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.