A06987 Summary:

BILL NO    A06987B

SAME AS    SAME AS S04881-B

SPONSOR    Gunther

COSPNSR    Maisel, Zebrowski, Reilly, Calhoun, Thiele, Gabryszak, Weisenberg,
           Schimel, Robinson, Paulin, Jaffee, Roberts, Latimer, Englebright,
           Cook

MLTSPNSR   Abbate, Abinanti, Arroyo, Boyland, Castelli, Ceretto, Conte, Crouch,
           DenDekker, Dinowitz, Goodell, Jeffries, Johns, Jordan, Lupardo,
           Markey, McDonough, McEneny, Meng, Miller D, Millman, Palmesano,
           Perry, Pretlow, Rabbitt, Raia, Saladino, Tenney, Titone

Amd SS7.17, 9.47, 9.48, 9.60 & 29.15, Ment Hyg L; amd S404, Cor L; amd S18,
Chap 408 of 1999

Enhances the assisted outpatient treatment program; eliminates the expiration
and repeal of Kendra's Law.
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A06987 Actions:

BILL NO    A06987B

04/07/2011 referred to mental health
01/04/2012 referred to mental health
05/07/2012 amend (t) and recommit to mental health
05/07/2012 print number 6987a
06/12/2012 amend and recommit to mental health
06/12/2012 print number 6987b
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A06987 Votes:

There are no votes for this bill in this legislative session.
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A06987 Memo:

BILL NUMBER:A6987B

TITLE  OF  BILL:    An  act  to  amend  the  mental  hygiene law and the
correction law, in relation to enhancing the assisted outpatient  treat-
ment  program;  and  to  amend  Kendra's  Law, in relation to making the
provisions thereof permanent

PURPOSE OR GENERAL IDEA OF BILL:  To improve care for people with  seri-
ous mental illness, and protect the safety of patients and the public by
streamlining  and  improving  New  York's  Assisted Outpatient Treatment
(AOT) program (Kendra's Law).

SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Mental Hygiene Law (MHL) S 7.17(f) to require that  AOT
program coordinators: monitor local programs to ensure that expiring AOT
orders  are  adequately  reviewed  to consider the need for renewal; and
monitor local needs for training of judges and court personnel to ensure
that the office of mental health adequately provides such training.

Section 2 provides that an educational pamphlet on AOT shall  be  devel-
oped  and distributed to family members of persons who may be in need of
AOT

Section 3 clarifies  that  directors  of  community  services  shall  be
responsible  for  ensuring that reports of persons who may be in need of
continued AOT orders are subject to  a  timely  investigation.  It  also
provides that directors of community services shall notify program coor-
dinators  when  AOT  patients  cannot be located or are believed to have
taken residence outside of the local governmental unit served.

Section 4 amends MHL, S 9.48 to  require  that  AOT  program  directors'
quarterly  reports  to  program  coordinators include information on any
expired AOT court orders, including the determination made as to whether
to petition for renewal, the  basis  for  such  determination,  and  the
court's disposition of the renewal petition, if any.

Section  5  amends MHL S 9.60 to clarify that assisted outpatient treat-
ment services provided may  include:  medication  education  or  symptom
management  education;  appointment  of a representative payee; and that
tests for alcohol or drugs may be random. Also provides that the parties
to the treatment order may stipulate, upon mutual consent, that an exam-
ining physician need not testify  in  court.  Also,  provides  that  the
appointed  physician  shall  make a reasonable effort to gather relevant
information for the development of a treatment plan  from  a  member  or
members of the patient's family or significant other.

This  section  also clarifies that directors of hospitals or superinten-
dents of correctional facilities may initiate a petition.

This section also provides that the Commissioner will establish a proce-
dure to ensure that reports of persons who may be in need  of  AOT  that

are  made  by  family  and  community  members  of  such  person are, if
warranted, investigated in a timely manner, and that ROT  petitions  are
filed, where appropriate.

This section also provides that the, Commissioner shall promulgate regu-
lations  to  require  that  prior to a assisted outpatient relocating to
within the state of New York to a location not  served  by  his  or  her
current  director of community services, that patient or other appropri-
ate party must notify the program coordinator. The  program  coordinator
shall  then redetermine who the appropriate director shall be, and cause
a copy of the court order and treatment plan to be  transmitted  to  the
new director.

This  section  also  provides  that  a director shall review whether the
assisted outpatient continues to meet ROT criteria within 30 days before
the expiration of an order for ACT. If the director determines that such
assisted outpatient no longer  meets  the  criteria,  such  director  is
required  to  give notice to the program coordinator that a petition for
continued AOT is  unnecessary.  However,  if  such  assisted  outpatient
continues  to  meet  the  criteria,  as determined by the director, such
director shall file a petition for continued treatment.

This provision clarifies procedures any other person authorized to peti-
tion for continued AOT may use to bring such petition in the event  that
the  appropriate  director  or  current petitioner does not petition for
continued AOT prior to the expiration of the court order.

This section also provides that counties  shall  notify  the  department
when  an  assisted  outpatient is missing and thereby unavailable for an
evaluation as to whether he or she continues to meet  AOT  criteria.  It
also  provides  that  when  a patient is missing upon expiration date of
order, that the order shall be extended  until  sixty  days  after  such
patient is found.

Section  6  amends MHL S 29.15: if the director of the hospital does not
petition for AOT upon the discharge of an involuntarily committed  inpa-
tient or upon the expiration of a period of conditional release for such
inpatient,  such  director  shall report the discharge in writing to the
director of community services of the local government  unit  where  the
inpatient is expected to reside.

Section  7  amends subdivision I of section 404 of the correction law to
require that, prior to discharging an inmate who is still mentally  ill,
the  director  shall,  where  appropriate,  either  apply for a person's
admission to a hospital for care and treatment, or initiate  a  petition
for  an  order authorizing assisted outpatient treatment, or the commis-
sioner may apply for the person's admission to a secure treatment facil-
ity.

Section 8 would repeal the current sunset date to make the provisions of
Kendra's Law permanent.

Section 9 Severability.

Section 10 states that this act shall take effect immediately.

JUSTIFICATION:  In 1999, the legislature enacted "Kendra's Law,': estab-
lishing  a  statewide  court-ordered assisted outpatient treatment (AOT)
program to improve outcomes for persons with severe mental illness  who,
in view of their treatment history and present circumstances, are likely
to  have  difficulty  living safely in the community. At the approach of
the law's original 2005 expiration date, the legislature  took  note  of
Office  of Mental Health (OMR) research documenting declines in rates of
homelessness, hospitalization, substance  abuse,  alcoholism,  violence,
arrest  and incarceration, and documented increases in treatment compli-
ance, service engagement and positive consumer perceptions. In 2005, the
legislature opted to extend Kendra's Law for an additional five years to
further evaluate the program.

On June 30, 2009, a team of independent researchers released the  report
of  their  long term study of AOT throughout New York State and in Octo-
ber, 2010 Psychiatric Services published six peer  reviewed  studies  on
the  AOT  program.  These  reports  confirm  the earlier OMH data. These
studies found patients given mandatory  outpatient  treatment  who  were
more  violent  to  begin with - were nevertheless four times less likely
than members of the control group to perpetrate serious  violence  after
undergoing assisted outpatient treatment and found less frequent psychi-
atric hospitalizations, shorter length of hospitalizations, reduction in
the likelihood of arrest, higher social functioning, slightly less stig-
ma and no increase in perceived coercion. AOT stimulates service provid-
ers  efforts  to  prioritize care for AOT recipients; judges hearing AOT
cases could benefit  from  additional  AOT  training;  counties  favored
increasing  the availability of stipulations to reduce the court burden,
costs, and transportation burdens; recipients are far more  likely  than
other  patients  to consistently receive psychotropic medications appro-
priate to their psychiatric condition; that those who  receive  AOT  for
periods  of at least one year are more likely than those who receive AOT
for shorter periods to sustain gains after leaving the program; that the
law has been applied in a non-discriminatory manner; and that the  court
order  itself,  in  addition  to high quality services, is a significant
factor in the program's success.

The experience of thousands of patients, treatment providers  and  fami-
lies  who  have utilized Kendra's Law since 1999, point to several areas
where the law should be  improved  to  achieve  costs  savings,  promote
smoother  functioning  of the AOT program and easier access to those who
stand to benefit from it.  The  amendments  included  in  this  act  are
intended  to reflect these findings and maximize the unique potential of
this legislation to simultaneously  serve  the  goals  of  compassionate
care, fiscal responsibility, and public safety.

PRIOR LEGISLATIVE HISTORY:  New Bill.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE:  This act shall take effect immediately.
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A06987 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                        6987--B

                              2011-2012 Regular Sessions

                                 I N  A S S E M B L Y

                                     April 7, 2011
                                      ___________

       Introduced  by  M.  of  A.  GUNTHER, MAISEL, ZEBROWSKI, REILLY, CALHOUN,
         THIELE, GABRYSZAK,  WEISENBERG,  SCHIMEL,  ROBINSON,  PAULIN,  JAFFEE,
         ROBERTS,  LATIMER, ENGLEBRIGHT, COOK -- Multi-Sponsored by -- M. of A.
         ABBATE, ABINANTI, ARROYO, BOYLAND, CASTELLI, CERETTO,  CONTE,  CROUCH,
         DenDEKKER,   DINOWITZ,  GOODELL,  JEFFRIES,  JOHNS,  JORDAN,  LUPARDO,
         MARKEY,  McDONOUGH,  McENENY,  MENG,  D. MILLER,  MILLMAN,  PALMESANO,
         PERRY,  PRETLOW,  RABBITT, RAIA, SALADINO, TENNEY, TITONE -- read once
         and referred to the Committee on Mental Health -- recommitted  to  the
         Committee  on Mental Health in accordance with Assembly Rule 3, sec. 2
         -- committee discharged, bill amended, ordered  reprinted  as  amended
         and  recommitted to said committee -- again reported from said commit-
         tee with amendments, 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;
   14    (iv)  that  a  mechanism  exists  for  such case manager, or assertive
   15  community treatment team, to regularly report the assisted  outpatient's

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10473-12-2
       A. 6987--B                          2

    1  compliance, or lack of compliance with treatment, to the director of the
    2  assisted outpatient treatment program;
    3    (v)  that directors of community services establish procedures [which]
    4  THAT provide that reports of persons who may  be  in  need  of  assisted
    5  outpatient  treatment are appropriately investigated in a timely manner;
    6  [and]
    7    (vi) that assisted outpatient treatment services are  delivered  in  a
    8  timely manner[.];
    9    (VII)  THAT,  PRIOR TO THE EXPIRATION OF ASSISTED OUTPATIENT TREATMENT
   10  ORDERS, THE  CLINICAL  NEEDS  OF  ASSISTED  OUTPATIENTS  ARE  ADEQUATELY
   11  REVIEWED  IN  DETERMINING  THE  NEED  TO PETITION FOR CONTINUED ASSISTED
   12  OUTPATIENT TREATMENT PURSUANT TO SUBDIVISION (M) OF SECTION 9.60 OF THIS
   13  TITLE;
   14    (VIII) THAT THE APPROPRIATE DIRECTOR IS DETERMINED FOR  EACH  ASSISTED
   15  OUTPATIENT, PURSUANT TO SUBDIVISIONS (K) AND (L) OF SECTION 9.60 OF THIS
   16  TITLE; AND
   17    (IX)  THAT  THE OFFICE FULFILLS ITS DUTIES PURSUANT TO SUBDIVISION (T)
   18  OF SECTION 9.60 OF THIS TITLE TO MEET LOCAL NEEDS FOR TRAINING OF JUDGES
   19  AND COURT PERSONNEL.
   20    S 2. Subdivision (f) of section 7.17 of  the  mental  hygiene  law  is
   21  amended by adding a new paragraph 5 to read as follows:
   22    (5)  THE  COMMISSIONER  SHALL  DEVELOP  AN EDUCATIONAL PAMPHLET ON THE
   23  PROCESS OF PETITIONING FOR ASSISTED  OUTPATIENT  TREATMENT  FOR  DISSEM-
   24  INATION  TO  INDIVIDUALS SEEKING TO SUBMIT REPORTS OF PERSONS WHO MAY BE
   25  IN NEED OF ASSISTED OUTPATIENT TREATMENT,  AND  INDIVIDUALS  SEEKING  TO
   26  FILE A PETITION PURSUANT TO SUBPARAGRAPH (I) OR (II) OF PARAGRAPH ONE OF
   27  SUBDIVISION  (F)  OF SECTION 9.60 OF THIS TITLE. SUCH PAMPHLET SHALL SET
   28  FORTH, IN PLAIN LANGUAGE: THE CRITERIA FOR  ASSISTED  OUTPATIENT  TREAT-
   29  MENT,  RESOURCES  AVAILABLE TO SUCH INDIVIDUALS, THE RESPONSIBILITIES OF
   30  PROGRAM COORDINATORS AND DIRECTORS OF COMMUNITY SERVICES, A  SUMMARY  OF
   31  CURRENT  LAW,  THE PROCESS FOR PETITIONING FOR CONTINUED ASSISTED OUTPA-
   32  TIENT TREATMENT, AND OTHER SUCH INFORMATION THE COMMISSIONER  DETERMINES
   33  TO BE PERTINENT.
   34    S  3.    Subdivision (b) of section 9.47 of the mental hygiene law, as
   35  amended by chapter 158 of the laws  of  2005,  is  amended  to  read  as
   36  follows:
   37    (b) All directors of community services shall be responsible for:
   38    (1) receiving reports of persons who may be in need of assisted outpa-
   39  tient treatment PURSUANT TO SECTION 9.60 OF THIS ARTICLE and documenting
   40  the receipt date of such reports;
   41    (2) conducting timely investigations of such reports RECEIVED PURSUANT
   42  TO  PARAGRAPH  ONE OF THIS SUBDIVISION and providing written notice upon
   43  the completion of investigations to reporting persons and program  coor-
   44  dinators,  appointed  by the commissioner [of mental health] pursuant to
   45  subdivision (f) of section 7.17  of  this  title,  and  documenting  the
   46  initiation  and completion dates of such investigations and the disposi-
   47  tions;
   48    (3) filing of petitions for assisted outpatient treatment pursuant  to
   49  [paragraph] SUBPARAGRAPH (vii) of PARAGRAPH ONE OF subdivision [(e)] (F)
   50  of  section  9.60  of  this article, and documenting the petition filing
   51  [date] DATES and the [date] DATES of the court [order] ORDERS;
   52    (4) coordinating the timely delivery of court  ordered  services  with
   53  program coordinators and documenting the date assisted outpatients begin
   54  to receive the services mandated in the court order; [and]
       A. 6987--B                          3

    1    (5) NOTIFYING PROGRAM COORDINATORS WHEN ASSISTED OUTPATIENTS CANNOT BE
    2  LOCATED AFTER REASONABLE EFFORTS OR ARE BELIEVED TO HAVE TAKEN RESIDENCE
    3  OUTSIDE OF THE LOCAL GOVERNMENTAL UNIT SERVED; AND
    4    (6)  reporting on a quarterly basis to program coordinators the infor-
    5  mation collected pursuant to this subdivision.
    6    S 4.  Paragraphs (viii) and (ix) of subdivision (b) of section 9.48 of
    7  the mental hygiene law are renumbered paragraphs (ix) and (x) and a  new
    8  paragraph (viii) is added to read as follows:
    9    (VIII)  AN  ACCOUNT  OF  ANY COURT ORDER EXPIRATION, INCLUDING BUT NOT
   10  LIMITED TO THE DIRECTOR'S DETERMINATION AS TO WHETHER  TO  PETITION  FOR
   11  CONTINUED  ASSISTED  OUTPATIENT  TREATMENT,  PURSUANT TO SECTION 9.60 OF
   12  THIS ARTICLE, THE BASIS FOR SUCH DETERMINATION, AND THE  DISPOSITION  OF
   13  ANY SUCH PETITION;
   14    S 5. Section 9.60 of the mental hygiene law, as amended by chapter 158
   15  of  the  laws  of  2005,  paragraph  1  of subdivision (a) as amended by
   16  section 1 of part E of chapter 111 of the laws of 2010, paragraph  5  of
   17  subdivision  (c)  as  amended  by  chapter  137  of the laws of 2005, is
   18  amended to read as follows:
   19  S 9.60 Assisted outpatient treatment.
   20    (a) Definitions. For purposes of this  section,  the  following  defi-
   21  nitions shall apply:
   22    (1)  "assisted  outpatient  treatment" shall mean categories of outpa-
   23  tient services [which] THAT have been ordered by the court  pursuant  to
   24  this  section.  Such treatment shall include case management services or
   25  assertive community treatment team  services  to  provide  care  coordi-
   26  nation,  and  may  also  include  any  of  the  following  categories of
   27  services: medication SUPPORT; MEDICATION EDUCATION OR SYMPTOM MANAGEMENT
   28  EDUCATION; periodic blood tests or urinalysis  to  determine  compliance
   29  with prescribed medications; individual or group therapy; day or partial
   30  day  programming  activities;  educational  and  vocational  training or
   31  activities; APPOINTMENT OF A REPRESENTATIVE  PAYEE  OR  OTHER  FINANCIAL
   32  MANAGEMENT  SERVICES,  SUBJECT  TO FINAL APPROVAL OF THE SOCIAL SECURITY
   33  ADMINISTRATION, WHERE APPLICABLE; alcohol or substance  abuse  treatment
   34  and  counseling and periodic OR RANDOM tests for the presence of alcohol
   35  or illegal drugs for persons with a  history  of  alcohol  or  substance
   36  abuse; supervision of living arrangements; and any other services within
   37  a  local  services  plan developed pursuant to article forty-one of this
   38  chapter, CLINICAL OR NON-CLINICAL,  prescribed  to  treat  the  person's
   39  mental illness and to assist the person in living and functioning in the
   40  community,  or to attempt to prevent a relapse or deterioration that may
   41  reasonably be predicted to result in [suicide] SERIOUS PHYSICAL HARM  TO
   42  ANY PERSON or the need for hospitalization.
   43    (2)  "director"  shall  mean  the  director of community services of a
   44  local governmental unit, or the director of a hospital licensed or oper-
   45  ated by the office of mental health which operates, directs  and  super-
   46  vises an assisted outpatient treatment program.
   47    (3)  "director  of  community  services" and "local governmental unit"
   48  shall have the same meanings as provided in article  forty-one  of  this
   49  chapter.
   50    (4)  "assisted  outpatient  treatment  program" shall mean a system to
   51  arrange for and coordinate the provision of assisted  outpatient  treat-
   52  ment, to monitor treatment compliance by assisted outpatients, to evalu-
   53  ate  the condition or needs of assisted outpatients, to take appropriate
   54  steps to address the needs of such individuals, and to ensure compliance
   55  with court orders.
       A. 6987--B                          4

    1    (5) "assisted outpatient" shall mean the person under a court order to
    2  receive assisted outpatient treatment.
    3    (6)  "subject  of the petition" or "subject" shall mean the person who
    4  is alleged in a petition, filed  pursuant  to  the  provisions  of  this
    5  section, to meet the criteria for assisted outpatient treatment.
    6    (7)  "correctional  facility"  and "local correctional facility" shall
    7  have the same meanings as provided in section two of the correction law.
    8    (8) "health care proxy" and "health care agent" shall  have  the  same
    9  meanings as provided in article twenty-nine-C of the public health law.
   10    (9)  "program  coordinator"  shall mean an individual appointed by the
   11  commissioner [of mental health], pursuant to subdivision (f) of  section
   12  7.17  of this chapter, who is responsible for the oversight and monitor-
   13  ing of assisted outpatient treatment programs.
   14    (b) Programs. The director of community services of each local govern-
   15  mental unit shall operate, direct and supervise an  assisted  outpatient
   16  treatment  program.  The  director of a hospital licensed or operated by
   17  the office [of mental health]  may  operate,  direct  and  supervise  an
   18  assisted  outpatient treatment program, upon approval by the commission-
   19  er. Directors of community services shall be permitted  to  satisfy  the
   20  provisions  of  this subdivision through the operation of joint assisted
   21  outpatient treatment programs. Nothing  in  this  subdivision  shall  be
   22  interpreted  to  preclude  the  combination  or  coordination of efforts
   23  between and among local governmental units and  hospitals  in  providing
   24  and coordinating assisted outpatient treatment.
   25    (c)  Criteria.  A person may be ordered to receive assisted outpatient
   26  treatment if the court finds that such person:
   27    (1) is eighteen years of age or older; and
   28    (2) is suffering from a mental illness; and
   29    (3) is unlikely to survive safely  in  the  community  without  super-
   30  vision, based on a clinical determination; and
   31    (4)  has  a  history  of  lack of compliance with treatment for mental
   32  illness that has:
   33    (i) [prior to the filing of the petition,] at least twice  within  the
   34  [last]  thirty-six  months  PRIOR  TO  THE FILING OF THE PETITION been a
   35  significant factor in necessitating hospitalization in  a  hospital,  or
   36  receipt  of  services  in  a  forensic  or other mental health unit of a
   37  correctional facility or a local correctional facility[, not including];
   38  PROVIDED THAT SUCH THIRTY-SIX MONTH PERIOD  SHALL  BE  EXTENDED  BY  THE
   39  LENGTH  OF  any current period[, or period ending] OF HOSPITALIZATION OR
   40  INCARCERATION, AND ANY SUCH  PERIOD  THAT  ENDED  within  the  last  six
   41  months[,  during  which the person was or is hospitalized or incarcerat-
   42  ed]; or
   43    (ii) WITHIN FORTY-EIGHT MONTHS prior to the filing  of  the  petition,
   44  resulted  in one or more acts of serious violent behavior toward self or
   45  others or threats of, or attempts at, serious physical harm to  self  or
   46  others  [within  the  last  forty-eight months, not including]; PROVIDED
   47  THAT SUCH FORTY-EIGHT MONTH PERIOD SHALL BE EXTENDED BY  THE  LENGTH  OF
   48  any  current period[, or period ending] OF HOSPITALIZATION OR INCARCERA-
   49  TION, AND ANY SUCH PERIOD THAT ENDED within the  last  six  months[,  in
   50  which the person was or is hospitalized or incarcerated]; and
   51    (5)  is,  as a result of his or her mental illness, unlikely to volun-
   52  tarily participate in outpatient treatment that would enable him or  her
   53  to live safely in the community; and
   54    (6)  in  view of his or her treatment history and current behavior, is
   55  in need of assisted outpatient treatment in order to prevent  a  relapse
       A. 6987--B                          5

    1  or  deterioration which would be likely to result in serious harm to the
    2  person or others as defined in section 9.01 of this article; and
    3    (7) is likely to benefit from assisted outpatient treatment.
    4    (d) Health care proxy. Nothing in this section shall preclude a person
    5  with  a  health  care proxy from being subject to a petition pursuant to
    6  this chapter and consistent with article  twenty-nine-C  of  the  public
    7  health law.
    8    (e)  INVESTIGATION OF REPORTS. THE COMMISSIONER SHALL PROMULGATE REGU-
    9  LATIONS ESTABLISHING A PROCEDURE TO ENSURE THAT REPORTS OF A PERSON  WHO
   10  MAY  BE  IN  NEED  OF  ASSISTED  OUTPATIENT  TREATMENT,  INCLUDING THOSE
   11  RECEIVED FROM FAMILY AND COMMUNITY MEMBERS OF SUCH PERSON, ARE  INVESTI-
   12  GATED IN A TIMELY MANNER AND, WHERE APPROPRIATE, RESULT IN THE FILING OF
   13  PETITIONS FOR ASSISTED OUTPATIENT TREATMENT.
   14    (F)  Petition  to  the  court. (1) A petition for an order authorizing
   15  assisted outpatient treatment may be filed  in  the  supreme  or  county
   16  court  in  the county in which the subject of the petition is present or
   17  reasonably believed to be present. Such petition may be  initiated  only
   18  by the following persons:
   19    (i) any person eighteen years of age or older with whom the subject of
   20  the petition resides; or
   21    (ii)  the  parent,  spouse, sibling eighteen years of age or older, or
   22  child eighteen years of age or older of the subject of the petition; or
   23    (iii) the director of a hospital in which the subject of the  petition
   24  is hospitalized; or
   25    (iv)  the director of any public or charitable organization, agency or
   26  home providing mental health services to the subject of the petition  or
   27  in whose institution the subject of the petition resides; or
   28    (v)  a  qualified psychiatrist who is either supervising the treatment
   29  of or treating the subject of the petition for a mental illness; or
   30    (vi) a psychologist, licensed pursuant to article one  hundred  fifty-
   31  three  of  the  education  law, or a social worker, licensed pursuant to
   32  article one hundred fifty-four of the education law, who is treating the
   33  subject of the petition for a mental illness; or
   34    (vii) the director of community services, or his or her  designee,  or
   35  the  social services official, as defined in the social services law, of
   36  the city or county in which the subject of the petition  is  present  or
   37  reasonably believed to be present; or
   38    (viii) a parole officer or probation officer assigned to supervise the
   39  subject of the petition[.]; OR
   40    (IX)  THE  DIRECTOR OF THE HOSPITAL OR THE SUPERINTENDENT OF A CORREC-
   41  TIONAL FACILITY IN WHICH THE SUBJECT  OF  THE  PETITION  IS  IMPRISONED,
   42  PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE CORRECTION LAW.
   43    (2)  THE  COMMISSIONER  SHALL PROMULGATE REGULATIONS PURSUANT TO WHICH
   44  PERSONS INITIATING A PETITION, PURSUANT TO SUBPARAGRAPHS (I) AND (II) OF
   45  PARAGRAPH ONE OF THIS SUBDIVISION, MAY RECEIVE ASSISTANCE IN FILING SUCH
   46  PETITIONS, WHERE APPROPRIATE, AS DETERMINED PURSUANT TO SUBDIVISION  (E)
   47  OF THIS SECTION.
   48    (3) The petition shall state:
   49    (i)  each  of  the  criteria  for assisted outpatient treatment as set
   50  forth in subdivision (c) of this section;
   51    (ii) facts which support the petitioner's belief that the  subject  of
   52  the  petition  meets  each  criterion,  provided that the hearing on the
   53  petition need not be limited to the stated facts; and
   54    (iii) that the subject of the petition is present,  or  is  reasonably
   55  believed to be present, within the county where such petition is filed.
       A. 6987--B                          6

    1    [(3)] (4) The petition shall be accompanied by an affirmation or affi-
    2  davit of a physician, who shall not be the petitioner, stating THAT SUCH
    3  PHYSICIAN  IS WILLING AND ABLE TO TESTIFY AT THE HEARING ON THE PETITION
    4  AND THAT either [that]:
    5    (i) such physician has personally examined the subject of the petition
    6  no  more  than  ten  days prior to the submission of the petition[,] AND
    7  recommends assisted outpatient treatment for the subject  of  the  peti-
    8  tion[,  and  is  willing and able to testify at the hearing on the peti-
    9  tion]; or
   10    (ii) no more than ten days prior to the filing of the  petition,  such
   11  physician  or  his or her designee has made appropriate attempts but has
   12  not been successful in eliciting the cooperation of the subject  of  the
   13  petition  to  submit  to  an  examination,  such physician has reason to
   14  suspect that the subject of the petition meets the criteria for assisted
   15  outpatient treatment, and such physician is willing and able to  examine
   16  the subject of the petition [and testify at the hearing on the petition]
   17  PRIOR TO PROVIDING TESTIMONY.
   18    [(4)]  (5)  In  counties  with  a population of less than seventy-five
   19  thousand, the affirmation or affidavit  required  by  paragraph  [three]
   20  FOUR  of  this subdivision may be made by a physician who is an employee
   21  of the office.  The office is authorized AND DIRECTED to make available,
   22  at no cost to the county, a  qualified  physician  for  the  purpose  of
   23  making  such  affirmation or affidavit consistent with the provisions of
   24  such paragraph.
   25    [(f)] (G) Service. The petitioner shall cause written  notice  of  the
   26  petition  to  be given to the subject of the petition and a copy thereof
   27  to be given personally or by mail to the persons listed in section  9.29
   28  of this article, the mental hygiene legal service, the health care agent
   29  if  any  such  agent is known to the petitioner, the appropriate program
   30  coordinator, and the appropriate director of community services, if such
   31  director is not the petitioner.
   32    [(g)] (H) Right to counsel. The subject of the petition shall have the
   33  right to be represented by the mental hygiene legal service, or private-
   34  ly financed counsel, at all stages of a proceeding commenced under  this
   35  section.
   36    [(h)]  (I)  Hearing. (1) Upon receipt of the petition, the court shall
   37  fix the date for a hearing. Such date shall be no later than three  days
   38  from  the  date such petition is received by the court, excluding Satur-
   39  days, Sundays and holidays. Adjournments shall  be  permitted  only  for
   40  good cause shown. In granting adjournments, the court shall consider the
   41  need  for  further  examination  by a physician or the potential need to
   42  provide assisted outpatient treatment  expeditiously.  The  court  shall
   43  cause  the  subject  of  the petition, any other person receiving notice
   44  pursuant to subdivision [(f)] (G) of this section, the  petitioner,  the
   45  physician  whose  affirmation or affidavit accompanied the petition, and
   46  such other persons as the court may determine  to  be  advised  of  such
   47  date.  Upon  such  date, or upon such other date to which the proceeding
   48  may be adjourned, the court shall hear testimony and, if  it  be  deemed
   49  advisable  and  the  subject  of  the petition is available, examine the
   50  subject of the petition in or out of court. If the subject of the  peti-
   51  tion  does not appear at the hearing, and appropriate attempts to elicit
   52  the attendance of the subject have failed, the  court  may  conduct  the
   53  hearing  in  the  subject's  absence.  In such case, the court shall set
   54  forth the factual basis for conducting the hearing without the  presence
   55  of the subject of the petition.
       A. 6987--B                          7

    1    (2)  The court shall not order assisted outpatient treatment unless an
    2  examining physician, who recommends assisted  outpatient  treatment  and
    3  has  personally  examined  the  subject of the petition no more than ten
    4  days before the filing of the petition, testifies in person at the hear-
    5  ing.  Such  physician  shall state the facts and clinical determinations
    6  which support the allegation that the subject of the petition meets each
    7  of the criteria for assisted outpatient  treatment;  PROVIDED  THAT  THE
    8  PARTIES MAY STIPULATE, UPON MUTUAL CONSENT, THAT SUCH PHYSICIAN NEED NOT
    9  TESTIFY.
   10    (3)  If  the  subject  of the petition has refused to be examined by a
   11  physician, the court may request the subject to consent to  an  examina-
   12  tion  by a physician appointed by the court. If the subject of the peti-
   13  tion does not consent and the court finds reasonable  cause  to  believe
   14  that the allegations in the petition are true, the court may order peace
   15  officers,  acting  pursuant  to their special duties, or police officers
   16  who are members of an authorized police department or  force,  or  of  a
   17  sheriff's  department  to  take the subject of the petition into custody
   18  and transport him or her to a hospital for examination by  a  physician.
   19  Retention  of  the  subject  of  the petition under such order shall not
   20  exceed twenty-four hours. The examination of the subject of the petition
   21  may be performed by the physician whose affirmation or affidavit  accom-
   22  panied the petition pursuant to paragraph three of subdivision [(e)] (F)
   23  of  this  section,  if  such physician is privileged by such hospital or
   24  otherwise authorized by such hospital to do so. If such  examination  is
   25  performed by another physician, the examining physician may consult with
   26  the physician whose affirmation or affidavit accompanied the petition as
   27  to whether the subject meets the criteria for assisted outpatient treat-
   28  ment.
   29    (4) A physician who testifies pursuant to paragraph two of this subdi-
   30  vision  shall  state:  (i) the facts [which] AND CLINICAL DETERMINATIONS
   31  THAT support the allegation that the subject meets each of the  criteria
   32  for  assisted outpatient treatment, (ii) that the treatment is the least
   33  restrictive  alternative,  (iii)  the  recommended  assisted  outpatient
   34  treatment,  and  (iv)  the rationale for the recommended assisted outpa-
   35  tient  treatment.  If  the  recommended  assisted  outpatient  treatment
   36  includes medication, such physician's testimony shall describe the types
   37  or  classes of medication which should be authorized, shall describe the
   38  beneficial and detrimental physical and mental effects of  such  medica-
   39  tion,  and shall recommend whether such medication should be self-admin-
   40  istered or administered by authorized personnel.
   41    (5) The subject of the petition shall be afforded  an  opportunity  to
   42  present  evidence, to call witnesses on his or her behalf, and to cross-
   43  examine adverse witnesses.
   44    [(i)] (J) Written treatment  plan.  (1)  The  court  shall  not  order
   45  assisted outpatient treatment unless a physician appointed by the appro-
   46  priate  director,  in  consultation  with  such  director,  develops and
   47  provides to the court a proposed written  treatment  plan.  The  written
   48  treatment  plan  shall  include  case  management  services or assertive
   49  community treatment team services  to  provide  care  coordination.  The
   50  written treatment plan also shall include all categories of services, as
   51  set  forth  in  paragraph  one of subdivision (a) of this section, which
   52  such physician recommends that the subject of the petition receive.  All
   53  service  providers  shall  be  notified regarding their inclusion in the
   54  written treatment plan. If the written treatment plan  includes  medica-
   55  tion, it shall state whether such medication should be self-administered
   56  or  administered  by  authorized  personnel,  and shall specify type and
       A. 6987--B                          8

    1  dosage range of medication most likely to provide  maximum  benefit  for
    2  the subject. If the written treatment plan includes alcohol or substance
    3  abuse  counseling  and  treatment,  such  plan  may  include a provision
    4  requiring  relevant  testing  for  either  alcohol or illegal substances
    5  provided the physician's  clinical  basis  for  recommending  such  plan
    6  provides sufficient facts for the court to find (i) that such person has
    7  a  history  of  alcohol or substance abuse that is clinically related to
    8  the mental illness; and (ii) that such testing is necessary to prevent a
    9  relapse or deterioration which would be likely to result in serious harm
   10  to the person or others. If a director is the  petitioner,  the  written
   11  treatment  plan shall be provided to the court no later than the date of
   12  the hearing on the petition. If a person other than a  director  is  the
   13  petitioner,  such  plan shall be provided to the court no later than the
   14  date set by the court pursuant to paragraph three of  subdivision  [(j)]
   15  (K) of this section.
   16    (2)  The  physician  appointed  to  develop the written treatment plan
   17  shall provide the following persons  with  an  opportunity  to  actively
   18  participate  in  the  development of such plan: the subject of the peti-
   19  tion; the treating physician, if  any;  and  upon  the  request  of  the
   20  subject  of  the  petition,  an  individual  significant  to the subject
   21  including any relative, close friend or individual  otherwise  concerned
   22  with  the  welfare  of the subject. THE APPOINTED PHYSICIAN SHALL MAKE A
   23  REASONABLE EFFORT TO GATHER RELEVANT INFORMATION FOR THE DEVELOPMENT  OF
   24  THE  TREATMENT  PLAN FROM THE SUBJECT OF THE PETITION'S FAMILY MEMBER OR
   25  MEMBERS, OR HIS OR HER SIGNIFICANT OTHER. If the subject of the petition
   26  has executed a health care proxy, the appointed physician shall consider
   27  any directions included in such proxy in developing the  written  treat-
   28  ment plan.
   29    (3)  The  court shall not order assisted outpatient treatment unless a
   30  physician appearing on behalf of a director  testifies  to  explain  the
   31  written  proposed  treatment  plan; PROVIDED THAT THE PARTIES MAY STIPU-
   32  LATE, UPON MUTUAL CONSENT, THAT SUCH PHYSICIAN NEED NOT TESTIFY.    Such
   33  physician  shall  state  the categories of assisted outpatient treatment
   34  recommended, the rationale for each such category, facts which establish
   35  that such treatment is the least restrictive alternative,  and,  if  the
   36  recommended assisted outpatient treatment plan includes medication, such
   37  physician  shall  state  the types or classes of medication recommended,
   38  the beneficial and detrimental physical and mental effects of such medi-
   39  cation, and whether  such  medication  should  be  self-administered  or
   40  administered  by an authorized professional. If the subject of the peti-
   41  tion has executed a health care proxy, such physician  shall  state  the
   42  consideration given to any directions included in such proxy in develop-
   43  ing  the written treatment plan. If a director is the petitioner, testi-
   44  mony pursuant to this paragraph shall be given at  the  hearing  on  the
   45  petition.  If  a  person  other  than a director is the petitioner, such
   46  testimony shall be given on the date set by the court pursuant to  para-
   47  graph three of subdivision [(j)] (K) of this section.
   48    [(j)] (K) Disposition. (1) If after hearing all relevant evidence, the
   49  court does not find by clear and convincing evidence that the subject of
   50  the  petition  meets the criteria for assisted outpatient treatment, the
   51  court shall dismiss the petition.
   52    (2) If after hearing all relevant evidence, the court finds  by  clear
   53  and  convincing  evidence  that  the  subject  of the petition meets the
   54  criteria for assisted outpatient treatment, and there is no  appropriate
   55  and  feasible  less  restrictive  alternative,  the  court may order the
   56  subject to receive assisted outpatient treatment for an  initial  period
       A. 6987--B                          9

    1  not to exceed [six months] ONE YEAR.  In fashioning the order, the court
    2  shall  specifically  make findings by clear and convincing evidence that
    3  the proposed treatment is the least  restrictive  treatment  appropriate
    4  and  feasible  for the subject. The order shall state an assisted outpa-
    5  tient treatment plan, which shall include  all  categories  of  assisted
    6  outpatient  treatment,  as set forth in paragraph one of subdivision (a)
    7  of this section, which the assisted outpatient is to receive, but  shall
    8  not  include  any  such category that has not been recommended in [both]
    9  the proposed written treatment plan and [the] IN ANY testimony  provided
   10  to the court pursuant to subdivision [(i)] (J) of this section.
   11    (3)  If  after hearing all relevant evidence presented by a petitioner
   12  who is not a director, the court finds by clear and convincing  evidence
   13  that  the subject of the petition meets the criteria for assisted outpa-
   14  tient treatment, and the court has yet to be  provided  with  a  written
   15  proposed  treatment plan and testimony pursuant to subdivision [(i)] (J)
   16  of this section, the court  shall  order  the  appropriate  director  to
   17  provide  the  court with such plan and testimony no later than the third
   18  day, excluding Saturdays, Sundays and  holidays,  immediately  following
   19  the  date  of  such  order; PROVIDED THAT THE PARTIES MAY STIPULATE UPON
   20  MUTUAL CONSENT THAT SUCH TESTIMONY NEED NOT BE PROVIDED.  Upon receiving
   21  such plan and ANY REQUIRED  testimony,  the  court  may  order  assisted
   22  outpatient treatment as provided in paragraph two of this subdivision.
   23    (4)  A  court  may  order  the patient to self-administer psychotropic
   24  drugs or accept the administration of such drugs by authorized personnel
   25  as part of an assisted outpatient  treatment  program.  Such  order  may
   26  specify  the  type  and dosage range of such psychotropic drugs and such
   27  order shall be effective for the duration of  such  assisted  outpatient
   28  treatment.
   29    (5)  If  the petitioner is the director of a hospital that operates an
   30  assisted outpatient treatment program, the court order shall direct  the
   31  hospital  director  to provide or arrange for all categories of assisted
   32  outpatient treatment for the assisted outpatient throughout  the  period
   33  of  the order. For all other persons, the order shall require the direc-
   34  tor of community services of the appropriate local governmental unit  to
   35  provide  or  arrange for all categories of assisted outpatient treatment
   36  for the assisted outpatient throughout the period of the order.   ORDERS
   37  ISSUED  ON OR AFTER THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF TWO
   38  THOUSAND TWELVE THAT AMENDED THIS SECTION SHALL REQUIRE THE  APPROPRIATE
   39  DIRECTOR  "AS  DETERMINED  BY  THE  PROGRAM  COORDINATOR"  TO PROVIDE OR
   40  ARRANGE FOR ALL CATEGORIES OF  ASSISTED  OUTPATIENT  TREATMENT  FOR  THE
   41  ASSISTED OUTPATIENT THROUGHOUT THE PERIOD OF THE ORDER.
   42    (6) The director shall cause a copy of any court order issued pursuant
   43  to  this section to be served personally, or by mail, facsimile or elec-
   44  tronic means, upon the assisted outpatient,  the  mental  hygiene  legal
   45  service  or  anyone  acting  on  the  assisted  outpatient's behalf, the
   46  original petitioner, identified service providers, and all others  enti-
   47  tled to notice under subdivision [(f)] (G) of this section.
   48    [(k)]  (L)  RELOCATION OF ASSISTED OUTPATIENTS. THE COMMISSIONER SHALL
   49  PROMULGATE REGULATIONS REQUIRING THAT, DURING THE PERIOD OF  THE  ORDER,
   50  AN  ASSISTED  OUTPATIENT  AND ANY OTHER APPROPRIATE PERSONS SHALL NOTIFY
   51  THE PROGRAM COORDINATOR WITHIN A REASONABLE TIME PRIOR TO SUCH  ASSISTED
   52  OUTPATIENT RELOCATING WITHIN THE STATE OF NEW YORK TO AN AREA NOT SERVED
   53  BY  THE  DIRECTOR  WHO  HAS  BEEN DIRECTED TO PROVIDE OR ARRANGE FOR THE
   54  ASSISTED OUTPATIENT TREATMENT. UPON RECEIVING NOTIFICATION OF SUCH RELO-
   55  CATION, THE PROGRAM COORDINATOR SHALL REDETERMINE  WHO  THE  APPROPRIATE
       A. 6987--B                         10

    1  DIRECTOR SHALL BE AND CAUSE A COPY OF THE COURT ORDER AND TREATMENT PLAN
    2  TO BE TRANSMITTED TO SUCH DIRECTOR.
    3    (M)  Petition  for  [additional  periods of] CONTINUED treatment.  (1)
    4  WITHIN THIRTY DAYS PRIOR TO THE EXPIRATION OF AN ORDER PURSUANT TO  THIS
    5  SECTION,  THE  APPROPRIATE  DIRECTOR  SHALL  REVIEW WHETHER THE ASSISTED
    6  OUTPATIENT CONTINUES TO MEET THE CRITERIA FOR ASSISTED OUTPATIENT TREAT-
    7  MENT.  UPON DETERMINING THAT ONE OR MORE OF SUCH CRITERIA ARE NO  LONGER
    8  MET,  SUCH DIRECTOR SHALL NOTIFY THE PROGRAM COORDINATOR IN WRITING THAT
    9  A PETITION FOR CONTINUED ASSISTED OUTPATIENT TREATMENT IS NOT WARRANTED.
   10  UPON DETERMINING THAT SUCH CRITERIA CONTINUE TO BE MET, HE OR SHE  SHALL
   11  PETITION  THE COURT TO ORDER CONTINUED ASSISTED OUTPATIENT TREATMENT FOR
   12  A PERIOD NOT TO EXCEED ONE YEAR FROM THE EXPIRATION DATE OF THE  CURRENT
   13  ORDER.  IF THE COURT'S DISPOSITION OF SUCH PETITION DOES NOT OCCUR PRIOR
   14  TO THE EXPIRATION DATE OF THE CURRENT ORDER,  THE  CURRENT  ORDER  SHALL
   15  REMAIN  IN  EFFECT  UNTIL SUCH DISPOSITION. THE PROCEDURES FOR OBTAINING
   16  ANY ORDER PURSUANT TO THIS SUBDIVISION SHALL BE IN ACCORDANCE  WITH  THE
   17  PROVISIONS  OF  THE FOREGOING SUBDIVISION OF THIS SECTION; PROVIDED THAT
   18  THE TIME RESTRICTIONS INCLUDED IN PARAGRAPH FOUR OF SUBDIVISION  (C)  OF
   19  THIS SECTION SHALL NOT BE APPLICABLE. THE NOTICE PROVISIONS SET FORTH IN
   20  PARAGRAPH  SIX  OF  SUBDIVISION (K) OF THIS SECTION SHALL BE APPLICABLE.
   21  ANY COURT ORDER REQUIRING PERIODIC BLOOD TESTS  OR  URINALYSIS  FOR  THE
   22  PRESENCE  OF  ALCOHOL  OR ILLEGAL DRUGS SHALL BE SUBJECT TO REVIEW AFTER
   23  SIX MONTHS BY THE PHYSICIAN WHO DEVELOPED THE WRITTEN TREATMENT PLAN  OR
   24  ANOTHER  PHYSICIAN  DESIGNATED BY THE DIRECTOR, AND SUCH PHYSICIAN SHALL
   25  BE AUTHORIZED TO  TERMINATE  SUCH  BLOOD  TESTS  OR  URINALYSIS  WITHOUT
   26  FURTHER ACTION BY THE COURT.
   27    (2) Within thirty days prior to the expiration of an order of assisted
   28  outpatient  treatment,  [the  appropriate director or] the current peti-
   29  tioner, if the current petition was filed pursuant to  subparagraph  (i)
   30  or  (ii)  of paragraph one of subdivision [(e)] (F) of this section, and
   31  the current petitioner retains his or her original  status  pursuant  to
   32  the  applicable  subparagraph, may petition the court to order continued
   33  assisted outpatient treatment for a period not to exceed one  year  from
   34  the  expiration date of the current order. If the court's disposition of
   35  such petition does not occur prior to the expiration date of the current
   36  order, the current order shall remain in effect until such  disposition.
   37  The  procedures  for  obtaining  any  order pursuant to this subdivision
   38  shall be in accordance with the provisions of the foregoing subdivisions
   39  of this section; provided that the time restrictions included  in  para-
   40  graph  four  of subdivision (c) of this section shall not be applicable.
   41  The notice provisions set forth in paragraph six  of  subdivision  [(j)]
   42  (K)  of  this  section  shall be applicable.   Any court order requiring
   43  periodic blood tests or urinalysis for the presence of alcohol or  ille-
   44  gal  drugs  shall be subject to review after six months by the physician
   45  who developed the written treatment plan or another physician designated
   46  by the director, and such physician shall  be  authorized  to  terminate
   47  such blood tests or urinalysis without further action by the court.
   48    (3)  IF  NEITHER  THE  APPROPRIATE DIRECTOR NOR THE CURRENT PETITIONER
   49  PETITION FOR CONTINUED ASSISTED OUTPATIENT TREATMENT  PURSUANT  TO  THIS
   50  PARAGRAPH  AND  THE ORDER OF THE COURT EXPIRES, ANY OTHER PERSON AUTHOR-
   51  IZED TO PETITION PURSUANT TO PARAGRAPH ONE OF SUBDIVISION  (F)  OF  THIS
   52  SECTION  MAY BRING A NEW PETITION FOR ASSISTED OUTPATIENT TREATMENT.  IF
   53  SUCH NEW PETITION IS FILED LESS THAN SIXTY DAYS AFTER THE EXPIRATION  OF
   54  SUCH ORDER, THE TIME RESTRICTIONS PROVIDED IN PARAGRAPH FOUR OF SUBDIVI-
   55  SION (C) OF THIS SECTION SHALL NOT BE APPLICABLE TO THE NEW PETITION.
       A. 6987--B                         11

    1    (4)  IF, THIRTY DAYS PRIOR TO THE EXPIRATION OF AN ORDER, THE ASSISTED
    2  OUTPATIENT IS DEEMED BY THE  APPROPRIATE  DIRECTOR  TO  BE  MISSING  AND
    3  THEREBY  UNAVAILABLE FOR EVALUATION AS TO WHETHER HE OR SHE CONTINUES TO
    4  MEET THE CRITERIA FOR ASSISTED OUTPATIENT TREATMENT, SUCH DIRECTOR SHALL
    5  PETITION  THE  COURT TO EXTEND THE TERM OF THE CURRENT ORDER UNTIL SIXTY
    6  DAYS AFTER SUCH TIME AS THE ASSISTED OUTPATIENT IS LOCATED. IF THE COURT
    7  GRANTS THE EXTENSION, THE DIRECTOR SHALL CONTINUE REASONABLE EFFORTS  TO
    8  LOCATE  THE  ASSISTED OUTPATIENT.   UPON LOCATION OF THE ASSISTED OUTPA-
    9  TIENT, THE DIRECTOR SHALL REVIEW WHETHER THE ASSISTED OUTPATIENT CONTIN-
   10  UES TO MEET THE CRITERIA FOR ASSISTED OUTPATIENT TREATMENT, PURSUANT  TO
   11  PARAGRAPH TWO OF THIS SUBDIVISION.
   12    [(l)]  (N)  Petition  for  an  order to stay, vacate or modify. (1) In
   13  addition to any other right or remedy available by law with  respect  to
   14  the  order  for  assisted outpatient treatment, the assisted outpatient,
   15  the mental hygiene legal service,  or  anyone  acting  on  the  assisted
   16  outpatient's  behalf  may  petition the court on notice to the director,
   17  the original petitioner, and all others entitled to notice under  subdi-
   18  vision [(f)] (G) of this section to stay, vacate or modify the order.
   19    (2)  The  appropriate  director  shall petition the court for approval
   20  before instituting a proposed material change in the assisted outpatient
   21  treatment plan, unless such change is authorized by  the  order  of  the
   22  court. Such petition shall be filed on notice to all parties entitled to
   23  notice  under subdivision [(f)] (G) of this section. Not later than five
   24  days after receiving such petition,  excluding  Saturdays,  Sundays  and
   25  holidays,  the court shall hold a hearing on the petition; provided that
   26  if the assisted outpatient informs the court that he or  she  agrees  to
   27  the  proposed material change, the court may approve such change without
   28  a hearing. Non-material changes may be instituted by the director  with-
   29  out  court  approval.  For  the  purposes  of this paragraph, a material
   30  change is an addition or deletion of a category of services to or from a
   31  current assisted outpatient treatment plan, or any deviation without the
   32  assisted outpatient's consent from the terms of a current order relating
   33  to the administration of psychotropic drugs.
   34    [(m)] (O) Appeals. Review of an order issued pursuant to this  section
   35  shall  be  had  in  like  manner  as  specified  in section 9.35 of this
   36  article; PROVIDED THAT NOTICE SHALL BE PROVIDED TO ALL PARTIES  ENTITLED
   37  TO NOTICE UNDER SUBDIVISION (G) OF THIS SECTION.
   38    [(n)]  (P) Failure to comply with assisted outpatient treatment. Where
   39  in the clinical judgment of a physician, (i)  the  assisted  outpatient,
   40  has  failed or refused to comply with the assisted outpatient treatment,
   41  (ii) efforts were made to solicit compliance, and  (iii)  such  assisted
   42  outpatient  may be in need of involuntary admission to a hospital pursu-
   43  ant to section 9.27 of this article or immediate observation,  care  and
   44  treatment  pursuant to section 9.39 or 9.40 of this article, such physi-
   45  cian may request the director  of  community  services,  the  director's
   46  designee,  or  any  physician  designated  by  the director of community
   47  services pursuant to section 9.37 of this article, to direct the removal
   48  of such assisted outpatient to an appropriate hospital for  an  examina-
   49  tion  to  determine  if such person has a mental illness for which HE OR
   50  SHE IS IN NEED OF hospitalization is necessary pursuant to section 9.27,
   51  9.39 or 9.40 of this article[. Furthermore, if such assisted  outpatient
   52  refuses to take medications as required by the court order, or he or she
   53  refuses  to  take, or fails a blood test, urinalysis, or alcohol or drug
   54  test as required by the court order, such physician  may  consider  such
   55  refusal  or  failure  when determining whether]; PROVIDED THAT IF, AFTER
   56  EFFORTS TO  SOLICIT  COMPLIANCE,  SUCH  PHYSICIAN  DETERMINES  THAT  THE
       A. 6987--B                         12

    1  ASSISTED  OUTPATIENT'S  FAILURE  TO  COMPLY WITH THE ASSISTED OUTPATIENT
    2  TREATMENT INCLUDES A SUBSTANTIAL FAILURE TO  TAKE  MEDICATION,  PASS  OR
    3  SUBMIT  TO BLOOD TESTING OR URINALYSIS, OR RECEIVE TREATMENT FOR ALCOHOL
    4  OR  SUBSTANCE ABUSE, SUCH PHYSICIAN MAY PRESUME THAT the assisted outpa-
    5  tient is in need of an examination to determine whether he or she has  a
    6  mental  illness for which hospitalization is necessary. Upon the request
    7  of such physician, the director, the director's designee, or any  physi-
    8  cian  designated  pursuant  to  section 9.37 of this article, may direct
    9  peace officers, acting pursuant to their special duties, or police offi-
   10  cers who are members of an authorized police department or force or of a
   11  sheriff's department to take the assisted outpatient  into  custody  and
   12  transport  him  or her to the hospital operating the assisted outpatient
   13  treatment program or to any  hospital  authorized  by  the  director  of
   14  community  services  to receive such persons. Such law enforcement offi-
   15  cials shall carry out such directive. Upon the request  of  such  physi-
   16  cian, the director, the director's designee, or any physician designated
   17  pursuant  to  section  9.37  of  this  article, an ambulance service, as
   18  defined by subdivision two of section three thousand one of  the  public
   19  health  law,  or  an  approved mobile crisis outreach team as defined in
   20  section 9.58 of this article shall be authorized to  take  into  custody
   21  and  transport  any  such  person to the hospital operating the assisted
   22  outpatient treatment program, or to any other hospital authorized by the
   23  director of community services to receive such persons. Any director  of
   24  community  services,  or  designee,  shall  be  authorized to direct the
   25  removal of an assisted outpatient who is present in his or her county to
   26  an appropriate hospital, in  accordance  with  the  provisions  of  this
   27  subdivision,  based  upon a determination of the appropriate director of
   28  community services directing the removal  of  such  assisted  outpatient
   29  pursuant  to  this subdivision. Such person may be retained for observa-
   30  tion, care and treatment and further examination in the hospital for  up
   31  to  seventy-two  hours  to  permit a physician to determine whether such
   32  person has a mental illness and is  in  need  of  involuntary  care  and
   33  treatment  in a hospital pursuant to the provisions of this article. Any
   34  continued involuntary retention  OF  THE  ASSISTED  OUTPATIENT  in  such
   35  hospital  beyond the initial seventy-two hour period shall be in accord-
   36  ance with the provisions of this article  relating  to  the  involuntary
   37  admission  and retention of a person. If at any time during the seventy-
   38  two hour period the person is determined not  to  meet  the  involuntary
   39  admission  and  retention provisions of this article, and does not agree
   40  to stay in the hospital as a voluntary or informal patient,  he  or  she
   41  must be released. Failure to comply with an order of assisted outpatient
   42  treatment  shall  not  be  grounds for involuntary civil commitment or a
   43  finding of contempt of court.
   44    [(o)] (Q) Effect of determination that a person is in need of assisted
   45  outpatient treatment. The determination by a court that a person  is  in
   46  need  of  assisted  outpatient  treatment  shall  not be construed as or
   47  deemed to be a determination that such person is incapacitated  pursuant
   48  to article eighty-one of this chapter.
   49    [(p)] (R) False petition. A person making a false statement or provid-
   50  ing  false information or false testimony in a petition or hearing under
   51  this section shall be subject to criminal prosecution pursuant to  arti-
   52  cle  one  hundred  seventy-five  or article two hundred ten of the penal
   53  law.
   54    [(q)] (S) Exception. Nothing in this section  shall  be  construed  to
   55  affect  the  ability of the director of a hospital to receive, admit, or
       A. 6987--B                         13

    1  retain patients who  otherwise  meet  the  provisions  of  this  article
    2  regarding receipt, retention or admission.
    3    [(r)]  (T)  Education and training. (1) The office [of mental health],
    4  in consultation with the office of court administration,  shall  prepare
    5  educational  and  training  materials  on the use of this section, which
    6  shall be made  available  to  local  governmental  units,  providers  of
    7  services,  judges,  court  personnel,  law enforcement officials and the
    8  general public.
    9    (2) The office, in consultation with  the  office  of  court  adminis-
   10  tration,  shall  establish  a mental health training program for supreme
   11  and county court judges and court  personnel,  AND  SHALL  PROVIDE  SUCH
   12  TRAINING WITH SUCH FREQUENCY AND IN SUCH LOCATIONS AS MAY BE APPROPRIATE
   13  TO  MEET  STATEWIDE NEEDS.  Such training shall focus on the use of this
   14  section and generally address issues  relating  to  mental  illness  and
   15  mental health treatment.
   16    S  6.  Section  29.15 of the mental hygiene law is amended by adding a
   17  new subdivision (o) to read as follows:
   18    (O) IF THE DIRECTOR OF A DEPARTMENT FACILITY  DOES  NOT  PETITION  FOR
   19  ASSISTED  OUTPATIENT  TREATMENT PURSUANT TO SECTION 9.60 OF THIS CHAPTER
   20  UPON THE DISCHARGE OF AN INPATIENT ADMITTED PURSUANT  TO  SECTION  9.27,
   21  9.39  OR  9.40  OF  THIS  CHAPTER, OR UPON THE EXPIRATION OF A PERIOD OF
   22  CONDITIONAL RELEASE FOR SUCH INPATIENT, SUCH DIRECTOR SHALL REPORT  SUCH
   23  DISCHARGE  OR  SUCH  EXPIRATION  IN WRITING TO THE DIRECTOR OF COMMUNITY
   24  SERVICES OF THE LOCAL  GOVERNMENTAL  UNIT  IN  WHICH  THE  INPATIENT  IS
   25  EXPECTED TO RESIDE.
   26    S 7. Subdivision 1 of section 404 of the correction law, as amended by
   27  chapter 7 of the laws of 2007, is amended to read as follows:
   28    1.  Whenever  an  inmate  committed to a hospital in the department of
   29  mental hygiene or whenever an inmate is examined in anticipation of  his
   30  or  her  conditional release, release to parole supervision, or when his
   31  or her sentence to a term of imprisonment expires and such inmate  shall
   32  continue  to  be  mentally  ill and in need of care and treatment at the
   33  time of his or her conditional release, release to  parole  supervision,
   34  or  when  his  or  her  sentence  to a term of imprisonment expires, the
   35  director of the hospital or the superintendent of a correctional facili-
   36  ty [may] SHALL, WHERE APPROPRIATE, EITHER apply for the person's  admis-
   37  sion to a hospital for the care and treatment of the mentally ill in the
   38  department  of  mental  hygiene  pursuant  to article nine of the mental
   39  hygiene law[,] or [alternatively]  INITIATE  A  PETITION  FOR  AN  ORDER
   40  AUTHORIZING  ASSISTED  OUTPATIENT TREATMENT, PURSUANT TO SECTION 9.60 OF
   41  THE MENTAL HYGIENE LAW, OR the commissioner may apply for  the  person's
   42  admission  to a secure treatment facility pursuant to article ten of the
   43  mental hygiene law.
   44    S 8. Section 18 of chapter 408  of  the  laws  of  1999,  constituting
   45  Kendra's  Law, as amended by chapter 139 of the laws of 2010, is amended
   46  to read as follows:
   47    S 18. This act shall take effect immediately,  provided  that  section
   48  fifteen  of this act shall take effect April 1, 2000, provided, further,
   49  that subdivision (e) of section 9.60 of the mental hygiene law as  added
   50  by  section  six  of  this act shall be effective 90 days after this act
   51  shall become law[; and that this act shall expire and be deemed repealed
   52  June 30, 2015].
   53    S 9. Severability. If any clause, sentence, paragraph, section or part
   54  of this act shall be adjudged by any court of competent jurisdiction  to
   55  be  invalid,  and  after  exhaustion of all further judicial review, the
   56  judgment shall not affect, impair or invalidate the  remainder  thereof,
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    1  but  shall  be  confined in its operation to the clause, sentence, para-
    2  graph, section or part thereof directly involved in the controversy.
    3    S 10.  This act shall take effect immediately.
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