N.Y. Comp. Codes R. & Regs. tit. 14, § 540.9 – Hospital forensic committee procedures; clinical director.

(a) A patient who wishes to be discharged or conditionally released, converted to civil status, transferred to a less secure facility or granted escorted or unescorted furlough privileges or his or her legal representative may request his treatment team to make an appropriate application to the hospital forensic committee.
(b) When the treatment team serving a patient is of the opinion that such patient is appropriate for escorted furlough, unescorted furlough, transfer, discharge, conditional release or conversion to civil status, it shall recommend to the unit chief that an application be made to the hospital forensic committee and the clinical director. When the treatment team serving a patient is of the opinion that such patient is appropriate for return to the custody of the criminal court, it shall recommend to the unit chief that an application be made to the hospital forensic committee or to the clinical director, if he or she has designated a psychiatric examiner in accordance with procedures described in section 540.8(c) of this Part. The treatment team may act on its own initiative or at the patient's request.
(c) If the unit chief, after review of the case, agrees with the opinion of the treatment team, he or she and the team psychiatrist shall execute an application. Upon completion of the application, the unit chief shall forward it to the hospital forensic committee or to the clinical director, if he or she has designated a psychiatric examiner in accordance with the procedures described in section 540.8(c) of this Part.
(d) The committee shall meet to discuss the application within seven days of its receipt of the application from the unit chief. The committee shall notify the patient, the patient's attorney, and the Mental Hygiene Legal Service of its meeting at least three days prior to the meeting. Proof of service of such notice shall be placed in the patient's record. The patient, the Mental Hygiene Legal Service or an attorney or representative of his or her choice may attend the meeting.
(e) The committee shall review all information pertaining to the patient and, if necessary, conduct a joint examination of the patient. Within seven days of its meeting to discuss the application, the committee shall make a written recommendation to the clinical director regarding the merits of the application. Such recommendation need not be unanimous. If one member of the committee disagrees, he or she shall so notify the clinical director, in writing.
(f) If the application on behalf of the patient is for conversion of the patient to civil status, the committee shall consider whether the patient is mentally ill, in need of care and treatment in a hospital, lacks the judgment necessary to understand such need, and would either be unable to live outside the hospital with the help of family or friends or would pose a danger to himself or herself or others. If the patient meets such criteria, the committee shall recommend to the clinical director that the patient be involuntarily civilly committed. If the patient does not meet those criteria but is suitable for continued hospitalization, the committee shall recommend to the clinical director that the patient be converted to voluntary civil status. If the patient should not be hospitalized, the committee shall so recommend to the clinical director.
(g) If an application is made seeking the discharge or conditional release of a patient against whom criminal charges are not pending, the committee shall consider whether the patient suffers a mental illness and requires inpatient care and treatment in a hospital, lacks the judgment to understand his or her need for such treatment and would either be unable to live outside the hospital with the help of family or friends or would pose a danger to himself or herself or other persons if released. If the patient meets each of the above criteria, the committee shall recommend that the patient continue in the custody of the commissioner as an involuntary civil patient. If the committee believes that the patient does not meet such criteria, it shall recommend that the patient be released.
(h) If an application is made to the committee in accordance with the procedures described in section 540.8(b) of this Part, for a determination of fitness to stand trial and return to court of a patient against whom criminal changes remain pending, the committee shall consider whether the patient suffers a mental illness which renders him or her incapable of understanding the charges against him and assisting in his or her own defense.
(i) If an application is made for the granting of escorted or unescorted furlough, the committee may recommend that such furlough privileges be granted if it finds that they would be clinically beneficial to the patient and that, in its opinion, the patient may be granted furlough privileges without endangering another person or persons outside the facility. If the committee recommends that escorted or unescorted furlough be granted, it shall also recommend the duration of each exercise of those furlough privileges and the period of time for which the granting of furlough privileges should remain outstanding. If an application is made to grant a patient escorted or unescorted furlough privileges and the committee is of the opinion that the patient would pose an immediate danger to another person or persons if allowed outside the facility, or that the patient is otherwise not suited for such furlough, it shall recommend that the furlough be denied.
(j) If an application is made to transfer the patient to a less secure facility, the committee shall consider whether such transfer would be in the best interest of the patient and whether the patient's behavior is such that the transfer would jeopardize the safety of the patient, other patients or staff at a less secure facility. If the committee is of the opinion that such transfer could jeopardize the safety of the patient or any other person, or would render an escape attempt likely, it shall recommend against transfer.
1. (1) The clinical director shall have responsibility for deciding whether to grant an application for the conversion to civil status, granting of furlough, discharge, or conditional release of a patient. In exercising such responsibility, he or she shall review the recommendations of the hospital forensic committee. The clinical director need not follow such recommendation, but shall not take action contrary to the recommendation of a majority of the committee without first consulting with a clinician who is not employed at the facility.
2. (2) The clinical director shall have responsibility for deciding whether to grant an application for a return to court of a patient who is no longer an incapacitated person but against whom criminal charges remain pending. In exercising such responsibility, he or she shall:
  1. (i) review the recommendation of the hospital forensic committee if consultation is requested in accordance with section 540.8(b) of this Part. The clinical director is not required to follow such recommendations, but shall not take action contrary to the recommendation of a majority of the committee without first consulting with a clinician who is not employed at the facility; or
  2. (ii) review the report and recommendations of the psychiatric examiner that he or she has designated in accordance with the procedures described in section 540.8(c) of this Part. The clinical director is not required to follow such recommendations.
(k)
(l) If the clinical director decides to grant a patient escorted or unescorted furlough, he or she shall specify the allowable duration of each exercise of those furlough privileges and the period of time for which furlough privileges may be granted.
(m) In the event the patient's treatment team becomes aware of a change in the patient's condition that would warrant discontinuation of escorted or unescorted furlough, the treatment team leader shall so notify the unit chief, who shall notify the clinical director, who may revoke the grant of such furlough privileges to the patient. The unit chief or the physician treating the patient may immediately suspend a patient's furlough privileges in the event of an emergency.
(n) If the clinical director decides to grant the patient's application, he or she shall follow the notice requirements described in section 540.10 of this Part, if applicable.
(o) The clinical director need not comply with the notice requirements and procedures described in section 540.10 of this Part if a hearing is held at the time a patient is converted to civil status or at any other time after commitment and a court issues an order authorizing transfer, discharge, conditional release, or the granting of escorted or unescorted privileges at the discretion of the facility.