137 - Program of treatment, control, discipline at correctional facilities.

§  137.  Program  of  treatment,  control,  discipline at correctional  facilities.  1.   The   commissioner   shall   establish   program   and  classification  procedures  designed to assure the complete study of the  background and condition of each inmate in the care or  custody  of  the  department  and  the assignment of such inmate to a program that is most  likely to be useful in assisting him to refrain from  future  violations  of  the  law.  Such  procedures shall be incorporated into the rules and  regulations of the department and  shall  require  among  other  things:  consideration  of  the  physical,  mental and emotional condition of the  inmate;  consideration  of  his  educational   and   vocational   needs;  consideration  of  the  danger  he presents to the community or to other  inmates; the recording of continuous case histories including  notations  as  to  apparent  success or failure of treatment employed; and periodic  review of case histories and treatment methods used.    2. The commissioner shall provide for such measures  as  he  may  deem  necessary  or  appropriate  for  the  safety,  security  and  control of  correctional facilities and the maintenance of order therein.    3. Each inmate shall be entitled to clothing suited to the season  and  weather  conditions  and  to  a  sufficient  quantity  of  wholesome and  nutritious food. To the extent practicable, the clothing and bedding  of  inmates  shall  be  manufactured  and  laundered  in institutions in the  department.    4. Whenever there shall be a sufficient number of cells or rooms in  a  correctional   facility,   each   inmate   shall   be   given   sleeping  accommodations in a separate  cell  or  room,  provided,  however,  that  nothing  herein contained shall be construed so as to limit the right of  the department to utilize dormitory-type accommodations where  necessary  or where appropriate to a program of treatment.    5.  No  inmate  in  the  care  or  custody  of the department shall be  subjected to degrading treatment, and no officer or  other  employee  of  the  department shall inflict any blows whatever upon any inmate, unless  in self defense, or to suppress  a  revolt  or  insurrection.  When  any  inmate,  or  group of inmates, shall offer violence to any person, or do  or attempt to do any injury to property, or attempt to escape, or resist  or disobey any lawful direction, the officers and  employees  shall  use  all  suitable  means to defend themselves, to maintain order, to enforce  observation of discipline, to secure the persons of the offenders and to  prevent any such attempt or escape.    6. * The superintendent of a correctional facility may keep any inmate  confined in a cell or room, apart from the accommodations  provided  for  inmates  who  are  participating  in  programs of the facility, for such  period as may be necessary for maintenance of order or  discipline,  but  in any such case the following conditions shall be observed:    * NB Effective until July 1, 2011    *   Except  as provided in paragraphs (d) and (e) of this subdivision,  the superintendent of  a  correctional  facility  may  keep  any  inmate  confined  in  a cell or room, apart from the accommodations provided for  inmates who are participating in programs  of  the  facility,  for  such  period  as  may be necessary for maintenance of order or discipline, but  in any such case the following conditions shall be observed:    * NB Effective July 1, 2011    (a) The inmate  shall  be  supplied  with  a  sufficient  quantity  of  wholesome  and  nutritious  food, provided, however, that such food need  not be the same as the food supplied to inmates who are participating in  programs of the facility;    (b) Adequate sanitary and other conditions required for the health  of  the inmate shall be maintained;(c)  Where  such  confinement is for a period in excess of twenty-four  hours, the superintendent shall arrange for the facility health services  director, or a registered nurse or physician's associate approved by the  facility health services director to visit such inmate at the expiration  of  twenty-four hours and at least once in every twenty-four hour period  thereafter, during the period of such confinement, to examine  into  the  state  of  health  of the inmate, and the superintendent shall give full  consideration to any recommendation that may be  made  by  the  facility  health  services  director for measures with respect to dietary needs or  conditions of confinement of such inmate required to maintain the health  of such inmate; and    * (d) The superintendent shall make a full report to the  commissioner  at  least  once a week concerning the condition of such inmate and shall  forthwith report to the  commissioner  any  recommendation  relative  to  health  maintenance  or health care delivery made by the facility health  services director that is not endorsed or carried out, as the  case  may  be, by the superintendent.    * NB Effective until July 1, 2011    * (d)  (i)  Except  as set forth in clause (E) of subparagraph (ii) of  this paragraph, the  department,  in  consultation  with  mental  health  clinicians,  shall divert or remove inmates with serious mental illness,  as defined  in  paragraph  (e)  of  this  subdivision,  from  segregated  confinement, where such confinement could potentially be for a period in  excess  of  thirty  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.    (ii) (A) Upon placement of an inmate into segregated confinement 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 inmate 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 inmate into segregated confinement at a level one  or level two facility, the inmate shall be assessed by a  mental  health  clinician.    (B) Upon placement of an inmate into segregated confinement 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  inmate  is  at risk of suicide, a mental  health clinician shall be consulted and appropriate  safety  precautions  shall  be taken. All inmates placed in segregated confinement at a level  three or level four facility  shall  be  assessed  by  a  mental  health  clinician,  within  fourteen  days  of  such  placement  into segregated  confinement.    (C) At the initial assessment, if the mental  health  clinician  finds  that  an  inmate suffers from a serious mental illness, a recommendation  shall be made whether exceptional circumstances, as described in  clause  (E)  of  this  subparagraph,  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.   Theadministrative  process  described  in  this  clause  shall be completed  within fourteen days of the initial assessment, and  if  the  result  of  such  process  is  that  the  inmate  should  be removed from segregated  confinement,  such removal shall occur as soon as practicable, but in no  event  more  than  seventy-two  hours  from  the   completion   of   the  administrative process.    (D)  If  an  inmate  with  a serious mental illness is not diverted or  removed to a residential mental health treatment unit, such inmate shall  be reassessed by a mental health clinician within fourteen days  of  the  initial  assessment  and  at  least once every fourteen days thereafter.  After each such additional assessment, a recommendation  as  to  whether  such  inmate should be removed from segregated confinement shall be made  and reviewed according to the process set forth in clause  (C)  of  this  subparagraph.    (E) A recommendation or determination whether to remove an inmate from  segregated  confinement  shall  take  into  account the assessing mental  health clinicians' opinions as to  the  inmate's  mental  condition  and  treatment  needs,  and  shall  also  take  into  account  any safety and  security concerns that would be posed by the inmate's removal,  even  if  additional restrictions were placed on the inmate's access to treatment,  property,   services  or  privileges  in  a  residential  mental  health  treatment unit. A  recommendation  or  determination  shall  direct  the  inmate's  removal  from  segregated  confinement except in the following  exceptional circumstances: (1) when  the  reviewer  finds  that  removal  would  pose  a  substantial  risk  to  the safety of the inmate or other  persons, or a substantial threat to the security of the  facility,  even  if  additional  restrictions  were  placed  on  the  inmate's  access to  treatment, property, services or  privileges  in  a  residential  mental  health treatment unit; or (2) when the assessing mental health clinician  determines  that  such placement is in the inmate's best interests based  on his or her mental condition  and  that  removing  such  inmate  to  a  residential  mental health treatment unit would be detrimental to his or  her mental condition. Any determination not to  remove  an  inmate  with  serious  mental  illness from segregated confinement shall be documented  in writing and include the reasons for the determination.    (iii) Inmates with serious mental illness  who  are  not  diverted  or  removed  from segregated confinement shall be offered a heightened level  of care, involving a minimum of two hours each day, five days a week, of  out-of-cell therapeutic treatment and programming. This heightened level  of care shall not be offered only in the following circumstances:    (A) The heightened level of care shall not apply when an  inmate  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 inmate's  clinical  status  change.  Such determination shall be reviewed and documented by a mental  health clinician every thirty days, and in consultation with the Central  New York Psychiatric Center clinical director or his or her designee not  less than every ninety days.    (B) 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 inmates 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 inmate remains in  segregated  confinement.  Thefacility shall attempt to resolve such exceptional circumstances so that  the  heightened  level  of  care  may  be  provided. If such exceptional  circumstances remain unresolved for thirty days,  the  matter  shall  be  referred to the joint central office review committee for review.    (iv)  Inmates  with  serious  mental  illness  who are not diverted or  removed from segregated confinement shall not be placed on a  restricted  diet,  unless there has been a written determination that the restricted  diet is necessary for reasons of safety and security.  If  a  restricted  diet  is  imposed,  it  shall  be  limited  to seven days, except in the  exceptional circumstances where  the  joint  case  management  committee  determines that limiting the restricted diet to seven days would pose an  unacceptable  risk  to  the  safety and security of inmates or staff. In  such case, the need for a restricted diet shall  be  reassessed  by  the  joint case management committee every seven days.    (v)  All inmates 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  fourteen  days of their initial mental health  assessment,  and  additional  interviews  at  least  every  thirty  days  thereafter,  unless  the  mental  health  clinician  at  the most recent  interview recommends an earlier interview or assessment. All inmates  in  segregated  confinement  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 thirty days  of  their  initial  mental  health  assessment,  and  additional  interviews at least every ninety days thereafter, unless the  mental health clinician at  the  most  recent  interview  recommends  an  earlier interview or assessment.    * NB Effective July 1, 2011    * (e)  An  inmate has a serious mental illness when he or she has been  determined by a mental health clinician to meet  at  least  one  of  the  following criteria:    (i)  he  or  she  has  a  current diagnosis of, or is diagnosed at the  initial or any  subsequent  assessment  conducted  during  the  inmate's  segregated  confinement with, one or more of the following types of Axis  I diagnoses, as described in the most recent edition of  the  Diagnostic  and  Statistical Manual of Mental Disorders, and such diagnoses shall be  made based upon all relevant clinical factors, including but not limited  to symptoms related to such diagnoses:    (A) schizophrenia (all sub-types),    (B) delusional disorder,    (C) schizophreniform disorder,    (D) schizoaffective disorder,    (E) brief psychotic disorder,    (F) substance-induced psychotic disorder (excluding  intoxication  and  withdrawal),    (G) psychotic disorder not otherwise specified,    (H) major depressive disorders, or    (I) bipolar disorder I and II;    (ii)  he  or  she  is  actively  suicidal  or has engaged in a recent,  serious suicide attempt;    (iii) he or she has been diagnosed with a  mental  condition  that  is  frequently  characterized  by  breaks  with  reality,  or perceptions of  reality, that lead the individual to experience  significant  functional  impairment  involving  acts  of  self-harm or other behavior that have a  seriously adverse effect on life or on mental or physical health;    (iv) he or she has been diagnosed with an organic brain syndrome  that  results  in  a  significant  functional  impairment  involving  acts  ofself-harm or other behavior that have a seriously adverse effect on life  or on mental or physical health;    (v)  he  or  she has been diagnosed with a severe personality disorder  that is manifested by frequent episodes of psychosis or depression,  and  results  in  a  significant  functional  impairment  involving  acts  of  self-harm or other behavior that have a seriously adverse effect on life  or on mental or physical health; or    (vi) he or she has been determined by a  mental  health  clinician  to  have  otherwise substantially deteriorated mentally or emotionally while  confined in  segregated  confinement  and  is  experiencing  significant  functional  impairment  indicating a diagnosis of serious mental illness  and involving acts of self-harm or other behavior that  have  a  serious  adverse effect on life or on mental or physical health.    * NB Effective July 1, 2011    * (f)  The superintendent shall make a full report to the commissioner  at least once a week concerning the condition of such inmate  and  shall  forthwith  report  to  the  commissioner  any recommendation relative to  health maintenance or health care delivery made by the  facility  health  services  director  and  any  recommendation  relative  to mental health  treatment or confinement of an inmate with a serious mental illness made  by the mental health clinician pursuant to paragraphs  (d)  and  (e)  of  this  subdivision  that  is not endorsed or carried out, as the case may  be, by the superintendent.    * NB Effective July 1, 2011