Absence without Authorization

(1) Classification as AWA. Any patient admitted or committed to a Department facility pursuant to M.G.L. c. 123, §§ 7, 8, 10, 11, 12, 15, 16, 17 or 18, who leaves the facility grounds or an off-grounds program or activity without permission and fails to return within a reasonable time, or any patient who, having left the facility with permission, fails to return at the designated time or within a reasonable time thereafter, shall be classified by the facility director as "absent without authorization" (AWA). (2) Classification as AWA: Action to Be Taken. (a) Immediate Classification. A patient who is admitted or committed pursuant to M.G.L. c. 123, §§ 7, 8, 10, 11 or 12 and who is at a high risk of harm to self or others or a patient who is committed pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18 who leaves the facility grounds or an off-grounds program or activity without permission shall be immediately classified as AWA. (b) Classification by Midnight Census. A patient who does not meet the criteria of 104 CMR 27.15(2)(a) shall be classified as AWA if he or she has not returned within a reasonable time based on clinical judgment or by the midnight census, whichever is earlier. (c) The facility shall take prompt and vigorous measures to secure the patient’s return. (d) When a patient is classified as AWA, the facility director or designee shall immediately notify the following parties: 1. Local and State Police. The police shall be provided with the patient’s description, other information that would assist the police in locating the patient, and information of the patient’s tendencies to be assaultive, homicidal, suicidal or to use weapons; 2. the district attorney of the county in which the facility is located; 3. the patient’s next of kin; 4. the patient’s legally authorized representative; 5. any person known to be placed at risk because the patient has left the facility; and 6. designated individuals within the Department. (3) Return from AWA: Action to Be Taken. (a) A patient who had been admitted pursuant to M.G.L. c. 123, §§ 10 and 11 or committed pursuant to M.G.L. c. 123, §§ 7 and 8, and who has not been discharged from the facility as provided in 104 CMR 27.15(4), may return or be returned to the facility under the original legal status within six months of being classified as AWA; provided however, if a patient was hospitalized pursuant to an order of commitment under M.G.L. c. 123, §§ 7 and 8 that has expired. Such patient may not be retained involuntarily unless he or she is assessed and admitted in accordance with the requirements of M.G.L. c. 123, § 12, and 104 CMR 27.07. (b) A patient who was committed to a Department facility pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18 may return or be returned to the facility under the original legal status; provided however, that a patient who was committed after a finding of incompetence to stand trial whose charges have been dismissed, and whose commitment has expired, may not be retained involuntarily unless he or she is assessed and admitted in accordance with the requirements of M.G.L. c. 123, § 12, and 104 CMR 27.07. (c) All parties who were notified at the time of a patient’s classification as AWA, shall be notified of the patient’s return to the facility by the facility director or designee. (4) Discharge of Patients on AWA: Action to Be Taken. (a) Six months after being classified as AWA, a patient on AWA who is not committed pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18 may be discharged from the facility upon authorization by the facility director after review by senior clinical staff; provided however, that a patient who was committed after a finding of incompetence to stand trial whose charges have been dismissed may be so discharged; provided further, that the facility director, in consultation with senior clinical staff, may discharge a patient on AWA status at an earlier date. (b) Except for a patient who was committed after a finding of incompetence to stand trial whose charges have been dismissed, there shall be no discharge of a person on AWA status who has been committed to a Department facility pursuant to M.G.L. c. 123, §§ 15, 16, 17 or 18. (c) All parties who were notified at the time of a patient’s classification as AWA, shall be notified of the facility’s decision to discharge the patient pursuant to 104 CMR 27.15(4)(a).