N.Y. Comp. Codes R. & Regs. tit. 14 § 815.7

Current through Register Vol. 46, No. 45, November 2, 2024

Section 815.7 - Procedure at discharge

(a) The director of a facility or service provider shall be responsible for any recommendation to discharge a patient against the patient's wishes. The director or their designee shall implement such recommendations only after the director:

(1) reviews the recommendation to discharge to ensure that the reason(s) is fair, not arbitrary or capricious, and is serious enough to warrant discharge;

(2) reviews and evaluates the patient's total response to treatment, in light of the recommendation to discharge;

(3) confers with staff at a multidisciplinary meeting to discuss the patient's response to treatment and the recommendation to discharge;

(4) confirms that, within reasonable clinical judgment, all incremental strength-based and trauma-informed interventions have been tried but without success, including consideration of transfer to another provider;

(5) provides a written notice to the patient that indicates the reason(s) for the recommended discharge as well as required information on how to appeal;

(6) if the patient appeals, meets with the patient to conduct the appeal no sooner than twenty-four (24) hours after provision of the notice, to allow the patient time to seek the advice of others, if desired, and discusses with the patient the reasons to implement or rescind the recommendation to discharge; and

(7) informs the patient in writing of the decision to implement or rescind the recommendation to discharge no later than seventy-two (72) hours after the appeal is made;

(i) if discharge is decided after the appeal, assures that the patient receives information about treatment and referral options, and connections to such referrals if desired;

(ii) if rescission of the discharge is decided after the appeal, assure the patient full opportunity to continue treatment.

(b) For providers of opioid full agonist medications, no dose taper shall begin until after completion of the aforesaid process and all efforts to transfer the patient to another provider of opioid full agonist medications have been exhausted.

(c) For inpatient and residential providers, no patient shall be forced to leave the program until after completion of the aforesaid process. No patient shall be forced to leave the program between 6:00 P.M. and 8:00 A.M. unless appropriate arrangements have been made. Safe and appropriate transportation, travel arrangements, and travel costs shall be provided or arranged as needed.

(d) The patient, and their family/significant other(s) shall be offered overdose prevention education, naloxone education and training and a naloxone kit or prescription.

(e) None of the foregoing shall apply to an emergency discharge where the patient is determined reasonably to be a danger to others. A provider may make an emergency discharge immediately upon making such a determination, subject to the patient's right to appeal after the patient is discharged.

(f) A discharge pursuant to a patient's refusal to consent to a proper request to screen in accordance with section 815.10 of this Part may be made immediately upon the refusal but incremental strength-based and trauma informed interventions should be employed before a patient is discharged for the refusal, subject to the patient's right to appeal after the patient is discharged.

(g) All of the foregoing must be documented in the patient's record.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 815.7

Adopted New York State Register September 9, 2015/Volume XXXVII, Issue 36, eff. 9/9/2015

Amended New York State Register April 10, 2019/Volume XLI, Issue 15, eff. 4/10/2019

Amended New York State Register September 14, 2022/Volume XLIV, Issue 37, eff. 10/1/2022