Bill Text: NY A04451 | 2023-2024 | General Assembly | Introduced
Bill Title: Enhances the assisted outpatient treatment program; eliminates the expiration and repeal of Kendra's Law.
Spectrum: Partisan Bill (Democrat 10-0)
Status: (Introduced) 2024-01-03 - referred to mental health [A04451 Detail]
Download: New_York-2023-A04451-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 4451 2023-2024 Regular Sessions IN ASSEMBLY February 14, 2023 ___________ Introduced by M. of A. GUNTHER, ZEBROWSKI, PAULIN, THIELE, COOK, WEPRIN, OTIS, STECK, WILLIAMS, WALLACE -- read once and referred to the Committee on Mental Health AN ACT to amend the mental hygiene law and the correction law, in relation to enhancing the assisted outpatient treatment program; and to amend Kendra's Law, in relation to making the provisions thereof permanent The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 2 of subdivision (f) of section 7.17 of the 2 mental hygiene law, as amended by chapter 158 of the laws of 2005, is 3 amended to read as follows: 4 (2) The oversight and monitoring role of the program coordinator of 5 the assisted outpatient treatment program shall include each of the 6 following: 7 (i) that each assisted outpatient receives the treatment provided for 8 in the court order issued pursuant to section 9.60 of this [chapter] 9 title; 10 (ii) that existing services located in the assisted outpatient's 11 community are utilized whenever practicable; 12 (iii) that a case manager or assertive community treatment team is 13 designated for each assisted outpatient; 14 (iv) that a mechanism exists for such case manager, or assertive 15 community treatment team, to regularly report the assisted outpatient's 16 compliance, or lack of compliance with treatment, to the director of the 17 assisted outpatient treatment program; 18 (v) that directors of community services establish procedures [which] 19 that provide that reports of persons who may be in need of assisted 20 outpatient treatment are appropriately investigated in a timely manner; 21 [and] EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD08031-01-3A. 4451 2 1 (vi) that assisted outpatient treatment services are delivered in a 2 timely manner[.]; 3 (vii) that, prior to the expiration of assisted outpatient treatment 4 orders, the clinical needs of assisted outpatients are adequately 5 reviewed in determining the need to petition for continued assisted 6 outpatient treatment pursuant to subdivision (m) of section 9.60 of this 7 title; 8 (viii) that the appropriate director is determined for each assisted 9 outpatient, pursuant to subdivisions (k) and (l) of section 9.60 of this 10 title; and 11 (ix) that the office fulfills its duties pursuant to subdivision (t) 12 of section 9.60 of this title to meet local needs for training of judges 13 and court personnel. 14 § 2. Subdivision (f) of section 7.17 of the mental hygiene law is 15 amended by adding a new paragraph 5 to read as follows: 16 (5) The commissioner shall develop an educational pamphlet on the 17 process of petitioning for assisted outpatient treatment for dissem- 18 ination to individuals seeking to submit reports of persons who may be 19 in need of assisted outpatient treatment, and individuals seeking to 20 file a petition pursuant to subparagraph (i) or (ii) of paragraph one of 21 subdivision (f) of section 9.60 of this title. Such pamphlet shall set 22 forth, in plain language: the criteria for assisted outpatient treat- 23 ment, resources available to such individuals, the responsibilities of 24 program coordinators and directors of community services, a summary of 25 current law, the process for petitioning for continued assisted outpa- 26 tient treatment, and other such information the commissioner determines 27 to be pertinent. 28 § 3. Subdivision (b) of section 9.47 of the mental hygiene law, as 29 amended by chapter 158 of the laws of 2005, paragraphs 5 and 6 as added 30 and paragraph 7 as renumbered by chapter 1 of the laws of 2013, is 31 amended to read as follows: 32 (b) All directors of community services shall be responsible for: 33 (1) receiving reports of persons who may be in need of assisted outpa- 34 tient treatment pursuant to section 9.60 of this article and documenting 35 the receipt date of such reports; 36 (2) conducting timely investigations of such reports received pursuant 37 to paragraph one of this subdivision and providing written notice upon 38 the completion of investigations to reporting persons and program coor- 39 dinators, appointed by the commissioner [of mental health] pursuant to 40 subdivision (f) of section 7.17 of this title, and documenting the 41 initiation and completion dates of such investigations and the disposi- 42 tions; 43 (3) filing of petitions for assisted outpatient treatment pursuant to 44 [paragraph] subparagraph (vii) of paragraph one of subdivision [(e)] (f) 45 of section 9.60 of this article, and documenting the petition filing 46 [date] dates and the [date] dates of the court [order] orders; 47 (4) coordinating the timely delivery of court ordered services with 48 program coordinators and documenting the date assisted outpatients begin 49 to receive the services mandated in the court order; [and] 50 (5) ensuring evaluation of the need for ongoing assisted outpatient 51 treatment pursuant to subdivision [(k)] (m) of section 9.60 of this 52 article prior to the expiration of any assisted outpatient treatment 53 order; 54 (6) if he or she has been ordered to provide for or arrange for 55 assisted outpatient treatment pursuant to paragraph five of subdivision 56 [(j)] (k) of section 9.60 of this article or became the appropriateA. 4451 3 1 director pursuant to this paragraph or subdivision (c) of section 9.48 2 of this article, notifying the director of community services of the new 3 county of residence when he or she has reason to believe that an 4 assisted outpatient has or will change his or her county of residence 5 during the pendency of an assisted outpatient treatment order. Upon such 6 change of residence, the director of the new county of residence shall 7 become the appropriate director, as such term is defined in section 9.60 8 of this article; [and] 9 (7) notifying program coordinators when assisted outpatients cannot be 10 located after reasonable efforts or are believed to have taken residence 11 outside of the local governmental unit served; and 12 (8) reporting on a quarterly basis to program coordinators the infor- 13 mation collected pursuant to this subdivision. 14 § 4. Paragraphs (viii) and (ix) of subdivision (b) of section 9.48 of 15 the mental hygiene law are renumbered paragraphs (ix) and (x) and a new 16 paragraph (viii) is added to read as follows: 17 (viii) an account of any court order expiration, including but not 18 limited to the director's determination as to whether to petition for 19 continued assisted outpatient treatment, pursuant to section 9.60 of 20 this article, the basis for such determination, and the disposition of 21 any such petition; 22 § 5. Section 9.60 of the mental hygiene law, as amended by chapter 158 23 of the laws of 2005, paragraph 1 of subdivision (a) as amended by 24 section 1 of part E of chapter 111 of the laws of 2010, paragraph 3 of 25 subdivision (a), paragraphs 2 and 5 of subdivision (j), and subdivisions 26 (k) and (n) as amended by chapter 1 of the laws of 2013, paragraph 5 of 27 subdivision (c) as amended by chapter 137 of the laws of 2005, paragraph 28 4 of subdivision (e) as amended by chapter 382 of the laws of 2015, 29 paragraph 4 of subdivision (c), paragraph 2 of subdivision (h) as 30 amended and subdivision (s) as added by section 2 of subpart H of part 31 UU of chapter 56 of the laws of 2022, is amended to read as follows: 32 § 9.60 Assisted outpatient treatment. 33 (a) Definitions. For purposes of this section, the following defi- 34 nitions shall apply: 35 (1) "assisted outpatient treatment" shall mean categories of outpa- 36 tient services [which] that have been ordered by the court pursuant to 37 this section. Such treatment shall include case management services or 38 assertive community treatment team services to provide care coordi- 39 nation, and may also include any of the following categories of 40 services: medication support; medication education or symptom management 41 education; periodic blood tests or urinalysis to determine compliance 42 with prescribed medications; individual or group therapy; day or partial 43 day programming activities; educational and vocational training or 44 activities; appointment of a representative payee or other financial 45 management services, subject to final approval of the Social Security 46 Administration, where applicable; alcohol or substance abuse treatment 47 and counseling and periodic or random tests for the presence of alcohol 48 or illegal drugs for persons with a history of alcohol or substance 49 abuse; supervision of living arrangements; and any other services within 50 a local services plan developed pursuant to article forty-one of this 51 chapter, clinical or non-clinical, prescribed to treat the person's 52 mental illness and to assist the person in living and functioning in the 53 community, or to attempt to prevent a relapse or deterioration that may 54 reasonably be predicted to result in [suicide] serious physical harm to 55 any person or the need for hospitalization.A. 4451 4 1 (2) "director" shall mean the director of community services of a 2 local governmental unit, or the director of a hospital licensed or oper- 3 ated by the office of mental health which operates, directs and super- 4 vises an assisted outpatient treatment program. 5 (3) "director of community services" and "local governmental unit" 6 shall have the same meanings as provided in article forty-one of this 7 chapter. The "appropriate director" shall mean the director of community 8 services of the county where the assisted outpatient resides, even if it 9 is a different county than the county where the assisted outpatient 10 treatment order was originally issued. 11 (4) "assisted outpatient treatment program" shall mean a system to 12 arrange for and coordinate the provision of assisted outpatient treat- 13 ment, to monitor treatment compliance by assisted outpatients, to evalu- 14 ate the condition or needs of assisted outpatients, to take appropriate 15 steps to address the needs of such individuals, and to ensure compliance 16 with court orders. 17 (5) "assisted outpatient" shall mean the person under a court order to 18 receive assisted outpatient treatment. 19 (6) "subject of the petition" or "subject" shall mean the person who 20 is alleged in a petition, filed pursuant to the provisions of this 21 section, to meet the criteria for assisted outpatient treatment. 22 (7) "correctional facility" and "local correctional facility" shall 23 have the same meanings as provided in section two of the correction law. 24 (8) "health care proxy" and "health care agent" shall have the same 25 meanings as provided in article twenty-nine-C of the public health law. 26 (9) "program coordinator" shall mean an individual appointed by the 27 commissioner [of mental health], pursuant to subdivision (f) of section 28 7.17 of this chapter, who is responsible for the oversight and monitor- 29 ing of assisted outpatient treatment programs. 30 (b) Programs. The director of community services of each local govern- 31 mental unit shall operate, direct and supervise an assisted outpatient 32 treatment program. The director of a hospital licensed or operated by 33 the office [of mental health] may operate, direct and supervise an 34 assisted outpatient treatment program, upon approval by the commission- 35 er. Directors of community services shall be permitted to satisfy the 36 provisions of this subdivision through the operation of joint assisted 37 outpatient treatment programs. Nothing in this subdivision shall be 38 interpreted to preclude the combination or coordination of efforts 39 between and among local governmental units and hospitals in providing 40 and coordinating assisted outpatient treatment. 41 (c) Criteria. A person may be ordered to receive assisted outpatient 42 treatment if the court finds that such person: 43 (1) is eighteen years of age or older; and 44 (2) is suffering from a mental illness; and 45 (3) is unlikely to survive safely in the community without super- 46 vision, based on a clinical determination; and 47 (4) has a history of lack of compliance with treatment for mental 48 illness that has: 49 (i) except as otherwise provided in subparagraph (iii) of this para- 50 graph, prior to the filing of the petition, at least twice within the 51 last thirty-six months been a significant factor in necessitating hospi- 52 talization in a hospital, or receipt of services in a forensic or other 53 mental health unit of a correctional facility or a local correctional 54 facility[, not including]; provided that such thirty-six month period 55 shall be extended by the length of any current period[, or periodA. 4451 5 1ending] within the last six months[, during which the person was or is2hospitalized or incarcerated]; or 3 (ii) except as otherwise provided in subparagraph (iii) of this para- 4 graph, within forty-eight months prior to the filing of the petition, 5 resulted in one or more acts of serious violent behavior toward self or 6 others or threats of, or attempts at, serious physical harm to self or 7 others [within the last forty-eight months, not including]; provided 8 that such forty-eight month period shall be extended by the length of 9 any current period[, or period ending] of hospitalization or incarcera- 10 tion, and any such period that ended within the last six months[, in11which the person was or is hospitalized or incarcerated]; or 12 (iii) notwithstanding subparagraphs (i) and (ii) of this paragraph, 13 resulted in the issuance of a court order for assisted outpatient treat- 14 ment which has expired within the last six months, and since the expira- 15 tion of the order, the person has experienced a substantial increase in 16 symptoms of mental illness and such symptoms substantially interferes 17 with or limits one or more major life activities as determined by a 18 director of community services who previously was required to coordinate 19 and monitor the care of any individual who was subject to such expired 20 assisted outpatient treatment order. The applicable director of communi- 21 ty services or their designee shall arrange for the individual to be 22 evaluated by a physician. If the physician determines court ordered 23 services are clinically necessary and the least restrictive option, the 24 director of community services may initiate a court proceeding. 25 (5) is, as a result of his or her mental illness, unlikely to volun- 26 tarily participate in outpatient treatment that would enable him or her 27 to live safely in the community; and 28 (6) in view of his or her treatment history and current behavior, is 29 in need of assisted outpatient treatment in order to prevent a relapse 30 or deterioration which would be likely to result in serious harm to the 31 person or others as defined in section 9.01 of this article; and 32 (7) is likely to benefit from assisted outpatient treatment. 33 (d) Health care proxy. Nothing in this section shall preclude a person 34 with a health care proxy from being subject to a petition pursuant to 35 this chapter and consistent with article twenty-nine-C of the public 36 health law. 37 (e) Investigation of reports. The commissioner shall promulgate regu- 38 lations establishing a procedure to ensure that reports of a person who 39 may be in need of assisted outpatient treatment, including those 40 received from family and community members of such person, are investi- 41 gated in a timely manner and, where appropriate, result in the filing of 42 petitions for assisted outpatient treatment. 43 (f) Petition to the court. (1) A petition for an order authorizing 44 assisted outpatient treatment may be filed in the supreme or county 45 court in the county in which the subject of the petition is present or 46 reasonably believed to be present. When a director of community 47 services has reason to believe that an assisted outpatient has changed 48 his or her county of residence, future petitions and applications under 49 this section may be filed in the supreme or county court in the new 50 county of residence, which shall have concurrent jurisdiction with the 51 court that initially ordered such treatment. Such petition may be initi- 52 ated only by the following persons: 53 (i) any person eighteen years of age or older with whom the subject of 54 the petition resides; or 55 (ii) the parent, spouse, sibling eighteen years of age or older, or 56 child eighteen years of age or older of the subject of the petition; orA. 4451 6 1 (iii) the director of a hospital in which the subject of the petition 2 is hospitalized, or pursuant to section four hundred four of the 3 correction law; or 4 (iv) the director of any public or charitable organization, agency or 5 home providing mental health services to the subject of the petition or 6 in whose institution the subject of the petition resides; or 7 (v) a qualified psychiatrist who is either supervising the treatment 8 of or treating the subject of the petition for a mental illness; or 9 (vi) a psychologist, licensed pursuant to article one hundred fifty- 10 three of the education law, or a social worker, licensed pursuant to 11 article one hundred fifty-four of the education law, who is treating the 12 subject of the petition for a mental illness; or 13 (vii) the director of community services, or his or her designee, or 14 the social services official, as defined in the social services law, of 15 the city or county in which the subject of the petition is present or 16 reasonably believed to be present; or 17 (viii) a parole officer or probation officer assigned to supervise the 18 subject of the petition[.]; or 19 (ix) the director of the hospital or the superintendent of a correc- 20 tional facility in which the subject of the petition is imprisoned, 21 pursuant to section four hundred four of the correction law. 22 (2) The commissioner shall promulgate regulations pursuant to which 23 persons initiating a petition, pursuant to subparagraphs (i) and (ii) of 24 paragraph one of this subdivision, may receive assistance in filing such 25 petitions, where appropriate, as determined pursuant to subdivision (e) 26 of this section. 27 (3) The petition shall state: 28 (i) each of the criteria for assisted outpatient treatment as set 29 forth in subdivision (c) of this section; 30 (ii) facts which support the petitioner's belief that the subject of 31 the petition meets each criterion, provided that the hearing on the 32 petition need not be limited to the stated facts; and 33 (iii) that the subject of the petition is present, or is reasonably 34 believed to be present, within the county where such petition is filed. 35 [(3)] (4) The petition shall be accompanied by an affirmation or affi- 36 davit of a physician, who shall not be the petitioner, stating that such 37 physician is willing and able to testify at the hearing on the petition 38 and that either [that]: 39 (i) such physician has personally examined the subject of the petition 40 no more than ten days prior to the submission of the petition[,] and 41 recommends assisted outpatient treatment for the subject of the peti- 42 tion[, and is willing and able to testify at the hearing on the peti-43tion]; or 44 (ii) no more than ten days prior to the filing of the petition, such 45 physician or his or her designee has made appropriate attempts but has 46 not been successful in eliciting the cooperation of the subject of the 47 petition to submit to an examination, such physician has reason to 48 suspect that the subject of the petition meets the criteria for assisted 49 outpatient treatment, and such physician is willing and able to examine 50 the subject of the petition [and testify at the hearing on the petition] 51 prior to providing testimony. 52 [(4)] (5) In counties with a population of less than eighty thousand, 53 the affirmation or affidavit required by paragraph [three] four of this 54 subdivision may be made by a physician who is an employee of the office. 55 The office is authorized and directed to make available, at no cost toA. 4451 7 1 the county, a qualified physician for the purpose of making such affir- 2 mation or affidavit consistent with the provisions of such paragraph. 3 [(f)] (g) Service. The petitioner shall cause written notice of the 4 petition to be given to the subject of the petition and a copy thereof 5 to be given personally or by mail to the persons listed in section 9.29 6 of this article, the mental hygiene legal service, the health care agent 7 if any such agent is known to the petitioner, the appropriate program 8 coordinator, and the appropriate director of community services, if such 9 director is not the petitioner. 10 [(g)] (h) Right to counsel. The subject of the petition shall have the 11 right to be represented by the mental hygiene legal service, or private- 12 ly financed counsel, at all stages of a proceeding commenced under this 13 section. 14 [(h)] (i) Hearing. (1) Upon receipt of the petition, the court shall 15 fix the date for a hearing. Such date shall be no later than three days 16 from the date such petition is received by the court, excluding Satur- 17 days, Sundays and holidays. Adjournments shall be permitted only for 18 good cause shown. In granting adjournments, the court shall consider the 19 need for further examination by a physician or the potential need to 20 provide assisted outpatient treatment expeditiously. The court shall 21 cause the subject of the petition, any other person receiving notice 22 pursuant to subdivision [(f)] (g) of this section, the petitioner, the 23 physician whose affirmation or affidavit accompanied the petition, and 24 such other persons as the court may determine to be advised of such 25 date. Upon such date, or upon such other date to which the proceeding 26 may be adjourned, the court shall hear testimony and, if it be deemed 27 advisable and the subject of the petition is available, examine the 28 subject of the petition in or out of court. If the subject of the peti- 29 tion does not appear at the hearing, and appropriate attempts to elicit 30 the attendance of the subject have failed, the court may conduct the 31 hearing in the subject's absence. In such case, the court shall set 32 forth the factual basis for conducting the hearing without the presence 33 of the subject of the petition. 34 (2) The court shall not order assisted outpatient treatment unless an 35 examining physician, who recommends assisted outpatient treatment and 36 has personally examined the subject of the petition no more than ten 37 days before the filing of the petition, testifies in person or by video- 38 conference at the hearing. Provided however, a physician shall only be 39 authorized to testify by video conference when it has been: (i) shown 40 that diligent efforts have been made to attend such hearing in person 41 and the subject of the petition consents to the physician testifying by 42 video conference; or (ii) the court orders the physician to testify by 43 video conference upon a finding of good cause. Such physician shall 44 state the facts and clinical determinations which support the allegation 45 that the subject of the petition meets each of the criteria for assisted 46 outpatient treatment; provided that the parties may stipulate, upon 47 mutual consent, that such physician need not testify. 48 (3) If the subject of the petition has refused to be examined by a 49 physician, the court may request the subject to consent to an examina- 50 tion by a physician appointed by the court. If the subject of the peti- 51 tion does not consent and the court finds reasonable cause to believe 52 that the allegations in the petition are true, the court may order peace 53 officers, acting pursuant to their special duties, or police officers 54 who are members of an authorized police department or force, or of a 55 sheriff's department to take the subject of the petition into custody 56 and transport him or her to a hospital for examination by a physician.A. 4451 8 1 Retention of the subject of the petition under such order shall not 2 exceed twenty-four hours. The examination of the subject of the petition 3 may be performed by the physician whose affirmation or affidavit accom- 4 panied the petition pursuant to paragraph [three] four of subdivision 5 [(e)] (f) of this section, if such physician is privileged by such 6 hospital or otherwise authorized by such hospital to do so. If such 7 examination is performed by another physician, the examining physician 8 may consult with the physician whose affirmation or affidavit accompa- 9 nied the petition as to whether the subject meets the criteria for 10 assisted outpatient treatment. 11 (4) A physician who testifies pursuant to paragraph two of this subdi- 12 vision shall state: (i) the facts [which] and clinical determinations 13 that support the allegation that the subject meets each of the criteria 14 for assisted outpatient treatment, (ii) that the treatment is the least 15 restrictive alternative, (iii) the recommended assisted outpatient 16 treatment, and (iv) the rationale for the recommended assisted outpa- 17 tient treatment. If the recommended assisted outpatient treatment 18 includes medication, such physician's testimony shall describe the types 19 or classes of medication which should be authorized, shall describe the 20 beneficial and detrimental physical and mental effects of such medica- 21 tion, and shall recommend whether such medication should be self-admin- 22 istered or administered by authorized personnel. 23 (5) The subject of the petition shall be afforded an opportunity to 24 present evidence, to call witnesses on his or her behalf, and to cross- 25 examine adverse witnesses. 26 [(i)] (j) Written treatment plan. (1) The court shall not order 27 assisted outpatient treatment unless a physician appointed by the appro- 28 priate director, in consultation with such director, develops and 29 provides to the court a proposed written treatment plan. The written 30 treatment plan shall include case management services or assertive 31 community treatment team services to provide care coordination. The 32 written treatment plan also shall include all categories of services, as 33 set forth in paragraph one of subdivision (a) of this section, which 34 such physician recommends that the subject of the petition receive. All 35 service providers shall be notified regarding their inclusion in the 36 written treatment plan. If the written treatment plan includes medica- 37 tion, it shall state whether such medication should be self-administered 38 or administered by authorized personnel, and shall specify type and 39 dosage range of medication most likely to provide maximum benefit for 40 the subject. If the written treatment plan includes alcohol or substance 41 abuse counseling and treatment, such plan may include a provision 42 requiring relevant testing for either alcohol or illegal substances 43 provided the physician's clinical basis for recommending such plan 44 provides sufficient facts for the court to find (i) that such person has 45 a history of alcohol or substance abuse that is clinically related to 46 the mental illness; and (ii) that such testing is necessary to prevent a 47 relapse or deterioration which would be likely to result in serious harm 48 to the person or others. If a director is the petitioner, the written 49 treatment plan shall be provided to the court no later than the date of 50 the hearing on the petition. If a person other than a director is the 51 petitioner, such plan shall be provided to the court no later than the 52 date set by the court pursuant to paragraph three of subdivision [(j)] 53 (k) of this section. 54 (2) The physician appointed to develop the written treatment plan 55 shall provide the following persons with an opportunity to actively 56 participate in the development of such plan: the subject of the peti-A. 4451 9 1 tion; the treating physician, if any; and upon the request of the 2 subject of the petition, an individual significant to the subject 3 including any relative, close friend or individual otherwise concerned 4 with the welfare of the subject. The appointed physician shall make a 5 reasonable effort to gather relevant information for the development of 6 the treatment plan from the subject of the petition's family member or 7 members, or his or her significant other. If the subject of the petition 8 has executed a health care proxy, the appointed physician shall consider 9 any directions included in such proxy in developing the written treat- 10 ment plan. 11 (3) The court shall not order assisted outpatient treatment unless a 12 physician appearing on behalf of a director testifies to explain the 13 written proposed treatment plan; provided that the parties may stipu- 14 late, upon mutual consent, that such physician need not testify. Such 15 physician shall state the categories of assisted outpatient treatment 16 recommended, the rationale for each such category, facts which establish 17 that such treatment is the least restrictive alternative, and, if the 18 recommended assisted outpatient treatment plan includes medication, such 19 physician shall state the types or classes of medication recommended, 20 the beneficial and detrimental physical and mental effects of such medi- 21 cation, and whether such medication should be self-administered or 22 administered by an authorized professional. If the subject of the peti- 23 tion has executed a health care proxy, such physician shall state the 24 consideration given to any directions included in such proxy in develop- 25 ing the written treatment plan. If a director is the petitioner, testi- 26 mony pursuant to this paragraph shall be given at the hearing on the 27 petition. If a person other than a director is the petitioner, such 28 testimony shall be given on the date set by the court pursuant to para- 29 graph three of subdivision [(j)] (k) of this section. 30 [(j)] (k) Disposition. (1) If after hearing all relevant evidence, the 31 court does not find by clear and convincing evidence that the subject of 32 the petition meets the criteria for assisted outpatient treatment, the 33 court shall dismiss the petition. 34 (2) If after hearing all relevant evidence, the court finds by clear 35 and convincing evidence that the subject of the petition meets the 36 criteria for assisted outpatient treatment, and there is no appropriate 37 and feasible less restrictive alternative, the court may order the 38 subject to receive assisted outpatient treatment for an initial period 39 not to exceed one year. In fashioning the order, the court shall specif- 40 ically make findings by clear and convincing evidence that the proposed 41 treatment is the least restrictive treatment appropriate and feasible 42 for the subject. The order shall state an assisted outpatient treatment 43 plan, which shall include all categories of assisted outpatient treat- 44 ment, as set forth in paragraph one of subdivision (a) of this section, 45 which the assisted outpatient is to receive, but shall not include any 46 such category that has not been recommended in [both] the proposed writ- 47 ten treatment plan and [the] in any testimony provided to the court 48 pursuant to subdivision [(i)](j) of this section. 49 (3) If after hearing all relevant evidence presented by a petitioner 50 who is not a director, the court finds by clear and convincing evidence 51 that the subject of the petition meets the criteria for assisted outpa- 52 tient treatment, and the court has yet to be provided with a written 53 proposed treatment plan and testimony pursuant to subdivision [(i)] (j) 54 of this section, the court shall order the appropriate director to 55 provide the court with such plan and testimony no later than the third 56 day, excluding Saturdays, Sundays and holidays, immediately followingA. 4451 10 1 the date of such order; provided that the parties may stipulate, upon 2 mutual consent, that such testimony need not be provided. Upon receiv- 3 ing such plan and any required testimony, the court may order assisted 4 outpatient treatment as provided in paragraph two of this subdivision. 5 (4) A court may order the patient to self-administer psychotropic 6 drugs or accept the administration of such drugs by authorized personnel 7 as part of an assisted outpatient treatment program. Such order may 8 specify the type and dosage range of such psychotropic drugs and such 9 order shall be effective for the duration of such assisted outpatient 10 treatment. 11 (5) If the petitioner is the director of a hospital that operates an 12 assisted outpatient treatment program, the court order shall direct the 13 hospital director to provide or arrange for all categories of assisted 14 outpatient treatment for the assisted outpatient throughout the period 15 of the order. In all other instances, the order shall require the appro- 16 priate director, as that term is defined in this section, to provide or 17 arrange for all categories of assisted outpatient treatment for the 18 assisted outpatient throughout the period of the order. Orders issued 19 on or after the effective date of the chapter of the laws of two thou- 20 sand twenty-three that amended this section shall require the appropri- 21 ate director "as determined by the program coordinator" to provide or 22 arrange for all categories of assisted outpatient treatment for the 23 assisted outpatient throughout the period of the order. 24 (6) The director shall cause a copy of any court order issued pursuant 25 to this section to be served personally, or by mail, facsimile or elec- 26 tronic means, upon the assisted outpatient, the mental hygiene legal 27 service or anyone acting on the assisted outpatient's behalf, the 28 original petitioner, identified service providers, and all others enti- 29 tled to notice under subdivision [(f)] (g) of this section. 30 [(k)] (l) Relocation of assisted outpatients. The commissioner shall 31 promulgate regulations requiring that, during the period of the order, 32 an assisted outpatient and any other appropriate persons shall notify 33 the program coordinator within a reasonable time prior to such assisted 34 outpatient relocating within the state of New York to an area not served 35 by the director who has been directed to provide or arrange for the 36 assisted outpatient treatment. Upon receiving notification of such relo- 37 cation, the program coordinator shall redetermine who the appropriate 38 director shall be and cause a copy of the court order and treatment plan 39 to be transmitted to such director. 40 (m) Petition for [additional periods of] continued treatment. (1) 41 [Prior] Within thirty days prior to the expiration of an order pursuant 42 to this section, the appropriate director shall review whether the 43 assisted outpatient continues to meet the criteria for assisted outpa- 44 tient treatment. [If, as documented in the petition, the director deter-45mines that such criteria continue to be met or has made appropriate46attempts to, but has not been successful in eliciting, the cooperation47of the subject to submit to an examination, within thirty days prior to48the expiration of an order of assisted outpatient treatment, such direc-49tor may petition the court to order continued assisted outpatient treat-50ment pursuant to paragraph two of this subdivision. Upon determining51whether such criteria continue to be met, such director shall notify the52program coordinator in writing as to whether a petition for continued53assisted outpatient treatment is warranted and whether such a petition54was or will be filed.] Upon determining that one or more of such crite- 55 ria are no longer met, such director shall notify the program coordina- 56 tor in writing that a petition for continued assisted outpatient treat-A. 4451 11 1 ment is not warranted. Upon determining that such criteria continue to 2 be met, he or she shall petition the court to order continued assisted 3 outpatient treatment for a period not to exceed one year from the expi- 4 ration date of the current order. If the court's disposition of such 5 petition does not occur prior to the expiration date of the current 6 order, the current order shall remain in effect until such disposition. 7 The procedures for obtaining any order pursuant to this subdivision 8 shall be in accordance with the provisions of the foregoing subdivision 9 of this section; provided that the time restrictions included in para- 10 graph four of subdivision (c) of this section shall not be applicable. 11 The notice provisions set forth in paragraph six of subdivision (k) of 12 this section shall be applicable. Any court order requiring periodic 13 blood tests or urinalysis for the presence of alcohol or illegal drugs 14 shall be subject to review after six months by the physician who devel- 15 oped the written treatment plan or another physician designated by the 16 director, and such physician shall be authorized to terminate such blood 17 tests or urinalysis without further action by the court. 18 (2) Within thirty days prior to the expiration of an order of assisted 19 outpatient treatment, [the appropriate director or] the current peti- 20 tioner, if the current petition was filed pursuant to subparagraph (i) 21 or (ii) of paragraph one of subdivision [(e)] (f) of this section, and 22 the current petitioner retains his or her original status pursuant to 23 the applicable subparagraph, may petition the court to order continued 24 assisted outpatient treatment for a period not to exceed one year from 25 the expiration date of the current order. If the court's disposition of 26 such petition does not occur prior to the expiration date of the current 27 order, the current order shall remain in effect until such disposition. 28 The procedures for obtaining any order pursuant to this subdivision 29 shall be in accordance with the provisions of the foregoing subdivisions 30 of this section; provided that the time restrictions included in para- 31 graph four of subdivision (c) of this section shall not be applicable. 32 The notice provisions set forth in paragraph six of subdivision [(j)] 33 (k) of this section shall be applicable. Any court order requiring peri- 34 odic blood tests or urinalysis for the presence of alcohol or illegal 35 drugs shall be subject to review after six months by the physician who 36 developed the written treatment plan or another physician designated by 37 the director, and such physician shall be authorized to terminate such 38 blood tests or urinalysis without further action by the court. 39 [(l)] (3) If neither the appropriate director nor the current peti- 40 tioner petition for continued assisted outpatient treatment pursuant to 41 this paragraph and the order of the court expires, any other person 42 authorized to petition pursuant to paragraph one of subdivision (f) of 43 this section may bring a new petition for assisted outpatient treatment. 44 If such new petition is filed less than sixty days after the expiration 45 of such order, the time restrictions provided in paragraph four of 46 subdivision (c) of this section shall not be applicable to the new peti- 47 tion. 48 (4) If, thirty days prior to the expiration of an order, the assisted 49 outpatient is deemed by the appropriate director to be missing and 50 thereby unavailable for evaluation as to whether he or she continues to 51 meet the criteria for assisted outpatient treatment, such director shall 52 petition the court to extend the term of the current order until sixty 53 days after such time as the assisted outpatient is located. If the court 54 grants the extension, the director shall continue reasonable efforts to 55 locate the assisted outpatient. Upon location of the assisted outpa- 56 tient, the director shall review whether the assisted outpatient contin-A. 4451 12 1 ues to meet the criteria for assisted outpatient treatment, pursuant to 2 paragraph two of this subdivision. 3 (n) Petition for an order to stay, vacate or modify. (1) In addition 4 to any other right or remedy available by law with respect to the order 5 for assisted outpatient treatment, the assisted outpatient, the mental 6 hygiene legal service, or anyone acting on the assisted outpatient's 7 behalf may petition the court on notice to the director, the original 8 petitioner, and all others entitled to notice under subdivision [(f)] 9 (g) of this section to stay, vacate or modify the order. 10 (2) The appropriate director shall petition the court for approval 11 before instituting a proposed material change in the assisted outpatient 12 treatment plan, unless such change is authorized by the order of the 13 court. Such petitions to change an assisted outpatient treatment plan, 14 as well as petitions for continued treatment, may be made to any judge 15 of the supreme or county courts in the county in which the subject of 16 the petition is present or reasonably believed to be present. Such peti- 17 tion shall be filed on notice to all parties entitled to notice under 18 subdivision [(f)] (g) of this section. Not later than five days after 19 receiving such petition, excluding Saturdays, Sundays and holidays, the 20 court shall hold a hearing on the petition; provided that if the 21 assisted outpatient informs the court that he or she agrees to the 22 proposed material change, the court may approve such change without a 23 hearing. Non-material changes may be instituted by the director without 24 court approval. For the purposes of this paragraph, a material change is 25 an addition or deletion of a category of services to or from a current 26 assisted outpatient treatment plan, or any deviation without the 27 assisted outpatient's consent from the terms of a current order relating 28 to the administration of psychotropic drugs. 29 [(m)] (o) Appeals. Review of an order issued pursuant to this section 30 shall be had in like manner as specified in section 9.35 of this 31 article; provided that notice shall be provided to all parties entitled 32 to notice under subdivision (g) of this section. 33 [(n)] (p) Failure to comply with assisted outpatient treatment. Where 34 in the clinical judgment of a physician, (i) the assisted outpatient, 35 has failed or refused to comply with the assisted outpatient treatment, 36 (ii) efforts were made to solicit compliance, and (iii) such assisted 37 outpatient may be in need of involuntary admission to a hospital pursu- 38 ant to section 9.27 of this article or immediate observation, care and 39 treatment pursuant to section 9.39 or 9.40 of this article, such physi- 40 cian may request the appropriate director of community services, the 41 director's designee, or any physician designated by the director of 42 community services pursuant to section 9.37 of this article, to direct 43 the removal of such assisted outpatient to an appropriate hospital for 44 an examination to determine if such person has a mental illness for 45 which he or she is in need of hospitalization is necessary pursuant to 46 section 9.27, 9.39 or 9.40 of this article[. Furthermore, if such47assisted outpatient refuses to take medications as required by the court48order, or he or she refuses to take, or fails a blood test, urinalysis,49or alcohol or drug test as required by the court order, such physician50may consider such refusal or failure when determining whether]; provided 51 that if, after efforts to solicit compliance, such physician determines 52 that the assisted outpatient's failure to comply with the assisted 53 outpatient treatment includes a substantial failure to take medication, 54 pass or submit to blood testing or urinalysis, or receive treatment for 55 alcohol or substance abuse, such physician may presume that the assisted 56 outpatient is in need of an examination to determine whether he or sheA. 4451 13 1 has a mental illness for which hospitalization is necessary. Upon the 2 request of such physician, the appropriate director, the director's 3 designee, or any physician designated pursuant to section 9.37 of this 4 article, may direct peace officers, acting pursuant to their special 5 duties, or police officers who are members of an authorized police 6 department or force or of a sheriff's department to take the assisted 7 outpatient into custody and transport him or her to the hospital operat- 8 ing the assisted outpatient treatment program or to any hospital author- 9 ized by the director of community services to receive such persons. Such 10 law enforcement officials shall carry out such directive. Upon the 11 request of such physician, the appropriate director, the director's 12 designee, or any physician designated pursuant to section 9.37 of this 13 article, an ambulance service, as defined by subdivision two of section 14 three thousand one of the public health law, or an approved mobile 15 crisis outreach team as defined in section 9.58 of this article shall be 16 authorized to take into custody and transport any such person to the 17 hospital operating the assisted outpatient treatment program, or to any 18 other hospital authorized by the appropriate director of community 19 services to receive such persons. Any director of community services, or 20 designee, shall be authorized to direct the removal of an assisted 21 outpatient who is present in his or her county to an appropriate hospi- 22 tal, in accordance with the provisions of this subdivision, based upon a 23 determination of the appropriate director of community services direct- 24 ing the removal of such assisted outpatient pursuant to this subdivi- 25 sion. Such person may be retained for observation, care and treatment 26 and further examination in the hospital for up to seventy-two hours to 27 permit a physician to determine whether such person has a mental illness 28 and is in need of involuntary care and treatment in a hospital pursuant 29 to the provisions of this article. Any continued involuntary retention 30 of the assisted outpatient in such hospital beyond the initial seventy- 31 two hour period shall be in accordance with the provisions of this arti- 32 cle relating to the involuntary admission and retention of a person. If 33 at any time during the seventy-two hour period the person is determined 34 not to meet the involuntary admission and retention provisions of this 35 article, and does not agree to stay in the hospital as a voluntary or 36 informal patient, he or she must be released. Failure to comply with an 37 order of assisted outpatient treatment shall not be grounds for involun- 38 tary civil commitment or a finding of contempt of court. 39 [(o)] (q) Effect of determination that a person is in need of assisted 40 outpatient treatment. The determination by a court that a person is in 41 need of assisted outpatient treatment shall not be construed as or 42 deemed to be a determination that such person is incapacitated pursuant 43 to article eighty-one of this chapter. 44 [(p)] (r) False petition. A person making a false statement or provid- 45 ing false information or false testimony in a petition or hearing under 46 this section shall be subject to criminal prosecution pursuant to arti- 47 cle one hundred seventy-five or article two hundred ten of the penal 48 law. 49 [(q)] (s) Exception. Nothing in this section shall be construed to 50 affect the ability of the director of a hospital to receive, admit, or 51 retain patients who otherwise meet the provisions of this article 52 regarding receipt, retention or admission. 53 [(r)] (t) Education and training. (1) The office [of mental health], 54 in consultation with the office of court administration, shall prepare 55 educational and training materials on the use of this section, which 56 shall be made available to local governmental units, providers ofA. 4451 14 1 services, judges, court personnel, law enforcement officials and the 2 general public. 3 (2) The office, in consultation with the office of court adminis- 4 tration, shall establish a mental health training program for supreme 5 and county court judges and court personnel, and shall provide such 6 training with such frequency and in such locations as may be appropriate 7 to meet statewide needs. Such training shall focus on the use of this 8 section and generally address issues relating to mental illness and 9 mental health treatment. 10 [(s)] (u) A director of community services or his or her designee may 11 require a provider of inpatient psychiatric services operated or 12 licensed by the office of mental health to provide contemporaneous 13 information, including but not limited to relevant clinical records, 14 documents, and other information concerning the person receiving 15 assisted outpatient treatment pursuant to an active assisted outpatient 16 treatment order, that is deemed necessary by such director or designee 17 who is required to coordinate and monitor the care of any individual who 18 was subject to an active assisted outpatient treatment order to appro- 19 priately discharge their duties pursuant to section 9.47 of this arti- 20 cle, and where such provider of inpatient psychiatric services is 21 required to disclose such information pursuant to paragraph twelve of 22 subdivision (c) of section 33.13 of this chapter and such disclosure is 23 in accordance with all other applicable state and federal confidentiali- 24 ty laws. None of the records or information obtained by the director of 25 community services pursuant to this subdivision shall be public records, 26 and the records shall not be released by the director to any person or 27 agency, except as already authorized by law. 28 § 6. Section 29.15 of the mental hygiene law is amended by adding a 29 new subdivision (o) to read as follows: 30 (o) If the director of a department facility does not petition for 31 assisted outpatient treatment pursuant to section 9.60 of this chapter 32 upon the discharge of an inpatient admitted pursuant to section 9.27, 33 9.39 or 9.40 of this chapter, or upon the expiration of a period of 34 conditional release for such inpatient, such director shall report such 35 discharge or such expiration in writing to the director of community 36 services of the local governmental unit in which the inpatient is 37 expected to reside. 38 § 7. Subdivision 3 of section 404 of the correction law, as amended by 39 chapter 322 of the laws of 2021, is amended and a new subdivision 5 is 40 added to read as follows: 41 3. Within a reasonable period prior to discharge of an incarcerated 42 individual committed from a [state correctional facility from a] hospi- 43 tal in the department of mental hygiene to the community, the director 44 shall ensure that a clinical assessment has been completed to determine 45 whether the incarcerated individual meets the criteria for assisted 46 outpatient treatment pursuant to subdivision (c) of section 9.60 of the 47 mental hygiene law. If, as a result of such assessment, the director 48 determines that the incarcerated individual meets such criteria, prior 49 to discharge the director of the hospital shall either petition for a 50 court order pursuant to section 9.60 of the mental hygiene law, or 51 report in writing to the director of community services of the local 52 governmental unit in which the incarcerated individual is expected to 53 reside so that an investigation [may] shall be conducted pursuant to 54 section 9.47 of the mental hygiene law. 55 5. Within a reasonable period prior to release or discharge of an 56 incarcerated individual who is not currently committed to a hospital inA. 4451 15 1 the department of mental hygiene from a state correctional facility to 2 the community, if such incarcerated individual has a serious mental 3 illness pursuant to paragraph (e) of subdivision six of section one 4 hundred thirty-seven of this chapter, the department shall notify the 5 director of a hospital who shall ensure that a clinical assessment has 6 been completed to determine whether the incarcerated individual meets 7 the criteria for assisted outpatient treatment pursuant to subdivision 8 (c) of section 9.60 of the mental hygiene law. If, as a result of such 9 assessment, the director determines that the incarcerated individual 10 meets such criteria, prior to release or discharge, the director of the 11 hospital shall either petition for a court order pursuant to section 12 9.60 of the mental hygiene law, or report in writing to the director of 13 community services of the local governmental unit in which the incarcer- 14 ated individual is expected to reside so that an investigation shall be 15 conducted pursuant to section 9.47 of the mental hygiene law. 16 § 8. Section 18 of chapter 408 of the laws of 1999, constituting 17 Kendra's Law, as amended by section 1 of subpart H of part UU of chapter 18 56 of the laws of 2022, is amended to read as follows: 19 § 18. This act shall take effect immediately, provided that section 20 fifteen of this act shall take effect April 1, 2000, provided, further, 21 that subdivision (e) of section 9.60 of the mental hygiene law as added 22 by section six of this act shall be effective 90 days after this act 23 shall become law[; and that this act shall expire and be deemed repealed24June 30, 2027]. 25 § 9. Severability. If any clause, sentence, paragraph, section or part 26 of this act shall be adjudged by any court of competent jurisdiction to 27 be invalid, and after exhaustion of all further judicial review, the 28 judgment shall not affect, impair or invalidate the remainder thereof, 29 but shall be confined in its operation to the clause, sentence, para- 30 graph, section or part thereof directly involved in the controversy. 31 § 10. This act shall take effect immediately.
