Bill Text: NY S00516 | 2017-2018 | General Assembly | Amended


Bill Title: Enhances the assisted outpatient treatment program; eliminates the expiration and repeal of Kendra's Law.

Spectrum: Moderate Partisan Bill (Republican 24-5)

Status: (Engrossed - Dead) 2018-03-26 - referred to mental health [S00516 Detail]

Download: New_York-2017-S00516-Amended.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                         516--B
                               2017-2018 Regular Sessions
                    IN SENATE
                                       (Prefiled)
                                     January 4, 2017
                                       ___________
        Introduced  by  Sens.  YOUNG, ADDABBO, AKSHAR, AMEDORE, AVELLA, BONACIC,
          BOYLE, DeFRANCISCO, FELDER, FUNKE, GALLIVAN, GOLDEN, GRIFFO,  HELMING,
          LANZA,  LARKIN,  LITTLE,  MARCELLINO, MARCHIONE, MURPHY, O'MARA, PHIL-
          LIPS, RANZENHOFER, RITCHIE, ROBACH, SERINO, SEWARD, STAVISKY,  VALESKY
          -- read twice and ordered printed, and when printed to be committed to
          the  Committee  on  Mental  Health  and  Developmental Disabilities --
          recommitted to the Committee on Mental Health and Developmental  Disa-
          bilities  in  accordance  with  Senate  Rule  6,  sec.  8 -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee  --  committee  discharged,  bill  amended,  ordered
          reprinted as amended and recommitted to said committee
        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;
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05836-04-8

        S. 516--B                           2
     1    (iv)  that  a  mechanism  exists  for  such case manager, or assertive
     2  community treatment team, to regularly report the assisted  outpatient's
     3  compliance, or lack of compliance with treatment, to the director of the
     4  assisted outpatient treatment program;
     5    (v)  that directors of community services establish procedures [which]
     6  that provide that reports of persons who may  be  in  need  of  assisted
     7  outpatient  treatment are appropriately investigated in a timely manner;
     8  [and]
     9    (vi) that assisted outpatient treatment services are  delivered  in  a
    10  timely manner[.];
    11    (vii)  that,  prior to the expiration of assisted outpatient treatment
    12  orders, the  clinical  needs  of  assisted  outpatients  are  adequately
    13  reviewed  in  determining  the  need  to petition for continued assisted
    14  outpatient treatment pursuant to subdivision (m) of section 9.60 of this
    15  title;
    16    (viii) that the appropriate director is determined for  each  assisted
    17  outpatient, pursuant to subdivisions (k) and (l) of section 9.60 of this
    18  title; and
    19    (ix)  that  the office fulfills its duties pursuant to subdivision (t)
    20  of section 9.60 of this title to meet local needs for training of judges
    21  and court personnel.
    22    § 2. Subdivision (f) of section 7.17 of  the  mental  hygiene  law  is
    23  amended by adding a new paragraph 5 to read as follows:
    24    (5)  The  commissioner  shall  develop  an educational pamphlet on the
    25  process of petitioning for assisted  outpatient  treatment  for  dissem-
    26  ination  to  individuals seeking to submit reports of persons who may be
    27  in need of assisted outpatient treatment,  and  individuals  seeking  to
    28  file a petition pursuant to subparagraph (i) or (ii) of paragraph one of
    29  subdivision  (f)  of section 9.60 of this title. Such pamphlet shall set
    30  forth, in plain language: the criteria for  assisted  outpatient  treat-
    31  ment,  resources  available to such individuals, the responsibilities of
    32  program coordinators and directors of community services, a  summary  of
    33  current  law,  the process for petitioning for continued assisted outpa-
    34  tient treatment, and other such information the commissioner  determines
    35  to be pertinent.
    36    §  3.    Subdivision (b) of section 9.47 of the mental hygiene law, as
    37  amended by chapter 158 of the laws of 2005, paragraphs 5 and 6 as  added
    38  and  paragraph  7  as  renumbered  by  chapter 1 of the laws of 2013, is
    39  amended to read as follows:
    40    (b) All directors of community services shall be responsible for:
    41    (1) receiving reports of persons who may be in need of assisted outpa-
    42  tient treatment pursuant to section 9.60 of this article and documenting
    43  the receipt date of such reports;
    44    (2) conducting timely investigations of such reports received pursuant
    45  to paragraph one of this subdivision and providing written  notice  upon
    46  the  completion of investigations to reporting persons and program coor-
    47  dinators, appointed by the commissioner [of mental health]  pursuant  to
    48  subdivision  (f)  of  section  7.17  of  this title, and documenting the
    49  initiation and completion dates of such investigations and the  disposi-
    50  tions;
    51    (3)  filing of petitions for assisted outpatient treatment pursuant to
    52  [paragraph] subparagraph (vii) of paragraph one of subdivision [(e)] (f)
    53  of section 9.60 of this article, and  documenting  the  petition  filing
    54  [date] dates and the [date] dates of the court [order] orders;

        S. 516--B                           3
     1    (4)  coordinating  the  timely delivery of court ordered services with
     2  program coordinators and documenting the date assisted outpatients begin
     3  to receive the services mandated in the court order; [and]
     4    (5)  ensuring  evaluation  of the need for ongoing assisted outpatient
     5  treatment pursuant to subdivision [(k)] (m)  of  section  9.60  of  this
     6  article  prior  to  the  expiration of any assisted outpatient treatment
     7  order;
     8    (6) if he or she has been  ordered  to  provide  for  or  arrange  for
     9  assisted  outpatient treatment pursuant to paragraph five of subdivision
    10  [(j)] (k) of section 9.60 of this  article  or  became  the  appropriate
    11  director  pursuant  to this paragraph or subdivision (c) of section 9.48
    12  of this article, notifying the director of community services of the new
    13  county of residence when he  or  she  has  reason  to  believe  that  an
    14  assisted  outpatient  has  or will change his or her county of residence
    15  during the pendency of an assisted outpatient treatment order. Upon such
    16  change of residence, the director of the new county of  residence  shall
    17  become the appropriate director, as such term is defined in section 9.60
    18  of this article; [and]
    19    (7) notifying program coordinators when assisted outpatients cannot be
    20  located after reasonable efforts or are believed to have taken residence
    21  outside of the local governmental unit served; and
    22    (8)  reporting on a quarterly basis to program coordinators the infor-
    23  mation collected pursuant to this subdivision.
    24    § 4.  Paragraphs (viii) and (ix) of subdivision (b) of section 9.48 of
    25  the mental hygiene law are renumbered paragraphs (ix) and (x) and a  new
    26  paragraph (viii) is added to read as follows:
    27    (viii)  an  account  of  any court order expiration, including but not
    28  limited to the director's determination as to whether  to  petition  for
    29  continued  assisted  outpatient  treatment,  pursuant to section 9.60 of
    30  this article, the basis for such determination, and the  disposition  of
    31  any such petition;
    32    § 5. Section 9.60 of the mental hygiene law, as amended by chapter 158
    33  of  the  laws  of  2005,  paragraph  1  of subdivision (a) as amended by
    34  section 1 of part E of chapter 111 of the laws of 2010, paragraph  3  of
    35  subdivision (a), paragraphs 2 and 5 of subdivision (j), and subdivisions
    36  (k)  and (n) as amended by chapter 1 of the laws of 2013, paragraph 5 of
    37  subdivision (c) as amended by chapter 137 of the laws of 2005, paragraph
    38  4 of subdivision (e) as amended by chapter 382 of the laws of  2015,  is
    39  amended to read as follows:
    40  § 9.60 Assisted outpatient treatment.
    41    (a)  Definitions.  For  purposes  of this section, the following defi-
    42  nitions shall apply:
    43    (1) "assisted outpatient treatment" shall mean  categories  of  outpa-
    44  tient  services  [which] that have been ordered by the court pursuant to
    45  this section.  Such treatment shall include case management services  or
    46  assertive  community  treatment  team  services  to provide care coordi-
    47  nation, and  may  also  include  any  of  the  following  categories  of
    48  services: medication support; medication education or symptom management
    49  education;  periodic  blood  tests or urinalysis to determine compliance
    50  with prescribed medications; individual or group therapy; day or partial
    51  day programming  activities;  educational  and  vocational  training  or
    52  activities;  appointment  of  a  representative payee or other financial
    53  management services, subject to final approval of  the  Social  Security
    54  Administration,  where  applicable; alcohol or substance abuse treatment
    55  and counseling and periodic or random tests for the presence of  alcohol
    56  or  illegal  drugs  for  persons  with a history of alcohol or substance

        S. 516--B                           4
     1  abuse; supervision of living arrangements; and any other services within
     2  a local services plan developed pursuant to article  forty-one  of  this
     3  chapter,  clinical  or  non-clinical,  prescribed  to treat the person's
     4  mental illness and to assist the person in living and functioning in the
     5  community,  or to attempt to prevent a relapse or deterioration that may
     6  reasonably be predicted to result in attempted suicide, serious physical
     7  harm to any person or the need for hospitalization.
     8    (2) "director" shall mean the director  of  community  services  of  a
     9  local governmental unit, or the director of a hospital licensed or oper-
    10  ated  by  the office of mental health which operates, directs and super-
    11  vises an assisted outpatient treatment program.
    12    (3) "director of community services"  and  "local  governmental  unit"
    13  shall  have  the  same meanings as provided in article forty-one of this
    14  chapter. The "appropriate director" shall mean the director of community
    15  services of the county where the assisted outpatient resides, even if it
    16  is a different county than the  county  where  the  assisted  outpatient
    17  treatment order was originally issued.
    18    (4)  "assisted  outpatient  treatment  program" shall mean a system to
    19  arrange for and coordinate the provision of assisted  outpatient  treat-
    20  ment, to monitor treatment compliance by assisted outpatients, to evalu-
    21  ate  the condition or needs of assisted outpatients, to take appropriate
    22  steps to address the needs of such individuals, and to ensure compliance
    23  with court orders.
    24    (5) "assisted outpatient" shall mean the person under a court order to
    25  receive assisted outpatient treatment.
    26    (6) "subject of the petition" or "subject" shall mean the  person  who
    27  is  alleged  in  a  petition,  filed  pursuant to the provisions of this
    28  section, to meet the criteria for assisted outpatient treatment.
    29    (7) "correctional facility" and "local  correctional  facility"  shall
    30  have the same meanings as provided in section two of the correction law.
    31    (8)  "health  care  proxy" and "health care agent" shall have the same
    32  meanings as provided in article twenty-nine-C of the public health law.
    33    (9) "program coordinator" shall mean an individual  appointed  by  the
    34  commissioner  [of mental health], pursuant to subdivision (f) of section
    35  7.17 of this chapter, who is responsible for the oversight and  monitor-
    36  ing of assisted outpatient treatment programs.
    37    (b) Programs. The director of community services of each local govern-
    38  mental  unit  shall operate, direct and supervise an assisted outpatient
    39  treatment program. The director of a hospital licensed  or  operated  by
    40  the  office  [of  mental  health]  may  operate, direct and supervise an
    41  assisted outpatient treatment program, upon approval by the  commission-
    42  er.  Directors  of  community services shall be permitted to satisfy the
    43  provisions of this subdivision through the operation of  joint  assisted
    44  outpatient  treatment  programs.  Nothing  in  this subdivision shall be
    45  interpreted to preclude  the  combination  or  coordination  of  efforts
    46  between  and  among  local governmental units and hospitals in providing
    47  and coordinating assisted outpatient treatment.
    48    (c) Criteria. A person may be ordered to receive  assisted  outpatient
    49  treatment if the court finds that such person:
    50    (1) is eighteen years of age or older; and
    51    (2) is suffering from a mental illness; and
    52    (3)  is  unlikely  to  survive  safely in the community without super-
    53  vision, based on a clinical determination; and
    54    (4) has a history of lack of  compliance  with  treatment  for  mental
    55  illness that has:

        S. 516--B                           5
     1    (i)  [prior  to the filing of the petition,] at least twice within the
     2  [last] thirty-six months prior to the filing  of  the  petition  been  a
     3  significant  factor  in  necessitating hospitalization in a hospital, or
     4  receipt of services in a forensic or  other  mental  health  unit  of  a
     5  correctional facility or a local correctional facility[, not including];
     6  provided  that  such  thirty-six  month  period shall be extended by the
     7  length of any current period[, or period ending] of  hospitalization  or
     8  incarceration,  and  any  such  period  that  ended  within the last six
     9  months[, during which the person was or is hospitalized  or  incarcerat-
    10  ed]; or
    11    (ii)  within  forty-eight  months prior to the filing of the petition,
    12  resulted in one or more acts of serious violent behavior toward self  or
    13  others  or  threats of, or attempts at, serious physical harm to self or
    14  others [within the last forty-eight  months,  not  including];  provided
    15  that  such  forty-eight  month period shall be extended by the length of
    16  any current period[, or period ending] of hospitalization or  incarcera-
    17  tion,  and  any  such  period that ended within the last six months[, in
    18  which the person was or is hospitalized or incarcerated]; and
    19    (5) is, as a result of his or her mental illness, unlikely  to  volun-
    20  tarily  participate in outpatient treatment that would enable him or her
    21  to live safely in the community; and
    22    (6) in view of his or her treatment history and current  behavior,  is
    23  in  need  of assisted outpatient treatment in order to prevent a relapse
    24  or deterioration which would be likely to result in serious harm to  the
    25  person or others as defined in section 9.01 of this article; and
    26    (7) is likely to benefit from assisted outpatient treatment.
    27    (d) Health care proxy. Nothing in this section shall preclude a person
    28  with  a  health  care proxy from being subject to a petition pursuant to
    29  this chapter and consistent with article  twenty-nine-C  of  the  public
    30  health law.
    31    (e)  Investigation of reports. The commissioner shall promulgate regu-
    32  lations establishing a procedure to ensure that reports of a person  who
    33  may  be  in  need  of  assisted  outpatient  treatment,  including those
    34  received from family and community members of such person, are  investi-
    35  gated in a timely manner and, where appropriate, result in the filing of
    36  petitions for assisted outpatient treatment.
    37    (f)  Petition  to  the  court. (1) A petition for an order authorizing
    38  assisted outpatient treatment may be filed  in  the  supreme  or  county
    39  court  in  the county in which the subject of the petition is present or
    40  reasonably believed to  be  present.    When  a  director  of  community
    41  services  has  reason to believe that an assisted outpatient has changed
    42  his or her county of residence, future petitions and applications  under
    43  this  section  may  be  filed  in the supreme or county court in the new
    44  county of residence, which shall have concurrent jurisdiction  with  the
    45  court that initially ordered such treatment. Such petition may be initi-
    46  ated only by the following persons:
    47    (i) any person eighteen years of age or older with whom the subject of
    48  the petition resides; or
    49    (ii)  the  parent,  spouse, sibling eighteen years of age or older, or
    50  child eighteen years of age or older of the subject of the petition; or
    51    (iii) the director of a hospital in which the subject of the  petition
    52  is  hospitalized,  or  pursuant  to  section  four  hundred  four of the
    53  correction law; or
    54    (iv) the director of any public or charitable organization, agency  or
    55  home  providing mental health services to the subject of the petition or
    56  in whose institution the subject of the petition resides; or

        S. 516--B                           6
     1    (v) a qualified psychiatrist who is either supervising  the  treatment
     2  of or treating the subject of the petition for a mental illness; or
     3    (vi)  a  psychologist, licensed pursuant to article one hundred fifty-
     4  three of the education law, or a social  worker,  licensed  pursuant  to
     5  article one hundred fifty-four of the education law, who is treating the
     6  subject of the petition for a mental illness; or
     7    (vii)  the  director of community services, or his or her designee, or
     8  the social services official, as defined in the social services law,  of
     9  the  city  or  county in which the subject of the petition is present or
    10  reasonably believed to be present; or
    11    (viii) a parole officer or probation officer assigned to supervise the
    12  subject of the petition[.]; or
    13    (ix) a physician licensed pursuant to article one  hundred  thirty-one
    14  of  the education law, who is treating the subject of the petition, or a
    15  certified nurse practitioner licensed and certified pursuant to  article
    16  one  hundred  thirty-nine  of  the  education  law,  who is treating the
    17  subject of the petition; or
    18    (x) the director of any facility which is primarily providing  shelter
    19  to homeless individuals; or
    20    (xi)  the  director of the hospital or the superintendent of a correc-
    21  tional facility in which the subject  of  the  petition  is  imprisoned,
    22  pursuant to section four hundred four of the correction law.
    23    (2)  The  commissioner  shall promulgate regulations pursuant to which
    24  persons initiating a petition, pursuant to subparagraphs (i) and (ii) of
    25  paragraph one of this subdivision, may receive assistance in filing such
    26  petitions, where appropriate, as determined pursuant to subdivision  (e)
    27  of this section.
    28    (3) The petition shall state:
    29    (i)  each  of  the  criteria  for assisted outpatient treatment as set
    30  forth in subdivision (c) of this section;
    31    (ii) facts which support the petitioner's belief that the  subject  of
    32  the  petition  meets  each  criterion,  provided that the hearing on the
    33  petition need not be limited to the stated facts; and
    34    (iii) that the subject of the petition is present,  or  is  reasonably
    35  believed to be present, within the county where such petition is filed.
    36    [(3)] (4) The petition shall be accompanied by an affirmation or affi-
    37  davit of a physician, who shall not be the petitioner, stating that such
    38  physician  is willing and able to testify at the hearing on the petition
    39  and that either [that]:
    40    (i) such physician has personally examined the subject of the petition
    41  no more than ten days prior to the submission  of  the  petition[,]  and
    42  recommends  assisted  outpatient  treatment for the subject of the peti-
    43  tion[, and is willing and able to testify at the hearing  on  the  peti-
    44  tion]; or
    45    (ii)  no  more than ten days prior to the filing of the petition, such
    46  physician or his or her designee has made appropriate attempts  but  has
    47  not  been  successful in eliciting the cooperation of the subject of the
    48  petition to submit to an  examination,  such  physician  has  reason  to
    49  suspect that the subject of the petition meets the criteria for assisted
    50  outpatient  treatment, and such physician is willing and able to examine
    51  the subject of the petition [and testify at the hearing on the petition]
    52  prior to providing testimony.
    53    [(4)] (5) In counties with a population of less than eighty  thousand,
    54  the  affirmation or affidavit required by paragraph [three] four of this
    55  subdivision may be made by a physician who is an employee of the office.
    56  The office is authorized and directed to make available, at no  cost  to

        S. 516--B                           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 at the hear-
    38  ing.  Such  physician  shall state the facts and clinical determinations
    39  which support the allegation that the subject of the petition meets each
    40  of the criteria for assisted outpatient  treatment;  provided  that  the
    41  parties may stipulate, upon mutual consent, that such physician need not
    42  testify.
    43    (3)  If  the  subject  of the petition has refused to be examined by a
    44  physician, the court may request the subject to consent to  an  examina-
    45  tion  by a physician appointed by the court. If the subject of the peti-
    46  tion does not consent and the court finds reasonable  cause  to  believe
    47  that the allegations in the petition are true, the court may order peace
    48  officers,  acting  pursuant  to their special duties, or police officers
    49  who are members of an authorized police department or  force,  or  of  a
    50  sheriff's  department  to  take the subject of the petition into custody
    51  and transport him or her to a hospital for examination by  a  physician.
    52  Retention  of  the  subject  of  the petition under such order shall not
    53  exceed twenty-four hours. The examination of the subject of the petition
    54  may be performed by the physician whose affirmation or affidavit  accom-
    55  panied  the  petition  pursuant to paragraph [three] four of subdivision
    56  [(e)] (f) of this section, if  such  physician  is  privileged  by  such

        S. 516--B                           8
     1  hospital  or  otherwise  authorized  by  such hospital to do so. If such
     2  examination is performed by another physician, the  examining  physician
     3  may  consult  with the physician whose affirmation or affidavit accompa-
     4  nied  the  petition  as  to  whether  the subject meets the criteria for
     5  assisted outpatient treatment.
     6    (4) A physician who testifies pursuant to paragraph two of this subdi-
     7  vision shall state: (i) the facts [which]  and  clinical  determinations
     8  that  support the allegation that the subject meets each of the criteria
     9  for assisted outpatient treatment, (ii) that the treatment is the  least
    10  restrictive  alternative,  (iii)  the  recommended  assisted  outpatient
    11  treatment, and (iv) the rationale for the  recommended  assisted  outpa-
    12  tient  treatment.  If  the  recommended  assisted  outpatient  treatment
    13  includes medication, such physician's testimony shall describe the types
    14  or classes of medication which should be authorized, shall describe  the
    15  beneficial  and  detrimental physical and mental effects of such medica-
    16  tion, and shall recommend whether such medication should be  self-admin-
    17  istered or administered by authorized personnel.
    18    (5)  The  subject  of the petition shall be afforded an opportunity to
    19  present evidence, to call witnesses on his or her behalf, and to  cross-
    20  examine adverse witnesses.
    21    [(i)]  (j)  Written  treatment  plan.  (1)  The  court shall not order
    22  assisted outpatient treatment unless a physician appointed by the appro-
    23  priate director,  in  consultation  with  such  director,  develops  and
    24  provides  to  the  court  a proposed written treatment plan. The written
    25  treatment plan shall  include  case  management  services  or  assertive
    26  community  treatment  team  services  to  provide care coordination. The
    27  written treatment plan also shall include all categories of services, as
    28  set forth in paragraph one of subdivision (a)  of  this  section,  which
    29  such  physician recommends that the subject of the petition receive. All
    30  service providers shall be notified regarding  their  inclusion  in  the
    31  written  treatment  plan. If the written treatment plan includes medica-
    32  tion, it shall state whether such medication should be self-administered
    33  or administered by authorized personnel,  and  shall  specify  type  and
    34  dosage  range  of  medication most likely to provide maximum benefit for
    35  the subject. If the written treatment plan includes alcohol or substance
    36  abuse counseling and  treatment,  such  plan  may  include  a  provision
    37  requiring  relevant  testing  for  either  alcohol or illegal substances
    38  provided the physician's  clinical  basis  for  recommending  such  plan
    39  provides sufficient facts for the court to find (i) that such person has
    40  a  history  of  alcohol or substance abuse that is clinically related to
    41  the mental illness; and (ii) that such testing is necessary to prevent a
    42  relapse or deterioration which would be likely to result in serious harm
    43  to the person or others. If a director is the  petitioner,  the  written
    44  treatment  plan shall be provided to the court no later than the date of
    45  the hearing on the petition. If a person other than a  director  is  the
    46  petitioner,  such  plan shall be provided to the court no later than the
    47  date set by the court pursuant to paragraph three of  subdivision  [(j)]
    48  (k) of this section.
    49    (2)  The  physician  appointed  to  develop the written treatment plan
    50  shall provide the following persons  with  an  opportunity  to  actively
    51  participate  in  the  development of such plan: the subject of the peti-
    52  tion; the treating physician, if  any;  and  upon  the  request  of  the
    53  subject  of  the  petition,  an  individual  significant  to the subject
    54  including any relative, close friend or individual  otherwise  concerned
    55  with  the  welfare  of the subject. The appointed physician shall make a
    56  reasonable effort to gather relevant information for the development  of

        S. 516--B                           9
     1  the  treatment  plan from the subject of the petition's family member or
     2  members, or his or her significant other. If the subject of the petition
     3  has executed a health care proxy, the appointed physician shall consider
     4  any  directions  included in such proxy in developing the written treat-
     5  ment plan.
     6    (3) The court shall not order assisted outpatient treatment  unless  a
     7  physician  appearing  on  behalf  of a director testifies to explain the
     8  written proposed treatment plan; provided that the  parties  may  stipu-
     9  late,  upon  mutual consent, that such physician need not testify.  Such
    10  physician shall state the categories of  assisted  outpatient  treatment
    11  recommended, the rationale for each such category, facts which establish
    12  that  such  treatment  is the least restrictive alternative, and, if the
    13  recommended assisted outpatient treatment plan includes medication, such
    14  physician shall state the types or classes  of  medication  recommended,
    15  the beneficial and detrimental physical and mental effects of such medi-
    16  cation,  and  whether  such  medication  should  be self-administered or
    17  administered by an authorized professional. If the subject of the  peti-
    18  tion  has  executed  a health care proxy, such physician shall state the
    19  consideration given to any directions included in such proxy in develop-
    20  ing the written treatment plan. If a director is the petitioner,  testi-
    21  mony  pursuant  to  this  paragraph shall be given at the hearing on the
    22  petition. If a person other than a  director  is  the  petitioner,  such
    23  testimony  shall be given on the date set by the court pursuant to para-
    24  graph three of subdivision [(j)] (k) of this section.
    25    [(j)] (k) Disposition. (1) If after hearing all relevant evidence, the
    26  court does not find by clear and convincing evidence that the subject of
    27  the petition meets the criteria for assisted outpatient  treatment,  the
    28  court shall dismiss the petition.
    29    (2)  If  after hearing all relevant evidence, the court finds by clear
    30  and convincing evidence that the  subject  of  the  petition  meets  the
    31  criteria  for assisted outpatient treatment, and there is no appropriate
    32  and feasible less restrictive  alternative,  the  court  may  order  the
    33  subject  to  receive assisted outpatient treatment for an initial period
    34  not to exceed one year. In fashioning the order, the court shall specif-
    35  ically make findings by clear and convincing evidence that the  proposed
    36  treatment  is  the  least restrictive treatment appropriate and feasible
    37  for the subject. The order shall state an assisted outpatient  treatment
    38  plan,  which  shall include all categories of assisted outpatient treat-
    39  ment, as set forth in paragraph one of subdivision (a) of this  section,
    40  which  the  assisted outpatient is to receive, but shall not include any
    41  such category that has not been recommended in [both] the proposed writ-
    42  ten treatment plan and [the] in any  testimony  provided  to  the  court
    43  pursuant to subdivision [(i)](j) of this section.
    44    (3)  If  after hearing all relevant evidence presented by a petitioner
    45  who is not a director, the court finds by clear and convincing  evidence
    46  that  the subject of the petition meets the criteria for assisted outpa-
    47  tient treatment, and the court has yet to be  provided  with  a  written
    48  proposed  treatment plan and testimony pursuant to subdivision [(i)] (j)
    49  of this section, the court  shall  order  the  appropriate  director  to
    50  provide  the  court with such plan and testimony no later than the third
    51  day, excluding Saturdays, Sundays and  holidays,  immediately  following
    52  the  date  of  such  order; provided that the parties may stipulate upon
    53  mutual consent that such testimony need not be provided.  Upon receiving
    54  such plan and any required  testimony,  the  court  may  order  assisted
    55  outpatient treatment as provided in paragraph two of this subdivision.

        S. 516--B                          10
     1    (4)  A  court  may  order  the patient to self-administer psychotropic
     2  drugs or accept the administration of such drugs by authorized personnel
     3  as part of an assisted outpatient  treatment  program.  Such  order  may
     4  specify  the  type  and dosage range of such psychotropic drugs and such
     5  order  shall  be  effective for the duration of such assisted outpatient
     6  treatment.
     7    (5) If the petitioner is the director of a hospital that  operates  an
     8  assisted  outpatient treatment program, the court order shall direct the
     9  hospital director to provide or arrange for all categories  of  assisted
    10  outpatient  treatment  for the assisted outpatient throughout the period
    11  of the order. In all other instances, the order shall require the appro-
    12  priate director, as that term is defined in this section, to provide  or
    13  arrange  for  all  categories  of  assisted outpatient treatment for the
    14  assisted outpatient throughout the period of the order.   Orders  issued
    15  on  or  after the effective date of the chapter of the laws of two thou-
    16  sand eighteen that amended this section shall  require  the  appropriate
    17  director  "as  determined  by  the  program  coordinator"  to provide or
    18  arrange for all categories of  assisted  outpatient  treatment  for  the
    19  assisted outpatient throughout the period of the order.
    20    (6) The director shall cause a copy of any court order issued pursuant
    21  to  this section to be served personally, or by mail, facsimile or elec-
    22  tronic means, upon the assisted outpatient,  the  mental  hygiene  legal
    23  service  or  anyone  acting  on  the  assisted  outpatient's behalf, the
    24  original petitioner, identified service providers, and all others  enti-
    25  tled to notice under subdivision [(f)] (g) of this section.
    26    [(k)]  (l)  Relocation of assisted outpatients. The commissioner shall
    27  promulgate regulations requiring that, during the period of  the  order,
    28  an  assisted  outpatient  and any other appropriate persons shall notify
    29  the program coordinator within a reasonable time prior to such  assisted
    30  outpatient relocating within the state of New York to an area not served
    31  by  the  director  who  has  been directed to provide or arrange for the
    32  assisted outpatient treatment. Upon receiving notification of such relo-
    33  cation, the program coordinator shall redetermine  who  the  appropriate
    34  director shall be and cause a copy of the court order and treatment plan
    35  to be transmitted to such director.
    36    (m)  Petition  for  [additional  periods  of] continued treatment. (1)
    37  [Prior] Within thirty days prior to the expiration of an order  pursuant
    38  to  this  section,  the  appropriate  director  shall review whether the
    39  assisted outpatient continues to meet the criteria for  assisted  outpa-
    40  tient treatment. [If, as documented in the petition, the director deter-
    41  mines  that  such  criteria  continue  to be met or has made appropriate
    42  attempts to, but has not been successful in eliciting,  the  cooperation
    43  of  the subject to submit to an examination, within thirty days prior to
    44  the expiration of an order of assisted outpatient treatment, such direc-
    45  tor may petition the court to order continued assisted outpatient treat-
    46  ment pursuant to paragraph two of  this  subdivision.  Upon  determining
    47  whether such criteria continue to be met, such director shall notify the
    48  program  coordinator  in  writing as to whether a petition for continued
    49  assisted outpatient treatment is warranted and whether such  a  petition
    50  was  or will be filed.] Upon determining that one or more of such crite-
    51  ria are no longer met, such director shall notify the program  coordina-
    52  tor  in writing that a petition for continued assisted outpatient treat-
    53  ment is not warranted.  Upon determining that such criteria continue  to
    54  be  met,  he or she shall petition the court to order continued assisted
    55  outpatient treatment for a period not to exceed one year from the  expi-
    56  ration  date  of  the  current order. If the court's disposition of such

        S. 516--B                          11
     1  petition does not occur prior to the  expiration  date  of  the  current
     2  order,  the current order shall remain in effect until such disposition.
     3  The procedures for obtaining any  order  pursuant  to  this  subdivision
     4  shall  be in accordance with the provisions of the foregoing subdivision
     5  of this section; provided that the time restrictions included  in  para-
     6  graph  four  of subdivision (c) of this section shall not be applicable.
     7  The notice provisions set forth in paragraph six of subdivision  (k)  of
     8  this  section  shall  be  applicable. Any court order requiring periodic
     9  blood tests or urinalysis for the presence of alcohol or  illegal  drugs
    10  shall  be subject to review after six months by the physician who devel-
    11  oped the written treatment plan or another physician designated  by  the
    12  director, and such physician shall be authorized to terminate such blood
    13  tests or urinalysis without further action by the court.
    14    (2) Within thirty days prior to the expiration of an order of assisted
    15  outpatient  treatment,  [the  appropriate director or] the current peti-
    16  tioner, if the current petition was filed pursuant to  subparagraph  (i)
    17  or  (ii)  of paragraph one of subdivision [(e)] (f) of this section, and
    18  the current petitioner retains his or her original  status  pursuant  to
    19  the  applicable  subparagraph, may petition the court to order continued
    20  assisted outpatient treatment for a period not to exceed one  year  from
    21  the  expiration date of the current order. If the court's disposition of
    22  such petition does not occur prior to the expiration date of the current
    23  order, the current order shall remain in effect until such  disposition.
    24  The  procedures  for  obtaining  any  order pursuant to this subdivision
    25  shall be in accordance with the provisions of the foregoing subdivisions
    26  of this section; provided that the time restrictions included  in  para-
    27  graph  four  of subdivision (c) of this section shall not be applicable.
    28  The notice provisions set forth in paragraph six  of  subdivision  [(j)]
    29  (k) of this section shall be applicable. Any court order requiring peri-
    30  odic  blood  tests  or urinalysis for the presence of alcohol or illegal
    31  drugs shall be subject to review after six months by the  physician  who
    32  developed  the written treatment plan or another physician designated by
    33  the director, and such physician shall be authorized to  terminate  such
    34  blood tests or urinalysis without further action by the court.
    35    [(l)]  (3)  If  neither the appropriate director nor the current peti-
    36  tioner petition for continued assisted outpatient treatment pursuant  to
    37  this  paragraph  and  the  order  of the court expires, any other person
    38  authorized to petition pursuant to paragraph one of subdivision  (f)  of
    39  this section may bring a new petition for assisted outpatient treatment.
    40  If  such new petition is filed less than sixty days after the expiration
    41  of such order, the time  restrictions  provided  in  paragraph  four  of
    42  subdivision (c) of this section shall not be applicable to the new peti-
    43  tion.
    44    (4)  If, thirty days prior to the expiration of an order, the assisted
    45  outpatient is deemed by the  appropriate  director  to  be  missing  and
    46  thereby  unavailable for evaluation as to whether he or she continues to
    47  meet the criteria for assisted outpatient treatment, such director shall
    48  petition the court to extend the term of the current order  until  sixty
    49  days after such time as the assisted outpatient is located. If the court
    50  grants  the extension, the director shall continue reasonable efforts to
    51  locate the assisted outpatient.  Upon location of  the  assisted  outpa-
    52  tient, the director shall review whether the assisted outpatient contin-
    53  ues  to meet the criteria for assisted outpatient treatment, pursuant to
    54  paragraph two of this subdivision.
    55    (n) Petition for an order to stay, vacate or modify. (1)  In  addition
    56  to  any other right or remedy available by law with respect to the order

        S. 516--B                          12
     1  for assisted outpatient treatment, the assisted outpatient,  the  mental
     2  hygiene  legal  service,  or  anyone acting on the assisted outpatient's
     3  behalf may petition the court on notice to the  director,  the  original
     4  petitioner,  and  all  others entitled to notice under subdivision [(f)]
     5  (g) of this section to stay, vacate or modify the order.
     6    (2) The appropriate director shall petition  the  court  for  approval
     7  before instituting a proposed material change in the assisted outpatient
     8  treatment  plan,  unless  such  change is authorized by the order of the
     9  court.  Such petitions to change an assisted outpatient treatment  plan,
    10  as  well  as petitions for continued treatment, may be made to any judge
    11  of the supreme or county courts in the county in which  the  subject  of
    12  the petition is present or reasonably believed to be present. Such peti-
    13  tion  shall  be  filed on notice to all parties entitled to notice under
    14  subdivision [(f)] (g) of this section. Not later than  five  days  after
    15  receiving  such petition, excluding Saturdays, Sundays and holidays, the
    16  court shall hold a  hearing  on  the  petition;  provided  that  if  the
    17  assisted  outpatient  informs  the  court  that  he or she agrees to the
    18  proposed material change, the court may approve such  change  without  a
    19  hearing.  Non-material changes may be instituted by the director without
    20  court approval. For the purposes of this paragraph, a material change is
    21  an addition or deletion of a category of services to or from  a  current
    22  assisted  outpatient  treatment  plan,  or  any  deviation  without  the
    23  assisted outpatient's consent from the terms of a current order relating
    24  to the administration of psychotropic drugs.
    25    [(m)] (o) Appeals. Review of an order issued pursuant to this  section
    26  shall  be  had  in  like  manner  as  specified  in section 9.35 of this
    27  article; provided that notice shall be provided to all parties  entitled
    28  to notice under subdivision (g) of this section.
    29    [(n)]  (p) Failure to comply with assisted outpatient treatment. Where
    30  in the clinical judgment of a physician, (i)  the  assisted  outpatient,
    31  has  failed or refused to comply with the assisted outpatient treatment,
    32  (ii) efforts were made to solicit compliance, and  (iii)  such  assisted
    33  outpatient  may be in need of involuntary admission to a hospital pursu-
    34  ant to section 9.27 of this article or immediate observation,  care  and
    35  treatment  pursuant to section 9.39 or 9.40 of this article, such physi-
    36  cian may request the appropriate director  of  community  services,  the
    37  director's  designee,  or  any  physician  designated by the director of
    38  community services pursuant to section 9.37 of this article,  to  direct
    39  the  removal  of such assisted outpatient to an appropriate hospital for
    40  an examination to determine if such person  has  a  mental  illness  for
    41  which  he  or she is in need of hospitalization is necessary pursuant to
    42  section 9.27, 9.39 or  9.40  of  this  article[.  Furthermore,  if  such
    43  assisted outpatient refuses to take medications as required by the court
    44  order,  or he or she refuses to take, or fails a blood test, urinalysis,
    45  or alcohol or drug test as required by the court order,  such  physician
    46  may consider such refusal or failure when determining whether]; provided
    47  that  if, after efforts to solicit compliance, such physician determines
    48  that the assisted outpatient's  failure  to  comply  with  the  assisted
    49  outpatient  treatment includes a substantial failure to take medication,
    50  pass or submit to blood testing or urinalysis, or receive treatment  for
    51  alcohol or substance abuse, such physician may presume that the assisted
    52  outpatient  is  in need of an examination to determine whether he or she
    53  has a mental illness for which hospitalization is  necessary.  Upon  the
    54  request  of  such  physician,  the  appropriate director, the director's
    55  designee, or any physician designated pursuant to section 9.37  of  this
    56  article,  may  direct  peace  officers, acting pursuant to their special

        S. 516--B                          13
     1  duties, or police officers who  are  members  of  an  authorized  police
     2  department  or  force  or of a sheriff's department to take the assisted
     3  outpatient into custody and transport him or her to the hospital operat-
     4  ing the assisted outpatient treatment program or to any hospital author-
     5  ized by the director of community services to receive such persons. Such
     6  law  enforcement  officials  shall  carry  out  such directive. Upon the
     7  request of such physician,  the  appropriate  director,  the  director's
     8  designee,  or  any physician designated pursuant to section 9.37 of this
     9  article, an ambulance service, as defined by subdivision two of  section
    10  three  thousand  one  of  the  public  health law, or an approved mobile
    11  crisis outreach team as defined in section 9.58 of this article shall be
    12  authorized to take into custody and transport any  such  person  to  the
    13  hospital  operating the assisted outpatient treatment program, or to any
    14  other hospital authorized  by  the  appropriate  director  of  community
    15  services to receive such persons. Any director of community services, or
    16  designee,  shall  be  authorized  to  direct  the removal of an assisted
    17  outpatient who is present in his or her county to an appropriate  hospi-
    18  tal, in accordance with the provisions of this subdivision, based upon a
    19  determination  of the appropriate director of community services direct-
    20  ing the removal of such assisted outpatient pursuant  to  this  subdivi-
    21  sion.  Such  person  may be retained for observation, care and treatment
    22  and further examination in the hospital for up to seventy-two  hours  to
    23  permit a physician to determine whether such person has a mental illness
    24  and  is in need of involuntary care and treatment in a hospital pursuant
    25  to the provisions of this article. Any continued  involuntary  retention
    26  of  the assisted outpatient in such hospital beyond the initial seventy-
    27  two hour period shall be in accordance with the provisions of this arti-
    28  cle relating to the involuntary admission and retention of a person.  If
    29  at  any time during the seventy-two hour period the person is determined
    30  not to meet the involuntary admission and retention provisions  of  this
    31  article,  and  does  not agree to stay in the hospital as a voluntary or
    32  informal patient, he or she must be released. Failure to comply with  an
    33  order of assisted outpatient treatment shall not be grounds for involun-
    34  tary civil commitment or a finding of contempt of court.
    35    [(o)] (q) Effect of determination that a person is in need of assisted
    36  outpatient  treatment.  The determination by a court that a person is in
    37  need of assisted outpatient treatment  shall  not  be  construed  as  or
    38  deemed  to be a determination that such person is incapacitated pursuant
    39  to article eighty-one of this chapter.
    40    [(p)] (r) False petition. A person making a false statement or provid-
    41  ing false information or false testimony in a petition or hearing  under
    42  this  section shall be subject to criminal prosecution pursuant to arti-
    43  cle one hundred seventy-five or article two hundred  ten  of  the  penal
    44  law.
    45    [(q)]  (s)  Exception.  Nothing  in this section shall be construed to
    46  affect the ability of the director of a hospital to receive,  admit,  or
    47  retain  patients  who  otherwise  meet  the  provisions  of this article
    48  regarding receipt, retention or admission.
    49    [(r)] (t) Education and training. (1) The office [of  mental  health],
    50  in  consultation  with the office of court administration, shall prepare
    51  educational and training materials on the use  of  this  section,  which
    52  shall  be  made  available  to  local  governmental  units, providers of
    53  services, judges, court personnel, law  enforcement  officials  and  the
    54  general public.
    55    (2)  The  office,  in  consultation  with the office of court adminis-
    56  tration, shall establish a mental health training  program  for  supreme

        S. 516--B                          14
     1  and  county  court  judges  and  court personnel, and shall provide such
     2  training with such frequency and in such locations as may be appropriate
     3  to meet statewide needs.  Such training shall focus on the use  of  this
     4  section  and  generally  address  issues  relating to mental illness and
     5  mental health treatment.
     6    § 6. Section 29.15 of the mental hygiene law is amended  by  adding  a
     7  new subdivision (o) to read as follows:
     8    (o)  If  the  director  of a department facility does not petition for
     9  assisted outpatient treatment pursuant to section 9.60 of  this  chapter
    10  upon  the  discharge  of an inpatient admitted pursuant to section 9.27,
    11  9.39 or 9.40 of this chapter, or upon the  expiration  of  a  period  of
    12  conditional  release for such inpatient, such director shall report such
    13  discharge or such expiration in writing to  the  director  of  community
    14  services  of  the  local  governmental  unit  in  which the inpatient is
    15  expected to reside.
    16    § 7. Subdivision 3 of section 404 of the correction law, as  added  by
    17  chapter  1  of  the  laws of 2013, is amended and a new subdivision 5 is
    18  added to read as follows:
    19    3. Within a reasonable period prior to discharge of an inmate  commit-
    20  ted  from a [state correctional facility from a] hospital in the depart-
    21  ment of mental hygiene to the community, the director shall ensure  that
    22  a clinical assessment has been completed to determine whether the inmate
    23  meets  the criteria for assisted outpatient treatment pursuant to subdi-
    24  vision (c) of section 9.60 of the mental hygiene law. If, as a result of
    25  such assessment, the director determines  that  the  inmate  meets  such
    26  criteria,  prior  to discharge the director of the hospital shall either
    27  petition for a court order  pursuant  to  section  9.60  of  the  mental
    28  hygiene  law, or report in writing to the director of community services
    29  of the local governmental unit in which the inmate is expected to reside
    30  so that an investigation [may] shall be conducted  pursuant  to  section
    31  9.47 of the mental hygiene law.
    32    5.  Within  a  reasonable  period  prior to release or discharge of an
    33  inmate who is not currently committed to a hospital in the department of
    34  mental hygiene from a state correctional facility to the  community,  if
    35  such  inmate  has  a serious mental illness pursuant to paragraph (e) of
    36  subdivision six of section one hundred thirty-seven of this chapter, the
    37  department shall notify the director of a hospital who shall ensure that
    38  a clinical assessment has been completed to determine whether the inmate
    39  meets the criteria for assisted outpatient treatment pursuant to  subdi-
    40  vision (c) of section 9.60 of the mental hygiene law. If, as a result of
    41  such  assessment,  the  director  determines  that the inmate meets such
    42  criteria, prior to release or discharge, the director  of  the  hospital
    43  shall  either petition for a court order pursuant to section 9.60 of the
    44  mental hygiene law, or report in writing to the  director  of  community
    45  services  of the local governmental unit in which the inmate is expected
    46  to reside so that  an  investigation  shall  be  conducted  pursuant  to
    47  section 9.47 of the mental hygiene law.
    48    §  8.  Section  18  of  chapter  408 of the laws of 1999, constituting
    49  Kendra's Law, as amended by chapter 67 of the laws of 2017,  is  amended
    50  to read as follows:
    51    §  18.  This  act shall take effect immediately, provided that section
    52  fifteen of this act shall take effect April 1, 2000, provided,  further,
    53  that  subdivision (e) of section 9.60 of the mental hygiene law as added
    54  by section six of this act shall be effective 90  days  after  this  act
    55  shall become law[; and that this act shall expire and be deemed repealed
    56  June 30, 2022].

        S. 516--B                          15
     1    § 9. Severability. If any clause, sentence, paragraph, section or part
     2  of  this act shall be adjudged by any court of competent jurisdiction to
     3  be invalid, and after exhaustion of all  further  judicial  review,  the
     4  judgment  shall  not affect, impair or invalidate the remainder thereof,
     5  but  shall  be  confined in its operation to the clause, sentence, para-
     6  graph, section or part thereof directly involved in the controversy.
     7    § 10.  This act shall take effect immediately.
feedback