Voluntary and Conditional Voluntary Admission

(1) Eligibility for Voluntary or Conditional Voluntary Admission. (a) A person may be admitted on a voluntary status pursuant to M.G.L. c. 123, § 10 or a conditional voluntary status pursuant to M.G.L. c. 123, §§ 10 and 11 to a facility upon written application, provided that in the opinion of the facility director, or designee, such patient qualifies for admission in accordance with 104 CMR 27.05(2), and has the capacity to apply for such admission and is desirous of receiving treatment. (b) A person’s application for voluntary or conditional voluntary status shall only be accepted upon a determination by the admitting or treating clinician that the patient has reached 16 years of age, has capacity to apply for such status, and is in need of care and treatment, or if application is made on behalf of the patient by a legally authorized representative that the legally authorized representative has authority to do so. 1. An application made on behalf of a minor by the minor’s parent or guardian may be accepted upon a determination by the admitting or treating clinician that the person making such application is in fact the minor’s legally authorized representative. 2. An application made on behalf of a person by his or her health care agent may be accepted upon a determination by the admitting or treating clinician that the health care agent is acting pursuant to a valid and invoked health care proxy that has not been revoked by the patient. (c) For purposes of 104 CMR 27.06, capacity to apply means: 1. that a patient admitted on a voluntary status understands that he or she is in a facility for treatment and that he or she may leave the facility at any time. 2. that a patient admitted on a conditional voluntary status understands that he or she is in a facility for treatment, understands the three-day notice provisions, and understands the facility director’s right to file a petition for commitment and thereby retain him or her at the facility. (2) Prior to admission, such person shall be afforded the opportunity for consultation with an attorney, or with a person who is working under the supervision of an attorney, concerning the legal effect of the admission. (3) Upon admission, the patient and his or her legally authorized representative shall receive information concerning the legal and human rights which he or she retains after admission to the facility. (4) A patient on voluntary status shall be discharged upon his or her request, or upon the request of the patient’s legally authorized representative who applied for the admission of such patient, in as provided in 104 CMR 27.09. (5) A patient on conditional voluntary status, or a legally authorized representative who applied for the admission of such patient, may be required to give three days prior written notice to the facility director of his or her intention to leave such facility or to withdraw such patient from the facility. Upon submission of a three-day notice, the facility director shall proceed as provided in 104 CMR 27.09(4). (a) A patient admitted on application of a health care agent pursuant to a health care proxy that has not been affirmed in accordance with M.G.L. c. 201D may revoke such proxy orally or in writing, which revocation shall constitute submission of a three-day notice; provided however, that the patient may retract such three-day notice pursuant to 104 CMR 27.06(5)(b). The submission of a three-day notice by such a patient shall be deemed a revocation of the health care proxy for purposes of 104 CMR 27.06(5). (b) A three-day notice may only be retracted by written notice to the facility director; provided however, that such retraction shall only be accepted upon a determination by the facility director or designee that the patient has the capacity to apply for conditional voluntary status pursuant to 104 CMR 27.06(1)(c). (c) A three-day notice and any retraction thereof shall become part of the patient’s record. (d) The form and content of a three-day notice, or retraction thereof, shall be deemed sufficient so long as it conveys the patient’s intention, without requirement that it be on any particular form of the facility. (6) Prior to admitting a person on conditional voluntary status, the admitting personnel shall inform such person of the three-day notice requirements established in M.G.L. c. 123, § 11, and of the facility director’s right to file a petition for commitment upon notice that the patient wishes to leave, pursuant to M.G.L. c. 123, § 11. (7) A patient who is 16 or 17 years of age, or who during the course of hospitalization reaches 16 years of age, and who has been admitted to a facility on a voluntary or conditional voluntary status by application of a legally authorized representative shall have the same rights as those patients 16 years of age or older who have applied and been admitted on their own behalf, including the right to leave the facility upon submission of a three-day notice of intent to do so, and the right to remain at the facility, upon written application, despite notice by a legally authorized representative of intention to withdraw such patient. (8) Application for conditional voluntary admission shall be made only upon such form as the Department may prescribe.