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                                                       PRINTER'S NO. 205

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 213 Session of 2005


        INTRODUCED BY GREENLEAF, ORIE, ERICKSON, COSTA, KITCHEN,
           TOMLINSON, WOZNIAK, THOMPSON, O'PAKE AND BOSCOLA,
           FEBRUARY 8, 2005

        REFERRED TO PUBLIC HEALTH AND WELFARE, FEBRUARY 8, 2005

                                     AN ACT

     1  Amending the act of July 9, 1976 (P.L.817, No.143), entitled "An
     2     act relating to mental health procedures; providing for the
     3     treatment and rights of mentally disabled persons, for
     4     voluntary and involuntary examination and treatment and for
     5     determinations affecting those charged with crime or under
     6     sentence," adding provisions relating to assisted outpatient
     7     treatment programs.

     8     The General Assembly of the Commonwealth of Pennsylvania
     9  hereby enacts as follows:
    10     Section 1.  The act of July 9, 1976 (P.L.817, No.143), known
    11  as the Mental Health Procedures Act, is amended by adding an
    12  article to read:
    13                           ARTICLE III-A
    14                   Assisted Outpatient Treatment
    15  Section 301-A.  Definitions.
    16     The following words and phrases when used in this article
    17  shall have the meanings given to them in this section unless the
    18  context clearly indicates otherwise:
    19     "Assisted outpatient" or "patient."  A person under a court
    20  order to receive assisted outpatient treatment.

     1     "Assisted outpatient treatment."  Any of the following
     2  categories of outpatient services which have been ordered by the
     3  court pursuant to section 305-A (relating to assisted outpatient
     4  treatment program):
     5         (1)  Case management services or assertive community
     6     treatment team services to provide care coordination.
     7         (2)  Medication.
     8         (3)  Periodic blood tests or urinalysis to determine
     9     compliance with prescribed medications.
    10         (4)  Individual or group therapy.
    11         (5)  Day or partial programming activities.
    12         (6)  Educational and vocational training or activities.
    13         (7)  Alcohol or substance abuse treatment and counseling
    14     and periodic tests for the presence of alcohol or illegal
    15     drugs for persons with a history of alcohol or substance
    16     abuse.
    17         (8)  Supervision of living arrangements.
    18         (9)  Any other services within an individualized
    19     treatment plan developed pursuant to Article I (relating to
    20     general provisions) prescribed to treat the person's mental
    21     illness and to assist the person in living and functioning in
    22     the community, or to attempt to prevent a relapse or
    23     deterioration that may reasonably be predicted to result in
    24     suicide or the need for hospitalization.
    25     "Assisted outpatient treatment program" or "program."  A
    26  system to arrange for and coordinate the provision of assisted
    27  outpatient treatment, to monitor treatment compliance by
    28  assisted outpatients, to evaluate the condition or needs of
    29  assisted outpatients, to take appropriate steps to address the
    30  needs of assisted outpatients and to ensure compliance with
    20050S0213B0205                  - 2 -     

     1  court orders.
     2     "Director."  The director of a hospital licensed or operated
     3  by the Department of Public Welfare which operates, directs and
     4  supervises an assisted outpatient treatment program, or the
     5  county administrator which operates, directs and supervises an
     6  assisted outpatient treatment program.
     7     "Program coordinator."  An individual appointed under section
     8  302-A(a) (relating to program coordinators to be appointed) who
     9  is responsible for the oversight and monitoring of assisted
    10  outpatient treatment programs.
    11     "Subject of the petition" or "subject."  A person who is
    12  alleged in a petition, filed pursuant to the provisions of
    13  section 305-A (relating to assisted outpatient treatment
    14  program), to meet the criteria for assisted outpatient
    15  treatment.
    16  Section 302-A.  Program coordinators to be appointed.
    17     (a)  Duty of secretary.--The Secretary of Public Welfare
    18  shall appoint program coordinators of assisted outpatient
    19  treatment, who shall be responsible for the oversight and
    20  monitoring of assisted outpatient treatment programs established
    21  pursuant to section 305-A (relating to assisted outpatient
    22  treatment program). County administrators shall work in
    23  conjunction with the program coordinators to coordinate the
    24  implementation of assisted outpatient treatment programs.
    25     (b)  Oversight and monitoring duties.--The oversight and
    26  monitoring role of the program coordinator of the assisted
    27  outpatient treatment program shall include each of the
    28  following:
    29         (1)  That each assisted outpatient receives the treatment
    30     provided for in the court order issued pursuant to section
    20050S0213B0205                  - 3 -     

     1     305-A.
     2         (2)  That existing services located in the assisted
     3     outpatient's community are utilized whenever practicable.
     4         (3)  That a case manager or assertive community treatment
     5     team is designated for each assisted outpatient.
     6         (4)  That a mechanism exists for a case manager, or
     7     assertive community treatment team, to regularly report the
     8     assisted outpatient's compliance, or lack of compliance, with
     9     treatment to the director of the assisted outpatient
    10     treatment program.
    11         (5)  That assisted outpatient treatment services are
    12     delivered in a timely manner.
    13     (c)  Standards to be developed.--The Secretary of Public
    14  Welfare shall develop standards designed to ensure that case
    15  managers or assertive community treatment teams have appropriate
    16  training and have clinically manageable caseloads designed to
    17  provide effective case management or other care coordination
    18  services for persons subject to a court order under section 305-
    19  A.
    20     (d)  Corrective action to be taken.--Upon review or receiving
    21  notice that services are not being delivered in a timely manner,
    22  the program coordinator shall require the director of the
    23  assisted outpatient treatment program to immediately commence
    24  corrective action and inform the program coordinator of the
    25  corrective action taken. Failure of a director to take
    26  corrective action shall be reported by the program coordinator
    27  to the Secretary of Public Welfare as well as to the court which
    28  ordered the assisted outpatient treatment.
    29  Section 303-A.  Duties of county administrators.
    30     Each county administrator shall be responsible for the filing
    20050S0213B0205                  - 4 -     

     1  of petitions for assisted outpatient treatment pursuant to
     2  section 305-A (relating to assisted outpatient treatment
     3  program), for the receipt and investigation of reports of
     4  persons who are alleged to be in need of that treatment and for
     5  coordinating the delivery of court-ordered services with program
     6  coordinators, appointed by the Secretary of Public Welfare
     7  pursuant to section 302-A(a) (relating to program coordinators
     8  to be appointed). In discharge of the duties imposed by section
     9  305-A, directors of community services may provide services
    10  directly, or may coordinate services with the offices of the
    11  Secretary of Public Welfare or may contract with any public or
    12  private provider to provide services for assisted outpatient
    13  treatment programs as may be necessary to carry out the duties
    14  imposed pursuant to this article.
    15  Section 304-A.  Directors of assisted outpatient treatment
    16                     programs.
    17     (a)  General duties.--
    18         (1)  Directors of assisted outpatient treatment programs
    19     established pursuant to section 305-A (relating to assisted
    20     outpatient treatment program) shall provide a written report
    21     to the program coordinators, appointed by the Secretary of
    22     Public Welfare pursuant to section 302-A(a) (relating to
    23     program coordinators to be appointed), within three days of
    24     the issuance of a court order. The report shall demonstrate
    25     that mechanisms are in place to ensure the delivery of
    26     services and medications as required by the court order and
    27     shall include, but not be limited to, the following:
    28             (i)  A copy of the court order.
    29             (ii)  A copy of the written treatment plan.
    30             (iii)  The identity of the case manager or assertive
    20050S0213B0205                  - 5 -     

     1         community treatment team, including the name and contact
     2         data of the organization which the case manager or
     3         assertive community treatment team member represents.
     4             (iv)  The identity of providers of services.
     5             (v)  The date on which services have commenced or
     6         will commence.
     7         (2)  The directors of assisted outpatient treatment
     8     programs shall ensure the timely delivery of services
     9     described in section 305-A pursuant to any court order issued
    10     thereunder. Directors of assisted outpatient treatment
    11     programs shall immediately commence corrective action upon
    12     receiving notice from program coordinators that services are
    13     not being provided in a timely manner, and the directors
    14     shall inform the program coordinator of the corrective action
    15     taken.
    16     (b)  Quarterly reports to program coordinators.--Directors of
    17  assisted outpatient treatment programs shall submit quarterly
    18  reports to the program coordinators regarding the assisted
    19  outpatient treatment program operated or administered by them.
    20  The report shall include the following information:
    21         (1)  The names of individuals served by the program.
    22         (2)  The percentage of petitions for assisted outpatient
    23     treatment that are granted by the court.
    24         (3)  Any change in status of assisted outpatients,
    25     including, but not limited to, the number of individuals who
    26     have failed to comply with court-ordered assisted outpatient
    27     treatment.
    28         (4)  A description of material changes in written
    29     treatment plans of assisted outpatients.
    30         (5)  Any change in case managers.
    20050S0213B0205                  - 6 -     

     1         (6)  A description of the categories of services which
     2     have been ordered by the court.
     3         (7)  Living arrangements of individuals served by the
     4     program including the number, if any, who are homeless.
     5         (8)  Any other information as required by the Secretary
     6     of Public Welfare.
     7         (9)  Any recommendations to improve the program Statewide
     8     or locally.
     9  Section 305-A.  Assisted outpatient treatment program.
    10     (a)  Director to obtain approval from secretary.--A director
    11  may operate, direct and supervise an assisted outpatient
    12  treatment program as provided in this section, upon approval by
    13  the Secretary of Public Welfare. The county administrator shall
    14  operate, direct and supervise an assisted outpatient treatment
    15  program as provided in this section, upon approval by the
    16  Secretary of Public Welfare. County administrators shall be
    17  permitted to satisfy the provisions of this article through the
    18  operation of joint assisted outpatient treatment programs.
    19  Nothing in this article shall be construed to preclude the
    20  combination or coordination of efforts between and among
    21  counties and hospitals in providing and coordinating assisted
    22  outpatient treatment.
    23     (b)  Criteria for assisted outpatient treatment.--A patient
    24  may be ordered to obtain assisted outpatient treatment if the
    25  court finds the following:
    26         (1)  The patient is 18 years of age or older.
    27         (2)  The patient is suffering from a mental illness.
    28         (3)  The patient is unlikely to survive safely in the
    29     community without supervision, based on a clinical
    30     determination.
    20050S0213B0205                  - 7 -     

     1         (4)  The patient has a history of lack of compliance with
     2     treatment for mental illness that has:
     3             (i)  at least twice within the preceding 36 months
     4         been a significant factor in necessitating
     5         hospitalization, or receipt of services in a forensic or
     6         other mental health unit of a correctional facility, not
     7         including any period during which the person was
     8         hospitalized or imprisoned immediately preceding the
     9         filing of the petition; or
    10             (ii)  resulted in one or more acts of serious violent
    11         behavior toward self or others or threats of, or attempts
    12         at, serious physical harm to self or others within the
    13         preceding 48 months, not including any period in which
    14         the person was hospitalized or imprisoned immediately
    15         preceding the filing of the petition.
    16         (5)  The patient is, as a result of the patient's mental
    17     illness, unlikely to voluntarily participate in the
    18     recommended treatment pursuant to the treatment plan.
    19         (6)  In view of the patient's treatment history and
    20     current behavior, the patient is in need of assisted
    21     outpatient treatment in order to prevent a relapse or
    22     deterioration which would be likely to pose a clear and
    23     present danger of harm to others or to himself as determined
    24     under section 301 (relating to persons who may be subject to
    25     involuntary emergency examination and treatment).
    26         (7)  It is likely that the patient will benefit from
    27     assisted outpatient treatment.
    28     (c)  Petition to the court.--
    29         (1)  A petition for an order authorizing assisted
    30     outpatient treatment may be filed in the court of common
    20050S0213B0205                  - 8 -     

     1     pleas of the county in which the subject of the petition is
     2     present or reasonably believed to be present. A petition to
     3     obtain an order authorizing assisted outpatient treatment may
     4     be initiated only by the following persons:
     5             (i)  a person 18 years of age or older with whom the
     6         subject of the petition resides;
     7             (ii)  the parent, spouse, sibling 18 years of age or
     8         older, or child 18 years of age or older of the subject
     9         of the petition;
    10             (iii)  the director of the facility in which the
    11         subject of the petition is hospitalized;
    12             (iv)  the director of any public or charitable
    13         organization, agency or home providing mental health
    14         services to the subject of the petition in whose
    15         institution the subject of the petition resides;
    16             (v)  a qualified psychiatrist who is either
    17         supervising the treatment of or treating the subject of
    18         the petition for a mental illness;
    19             (vi)  the county administrator, or his designee; or
    20             (vii)  a parole officer or probation officer assigned
    21         to supervise the subject of the petition.
    22         (2)  The petition shall state:
    23             (i)  Each of the criteria for assisted outpatient
    24         treatment as set forth in subsection (b).
    25             (ii)  The facts which support the petitioner's belief
    26         that the person who is the subject of the petition meets
    27         each criterion, provided that the hearing on the petition
    28         need not be limited to the stated facts.
    29             (iii)  That the subject of the petition is present,
    30         or is reasonably believed to be present, within the
    20050S0213B0205                  - 9 -     

     1         county where the petition is filed.
     2         (3)  The petition shall be accompanied by an affirmation
     3     or affidavit of a physician, who shall not be the petitioner,
     4     and shall state either that:
     5             (i)  The physician has personally examined the person
     6         who is the subject of the petition not more than ten days
     7         prior to the submission of the petition, recommends
     8         assisted outpatient treatment for the subject of the
     9         petition and is willing and able to testify at the
    10         hearing on the petition.
    11             (ii)  Not more than ten days prior to the filing of
    12         the petition, the physician or his designee has made
    13         appropriate attempts to elicit the cooperation of the
    14         subject of the petition but has not been successful in
    15         persuading the subject to submit to an examination, that
    16         the physician has reason to suspect that the subject of
    17         the petition meets the criteria for assisted outpatient
    18         treatment, and that the physician is willing and able to
    19         examine the subject of the petition and testify at the
    20         hearing on the petition.
    21     (d)  Right to counsel.--The subject of the petition shall
    22  have the right to be represented by counsel at the expense of
    23  the subject of the petition at all stages of a proceeding
    24  commenced under this section.
    25     (e)  Hearing.--
    26         (1)  Upon receipt by the court of the petition submitted
    27     pursuant to subsection (c), the court shall fix the date for
    28     a hearing at a time not later than three days from the date
    29     the petition is received by the court, excluding Saturdays,
    30     Sundays and holidays. Adjournments shall be permitted only
    20050S0213B0205                 - 10 -     

     1     for good cause shown. In granting adjournments, the court
     2     shall consider the need for further examination by a
     3     physician or the potential need to provide assisted
     4     outpatient treatment expeditiously.
     5         (2)  The court shall cause the subject of the petition,
     6     the petitioner, the physician whose affirmation or affidavit
     7     accompanied the petition, the appropriate director, and such
     8     other persons as the court may determine to be advised of the
     9     date for the hearing.
    10         (3)  Upon the date for the hearing, or upon such other
    11     date to which the proceeding may be adjourned, the court
    12     shall hear testimony and, if it be deemed advisable and the
    13     subject of the petition is available, examine the subject
    14     alleged to be in need of assisted outpatient treatment in or
    15     out of court.
    16         (4)  If the subject of the petition does not appear at
    17     the hearing, and appropriate attempts to elicit the
    18     attendance of the subject have failed, the court may conduct
    19     the hearing in the subject's absence. If the hearing is
    20     conducted without the subject of the petition present, the
    21     court shall set forth the factual basis for conducting the
    22     hearing without the presence of the subject of the petition.
    23         (5)  The court may not order assisted outpatient
    24     treatment unless an examining physician, who has personally
    25     examined the subject of the petition within the time period
    26     commencing ten days before the filing of the petition,
    27     testifies in person at the hearing.
    28         (6)  If the subject of the petition has refused to be
    29     examined by a physician, the court may request the subject to
    30     consent to an examination by a physician appointed by the
    20050S0213B0205                 - 11 -     

     1     court. If the subject of the petition does not consent and
     2     the court finds reasonable cause to believe that the
     3     allegations in the petition are true, the court may order law
     4     enforcement officers or of a sheriff's department to take the
     5     subject of the petition into custody and transport him to a
     6     hospital for examination by a physician. Retention of the
     7     subject of the petition under the order shall not exceed 24
     8     hours.
     9         (7)  The examination of the subject of the petition may
    10     be performed by the physician whose affirmation or affidavit
    11     accompanied the petition, if the physician is privileged by
    12     the hospital or otherwise authorized by the hospital to do
    13     so. If the examination is performed by another physician of
    14     the hospital, the examining physician shall be authorized to
    15     consult with the physician whose affirmation or affidavit
    16     accompanied the petition regarding the issues of whether the
    17     allegations in the petition are true and whether the subject
    18     meets the criteria for assisted outpatient treatment.
    19         (8)  A physician who testifies pursuant to paragraph (5)
    20     shall state the facts which support the allegation that the
    21     subject meets each of the criteria for assisted outpatient
    22     treatment, and the treatment is the least restrictive
    23     alternative, the recommended assisted outpatient treatment,
    24     and the rationale for the recommended assisted outpatient
    25     treatment. If the recommended assisted outpatient treatment
    26     includes medication, the physician's testimony shall describe
    27     the types or classes of medication which should be
    28     authorized, shall describe the beneficial and detrimental
    29     physical and mental effects of the medication, and shall
    30     recommend whether the medication should be self-administered
    20050S0213B0205                 - 12 -     

     1     or administered by authorized personnel.
     2         (9)  The subject of the petition shall be afforded an
     3     opportunity to present evidence, to call witnesses on behalf
     4     of the subject, and to cross-examine adverse witnesses.
     5     (f)  Written individualized treatment plan.--
     6         (1) (i)  The court may not order assisted outpatient
     7         treatment unless an examining physician appointed by the
     8         appropriate director develops and provides to the court a
     9         proposed written individualized treatment plan. The
    10         written individualized treatment plan shall include case
    11         management services or assertive community treatment
    12         teams to provide care coordination, and all categories of
    13         services which the physician recommends that the subject
    14         of the petition should receive.
    15             (ii)  If the written individualized treatment plan
    16         includes medication, it shall state whether the
    17         medication should be self-administered or administered by
    18         authorized personnel, and shall specify type and dosage
    19         range of medication most likely to provide maximum
    20         benefit for the subject.
    21             (iii)  If the written individualized treatment plan
    22         includes alcohol or substance abuse counseling and
    23         treatment, the plan may include a provision requiring
    24         relevant testing for either alcohol or illegal substances
    25         provided the physician's clinical basis for recommending
    26         the plan provides sufficient facts for the court to find:
    27                 (A)  That the person has a history of alcohol or
    28             substance abuse that is clinically related to the
    29             mental illness.
    30                 (B)  That the testing is necessary to prevent a
    20050S0213B0205                 - 13 -     

     1             relapse or deterioration which would be likely to
     2             result in serious harm to the person or others.
     3             (iv)  In developing the plan, the physician shall
     4         provide the following persons with an opportunity to
     5         actively participate in the development of the plan: the
     6         subject of the petition; the treating physician; and upon
     7         the request of the patient, an individual significant to
     8         the patient including any relative, close friend or
     9         individual otherwise concerned with the welfare of the
    10         patient. If the petitioner is a director, the plan shall
    11         be provided to the court no later than the date of the
    12         hearing on the petition.
    13         (2)  The court shall not order assisted outpatient
    14     treatment unless a physician testifies to explain the written
    15     proposed treatment plan. The testimony shall state:
    16             (i)  The categories of assisted outpatient treatment
    17         recommended.
    18             (ii)  The rationale for each category.
    19             (iii)  Facts which establish that the treatment is
    20         the least restrictive alternative.
    21             (iv)  If the recommended assisted outpatient
    22         treatment includes medication, the types or classes of
    23         medication recommended, the beneficial and detrimental
    24         physical and mental effects of the medication, and
    25         whether the medication should be self-administered or
    26         administered by an authorized professional.
    27  If the petitioner is a director the testimony shall be given at
    28  the hearing on the petition.
    29     (g)  Disposition.--
    30         (1)  If after hearing all relevant evidence, the court
    20050S0213B0205                 - 14 -     

     1     finds that the subject of the petition does not meet the
     2     criteria for assisted outpatient treatment, the court shall
     3     dismiss the petition.
     4         (2)  If after hearing all relevant evidence, the court
     5     finds by clear and convincing evidence that the subject of
     6     the petition meets the criteria for assisted outpatient
     7     treatment and there is no appropriate and feasible less
     8     restrictive alternative, the court shall be authorized to
     9     order the subject to receive assisted outpatient treatment
    10     for an initial period not to exceed six months. In fashioning
    11     the order, the court shall specifically make findings by
    12     clear and convincing evidence that the proposed treatment is
    13     the least restrictive treatment appropriate and feasible for
    14     the subject. The order shall state the categories of assisted
    15     outpatient treatment which the subject is to receive. The
    16     court may not order treatment that has not been recommended
    17     by the examining physician and included in the written
    18     treatment plan for assisted outpatient treatment as required
    19     by subsection (f).
    20         (3)  If after hearing all relevant evidence the court
    21     finds by clear and convincing evidence that the subject of
    22     the petition meets the criteria for assisted outpatient
    23     treatment, and the court has yet to be provided with a
    24     written individualized treatment plan and testimony pursuant
    25     to subsection (f), the court shall order the county
    26     administrator to provide the court with the plan and
    27     testimony no later than the third day, excluding Saturdays,
    28     Sundays and holidays, immediately following the date of the
    29     order. Upon receiving the plan and testimony, the court may
    30     order assisted outpatient treatment as provided in paragraph
    20050S0213B0205                 - 15 -     

     1     (2).
     2         (4)  A court may order the patient to self-administer
     3     psychotropic drugs or accept the administration of the drugs
     4     by authorized personnel as part of an assisted outpatient
     5     treatment program. The order may specify the type and dosage
     6     range of psychotropic drugs and the order shall be effective
     7     for the duration of the assisted outpatient treatment.
     8         (5)  If the petitioner is the director of a hospital that
     9     operates an assisted outpatient treatment program, the court
    10     order shall direct the hospital director to provide or
    11     arrange for all categories of assisted outpatient treatment
    12     for the assisted outpatient throughout the period of the
    13     order. For all other persons, the order shall require the
    14     director of community services of the appropriate local
    15     governmental unit to provide or arrange for all categories of
    16     assisted outpatient treatment for the assisted outpatient
    17     throughout the period of the order.
    18         (6)  The director or his designee shall apply to the
    19     court for approval before instituting a proposed material
    20     change in the assisted outpatient treatment order unless the
    21     change is contemplated in the order. Nonmaterial changes may
    22     be instituted by the assisted outpatient treatment program
    23     without court approval. For the purposes of this paragraph, a
    24     material change shall mean an addition or deletion of a
    25     category of assisted outpatient treatment from the order of
    26     the court, or any deviation without the patient's consent
    27     from the terms of an existing order relating to the
    28     administration of psychotropic drugs.
    29     (h)  Applications for additional periods of treatment.--If
    30  the director determines that the condition of the patient
    20050S0213B0205                 - 16 -     

     1  requires further assisted outpatient treatment, the director
     2  shall apply prior to the expiration of the period of assisted
     3  outpatient treatment ordered by the court for a second or
     4  subsequent order authorizing continued assisted outpatient
     5  treatment for a period not to exceed one year from the date of
     6  the order. The procedures for obtaining any order pursuant to
     7  this subsection shall be in accordance with this section,
     8  provided that the time period included in subsection (b)(4)(i)
     9  and (ii) shall not be applicable in determining the
    10  appropriateness of additional periods of assisted outpatient
    11  treatment. Any court order requiring periodic blood tests or
    12  urinalysis for the presence of alcohol or illegal drugs shall be
    13  subject to review after six months by the physician who
    14  developed the written individualized treatment plan or another
    15  physician designated by the director, and the physician shall be
    16  authorized to terminate the blood tests or urinalysis without
    17  further action by the court.
    18     (i)  Application for order to stay, vacate or modify.--In
    19  addition to any other right or remedy available by law with
    20  respect to the order for assisted outpatient treatment, the
    21  patient, the patient's counsel, or anyone acting on the
    22  patient's behalf may apply on notice to the appropriate director
    23  and the original petitioner to the court to stay, vacate or
    24  modify the order.
    25     (j)  Appeals.--Review of an order issued pursuant to this
    26  section shall be had in like manner as specified in section 303
    27  (relating to extended involuntary emergency treatment certified
    28  by a judge or mental health review officer - not to exceed
    29  twenty days).
    30     (k)  Failure to comply with assisted outpatient treatment.--
    20050S0213B0205                 - 17 -     

     1         (1)  Where, in the clinical judgment of a physician, the
     2     patient has failed or has refused to comply with the
     3     treatment ordered by the court, and in the physician's
     4     clinical judgment efforts were made to solicit compliance,
     5     and, in the clinical judgment of the physician the patient
     6     may be in need of treatment under section 302 (relating to
     7     involuntary emergency examination and treatment authorized by
     8     a physician - not to exceed one hundred twenty hours) or 303,
     9     the physician may request the director or the director's
    10     designee to direct the removal of the patient to an
    11     appropriate hospital for an examination to determine if the
    12     patient has a mental illness for which hospitalization is
    13     necessary.
    14         (2)  If the patient refuses to take medications as
    15     required by the court order, or he refuses to take, or fails
    16     a blood test, urinalysis or alcohol or drug test as required
    17     by the court order, the physician may consider that refusal
    18     or failure when determining whether the assisted outpatient
    19     is in need of an examination to determine whether he has a
    20     mental illness for which hospitalization is necessary.
    21         (3)  Upon the request of the physician, the director or
    22     the director's designee may direct law enforcement officers
    23     or the sheriff's department to take into custody and
    24     transport the patient to the hospital operating the assisted
    25     outpatient treatment program or to any hospital authorized by
    26     the director of community services to receive such patients.
    27     The law enforcement officials shall carry out the directive.
    28         (4)  Upon the request of the physician, the director or
    29     the director's designee, the court may authorize the patient
    30     to be taken into custody and transported to the hospital
    20050S0213B0205                 - 18 -     

     1     operating the assisted outpatient treatment program, or to
     2     any other hospital authorized by the county administrator to
     3     receive such patients in accordance with section 306
     4     (relating to transfer of persons in involuntary treatment).
     5     The patient may be retained for observation, care and
     6     treatment and further examination in the hospital for up to
     7     72 hours to permit a physician to determine whether the
     8     patient has a mental illness and is in need of involuntary
     9     care and treatment in a hospital pursuant to this act. Any
    10     continued involuntary retention in the hospital beyond the
    11     initial 72-hour period shall be in accordance with this act
    12     relating to the involuntary admission and retention of a
    13     person. If at any time during the 72-hour period the person
    14     is determined not to meet the involuntary admission and
    15     retention provisions of this act, and does not agree to stay
    16     in the hospital as a voluntary or informal patient, he shall
    17     be released. Failure to comply with an order of assisted
    18     outpatient treatment shall not be grounds for involuntary
    19     civil commitment or a finding of contempt of court.
    20     (l)  False petition.--A person making a false statement or
    21  providing false information or false testimony in a petition or
    22  hearing under this section is subject to criminal prosecution
    23  pursuant to 18 Pa.C.S. § 4903 (relating to false swearing).
    24     (m)  Construction.--Nothing in this section shall be
    25  construed to affect the ability of the director of a hospital to
    26  receive, admit or retain patients who otherwise meet the
    27  provisions of this act regarding receipt, retention or
    28  admission.
    29     (n)  Educational materials.--The Department of Public
    30  Welfare, in consultation with the county administrator, shall
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     1  prepare educational and training materials on the use of this
     2  section, which shall be made available to county providers of
     3  services, judges, court personnel, law enforcement officials and
     4  the general public.
     5     Section 2.  This act shall take effect in 60 days.

















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