2023 New York Laws › MHY - Mental Hygiene › Title E - General Provisions › Article 29 - General Provisions Relating to In-Patient Facilities › 29.15 - Discharge and Conditional Release of Patients to the Community.

§ 29.15 Discharge and conditional release of patients to the community.
(a)  A  patient  may  be  discharged  or conditionally released to the
community by the director of a department facility, if, in  the  opinion
of staff familiar with the patient's case history, such patient does not
require active in-patient care and treatment.
(b)  A  patient may be conditionally released, rather than discharged,
when in the opinion of staff familiar with the patient's  case  history,
the  clinical  needs  of  such  patient  warrant  this  more restrictive
placement, provided, however, that
1. an involuntary patient may be conditionally released only  for  the
remainder of the authorized retention period; and
2.  except as provided in subdivision (d) of this section, a voluntary
patient may be conditionally released only for a  twelve  month  period,
provided however that (i) a voluntary patient under sixteen years of age
may  be  conditionally released only after consultation with the parent,
legal guardian, or next-of-kin of such patient; (ii) a voluntary patient
over sixteen and under  eighteen  years  of  age  may  be  conditionally
released  only with his consent or with the consent of the parent, legal
guardian, or next-of-kin of such  patient;  (iii)  a  voluntary  patient
eighteen  years  of age or older may be conditionally released only with
his consent.
(c) The director of a department facility from which  any  patient  is
conditionally released shall cause all such patients to be informed once
during  each  one  hundred  twenty  days of conditional release of their
status and rights, including their right  to  avail  themselves  of  the
facilities  of  the  mental  hygiene  legal service. At the time of such
periodic notification, the written consent of a patient to his continued
stay on conditional release status shall be obtained and a copy  thereof
shall be given to the mental hygiene legal service.
(d)  1. No voluntary patient who has been conditionally released shall
be continued on such status for a period beyond twelve months  from  the
date  of  commencement  of  such status or beyond twelve months from the
effective  date  of  this  statute,  whichever  is  later,  unless   the
suitability of such patient to remain on such status and his willingness
to  so  remain  have  been  reviewed.  The  director  shall  review  the
suitability of such patient to remain in such  status,  and  the  mental
hygiene  legal  service  shall review the willingness of such patient to
remain in such status. Notice of  the  determination  of  the  patient's
suitability  made  by  the director shall be given to the mental hygiene
legal service. If the mental hygiene legal service finds that  there  is
any  ground  to doubt the director's determination of the suitability of
such patient to remain on such status, or the willingness of the patient
to so remain, it shall make an application, upon notice to  the  patient
and  the  director  of  the facility for a court order determining those
questions. In any such proceeding, the patient or someone on his  behalf
or the mental hygiene legal service may request a hearing. If the mental
hygiene legal service finds no grounds to doubt the determination of the
director  as  to  the  suitability  or the willingness of the patient to
continue on conditional release status, it  shall  so  certify  and  the
patient may be continued on such status. A copy of such certification of
review shall be filed in the patient's record.
2.  If  an  application for a court order has been made, the court, in
determining  the  proceeding,  may  approve  the  continued  conditional
release  of  the  patient or, if the court finds that the patient is not
suitable or willing to continue on conditional release  status,  it  may
order the discharge of such patient.
3.  Prior  to  the  termination  of twelve months from the date of the
certification by the mental hygiene legal service of such  first  review

or,  if an application for a court order has been made, from the date of
the first order and, thereafter, prior  to  the  termination  of  twelve
months  from  any  subsequent  certification or subsequent order, as the
case  may  be,  the  director and the mental hygiene legal service shall
conduct another review of the patient's suitability and  willingness  to
remain  on  conditional  release  status,  as set forth in the foregoing
subdivisions.
(e) * 1. In the case of an involuntary patient on conditional release,
the director may terminate the conditional release and order the patient
to return to the facility at  any  time  during  the  period  for  which
retention  was  authorized,  if, in the director's judgment, the patient
needs in-patient care and treatment and the conditional  release  is  no
longer  appropriate;  provided,  however,  that  in  any  such case, the
director shall cause written notice of such patient's return to be given
to the mental hygiene  legal  service.  The  director  shall  cause  the
patient  to  be retained for observation, care and treatment and further
examination in a hospital for up to seventy-two hours if a physician  on
the  staff of the hospital determines that such person may have a mental
illness and may be in need  of  involuntary  care  and  treatment  in  a
hospital pursuant to the provisions of article nine of this chapter. Any
continued retention in such hospital beyond the initial seventy-two hour
period  shall  be  in  accordance  with  the  provisions of this chapter
relating to the involuntary admission and retention of a person.  If  at
any time during the seventy-two hour period the person is determined not
to  meet  the  involuntary  admission  and  retention provisions of this
chapter, and does not agree to stay in the hospital as  a  voluntary  or
informal  patient,  he  or she must be released, either conditionally or
unconditionally.
* NB Effective until June 30, 2027
* 1. In the case of an involuntary patient on conditional release, the
director may terminate the conditional release and order the patient  to
return to the facility at any time during the period for which retention
was  authorized,  if,  in  the  director's  judgment,  the patient needs
in-patient care and treatment and the conditional release is  no  longer
appropriate provided, however, that in any such case, the director shall
cause  written notice of such patient's return to be given to the mental
hygiene legal service. If, at any time prior to the expiration of thirty
days from the date of return to the facility,  he  or  any  relative  or
friend  or  the  mental hygiene legal service gives notice in writing to
the director of request for hearing on the question of  the  suitability
of  such  patient's  return  to  the  facility,  a hearing shall be held
pursuant to the provisions of this chapter relating to  the  involuntary
admission of a person.
* NB Effective June 30, 2027
2.  In  the  case  of  a voluntary patient on conditional release, the
director may terminate the conditional release and order the patient  to
return to the facility at any time, if, in the judgment of the director,
the  patient  needs  in-patient  care  and treatment and the conditional
release is no  longer  appropriate,  provided,  however,  that  if  such
patient  does  not  consent  to  return to the facility, he shall not be
returned to the facility, except in accordance with  the  provisions  of
this chapter and the regulations of the commissioner for the involuntary
admission of a person.
(f)   The   discharge   or  conditional  release  of  all  clients  at
developmental centers, patients at psychiatric centers  or  patients  at
psychiatric  inpatient  services  subject  to licensure by the office of
mental health shall  be  in  accordance  with  a  written  service  plan
prepared  by  staff  familiar  with  the  case  history of the client or

patient to be discharged or conditionally released  and  in  cooperation
with  appropriate  social  services  officials  and  directors  of local
governmental units. In causing such plan to be prepared, the director of
the  facility  shall take steps to assure that the following persons are
interviewed, provided an opportunity  to  actively  participate  in  the
development  of  such  plan  and  advised  of whatever services might be
available to the patient through the mental hygiene legal  service:  the
patient  to  be  discharged  or  conditionally  released;  an authorized
representative of the patient, to include the parent or parents  if  the
patient  is  a  minor,  unless  such minor sixteen years of age or older
objects to the participation of the parent or parents and there has been
a clinical determination by a physician  that  the  involvement  of  the
parent  or  parents is not clinically appropriate and such determination
is documented in the clinical record and there is no plan  to  discharge
or release the minor to the home of such parent or parents; and upon the
request  of  the  patient  sixteen  years of age or older, a significant
individual to the  patient  including  any  relative,  close  friend  or
individual  otherwise  concerned  with the welfare of the patient, other
than an employee of the facility.
(g) A written service plan prepared pursuant  to  this  section  shall
include, but shall not be limited to, the following:
1.  a  statement  of  the  patient's  need,  if  any, for supervision,
medication, aftercare services, and  assistance  in  finding  employment
following discharge or conditional release, and
2.  a  specific  recommendation  of the type of residence in which the
patient is to live and a  listing  of  the  services  available  to  the
patient in such residence.
3.  A  listing  of  organizations,  facilities, including those of the
department, and individuals who are available  to  provide  services  in
accordance with the identified needs of the patient.
4.  The  notification  of  the  appropriate  school  district  and the
committee on special  education  regarding  the  proposed  discharge  or
release  of a patient under twenty-one years of age, consistent with all
applicable federal and state laws relating to  confidentiality  of  such
information.
5.  An  evaluation of the patient's need and potential eligibility for
public benefits following discharge or  conditional  release,  including
public assistance, medicaid, and supplemental security income.
6.  Material  providing information related to extreme risk protection
orders, pursuant to article sixty-three-A of the civil practice law  and
rules.  Such information may be provided to the patient or, upon consent
of the  patient,  to  an  authorized  representative  who  has  actively
participated  in the patient's treatment plan. Such information may only
be provided if the director of the facility and such facility's clinical
staff  who  worked  directly  with  the  patient  determine  through  an
evaluation and assessment, that there is the presence of a mental health
diagnosis  or  symptoms  of  a  mental illness exhibited by the patient,
which indicates the patient may be at substantial risk of physical  harm
to  himself  or  herself, or has made threats of or attempts at suicide.
Such determination and the basis for it shall be included in the written
clinical record.
An inpatient facility operated or licensed by  the  office  of  mental
health  shall  provide  reasonable  and  appropriate  assistance  to the
patient,  in  cooperation  with  local  social  services  districts,  in
applying for benefits identified in the written service plan pursuant to
paragraph  five  of  this subdivision, prior to discharge or conditional
release.
(h) It shall also  be  the  responsibility  of  the  director  of  any
department  facility  from which a client or patient has been discharged
or conditionally released,  in  collaboration,  when  appropriate,  with
appropriate   social   services   officials   and   directors  of  local
governmental  units,  to  prepare,  to  cause  to be implemented, and to
monitor a comprehensive program designed:
1. to determine whether the residence in which such client or  patient
is  living, is adequate and appropriate for the needs of such patient or
client;
2. to verify that such patient or client  is  receiving  the  services
specified in such patient's or client's written service plan; and
3.  to  recommend,  and  to take steps to assure the provision of, any
additional services.
(i) 1. No patient about to be  discharged  or  conditionally  released
from a department facility or an inpatient facility operated or licensed
by  the  office  of  mental  health  shall  be  directly referred to any
facility subject to licensure, certification or approval  by  any  state
agency  or  department, unless it has been determined that such facility
has a current and valid license, certificate or approval.  In  addition,
no  patient  about  to  be  discharged  or conditionally released from a
department facility  shall  be  directly  referred  to  any  residential
accommodation not subject to licensure, certification or approval by any
state  agency  or  department  unless  it  has  been  determined,  after
consultation with appropriate  local  agencies,  that  such  residential
accommodation complies with all appropriate local zoning, building, fire
and safety codes, ordinances and regulations.
2. (I) A patient about to be discharged or conditionally released from
a department facility licensed or operated by the office for people with
developmental  disabilities  or  from  an inpatient facility operated or
licensed by the office of alcoholism and substance abuse services or the
office of mental health to an adult home or  residence  for  adults,  as
defined  in  section  two  of the social services law, shall be referred
only to such home or residence that is consistent  with  that  patient's
needs  and  that  operates pursuant to section four hundred sixty of the
social services  law,  provided  further  that:  (A)  for  a  department
facility   licensed   or   operated   by  the  office  for  people  with
developmental disabilities or for an inpatient facility operated by  the
office  of  alcoholism  and  substance  abuse  services or the office of
mental health, the facility  director  retains  authority  to  determine
whether the home, program or residence is consistent with that patient's
needs  and  (B) such referral shall be made to the patient's home county
whenever possible or appropriate.
(II) No patient about to be discharged or conditionally released  from
a department facility licensed or operated by the office for people with
developmental  disabilities  or  from  an inpatient facility operated or
licensed by the office of alcoholism and substance abuse services or the
office of mental health shall be referred to any adult home or residence
for adults, as defined in section two of the social services law,  which
has  received  an  official written notice from the department of health
of: (A) the proposed revocation, suspension or denial of  its  operating
certificate;  (B)  the  limitation  of  its  operating  certificate with
respect to new admissions; (C) the issuance of a  department  of  health
order  or  commissioner  of  health's  order or the seeking of equitable
relief pursuant to section four hundred sixty-d of the  social  services
law;  (D)  the  proposed assessment of civil penalties for violations of
the provisions of subparagraph two of paragraph (b) of subdivision seven
of section four hundred sixty-d of the social services law; or placement
on the "do not refer list" pursuant to subdivision  fifteen  of  section

four  hundred  sixty-d  of the social services law. Referrals may resume
when such enforcement actions are resolved.
(III)  A  community  provider  of mental hygiene services, including a
provider of case management services, which serves residents of any home
or residence in which  the  department  of  social  services  has  acted
pursuant  to subdivision nine of section four hundred sixty-one-c of the
social services law, shall assist the operator of such home or residence
or the department of social services in efforts to secure an appropriate
alternate placement of a resident.
(IV) The commissioner shall promptly refer to the department of social
services any serious complaint  received  about  the  care  provided  or
health  and  safety conditions in an adult home or residence for adults.
The commissioner may as appropriate  assist  the  department  of  social
services  in the investigation and resolution of such complaints as well
as in the investigation and resolution of any such  complaint  which  is
initially received by the department of social services.
(j) The department shall submit to the legislature and the governor by
the   first   day   of   January,   nineteen  hundred  seventy-eight,  a
comprehensive plan describing those reasonable  steps  taken  or  to  be
taken  by  the  department  to  locate former patients who had been in a
department facility for a continuous period for two or more years  prior
to their discharge or conditional release and who had been discharged or
conditionally  released  on  or  after the thirty-first day of December,
nineteen hundred seventy without the benefit of a written service  plan.
In  each  case  in which the person has been located, the department, in
cooperation with appropriate social services officials and directors  of
community services, shall make every effort to develop a written service
plan  for  such  person  and shall assume the same responsibilities with
respect to such person as the department  is  required  to  assume  with
respect  to a person who was discharged or conditionally released from a
department facility pursuant to a written service plan.
(k) No patient shall be required, as  a  condition  precedent  to  his
discharge, to agree to the terms of a written service plan. If after the
advisability  of  following  the program proposed in the written service
plan has been explained to the patient who has been discharged or who is
to be discharged, such patient expresses his objection to  such  program
or  any  part thereof, a notation of such objection shall be made in the
patient's records.
(l) Nothing in this section shall be construed to prohibit, limit,  or
restrict the obligation of the director of a department facility to make
necessary expenditures for the board and family care of patients subject
to  the  approval of the commissioner, provided that no such expenditure
shall be made with respect  to  any  patient  who  is  receiving  public
assistance and care under the social services law.
(m)  It  shall be the responsibility of the chief administrator of any
facility providing inpatient services subject to licensure by the office
of mental health to notify, when appropriate, the local social  services
commissioner   and   appropriate   state   and   local   mental   health
representatives  when  an  inpatient  is  about  to  be  discharged   or
conditionally  released  and  to  provide  to such officials the written
service plan developed for such inpatient as required under  subdivision
(f) of this section.
(n)  It  shall  be  the  duty  of  directors  of local social services
districts and local governmental  units  to  cooperate  with  facilities
licensed  or  operated by an office of the department in the preparation
and implementation of comprehensive written services plans  as  required
by this section.