S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9669
 
                           I N  A S S E M B L Y
 
                              March 28, 2022
                                ___________
 
 Introduced  by  M.  of  A.  BRAUNSTEIN  -- read once and referred to the
   Committee on Mental Health
 
 AN ACT to amend the mental hygiene law, in relation  to  clarifying  the
   standards for involuntary in-patient care and treatment
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1.  Short Title. This act shall be  known  as  the  "New  York
 State Mental Health Reform Act".
   §  2.  Legislative  findings. With the intent of restoring dignity and
 transparency to our state's treatment and care of mentally ill patients,
 the state engaged in reforming procedures and policies  in  implementing
 preferred outpatient treatment through a structured outpatient treatment
 process  commonly  referred  to  as  Kendra's Law. The law was to ensure
 those individuals requiring mental  health  treatment  were  afforded  a
 dignified  process  in treatment while allowing the patient's liberty to
 be free to pursue their daily lives without stigma or negative  connota-
 tions attached to mental health.
   Unfortunately, the practical application of the state's mental hygiene
 laws  has allowed thousands of people who require  more stringent mental
 health protocols for treatment to go without  appropriate  oversight  to
 ensure  their  treatment is pursued thus, resulting in severe behavioral
 transgression to include a large degree of homelessness, criminal behav-
 ior, toxic drug use and alcoholism. The severity of  abhorrent  outcomes
 as  the  result  of  a failure to give medical professionals, as well as
 judicial direction in determining certain behavioral dysfunction(s) that
 display a need for in-patient  care,  has  severely  impacted  patient's
 health, welfare, and their ability to regularly function in society. All
 too  often,  we are seeing unsuspecting citizens killed or maimed as the
 result of violent behavior by patients who have  either  disregarded  or
 rejected available or mandated mental health services due to their dete-
 riorating  mental state, which compounds the deleterious outcome for the
 patient as well as society.    Although  outpatient  commitment  is  the
 preferred mode of treatment for patients seeking mental health services,
 the  occasion  arises  where  judicial  intervention  to seek immediate,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD14879-03-2
 A. 9669                             2
 
 mandated treatment through court ordered in-patient treatment, in  order
 to  facilitate  an  expedited pathway for seeking medical or psychiatric
 help is necessary to prevent on-going negative behavioral episodes  that
 places the patient or the public at risk of physical injury or death.
   §  3.  The second, third and fourth undesignated paragraphs of section
 9.01 of the mental hygiene law, as amended by chapter 723 of the laws of
 1989, are amended to read as follows:
   "in need of involuntary care and treatment" means that a person has  a
 mental  illness  for which care and treatment as a patient in a hospital
 is essential to such person's welfare and [whose] WHICH SO  IMPAIRS  THE
 PERSON'S  judgment [is so impaired that he] THAT THE PERSON is unable to
 understand the need for such care and treatment. CARE AND TREATMENT IN A
 HOSPITAL SHALL BE CONSIDERED ESSENTIAL TO A PERSON'S WELFARE IF, IN  THE
 ABSENCE OF SUCH CARE AND TREATMENT, THE PERSON'S MENTAL ILLNESS IS LIKE-
 LY TO RESULT IN SERIOUS HARM.
   ["likelihood to result in serious harm" or] "likely to result in seri-
 ous  harm"  means  PRESENTING  A SUBSTANTIAL RISK OF: (a) [a substantial
 risk of] physical OR MENTAL harm to the person as manifested by:
   (I) threats of or attempts at suicide or serious bodily harm;
   (II) SUBSTANTIAL INTERFERENCE WITH THE PERSON'S ABILITY  TO  MEET  THE
 PERSON'S NEEDS FOR FOOD, CLOTHING, SHELTER OR MEDICAL CARE; or
   (III)  other  conduct  demonstrating  that  the person is dangerous to
 himself or herself, or (b) [a substantial risk of physical harm to other
 persons as manifested by] homicidal or other violent behavior  by  which
 others  are  placed in reasonable fear of serious physical harm.  EVALU-
 ATION OF THE LIKELIHOOD THAT A PERSON'S MENTAL ILLNESS  WILL  RESULT  IN
 SERIOUS  HARM  SHALL  INCLUDE CONSIDERATION OF ALL RELEVANT INFORMATION,
 INCLUDING CREDIBLE REPORTS OF THE PERSON'S RECENT BEHAVIOR AND ANY KNOWN
 RELEVANT ASPECTS OF THE PERSON'S MEDICAL AND BEHAVIORAL HISTORY.
   "need for retention" means [that] THE NEED OF a person  who  has  been
 admitted  to  a  hospital  pursuant  to  this article [is in need] FOR A
 FURTHER PERIOD of involuntary care and treatment in a  hospital  [for  a
 further  period]. EVALUATION OF NEED FOR RETENTION SHALL INCLUDE CONSID-
 ERATION OF THE PERSON'S PREPAREDNESS,  WITH  APPROPRIATE  AND  AVAILABLE
 SUPPORT, TO ADHERE TO ESSENTIAL OUTPATIENT TREATMENT.
   §  4.  Subdivision  (a)  of section 9.39 of the mental hygiene law, as
 amended by chapter 789 of the laws  of  1985,  is  amended  to  read  as
 follows:
   (a) The director of any hospital maintaining adequate staff and facil-
 ities  for  the observation, examination, care, and treatment of persons
 alleged to be mentally ill and approved by the commissioner  to  receive
 and  retain  patients  pursuant  to  this section may receive and retain
 therein as a patient for a period of fifteen days any person alleged  to
 have  a mental illness for which immediate observation, care, and treat-
 ment in a hospital is appropriate and which is likely to result in seri-
 ous harm to himself or others. ["Likelihood to result in  serious  harm"
 as used in this article shall mean:
   1.  substantial  risk  of  physical  harm  to himself as manifested by
 threats of or attempts at  suicide  or  serious  bodily  harm  or  other
 conduct demonstrating that he is dangerous to himself, or
   2.  a substantial risk of physical harm to other persons as manifested
 by homicidal or other violent behavior by which  others  are  placed  in
 reasonable fear of serious physical harm.]
   The  director  shall cause to be entered upon the hospital records the
 name of the person or persons, if any, who have brought such  person  to
 A. 9669                             3
 
 the  hospital and the details of the circumstances leading to the hospi-
 talization of such person.
   The  director  shall  admit  such person pursuant to the provisions of
 this section only if a staff physician of the hospital upon  examination
 of  such  person finds that such person qualifies under the requirements
 of this section. Such person shall not be retained for a period of  more
 than  forty-eight  hours  unless  within  such  period  such  finding is
 confirmed after examination by another physician who shall be  a  member
 of  the  psychiatric staff of the hospital. Such person shall be served,
 at the time of admission, with written notice of his status  and  rights
 as a patient under this section. Such notice shall contain the patient's
 name.  At  the  same time, such notice shall also be given to the mental
 hygiene legal service and personally  or  by  mail  to  such  person  or
 persons,  not to exceed three in number, as may be designated in writing
 to receive such notice by the person alleged to be mentally ill.  If  at
 any  time  after  admission,  the  patient, any relative, friend, or the
 mental hygiene legal service gives notice to the director in writing  of
 request for court hearing on the question of need for immediate observa-
 tion, care, and treatment, a hearing shall be held as herein provided as
 soon  as practicable but in any event not more than five days after such
 request is received, except that the commencement of such hearing may be
 adjourned at the request of the patient. It shall be  the  duty  of  the
 director  upon  receiving  notice of such request for hearing to forward
 forthwith a copy of such notice with a record  of  the  patient  to  the
 supreme  court  or  county  court  in  the county where such hospital is
 located. A copy of such notice and record shall also be given the mental
 hygiene legal service. The court which receives such  notice  shall  fix
 the  date of such hearing and cause the patient or other person request-
 ing the hearing, the director, the mental hygiene legal service and such
 other persons as the court may determine to be  advised  of  such  date.
 Upon  such  date, or upon such other date to which the proceeding may be
 adjourned, the court shall hear testimony and examine the person alleged
 to be mentally ill, if it be deemed advisable in or out  of  court,  and
 shall  render  a  decision  in writing that there is reasonable cause to
 believe that the patient has a mental illness for which immediate  inpa-
 tient care and treatment in a hospital is appropriate and which is like-
 ly  to  result in serious harm to himself or others. If it be determined
 that there is such reasonable cause, the court shall forthwith issue  an
 order  authorizing the retention of such patient for any such purpose or
 purposes in the hospital for a period not to exceed  fifteen  days  from
 the  date of admission. Any such order entered by the court shall not be
 deemed to be an adjudication that the patient is mentally ill, but  only
 a determination that there is reasonable cause to retain the patient for
 the purposes of this section.
   §  5.  This  act  shall take effect on the sixtieth day after it shall
 have become a law.