New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 540 - Patients Committed To The Custody Of The Commissioner Pursuant To Cpl Article 730 › Section 540.9 - Hospital forensic committee procedures; clinical director

Current through Register Vol. 46, No. 28, July 10, 2024
(a) A patient who
				wishes to be discharged or conditionally released, converted to civil status,
				transferred to a less secure facility or granted escorted or unescorted
				furlough privileges or his or her legal representative may request his
				treatment team to make an appropriate application to the hospital forensic
				committee.
(b) When the treatment
				team serving a patient is of the opinion that such patient is appropriate for
				escorted furlough, unescorted furlough, transfer, discharge, conditional
				release or conversion to civil status, it shall recommend to the unit chief
				that an application be made to the hospital forensic committee and the clinical
				director. When the treatment team serving a patient is of the opinion that such
				patient is appropriate for return to the custody of the criminal court, it
				shall recommend to the unit chief that an application be made to the hospital
				forensic committee or to the clinical director, if he or she has designated a
				psychiatric examiner in accordance with procedures described in section
				540.8(c) 
				of this Part. The treatment team may act on its own initiative or at the
				patient's request.
(c) If the unit
				chief, after review of the case, agrees with the opinion of the treatment team,
				he or she and the team psychiatrist shall execute an application. Upon
				completion of the application, the unit chief shall forward it to the hospital
				forensic committee or to the clinical director, if he or she has designated a
				psychiatric examiner in accordance with the procedures described in section
				540.8(c) 
				of this Part.
(d) The committee
				shall meet to discuss the application within seven days of its receipt of the
				application from the unit chief. The committee shall notify the patient, the
				patient's attorney, and the Mental Hygiene Legal Service of its meeting at
				least three days prior to the meeting. Proof of service of such notice shall be
				placed in the patient's record. The patient, the Mental Hygiene Legal Service
				or an attorney or representative of his or her choice may attend the
				meeting.
(e) The committee shall
				review all information pertaining to the patient and, if necessary, conduct a
				joint examination of the patient. Within seven days of its meeting to discuss
				the application, the committee shall make a written recommendation to the
				clinical director regarding the merits of the application. Such recommendation
				need not be unanimous. If one member of the committee disagrees, he or she
				shall so notify the clinical director, in writing.
(f) If the application on behalf of the
				patient is for conversion of the patient to civil status, the committee shall
				consider whether the patient is mentally ill, in need of care and treatment in
				a hospital, lacks the judgment necessary to understand such need, and would
				either be unable to live outside the hospital with the help of family or
				friends or would pose a danger to himself or herself or others. If the patient
				meets such criteria, the committee shall recommend to the clinical director
				that the patient be involuntarily civilly committed. If the patient does not
				meet those criteria but is suitable for continued hospitalization, the
				committee shall recommend to the clinical director that the patient be
				converted to voluntary civil status. If the patient should not be hospitalized,
				the committee shall so recommend to the clinical director.
(g) If an application is made seeking the
				discharge or conditional release of a patient against whom criminal charges are
				not pending, the committee shall consider whether the patient suffers a mental
				illness and requires inpatient care and treatment in a hospital, lacks the
				judgment to understand his or her need for such treatment and would either be
				unable to live outside the hospital with the help of family or friends or would
				pose a danger to himself or herself or other persons if released. If the
				patient meets each of the above criteria, the committee shall recommend that
				the patient continue in the custody of the commissioner as an involuntary civil
				patient. If the committee believes that the patient does not meet such
				criteria, it shall recommend that the patient be released.
(h) If an application is made to the
				committee in accordance with the procedures described in section
				540.8(b) 
				of this Part, for a determination of fitness to stand trial and return to court
				of a patient against whom criminal changes remain pending, the committee shall
				consider whether the patient suffers a mental illness which renders him or her
				incapable of understanding the charges against him and assisting in his or her
				own defense.
(i) If an application
				is made for the granting of escorted or unescorted furlough, the committee may
				recommend that such furlough privileges be granted if it finds that they would
				be clinically beneficial to the patient and that, in its opinion, the patient
				may be granted furlough privileges without endangering another person or
				persons outside the facility. If the committee recommends that escorted or
				unescorted furlough be granted, it shall also recommend the duration of each
				exercise of those furlough privileges and the period of time for which the
				granting of furlough privileges should remain outstanding. If an application is
				made to grant a patient escorted or unescorted furlough privileges and the
				committee is of the opinion that the patient would pose an immediate danger to
				another person or persons if allowed outside the facility, or that the patient
				is otherwise not suited for such furlough, it shall recommend that the furlough
				be denied.
(j) If an application is
				made to transfer the patient to a less secure facility, the committee shall
				consider whether such transfer would be in the best interest of the patient and
				whether the patient's behavior is such that the transfer would jeopardize the
				safety of the patient, other patients or staff at a less secure facility. If
				the committee is of the opinion that such transfer could jeopardize the safety
				of the patient or any other person, or would render an escape attempt likely,
				it shall recommend against transfer.
(k)
(1) The
				clinical director shall have responsibility for deciding whether to grant an
				application for the conversion to civil status, granting of furlough,
				discharge, or conditional release of a patient. In exercising such
				responsibility, he or shall review the recommendations of the hospital forensic
				committee. The clinical director need not follow such recommendations, but
				shall not take action contrary to the recommendation of a majority of the
				committee without first consulting with a clinician who is not employed at the
				facility.
(2) The clinical director
				shall have responsibility for deciding whether to grant an application for a
				return to court of a patient who is no longer an incapacitated person but
				against whom criminal charges remain pending. In exercising such
				responsibility, he or she shall:
(i) review
				the recommendation of the hospital forensic committee if consultation is
				requested in accordance with section
				540.8(b) 
				of this Part. The clinical director is not required to follow such
				recommendations, but shall not take action contrary to the recommendation of a
				majority of the committee without first consulting with a clinician who is not
				employed at the facility; or
(ii)
				review the report and recommendations of the psychiatric examiner that he or
				she has designated in accordance with the procedures described in section
				540.8(c) 
				of this Part. The clinical director is not required to follow such
				recommendations.