ALLOWING MINORS TO CONSENT TO MEDICAL CARE
                  Act of Feb. 13, 1970, P.L. 19, No. 10               Cl. 35
                                  AN ACT

     Enabling certain minors to consent to medical, dental and health
        services, declaring consent unnecessary under certain
        circumstances.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

        Section 1.  Individual Consent.--Any minor who is eighteen
     years of age or older, or has graduated from high school, or has
     married, or has been pregnant, may give effective consent to
     medical, dental and health services for himself or herself, and
     the consent of no other person shall be necessary.
        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.
        (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.
        (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,
     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
     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,
     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.
        (1.1 added Nov. 20, 2004, P.L.1149, No.147)

        Compiler's Note:  See section 2 of Act 147 of 2004 in the
            appendix to this act for special provisions relating to
            report by Legislative Budget and Finance Committee.
        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
     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.
        (1.2 added Nov. 20, 2004, P.L.1149, No.147)
        Section 2.  Consent for Children with Minor Parents.--Any
     minor who has been married or has borne a child may give
     effective consent to medical, dental and health services for his
     or her child.
        Section 3.  Pregnancy, Venereal Disease and Other Reportable
     Diseases.--Any minor may give effective consent for medical and
     health services to determine the presence of or to treat
     pregnancy, and venereal disease and other diseases reportable
     under the act of April 23, 1956 (P.L.1510), known as the
     "Disease Prevention and Control Law of 1955," and the consent of
     no other person shall be necessary.
        Section 4.  When Consent Unnecessary.--Medical, dental and
     health services may be rendered to minors of any age without the
     consent of a parent or legal guardian when, in the physician's
     judgment, an attempt to secure consent would result in delay of
     treatment which would increase the risk to the minor's life or
     health.
        Section 5.  Liability for Rendering Services.--The consent of
     a minor who professes to be, but is not a minor whose consent
     alone is effective to medical, dental and health services shall
     be deemed effective without the consent of the minor's parent or
     legal guardian, if the physician or other person relied in good
     faith upon the representations of the minor.


                                 APPENDIX

                                 -------
             Supplementary Provisions of Amendatory Statutes
                                 -------

                   2004, NOVEMBER 23, P.L.1149, NO.147

        Section 2.  No later than 12 months from the effective date
     of this act, the Legislative Budget and Finance Committee shall
     prepare a report on the mental health system for children and
     youth in this Commonwealth. The report shall evaluate the
     continuum of mental health services for children and their
     families and include a review of the availability of community-
     based outpatient and inpatient mental health services across
     this Commonwealth; statistical information on the number of
     children needing mental health services; a survey of the number
     of petitions filed under section 1.1(b)(7) and (8) of the act,
     including an assessment of those petitions resulting in
     treatment or continued treatment and the ordered treatment
     period; the timeliness and extent of services; costs for various
     types of mental health services for children and youth; the
     extent to which public and private health insurance, including
     medical assistance, provides coverage for different mental
     health treatment and services; gaps in mental health services
     for children and youth; and the impact and effectiveness of this
     act in respect to providing mental health treatment for children
     and youth. The Legislative Budget and Finance Committee shall
     report its findings and recommendations to the Judiciary
     Committee and the Public Health and Welfare Committee of the
     Senate and to the Judiciary Committee and the Health and Human
     Services Committee of the House of Representatives.

        Compiler's Note.  Act 147 added section 1.1 of Act 10.