PRIOR PRINTER'S NO. 961 PRINTER'S NO. 3739
No. 826 Session of 2003
INTRODUCED BY MAITLAND, MACKERETH, VANCE, TRUE, BAKER, BARRAR,
BROWNE, CAPPELLI, CAWLEY, CRAHALLA, DeLUCA, DeWEESE, EGOLF,
FAIRCHILD, FLEAGLE, GRUCELA, HARHAI, HORSEY, KELLER,
LAUGHLIN, LEDERER, LEH, MANN, McILHATTAN, McNAUGHTON,
R. MILLER, S. MILLER, PRESTON, ROEBUCK, SATHER, SAYLOR,
SCHRODER, SCRIMENTI, B. SMITH, SURRA, J. TAYLOR, THOMAS,
TIGUE, WATSON, WEBER, E. Z. TAYLOR, O'NEILL, JAMES, PAYNE AND
HARPER, MARCH 11, 2003
AS REPORTED FROM COMMITTEE ON JUDICIARY, HOUSE OF
REPRESENTATIVES, AS AMENDED, APRIL 13, 2004
AN ACT
1 Amending the act of February 13, 1970 (P.L.19, No.10), entitled
2 "An act enabling certain minors to consent to medical, dental
3 and health services, declaring consent unnecessary under
4 certain circumstances," further providing for consent to
5 treatment; AND PROVIDING FOR RELEASE OF MEDICAL RECORDS AND <--
6 FOR CERTAIN COURT REPORTING.
7 The General Assembly of the Commonwealth of Pennsylvania
8 hereby enacts as follows:
9 Section 1. The act of February 13, 1970 (P.L.19, No.10),
10 entitled "An act enabling certain minors to consent to medical,
11 dental and health services, declaring consent unnecessary under
12 certain circumstances," is amended by adding sections to read:
13 Section 1.1. Mental Health Treatment.--(a) The following
14 shall apply to consent for outpatient treatment:
15 (1) Any minor who is fourteen years of age or older may
16 consent on his or her own behalf to outpatient mental health
1 examination and treatment, and the minor's parent or legal
2 guardian's consent shall not be necessary.
3 (2) A parent or legal guardian of a minor less than eighteen
4 years of age may consent to voluntary outpatient mental health
5 examination or treatment on behalf of the minor, and the minor's
6 consent shall not be necessary.
7 (3) A minor may not abrogate consent provided by a parent or
8 legal guardian on the minor's behalf, nor may a parent or legal
9 guardian abrogate consent given by the minor on his or her own
10 behalf.
11 (b) The following shall apply to consent for inpatient
12 treatment:
13 (1) A minor's parent or legal guardian may consent to
14 voluntary inpatient treatment, pursuant to Article II of the act
15 of July 9, 1976 (P.L.817, No.143), known as the "Mental Health
16 Procedures Act," on behalf of a minor less than eighteen years
17 of age on the recommendation of a physician who has examined the
18 minor. The minor's consent shall not be necessary.
19 (2) Nothing in this section shall be construed as
20 restricting or altering a minor's existing rights, including,
21 but not limited to, those enumerated under the "Mental Health
22 Procedures Act" to consent to voluntary inpatient mental health
23 treatment on his or her own behalf at fourteen years of age or
24 older.
25 (3) Nothing in this section shall be construed as
26 restricting or altering a parent or legal guardian's existing
27 rights to object to a minor's voluntary treatment provided
28 pursuant to the minor's consent on his or her own behalf.
29 (4) A minor may not abrogate consent provided by a parent or
30 legal guardian on the minor's behalf, nor may a parent or legal
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1 guardian abrogate consent given by the minor on his or her own
2 behalf.
3 (5) A PARENT OR LEGAL GUARDIAN WHO HAS PROVIDED CONSENT TO <--
4 INPATIENT TREATMENT UNDER PARAGRAPH (1) MAY REVOKE THAT CONSENT.
5 THE REVOCATION SHALL BE EFFECTIVE UNLESS THE MINOR IS FOURTEEN
6 TO EIGHTEEN YEARS OF AGE AND CONSENTS TO CONTINUED INPATIENT
7 TREATMENT.
8 (6) A MINOR FOURTEEN TO EIGHTEEN YEARS OF AGE WHO HAS
9 PROVIDED CONSENT TO INPATIENT TREATMENT MAY REVOKE THAT CONSENT.
10 THE REVOCATION SHALL BE EFFECTIVE UNLESS THE MINOR'S PARENT OR
11 LEGAL GUARDIAN HAS PROVIDED CONSENT FOR CONTINUED INPATIENT
12 TREATMENT UNDER PARAGRAPH (1).
13 (5) (7) At the time of admission, the director of the <--
14 admitting facility or his designee shall provide the minor with
15 an explanation of the nature of the mental health treatment in
16 which he may be involved together with a statement of his
17 rights, including the right to object to treatment by filing a
18 petition with the court. If the minor wishes to exercise this
19 right, the director of the facility or his designee shall
20 provide a form for the minor to provide notice of the request
21 for modification or withdrawal from treatment. The director of
22 the facility or his designee shall file the signed petition with
23 the court.
24 (6) (8) Any minor fourteen years of age or older and under <--
25 eighteen years of age who has been confined for inpatient
26 treatment on the consent of a parent or legal guardian and who
27 objects to continued inpatient treatment may file a petition in
28 the court of common pleas requesting a withdrawal from or
29 modification of treatment. The court shall promptly appoint an
30 attorney for such minor person and schedule a hearing to be held
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1 within seventy-two hours following the filing of the petition,
2 unless continued upon the request of the attorney for the minor,
3 by a judge or mental health review officer who shall determine
4 whether or not the voluntary mental health treatment is in the
5 best interest of the minor. For inpatient treatment to continue
6 against the minor's wishes, the court must find all of the
7 following by clear and convincing evidence:
8 (i) that the minor has a diagnosed mental disorder;
9 (ii) that the disorder is treatable;
10 (iii) that the disorder can be treated in the particular
11 facility where the treatment is taking place; and
12 (iv) that the treatment PROPOSED INPATIENT TREATMENT SETTING <--
13 represents the least restrictive alternative that is medically
14 appropriate.
15 (7) A minor ordered to undergo treatment due to a <--
16 determination under paragraph (6) shall remain under the
17 treatment designated by the court for a period of twenty days.
18 The minor shall be discharged whenever the director of the
19 facility determines that the minor no longer is in need of
20 treatment
21 (9) A MINOR ORDERED TO UNDERGO TREATMENT DUE TO A <--
22 DETERMINATION UNDER PARAGRAPH (8) SHALL REMAIN AND RECEIVE
23 INPATIENT TREATMENT AT THE TREATMENT SETTING DESIGNATED BY THE
24 COURT FOR A PERIOD NOT MORE THAN TWENTY DAYS. THE MINOR SHALL BE
25 DISCHARGED WHENEVER THE ATTENDING PHYSICIAN DETERMINES THAT THE
26 MINOR NO LONGER IS IN NEED OF TREATMENT, CONSENT TO TREATMENT
27 HAS BEEN REVOKED UNDER PARAGRAPH (5), or at the end of the time
28 period of the order, whichever occurs first. Prior to the end of <--
29 the time period of the order, the court shall conduct a review
30 hearing in WHICHEVER OCCURS FIRST. IF THE ATTENDING PHYSICIAN <--
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1 DETERMINES THAT CONTINUED INPATIENT TREATMENT WILL BE NECESSARY
2 AT THE END OF THE TIME PERIOD OF THE ORDER AND THE MINOR DOES
3 NOT CONSENT TO CONTINUED INPATIENT TREATMENT, THE COURT SHALL,
4 PRIOR TO THE END OF THE TIME PERIOD OF THE ORDER, CONDUCT A
5 REVIEW HEARING IN accordance with this subsection to determine
6 whether to:
7 (i) release the minor; or
8 (ii) make a subsequent order for inpatient mental health
9 treatment for a period not to exceed sixty days subject to
10 discharge of the minor whenever the director of the facility <--
11 ATTENDING PHYSICIAN determines that the minor no longer is in <--
12 need of treatment OR IF CONSENT TO TREATMENT HAS BEEN REVOKED <--
13 UNDER PARAGRAPH (5).
14 (8) (10) The procedure for a sixty-day period of treatment <--
15 under paragraph (7)(ii) (9)(II) shall be repeated until the <--
16 court determines to release the minor or the minor is discharged
17 in accordance with paragraph (7) (9). <--
18 (C) NOTHING IN SUBSECTIONS (A) AND (B) IS INTENDED TO <--
19 RESTRICT THE RIGHTS OF A MINOR WHO SATISFIES THE CONDITIONS OF
20 SECTION 1 TO CONSENT TO MENTAL HEALTH TREATMENT NOR TO ENLARGE
21 THE RIGHTS OF PARENTS TO CONSENT TO MENTAL HEALTH TREATMENT FOR
22 SUCH MINORS.
23 (c) Definitions.-- <--
24 (D) As used in this section, the following words and phrases <--
25 shall have the meanings given to them in this subsection:
26 "Court of common pleas" means the court of common pleas in
27 the county where the subject of the proceeding is being treated.
28 "Facility" means any mental health establishment, hospital,
29 clinic, institution, center, day-care center, base service unit,
30 community mental health center, or part thereof, that provides
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1 for the diagnosis, treatment, care or rehabilitation of mentally
2 ill persons.
3 "Inpatient treatment" means all mental health treatment that
4 requires full-time or part-time residence in a facility that
5 provides mental health treatment.
6 "Mental health treatment" means a course of treatment,
7 including evaluation, diagnosis, therapy and rehabilitation,
8 designed and administered to alleviate an individual's pain and
9 distress and to maximize the probability of recovery from mental
10 illness. The term also includes care and other services which
11 supplement treatment and aid or promote recovery.
12 Section 1.2. Release of Medical Records.--The individual <--
13 consenting to treatment of the minor may consent to the release
14 of the minor's medical records. (A) WHEN A PARENT OR LEGAL <--
15 GUARDIAN HAS CONSENTED TO TREATMENT OF A MINOR FOURTEEN YEARS OF
16 AGE OR OLDER UNDER SECTION 1.1(A)(2) OR (B)(1), THE FOLLOWING
17 SHALL APPLY TO RELEASE OF THE MINOR'S MEDICAL RECORDS AND
18 INFORMATION:
19 (1) THE PARENT OR LEGAL GUARDIAN MAY CONSENT TO RELEASE OF
20 THE MINOR'S MEDICAL RECORDS AND INFORMATION, INCLUDING, BUT NOT
21 LIMITED TO, RECORDS OF PRIOR MENTAL HEALTH TREATMENT, TO THE
22 MINOR'S MENTAL HEALTH TREATMENT PROVIDERS. IF DEEMED PERTINENT
23 BY THE MINOR'S MENTAL HEALTH TREATMENT PROVIDERS, THE RELEASE
24 MAY ALSO INCLUDE RECORDS OF PRIOR MENTAL HEALTH TREATMENT FOR
25 WHICH THE MINOR HAD PROVIDED CONSENT TO TREATMENT. RELEASE OF
26 MENTAL HEALTH RECORDS AND INFORMATION SHALL BE LIMITED TO
27 RELEASE DIRECTLY FROM ONE PROVIDER OF TREATMENT TO ANOTHER.
28 (2) THE PARENT OR LEGAL GUARDIAN MAY CONSENT TO RELEASE OF
29 THE MINOR'S MENTAL HEALTH RECORDS AND INFORMATION TO THE PRIMARY
30 CARE PROVIDER, AND THOSE RECORDS SHALL BE PROVIDED IF, IN THE
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1 JUDGMENT OF THE MINOR'S MENTAL HEALTH TREATMENT PROVIDER, THE
2 TRANSFER WOULD NOT BE DETRIMENTAL TO THE MINOR. RELEASE OF
3 MENTAL HEALTH RECORDS AND INFORMATION SHALL BE LIMITED TO
4 RELEASE DIRECTLY FROM THE PROVIDER OF MENTAL HEALTH TREATMENT OR
5 THE FACILITY TO THE PRIMARY CARE PROVIDER.
6 (3) THE PARENT OR LEGAL GUARDIAN SHALL HAVE THE RIGHT TO
7 INFORMATION NECESSARY FOR PROVIDING CONSENT TO THE MINOR'S
8 MENTAL HEALTH TREATMENT, INCLUDING, BUT NOT LIMITED TO, THE
9 SYMPTOMS AND CONDITIONS TO BE TREATED, MEDICATIONS AND OTHER
10 TREATMENTS TO BE PROVIDED, RISKS, BENEFITS AND EXPECTED RESULTS.
11 (4) EXCEPT TO THE EXTENT SET FORTH ABOVE, THE MINOR SHALL
12 CONTROL THE RELEASE OF THE MINOR'S MENTAL HEALTH RECORDS AND
13 INFORMATION TO THE EXTENT ALLOWED BY LAW.
14 (B) CONSENT TO RELEASE OF MENTAL HEALTH RECORDS FOR ALL
15 PURPOSES AND IN ALL CIRCUMSTANCES OTHER THAN THOSE PROVIDED FOR
16 IN SUBSECTION (A) SHALL BE SUBJECT TO THE PROVISIONS OF THE ACT
17 OF JULY 9, 1976 (P.L.817, NO.143), KNOWN AS THE "MENTAL HEALTH
18 PROCEDURES ACT," AND OTHER APPLICABLE FEDERAL AND STATE STATUTES
19 AND REGULATIONS. SUBJECT TO THE PROVISIONS OF SUBSECTION (A)(1),
20 WHEN A MINOR HAS PROVIDED CONSENT TO OUTPATIENT MENTAL HEALTH
21 TREATMENT UNDER SECTION 1.1(A)(1), THE MINOR SHALL CONTROL THE
22 RECORDS OF TREATMENT TO THE SAME EXTENT AS THE MINOR WOULD
23 CONTROL RECORDS OF INPATIENT CARE OR INVOLUNTARY OUTPATIENT CARE
24 UNDER THE "MENTAL HEALTH PROCEDURES ACT" AND ITS REGULATIONS.
25 Section 1.3. Court Reporting.--(a) Each court of common
26 pleas shall report annually to the Administrative Office of
27 Pennsylvania Courts the number of:
28 (1) Petitions filed under section 1.1(b)(5) 1.1(B)(7). <--
29 (2) Petitions resulting in minors ordered to undergo
30 treatment.
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1 (3) Subsequent treatment period ordered per minor.
2 (b) The Administrative Office of Pennsylvania Courts shall
3 compile the figures reported under this section and report its
4 findings, within sixty days of the receipt of the last report,
5 to the Public Health and Welfare Committee of the Senate and the
6 Health and Human Services Committee of the House of
7 Representatives.
8 (c) This section shall expire March 1, 2005.
9 Section 2. This act shall take effect in 60 days.
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