Sec. 319.3. Admissions and placement

(a) Except as set forth in paragraph (b)(5) of this section, the department, in consultation with mental health clinicians, shall divert or remove incarcerated individuals with serious mental illness, as defined in Correction Law section 137, from segregated confinement or confinement in a residential rehabilitation unit or step-down unit, where such confinement could potentially be for a period in excess of 30-days, to a residential mental health treatment unit. Nothing in this paragraph shall be deemed to prevent the disciplinary process from proceeding in accordance with department rules and regulations for disciplinary hearings.

(b)

(1) Upon placement of an incarcerated individual into segregated confinement, or a residential rehabilitation unit, or step-down unit at a level one or level two facility, a suicide prevention screening instrument shall be administered by staff from the department or the office of mental health who has been trained for that purpose. If such a screening instrument reveals that the incarcerated individual is at risk of suicide, a mental health clinician shall be consulted, and appropriate safety precautions shall be taken. Additionally, within one business day of the placement of such an incarcerated individual into segregated confinement at a level one or level two facility, the incarcerated individual shall be assessed by a mental health clinician.

(2) Upon placement of an incarcerated individual into segregated confinement, or a residential rehabilitation unit, or step-down unit at a level three or level four facility, a suicide prevention screening instrument shall be administered by staff from the department or the office of mental health who has been trained for that purpose. If such a screening instrument reveals that the incarcerated individual is at risk of suicide, a mental health clinician shall be consulted, and appropriate safety precautions shall be taken. All incarcerated individuals placed in segregated confinement or a residential rehabilitation unit, or step-down unit at a level three or level four facility shall be assessed by a mental health clinician, within seven days of such placement into segregated confinement.

(3) At the initial assessment, if the mental health clinician finds that an incarcerated individual suffers from a serious mental illness, that person shall be diverted or removed from segregated confinement, or a residential rehabilitation unit, or step-down unit and a recommendation shall be made whether exceptional circumstances, as described in paragraph (5) of this subdivision, exist. In a facility with a joint case management committee, such recommendation shall be made by such committee. In a facility without a joint case management committee, the recommendation shall be made jointly by a committee consisting of the facility’s highest-ranking mental health clinician, the deputy superintendent for security, and the deputy superintendent for program services, or their equivalents. Any such recommendation shall be reviewed by the joint central office review committee. The administrative process described in this clause shall be completed within 7 days of the initial assessment, and if the result of such process is that the incarcerated individual should be removed from segregated confinement, or a residential rehabilitation unit, or step-down unit, such removal shall occur as soon as practicable, but in no event more than 72 hours from the completion of the administrative process. Except in exceptional circumstances, nothing in this section shall permit the placement of an incarcerated individual with serious mental illness into segregated confinement at any time, even for the purposes of assessment. For purposes of this paragraph, exceptional circumstances shall mean the occurrence of an act of serious misconduct by the incarcerated individual with serious mental illness, and, in the judgment of the superintendent, or, if unavailable, the highest ranking security individual at the facility when the serious misconduct occurred, that there exists an immediate threat to the health and well-being of the incarcerated individual, one or more other incarcerated individuals or staff, such that the incarcerated individual cannot be safely housed in any other immediately available housing unit at the facility. Upon a finding of exceptional circumstances, the incarcerated individual may be housed in segregated confinement for a period not to exceed 48 hours. As soon as possible during such temporary placement of the incarcerated individual in segregated confinement, however, an assessment shall be made by a staff member from the office of mental health, as well as by a facility health services practitioner, to ascertain the current condition of the incarcerated individual in segregated confinement. If either individual determines that such temporary placement in segregated confinement poses a significant risk of harm to the incarcerated individual, then the superintendent, or highest-ranking security official, at the facility, shall arrange for the immediate removal of such individual and transfer to a different facility where the individual can be safely housed in a setting that is not segregated confinement.

(4) If an incarcerated individual with a serious mental illness is not diverted or removed to a residential mental health treatment unit, such incarcerated individual shall be diverted to a residential rehabilitation unit or step-down unit and reassessed by a mental health clinician within 14-days of the initial assessment and at least once every 14-days thereafter. After each such additional assessment, a recommendation as to whether such incarcerated individual should be removed from a residential rehabilitation unit or step-down unit shall be made and reviewed according to the process set forth in paragraph (3) of this subdivision.

(5) A recommendation or determination whether to remove an incarcerated individual from a residential rehabilitation unit or step-down unit shall take into account the assessing mental health clinicians’ opinions as to the incarcerated individual’s mental condition and treatment needs, and shall also take into account any safety and security concerns that would be posed by the incarcerated individual’s removal, even if additional restrictions were placed on the incarcerated individual’s access to treatment, property, services or privileges in a residential mental health treatment unit. A recommendation or determination shall direct the incarcerated individual’s removal from a residential rehabilitation unit or step-down unit except in the following exceptional circumstances:

(i) when the reviewer finds that removal would pose a substantial risk to the safety of the incarcerated individual or other persons, or a substantial threat to the security of the facility, even if additional restrictions were placed on the incarcerated individual’s access to treatment, property, services or privileges in a residential mental health treatment unit; or

(ii) when the assessing mental health clinician determines that such placement is in the incarcerated individual’s best interests based on his or her mental condition and that removing such incarcerated individual to a residential mental health treatment unit would be detrimental to his or her mental condition. Any determination not to remove an incarcerated individual with serious mental illness from a residential rehabilitation unit or step-down unit shall be documented in writing and include the reasons for the determination.

(c) Incarcerated individuals with serious mental illness who are not diverted or removed from a residential rehabilitation unit or step-down unit shall be offered a heightened level of mental health care, involving a minimum of three hours daily of out-of-cell therapeutic treatment and programming. This heightened level of care shall not be offered only in the following circumstances:

(1) The heightened level of care shall not apply when an incarcerated individual with serious mental illness does not, in the reasonable judgment of a mental health clinician, require the heightened level of care. Such determination shall be documented with a written statement of the basis of such determination and shall be reviewed by the Central New York Psychiatric Center clinical director or his or her designee. Such a determination is subject to change should the incarcerated individual’s clinical status change. Such determination shall be reviewed and documented by a mental health clinician every 30-days, and in consultation with the Central New York Psychiatric Center clinical director or his or her designee not less than every 90-days.

(2) The heightened level of care shall not apply in exceptional circumstances when providing such care would create an unacceptable risk to the safety and security of incarcerated individuals or staff. Such determination shall be documented by security personnel together with the basis of such determination and shall be reviewed by the facility superintendent, in consultation with a mental health clinician, not less than every seven days for as long as the incarcerated individual remains in a residential rehabilitation unit or step-down unit. The facility shall attempt to resolve such exceptional circumstances so that the heightened level of care may be provided. If such exceptional circumstances remain unresolved for 30-days, the matter shall be referred to the joint central office review committee for review.

(d) All incarcerated individuals in segregated confinement in a level one or level two facility who are not assessed with a serious mental illness at the initial assessment shall be offered at least one interview with a mental health clinician within seven days of their initial mental health assessment, unless the mental health clinician at the most recent interview recommends an earlier interview or assessment. All incarcerated individuals in a residential rehabilitation unit or step-down unit in a level three or level four facility who are not assessed with a serious mental illness at the initial assessment shall be offered at least one interview with a mental health clinician within 30-days of their initial mental health assessment, and additional interviews at least every 90-days thereafter, unless the mental health clinician at the most recent interview recommends an earlier interview or assessment.