient is
conditionally released shall cause all such patients to be informed once
during each one hundred twenty days of conditional release of their
status and rights, including their right to avail themselves of the
facilities of the mental hygiene legal service. At the time of such
periodic notification, the written consent of a patient to his continued
stay on conditional release status shall be obtained and a copy thereof
shall be given to the mental hygiene legal service.

(d) 1. No voluntary patient who has been conditionally released shall
be continued on such status for a period beyond twelve months from the
date of commencement of such status or beyond twelve months from the
effective date of this statute, whichever is later, unless the
suitability of such patient to remain on such status and his willingness
to so remain have been reviewed. The director shall review the
suitability of such patient to remain in such status, and the mental
hygiene legal service shall review the willingness of such patient to
remain in such status. Notice of the determination of the patient's
suitability made by the director shall be given to the mental hygiene
legal service. If the mental hygiene legal service finds that there is
any ground to doubt the director's determination of the suitability of
such patient to remain on such status, or the willingness of the patient
to so remain, it shall make an application, upon notice to the patient
and the director of the facility for a court order determining those
questions. In any such proceeding, the patient or someone on his behalf
or the mental hygiene legal service may request a hearing. If the mental
hygiene legal service finds no grounds to doubt the determination of the
director as to the suitability or the willingness of the patient to
continue on conditional release status, it shall so certify and the
patient may be continued on such status. A copy of such certification of
review shall be filed in the patient's record.

2. If an application for a court order has been made, the court, in
determining the proceeding, may approve the continued conditional
release of the patient or, if the court finds that the patient is not
suitable or willing to continue on conditional release status, it may
order the discharge of such patient.

3. Prior to the termination of twelve months from the date of the
certification by the mental hygiene legal service of such first review
or, if an application for a court order has been made, from the date of
the first order and, thereafter, prior to the termination of twelve
months from any subsequent certification or subsequent order, as the
case may be, the director and the mental hygiene legal service shall
conduct another review of the patient's suitability and willingness to
remain on conditional release status, as set forth in the foregoing
subdivisions.

(e) * 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-patient care and treatment and the conditional release is no
longer appropriate; 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 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.

* NB Effective until June 30, 2027

* 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-patient care and treatment and the conditional release is no longer
appropriate 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. If, at any time prior to the expiration of thirty
days from the date of return to the facility, he or any relative or
friend or the mental hygiene legal service gives notice in writing to
the director of request for hearing on the question of the suitability
of such patient's return to the facility, a hearing shall be held
pursuant to the provisions of this chapter relating to the involuntary
admission of a person.

* NB Effective June 30, 2027

2. In the case of a voluntary patient on conditional release, the
director may terminate the conditional release and order the patient to
return to the facility at any time, if, in the judgment of the director,
the patient needs in-patient care and treatment and the conditional
release is no longer appropriate, provided, however, that if such
patient does not consent to return to the facility, he shall not be
returned to the facility, except in accordance with the provisions of
this chapter and the regulations of the commissioner for the involuntary
admission of a person.

(f) The discharge or conditional release of all clients at
developmental centers, patients at psychiatric centers or patients at
psychiatric 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 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; 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
individual 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.

(g) A written service plan prepared pursuant to this section shall
include, but shall not be limited to, the following:

1. a statement of the patient's need, if any, for supervision,
medication, aftercare services, and assistance in finding employment
following discharge or conditional release, and

2. a specific recommendation of the type of residence in which the
patient is to live and a listing of the services available to the
patient in such residence.

3. A listing of organizations, facilities, including those of the
department, and individuals who are available to provide services in
accordance with the identified needs of the patient.

4. The notification of the appropriate school district and the
committee on special education regarding the proposed discharge or
release of a patient under twenty-one years of age, consistent with all
applicable federal and state laws relating to confidentiality of such
information.

5. An evaluation of the patient's need and potential eligibility for
public benefits following discharge or conditional release, including
public assistance, medicaid, and supplemental security income.

6. Material providing information related to extreme risk protection
orders, pursuant to article sixty-three-A of the civil practice law and
rules. Such information may be provided to the patient or, upon consent
of the patient, to an authorized representative who has actively
participated in the patient's treatment plan. Such information may only
be provided if the director of the facility and such facility's clinical
staff who worked directly with the patient determine through an
evaluation and assessment, that there is the presence of a mental health
diagnosis or symptoms of a mental illness exhibited by the patient,
which indicates the patient may be at substantial risk of physical harm
to himself or herself, or has made threats of or attempts at suicide.
Such determination and the basis for it shall be included in the written
clinical record.

An inpatient facility operated or licensed by the office of mental
health shall provide reasonable and appropriate assistance to the
patient, in cooperation with local social services districts, in
applying for benefits identified in the written service plan pursuant to
paragraph five of this subdivision, prior to discharge or conditional
release.

(h) It shall also be the responsibility of the director of any
department facility from which a client or patient has been discharged
or conditionally released, in collaboration, when appropriate, with
appropriate social services officials and directors of local
governmental units, to prepare, to cause to be implemented, and to
monitor a comprehensive program designed:

1. to determine whether the residence in which such client or patient
is living, is adequate and appropriate for the needs of such patient or
client;

2. to verify that such patient or client is receiving the services
specified in such patient's or client's written service plan; and

3. to recommend, and to take steps to assure the provision of, any
additional services.

(i) 1. No patient about to be discharged or conditionally released
from a department facility or an inpatient facility operated or licensed
by the office of mental health shall be directly referred to any
facility subject to licensure, certification or approval by any state
agency or department, unless it has been determined that such facility
has a current and valid license, certificate or approval. In addition,
no patient about to be discharged or conditionally released from a
department facility shall be directly referred to any residential
accommodation not subject to licensure, certification or approval by any
state agency or department unless it has been determined, after
consultation with appropriate local agencies, that such residential
accommodation complies with all appropriate local zoning, building, fire
and safety codes, ordinances and regulations.

2. (I) A patient about to be discharged or conditionally released from
a department facility licensed or operated by the office for people with
developmental disabilities or from an inpatient facility operated or
licensed by the office of alcoholism and substance abuse services or the
office of mental health to an adult home or residence for adults, as
defined in section two of the social services law, shall be referred
only to such home or residence that is consistent with that patient's
needs and that operates pursuant to section four hundred sixty of the
social services law, provided further that: (A) for a department
facility licensed or operated by the office for people with
developmental disabilities or for an inpatient facility operated by the
office of alcoholism and substance abuse services or the office of
mental health, the facility director retains authority to determine
whether the home, program or residence is consistent with that patient's
needs and (B) such referral shall be made to the patient's home county
whenever possible or appropriate.

(II) No patient about to be discharged or conditionally released from
a department facility licensed or operated by the office for people with
developmental disabilities or from an inpatient facility operated or
licensed by the office of alcoholism and substance abuse services or the
office of mental health shall be referred to any adult home or residence
for adults, as defined in section two of the social services law, which
has received an official written notice from the department of health
of: (A) the proposed revocation, suspension or denial of its operating
certificate; (B) the limitation of its operating certificate with
respect to new admissions; (C) the issuance of a department of health
order or commissioner of health's order or the seeking of equitable
relief pursuant to section four hundred sixty-d of the social services
law; (D) the proposed assessment of civil penalties for violations of
the provisions of subparagraph two of paragraph (b) of subdivision seven
of section four hundred sixty-d of the social services law; or placement
on the "do not refer list" pursuant to subdivision fifteen of section
four hundred sixty-d of the social services law. Referrals may resume
when such enforcement actions are resolved.

(III) A community provider of mental hygiene services, including a
provider of case management services, which serves residents of any home
or residence in which the department of social services has acted
pursuant to subdivision nine of section four hundred sixty-one-c of the
social services law, shall assist the operator of such home or residence
or the department of social services in efforts to secure an appropriate
alternate placement of a resident.

(IV) The commissioner shall promptly refer to the department of social
services any serious complaint received about the care provided or
health and safety conditions in an adult home or residence for adults.
The commissioner may as appropriate assist the department of social
services in the investigation and resolution of such complaints as well
as in the investigation and resolution of any such complaint which is
initially received by the department of social services.

(j) The department shall submit to the legislature and the governor by
the first day of January, nineteen hundred seventy-eight, a
comprehensive plan describing those reasonable steps taken or to be
taken by the department to locate former patients who had been in a
department facility for a continuous period for two or more years prior
to their discharge or conditional release and who had been discharged or
conditionally released on or after the thirty-first day of December,
nineteen hundred seventy without the benefit of a written service plan.
In each case in which the person has been located, the department, in
cooperation with appropriate social services officials and directors of
community services, shall make every effort to develop a written service
plan for such person and shall assume the same responsibilities with
respect to such person as the department is required to assume with
respect to a person who was discharged or conditionally released from a
department facility pursuant to a written service plan.

(k) No patient shall be required, as a condition precedent to his
discharge, to agree to the terms of a written service plan. If after the
advisability of following the program proposed in the written service
plan has been explained to the patient who has been discharged or who is
to be discharged, such patient expresses his objection to such program
or any part thereof, a notation of such objection shall be made in the
patient's records.

(l) Nothing in this section shall be construed to prohibit, limit, or
restrict the obligation of the director of a department facility to make
necessary expenditures for the board and family care of patients subject
to the approval of the commissioner, provided that no such expenditure
shall be made with respect to any patient who is receiving public
assistance and care under the social services law.

(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
representatives when an inpatient is about to be discharged or
conditionally released and to provide to such officials the written
service plan developed for such inpatient as required under subdivision
(f) of this section.

(n) It shall be the duty of directors of local social services
districts and local governmental units to cooperate with facilities
licensed or operated by an office of the department in the preparation
and implementation of comprehensive written services plans as required
by this section.