S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    812
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 11, 2023
                                ___________
 
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01614-01-3
              

 A. 812                              2
 
 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,
 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, HERSELF or others. ["Likelihood to result in seri-
 ous 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.]
 A. 812                              3
 
   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
 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 OR HER  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, HERSELF or  others.  If  it  be
 determined  that  there is such reasonable cause, the court shall forth-
 with 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.