N.Y. Mental Hygiene Law § 22.09: Emergency services for persons intoxicated, impaired, or incapacitated by alcohol and/or substances

§ 22.09 Emergency services for persons intoxicated, impaired, or

incapacitated by alcohol and/or substances.

(a) As used in this article:

1. "Intoxicated or impaired person" means a person whose mental or

physical functioning is substantially impaired as a result of the

presence of alcohol and/or substances in his or her body.

2. "Incapacitated" means that a person, as a result of the use of

alcohol and/or substances, is unconscious or has his or her judgment

otherwise so impaired that he or she is incapable of realizing and

making a rational decision with respect to his or her need for

treatment.

3. "Likelihood to result in harm" or "likely to result in harm" means

(i) a substantial risk of physical harm to the person as manifested by

threats of or attempts at suicide or serious bodily harm or other

conduct demonstrating that the person is dangerous to himself or

herself, or (ii) 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.

4. "Emergency services" means immediate physical examination,

assessment, care and treatment of an incapacitated person for the

purpose of confirming that the person is, and continues to be,

incapacitated by alcohol and/or substances to the degree that there is a

likelihood to result in harm to the person or others.

5. "Treatment facility" means a facility designated by the

commissioner which may only include a general hospital as defined in

article twenty-eight of the public health law, or a medically managed or

medically supervised withdrawal, inpatient rehabilitation, or

residential stabilization treatment program that has been certified by

the commissioner to have appropriate medical staff available on-site at

all times to provide emergency services and continued evaluation of

capacity of individuals retained under this section or a crisis

stabilization center licensed pursuant to article 36.01 of this chapter.

(b) 1. An intoxicated or impaired person may come voluntarily for

emergency services to a chemical dependence program or treatment

facility authorized by the commissioner to provide such emergency

services. A person who appears to be intoxicated or impaired and who

consents to the proffered help may be assisted by any peace officer

acting pursuant to his or her special duties, police officer, or by a

designee of the director of community services to return to his or her

home, to a chemical dependence program or treatment facility, or to any

other facility authorized by the commissioner to provide such emergency

services. In such cases, the peace officer, police officer, or designee

of the director of community services shall accompany the intoxicated or

impaired person in a manner which is reasonably designed to assure his

or her safety, as set forth in regulations promulgated in accordance

with subdivision (d) of this section.

2. A person who appears to be incapacitated by alcohol and/or

substances to the degree that there is a likelihood to result in harm to

the person or to others may be taken by a peace officer acting pursuant

to his or her special duties, or a police officer who is a member of the

state police or of an authorized police department or force or of a

sheriff's department or by the director of community services or a

person duly designated by him or her to a treatment facility for

purposes of receiving emergency services. Every reasonable effort shall

be made to protect the health and safety of such person, including but

not limited to the requirement that the peace officer, police officer,

or director of community services or his or her designee shall accompany

the apparently incapacitated person in a manner which is reasonably

designed to assure his or her safety, as set forth in regulations

promulgated in accordance with subdivision (d) of this section.

3. A person who comes voluntarily or is brought without his or her

objection to any such facility or program in accordance with this

subdivision shall be given emergency care and treatment at such place if

found suitable therefor by authorized personnel, or referred to another

suitable facility or treatment program for care and treatment, or sent

to his or her home.

4. The director of a treatment facility may receive as a patient in

need of emergency services any person who appears to be incapacitated as

defined in this section.

5. A person who comes voluntarily or is brought with his or her

objection to a treatment facility shall be examined as soon as possible

but not more than twelve hours after arriving at such treatment facility

by an examining physician. If such examining physician determines that

such person is incapacitated by alcohol and/or substances to the degree

that there is a likelihood to result in harm to the person or others, he

or she may be retained to receive emergency services and shall be

regularly reevaluated to confirm continued incapacity by alcohol and/or

substances to the degree that there is a likelihood to result in harm to

the person or others. If the examining physician determines at any time

that such person is not incapacitated by alcohol and/or substances to

the degree that there is a likelihood to result in harm to the person or

others, he or she must be released. Notwithstanding any other law, in no

event may such person be retained against his or her objection beyond

whichever is the shorter of the following: (i) the time that he or she

is no longer incapacitated by alcohol and/or substances to the degree

that there is a likelihood to result in harm to the person or others or

(ii) a period longer than seventy-two hours.

6. Every reasonable effort must be made to obtain the person's consent

to give prompt notification of a person's retention in a facility or

program pursuant to this section to his or her closest relative or

friend, and, if requested by such person, to his or her attorney and

personal physician, in accordance with federal confidentiality

regulations.

7. A person may not be retained pursuant to this section beyond a

period of seventy-two hours without his or her consent. Persons suitable

therefor may be voluntarily admitted to a chemical dependence program or

facility pursuant to this article.

(c) Discharge procedures. 1. The discharge procedure process shall

begin as soon as the patient is admitted to the treatment facility and

shall be considered a part of the treatment planning process. The

discharge plan shall be developed in collaboration with the patient and

any significant other(s) the patient chooses to involve. If the patient

is a minor, the discharge plan must also be developed in consultation

with his or her parent or guardian, unless the minor is being treated

without parental consent as authorized by section 22.11 of this chapter.

2. No patient shall be discharged without a discharge plan which has

been completed and reviewed by the multi-disciplinary team prior to the

discharge of the patient. This review may be part of a regular treatment

plan review. The portion of the discharge plan which includes the

referrals for continuing care shall be given to the patient upon

discharge. This requirement shall not apply to patients who refuse

continuing care planning, provided, however, that the treatment facility

shall make reasonable efforts to provide information about the dangers

of long term substance use as well as information related to treatment

including, but not limited to, the OASAS HOPELINE and the OASAS Bed

Availability Dashboard.

3. The discharge plan shall be developed by the responsible clinical

staff member, who, in the development of such plan, shall consider the

patient's self-reported confidence in maintaining abstinence and

following an individualized relapse prevention plan. The responsible

clinical staff member shall also consider an assessment of the patient's

home and family environment, vocational/educational/employment status,

and the patient's relationships with significant others. The purpose of

the discharge plan shall be to establish the level of clinical and

social resources available to the patient upon discharge from the

inpatient service and the need for the services for significant others.

The discharge plan shall include, but not be limited to, the following:

(i) identification of continuing chemical dependence services

including management of withdrawal or continuing stabilization and any

other treatment, rehabilitation, self-help and vocational, educational

and employment services the patient will need after discharge;

(ii) identification of the type of residence, if any, that the patient

will need after discharge;

(iii) identification of specific providers of these needed services;

and

(iv) specific referrals and initial appointments for these needed

services.

4. A discharge summary which includes the course and results of care

and treatment must be prepared and included in each patient's case

record within twenty days of discharge.

(d) The commissioner shall promulgate all rules and regulations, after

consulting with representatives of appropriate law enforcement and

chemical dependence providers of services, establishing procedures for

taking intoxicated or impaired persons and persons apparently

incapacitated by alcohol and/or substances to their residences or to

appropriate public or private facilities for emergency services and for

minimizing the role of the police in obtaining treatment of such persons

necessary to implement the provisions of this section, including but not

limited to establishing procedures for transporting incapacitated

persons to a treatment facility for emergency services.