14 CRR-NY 815.7NY-CRR
14 CRR-NY 815.7
14 CRR-NY 815.7
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 interventions have been tried and failed, 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 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 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.
(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 naloxone education and training and a naloxone kit or prescription.
(e) None of the foregoing shall apply to an emergency discharge where the individual is reasonably determined 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, 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.
14 CRR-NY 815.7
Current through April 15, 2020
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