(a) The executive commissioner shall adopt or amend, and the department shall enforce, rules that require continuity of services and planning for patient care between department facilities and local mental health authorities.
(b) At a minimum, the rules must:
(1) specify the local mental health authority’s responsibility for ensuring the successful transition of patients who are determined by the facility to be medically appropriate for discharge; and
(2) require participation by a department facility in joint discharge planning with a local mental health authority before the facility discharges a patient or places the patient on an extended furlough with an intent to discharge.

(c) The local mental health authority shall plan with the department facility to determine the appropriate community services for the patient.
(d) The local mental health authority shall arrange for the provision of the services upon discharge.
(e) The commission shall require each facility to designate at least one employee to provide transition support services for patients who are determined medically appropriate for discharge from the facility.
(f) Transition support services provided by the local mental health authority must be designed to complement joint discharge planning efforts and may include:
(1) enhanced services and supports for complex or high-need patients, including services and supports necessary to create viable discharge or outpatient management plans; and
(2) post-discharge monitoring for up to one year after the discharge date to reduce the likelihood of readmission.
(g) The commission shall ensure that each department facility concentrates the provision of transition support services for patients who have been:
(1) admitted to and discharged from a facility multiple times during a 30-day period; or
(2) in the facility for longer than 365 consecutive days.