PRIOR PRINTER'S NOS. 1205, 1601               PRINTER'S NO. 1701

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 1025 Session of 1975


        INTRODUCED BY COPPERSMITH, DOUGHERTY, REIBMAN, HILL, FRAME AND
           FLEMING, SEPTEMBER 23, 1975

        AS AMENDED ON SECOND CONSIDERATION, MARCH 8, 1976

                                     AN ACT

     1  Relating to mental health procedures; providing for the
     2     treatment and rights of mentally disabled persons, for
     3     voluntary and involuntary examination and treatment and for
     4     determinations affecting those charged with crime or under
     5     sentence.
     6                         TABLE OF CONTENTS

     7  Article I.  General Provisions
     8     Section 101.  Short Title.
     9     Section 102.  Statement of Policy.
    10     Section 103.  Scope of Act.
    11     Section 104.  Provision for Treatment.
    12     Section 105.  Treatment Facilities.
    13     Section 106.  Persons Responsible for Formulation and
    14                   Review of Treatment Plan.
    15     Section 107.  Individualized Treatment Plan.
    16     Section 108.  Periodic Reexamination, Review and
    17                   Redisposition.
    18     Section 109.  Mental Health Review Officer.
    19     Section 110.  Written Applications, Petitions, Statements
    20                   and Certifications.

     1     Section 111.  Confidentiality of Records.
     2     Section 112.  Rules, Regulations and Forms.
     3     Section 113.  Rights and Remedies of Persons in Treatment.
     4     Section 114.  Immunity from Civil and Criminal Liability.
     5     Section 115.  Venue and Location of Legal Proceedings.
     6  Article II.  Voluntary Examination and Treatment
     7     Section 201.  Persons Who May Authorize Voluntary Treatment.
     8     Section 202.  To Whom Application May be Made.
     9     Section 203.  Explanation and Consent.
    10     Section 204.  Notice to Parents.
    11     Section 205.  Physical Examination and Formulation of
    12                   Individualized Treatment Plan.
    13     Section 206.  Withdrawal from Voluntary Inpatient Treatment.
    14     Section 207.  Transfer of Person in Voluntary Treatment.
    15  Article III.  Involuntary Examination and Treatment
    16     Section 301.  Persons Who May be Subject to Involuntary
    17                   Emergency Examination and Treatment.
    18     Section 302.  Involuntary Emergency Examination and Treatment
    19                   Authorized by a Physician - Not to Exceed
    20                   Seventy-two Hours.
    21     Section 303.  Extended Involuntary Emergency Treatment
    22                   Certified by a Judge or Mental Health Review
    23                   Officer - Not to Exceed Twenty Days.
    24     Section 304.  Court-ordered Involuntary Treatment Not to
    25                   Exceed Ninety Days.
    26     Section 305.  Additional Periods of Court-ordered Involuntary
    27                   Treatment.
    28     Section 306.  Transfer of Persons in Involuntary Treatment.
    29  Article IV.  Determinations Affecting Those Charged with Crime,
    30               or Under Sentence
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     1     Section 401.  Examination and Treatment of a Person Charged
     2                   with Crime or Serving Sentence.
     3     Section 402.  Incompetence to Proceed on Criminal Charges and
     4                   Lack of Criminal Responsibility as Defense.
     5     Section 403.  Hearing and Determination of Incompetency to
     6                   Proceed; Stay of Proceedings; Dismissal of
     7                   Charges.
     8     Section 404.  Hearing and Determination of Criminal
     9                   Responsibility; Bifurcated Trial.
    10     Section 405.  Examination of Person Charged with Crime as
    11                   Aid in Sentencing.
    12     Section 406.  Civil Procedure for Court-ordered Involuntary
    13                   Treatment Following a Determination of
    14                   Incompetency, or Acquittal by Reason of Lack of
    15                   Criminal Responsibility or in Conjunction with
    16                   Sentencing.
    17  Article V.  Effective Date and Applicability
    18     Section 501.  Effective Date and Applicability.

    19     The General Assembly of the Commonwealth of Pennsylvania
    20  hereby enacts as follows:
    21                             ARTICLE I
    22                         General Provisions
    23     Section 101.  Short Title.--This act shall be known and may
    24  be cited as the "Mental Health Procedures Act."
    25     Section 102.  Statement of Policy.--It is the policy of the
    26  Commonwealth of Pennsylvania to seek to assure the availability
    27  of adequate treatment to persons who are mentally ill, and it is
    28  the purpose of this act to establish procedures whereby this
    29  policy can be effected. Treatment on a voluntary basis shall be

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     1  preferred to involuntary treatment; and in every case, the least
     2  restrictions consistent with adequate treatment shall be
     3  employed. Persons who are mentally retarded, senile, alcoholic,
     4  or drug dependent shall receive mental health treatment only if
     5  they are also diagnosed as mentally ill, but these conditions of
     6  themselves shall not be deemed to constitute mental illness.
     7     Section 103.  Scope of Act.--This act establishes rights and
     8  procedures for all involuntary treatment of mentally ill
     9  persons, whether inpatient or outpatient, and for all voluntary
    10  inpatient treatment of mentally ill persons. "Inpatient
    11  treatment" shall include all treatment that requires full or
    12  part-time residence in a facility. For the purpose of this act,
    13  a "facility" means any mental health establishment, hospital,
    14  clinic, institution, center, day care center, base service unit,
    15  community mental health center, or part thereof, that provides
    16  for the diagnosis, treatment, care or rehabilitation of mentally
    17  ill persons, whether as outpatients or inpatients.
    18     Section 104.  Provision for Treatment.--Adequate treatment
    19  means a course of treatment designed and administered to
    20  alleviate a person's pain and distress and to maximize the
    21  probability of his recovery from mental illness. It shall be
    22  provided to all persons in treatment who are subject to this
    23  act. It may include inpatient treatment, partial
    24  hospitalization, or outpatient treatment. Adequate inpatient
    25  treatment shall include such accommodations, diet, heat, light,
    26  sanitary facilities, clothing, recreation, education and medical
    27  care as are necessary to maintain decent, safe and healthful
    28  living conditions.
    29     Treatment shall include diagnosis, evaluation, therapy, or
    30  rehabilitation needed to alleviate pain and distress and to
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     1  facilitate the recovery of a person from mental illness and
     2  shall also include care and other services that supplement
     3  treatment and aid or promote such recovery.
     4     Section 105.  Treatment Facilities.--Involuntary treatment
     5  and voluntary treatment funded in whole or in part by public
     6  moneys shall be available at a facility approved for such
     7  purposes by the county administrator (who shall be the County
     8  Mental Health and Mental Retardation Administrator of a county
     9  or counties, or his duly authorized delegate), or by the
    10  Department of Public Welfare, hereinafter cited as the
    11  "department." Approval of facilities shall be made by the
    12  appropriate authority which can be the department pursuant to
    13  regulations adopted by the department. Use of any facility not
    14  approved by the Joint Commission for Accreditation of Hospitals
    15  shall be prohibited, if the facility is of a type to which
    16  standards established by the Joint Commission are intended to
    17  apply. An exemption may be granted by the department for a
    18  period not in excess of one year and may be renewed in
    19  compelling circumstances. Notice of each exemption and the
    20  rationale for allowing the exemption must be published pursuant
    21  to the act of July 31, 1968 (P.L.769, No.240), known as the
    22  "Commonwealth Documents Law," and shall be prominently posted at
    23  the entrance to the main office and in the reception areas of
    24  the facility.
    25     Section 106.  Persons Responsible for Formulation and Review
    26  of Treatment Plan.--Pursuant to sections 107 and 108 of this
    27  act, a physician or a treatment team under the supervision of a
    28  physician shall formulate and review an individualized treatment
    29  plan for every person who is in treatment under this act.
    30     Section 107.  Individualized Treatment Plan.--Individualized
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     1  treatment plan means a plan of treatment formulated for a
     2  particular person in a program appropriate to his specific
     3  needs. To the extent possible, the plan shall be made with the
     4  cooperation, understanding and consent of the person in
     5  treatment, and shall impose the least restrictive alternative
     6  consistent with affording the person adequate treatment for his
     7  condition.
     8     Section 108.  Periodic Reexamination, Review and
     9  Redisposition.--(a) Reexamination and Review. Every person who
    10  is in treatment under this act shall be examined by a physician
    11  or a treatment team under the supervision of a physician and his
    12  treatment plan reviewed not less than once in every 30 days.
    13     (b)  Redisposition. On the basis of reexamination and review,
    14  the examining physician or a treatment team under the
    15  supervision of a physician may either authorize continuation of
    16  the existing treatment plan if appropriate, formulate a new
    17  individualized treatment plan, or recommend to the director the
    18  discharge of the person. A person shall not remain in treatment
    19  or under any particular mode of treatment for longer than such
    20  treatment is necessary and appropriate to his needs.
    21     (c)  Record of Reexamination and Review. The physician or
    22  clinical psychologist responsible for the treatment plan shall
    23  maintain a record of each reexamination and review under this
    24  section for each person in treatment to include:  (1) a report
    25  of the reexamination, including a diagnosis and prognosis; (2) a
    26  brief description of the treatment provided to the person during
    27  the period preceding the reexamination and the results of that
    28  treatment; (3) a statement of the reason for discharge or for
    29  continued treatment; (4) an individualized treatment plan for
    30  the next period, if any; (5) a statement of the reasons that
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     1  such treatment plan imposes the least restrictive alternative
     2  consistent with adequate treatment of his condition; and (6) a
     3  certification that the adequate treatment recommended is
     4  available and will be afforded in the treatment program.
     5     Section 109.  Mental Health Review Officer.--Legal
     6  proceedings concerning extended involuntary emergency treatment
     7  under section 303(c), or court-ordered involuntary treatment
     8  under section 304, may be conducted by a judge of the court of
     9  common pleas or by a mental health review officer authorized by
    10  the court to conduct the proceedings. Mental health review
    11  officers shall be members of the bar of the Supreme Court of
    12  Pennsylvania, without restriction as to the county of their
    13  residence and where possible should be familiar with the field
    14  of mental health. They shall be appointed by the respective
    15  courts of common pleas for terms not to exceed one year, and may
    16  be reappointed to successive terms.
    17     Section 110.  Written Applications, Petitions, Statements and
    18  Certifications.--(a) All written statements pursuant to section
    19  302(a)(3), and all applications, petitions, and certifications
    20  required under the provisions of this act shall be made subject
    21  to the penalties provided under 18 P.C.S.§4904 (relating to
    22  unsworn falsification to authorities) and shall contain a notice
    23  to that effect.
    24     (b)  All such applications, petitions, statements and
    25  certifications shall be filed with the county administrator in
    26  the county where the person was made subject to examination and
    27  treatment and such other county in the Commonwealth, if any, in
    28  which the person usually resides.
    29     Section 111.  Confidentiality of Records.--All documents
    30  concerning persons in treatment shall be kept confidential and,
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     1  without the person's written consent, may not be released or
     2  their contents disclosed to anyone except:  (1) those engaged in
     3  providing treatment for the person; (2) the county
     4  administrator, pursuant to section 110; and (3) a court in the
     5  course of legal proceedings authorized by this act. In no event,
     6  however, shall privileged communications, whether written or
     7  oral, be disclosed to anyone without such written consent. This
     8  shall not restrict the collection and analysis of clinical or
     9  statistical data by the department, the county administrator or
    10  the facility so long as the use and dissemination of such data
    11  does not identify individual patients. Nothing herein shall be
    12  construed to conflict with section 8 of the act of April 14,
    13  1972 (P.L.221, No.63), known as the "Pennsylvania Drug and
    14  Alcohol Abuse Control Act."
    15     Section 112.  Rules, Regulations and Forms.--The department
    16  shall adopt such rules, regulations and forms as may be required
    17  to effectuate the provisions of this act. Rules and regulations
    18  adopted under the provisions of this act shall be adopted
    19  according to provisions of section 201 of the act of October 20,
    20  1966 (3rd Sp.Sess., P.L.96, No.6), known as the "Mental Health
    21  and Mental Retardation Act of 1966," and the act of July 31,
    22  1968 (P.L.769, No.240), known as the "Commonwealth Documents
    23  Law."
    24     Section 113.  Rights and Remedies of Persons in Treatment.--
    25  Every person who is in treatment shall be entitled to all other
    26  rights now or hereafter provided under the laws of this
    27  Commonwealth, in addition to any rights provided for in this
    28  act. Actions requesting damages, declaratory judgment,
    29  injunction, mandamus, writs of prohibition, habeas corpus,
    30  including challenges to the legality of detention or degree of
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     1  restraint, and any other remedies or relief granted by law may
     2  be maintained in order to protect and effectuate the rights
     3  granted under this act.
     4     Section 114.  Immunity from Civil and Criminal Liability.--
     5  (a) In the absence of willful misconduct or gross negligence, a
     6  county administrator, a director of a facility, a physician or
     7  any other authorized person who participates in a decision that
     8  a person be examined or treated under this act, or that a person
     9  be discharged, or placed under partial hospitalization,
    10  outpatient care or leave of absence, or that the restraint upon
    11  such person be otherwise reduced, or a county administrator or
    12  other authorized person who denies an application for
    13  involuntary emergency examination and treatment, shall not be
    14  civilly or criminally liable for such decision or for any of its
    15  consequences.
    16     (b)  A judge or a mental health review officer shall not be
    17  civilly or criminally liable for any actions taken or decisions
    18  made by him pursuant to the authority conferred by this act.
    19     Section 115.  Venue and Location of Legal Proceedings.--(a)
    20  The jurisdiction of the courts of common pleas and juvenile
    21  courts conferred by Articles II and III shall be exercised
    22  initially by the court for the county in which the subject of
    23  the proceedings is or resides. Whenever involuntary treatment is
    24  ordered, jurisdiction over any subsequent proceeding shall be
    25  retained by the court in which the initial proceedings took
    26  place, but may be transferred to the county of the person's
    27  usual residence. In all cases, a judge of the court of common
    28  pleas or a mental health review officer of the county of venue
    29  may conduct legal proceedings at a facility where the person is
    30  in treatment whether or not its location is within the county.
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     1     (b)  Venue for actions instituted to effectuate rights under
     2  this act shall be as now or hereafter provided by law.
     3                             ARTICLE II
     4                Voluntary Examination and Treatment
     5     Section 201.  Persons Who May Authorize Voluntary
     6  Treatment.--Any person 14 years of age or over who believes that
     7  he is in need of treatment and substantially understands the
     8  nature of voluntary commitment may submit himself to examination
     9  and treatment under this act, provided that the decision to do
    10  so is made voluntarily. A parent, guardian, or person standing
    11  in loco parentis to a child less than 14 years of age may
    12  subject such child to examination and treatment under this act,
    13  and in so doing shall be deemed to be acting for the child.
    14  Except as otherwise authorized in this act, all of the
    15  provisions of this act governing examination and treatment shall
    16  apply.
    17     Section 202.  To Whom Application May be Made.--Application
    18  for voluntary examination and treatment shall be made to an
    19  approved facility or to the county administrator. When
    20  application is made to the county administrator, he shall
    21  designate the approved facility for examination and for such
    22  treatment as may be appropriate.
    23     Section 203.  Explanation and Consent.--Before a person is
    24  accepted for voluntary inpatient treatment, an explanation shall
    25  be made to him of such treatment, including the types of
    26  treatment in which he may be involved, and any restraints or
    27  restrictions to which he may be subject, together with a
    28  statement of his rights under this act. Consent shall be given
    29  in writing upon a form adopted by the department. The consent
    30  shall include the following representations:  That the person
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     1  understands his treatment will involve inpatient status; that he
     2  is willing to be admitted to a designated facility for the
     3  purpose of such examination and treatment; and that he consents
     4  to such admission voluntarily, without coercion or duress; and,
     5  if applicable, that he has voluntarily agreed to remain in
     6  treatment for a specified period of no longer than 72 hours
     7  after having given written notice of his intent to withdraw from
     8  treatment. The consent shall be part of the person's record.
     9     Section 204.  Notice to Parents.--Upon the acceptance of an
    10  application for examination and treatment by a minor 14 years or
    11  over but less than 18 years of age, the director of the facility
    12  shall promptly notify the minor's parents, guardian, or person
    13  standing in loco parentis, and shall inform them of the right to
    14  be heard upon the filing of an objection. Whenever such
    15  objection is filed, a hearing shall be held within 72 hours by a
    16  judge or mental health review officer, who shall determine
    17  whether or not the voluntary treatment is in the best interest
    18  of the minor.
    19     Section 205.  Physical Examination and Formulation of
    20  Individualized Treatment Plan.--Upon acceptance of a person for
    21  voluntary examination and treatment he shall be given a physical
    22  examination. Within 72 hours after acceptance of a person an
    23  individualized treatment plan shall be formulated by a physician
    24  or a treatment team under the supervision of a physician. The
    25  person shall be advised of the treatment plan, which shall
    26  become a part of his record. The treatment plan shall state
    27  whether inpatient treatment is considered necessary, and what
    28  restraints or restrictions, if any, will be administered, and
    29  shall set forth the bases for such conclusions.
    30     Section 206.  Withdrawal from Voluntary Inpatient
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     1  Treatment.--(a) A person in voluntary inpatient treatment may
     2  withdraw at any time by giving written notice unless, as stated
     3  in section 203, he has agreed in writing at the time of his
     4  admission that his release can be delayed following such notice
     5  for a period to be specified in the agreement, provided that
     6  such period shall not exceed 72 hours.
     7     (b)  If the person is under the age of 14, his parent, legal
     8  guardian, or person standing in loco parentis may effect his
     9  release. If any responsible party believes that it would be in
    10  the best interest of a person under 14 years of age in voluntary
    11  treatment to be withdrawn therefrom or afforded treatment
    12  constituting a less restrictive alternative, such party may file
    13  a petition in the Juvenile Division of the court of common pleas
    14  for the county in which the person under 14 years of age
    15  resides, requesting a withdrawal from or modification of
    16  treatment. The court shall promptly appoint an attorney for such
    17  minor person and schedule a hearing to determine what inpatient
    18  treatment, if any, is in the minor's best interest. The hearing
    19  shall be held within ten days of receipt of the petition, unless
    20  continued upon the request of the attorney for such minor. The
    21  hearing shall be conducted in accordance with the rules
    22  governing other Juvenile Court proceedings.
    23     (c)  Nothing in this act shall be construed to require a
    24  facility to continue inpatient treatment where the director of
    25  the facility determines such treatment is not medically
    26  indicated. Any dispute between a facility and a county
    27  administrator as to the medical necessity for voluntary
    28  impatient treatment of a person shall be decided by the
    29  Commissioner of Mental Health or his designate.
    30     Section 207.  Transfer of Person in Voluntary Treatment.--A
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     1  person who is in voluntary treatment may not be transferred from
     2  one facility to another without his written consent.
     3                            ARTICLE III
     4               Involuntary Examination and Treatment
     5     Section 301.  Persons Who May be Subject to Involuntary
     6  Emergency Examination and Treatment.--(a) Persons Subject.
     7  Whenever a person is severely mentally disabled and in need of
     8  immediate treatment, he may be made subject to involuntary
     9  emergency examination and treatment. A person is severely
    10  mentally disabled when, as a result of mental illness, his
    11  capacity to exercise self-control, judgment and discretion in
    12  the conduct of his affairs and social relations or to care for
    13  his own personal needs is so lessened that he poses a clear and
    14  present danger of harm to others or to himself.
    15     (b)  Determination of Clear and Present Danger. (1)  Clear
    16  and present danger to others shall be shown by establishing that
    17  within the past 30 days the person has inflicted or attempted to
    18  inflict serious bodily harm on another and that there is a
    19  reasonable probability that such conduct will be repeated. If,
    20  however, the person has been found incompetent to be tried or
    21  has been acquitted by reason of lack of criminal responsibility
    22  on charges arising from conduct involving infliction of or
    23  attempt to inflict substantial bodily harm on another, such 30-
    24  day limitation shall not apply so long as an application for
    25  examination and treatment is filed within 30 days after the date
    26  of such determination or verdict. In such case, a clear and
    27  present danger to others may be shown by establishing that the
    28  conduct charged in the criminal proceeding did occur, and that
    29  there is a reasonable probability that such conduct will be
    30  repeated.
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     1     (2)  Clear and present danger to himself shall be shown by
     2  establishing that within the past 30 days:
     3             (i) the person has acted in such manner as to
     4     evidence that he would be unable, without care supervision
     5     and the continued assistance of others, to satisfy his need
     6     for nourishment, personal or medical care, shelter, or self-
     7     protection and safety, and that there is a reasonable
     8     probability that death, serious bodily injury or serious
     9     physical debilitation would ensue within 30 days unless
    10     adequate treatment were afforded under this act; or
    11             (ii)  the person has attempted suicide and that there
    12     is the reasonable probability of suicide unless adequate
    13     treatment is afforded under this act; or
    14             (iii)  the person has severely mutilated himself or
    15     attempted to mutilate himself severely and that there is the
    16     reasonable probability of mutilation unless adequate
    17     treatment is afforded under this act.
    18     Section 302.  Involuntary Emergency Examination and Treatment
    19  Authorized by a Physician - Not to Exceed Seventy-two Hours.--
    20  (a)  Application for Examination. Emergency examination may be
    21  undertaken at a treatment facility upon the certification of a
    22  physician stating the need for such examination; or upon a
    23  warrant issued by the county administrator authorizing such
    24  examination; or without a warrant upon application by a
    25  physician or other authorized person who has personally observed
    26  conduct showing the need for such examination.
    27     (1)  Warrant for Emergency Examination. Upon written
    28  application by a physician or other responsible party setting
    29  forth facts constituting reasonable grounds to believe a person
    30  is severely mentally disabled and in need of immediate
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     1  treatment, the county administrator may issue a warrant
     2  requiring a person authorized by him, or any peace officer, to
     3  take such person to the facility specified in the warrant.
     4     (2)  Emergency Examination Without a Warrant. Upon personal
     5  observation of the conduct of a person constituting reasonable
     6  grounds to believe that he is severely mentally disabled and in
     7  need of immediate treatment, any physician or peace officer, or
     8  anyone authorized by the county administrator may take such
     9  person to an approved facility for an emergency examination.
    10  Upon arrival, he shall make a written statement setting forth
    11  the grounds for believing the person to be in need of such
    12  examination.
    13     (b)  Examination and Determination of Need for Emergency
    14  Treatment. A person taken to a facility shall be examined by a
    15  physician within two hours of arrival in order to determine if
    16  the person is severely mentally disabled within the meaning of
    17  section 301 and in need of immediate treatment. If it is
    18  determined that the person is severely mentally disabled and in
    19  need of emergency treatment, treatment shall be begun
    20  immediately. If the physician does not so find, or if at any
    21  time it appears there is no longer a need for immediate
    22  treatment, the person shall be discharged and returned to such
    23  place as he may reasonably direct. The physician shall make a
    24  record of the examination and his findings. In no event shall a
    25  person be accepted for involuntary emergency treatment if a
    26  previous application was granted for such treatment and the new
    27  application is not based on behavior occurring after the earlier
    28  application.
    29     (c)  Notification of Rights at Emergency Examination. Upon
    30  arrival at the facility, the person shall be informed of the
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     1  reasons for emergency examination and of his right to
     2  communicate immediately with others. He shall be given
     3  reasonable use of the telephone. He shall be requested to
     4  furnish the names of parties whom he may want notified of his
     5  custody and kept informed of his status. The county
     6  administrator or the director of the facility shall:
     7     (1)  give notice to such parties of the whereabouts and
     8  status of the person, how and when he may be contacted and
     9  visited, and how they may obtain information concerning him
    10  while he is in inpatient treatment; and
    11     (2)  take reasonable steps to assure that precautions while
    12  the person is detained, the health and safety needs of any of
    13  his dependents are met, and that his personal property and the
    14  premises he occupies are secure.
    15     (d)  Duration of Emergency Examination and Treatment. A
    16  person who is in treatment pursuant to this section shall be
    17  discharged whenever it is determined that he no longer is in
    18  need of treatment and in any event within 72 hours, unless
    19  within such period:
    20     (1)  he is admitted to voluntary treatment pursuant to
    21  section 202 of this act; or
    22     (2)  a certification for extended involuntary emergency
    23  treatment is filed pursuant to section 303 of this act.
    24     Section 303.  Extended Involuntary Emergency Treatment
    25  Certified by a Judge or Mental Health Review Officer - Not to
    26  Exceed Twenty Days.--(a) Persons Subject to Extended Involuntary
    27  Emergency Treatment. Application for extended involuntary
    28  emergency treatment may be made for any person who is being
    29  treated pursuant to section 302 whenever the facility determines
    30  that the need for emergency treatment is likely to extend beyond
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     1  72 hours. The application shall be filed forthwith in the court
     2  of common pleas, and shall state the grounds on which extended
     3  emergency treatment is believed to be necessary.
     4     (b)  Appointment of Counsel and Scheduling of Informal
     5  Hearing. Upon receiving such application, the court of common
     6  pleas shall appoint an attorney who shall represent the person
     7  unless it shall appear that the person can afford, and desires
     8  to have, private representation. Within 24 hours after the
     9  application is filed, an informal hearing shall be conducted by
    10  a judge or by a mental health review officer and, if
    11  practicable, shall be held at the facility.
    12     (c)  Informal Hearing on Extended Emergency Treatment
    13  Application. (1)  At the commencement of the informal hearing,
    14  the judge or the mental health review officer shall inform the
    15  person of the nature of the proceedings. Information relevant to
    16  whether the person is severely mentally disabled and in need of
    17  treatment shall be reviewed, including the reasons that
    18  continued involuntary treatment is considered necessary. Such
    19  explanation shall be made by a physician who examined the person
    20  and shall be in terms understandable to a layman. The person or
    21  his representative shall have the right to ask questions of the
    22  physician and of any other witnesses and to present any relevant
    23  information. At the conclusion of the review, if the judge or
    24  the review officer finds that the person is severely mentally
    25  disabled and in need of continued involuntary treatment, he
    26  shall so certify. Otherwise, he shall direct that the facility
    27  director or his designee discharge the person.
    28     (2)  A stenographic or other sufficient record of the
    29  proceedings shall be made. Such record shall be kept by the
    30  court or mental health review officer for at least one year.
    19750S1025B1701                 - 17 -

     1     (d)  Contents of Certification. A certification for extended
     2  involuntary treatment shall be made in writing upon a form
     3  adopted by the department and shall include:
     4     (1)  findings by the judge or mental health review officer as
     5  to the reasons that extended involuntary emergency treatment is
     6  necessary;
     7     (2)  a description of the treatment to be provided together
     8  with an explanation of the adequacy and appropriateness of such
     9  treatment, based upon the information received at the hearing;
    10     (3)  any documents required by the provisions of section 302;
    11     (4)  the application as filed pursuant to section 303(a);
    12     (5)  a statement that the person is represented by counsel;
    13  and
    14     (6)  an explanation of the effect of the certification, the
    15  person's right to petition the court for release under
    16  subsection (g), and the continuing right to be represented by
    17  counsel.
    18     (e)  Filing and Service. The certification shall be filed
    19  with the director of the facility and a copy served on the
    20  person, such other parties as the person requested to be
    21  notified pursuant to section 302(c), and on counsel.
    22     (f)  Effect of Certification. Upon the filing and service of
    23  a certification for extended involuntary emergency treatment,
    24  the person may be given treatment in an approved facility for a
    25  period not to exceed 20 days.
    26     (g)  Petition to Common Pleas Court. In all cases in which
    27  the hearing was conducted by a mental health review officer, a
    28  person made subject to treatment pursuant to this section shall
    29  have the right to petition the court of common pleas for review
    30  of the certification. A hearing shall be held within 72 hours
    19750S1025B1701                 - 18 -

     1  after the petition is filed unless a continuance is requested by
     2  the person's counsel. The hearing shall include a review of the
     3  certification and such evidence as the court may receive or
     4  require. If the court determines that further involuntary
     5  treatment is necessary and that the procedures prescribed by
     6  this act have been followed, it shall deny the petition.
     7  Otherwise, the person shall be discharged.
     8     (h)  Duration of Extended Involuntary Emergency Treatment.
     9  Whenever a person is no longer severely mentally disabled or in
    10  need of immediate treatment and, in any event, within 20 days
    11  after the filing of the certification, he shall be discharged,
    12  unless within such period:
    13     (1)  he is admitted to voluntary treatment pursuant to
    14  section 202; or
    15     (2)  the court orders involuntary treatment pursuant to
    16  section 304.
    17     Section 304.  Court-ordered Involuntary Treatment Not to
    18  Exceed Ninety Days.--(a) Persons for Whom Application May be
    19  Made. (1)  A person who is severely mentally disabled and in
    20  need of treatment, as defined in section 301(a), may be made
    21  subject to court-ordered involuntary treatment upon a
    22  determination of clear and present danger under section
    23  301(b)(1) (serious bodily harm to others), or section
    24  302(b)(2)(i) (inability to care for himself, creating a danger
    25  of death or serious harm to himself), or 301(b)(2)(ii)
    26  (attempted suicide), or 301(b)(2)(iii) (self-mutilation).
    27     (2)  Where a petition is filed for a person already subject
    28  to involuntary treatment, it shall be sufficient to represent,
    29  and upon hearing to reestablish, that the conduct originally
    30  required by section 301 in fact occurred, and that his condition
    19750S1025B1701                 - 19 -

     1  continues to evidence a clear and present danger to himself or
     2  others. In such event, it shall not be necessary to show the
     3  reoccurrence of dangerous conduct, either harmful or
     4  debilitating, within the past 30 days.
     5     (b)  Procedures for Initiating Court-ordered Involuntary
     6  Treatment for Persons Already Subject to Involuntary Treatment.
     7     (1)  Petition for court-ordered involuntary treatment for
     8  persons already subject to treatment under sections 303 and 305
     9  may be made by the county administrator to the court of common
    10  pleas.
    11     (2)  The petition shall be in writing upon a form adopted by
    12  the department and shall include a statement of the facts
    13  constituting reasonable grounds to believe that the person is
    14  severely mentally disabled and in need of treatment. It shall
    15  also state that the person has been given the information
    16  required by subsection (b)(3) and shall include copies of all
    17  documents relating to examination and treatment of the person
    18  which are required under this act.
    19     (3)  Upon the filing of the petition the county administrator
    20  shall serve a copy on the person, his attorney, and those
    21  designated to be kept informed, as provided in section 302(c),
    22  including an explanation of the nature of the proceedings, the
    23  person's right to an attorney and the services of an expert in
    24  the field of mental health, as provided by subsection (d).
    25     (4)  A hearing on the petition shall be held in all cases,
    26  not more than five days after the filing of the petition.
    27     (5)  Treatment shall be permitted to be maintained pending
    28  the determination of the petition.
    29     (c)  Procedures for Initiating Court-ordered Involuntary
    30  Treatment for Persons not in Involuntary Treatment. (1)  Any
    19750S1025B1701                 - 20 -

     1  responsible party may file a petition in the court of common
     2  pleas requesting court-ordered involuntary treatment for any
     3  person not already in involuntary treatment for whom application
     4  could be made under subsection (a).
     5     (2)  The petition shall be in writing upon a form adopted by
     6  the department and shall set forth facts constituting reasonable
     7  grounds to believe that the person is within the criteria for
     8  court-ordered treatment set forth in subsection (a).
     9     (3)  Upon a determination that the petition sets forth such
    10  reasonable cause, the court shall appoint an attorney to
    11  represent the person and set a date for the hearing as soon as
    12  practicable. The attorney shall represent the person unless it
    13  shall appear that he can afford, and desires to have, private
    14  representation.
    15     (4)  The court, by summons, shall direct the person to appear
    16  for a hearing. The court may issue a warrant directing a person
    17  authorized by the county administrator or a peace officer to
    18  bring such person before the court at the time of the hearing if
    19  there are reasonable grounds to believe that the person will not
    20  appear voluntarily. A copy of the petition shall be served on
    21  such person at least three days before the hearing together with
    22  a notice advising him that an attorney has been appointed who
    23  shall represent him unless he obtains an attorney himself, that
    24  he has a right to be assisted in the proceedings by an expert in
    25  the field of mental health, and that he may request or be made
    26  subject to psychiatric examination under subsection (c)(5).
    27     (5)  Upon motion of either the petitioner or the person, or
    28  upon its own motion, the court may order the person to be
    29  examined by a psychiatrist appointed by the court. Such
    30  examination shall be conducted on an outpatient basis, and the
    19750S1025B1701                 - 21 -

     1  person shall have the right to have counsel present. A report of
     2  the examination shall be given to the court and counsel at least
     3  48 hours prior to the hearing.
     4     (6)  Involuntary treatment shall not be authorized during the
     5  pendency of a petition except in accordance with section 302 or
     6  section 303.
     7     (d)  Professional Assistance. A person with respect to whom a
     8  hearing has been ordered under this section shall have and be
     9  informed of a right to employ a physician, clinical psychologist
    10  or other expert in mental health of his choice to assist him in
    11  connection with the hearing and to testify on his behalf. If the
    12  person cannot afford to engage such a professional, the court
    13  shall, on application, allow a reasonable fee for such purpose.
    14  The fee shall be a charge against the mental health and mental
    15  retardation program of the locality.
    16     (e)  Hearings on Petition for Court-ordered Involuntary
    17  Treatment. A hearing on a petition for court-ordered involuntary
    18  treatment shall be conducted according to the following:
    19     (1) The person shall have the right to counsel and to the
    20  assistance of an expert in mental health.
    21     (2)  The person shall not be called as a witness without his
    22  consent.
    23     (3)  The person shall have the right to confront and cross-
    24  examine all witnesses and to present evidence in his own behalf.
    25     (4)  The hearing shall be public unless it is requested to be
    26  private by the person or his counsel.
    27     (5)  A stenographic or other sufficient record shall be made,
    28  which shall be impounded by the court and may be obtained or
    29  examined only upon the request of the person or his counsel or
    30  by order of the court on good cause shown.
    19750S1025B1701                 - 22 -

     1     (6)  The hearing shall be conducted by a judge or by a mental
     2  health review officer and may be held at a location other than a
     3  courthouse when doing so appears to be in the best interest of
     4  the person.
     5     (7)  A decision shall be rendered within 48 hours after the
     6  close of evidence.
     7     (f)  Determination and Order. Upon a finding by clear and
     8  convincing evidence that the person is severely mentally
     9  disabled and in need of treatment and subject to section 304(a),
    10  an order shall be entered directing treatment of the person in
    11  an approved facility as an inpatient or an outpatient. Inpatient
    12  treatment shall be deemed appropriate only after full
    13  consideration has been given to less restrictive alternatives.
    14  Investigation of treatment alternatives shall include
    15  consideration of the person's relationship to his community and
    16  family, his employment possibilities, all available community
    17  resources, and guardianship services. An order for inpatient
    18  treatment shall include findings on this issue.
    19     (g)  Duration of Court-ordered Involuntary Treatment. (1)  A
    20  person may be made subject to court-ordered involuntary
    21  treatment under this section for a period not to exceed 90 days,
    22  excepting only that:
    23     Persons may be made subject to court-ordered involuntary
    24  treatment under this section for a period not to exceed one year
    25  if:
    26             (i)  severe mental disability is based on acts giving
    27     rise to the following charges under the Pennsylvania Crimes
    28     Code: murder (§2502); voluntary manslaughter (§2503);
    29     aggravated assault (§2702); kidnapping (§2901); rape
    30     (§3121(1) and (2)); involuntary deviate sexual intercourse
    19750S1025B1701                 - 23 -

     1     (§3123(1) and (2)); and
     2             (ii)  a finding of incompetency to be tried or a
     3     verdict of acquittal because of lack of criminal
     4     responsibility has been entered.
     5     (2)  If at any time the director of a facility concludes that
     6  the person is not severely mentally disabled or in need of
     7  treatment pursuant to subsection (a), he shall discharge the
     8  person.
     9     Section 305.  Additional Periods of Court-ordered Involuntary
    10  Treatment.--At the expiration of a period of court-ordered
    11  involuntary treatment under section 304(g), the court may order
    12  treatment for an additional period upon the application of the
    13  county administrator or the director of the facility in which
    14  the person is receiving treatment. Such order shall be entered
    15  upon hearing on findings as required by sections 304(a) and (b),
    16  and the further finding of a need for continuing involuntary
    17  treatment as shown by conduct during the person's most recent
    18  period of court-ordered treatment. A person found dangerous to
    19  himself under section 301(b)(2)(i),(ii) or (iii) shall be
    20  subject to an additional period of involuntary full-time
    21  inpatient treatment only if he has first been released to a less
    22  restrictive alternative. This limitation shall not apply where,
    23  upon application made by the county administrator or facility
    24  director, it is determined by a judge or mental health review
    25  officer that such release would not be in the person's best
    26  interest.
    27     Section 306.  Transfer of Persons in Involuntary Treatment.--
    28  Person in involuntary treatment pursuant to this act may be
    29  transferred to any approved facility. Whenever such transfer
    30  will constitute a greater restraint, it shall not take place
    19750S1025B1701                 - 24 -

     1  unless, upon hearing, a judge or mental health review officer
     2  finds it to be necessary and appropriate.
     3                             ARTICLE IV
     4         Determinations Affecting Those Charged With Crime,
     5                         Or Under Sentence
     6     Section 401.  Examination and Treatment of a Person Charged
     7  with Crime or Serving Sentence.--(a) Examination and treatment
     8  to be pursuant to civil provisions. Whenever a person who is
     9  charged with crime, or who is undergoing sentence, is or becomes
    10  severely mentally disabled, proceedings may be instituted for
    11  examination and treatment under the civil provisions of this act
    12  in the same manner as if he were not so charged or sentenced.
    13  Such proceedings, however, shall not affect the conditions of
    14  security required by his criminal detention or incarceration.
    15     (b)  Status in Involuntary Treatment. Whenever a person who
    16  is detained on criminal charges or is incarcerated is made
    17  subject to inpatient examination or treatment, he shall be
    18  transferred, for this purpose, to a mental health facility.
    19  During such period, provisions for his security shall continue
    20  to be enforced, unless in the interim a pretrial release is
    21  effected, or the term of imprisonment expires or is terminated,
    22  or it is otherwise ordered by the court having jurisdiction over
    23  his criminal status. Upon discharge from treatment, a person who
    24  is or remains subject to a detainer or sentence shall be
    25  returned to the authority entitled to have him in custody. The
    26  period of involuntary treatment shall be credited as time served
    27  on account of any sentence to be imposed on pending charges or
    28  any unexpired term of imprisonment.
    29     (c)  Persons Subject to the Juvenile Act. As to any person
    30  who is subject to a petition or who has been committed under the
    19750S1025B1701                 - 25 -

     1  Juvenile Act, the civil provisions of this act applicable to
     2  children of his age shall apply to all proceedings for his
     3  examination and treatment. If such a person is in detention or
     4  is committed, the court having jurisdiction under the Juvenile
     5  Act shall determine whether such security conditions shall
     6  continue to be enforced during any period of involuntary
     7  treatment and to whom the person should be released thereafter.
     8     Section 402.  Incompetence to Proceed on Criminal Charges and
     9  Lack of Criminal Responsibility as Defense.--(a) Definition of
    10  Incompetency. Whenever a person who has been charged with a
    11  crime is found to be substantially unable to understand the
    12  nature or object of the proceedings against him or to
    13  participate and assist in his defense, he shall be deemed
    14  incompetent to be tried, convicted or sentenced so long as such
    15  incapacity continues.
    16     (b)  Application for Incompetency Examination. Application to
    17  the court for an order directing an incompetency examination may
    18  be presented by an attorney for the Commonwealth, a person
    19  charged with a crime, his counsel, or the warden or other
    20  official in charge of the institution or place in which he is
    21  detained. A person charged with crime shall be represented
    22  either by counsel of his selection or by court-appointed
    23  counsel.
    24     (c)  Hearing; When Required. The court, either on application
    25  or on its own motion, may order an incompetency examination at
    26  any stage in the proceedings and may do so without a hearing
    27  unless the examination is objected to by the person charged with
    28  a crime or by his counsel. In such event, an examination shall
    29  be ordered only after determination upon a hearing that there is
    30  a prima facie question of incompetency.
    19750S1025B1701                 - 26 -

     1     (d)  Conduct of Examination; Report. When ordered by the
     2  court, an incompetency examination shall take place under the
     3  following conditions:
     4     (1)  It shall be conducted as an outpatient examination
     5  unless an inpatient examination is, or has been, authorized
     6  under another provision of this act.
     7     (2)  It shall be conducted by at least one psychiatrist and
     8  shall relate both to competency to proceed and to criminal
     9  responsibility for the crime charged.
    10     (3)  The person shall be entitled to have counsel present
    11  with him and shall not be required to answer any questions or to
    12  perform tests unless he has moved for or agreed to the
    13  examination. Nothing said or done by such person during the
    14  examination may be used as evidence against him in any criminal
    15  proceedings on any issue other than that of his mental
    16  condition.
    17     (4)  A report shall be submitted to the court and to counsel
    18  and shall contain a description of the examination, which shall
    19  include:
    20             (i)  diagnosis of the person's mental condition;
    21             (ii)  an opinion as to his capacity to understand the
    22         nature and object of the criminal proceedings against him
    23         and to assist in his defense;
    24             (iii)  an opinion as to his mental condition in
    25         relation to the standards for criminal responsibility as
    26         then provided by law if it appears that the facts
    27         concerning his mental condition may also be relevant to
    28         the question of legal responsibility; and
    29             (iv)  when so requested, an opinion as to whether he
    30         had the capacity to have a particular state of mind,
    19750S1025B1701                 - 27 -

     1         where such state of mind is a required element of the
     2         criminal charge.
     3     (e)  Defendant's Expert. The court may allow a psychiatrist
     4  retained by the defendant to witness and participate in the
     5  examination. Whenever a defendant who is financially unable to
     6  retain such expert has a substantial objection to the
     7  conclusions reached by the court-appointed psychiatrist, the
     8  court shall allow reasonable compensation for the employment of
     9  a psychiatrist of his selection, which amount shall be
    10  chargeable against the mental health and mental retardation
    11  program of the locality.
    12     (f)  Time Limit on Determination. The determination of the
    13  competency of a person who is detained under a criminal charge
    14  shall be rendered by the court within 20 days after the receipt
    15  of the report of examination unless the hearing was continued at
    16  the person's request.
    17     Section 403.  Hearing and Determination of Incompetency to
    18  Proceed; Stay of Proceedings; Dismissal of Charges.--(a)
    19  Competency Determination and Burden of Proof. The moving party
    20  shall have the burden of establishing incompetency to proceed by
    21  clear and convincing evidence. The determination shall be made
    22  by the court.
    23     (b)  Effect as Stay - Exception. A determination of
    24  incompetency to proceed shall effect a stay of the prosecution
    25  for so long as such incapacity persists, excepting that any
    26  legal objections suitable for determination prior to trial and
    27  without the personal participation of the person charged may be
    28  raised and decided in the interim.
    29     (c)  Defendant's Right to Counsel; Reexamination. A person
    30  who is determined to be incompetent to proceed shall have a
    19750S1025B1701                 - 28 -

     1  continuing right to counsel so long as the criminal charges are
     2  pending. Following such determination, the person charged shall
     3  be reexamined not less than every 60 days by a psychiatrist
     4  appointed by the court and a report of reexamination shall be
     5  submitted to the court and to counsel.
     6     (d)  Effect on Criminal Detention. Whenever a person who has
     7  been charged with a crime has been determined to be incompetent
     8  to proceed, he shall not for that reason alone be denied
     9  pretrial release. Nor shall he in any event be detained on the
    10  criminal charge longer than the reasonable period of time
    11  necessary to determine whether there is a substantial
    12  probability that he will attain that capacity in the foreseeable
    13  future. If the court determines there is no such probability, it
    14  shall discharge the person. Otherwise, he may continue to be
    15  criminally detained so long as such probability exists but in no
    16  event longer than the period of time specified in subsection
    17  403(f).
    18     (e)  Resumption of Proceedings or Dismissal. When the court,
    19  on its own motion or upon the application of the attorney for
    20  the Commonwealth or counsel for the defendant, determines that
    21  such person has regained his competence to proceed, the
    22  proceedings shall be resumed. If the court is of the opinion
    23  that by reason of the passage of time and its effect upon the
    24  criminal proceedings it would be unjust to resume the
    25  prosecution, the court may dismiss the charge and order the
    26  person discharged.
    27     (f)  Stay of Proceedings. In no instance shall the
    28  proceedings be stayed for a period in excess of the maximum
    29  sentence that may be imposed for the crime or crimes charged, or
    30  five years, whichever is less.
    19750S1025B1701                 - 29 -

     1     Section 404.  Hearing and Determination of Criminal
     2  Responsibility; Bifurcated Trial.--(a)  Criminal Responsibility
     3  Determination by Court. At a hearing under section 403 of this
     4  act the court may, in its discretion, also hear evidence on
     5  whether the person was criminally responsible for the commission
     6  of the crime charged. It shall do so in accordance with the
     7  rules governing the consideration and determination of the same
     8  issue at criminal trial. If the person is found to have lacked
     9  criminal responsibility, an acquittal shall be entered. If the
    10  person is not so acquitted, he may raise the defense at such
    11  time as he may be tried.
    12     (b)  Opinion Evidence on Mental Condition. At a hearing under
    13  section 403 or upon trial, a psychiatrist appointed  by the
    14  court may be called as a witness by the attorney for the
    15  Commonwealth or by the defendant and each party may also summon
    16  any other psychiatrist or other expert to testify.
    17     (c)  Bifurcation of Issues or Trial. Upon trial, the court,
    18  in the interest of justice, may direct that the issue of
    19  criminal responsibility be heard and determined separately from
    20  the other issues in the case and, in a trial by jury, that the
    21  issue of criminal responsibility be submitted to a separate
    22  jury. Upon a request for bifurcation, the court shall consider
    23  the substantiality of the defense of lack of responsibility and
    24  its effect upon other defenses, and the probability of a fair
    25  trial.
    26     Section 405.  Examination of Person Charged with Crime as Aid
    27  in Sentencing.--Examination Before Imposition of Sentence.
    28  Whenever a person who has been criminally charged is to be
    29  sentenced, the court may defer sentence and order him to be
    30  examined for mental illness to aid it in the determination of
    19750S1025B1701                 - 30 -

     1  disposition. This action may be taken on the court's initiative
     2  or on the application of the attorney for the Commonwealth, the
     3  person charged, his counsel, or any other person acting in his
     4  interest. If at the time of sentencing the person is not in
     5  detention, examination shall be on an outpatient basis unless
     6  inpatient examination for this purpose is ordered pursuant to
     7  the civil commitment provisions of Article III.
     8     Section 406.  Civil Procedure for Court-ordered Involuntary
     9  Treatment Following a Determination of Incompetency, or
    10  Acquittal by Reason of Lack of Criminal Responsibility or in
    11  Conjunction with Sentencing.--Upon a finding of incompetency to
    12  stand trial under section 403, after an acquittal by reason of
    13  lack of responsibility under section 404, or following an
    14  examination in aid of sentencing under section 405, the attorney
    15  for the Commonwealth, on his own or acting at the direction of
    16  the court, the defendant, his counsel, the county administrator,
    17  or any other interested party may petition the same court for an
    18  order directing involuntary treatment under section 304.
    19                             ARTICLE V
    20                   Effective Date, Applicability,
    21                      Repeals and Severability
    22     Section 501.  Effective Date and Applicability.--This act
    23  shall take effect 60 days after its enactment and shall
    24  thereupon apply immediately to all persons receiving voluntary
    25  treatment. As to all persons who were made subject to
    26  involuntary treatment prior to the effective date, it shall
    27  become applicable 180 days thereafter.
    28     Section 502.  Repeals.--(A) The definition of "mental          <--
    29  disability" in section 102, and sections 401, 402, 403, 404,
    30  405, 406, 407, 408, 409, 410, 411, 412, 413, 416, 418, 419, and   <--
    19750S1025B1701                 - 31 -

     1  420 420 AND 426, act of October 20, 1966 (3rd Sp.Sess., P.L.96,   <--
     2  No.6), known as the "Mental Health and Mental Retardation Act of
     3  1966," are hereby repealed, except in so far as they relate to
     4  mental retardation or to persons who are mentally retarded.
     5     (B)  ALL ACTS AND PARTS OF ACTS ARE REPEALED IN SO FAR AS      <--
     6  THEY ARE INCONSISTENT HEREWITH.
     7     Section 503.  Severability.--If any provision of this act
     8  including, but not limited to, any provision relating to
     9  children or the application thereof including but not limited to
    10  an application thereof to a child is held invalid, such
    11  invalidity shall not affect other provisions or applications of
    12  the act which can be given effect without the invalid provisions
    13  or application and to this end the provisions of this act are
    14  declared severable.











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