2023 New York Laws › MHY - Mental Hygiene › Title E - General Provisions › Article 33 - Rights of Patients › 33.03 - Quality of Care and Treatment.

§ 33.03 Quality of care and treatment.
(a)  Each patient in a facility and each person receiving services for
mental disability shall receive care and treatment that is suited to his
needs and  skillfully,  safely,  and  humanely  administered  with  full
respect for his dignity and personal integrity.
(b)  Subject  to  regulations  of  the commissioner, the director of a
facility shall require the following in order to  assure  protection  of
patients in their care and treatment:
1.  careful reexamination and evaluation of each patient not less than
once a year.
2.  medical  and  dental  evaluations  and   evaluations   of   mental
disabilities of inpatients by qualified professionals no less frequently
than once a year.
3.  the  order  of  a  staff  member  operating  within the scope of a
professional license for any treatment or therapy based  on  appropriate
examination.
4.  consent  for  surgery, shock treatment, major medical treatment in
the nature of surgery, or the use of experimental drugs or procedures.
5. inclusion in the patient's clinical record of all written treatment
plans and notation of examinations, individualized  treatment  programs,
evaluations  and  reexaminations,  orders  for  treatment,  and specific
therapies, signed by the personnel involved.
(c) A patient who is removed, but not discharged, from a  hospital  to
receive medical or surgical care at a facility, at a hospital as defined
in article twenty-eight of the public health law, or at the offices of a
health  care  professional,  shall  remain  subject to the provisions of
article nine of this chapter. During the period of time that the patient
is removed for the purpose of receiving such medical or  surgical  care,
all  of  the patient's rights enumerated by article nine of this chapter
shall be preserved. Nothing in this subdivision shall  be  construed  to
affect  the  status  or  rights of a patient pursuant to article nine of
this chapter, who is removed, but not discharged  from  a  hospital  for
other purposes.
(d)  The  commissioner shall promulgate and administer regulations and
policies for the establishment  of  minimum  standards  for  the  active
programming of patients in adult psychiatric centers.
1. Such standards shall take into account the: medical, psychological,
social,  vocational,  educational  and  recreational  needs  of patients
including the specialized needs of patients such as those  whose  mental
illness   is   combined   with   chemical  dependency  or  developmental
disability. The standards shall also take into account the type and  mix
of  programs  required  at  a  given  facility,  and the availability of
programming at a variety of times and locations.
2. Such standards shall include but  not  be  limited  to,  a  minimum
number  of  required hours of programming per patient per week and staff
requirements based on the type of programming and the needs of  patients
served.  Such  standards  shall  provide  for programming exemptions for
patients  whose  clinical   or   medical   condition   renders   program
participation   inappropriate  and  for  the  regular  review  of  those
exemptions.  Additionally,  a  patient  may  refuse   participation   in
programming  provided  however  that  such  refusal  is  consistent with
applicable provisions of law. The regulations  shall  also  provide  for
routine  evaluations  of  the implementation of scheduled programming as
well as its effect on identified patient needs.
* (e) 1. Notwithstanding the provisions of subdivisions four and  five
of  section twenty-nine hundred eighty-one of the public health law, the
commissioners of health, and developmental disabilities may approve  and
authorize the use of a simplified advance health care directives form by

persons  receiving  supports  and  services  from a provider of services
which is authorized to provide services pursuant to article  sixteen  of
this  chapter.  Such form shall specify, at the option of the principal,
what end-of-life treatment the person wishes to receive; may designate a
health  care  agent  consistent with the provisions of this article; and
may, at the option of the principal, authorize the health care agent  to
commence  making  decisions immediately upon the execution of the proxy,
provided that all such  decisions  made  prior  to  a  determination  of
incapacity  pursuant  to section twenty-nine hundred eighty-three of the
public health  law  shall  be  made  in  direct  consultation  with  the
principal  and  the attending physician; and provided, further, that if,
after such  consultation,  the  principal  disagrees  with  the  agent's
proposed  decision,  the principal's wishes shall prevail; and provided,
further, that, in the case of  any  decision  to  withhold  or  withdraw
artificial nutrition or hydration, the principal's wishes must have been
recorded  in  the health care directive or stated in the presence of the
agent and the attending  physician;  and  further,  provided,  that  the
consultation  among  principal,  agent  and  attending physician must be
summarized and recorded in the principal's medical record.
2. The simplified advance health care directives form,  authorized  by
paragraph   one   of   this  subdivision,  shall  be  developed  by  the
commissioner of developmental disabilities,  in  consultation  with  the
commissioner  of  health,  providers  of  service  authorized to provide
services  pursuant  to  article  sixteen  of  this  chapter,  advocates,
including  self-advocates,  and  parents  and  family members of persons
receiving services from such providers.
* NB Effective upon the date of the approval and availability  of  the
simplified  advance  health  care  directives  form  authorized  by this
subdivision and repealed 2 years after such date.
* NB There are 2 sb (e)'s
* (e) Meals provided by a facility in furtherance of a person's  right
to  a balanced and nutritious diet, as required by section 33.02 of this
article, shall be served at appropriate times and in as normal a  manner
as  possible.  Altering  the  composition  or timing of regularly served
meals shall be prohibited for disciplinary or punishment  purposes,  the
convenience  of the staff, or behavior modification. Restrictions may be
made for clinical reasons, pursuant  to  documentation  by  a  qualified
professional,  which  shall  specify  the clinical justification for the
restriction and the time  period  that  such  restriction  shall  be  in
effect,  and  which  shall  be  included  in  the  individual's  written
treatment or services plan.
* NB There are 2 sb (e)'s