Current through Register Vol. 46, No. 39, September 25, 2024
(a)
General.
Patients may object to any form of care and treatment and
may appeal decisions with which they disagree.
(b)
Effect of objection on treatment
process.
(1) Emergency treatment.
Facilities may give treatment, other than treatment for which informed consent
is required by section
27.9
of this Part, at any time to all patients, despite objection in a case where
the treatment appears necessary to avoid serious harm to life or limb of the
patients themselves or others. Emergency treatment in situations covered by
section
27.9
shall be pursuant to such section.
(2) Patients on voluntary or informal status.
Patients who are on a voluntary or informal status may not be given treatment
over their objection. When any such patient objects to all recommended forms of
treatment, the facility director may, after notification to the patient,
discharge the patient with recommendations for outpatient care if indicated,
or, if appropriate, take steps to convert the patient to involuntary status as
set forth in the Mental Hygiene Law. When a patient is discharged because of
objection to all recommended forms of treatment, the facility director should
have the patient's family notified if feasible.
(3) Patients on involuntary status. Patients
held on involuntary status may be given treatment over their objections only if
the following conditions are compiled with:
(i) If the objections raised by the patient
are disposed of as set forth in subdivisions (c), (d) and (e) of this
section.
(ii) If the objection is
based on an assertion that the treatment is in conflict with a religious belief
of the patient, only if there is a court order authorizing the particular
treatment.
(iii) If the type of
treatment to be provided required informed consent as required by section
27.9
of this Part, only to the extent allowed by such section.
(iv) If conditions specified in paragraph (1)
of this subdivision (need for emergency treatment) are present.
(c) Review of
objection.
Prior to initiating a treatment procedure over the
objection of a patient, such objection must be reviewed by the head of the
service. The decision of the head of the service shall be communicated to the
patient and his or her representative, if any, and to the Mental Health
Information Service, and treatment may be initiated unless the patient or her
or his representative chooses to appeal this decision to the director. The
appeal procedure shall be in accordance with subdivision (e) of this
section.
(d)
Patient's
right to representative.
Patients have the right to request that legal counsel or
other concerned person represent them in the formal appeal procedures
authorized in this section.
(e)
Appeal.
(1) If the patient or a representative of the
patient has appealed to the facility director from a decision of the head of
the service with respect to an objection to treatment, the director shall
consider the appeal and make a decision. The decision of the director shall be
communicated to the patient and the patient's representative, if any, and to
the Mental Health Information Service.
(2) A patient shall also have the right to
appeal to the director any decision to which he objects relating to his care
and treatment at the facility.
(3)
In cases of facilities operated by the Office of Mental Health, the patient may
appeal from any such decision of the director to the commissioner or his or her
designee. Such request for review must be filed with the director within five
days, excluding Saturdays, Sundays, and holidays, after notification of the
director's decision. The director of the facility shall forthwith transmit the
request to the commissioner or his or her designee. When the commissioner or
his or her designee decides the issue, the patient, the patient's
representative, and the director of the Mental Hygiene Legal Service shall be
notified of the decision.
