S4881A-2011 Actions

• Jun 7, 2012: PRINT NUMBER 4881B
• Jun 7, 2012: AMEND AND RECOMMIT TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
• May 3, 2012: PRINT NUMBER 4881A
• May 3, 2012: AMEND (T) AND RECOMMIT TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
• Jan 4, 2012: REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
• Apr 28, 2011: REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

S4881A-2011 Memo

BILL NUMBER:S4881A

TITLE OF BILL:

An act
to amend the mental hygiene law and the correction law, in relation to
enhancing the assisted outpatient treatment program; and to amend
Kendra's Law, in relation to making the provisions thereof permanent

PURPOSE OR GENERAL IDEA OF BILL:

To improve care for people with serious mental illness, and protect
the safety of patients and the public by streamlining and improving
New York's Assisted Outpatient Treatment (AOT) program (Kendra's Law).

SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Mental Hygiene Law (MHL) � 7.17(f) to require that
AOT program coordinators: monitor local programs to ensure that
expiring AOT orders are adequately reviewed to consider the need for
renewal;
and monitor local needs for training of judges and court personnel to
ensure that the office of mental health adequately provides such
training.

Section 2 clarifies that directors of community services shall be
responsible for ensuring that reports of persons who may be in need
of continued AOT orders are subject to a timely investigation.

Section 3 amends MHL � 9.48 to require that AOT program directors'
quarterly reports to program coordinators include information on any
expired AOT court orders, including the determination made as to
whether to petition for renewal, the basis for such determination,
and the court's disposition of the renewal petition, if any.

Section 4 amends MHL � 9.60 to clarify that assisted outpatient
treatment services provided may include:
medication education or symptom management education;
appointment of a representative payee; and that tests for alcohol or
drugs may be random. Also provides that the parties to the treatment
order may stipulate, upon mutual consent, that an examining physician
need not testify in court. Also, provides that the appointed
physician shall make a reasonable effort to gather relevant
information for the development of a treatment plan from a member or
members of the patient's family or significant other.

This section also clarifies that directors of hospitals or
superintendents of correctional facilities may initiate a petition.

This section also provides that the Commissioner will establish a
procedure to ensure that reports of persons who may be in need of AOT
that are made by family and community members of such person are, if
warranted, investigated in a timely manner, and that AOT petitions
are filed, where appropriate.


This section also provides that the Commissioner shall promulgate
regulations to require that prior to a assisted outpatient relocating
to within the state of New York to a location not served by his or
her current director of community services, that patient or other
appropriate party must notify the program coordinator. The program
coordinator shall then redetermine who the appropriate director shall
be, and cause a copy of the court order and treatment plan to be
transmitted to the new director.

This section also provides that a director shall review whether the
assisted outpatient continues to meet AOT criteria within 30 days
before the expiration of an order for AOT. If the director determines
that such assisted outpatient no longer meets the criteria, such
director is required to give notice to the program coordinator that a
petition for continued AOT is unnecessary. However, if such assisted
outpatient continues to meet the criteria, as determined by the
director, such director shall file a petition for continued treatment.

This provision clarifies procedures any other person authorized to
petition for continued AOT may use to bring such petition in the
event that the appropriate director or current petitioner does not
petition for continued AOT prior to the expiration of the court order.

Section 5 amends MHL �29.15: if the director of the hospital does not
petition for AOT upon the discharge of an involuntarily committed
inpatient or upon the expiration of a period of conditional release
for such inpatient, such director shall report the discharge in
writing to the director of community services of the local government
unit where the inpatient is expected to reside.

Section 6 amends subdivision 1 of section 404 of the correction law to
require that, prior to discharging an inmate who is still mentally
ill, the director shall, where appropriate either apply for a
person's admission to a hospital for care and treatment, or initiate
a petition for an order authorizing assisted outpatient treatment, or
the commissioner may apply for the person's admission to a secure
treatment facility.

Section 7 would repeal the current sunset date to make the provisions
of Kendra's Law permanent.

Section 8 Severability.

Section 9 states that this act shall take effect immediately.

JUSTIFICATION:

In 1999, the legislature enacted "Kendra's Law," establishing a
statewide court-ordered assisted outpatient treatment (AOT) program
to improve outcomes for persons with severe mental illness who, in
view of their treatment history and present circumstances, are likely
to have difficulty living safely in the community. At the approach of
the law's
original 2005 expiration date, the legislature took note of Office of
Mental Health (OMR) research documenting declines in rates of
homelessness, hospitalization, substance abuse, alcoholism, violence,
arrest and incarceration, and documented increases in treatment


compliance, service engagement and positive consumer perceptions. In
2005, the legislature opted to extend Kendra's Law for an additional
five years to further evaluate the program.

On June 30, 2009, a team of independent researchers released the
report of their long term study of AOT throughout New York State and
in October, 2010 Psychiatric Services published six peer reviewed
studies on the AOT program. These reports confirm the earlier OMH
data. These studies found patients given mandatory outpatient
treatment who were more violent to begin with - were nevertheless
four times less likely than members of the control group to
perpetrate serious violence after undergoing assisted outpatient
treatment and found less frequent psychiatric hospitalizations,
shorter length of hospitalizations, reduction in the likelihood of
arrest, higher social functioning, slightly less stigma and no
increase in perceived coercion. AOT stimulates service providers
efforts to prioritize care for AOT recipients; judges hearing AOT
cases could benefit from additional AOT training; counties favored
increasing the availability of stipulations to reduce the court
burden, costs, and transportation burdens; recipients are far more
likely than other patients to consistently receive psychotropic
medications appropriate to their psychiatric condition; that those
who receive AOT for periods of at least one year are more likely than
those who
receive AOT for shorter periods to sustain gains after leaving the
program; that the law has been applied in a non-discriminatory
manner; and that the court order itself, in addition to high quality
services, is a significant factor in the program's success.

The experience of thousands of patients, treatment providers and
families who have utilized Kendra's Law since 1999, point to several
areas where the law should be improved to achieve costs savings,
promote smoother functioning of the AOT program and easier access to
those who stand to benefit from it. The amendments included in this
act are intended to reflect these findings and maximize the unique
potential of this legislation to simultaneously serve the goals of
compassionate care, fiscal responsibility, and public safety.

PRIOR LEGISLATIVE HISTORY:

New Bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect immediately, with provisions.

S4881A-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                   4881--A

                         2011-2012 Regular Sessions

                              I N  SENATE

                               April 28, 2011
                                 ___________

  Introduced  by  Sens. YOUNG, ALESI, BONACIC, DeFRANCISCO, GOLDEN, LANZA,
    LARKIN, LIBOUS, MAZIARZ, McDONALD, PARKER -- read  twice  and  ordered
    printed,  and  when printed to be committed to the Committee on Mental
    Health and Developmental Disabilities -- recommitted to the  Committee
    on  Mental  Health  and  Developmental Disabilities in accordance with
    Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
    reprinted as amended and recommitted to said committee

  AN  ACT  to  amend  the  mental  hygiene  law and the correction law, in
    relation to enhancing the assisted outpatient treatment  program;  and
    to  amend  Kendra's  Law, in relation to making the provisions thereof
    permanent

    THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
  BLY, DO ENACT AS FOLLOWS:


    Section  1.  Paragraph  2  of  subdivision  (f) of section 7.17 of the
  mental hygiene law, as amended by chapter 158 of the laws  of  2005,  is
  amended to read as follows:

    (2)  The  oversight  and monitoring role of the program coordinator of
  the assisted outpatient treatment program  shall  include  each  of  the
  following:

    (i)  that each assisted outpatient receives the treatment provided for
  in the court order issued pursuant to section  9.60  of  this  [chapter]
  TITLE;
    (ii)  that  existing  services  located  in  the assisted outpatient's
  community are utilized whenever practicable;
    (iii) that a case manager or assertive  community  treatment  team  is
  designated for each assisted outpatient;
    (iv)  that  a  mechanism  exists  for  such case manager, or assertive
  community treatment team, to regularly report the assisted  outpatient's
  compliance, or lack of compliance with treatment, to the director of the
  assisted outpatient treatment program;

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD10473-07-2

 S. 4881--A                          2

    (v)  that directors of community services establish procedures [which]
  THAT provide that reports of persons who may  be  in  need  of  assisted
  outpatient  treatment are appropriately investigated in a timely manner;
  [and]
    (vi)  that  assisted  outpatient treatment services are delivered in a
  timely manner[.];
    (VII) THAT, PRIOR TO THE EXPIRATION OF ASSISTED  OUTPATIENT  TREATMENT
  ORDERS,  THE  CLINICAL  NEEDS  OF  ASSISTED  OUTPATIENTS  ARE ADEQUATELY
  REVIEWED IN DETERMINING THE NEED  TO  PETITION  FOR  CONTINUED  ASSISTED
  OUTPATIENT TREATMENT PURSUANT TO SUBDIVISION (M) OF SECTION 9.60 OF THIS
  TITLE;
    (VIII)  THAT  THE APPROPRIATE DIRECTOR IS DETERMINED FOR EACH ASSISTED
  OUTPATIENT, PURSUANT TO SUBDIVISIONS (K) AND (L) OF SECTION 9.60 OF THIS
  TITLE; AND
    (IX) THAT THE OFFICE FULFILLS ITS DUTIES PURSUANT TO  SUBDIVISION  (T)
  OF SECTION 9.60 OF THIS TITLE TO MEET LOCAL NEEDS FOR TRAINING OF JUDGES
  AND COURT PERSONNEL.
    S  2.  Subdivision  (b)  of section 9.47 of the mental hygiene law, as
  amended by chapter 158 of the laws  of  2005,  is  amended  to  read  as
  follows:

    (b) All directors of community services shall be responsible for:

    (1) receiving reports of persons who may be in need of assisted outpa-
  tient  treatment PURSUANT TO PARAGRAPH TWO OF SUBDIVISION (F) OF SECTION
  7.17 OF THIS TITLE and documenting the receipt date of such reports;
    (2) conducting timely investigations of such reports RECEIVED PURSUANT
  TO PARAGRAPH ONE OF THIS SUBDIVISION and providing written  notice  upon
  the  completion of investigations to reporting persons and program coor-
  dinators, appointed by the commissioner [of mental health]  pursuant  to
  subdivision  (f)  of  section  7.17  of  this title, and documenting the
  initiation and completion dates of such investigations and the  disposi-
  tions;
    (3)  filing of petitions for assisted outpatient treatment pursuant to
  [paragraph] SUBPARAGRAPH (vii) of PARAGRAPH ONE OF subdivision [(e)] (F)
  of section 9.60 of this article, and  documenting  the  petition  filing
  [date] DATES and the [date] DATES of the court [order] ORDERS;
    (4)  coordinating  the  timely delivery of court ordered services with
  program coordinators and documenting the date assisted outpatients begin
  to receive the services mandated in the court order; and
    (5) reporting on a quarterly basis to program coordinators the  infor-
  mation collected pursuant to this subdivision.
    S  3. Paragraphs (viii) and (ix) of subdivision (b) of section 9.48 of
  the mental hygiene law are renumbered paragraphs (ix) and (x) and a  new
  paragraph (viii) is added to read as follows:

    (VIII)  AN  ACCOUNT  OF  ANY COURT ORDER EXPIRATION, INCLUDING BUT NOT
  LIMITED TO THE DIRECTOR'S DETERMINATION AS TO WHETHER  TO  PETITION  FOR
  CONTINUED  ASSISTED  OUTPATIENT  TREATMENT,  PURSUANT TO SECTION 9.60 OF
  THIS ARTICLE, THE BASIS FOR SUCH DETERMINATION, AND THE  DISPOSITION  OF
  ANY SUCH PETITION;
    S 4. Section 9.60 of the mental hygiene law, as amended by chapter 158
  of  the  laws  of  2005,  paragraph  1  of subdivision (a) as amended by
  section 1 of part E of chapter 111 of the laws of 2010, paragraph  5  of
  subdivision  (c)  as  amended  by  chapter  137  of the laws of 2005, is
  amended to read as follows:

  S 9.60 Assisted outpatient treatment.
    (a) Definitions. For purposes of this  section,  the  following  defi-
  nitions shall apply:


 S. 4881--A                          3

    (1)  "assisted  outpatient  treatment" shall mean categories of outpa-
  tient services [which] THAT have been ordered by the court  pursuant  to
  this  section.  Such treatment shall include case management services or
  assertive community treatment team  services  to  provide  care  coordi-
  nation,  and  may  also  include  any  of  the  following  categories of
  services: medication SUPPORT; MEDICATION EDUCATION OR SYMPTOM MANAGEMENT
  EDUCATION; periodic blood tests or urinalysis  to  determine  compliance
  with prescribed medications; individual or group therapy; day or partial
  day  programming  activities;  educational  and  vocational  training or
  activities; APPOINTMENT OF A REPRESENTATIVE  PAYEE  OR  OTHER  FINANCIAL
  MANAGEMENT  SERVICES,  SUBJECT  TO FINAL APPROVAL OF THE SOCIAL SECURITY
  ADMINISTRATION, WHERE APPLICABLE; alcohol or substance  abuse  treatment
  and  counseling and periodic OR RANDOM tests for the presence of alcohol
  or illegal drugs for persons with a  history  of  alcohol  or  substance
  abuse; supervision of living arrangements; and any other services within
  a  local  services  plan developed pursuant to article forty-one of this
  chapter, CLINICAL OR NON-CLINICAL,  prescribed  to  treat  the  person's
  mental illness and to assist the person in living and functioning in the
  community,  or to attempt to prevent a relapse or deterioration that may
  reasonably be predicted to result in suicide or the need for  hospitali-
  zation.
    (2)  "director"  shall  mean  the  director of community services of a
  local governmental unit, or the director of a hospital licensed or oper-
  ated by the office of mental health which operates, directs  and  super-
  vises an assisted outpatient treatment program.
    (3)  "director  of  community  services" and "local governmental unit"
  shall have the same meanings as provided in article  forty-one  of  this
  chapter.
    (4)  "assisted  outpatient  treatment  program" shall mean a system to
  arrange for and coordinate the provision of assisted  outpatient  treat-
  ment, to monitor treatment compliance by assisted outpatients, to evalu-
  ate  the condition or needs of assisted outpatients, to take appropriate
  steps to address the needs of such individuals, and to ensure compliance
  with court orders.
    (5) "assisted outpatient" shall mean the person under a court order to
  receive assisted outpatient treatment.
    (6) "subject of the petition" or "subject" shall mean the  person  who
  is  alleged  in  a  petition,  filed  pursuant to the provisions of this
  section, to meet the criteria for assisted outpatient treatment.
    (7) "correctional facility" and "local  correctional  facility"  shall
  have the same meanings as provided in section two of the correction law.
    (8)  "health  care  proxy" and "health care agent" shall have the same
  meanings as provided in article twenty-nine-C of the public health law.
    (9) "program coordinator" shall mean an individual  appointed  by  the
  commissioner  [of mental health], pursuant to subdivision (f) of section
  7.17 of this chapter, who is responsible for the oversight and  monitor-
  ing of assisted outpatient treatment programs.
    (b) Programs. The director of community services of each local govern-
  mental  unit  shall operate, direct and supervise an assisted outpatient
  treatment program. The director of a hospital licensed  or  operated  by
  the  office  [of  mental  health]  may  operate, direct and supervise an
  assisted outpatient treatment program, upon approval by the  commission-
  er.  Directors  of  community services shall be permitted to satisfy the
  provisions of this subdivision through the operation of  joint  assisted
  outpatient  treatment  programs.  Nothing  in  this subdivision shall be
  interpreted to preclude  the  combination  or  coordination  of  efforts

 S. 4881--A                          4

  between  and  among  local governmental units and hospitals in providing
  and coordinating assisted outpatient treatment.
    (c)  Criteria.  A person may be ordered to receive assisted outpatient
  treatment if the court finds that such person:

    (1) is eighteen years of age or older; and
    (2) is suffering from a mental illness; and
    (3) is unlikely to survive safely  in  the  community  without  super-
  vision, based on a clinical determination; and
    (4)  has  a  history  of  lack of compliance with treatment for mental
  illness that has:

    (i) prior to the filing of the petition, at  least  twice  within  the
  last thirty-six months been a significant factor in necessitating hospi-
  talization  in a hospital, or receipt of services in a forensic or other
  mental health unit of a correctional facility or  a  local  correctional
  facility,  not including any current period, or period ending within the
  last six months, during which the  person  was  or  is  hospitalized  or
  incarcerated; or
    (ii) prior to the filing of the petition, resulted in one or more acts
  of  serious  violent  behavior  toward  self or others or threats of, or
  attempts at, serious physical harm to self or  others  within  the  last
  forty-eight  months,  not including any current period, or period ending
  within the last six months, in which the person was or  is  hospitalized
  or incarcerated; and
    (5)  is,  as a result of his or her mental illness, unlikely to volun-
  tarily participate in outpatient treatment that would enable him or  her
  to live safely in the community; and
    (6)  in  view of his or her treatment history and current behavior, is
  in need of assisted outpatient treatment in order to prevent  a  relapse
  or  deterioration which would be likely to result in serious harm to the
  person or others as defined in section 9.01 of this article; and
    (7) is likely to benefit from assisted outpatient treatment.
    (d) Health care proxy. Nothing in this section shall preclude a person
  with a health care proxy from being subject to a  petition  pursuant  to
  this  chapter  and  consistent  with article twenty-nine-C of the public
  health law.
    (e) INVESTIGATION OF REPORTS. THE COMMISSIONER SHALL PROMULGATE  REGU-
  LATIONS  ESTABLISHING A PROCEDURE TO ENSURE THAT REPORTS OF A PERSON WHO
  MAY BE  IN  NEED  OF  ASSISTED  OUTPATIENT  TREATMENT,  INCLUDING  THOSE
  RECEIVED  FROM FAMILY AND COMMUNITY MEMBERS OF SUCH PERSON, ARE INVESTI-
  GATED IN A TIMELY MANNER AND, WHERE APPROPRIATE, RESULT IN THE FILING OF
  PETITIONS FOR ASSISTED OUTPATIENT TREATMENT.
    (F) Petition to the court. (1) A petition  for  an  order  authorizing
  assisted  outpatient  treatment  may  be  filed in the supreme or county
  court in the county in which the subject of the petition is  present  or
  reasonably  believed  to be present. Such petition may be initiated only
  by the following persons:

    (i) any person eighteen years of age or older with whom the subject of
  the petition resides; or
    (ii) the parent, spouse, sibling eighteen years of age  or  older,  or
  child eighteen years of age or older of the subject of the petition; or
    (iii)  the director of a hospital in which the subject of the petition
  is hospitalized; or
    (iv) the director of any public or charitable organization, agency  or
  home  providing mental health services to the subject of the petition or
  in whose institution the subject of the petition resides; or

 S. 4881--A                          5

    (v) a qualified psychiatrist who is either supervising  the  treatment
  of or treating the subject of the petition for a mental illness; or
    (vi)  a  psychologist, licensed pursuant to article one hundred fifty-
  three of the education law, or a social  worker,  licensed  pursuant  to
  article one hundred fifty-four of the education law, who is treating the
  subject of the petition for a mental illness; or
    (vii)  the  director of community services, or his or her designee, or
  the social services official, as defined in the social services law,  of
  the  city  or  county in which the subject of the petition is present or
  reasonably believed to be present; or
    (viii) a parole officer or probation officer assigned to supervise the
  subject of the petition[.]; OR
    (IX) THE DIRECTOR OF THE HOSPITAL OR THE SUPERINTENDENT OF  A  CORREC-
  TIONAL  FACILITY  IN  WHICH  THE  SUBJECT OF THE PETITION IS IMPRISONED,
  PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE CORRECTION LAW.
    (2) THE COMMISSIONER SHALL PROMULGATE REGULATIONS  PURSUANT  TO  WHICH
  PERSONS INITIATING A PETITION, PURSUANT TO SUBPARAGRAPHS (I) AND (II) OF
  PARAGRAPH ONE OF THIS SUBDIVISION, MAY RECEIVE ASSISTANCE IN FILING SUCH
  PETITIONS,  WHERE APPROPRIATE, AS DETERMINED PURSUANT TO SUBDIVISION (E)
  OF THIS SECTION.
    (3) The petition shall state:

    (i) each of the criteria for  assisted  outpatient  treatment  as  set
  forth in subdivision (c) of this section;
    (ii)  facts  which support the petitioner's belief that the subject of
  the petition meets each criterion, provided  that  the  hearing  on  the
  petition need not be limited to the stated facts; and
    (iii)  that  the  subject of the petition is present, or is reasonably
  believed to be present, within the county where such petition is filed.
    [(3)] (4) The petition shall be accompanied by an affirmation or affi-
  davit of a physician, who shall not be the  petitioner,  stating  either
  that:

    (i) such physician has personally examined the subject of the petition
  no  more  than  ten days prior to the submission of the petition, recom-
  mends assisted outpatient treatment for the subject of the petition, and
  is willing and able to testify at the hearing on the petition; or
    (ii) no more than ten days prior to the filing of the  petition,  such
  physician  or  his or her designee has made appropriate attempts but has
  not been successful in eliciting the cooperation of the subject  of  the
  petition  to  submit  to  an  examination,  such physician has reason to
  suspect that the subject of the petition meets the criteria for assisted
  outpatient treatment, and such physician is willing and able to  examine
  the subject of the petition and testify at the hearing on the petition.
    [(4)]  (5)  In  counties  with  a population of less than seventy-five
  thousand, the affirmation or affidavit  required  by  paragraph  [three]
  FOUR  of  this subdivision may be made by a physician who is an employee
  of the office.  The office is authorized AND DIRECTED to make available,
  at no cost to the county, a  qualified  physician  for  the  purpose  of
  making  such  affirmation or affidavit consistent with the provisions of
  such paragraph.
    [(f)] (G) Service. The petitioner shall cause written  notice  of  the
  petition  to  be given to the subject of the petition and a copy thereof
  to be given personally or by mail to the persons listed in section  9.29
  of this article, the mental hygiene legal service, the health care agent
  if  any  such  agent is known to the petitioner, the appropriate program
  coordinator, and the appropriate director of community services, if such
  director is not the petitioner.

 S. 4881--A                          6

    [(g)] (H) Right to counsel. The subject of the petition shall have the
  right to be represented by the mental hygiene legal service, or private-
  ly financed counsel, at all stages of a proceeding commenced under  this
  section.
    [(h)]  (I)  Hearing. (1) Upon receipt of the petition, the court shall
  fix the date for a hearing. Such date shall be no later than three  days
  from  the  date such petition is received by the court, excluding Satur-
  days, Sundays and holidays. Adjournments shall  be  permitted  only  for
  good cause shown. In granting adjournments, the court shall consider the
  need  for  further  examination  by a physician or the potential need to
  provide assisted outpatient treatment  expeditiously.  The  court  shall
  cause  the  subject  of  the petition, any other person receiving notice
  pursuant to subdivision [(f)] (G) of this section, the  petitioner,  the
  physician  whose  affirmation or affidavit accompanied the petition, and
  such other persons as the court may determine  to  be  advised  of  such
  date.  Upon  such  date, or upon such other date to which the proceeding
  may be adjourned, the court shall hear testimony and, if  it  be  deemed
  advisable  and  the  subject  of  the petition is available, examine the
  subject of the petition in or out of court. If the subject of the  peti-
  tion  does not appear at the hearing, and appropriate attempts to elicit
  the attendance of the subject have failed, the  court  may  conduct  the
  hearing  in  the  subject's  absence.  In such case, the court shall set
  forth the factual basis for conducting the hearing without the  presence
  of the subject of the petition.
    (2)  The court shall not order assisted outpatient treatment unless an
  examining physician, who recommends assisted  outpatient  treatment  and
  has  personally  examined  the  subject of the petition no more than ten
  days before the filing of the petition, testifies in person at the hear-
  ing. Such physician shall state the facts  and  clinical  determinations
  which support the allegation that the subject of the petition meets each
  of  the  criteria  for  assisted outpatient treatment; PROVIDED THAT THE
  PARTIES MAY STIPULATE, UPON MUTUAL CONSENT, THAT SUCH PHYSICIAN NEED NOT
  TESTIFY.
    (3) If the subject of the petition has refused to  be  examined  by  a
  physician,  the  court may request the subject to consent to an examina-
  tion by a physician appointed by the court. If the subject of the  peti-
  tion  does  not  consent and the court finds reasonable cause to believe
  that the allegations in the petition are true, the court may order peace
  officers, acting pursuant to their special duties,  or  police  officers
  who  are  members  of  an authorized police department or force, or of a
  sheriff's department to take the subject of the  petition  into  custody
  and  transport  him or her to a hospital for examination by a physician.
  Retention of the subject of the petition  under  such  order  shall  not
  exceed twenty-four hours. The examination of the subject of the petition
  may  be performed by the physician whose affirmation or affidavit accom-
  panied the petition pursuant to paragraph three of subdivision [(e)] (F)
  of this section, if such physician is privileged  by  such  hospital  or
  otherwise  authorized  by such hospital to do so. If such examination is
  performed by another physician, the examining physician may consult with
  the physician whose affirmation or affidavit accompanied the petition as
  to whether the subject meets the criteria for assisted outpatient treat-
  ment.
    (4) A physician who testifies pursuant to paragraph two of this subdi-
  vision shall state: (i) the facts [which]  AND  CLINICAL  DETERMINATIONS
  THAT  support the allegation that the subject meets each of the criteria
  for assisted outpatient treatment, (ii) that the treatment is the  least

 S. 4881--A                          7

  restrictive  alternative,  (iii)  the  recommended  assisted  outpatient
  treatment, and (iv) the rationale for the  recommended  assisted  outpa-
  tient  treatment.  If  the  recommended  assisted  outpatient  treatment
  includes medication, such physician's testimony shall describe the types
  or  classes of medication which should be authorized, shall describe the
  beneficial and detrimental physical and mental effects of  such  medica-
  tion,  and shall recommend whether such medication should be self-admin-
  istered or administered by authorized personnel.
    (5) The subject of the petition shall be afforded  an  opportunity  to
  present  evidence, to call witnesses on his or her behalf, and to cross-
  examine adverse witnesses.
    [(i)] (J) Written treatment  plan.  (1)  The  court  shall  not  order
  assisted outpatient treatment unless a physician appointed by the appro-
  priate  director,  in  consultation  with  such  director,  develops and
  provides to the court a proposed written  treatment  plan.  The  written
  treatment  plan  shall  include  case  management  services or assertive
  community treatment team services  to  provide  care  coordination.  The
  written treatment plan also shall include all categories of services, as
  set  forth  in  paragraph  one of subdivision (a) of this section, which
  such physician recommends that the subject of the petition receive.  All
  service  providers  shall  be  notified regarding their inclusion in the
  written treatment plan. If the written treatment plan  includes  medica-
  tion, it shall state whether such medication should be self-administered
  or  administered  by  authorized  personnel,  and shall specify type and
  dosage range of medication most likely to provide  maximum  benefit  for
  the subject. If the written treatment plan includes alcohol or substance
  abuse  counseling  and  treatment,  such  plan  may  include a provision
  requiring relevant testing for  either  alcohol  or  illegal  substances
  provided  the  physician's  clinical  basis  for  recommending such plan
  provides sufficient facts for the court to find (i) that such person has
  a history of alcohol or substance abuse that is  clinically  related  to
  the mental illness; and (ii) that such testing is necessary to prevent a
  relapse or deterioration which would be likely to result in serious harm
  to  the  person  or others. If a director is the petitioner, the written
  treatment plan shall be provided to the court no later than the date  of
  the  hearing  on  the petition. If a person other than a director is the
  petitioner, such plan shall be provided to the court no later  than  the
  date  set  by the court pursuant to paragraph three of subdivision [(j)]
  (K) of this section.
    (2) The physician appointed to  develop  the  written  treatment  plan
  shall  provide  the  following  persons  with an opportunity to actively
  participate in the development of such plan: the subject  of  the  peti-
  tion;  the  treating  physician,  if  any;  and  upon the request of the
  subject of the  petition,  an  individual  significant  to  the  subject
  including  any  relative, close friend or individual otherwise concerned
  with the welfare of the subject. THE APPOINTED PHYSICIAN  SHALL  MAKE  A
  REASONABLE  EFFORT TO GATHER RELEVANT INFORMATION FOR THE DEVELOPMENT OF
  THE TREATMENT PLAN FROM THE SUBJECT OF THE PETITION'S FAMILY  MEMBER  OR
  MEMBERS, OR HIS OR HER SIGNIFICANT OTHER. If the subject of the petition
  has executed a health care proxy, the appointed physician shall consider
  any  directions  included in such proxy in developing the written treat-
  ment plan.
    (3) The court shall not order assisted outpatient treatment  unless  a
  physician  appearing  on  behalf  of a director testifies to explain the
  written proposed treatment plan; PROVIDED THAT THE  PARTIES  MAY  STIPU-
  LATE,  UPON  MUTUAL CONSENT, THAT SUCH PHYSICIAN NEED NOT TESTIFY.  Such

 S. 4881--A                          8

  physician shall state the categories of  assisted  outpatient  treatment
  recommended, the rationale for each such category, facts which establish
  that  such  treatment  is the least restrictive alternative, and, if the
  recommended assisted outpatient treatment plan includes medication, such
  physician  shall  state  the types or classes of medication recommended,
  the beneficial and detrimental physical and mental effects of such medi-
  cation, and whether  such  medication  should  be  self-administered  or
  administered  by an authorized professional. If the subject of the peti-
  tion has executed a health care proxy, such physician  shall  state  the
  consideration given to any directions included in such proxy in develop-
  ing  the written treatment plan. If a director is the petitioner, testi-
  mony pursuant to this paragraph shall be given at  the  hearing  on  the
  petition.  If  a  person  other  than a director is the petitioner, such
  testimony shall be given on the date set by the court pursuant to  para-
  graph three of subdivision [(j)] (K) of this section.
    [(j)] (K) Disposition. (1) If after hearing all relevant evidence, the
  court does not find by clear and convincing evidence that the subject of
  the  petition  meets the criteria for assisted outpatient treatment, the
  court shall dismiss the petition.
    (2) If after hearing all relevant evidence, the court finds  by  clear
  and  convincing  evidence  that  the  subject  of the petition meets the
  criteria for assisted outpatient treatment, and there is no  appropriate
  and  feasible  less  restrictive  alternative,  the  court may order the
  subject to receive assisted outpatient treatment for an  initial  period
  not to exceed [six months] ONE YEAR.  In fashioning the order, the court
  shall  specifically  make findings by clear and convincing evidence that
  the proposed treatment is the least  restrictive  treatment  appropriate
  and  feasible  for the subject. The order shall state an assisted outpa-
  tient treatment plan, which shall include  all  categories  of  assisted
  outpatient  treatment,  as set forth in paragraph one of subdivision (a)
  of this section, which the assisted outpatient is to receive, but  shall
  not  include  any  such category that has not been recommended in [both]
  the proposed written treatment plan and [the] IN ANY testimony  provided
  to the court pursuant to subdivision [(i)] (J) of this section.
    (3)  If  after hearing all relevant evidence presented by a petitioner
  who is not a director, the court finds by clear and convincing  evidence
  that  the subject of the petition meets the criteria for assisted outpa-
  tient treatment, and the court has yet to be  provided  with  a  written
  proposed  treatment plan and testimony pursuant to subdivision [(i)] (J)
  of this section, the court  shall  order  the  appropriate  director  to
  provide  the  court with such plan and testimony no later than the third
  day, excluding Saturdays, Sundays and  holidays,  immediately  following
  the  date  of  such  order; PROVIDED THAT THE PARTIES MAY STIPULATE UPON
  MUTUAL CONSENT THAT SUCH TESTIMONY NEED NOT BE PROVIDED.  Upon receiving
  such plan and ANY REQUIRED  testimony,  the  court  may  order  assisted
  outpatient treatment as provided in paragraph two of this subdivision.
    (4)  A  court  may  order  the patient to self-administer psychotropic
  drugs or accept the administration of such drugs by authorized personnel
  as part of an assisted outpatient  treatment  program.  Such  order  may
  specify  the  type  and dosage range of such psychotropic drugs and such
  order shall be effective for the duration of  such  assisted  outpatient
  treatment.
    (5)  If  the petitioner is the director of a hospital that operates an
  assisted outpatient treatment program, the court order shall direct  the
  hospital  director  to provide or arrange for all categories of assisted
  outpatient treatment for the assisted outpatient throughout  the  period

 S. 4881--A                          9

  of  the order. For all other persons, the order shall require the direc-
  tor of community services of the appropriate local governmental unit  to
  provide  or  arrange for all categories of assisted outpatient treatment
  for  the assisted outpatient throughout the period of the order.  ORDERS
  ISSUED ON OR AFTER THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF  TWO
  THOUSAND  TWELVE THAT AMENDED THIS SECTION SHALL REQUIRE THE APPROPRIATE
  DIRECTOR "AS DETERMINED  BY  THE  PROGRAM  COORDINATOR"  TO  PROVIDE  OR
  ARRANGE  FOR  ALL  CATEGORIES  OF  ASSISTED OUTPATIENT TREATMENT FOR THE
  ASSISTED OUTPATIENT THROUGHOUT THE PERIOD OF THE ORDER.
    (6) The director shall cause a copy of any court order issued pursuant
  to this section to be served personally, or by mail, facsimile or  elec-
  tronic  means,  upon  the  assisted outpatient, the mental hygiene legal
  service or anyone  acting  on  the  assisted  outpatient's  behalf,  the
  original  petitioner, identified service providers, and all others enti-
  tled to notice under subdivision [(f)] (G) of this section.
    [(k)] (L) RELOCATION OF ASSISTED OUTPATIENTS. THE  COMMISSIONER  SHALL
  PROMULGATE  REGULATIONS  REQUIRING THAT, DURING THE PERIOD OF THE ORDER,
  AN ASSISTED OUTPATIENT AND ANY OTHER APPROPRIATE  PERSONS  SHALL  NOTIFY
  THE  PROGRAM COORDINATOR WITHIN A REASONABLE TIME PRIOR TO SUCH ASSISTED
  OUTPATIENT RELOCATING WITHIN THE STATE OF NEW YORK TO AN AREA NOT SERVED
  BY THE DIRECTOR WHO HAS BEEN DIRECTED TO  PROVIDE  OR  ARRANGE  FOR  THE
  ASSISTED OUTPATIENT TREATMENT. UPON RECEIVING NOTIFICATION OF SUCH RELO-
  CATION,  THE  PROGRAM  COORDINATOR SHALL REDETERMINE WHO THE APPROPRIATE
  DIRECTOR SHALL BE AND CAUSE A COPY OF THE COURT ORDER AND TREATMENT PLAN
  TO BE TRANSMITTED TO SUCH DIRECTOR.
    (m) Petition for [additional periods of]  CONTINUED  treatment.    (1)
  WITHIN  THIRTY DAYS PRIOR TO THE EXPIRATION OF AN ORDER PURSUANT TO THIS
  SECTION, THE APPROPRIATE DIRECTOR  SHALL  REVIEW  WHETHER  THE  ASSISTED
  OUTPATIENT CONTINUES TO MEET THE CRITERIA FOR ASSISTED OUTPATIENT TREAT-
  MENT.   UPON DETERMINING THAT ONE OR MORE OF SUCH CRITERIA ARE NO LONGER
  MET, SUCH DIRECTOR SHALL NOTIFY THE PROGRAM COORDINATOR IN WRITING  THAT
  A PETITION FOR CONTINUED ASSISTED OUTPATIENT TREATMENT IS NOT WARRANTED.
  UPON  DETERMINING THAT SUCH CRITERIA CONTINUE TO BE MET, HE OR SHE SHALL
  PETITION THE COURT TO ORDER CONTINUED ASSISTED OUTPATIENT TREATMENT  FOR
  A  PERIOD NOT TO EXCEED ONE YEAR FROM THE EXPIRATION DATE OF THE CURRENT
  ORDER. IF THE COURT'S DISPOSITION OF SUCH PETITION DOES NOT OCCUR  PRIOR
  TO  THE  EXPIRATION  DATE  OF THE CURRENT ORDER, THE CURRENT ORDER SHALL
  REMAIN IN EFFECT UNTIL SUCH DISPOSITION. THE  PROCEDURES  FOR  OBTAINING
  ANY  ORDER  PURSUANT TO THIS SUBDIVISION SHALL BE IN ACCORDANCE WITH THE
  PROVISIONS OF THE FOREGOING SUBDIVISION OF THIS SECTION;  PROVIDED  THAT
  THE  TIME  RESTRICTIONS INCLUDED IN PARAGRAPH FOUR OF SUBDIVISION (C) OF
  THIS SECTION SHALL NOT BE APPLICABLE. THE NOTICE PROVISIONS SET FORTH IN
  PARAGRAPH SIX OF SUBDIVISION (K) OF THIS SECTION  SHALL  BE  APPLICABLE.
  ANY  COURT  ORDER  REQUIRING  PERIODIC BLOOD TESTS OR URINALYSIS FOR THE
  PRESENCE OF ALCOHOL OR ILLEGAL DRUGS SHALL BE SUBJECT  TO  REVIEW  AFTER
  SIX  MONTHS BY THE PHYSICIAN WHO DEVELOPED THE WRITTEN TREATMENT PLAN OR
  ANOTHER PHYSICIAN DESIGNATED BY THE DIRECTOR, AND SUCH  PHYSICIAN  SHALL
  BE  AUTHORIZED  TO  TERMINATE  SUCH  BLOOD  TESTS  OR URINALYSIS WITHOUT
  FURTHER ACTION BY THE COURT.
    (2) Within thirty days prior to the expiration of an order of assisted
  outpatient treatment, [the appropriate director or]  the  current  peti-
  tioner,  if  the current petition was filed pursuant to subparagraph (i)
  or (ii) of paragraph one of subdivision [(e)] (F) of this  section,  and
  the  current  petitioner  retains his or her original status pursuant to
  the applicable subparagraph, may petition the court to  order  continued
  assisted  outpatient  treatment for a period not to exceed one year from

 S. 4881--A                         10

  the expiration date of the current order. If the court's disposition  of
  such petition does not occur prior to the expiration date of the current
  order,  the current order shall remain in effect until such disposition.
  The  procedures  for  obtaining  any  order pursuant to this subdivision
  shall be in accordance with the provisions of the foregoing subdivisions
  of this section; provided that the time restrictions included  in  para-
  graph  four  of subdivision (c) of this section shall not be applicable.
  The notice provisions set forth in paragraph six  of  subdivision  [(j)]
  (K)  of  this  section  shall be applicable.   Any court order requiring
  periodic blood tests or urinalysis for the presence of alcohol or  ille-
  gal  drugs  shall be subject to review after six months by the physician
  who developed the written treatment plan or another physician designated
  by the director, and such physician shall  be  authorized  to  terminate
  such blood tests or urinalysis without further action by the court.
    (3)  IF  NEITHER  THE  APPROPRIATE DIRECTOR NOR THE CURRENT PETITIONER
  PETITION FOR CONTINUED ASSISTED OUTPATIENT TREATMENT  PURSUANT  TO  THIS
  PARAGRAPH  AND  THE ORDER OF THE COURT EXPIRES, ANY OTHER PERSON AUTHOR-
  IZED TO PETITION PURSUANT TO PARAGRAPH ONE OF SUBDIVISION  (F)  OF  THIS
  SECTION  MAY BRING A NEW PETITION FOR ASSISTED OUTPATIENT TREATMENT.  IF
  SUCH NEW PETITION IS FILED LESS THAN SIXTY DAYS AFTER THE EXPIRATION  OF
  SUCH ORDER, THE TIME RESTRICTIONS PROVIDED IN PARAGRAPH FOUR OF SUBDIVI-
  SION (C) OF THIS SECTION SHALL NOT BE APPLICABLE TO THE NEW PETITION.
    [(l)]  (N)  Petition  for  an  order to stay, vacate or modify. (1) In
  addition to any other right or remedy available by law with  respect  to
  the  order  for  assisted outpatient treatment, the assisted outpatient,
  the mental hygiene legal service,  or  anyone  acting  on  the  assisted
  outpatient's  behalf  may  petition the court on notice to the director,
  the original petitioner, and all others entitled to notice under  subdi-
  vision [(f)] (G) of this section to stay, vacate or modify the order.
    (2)  The  appropriate  director  shall petition the court for approval
  before instituting a proposed material change in the assisted outpatient
  treatment plan, unless such change is authorized by  the  order  of  the
  court. Such petition shall be filed on notice to all parties entitled to
  notice  under subdivision [(f)] (G) of this section. Not later than five
  days after receiving such petition,  excluding  Saturdays,  Sundays  and
  holidays,  the court shall hold a hearing on the petition; provided that
  if the assisted outpatient informs the court that he or  she  agrees  to
  the  proposed material change, the court may approve such change without
  a hearing. Non-material changes may be instituted by the director  with-
  out  court  approval.  For  the  purposes  of this paragraph, a material
  change is an addition or deletion of a category of services to or from a
  current assisted outpatient treatment plan, or any deviation without the
  assisted outpatient's consent from the terms of a current order relating
  to the administration of psychotropic drugs.
    [(m)] (O) Appeals. Review of an order issued pursuant to this  section
  shall  be  had  in  like  manner  as  specified  in section 9.35 of this
  article; PROVIDED THAT NOTICE SHALL BE PROVIDED TO ALL PARTIES  ENTITLED
  TO NOTICE UNDER SUBDIVISION (G) OF THIS SECTION.
    [(n)]  (P) Failure to comply with assisted outpatient treatment. Where
  in the clinical judgment of a physician, (i)  the  assisted  outpatient,
  has  failed or refused to comply with the assisted outpatient treatment,
  (ii) efforts were made to solicit compliance, and  (iii)  such  assisted
  outpatient  may be in need of involuntary admission to a hospital pursu-
  ant to section 9.27 of this article or immediate observation,  care  and
  treatment  pursuant to section 9.39 or 9.40 of this article, such physi-
  cian may request the director  of  community  services,  the  director's

 S. 4881--A                         11

  designee,  or  any  physician  designated  by  the director of community
  services pursuant to section 9.37 of this article, to direct the removal
  of such assisted outpatient to an appropriate hospital for  an  examina-
  tion  to  determine  if such person has a mental illness for which HE OR
  SHE IS IN NEED OF hospitalization is necessary pursuant to section 9.27,
  9.39 or 9.40 of this article[. Furthermore, if such assisted  outpatient
  refuses to take medications as required by the court order, or he or she
  refuses  to  take, or fails a blood test, urinalysis, or alcohol or drug
  test as required by the court order, such physician  may  consider  such
  refusal  or  failure  when determining whether]; PROVIDED THAT IF, AFTER
  EFFORTS TO  SOLICIT  COMPLIANCE,  SUCH  PHYSICIAN  DETERMINES  THAT  THE
  ASSISTED  OUTPATIENT'S  FAILURE  TO  COMPLY WITH THE ASSISTED OUTPATIENT
  TREATMENT INCLUDES A SUBSTANTIAL FAILURE TO  TAKE  MEDICATION,  PASS  OR
  SUBMIT  TO BLOOD TESTING OR URINALYSIS, OR RECEIVE TREATMENT FOR ALCOHOL
  OR SUBSTANCE ABUSE, SUCH PHYSICIAN MAY PRESUME THAT the assisted  outpa-
  tient  is in need of an examination to determine whether he or she has a
  mental illness for which hospitalization is necessary. Upon the  request
  of  such physician, the director, the director's designee, or any physi-
  cian designated pursuant to section 9.37 of  this  article,  may  direct
  peace officers, acting pursuant to their special duties, or police offi-
  cers who are members of an authorized police department or force or of a
  sheriff's  department  to  take the assisted outpatient into custody and
  transport him or her to the hospital operating the  assisted  outpatient
  treatment  program  or  to  any  hospital  authorized by the director of
  community services to receive such persons. Such law  enforcement  offi-
  cials  shall  carry  out such directive. Upon the request of such physi-
  cian, the director, the director's designee, or any physician designated
  pursuant to section 9.37 of  this  article,  an  ambulance  service,  as
  defined  by  subdivision two of section three thousand one of the public
  health law, or an approved mobile crisis outreach  team  as  defined  in
  section  9.58  of  this article shall be authorized to take into custody
  and transport any such person to the  hospital  operating  the  assisted
  outpatient treatment program, or to any other hospital authorized by the
  director  of community services to receive such persons. Any director of
  community services, or designee,  shall  be  authorized  to  direct  the
  removal of an assisted outpatient who is present in his or her county to
  an  appropriate  hospital,  in  accordance  with  the provisions of this
  subdivision, based upon a determination of the appropriate  director  of
  community  services  directing  the  removal of such assisted outpatient
  pursuant to this subdivision. Such person may be retained  for  observa-
  tion,  care and treatment and further examination in the hospital for up
  to seventy-two hours to permit a physician  to  determine  whether  such
  person  has  a  mental  illness  and  is in need of involuntary care and
  treatment in a hospital pursuant to the provisions of this article.  Any
  continued  involuntary  retention  OF  THE  ASSISTED  OUTPATIENT in such
  hospital beyond the initial seventy-two hour period shall be in  accord-
  ance  with  the  provisions  of this article relating to the involuntary
  admission and retention of a person. If at any time during the  seventy-
  two  hour  period  the  person is determined not to meet the involuntary
  admission and retention provisions of this article, and does  not  agree
  to  stay  in  the hospital as a voluntary or informal patient, he or she
  must be released. Failure to comply with an order of assisted outpatient
  treatment shall not be grounds for involuntary  civil  commitment  or  a
  finding of contempt of court.
    [(o)] (Q) Effect of determination that a person is in need of assisted
  outpatient  treatment.  The determination by a court that a person is in

 S. 4881--A                         12

  need of assisted outpatient treatment  shall  not  be  construed  as  or
  deemed  to be a determination that such person is incapacitated pursuant
  to article eighty-one of this chapter.
    [(p)] (R) False petition. A person making a false statement or provid-
  ing  false information or false testimony in a petition or hearing under
  this section shall be subject to criminal prosecution pursuant to  arti-
  cle  one  hundred  seventy-five  or article two hundred ten of the penal
  law.
    [(q)] (S) Exception. Nothing in this section  shall  be  construed  to
  affect  the  ability of the director of a hospital to receive, admit, or
  retain patients who  otherwise  meet  the  provisions  of  this  article
  regarding receipt, retention or admission.
    [(r)]  (T)  Education and training. (1) The office [of mental health],
  in consultation with the office of court administration,  shall  prepare
  educational  and  training  materials  on the use of this section, which
  shall be made  available  to  local  governmental  units,  providers  of
  services,  judges,  court  personnel,  law enforcement officials and the
  general public.
    (2) The office, in consultation with  the  office  of  court  adminis-
  tration,  shall  establish  a mental health training program for supreme
  and county court judges and court  personnel,  AND  SHALL  PROVIDE  SUCH
  TRAINING WITH SUCH FREQUENCY AND IN SUCH LOCATIONS AS MAY BE APPROPRIATE
  TO  MEET  STATEWIDE NEEDS.  Such training shall focus on the use of this
  section and generally address issues  relating  to  mental  illness  and
  mental health treatment.
    S  5.  Section  29.15 of the mental hygiene law is amended by adding a
  new subdivision (o) to read as follows:

    (O) IF THE DIRECTOR OF A DEPARTMENT FACILITY  DOES  NOT  PETITION  FOR
  ASSISTED  OUTPATIENT  TREATMENT PURSUANT TO SECTION 9.60 OF THIS CHAPTER
  UPON THE DISCHARGE OF AN INPATIENT ADMITTED PURSUANT  TO  SECTION  9.27,
  9.39  OR  9.40  OF  THIS  CHAPTER, OR UPON THE EXPIRATION OF A PERIOD OF
  CONDITIONAL RELEASE FOR SUCH INPATIENT, SUCH DIRECTOR SHALL REPORT  SUCH
  DISCHARGE  OR  SUCH  EXPIRATION  IN WRITING TO THE DIRECTOR OF COMMUNITY
  SERVICES OF THE LOCAL  GOVERNMENTAL  UNIT  IN  WHICH  THE  INPATIENT  IS
  EXPECTED TO RESIDE.
    S 6. Subdivision 1 of section 404 of the correction law, as amended by
  chapter 7 of the laws of 2007, is amended to read as follows:

    1.  Whenever  an  inmate  committed to a hospital in the department of
  mental hygiene or whenever an inmate is examined in anticipation of  his
  or  her  conditional release, release to parole supervision, or when his
  or her sentence to a term of imprisonment expires and such inmate  shall
  continue  to  be  mentally  ill and in need of care and treatment at the
  time of his or her conditional release, release to  parole  supervision,
  or  when  his  or  her  sentence  to a term of imprisonment expires, the
  director of the hospital or the superintendent of a correctional facili-
  ty [may] SHALL, WHERE APPROPRIATE, EITHER apply for the person's  admis-
  sion to a hospital for the care and treatment of the mentally ill in the
  department  of  mental  hygiene  pursuant  to article nine of the mental
  hygiene law[,] or [alternatively]  INITIATE  A  PETITION  FOR  AN  ORDER
  AUTHORIZING  ASSISTED  OUTPATIENT TREATMENT, PURSUANT TO SECTION 9.60 OF
  THE MENTAL HYGIENE LAW, OR the commissioner may apply for  the  person's
  admission  to a secure treatment facility pursuant to article ten of the
  mental hygiene law.
    S 7. Section 18 of chapter 408  of  the  laws  of  1999,  constituting
  Kendra's  Law, as amended by chapter 139 of the laws of 2010, is amended
  to read as follows:


 S. 4881--A                         13

    S 18. This act shall take effect immediately,  provided  that  section
  fifteen  of this act shall take effect April 1, 2000, provided, further,
  that subdivision (e) of section 9.60 of the mental hygiene law as  added
  by  section  six  of  this act shall be effective 90 days after this act
  shall become law[; and that this act shall expire and be deemed repealed
  June 30, 2015].
    S 8. Severability. If any clause, sentence, paragraph, section or part
  of  this act shall be adjudged by any court of competent jurisdiction to
  be invalid, and after exhaustion of all  further  judicial  review,  the
  judgment  shall  not affect, impair or invalidate the remainder thereof,
  but shall be confined in its operation to the  clause,  sentence,  para-
  graph, section or part thereof directly involved in the controversy.
    S 9.  This act shall take effect immediately.