N.Y. Mental Hygiene Law § 9.40: Emergency observation, care and treatment in comprehensive psychiatric emergency programs

* § 9.40 Emergency observation, care and treatment in comprehensive

psychiatric emergency programs.

(a) The director of any comprehensive psychiatric emergency program

may receive and retain therein for a period not to exceed seventy-two

hours, any person alleged to have a mental illness for which immediate

observation, care and treatment in such program is appropriate and which

is likely to result in serious harm to the person or others. The

director shall cause to be entered upon the program records the name of

the person or persons, if any, who have brought the person alleged to

have a mental illness to the program and the details of the

circumstances leading the person or persons to bring the person alleged

to have a mental illness to the program. The director shall, in

accordance with section 33.13 of this chapter, upon receipt of a person

under this section, ensure that reasonable efforts are made to identify

and promptly notify any community provider of mental health services

that maintains such person on its caseload.

(a-1) The director shall cause triage and referral services to be

provided by a psychiatric nurse practitioner or physician of the program

as soon as such person is received into the comprehensive psychiatric

emergency program. After receiving triage and referral services, such

person shall be appropriately treated and discharged, or referred for

further crisis intervention services including an examination by a

physician as described in subdivision (b) of this section.

(b) The director shall cause examination of such persons not

discharged after the provision of triage and referral services to be

initiated by a staff physician of the program as soon as practicable and

in any event within six hours after the person is received into the

program's emergency room. Such person may be retained for observation,

care and treatment and further examination for up to twenty-four hours

if, at the conclusion of such examination, such physician determines

that such person may have a mental illness for which immediate

observation, care and treatment in a comprehensive psychiatric emergency

program is appropriate, and which is likely to result in serious harm to

the person or others.

(c) No person shall be involuntarily retained in accordance with this

section for more than twenty-four hours, unless (i) within that time the

determination of the examining staff physician has been confirmed after

examination by another physician who is a member of the psychiatric

staff of the program and (ii) the person is admitted to an extended

observation bed, as such term is defined in section 31.27 of this

chapter. At the time of admission to an extended observation bed, such

person shall be served with written notice of his status and rights as a

patient under this section. Such notice shall contain the patient's

name. The notice shall be provided to the same persons and in the manner

as if provided pursuant to subdivision (a) of section 9.39 of this

article. Written requests for court hearings on the question of need for

immediate observation, care and treatment shall be made, and court

hearings shall be scheduled and held, in the manner provided pursuant to

subdivision (a) of section 9.39 of this article, provided however, if a

person is removed or admitted to a hospital pursuant to subdivision (e)

or (f) of this section the director of such hospital shall be

substituted for the director of the comprehensive psychiatric emergency

program in all legal proceedings regarding the continued retention of

the person.

(d) If at any time it is determined that the person is no longer in

need of immediate observation, care and treatment in accordance with

this section and is not in need of involuntary care and treatment in a

hospital, such person shall be released without regard to the provisions

of section 29.15 of this chapter, unless such person agrees to be

admitted to another appropriate hospital as a voluntary or informal

patient. Provided, however, the facility shall:

1. advise such person of clinically appropriate aftercare services;

and

2. for individuals with complex needs, as defined by the regulations

of the office:

(i) for individuals in care management programs, coordinate discharge

planning with the care management program; and

(ii) provide referrals, if clinically appropriate and available, for

care management services, community-based services, residential

services, or peerbased programs; and

3. comply with additional requirements as may be set forth by the

regulations of the office of mental health.

(e) If at any time within the seventy-two hour period it is determined

that such person continues to require immediate observation, care and

treatment in accordance with this section and such requirement is likely

to continue beyond the seventy-two hour period, such person shall be

removed within a reasonable period of time to an appropriate hospital

authorized to receive and retain patients pursuant to section 9.39 of

this article and such person shall be evaluated for admission and, if

appropriate, shall be admitted to such hospital in accordance with

section 9.39 of this article, except that if the person is admitted, the

fifteen day retention period of subdivision (b) of section 9.39 of this

article shall be calculated from the time such person was initially

registered into the emergency room of the comprehensive psychiatric

emergency program. Any person removed to a hospital pursuant to this

paragraph shall be removed without regard to the provisions of section

29.11 or 29.15 of this chapter and shall not be considered to have been

transferred or discharged to another hospital.

(f) Nothing in this section shall preclude the involuntary admission

of a person to an appropriate hospital pursuant to the provisions of

this article if at any time during the seventy-two hour period it is

determined that the person is in need of involuntary care and treatment

in a hospital and the person does not agree to be admitted to a hospital

as a voluntary or informal patient. Efforts shall be made to assure that

any arrangements for such involuntary admissions in an appropriate

hospital shall be made within a reasonable period of time.

(g) If a person is examined and determined to be mentally ill the fact

that such person suffers from alcohol or substance abuse shall not

preclude receipt or retention under this section.

(h) All time periods referenced in this section shall be calculated

from the time such person is initially registered into the emergency

room of the comprehensive psychiatric emergency program.

* NB Repealed July 1, 2027