Schoolcraft v. The City Of New York et al

Filing 352

DECLARATION of Gregory J. Radomisli in Support re: 351 MOTION for Summary Judgment .. Document filed by Jamaica Hospital Medical Center. (Attachments: # 1 Exhibit LL, # 2 Exhibit MM, # 3 Exhibit NN)(Radomisli, Gregory)

I3<D

Department of Psychiatry
Emergency Room Services
Policy & Procedure Manual
Subject:

Emergency Admission Procedures

Section 9.39 of the New York State Mental Hygiene Law provides.for
the emergency admission to an authorized hospital of any person
alleged to require immediate observation, care, and treatment for
mental illness. Pursuant to Section 9.39 the Psychiatric Emergency
Service of the Jamaica Hospital Medical Center receives patients
for immediate observation, care, and treatment.
Section 9,27 of the New York State Mental Hygiene Law provides for
involuntary emergency admission, on the certification of two
physicians, for immediate observation, care and treatment of
persons alleged to have a mental illness. Pursuant to Section 9.27
Jamaica Hospital Medical Center Psychiatric Emergency Room receives
patients.for admission and refers patients for admission to other
hospitals.

Reviewed & Revised:
6/05, 6/06, 6/07, 6/08

Psychiatric Emerobncy room -59
6/96, 5/97, 4/98, 6/99, 7/00, 6/Oi, 6/02, 6/03, 6/04,

THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL

SUBJECT:

INVOLUNTARY LEGAL STATUS

ISSUED:

4/95

REVIEWED: 9/96, 4/99, 4/00, 4/01, 4/02, 04/03, 04/04, 04/05,
04/06, 4/07, 4/08, 4/09, 4/10
'

Policy:
In the event that a patient is felt to be mentally ill and in
need of psychiatric hospitalization, and that he is unwilling or
unable to apply for Voluntary hospitalization as outlined in the
■ Policy for Voluntary Admissions, and if an eligible applicant
for involuntary admission is available, the patient is to be
admitted under Mental Health Law Section 9,27 (2PC).
Procedure:
1.
An application for the admission of a patient under this
status may be made by any person with whom the person resides,
the father or mother, husband or wife, brother or sister, or the
child of any such person or the nearest available relative, the
committee of such a person, an officer of any public or well
recognized charitable institution or agency or home in whose
institution the person resides, the director of community
services or social services official, the director of the
hospital or a designee.
2.
The "APPLICATION FOR INVOLUNTARY ADMISSION ON MEDICAL
CERTIFICATION,
(OMH 471}, must include the signature of the
applicant and a plausible statement by the applicant as to the
reasons for seeking admission for the patient in Part "A."
3.

The admitting psychiatrist is to complete Part "B.

4.
The admitting psychiatrist is to complete and sign the
"NOTICE OF STATUS AND RIGHTS - INVOLUNTARY STATUS,
(OMH 461) .
The document must be'’ printed with the address and telephone'
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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL
number of the Mental Hygiene Legal Service. The psychiatrist is
to ask the patient if there is anyone he wishes to be informed
of the admission or of the legal rights; these names and
addresses are to be noted in the "Copies to" section of the
document. The original is to be given to the patient, along
with an explanation of the document. A copy is to be placed in
the chart and given to each person designed by the patient at
the time of notification of rights.
*
Two physicians licensed in New York State must each
5.
complete a CERTIFICATE OF EXAMINING PHYSICIAN", (OMH 471A).
The applicant cannot be one of these certifying physicians.
The attending psychiatrist will be responsible for assuring
6.
that the legal status is converted to Voluntary or to Order of
Retention prior to the expiration date.

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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL
SUBJECT:

EMERGENCY ADMISSION STATUS

ISSUED:

4/95

REVIEWED: 9/96^ 4/99, 4/00, 4/01, 4/02, 04/03, 04/04, 04/05,
04/06, 4/07, 4/08, 4/09, 4/10

New York State Mental Hygiene Law, Title B,
References;
Article 9.39; NYCRR XIV, Sec. 15.2,15.3,15.9.
•

Policy:
Jamaica Hospital Medical Center will admit appropriate patients
in emergency situations under New York State Mental Hygiene Law,
Article 9.39, with careful attention to the preservation of
their legal rights as well as to their safety.
.
Patients alleged to have a mental illness for which immediate
observation, care and treatment in a hospital is appropriate and
which is likely to result in serious harm to himself or others,
may be admitted under this provision for a period of 15 days.
"'Likelihood to result in serious harm

is defined as;

(1)

Substantial risk of physical harm to himself as
manifested by threats of or attempts at suicide or
serious bodily harm or other conduct demonstrating
that he is dangerous to himself; OR

(2)

a substantial risk of physical harm to other persons
as manifested by homicidal or other violent behavior
by which others are placed in reasonable fear of
serious physical harm. r TT

The admitting physician must be licensed in New York State.

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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL

Procedure:
Following an examination and interviews with
1.
other informants which may be available, should the examining
physician consider the patient to meet the criteria above, he
should certify this finding on Form OMH 474.
The admitting doctor will record on OMH Form 474 the names
2.
of the people bringing the patient to the hospital, and the
circumstances leading to the hospitalization.
The admitting doctor will inform the patient and provide
3.
him with written notice of his status and rights, using OMH Form
474A. A signed copy of the notice must be placed in the
patient's record.
.
The admitting doctor will be responsible for assuring that
4.
second examination of the patient is conducted within 48 hours
a
of admission, for the purpose of confirmation of need for
If the admission occurs during routine
emergency admission.
weekday hours, the^admitting doctor will arrange for a
psychiatrist with admitting privileges to conduct this second
examination immediately. At other times, the admitting doctor
is to tell his successor on-call of the necessity of the
confirmation examination, Any difficulty in making such
arrangements is to be immediately referred to the Chairman or
one acting in his behalf.
The second examining psychiatrist must inquire of the
patient if the patient is willing to convert to voluntary
status. Should the patient reject this suggestion, and should
the psychiatrist find that the patient does not meet the above
criteria for emergency hospitalization, he must immediately
contact the Chairman, or one acting in his behalf, prior to
completion of page #2 of OMH 474. Should he concur that the
patient meets the criteria above for emergency admission, he
should proceed to complete page #2 of OMH Form 474,
5.

If at any time after admission the patient, a relative or
6.
friend. dr the MHLS gives written notice to the director of a
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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL
request for a court hearing, the director will imrriediately
deliver to the Supreme Court of Queens County and to the Mental
Health Legal Service a copy of the notice and a copy of the '
patient record.
7.
Within fifteen days of admission, the legal status of the
patient must be converted to Voluntary, or to Involuntary (under
section 9.27, "APPLICATION FOR INVOLUNTARY ADMISSION ON MEDICAL
CERTIFICATION") legal status, or discharged. If the patient is
converted to Involuntary legal status under Section 9.27, the
sixty day period of hospitalization which is authorized is to be
regarded as starting at the time the patient was first
hospitalized as an emergency admission.

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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL
SUBJECT; ADMISSIONS FROM THE EMERGENCY ROOM

ISSUED;

4/95

REVIEWED; 9/96, 4/99, 4/00, 4/01,4/02, 4/03, 04/04, 04/05, 4/06,
04/07, 4/08, 4/09, 4/10
REVISED: 4/02, 4/07

Purpose;

.

To ensure that patients in the Emergency Room are properly
evaluated prior to admission.
Policy:
A patient may be admitted from the emergency room to a
psychiatric inpatient unit only after evaluation in the
Emergency Room by a member of the Department of Psychiatry.
Procedure:
Each patient admitted to a psychiatric inpatient unit
.
1.
should have a medical clearance documented in the medical record
by the Emergency Room staff. Under extenuating circumstances.
_
the Chairman or designee may authorize admission. The medical
clearance is to reflect:
a.

b.
c.
d.

a medical history and physical exam by the medical
attending or house officer, including neurological
examination,
CBC, CMP, and any other blood tests felt by the
examining physician to be clinically indicated,
UCG and BCG for all females of childbearing age,
EKG for patients over 40 years of age.

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THE JAMAICA HOSPITAL MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY MANUAL

The patient may be admitted prior to obtaining blood test
2.
results if agreed upon by both the psychiatrist and medical
physician.
It is the responsibility of the admitting psychiatrist to
3.
determine that the patient is medically suitable for the
inpatient unit.
If medical problems or complaints arise on the Inpatient
4.
Units, Family Practice will be called to see the patient.
Family Practice will examine the patient, order appropriate
diagnostic tests and make recommendations. Family Practice will
document all findings and recommendations in the progress notes.
The admitting psychiatrist will be responsible for
5.
determining that valid legal papers are completed. In the case
of involuntary admission, a licensed Emergency Room physician
may act as certifier, No patient will be brought to the
inpatient
unit without valid legal papers.
The Emergency Room staff calls the inpatient unit for bed
6.
assignments,
The attending psychiatrist will be designated by the
7.
admitting psychiatrist on the Emergency Room record and in the
patient's admitting orders, and determined as follows:

a.

b. .

if the patient does not have a private attending,, the
patient will be assigned to an inpatient staff
attending designated by the Unit Chief,
if a staff attending cannot be determined, the
admission will be assigned to the Unit Chief.

A telephone report will be given by the Emergency Room
8.
nurse to the Inpatient Unit nurse, The Inpatient Unit will send
a staff member with a wheelchair to bring the patient to the
admitting unit .■
At the request of nursing, security staff will accompany
9.
patient and nurse to the inpatient unit.
45