PRINTER'S NO. 559
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
585
Session of
2023
INTRODUCED BY KINSEY, CEPHAS, MADDEN, HOHENSTEIN, SANCHEZ, HILL-
EVANS, KINKEAD, STURLA, D. WILLIAMS, OTTEN, N. NELSON, KHAN
AND SCOTT, MARCH 20, 2023
REFERRED TO COMMITTEE ON HUMAN SERVICES, MARCH 20, 2023
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, providing for behavioral health
response unit and crisis call center programs; establishing
the County and Regional Behavioral Health Response Unit and
Crisis Call Center Fund and the County and Regional
Behavioral Health Response Unit and Crisis Call Center Grant
Program.
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:
C HAPTER 83
BEHAVIORAL HEALTH RESPONSE UNIT AND
CRISIS CALL CENTER PROGRAMS
Sec.
8301. Scope of chapter.
8302. Legislative intent.
8303. Definitions.
8304. Powers and duties of department.
8305. Behavioral Health Consumer Advisory Board.
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8306. Counties.
8307. Plan.
8308. County and Regional Behavioral Health Response Unit and
Crisis Call Center Fund.
8309. County and Regional Behavioral Health Response Unit and
Crisis Call Center Grant Program.
ยง 8301. Scope of chapter.
This chapter relates to behavioral health response unit and
crisis call center programs.
ยง 8302. Legislative intent.
It is the intent of the General Assembly to authorize the
Department of Human Services to administer county and regionally
operated, non-law-enforcement-administered crisis call centers
and behavioral health mobile crisis response units to respond to
calls regarding crises that arise due to mental health disorder,
substance use disorder or homelessness.
ยง 8303. 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:
"Behavioral health consumer." An individual who:
(1) Has received mental health or substance use disorder
treatment services.
(2) Has a mental health disorder or substance use
disorder diagnosis.
(3) Has experienced a mental health disorder or
substance use disorder.
(4) Is a peer specialist.
"Behavioral health response unit." The behavioral health
response units established under this chapter.
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"Behavioral health response unit and crisis call center." A
county or regional behavioral health response unit and crisis
call center program established under this chapter.
"Board." The Behavioral Health Consumer Advisory Board
established under section 8305 (relating to Behavioral Health
Consumer Advisory Board).
"Coordinator." A behavioral health response unit and crisis
call center coordinator.
"County and regional program." County and regional
behavioral health response unit and crisis call center programs
established under this chapter.
"Crisis call center." The crisis call centers utilized under
this chapter.
"Department." The Department of Human Services of the
Commonwealth.
"Emergency medical services" or "EMS." As defined in section
8103 (relating to definitions).
"First responder." Fire, rescue or emergency medical service
personnel or law enforcement personnel.
"Fund." The County and Regional Behavioral Health Response
Unit and Crisis Call Center Fund established under section 8308
(relating to County and Regional Behavioral Health Response Unit
and Crisis Call Center Fund).
"Harm reduction services." Public health services designed
to empower an individual to mitigate the potential harm of risk-
associated behavior. The term includes:
(1) Distribution of sterile syringes and other sterile
injection-related equipment.
(2) Distribution of naloxone and training in overdose
response.
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(3) Collection of used syringes and other biohazard
waste.
(4) Rapid testing for HIV, the Hepatitis C virus and
other infectious diseases.
(5) Wound care.
(6) Referral to social services, health care services,
treatment for substance use disorders and other forms of
mutual aid.
"Law enforcement." The term shall have the same meaning as
"police department" under 53 Pa.C.S. ยง 2162 (relating to
definitions).
"Mental health disorder." A mental disorder, not including a
substance use disorder, defined in the Diagnostic and
Statistical Manual of Mental Disorders , Fifth Edition .
"Mental health disorder crisis counselor." A mental health
disorder professional with expertise or training in crisis
intervention theory and therapeutic practices.
"Peer specialist." An individual certified or qualified as a
peer specialist or as a recovery specialist by the department.
"Plan." A behavioral health response unit and crisis call
center plan.
"Program." County and regional behavioral health response
unit and crisis call center programs established under this
chapter.
"Regional" or "region." A geographic area that includes more
than one county.
"Sexual minorities." An individual who identifies as
lesbian, gay, bisexual, transgender, nonbinary, third gender,
intersex or any other nonheterosexual identification.
"Substance use disorder." A substance use disorder defined
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in the Diagnostic and Statistical Manual of Mental Disorders ,
Fifth Edition .
"Treatment." The treatment for substance use disorder or
mental health disorder with a licensed or certified
professional. The term includes an individualized assessment,
diagnosis, counseling, the prescription of medication, recovery
support services, hospitalization, nonhospital residential
services and withdrawal management.
ยง 8304. Powers and duties of department.
The department shall have the following powers and duties:
(1) To adopt rules and regulations as necessary to
enforce this chapter. Rules and regulations proposed under
the authority of this section shall be subject to review by
the General Counsel and the Attorney General in the manner
provided for the review of proposed rules and regulations
under the act of October 15, 1980 (P.L.950, No.164), known as
the Commonwealth Attorneys Act, and the act of June 25, 1982
(P.L.633, No.181), known as the Regulatory Review Act.
(2) To publish guidelines and application procedures for
counties developing and implementing a single county or
regional program under this chapter.
(3) To receive, review and approve or disapprove all
county and regional program plans in accordance with the
standards developed in consultation with the board.
(4) To designate a State coordinator who shall be an
employee of the department.
(5) To provide administrative and support staff to the
board as necessary.
(6) To establish and publish annually uniform standards
relating to administration and operation of county and
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regional programs in consultation with the board.
(7) To prescribe the applications and forms necessary to
enforce this chapter.
(8) No later than December 1 of each year, to report to
the General Assembly and the Governor on the administration
of the county and regional programs together with
recommendations for executive or legislative action necessary
for the improvement of the department's ability to meet the
department's goals. Additionally, the report should contain
summaries of the information collected by the county and
regional programs as detailed under this chapter.
(9) To adopt, in consultation with the board, minimum
training, certification and quality assurance standards for
behavioral health response units and crisis call center
staff.
(10) To take other actions necessary to implement and
enforce this chapter.
ยง 8305. Behavioral Health Consumer Advisory Board.
(a) Establishment.-- The Behavioral Health Consumer Advisory
Board is established within the department, consisting of at
least 10 members as follows:
(1) A majority of individuals from the following areas:
(i) Behavioral health consumers.
(ii) Individuals who have experienced homelessness.
(iii) Members of local immigrant communities.
(iv) Sexual minorities.
(v) Individuals with disabilities.
(vi) Individuals who are of racial or ethnic
minorities.
(2) The State coordinator as provided under section
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8304(4) (relating to powers and duties of department), who
shall serve as chairperson .
(3) The Deputy Secretary of the Office of Mental Health
and Substance Abuse Services or a designee.
(4) The coordinator of a city of the first class.
(5) The coordinator of a county of the second class.
(6) The coordinator of a county of the second class A.
(7) The coordinator of a county of the third or fourth
class.
(8) Two coordinators of a county of the fifth, sixth,
seventh or eighth class.
(9) The remainder of the board shall be determined by
the department.
(b) Quorum.--The department shall determine the number of
members of the board that shall constitute a quorum. If a quorum
is present, the consent of three-fourths of the members present
is required for any action of the board.
(c) Meetings.--The board shall meet at least once quarterly
and at any special session called by the chairperson. All
meetings of the board shall be conducted in accordance with 65
Pa.C.S. Ch. 7 (relating to open meetings).
(d) Compensation.--The members of the board shall serve
without compensation but shall be reimbursed for actual and
necessary travel and other expenses in connection with
attendance at meetings called by the chairperson.
(e) Powers and duties of board.--The board shall have the
following powers and duties:
(1) To advise the department on regulations and
guidelines relating to the administration and operation of
county and regional programs in this Commonwealth on the
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following:
(i) Standards for performance reviews and methods of
quality assurance programs to ensure public safety and
maintain and improve the performance of county and
regional programs.
(ii) Measures to ensure the compliance of county and
regional programs with best practice and applicable
Federal, State and local statute and regulations.
(iii) Measures to promote regionalization of
programs when the board deems it reasonable.
(iv) Training standards for county and regional
program staff.
(2) To promote effective communication and information
sharing between the department and county coordinators and
develop recommendations to improve county and regional
programs in this Commonwealth.
ยง 8306. Counties.
Each county shall have the following powers and duties in
relation to a program:
(1) To ensure the provision of a program in the county
or region's respective jurisdiction. With the permission of
the department and the board, a county may utilize existing
partnerships with public and private entities to meet the
requirements of this section. A county may provide behavioral
health response unit and crisis call center coverage to the
county's jurisdiction through participation in a regional
program.
(2) To develop, maintain or adopt a plan for the county
and submit the plan to the department for review. The
following apply:
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(i) The plan shall be reviewed and updated at a
frequency prescribed by the board.
(ii) A county may adopt the plan of a regional
program if the county is a participating member of that
region.
(3) To cooperate with the department and the board,
comply with the guidelines, standards and reporting
requirements established by the department and execute all
contracts, agreements, mutual aid agreements, cross-service
agreements and all other documents necessary to implement the
county's or region's program.
(4) To designate a program coordinator for the county
who shall develop and submit a plan for the implementation,
operation and maintenance of a program.
ยง 8307. Plan.
(a) Minimum standards.--Upon the agreement of a county to
establish a program as a regional or single county program, a
plan shall be adopted that meets the minimum standards
promulgated by the department. The county may obtain technical
assistance from the department and the board in formulating the
plan. Each plan shall be designed to meet the individual
circumstances of each community and public agency participating
in the program. Each plan shall consider efficiencies to be
achieved from regionalization and consolidation. At a minimum,
each plan must involve the following elements:
(1) Notwithstanding any other provision of law to the
contrary, law enforcement may not be dispatched to a call
alongside a behavioral health response unit dispatched from a
crisis call center involving crises that do not require law
enforcement response, including homelessness, intoxication,
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disorientation, substance use disorder, a mental health
disorder crisis and wellness checks. Other first responders
shall accompany a behavioral health response unit as
required.
(2) Law enforcement and the Department of Corrections
shall cooperate with county programs and provide access to
information available on the history of danger or potential
danger caused by clients to which a behavioral health
response unit is responding.
(3) Each behavioral health response unit responding to a
call shall consist of at least three members, consisting of
at least one emergency medical services provider, one trained
mental health disorder crisis counselor and one peer
specialist.
(4) Behavioral health response unit and crisis call
center staff shall undergo background investigations to
determine the individual's suitability for employment as a
staff member. This investigation shall be completed prior to
the employment of the staff member and shall include a
criminal history check as provided under 18 Pa.C.S. Ch. 91
(relating to criminal history record information) , a credit
check, personal interviews and any other applicable means of
determining eligibility as determined by the department. An
applicant who has been convicted of a felony is not eligible
for employment as a behavioral health response unit or crisis
call center staff member.
(5) Each behavioral health response unit shall carry
overdose reversal medication when responding to a call.
(6) Each program shall collect a standardized set of
minimum data, including demographic information on program
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participants, the general nature of the calls received and
the services provided. This data shall be reported to the
board and the department on a monthly basis once in
operation.
(7) Behavioral health response units shall provide
immediate stabilization in cases of urgent medical need or
psychological crisis, assessment, information, referral,
advocacy and, if requested by the affected individual,
transportation to the next step in treatment.
(8) Programs shall be operational and available to
provide services 24 hours every day.
(9) County and regional plans shall include a plan to
market the crisis call center's telephone number to the
crisis call center's jurisdiction to raise awareness of the
program.
(b) Confidentiality.--All services provided by the crisis
call centers and behavioral health response units shall remain
confidential and comply with Federal and State law governing the
confidentiality of health information, including the Health
Insurance Portability and Accountability Act of 1996 (Public Law
104-191, 110 Stat. 1936) and related rules and regulations.
(c) Information provided.--An individual using the services
of a behavioral health response unit shall be provided
information on accessing local harm reduction services,
substance use disorder treatment services, mental health
disorder services, housing assistance resources, health care
services and any other services that are deemed appropriate.
Each behavioral health response unit shall follow the principle
of least restrictive setting for any follow-up care.
(d) Substance use disorder treatment information.--If an
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individual with a substance use disorder requests or agrees to
be provided with information on treatment options, a behavioral
health response unit shall provide the individual with
information on accessing various types of treatment, including
outpatient treatment and medication for treatment of substance
use disorders.
(e) Regional systems.--Nothing in this chapter shall be
construed to prohibit the formation of multijurisdictional or
multiregional programs.
ยง 8308. County and Regional Behavioral Health Response Unit and
Crisis Call Center Fund.
(a) Establishment.--The County and Regional Behavioral
Health Response Unit and Crisis Call Center Fund is established
in the State Treasury as a nonlapsing restricted interest-
bearing account. Money in the fund and the interest the money
accrues is appropriated to the department to be disbursed by the
department.
(b) Composition of fund.--The following money shall be
deposited into the fund:
(1) Money appropriated by the General Assembly.
(2) Money from any other public or private source.
(3) Interest accrued by the fund.
(c) Transfer by Secretary of the Budget.--No later than 30
days after the effective date of this subsection, the Secretary
of the Budget shall transfer to the fund $5,000,000 of the
unexpended, unencumbered prior year funds that were originally
appropriated from the General Fund to an executive branch agency
which is subject to the policy, supervision and control of the
Governor. The Secretary of the Budget may only make the transfer
of funds if the transfer will not result in a deficit in any
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appropriation from which the funds are transferred. No less than
10 days prior to the transfer, the Secretary of the Budget shall
send notification of the transfer in writing to the chairperson
and minority chairperson of the Appropriations Committee of the
Senate and the chairperson and minority chairperson of the
Appropriations Committee of the House of Representatives.
(d) Appropriation by General Assembly.--Beginning with the
2024-2025 fiscal year, the General Assembly may appropriate
money to the fund.
(e) Use.--Money in the fund:
(1) Shall be used for reasonably necessary costs that
enhance, operate, administer or maintain programs in this
Commonwealth in accordance with this chapter and guidelines
set by the department. For the purposes of this paragraph,
reasonably necessary costs shall be determined by the
department, in consultation with the board, consistent with
the following:
(i) The department shall establish factors for
reasonably necessary costs.
(ii) The department shall provide the factors under
subparagraph (i) annually through department guidelines.
(iii) Notwithstanding guidelines provided by the
department, use of the fund by a county or regional
program or the department to establish, enhance, operate
or maintain Statewide interconnectivity and
administration of a behavioral health response unit and
crisis call center shall be deemed reasonably necessary.
(2) May not be expended on a program that does not
conform to the standards and guidance published by the
department.
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(3) May not be transferred for General Fund use by the
Commonwealth or counties.
(f) Audits.--Audits shall be in accordance with the
following:
(1) The fund shall be audited in a manner and frequency
consistent with other restricted receipts accounts
administered by the Commonwealth.
(2) The department shall require a biennial performance
audit of the use of the disbursements received from the fund,
including amounts placed in capital or operating reserve
consistent with published guidelines established by the
department.
ยง 8309. County and Regional Behavioral Health Response Unit and
Crisis Call Center Grant Program.
(a) Establishment.--The County and Regional Behavioral
Health Response Unit and Crisis Call Center Grant Program is
established within the department to provide grants to counties
and regional partnerships establishing or operating a program
under this chapter.
(b) Applications.--An application for a grant under this
chapter shall be submitted by an eligible applicant in the form
and manner prescribed by the department.
(c) Initial application period.--No later than March 1,
2024 , the department shall begin to accept applications from
eligible applicants for grant money available during the fiscal
year. The department shall provide notice of the application
period on the department's publicly accessible Internet website.
(d) Additional application period.--If money is available in
the fund, no later than October 1, 2024 , and each October 1
thereafter, the department shall provide notice of a new
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application period on the department's publicly accessible
Internet website. The department shall accept applications from
eligible applicants during the fiscal year.
(e) Review process.--The department, in consultation with
the board, shall review applications and make awards subject to
subsections (f) and (g) on a rolling basis. No later than 90
days after a completed application is received from an eligible
applicant, the department shall review and approve or deny the
application. An eligible applicant may revise and resubmit a
denied application to the department.
(f) Allocation.--An eligible applicant may not receive more
than the following amounts in a fiscal year:
(1) Subject to paragraphs (2), (3) and (4):
(i) The minimum grant amount awarded shall be no
less than $10,000.
(ii) The maximum grant amount awarded may not be
more than $250,000.
(2) The department may not require non-State financial
participation from an eligible applicant for a grant request
that is $50,000 or less.
(3) The department may award a grant between $50,001 and
$75,000 if the eligible applicant provides non-State
financial participation equal to 25% of the requested grant
amount.
(4) The department may award a grant between $75,001 and
$150,000 if the eligible applicant provides non-State
financial participation equal to 33% of the requested grant
amount.
(5) The department may award a grant between $150,001
and $250,000 if the eligible applicant provides non-State
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financial participation equal to 50% of the requested grant
amount.
(g) Limitations.--The following shall apply to grant
applications:
(1) The department may not provide grants in excess of
the amount in the fund.
(2) The department may prorate the grant amount to an
eligible applicant.
(3) The department shall only make grants available to
eligible applicants as long as available funds have not been
expended.
(h) Eligible projects.--The department may only award grants
from the fund for programs that have been approved by the
department. Applicants may only expend grant money received from
the fund on programs that have been approved by the department.
Section 2. Any regulation inconsistent with the provisions
of this act is abrogated to the extent of any inconsistency with
the addition of 35 Pa.C.S. Ch. 83.
Section 3. This act shall take effect in 180 days.
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