NYAPRS Note: New York State agencies have released more information on the procedures involved in the new clinician reporting requirements connected to the recently passed SAFE Act. A video and PowerPoint presentation is available at http://www.omh.ny.gov/omhweb/safe_act/nysafe.pdf.
State advocacy groups representing psychiatrists have written to Governor Cuomo requesting a delay in the program's start date to allow more clarifications.
See below for the article and more details from the state's presentations.
People with psychiatric diagnoses engaged in two Albany demonstrations earlier this year, organized by NYAPRS and the Mental Health Empowerment Project respectively, protesting against what they viewed as a rise in criminalizing 'psychiatric profiling' connected to the SAFE Act reporting and expansion of Kendra's Law court mandated treatment.
Psychiatrists Want Delay for Gun-Law Mandates By Jessica Bakeman Gannett News Service March 12, 2013
ALBANY - Mental health groups have urged the state to delay implementing the provision of the new gun control law that starting Saturday will require therapists to report potentially dangerous patients.
Treatment providers want specific changes to the language of the bill and more guidance on what it requires.
“Key groups of practitioners have major unanswered questions around the criteria on which to make the report and their liability in that,” said Harvey Rosenthal, executive director of the state Association of Psychiatric Rehabilitation Services. “There is some real alarm.”
The state has been working to educate providers on the law’s implications. The Office of Mental Health released a 22-minute video Tuesday outlining the reporting requirements, and there are support documents and frequently asked questions on the agency’s website.
“The office of Mental Health has been in constant contact with the mental health provider community to discuss implementation of this critically important provision of the SAFE Act,” OMH spokesman Ben Rosen said in an e-mail.
The state Medical Society and the Psychiatric Association asked Gov. Andrew Cuomo for an extension on March 1.
The request is “mainly because we think there is confusion amongst the health care providers that are obligated to make a report as to what the actual standard is,” said Liz Dears, the Medical Society’s senior vice president for legislative affairs.
Dears said the groups are slated to meet with the governor’s staff Thursday. She’s “hopeful” the provision’s effective date might be moved.
Richard Azzopardi, a Cuomo spokesman, said: “We have no intention of moving the date.”
The concerns from mental health providers is the latest issue with the gun-control law, which was passed Jan. 15. Gun-rights advocates have held three protests at the Capitol calling for the law’s repeal. There are also several lawsuits seeking to have it overturned.
The mental health providers’ main problem with the law is that the reporting criteria are not identical to current law that allows them to report dangerous patients to law enforcement or potential victims.
Current law allows reporting without a breach of confidentiality if a patient presents “a serious and imminent threat” to the health and safety of self or others.
Under the NY SAFE Act, the therapist must report “when in their reasonable professional judgment,” the patient “is likely to engage in conduct that would result in serious harm to self or others.”
“We believe that the mandate in the SAFE Act is so broad as to result in the reporting of many patients who would not be subject to reporting under (current law),” wrote Robert Hughes and Glenn Martin, presidents of the Medical Society and the Psychiatric Association, in the letter.
“We are concerned that the existence of two standards will cause significant confusion among health care professionals and could result in the reporting of persons who do not pose a serious and imminent threat to society,” they continued.
John Allen, special assistant to the commissioner of OMH, said in the tutorial video released Tuesday that there is an exception to the law’s reporting requirements.
“A report is not required when, in the mental health professional’s reasonable professional judgment, a report would endanger him or herself or would increase the danger to the potential victim or victims,” he said.
The video provided more information on the reporting process, including a tutorial on how to use the online portal.
When providers determine a patient is potentially dangerous, they fill out an online form and submit it to the county mental health offices. If county personnel agree the person might be a danger, they send the report to the state.
No clinical information is provided to the Division of Criminal Justice Services; only the patient’s name, address and other identifying information is passed along. The report must be deleted after five years, Allen said.
The state will check to see if the person is licensed to own a gun or has a registered assault weapon. Local officials must then decide whether to suspend or revoke the person’s licenses and may confiscate any firearms.
The report can also be used to determine whether a potentially dangerous person should be immediately transported to a hospital for a psychiatric evaluation.
The provisions can apply to children, Allen said.
“There is no specific age restriction or limitation in the SAFE Act,” he said.
NYS SAFE Act Reporting Policy
Effective March 16
Physicians, psychologists, registered nurses, or licensed clinical social workers in any setting (hospital, public clinic, private practice) must report as soon as practicable to their local County Director of Community Services or designee a person (regardless of age) who “is likely to engage in conduct that would result in serious harm to self or others” via on OMH online web portal.
The standard has the same meaning as the term “likelihood to result in serious harm,” which is defined in current law to mean threats of, or attempts at, suicide/serious bodily harm to self, or homicidal/violent behavior towards others.
This standard justifies the need for immediate action, such as an involuntary transport by police or an ambulance service to a psychiatric hospital for an examination. Under pre-existing mental hygiene law, the DCS or designee will also determine whether to direct an emergency “removal” and transport to a hospital for a psychiatric examination and possible admission.
Mental health professionals must use reasonable professional judgment when making this determination. A report is not required when, in the mental health professional’s reasonable professional judgment, a report would endanger him or her or would increase the danger to the potential victim or victims.
DCS Report to DCJS
If Director of Community Services or designee agrees that the person is likely to engage in such conduct, he/she fills out and submits secure online form to the NYS Division of Criminal Justice Services (DCJS).
DCS reports will be made through a secure online portal and will only include a patient’s name and other non-clinical identifying information (e.g., name, date of birth, race, sex, SS#, address) to DCJS.
DCJS determines if subject of report has or has applied for a firearms license or has registered an assault weapon, and works with State Police, which notifies the appropriate county firearms licensing official. Licensing officials will also notify local law enforcement to remove gun(s).
Freedom of Information Law "requires that the state keep confidential information that would result in an unwarranted invasion of personal privacy." The notification is for the purpose of limiting access to firearms and that the duration of any individual report will last for 5 years.