PRINTER'S NO. 2457
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1809
Session of
2017
INTRODUCED BY MURT, KINSEY, V. BROWN, DALEY, DEAN, DRISCOLL,
McCLINTON, READSHAW, ROEBUCK, ROZZI, THOMAS AND VAZQUEZ,
SEPTEMBER 21, 2017
REFERRED TO COMMITTEE ON HEALTH, SEPTEMBER 21, 2017
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, providing for use of electroconvulsive
therapy.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Title 35 of the Pennsylvania Consolidated
Statutes is amended by adding a chapter to read:
CHAPTER 54
USE OF ELECTROCONVULSIVE THERAPY
Sec.
5401. Scope of chapter.
5402. Definitions.
5403. Electroconvulsive therapy prohibited.
5404. Consent to electroconvulsive therapy.
5405. Revocation of consent to electroconvulsive therapy.
5406. Administration of electroconvulsive therapy by physician.
5407. Registration of medical equipment used for
electroconvulsive therapy.
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5408. Reports on administration of electroconvulsive therapy.
5409. Duties of department.
5410. Regulations.
§ 5401. Scope of chapter.
This chapter applies to the use of electroconvulsive therapy
by a person.
§ 5402. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Department." The Department of Health of the Commonwealth.
"Electroconvulsive therapy." A procedure, done under general
anesthesia, in which small electric currents are passed through
the brain, intentionally triggering a brief seizure.
§ 5403. Electroconvulsive therapy prohibited.
Electroconvulsive therapy may not be used on any of the
following individuals:
(1) A patient who is younger than 16 years of age.
(2) A patient who is 16 years of age or older and
voluntarily receiving mental health treatment under Article
II of the act of July 9, 1976 (P.L.817, No.143), known as the
Mental Health Procedures Act, unless the individual consents
to the use of the electroconvulsive therapy under section
5404 (relating to consent to electroconvulsive therapy).
(3) An individual who is 16 years of age or older and
involuntarily receiving mental health treatment under Article
III of the Mental Health Procedures Act, unless the
individual or the individual's guardian consents to the use
of electroconvulsive therapy under section 5404. If known by
the guardian of the individual, the guardian shall choose to
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consent or not consent under this paragraph based on the
individual's preference.
§ 5404. Consent to electroconvulsive therapy.
(a) Consent form.--The department shall have the following
duties:
(1) Developing a standard written consent form which
shall be used when electroconvulsive therapy is considered.
(2) Prescribing the information which shall be included
in the written supplement required under subsection (c).
(b) Contents.--The standard written consent form developed
under subsection (a)(1) shall clearly and explicitly state the
following:
(1) The nature and purpose of electroconvulsive therapy.
(2) The nature, degree, duration and probability of the
side effects and significant risks of electroconvulsive
therapy commonly known by the medical profession, including
the possibility of memory loss, injury or death.
(3) There is a division of opinion by the medical
profession as to the efficacy of electroconvulsive therapy.
(4) The probable degree and duration of improvement or
remission expected with or without electroconvulsive therapy.
(c) Duties of administrators.--Before a patient receives
electroconvulsive therapy, the hospital, facility or physician
administering the electroconvulsive therapy shall ensure all of
the following:
(1) The patient or patient's guardian receives a copy of
the standard written consent form under subsection (a)(1).
(2) The patient or the patient's guardian receives a
written supplement that contains related information about
the patient and electroconvulsive therapy.
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(3) The contents of the copy of the standard written
consent form under subsection (a)(1) and the written
supplement under paragraph (2) are explained to the patient
and the patient's guardian in the following manner:
(i) Orally, in simple, nontechnical terms.
(ii) Through the use of a means reasonably
calculated to communicate with a hearing impaired or
visually impaired person, if applicable.
(4) The patient or the patient's guardian, as
appropriate, signs a copy of the standard written consent
form under subsection (a)(1) and the written supplement under
paragraph (2) stating that the patient or the patient's
guardian has read the copy of the standard written consent
form and the written supplement and understands the
information included in the documents.
(5) The signed copy of the standard written consent form
under subsection (a)(1) is made a part of the patient's
clinical record.
(d) Senior patients.--Before a patient 65 years of age or
older receives electroconvulsive therapy, the hospital, facility
or physician administering the electroconvulsive therapy shall
ensure the following:
(1) No less than two physicians have signed an
appropriate form that states the electroconvulsive therapy is
medically necessary.
(2) The form specified under paragraph (1) is available
to the patient or the patient's guardian.
(3) The patient or the patient's guardian is informed
of any known current medical condition of the patient that
may increase the possibility of injury or death as a result
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of the electroconvulsive therapy.
(e) Validity.--Consent under this section shall not be valid
unless the individual providing consent understands the
information presented and consents voluntarily and without
coercion or undue influence.
§ 5405. Revocation of consent to electroconvulsive therapy.
A patient or the patient's guardian who consents to the use
of electroconvulsive therapy may revoke the consent for any
reason and at any time.
§ 5406. Administration of electroconvulsive therapy by
physician.
(a) Administration.--No individual other than a physician
may administer electroconvulsive therapy. A physician may not
delegate the act of administering the electroconvulsive therapy.
(b) Violation.--A nonphysician who administers
electroconvulsive therapy shall be engaging in the unlawful
practice of medicine as specified under section 38 of the act of
December 20, 1985 (P.L.457, No.112), known as the Medical
Practice Act.
§ 5407. Registration of medical equipment used for
electroconvulsive therapy.
(a) Prohibition.--Medical equipment may not be used for
electroconvulsive therapy unless the medical equipment is
registered with the department in accordance with this section.
(b) Filing.--A hospital or facility administering
electroconvulsive therapy or private physician administering
electroconvulsive therapy on an outpatient basis shall file an
application to register medical equipment used for
electroconvulsive therapy.
(c) Application fee.--The application under subsection (b)
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shall be submitted on a form prescribed by the department and
accompanied by a nonrefundable application fee. The department
shall set the application fee which shall not exceed the cost to
the department of implementing this section.
(d) Contents.--The application under subsection (b) shall
contain the following information:
(1) The model, manufacturer and age of each piece of
medical equipment used to administer the electroconvulsive
therapy.
(2) Any other information required by the department.
(e) Determination.--The following apply:
(1) The department may conduct an investigation as
necessary after receiving the application under subsection
(b) and the application fee under subsection (c) to determine
whether the medical equipment used for electroconvulsive
therapy is dangerous.
(2) The department may deny, suspend or revoke a
registration if the department determines that the medical
equipment used for electroconvulsive therapy is dangerous.
§ 5408. Reports on administration of electroconvulsive therapy.
(a) Reports.--A hospital or facility administering
electroconvulsive therapy or a private physician administering
electroconvulsive therapy on an outpatient basis shall submit to
the department quarterly reports on the administration of
electroconvulsive therapy.
(b) Contents.--A quarterly report submitted under subsection
(a) shall include all of the following information:
(1) The total number of patients who received the
electroconvulsive therapy.
(2) The number of patients voluntarily receiving mental
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health services under Article II of the act of July 9, 1976
(P.L.817, No.143), known as the Mental Health Procedures Act,
who consented to electroconvulsive therapy.
(3) The number of patients involuntarily receiving
mental health services under Article III of the Mental Health
Procedures Act who consented to electroconvulsive therapy.
(4) The number of patients involuntarily receiving
mental health services under Article III of the Mental Health
Procedures Act who had their guardians consent to
electroconvulsive therapy.
(5) The age, sex and race of the patients who received
electroconvulsive therapy.
(6) The payment sources for electroconvulsive therapy.
(7) The average number of electroconvulsive therapy
treatments administered for each complete series of
treatments, not including maintenance treatments.
(8) The average number of maintenance electroconvulsive
therapy treatments administered per month.
(9) The number of reported incidents of memory loss,
apnea, fractures and other injuries and cardiac arrests
without death.
(10) Autopsy findings if patient death occurs within 14
days after the date of the administration of
electroconvulsive therapy.
(11) Any other information deemed necessary by the
department to assess the administration of electroconvulsive
therapy.
§ 5409. Duties of department.
The department shall have the following duties:
(1) Using the information received from applications
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under sections 5407(b) (relating to registration of medical
equipment used for electroconvulsive therapy) and 5408(a)
(relating to reports on administration of electroconvulsive
therapy) to analyze the use of electroconvulsive therapy in
this Commonwealth.
(2) Filing an annual report with the Governor, the
President pro tempore of the Senate and the Speaker of the
House of Representatives summarizing the analysis under
paragraph (1). An annual report submitted under this
paragraph may not identify a physician who administered
electroconvulsive therapy or a patient who received
electroconvulsive therapy.
§ 5410. Regulations.
The department shall promulgate regulations necessary to
implement this chapter.
Section 2. This act shall take effect as follows:
(1) The addition of 35 Pa.C.S. § 5410 shall take effect
immediately.
(2) The remainder of this act shall take effect in 60
days.
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