Savastano v. Nurnberg

152 A.D.2d 290, 548 N.Y.S.2d 555, 1989 N.Y. App. Div. LEXIS 15798
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 11, 1989
StatusPublished
Cited by8 cases

This text of 152 A.D.2d 290 (Savastano v. Nurnberg) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Savastano v. Nurnberg, 152 A.D.2d 290, 548 N.Y.S.2d 555, 1989 N.Y. App. Div. LEXIS 15798 (N.Y. Ct. App. 1989).

Opinion

OPINION OF THE COURT

Lawrence, J.

This appeal concerns the right of the defendants to authorize the transfers of involuntarily admitted mentally ill patients, without their consent or a prior judicial hearing, from municipal facilities to psychiatric facilities operated by the New York State Office of Mental Health. We find that the statutory and regulatory scheme (see, Mental Hygiene Law § 29.11; 14 NYCRR 517.4) which permits the challenged transfers does not violate the Due Process Clause of either the US Constitution (US Const, 14th Amend, § 1) or the NY Constitution (NY Const, art I, § 6).

I

The over-all legislative scheme for the involuntary hospitalization of those individuals who have "a mental illness for which care and treatment as a patient in a hospital is essential” (Mental Hygiene Law §9.01) contemplates that the patient’s constitutional rights will be protected by provisions for judicial review at various stages of the patient’s hospitalization. Article 9 of the Mental Hygiene Law permits the director of any hospital to receive- and retain, as a patient, any person alleged to have a mental illness for which "immediate observation, care, and treatment in a hospital is appropriate and which [mental illness] is likely to result in serious harm to himself or others” (see, Mental Hygiene Law § 9.39 [a]). The authorization of the examining physician is sufficient to retain such a person initially (see, Mental Hygiene Law § 9.39 [a]). Retention of the patient for more than 48 hours requires confirmation of the first physician’s finding by a second physician who is a member of the psychiatric staff of the hospital (see, Mental Hygiene Law § 9.39 [a]). However, immediately upon admission, the patient must be informed in writing of his or her status and rights, including the availability of the Mental Hygiene Legal Service (Mental Hygiene Law § 9.07 [294]*294[a]), and, at any time after admission, the patient may request a court hearing on the need for retention (Mental Hygiene Law § 9.39 [a], [b]). Even if the patient does not seek court review, involuntary retention after 15 days is only authorized by compliance with the provisions governing "involuntary admission on application supported by medical certification” (see, Mental Hygiene Law § 9.39 [b]). This requires, in pertinent part, a new medical determination made by two examining physicians (Mental Hygiene Law § 9.27 [a]), confirmed by a third physician who is a member of the psychiatric staff of the hospital (Mental Hygiene Law § 9.27 [e]), that the patient is in need of involuntary care and treatment (Mental Hygiene Law § 9.27 [e]; § 9.01). Upon admission under this provision, the Mental Hygiene Legal Service must be notified and the patient may not be sent to another hospital by any form of involuntary admission without further notice to the Mental Hygiene Legal Service (Mental Hygiene Law §§ 9.07, 9.27 [f]; § 9.29).

A patient who has been involuntarily admitted pursuant to Mental Hygiene Law § 9.27 may be retained for up to 60 days from the date of admission on medical certification (Mental Hygiene Law §§ 9.31, 9.33). However, at anytime during the 60-day period a patient may request a court hearing on the question of the need for involuntary care and treatment (Mental Hygiene Law § 9.31 [a]). At such a hearing, the court shall determine if the patient is to be retained or discharged (Mental Hygiene Law § 9.31 [c]). Further, the court may determine whether the patient should be transferred to a State psychiatric or private facility or released to the care and custody of the relatives of the patient or "a committee of his person” (Mental Hygiene Law § 9.31 [c]). Within 30 days after this court order authorizing retention and/or transfer, a patient may seek a rehearing before a jury or another Justice, or a stay of the order pending appeal (Mental Hygiene Law § 9.35).

Where a patient, admitted on medical certification, does not seek a hearing challenging his involuntary admission during the 60-day period after his admission, the hospital must apply for a court order within that period to retain the patient.1 The court, after a hearing, if one is timely requested, may order [295]*295retention for up to six months, either at the requesting facility or at a State or private facility (Mental Hygiene Law § 9.33 [b]). The statute provides for a further retention order of up to one year and then retention orders for periods not to exceed two years (Mental Hygiene Law § 9.33 [d]).

The section under review, Mental Hygiene Law § 29.11, provides, in pertinent part, that the Commissioner of the New York State Office of Mental Health (hereinafter OMH) "may order or approve the transfer of a patient from one facility to another appropriate facility” (Mental Hygiene Law § 29.11 [a]) at any time, although "[n]o transfer shall be made to any facility other than a department facility without the consent of the facility to which the patient is transferred” (Mental Hygiene Law § 29.11 [d]). If, at the time the transfer is ordered, there is pending a request for a court hearing or decision on the question of the need for involuntary care and treatment, "the commissioner may either (i) stay his order of transfer until completion of the hearing, or (ii) direct the transfer to take place and the director of the state facility shall be substituted in all legal proceedings regarding continued retention of the patient” (Mental Hygiene Law § 29.11 [i]). In addition, when an order of transfer is issued, the receiving facility may retain the patient only for the balance of the period authorized for the retention of the patient, based upon the date of admission to the facility from which the patient is transferred (Mental Hygiene Law § 29.11 [j]).

Pursuant to his statutory authority, the Commissioner of OMH has promulgated the elaborate procedures to be followed concerning the transfer of involuntarily admitted mentally ill patients. In this action, these proceedings are attacked as unconstitutional.2 In pertinent part, an application for an order of transfer may be made by the patient, by a significant other or guardian of the patient, or by the sending hospital’s director or the designee thereof (14 NYCRR 517.4 [a]). A transfer is authorized when it is determined to be in the best interests of the patient.

"In making the determination of which hospital better serves the best interests of the patient, the following factors shall be considered:

[296]*296"(i) The patient’s need for continued inpatient treatment,

"(ii) The patient’s need for services which are more readily available or which can be more effectively provided at the receiving hospital.

"(in) Proximity of the sending and receiving hospitals to the patient’s significant others.

"(iv) The ability of the sending hospital to provide adequate overall treatment of the patient, as affected by:

"(a) overcrowding;

"(b) reduction or elimination of services beneficial to the patient; and

"(c) reduction in the number of approved beds.

"(v) The ability of the receiving hospital to provide adequate overall treatment of the patient, as affected by:

"(b) the availability of services beneficial to the patient; and

"(c) bed capacity” (14 NYCRR 517.4 [d] [1]).

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Bluebook (online)
152 A.D.2d 290, 548 N.Y.S.2d 555, 1989 N.Y. App. Div. LEXIS 15798, Counsel Stack Legal Research, https://law.counselstack.com/opinion/savastano-v-nurnberg-nyappdiv-1989.