PRIOR PRINTER'S NOS. 685, 1813
PRINTER'S NO. 2004
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
672
Session of
2019
INTRODUCED BY ORTITAY, HAHN, SNYDER, RYAN, PICKETT, BROWN, PYLE,
DUNBAR, GROVE, LONGIETTI, KIRKLAND, DiGIROLAMO, BERNSTINE,
MILLARD, MASSER, B. MILLER, NEILSON, SCHLEGEL CULVER,
MIZGORSKI, DeLUCA AND KEEFER, MARCH 1, 2019
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,
JUNE 4, 2019
AN ACT
Amending the act of February 13, 1970 (P.L.19, No.10), entitled
"An act enabling certain minors to consent to medical, dental
and health services, declaring consent unnecessary under
certain circumstances," further providing for mental health
treatment and for release of medical records.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Sections 1.1 and 1.2 of the act of February 13,
1970 (P.L.19, No.10), entitled "An act enabling certain minors
to consent to medical, dental and health services, declaring
consent unnecessary under certain circumstances," are amended to
read:
Section 1.1. Mental Health Treatment.--(a) [The following
shall apply to consent for outpatient treatment:
(1) Any minor who is fourteen years of age or older may
consent on his or her own behalf to outpatient mental health
examination and treatment, and the minor's parent's or legal
guardian's consent shall not be necessary.
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(2) A parent or legal guardian of a minor less than eighteen
years of age may consent to voluntary outpatient mental health
examination or treatment on behalf of the minor, and the minor's
consent shall not be necessary.
(3) A minor may not abrogate consent provided by a parent or
legal guardian on the minor's behalf, nor may a parent or legal
guardian abrogate consent given by the minor on his or her own
behalf.
(b) The following shall apply to consent for inpatient
treatment:
(1) A minor's parent or legal guardian may consent to
voluntary inpatient treatment pursuant to Article II of the act
of July 9, 1976 (P.L.817, No.143), known as the "Mental Health
Procedures Act," on behalf of a minor less than eighteen years
of age on the recommendation of a physician who has examined the
minor. The minor's consent shall not be necessary.
(2) Nothing in this section shall be construed as
restricting or altering a minor's existing rights, including,
but not limited to, those enumerated under the "Mental Health
Procedures Act," to consent to voluntary inpatient mental health
treatment on his or her own behalf at fourteen years of age or
older.
(3) Nothing in this section shall be construed as
restricting or altering a parent or legal guardian's existing
rights to object to a minor's voluntary treatment provided
pursuant to the minor's consent on his or her own behalf.
(4) A minor may not abrogate consent provided by a parent or
legal guardian on the minor's behalf, nor may a parent or legal
guardian abrogate consent given by the minor on his or her own
behalf.
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(5) A parent or legal guardian who has provided consent to
inpatient treatment under paragraph (1) may revoke that consent,
which revocation shall be effective unless the minor who is
fourteen to eighteen years of age has provided consent for
continued inpatient treatment.
(6) A minor who is fourteen to eighteen years of age who has
provided consent to inpatient treatment may revoke that consent,
which revocation shall be effective unless the parent or legal
guardian to the minor has provided for continued treatment under
paragraph (1).
(7) At the time of admission, the director of the admitting
facility or his designee shall provide the minor with an
explanation of the nature of the mental health treatment in
which he may be involved together with a statement of his
rights, including the right to object to treatment by filing a
petition with the court. If the minor wishes to exercise this
right, the director of the facility or his designee shall
provide a form for the minor to provide notice of the request
for modification or withdrawal from treatment. The director of
the facility or his designee shall file the signed petition with
the court.
(8) Any minor fourteen years of age or older and under
eighteen years of age who has been confined for inpatient
treatment on the consent of a parent or legal guardian and who
objects to continued inpatient treatment may file a petition in
the court of common pleas requesting a withdrawal from or
modification of treatment. The court shall promptly appoint an
attorney for such minor person and schedule a hearing to be held
within seventy-two hours following the filing of the petition,
unless continued upon the request of the attorney for the minor,
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by a judge or mental health review officer who shall determine
whether or not the voluntary mental health treatment is in the
best interest of the minor. For inpatient treatment to continue
against the minor's wishes, the court must find all of the
following by clear and convincing evidence:
(i) that the minor has a diagnosed mental disorder;
(ii) that the disorder is treatable;
(iii) that the disorder can be treated in the particular
facility where the treatment is taking place; and
(iv) that the proposed inpatient treatment setting
represents the least restrictive alternative that is medically
appropriate.
(9) A minor ordered to undergo treatment due to a
determination under paragraph (8) shall remain and receive
inpatient treatment at the treatment setting designated by the
court for a period of up to twenty days. The minor shall be
discharged whenever the attending physician determines that the
minor no longer is in need of treatment, consent to treatment
has been revoked under paragraph (5) or at the end of the time
period of the order, whichever occurs first. If the attending
physician determines continued inpatient treatment will be
necessary at the end of the time period of the order and the
minor does not consent to continued inpatient treatment prior to
the end of the time period of the order, the court shall conduct
a review hearing in accordance with this subsection to determine
whether to:
(i) release the minor; or
(ii) make a subsequent order for inpatient mental health
treatment for a period not to exceed sixty days subject to
discharge of the minor whenever the attending physician
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determines that the minor no longer is in need of treatment, or
if consent has been revoked under paragraph (5).
(10) The procedure for a sixty-day period of treatment under
paragraph (9)(ii) shall be repeated until the court determines
to release the minor or the minor is discharged in accordance
with paragraph (9).
(11) Nothing in this subsection shall prevent a
nonconsenting parent who has legal custody rights of a minor
child to object to the consent given by the other parent to
inpatient treatment under paragraph (1) by filing a petition in
a court of common pleas in the county where the child resides.
The court shall hold a hearing on the objection within seventy-
two hours of the filing of the petition.
(c) Nothing in subsections (a) and (b) is intended to
restrict the rights of a minor who satisfies the conditions of
section 1.
(d) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection:
"Court of common pleas" means the court of common pleas in
the county where the subject of the proceeding is being treated.
"Facility" means any mental health establishment, hospital,
clinic, institution, center, day-care center, base service unit,
community mental health center, or part thereof, that provides
for the diagnosis, treatment, care or rehabilitation of mentally
ill persons.
"Inpatient treatment" means all mental health treatment that
requires full-time or part-time residence in a facility that
provides mental health treatment.
"Mental health treatment" means a course of treatment,
including evaluation, diagnosis, therapy and rehabilitation,
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designed and administered to alleviate an individual's pain and
distress and to maximize the probability of recovery from mental
illness. The term also includes care and other services which
supplement treatment and aid or promote recovery.] The following
shall apply to consent for voluntary inpatient and outpatient
mental health treatment:
(1) A parent or legal guardian of a minor less than eighteen
years of age may consent to voluntary inpatient 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," if
inpatient mental health treatment is determined to be necessary
by a physician, licensed clinical psychologist or other mental
health professional or outpatient mental health treatment on
behalf of the minor, and the minor's consent shall not be
necessary. An initial determination that inpatient mental health
treatment of a minor is necessary under this paragraph shall be
independent of the requirements of section 205 of the "Mental
Health Procedures Act."
(2) A minor who is fourteen years of age or older may
consent on the minor's own behalf to voluntary inpatient mental
health treatment as provided under Article II of the "Mental
Health Procedures Act" or outpatient mental health treatment,
and the minor's parent's or legal guardian's consent shall not
be necessary.
(3) A minor OR ANOTHER PARENT OR LEGAL GUARDIAN may not
abrogate consent provided by a parent or legal guardian on the
minor's behalf to voluntary inpatient or outpatient mental
health treatment under paragraph (1) , NOR MAY A PARENT OR LEGAL
GUARDIAN ABROGATE CONSENT GIVEN BY THE MINOR ON THE MINOR'S OWN
BEHALF .
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(4) A parent or legal guardian who has provided consent to
voluntary inpatient or outpatient mental health treatment under
paragraph (1) may revoke that consent, which revocation shall be
effective unless the minor who is fourteen to eighteen years of
age has provided consent for continued voluntary inpatient or
outpatient mental health treatment.
(5) A minor who is fourteen to eighteen years of age who has
provided consent to voluntary inpatient or outpatient mental
health treatment may revoke that consent, which revocation shall
be effective unless the parent or legal guardian to the minor
has provided for continued treatment under paragraph (1).
(6) At the time of admission, the director of the admitting
facility or a designee of the director shall provide the minor
with an explanation of the nature of the mental health treatment
in which the minor may be involved together with a statement of
the minor's rights, including the right to object to treatment
by filing a petition with the court. If a THE minor wishes to
exercise this right AT ANY TIME , the director of the facility or
a designee of the director shall provide a form for the minor to
provide notice of the request for modification or withdrawal
from treatment. The director of the facility or a designee of
the director shall file the signed petition with the court.
(7) A WHEN A PETITION IS FILED ON BEHALF OF A minor fourteen
years of age or older and under eighteen years of age who has
been confined for inpatient treatment on the consent of a parent
or legal guardian and who objects to continued inpatient
treatment may file a petition in the court of common pleas BY
requesting a withdrawal from or modification of treatment . The ,
THE court shall promptly appoint an attorney for the minor and
schedule a hearing to be held within seventy-two hours following
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the filing of the petition, unless continued upon the request of
the attorney for the minor, by a judge or mental health review
officer who shall determine whether or not the voluntary mental
health treatment is in the best interest of the minor. For
inpatient treatment to continue against the minor's wishes, the
court must find all of the following by clear and convincing
evidence:
(i) that the minor has a diagnosed mental disorder;
(ii) that the disorder is treatable;
(iii) that the disorder can be treated in the particular
facility where the treatment is taking place; and
(iv) that the proposed inpatient treatment setting
represents the least restrictive alternative that is medically
appropriate.
(8) A MINOR ORDERED TO UNDERGO TREATMENT DUE TO A
DETERMINATION UNDER PARAGRAPH (7) SHALL REMAIN AND RECEIVE
INPATIENT TREATMENT AT THE TREATMENT SETTING DESIGNATED BY THE
COURT FOR A PERIOD OF UP TO TWENTY DAYS. THE MINOR SHALL BE
DISCHARGED WHENEVER THE ATTENDING PHYSICIAN DETERMINES THAT THE
MINOR NO LONGER IS IN NEED OF TREATMENT, CONSENT TO TREATMENT
HAS BEEN REVOKED UNDER PARAGRAPH (4) OR AT THE END OF THE TIME
PERIOD OF THE ORDER, WHICHEVER OCCURS FIRST. IF THE ATTENDING
PHYSICIAN DETERMINES CONTINUED INPATIENT TREATMENT WILL BE
NECESSARY AT THE END OF THE TIME PERIOD OF THE ORDER AND THE
MINOR DOES NOT CONSENT TO CONTINUED INPATIENT TREATMENT PRIOR TO
THE END OF THE TIME PERIOD OF THE ORDER, THE COURT SHALL CONDUCT
A REVIEW HEARING IN ACCORDANCE WITH THIS SUBSECTION TO DETERMINE
WHETHER TO:
(I) RELEASE THE MINOR; OR
(II) MAKE A SUBSEQUENT ORDER FOR INPATIENT MENTAL HEALTH
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TREATMENT FOR A PERIOD NOT TO EXCEED SIXTY DAYS SUBJECT TO
DISCHARGE OF THE MINOR WHENEVER THE ATTENDING PHYSICIAN
DETERMINES THAT THE MINOR NO LONGER IS IN NEED OF TREATMENT, OR
IF CONSENT HAS BEEN REVOKED UNDER PARAGRAPH (4).
(9) THE PROCEDURE FOR A SIXTY-DAY PERIOD OF TREATMENT UNDER
PARAGRAPH (8)(II) SHALL BE REPEATED UNTIL THE COURT DETERMINES
TO RELEASE THE MINOR OR THE MINOR IS DISCHARGED IN ACCORDANCE
WITH PARAGRAPH (8).
(10) NOTHING IN THIS SUBSECTION SHALL PREVENT A
NONCONSENTING PARENT WHO HAS LEGAL CUSTODY RIGHTS OF A MINOR
CHILD TO OBJECT TO THE CONSENT GIVEN BY THE OTHER PARENT TO
INPATIENT TREATMENT UNDER PARAGRAPH (1) BY FILING A PETITION IN
A COURT OF COMMON PLEAS IN THE COUNTY WHERE THE MINOR RESIDES.
THE COURT SHALL HOLD A HEARING ON THE OBJECTION WITHIN SEVENTY-
TWO HOURS OF THE FILING OF THE PETITION.
(b) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection:
"Facility" means any mental health establishment, hospital,
clinic, institution, center, day-care center, base service unit,
community mental health center, or part thereof, that provides
for the diagnosis, treatment, care or rehabilitation of persons
with mental illness.
"Inpatient treatment" means all mental health treatment that
requires full-time or part-time residence in a facility that
provides mental health treatment.
"Mental health treatment" means a course of treatment,
including evaluation, diagnosis, therapy and rehabilitation,
designed and administered to alleviate an individual's pain and
distress and to maximize the probability of recovery from mental
illness. The term also includes care and other services which
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supplement treatment and aid or promote recovery.
Section 1.2. Release of Medical Records.--(a) [When a
parent or legal guardian has consented to treatment of a minor
fourteen years of age or older under section 1.1(a)(2) or (b)
(1), the following shall apply to release of the minor's medical
records and information:
(1) The parent or legal guardian may consent to release of
the minor's medical records and information, including records
of prior mental health treatment for which the parent or legal
guardian had provided consent, to the minor's current mental
health treatment provider.
(2) If deemed pertinent by the minor's current mental health
treatment provider, the release of information under this
subsection may include a minor's mental health records and
information from prior mental health treatment for which the
minor had provided consent to treatment.
(3) The parent or legal guardian may consent to the release
of the minor's mental health records and information to the
primary care provider if, in the judgment of the minor's current
mental health treatment provider, such release would not be
detrimental to the minor.
(b) Release of mental health records and information under
subsection (a) shall be limited to release directly from one
provider of mental health treatment to another or from the
provider of mental health treatment to the primary care
provider.
(c) The parent or legal guardian who is providing consent to
mental health treatment of a minor fourteen years of age or
older under section 1.1(a)(2) or (b)(1) shall have the right to
information necessary for providing consent to the minor's
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mental health treatment, including symptoms and conditions to be
treated, medications and other treatments to be provided, risks
and benefits and expected results.
(d) Except to the extent set forth in subsection (a), (b) or
(c), the minor shall control the release of the minor's mental
health treatment records and information to the extent allowed
by law. When a minor has provided consent to outpatient mental
health treatment under section 1.1(a)(1), subject to subsection
(a)(2), the minor shall control the records of treatment to the
same extent as the minor would control the records of inpatient
care or involuntary outpatient care under the act of July 9,
1976 (P.L.817, No.143), known as the "Mental Health Procedures
Act," and its regulations.
(e) Consent to release of mental health records for all
purposes and in all circumstances other than those provided for
in this section shall be subject to the provisions of the
"Mental Health Procedures Act" and other applicable Federal and
State statutes and regulations.] When a parent or legal guardian
has consented to voluntary inpatient or outpatient mental health
treatment of a minor under section 1.1, the following shall
apply to release of the minor's medical records and information:
(1) The parent or legal guardian may consent to release of
the minor's medical records and information, including records
of prior mental health treatment for which the parent or legal
guardian had provided consent, to the minor's current mental
health treatment provider.
(2) If deemed pertinent by the minor's current mental health
treatment provider, the release of information under this
subsection may include a minor's mental health records and
information from prior mental health treatment for which the
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minor had provided consent to treatment.
(3) The parent or legal guardian may consent to the release
of the minor's mental health records and information to the
primary care provider if, in the judgment of the minor's current
mental health treatment provider, the release would not be
detrimental to the minor.
(b) Release of mental health records and information under
subsection (a) shall be limited to release directly from one
provider of mental health treatment to another or from the
provider of mental health treatment to the primary care
provider.
(c) The parent or legal guardian who is providing consent to
voluntary inpatient or outpatient mental health treatment of a
minor under section 1.1 shall have the right to information
necessary for providing consent to the minor's mental health
treatment, including symptoms and conditions to be treated,
medications and other treatments to be provided, risks and
benefits and expected results.
(d) Except to the extent provided subsection (a), (b) or
(c), the minor shall control the release of the minor's mental
health treatment records and information to the extent allowed
by law. When a minor has provided consent to outpatient mental
health treatment under section 1.1, subject to subsection (a)
(2), the minor shall control the records of treatment to the
same extent as the minor would control the records of inpatient
care or involuntary outpatient care under the act of July 9,
1976 (P.L.817, No.143), known as the "Mental Health Procedures
Act," and its regulations.
(e) Consent to release of mental health records for all
purposes and in all circumstances other than those provided for
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in this section shall be subject to the provisions of the
"Mental Health Procedures Act" and other applicable Federal and
State statutes and regulations.
Section 2. This act shall take effect in 60 days.
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