N.Y. Mental Hygiene Law § 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