PRIOR PRINTER'S NOS. 961, 3739 PRINTER'S NO. 3908
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,
HARPER AND HERMAN, MARCH 11, 2003
AS RE-REPORTED FROM COMMITTEE ON APPROPRIATIONS, HOUSE OF
REPRESENTATIVES, AS AMENDED, MAY 24, 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; AND REQUIRING A REPORT BY THE <--
7 LEGISLATIVE BUDGET AND FINANCE COMMITTEE.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. The act of February 13, 1970 (P.L.19, No.10),
11 entitled "An act enabling certain minors to consent to medical,
12 dental and health services, declaring consent unnecessary under
13 certain circumstances," is amended by adding sections to read:
14 Section 1.1. Mental Health Treatment.--(a) The following
15 shall apply to consent for outpatient treatment:
16 (1) Any minor who is fourteen years of age or older may
17 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 EXAMINING PHYSICIAN SHALL BE APPROPRIATELY <--
19 CREDENTIALED AT THE ADMITTING FACILITY OR SHALL CONSULT WITH A
20 PHYSICIAN WHO IS APPROPRIATELY CREDENTIALED AT THE ADMITTING
21 FACILITY. The minor's consent shall not be necessary.
22 (2) Nothing in this section shall be construed as
23 restricting or altering a minor's existing rights, including,
24 but not limited to, those enumerated under the "Mental Health
25 Procedures Act" to consent to voluntary inpatient mental health
26 treatment on his or her own behalf at fourteen years of age or
27 older.
28 (3) Nothing in this section shall be construed as
29 restricting or altering a parent or legal guardian's existing
30 rights to object to a minor's voluntary treatment provided
20030H0826B3908 - 2 -
1 pursuant to the minor's consent on his or her own behalf.
2 (4) A minor may not abrogate consent provided by a parent or
3 legal guardian on the minor's behalf, nor may a parent or legal
4 guardian abrogate consent given by the minor on his or her own
5 behalf.
6 (5) A parent or legal guardian who has provided consent to
7 inpatient treatment under paragraph (1) may revoke that consent.
8 The revocation shall be effective unless the minor is fourteen
9 to eighteen years of age and consents to continued inpatient
10 treatment.
11 (6) A minor fourteen to eighteen years of age who has
12 provided consent to inpatient treatment may revoke that consent.
13 The revocation shall be effective unless the minor's parent or
14 legal guardian has provided consent for continued inpatient
15 treatment under paragraph (1).
16 (7) At the time of admission, the director of the admitting
17 facility or his designee shall provide the minor with an
18 explanation of the nature of the mental health treatment in
19 which he may be involved together with a statement of his
20 rights, including the right to object to treatment by filing a
21 petition with the court. If the minor wishes to exercise this
22 right, the director of the facility or his designee shall
23 provide a form for the minor to provide notice of the request
24 for modification or withdrawal from treatment. The director of
25 the facility or his designee shall file the signed petition with
26 the court AS SOON AS POSSIBLE BUT NO LATER THAN THE END OF THE <--
27 NEXT BUSINESS DAY.
28 (8) Any minor fourteen years of age or older and under
29 eighteen years of age who has been confined for inpatient
30 treatment on the consent of a parent or legal guardian and who
20030H0826B3908 - 3 -
1 objects to continued inpatient treatment may file a petition in
2 the court of common pleas requesting a withdrawal from or
3 modification of treatment. The court shall promptly appoint an
4 attorney for such minor person and schedule a hearing to be held
5 within seventy-two hours following the filing of the petition,
6 unless continued upon the request of the attorney for the minor
7 OR BY A JUDGE FOR COMPELLING REASONS. THE HEARING SHALL BE <--
8 CONDUCTED by a judge or mental health review officer who shall
9 determine whether or not the voluntary mental health treatment
10 is in the best interest of the minor. For inpatient treatment to
11 continue against the minor's wishes, the court must find all of
12 the following by clear and convincing evidence:
13 (i) that the minor has a diagnosed mental disorder;
14 (ii) that the disorder is treatable;
15 (iii) that the disorder can be treated in the particular
16 facility where the treatment is taking place; and
17 (iv) that the proposed inpatient treatment setting
18 represents the least restrictive alternative that is medically
19 appropriate.
20 (9) A minor ordered to undergo treatment due to a
21 determination under paragraph (8) shall remain and receive
22 inpatient treatment at the treatment setting designated by the
23 court for a period not more than twenty days. The minor shall be
24 discharged whenever the attending physician determines that the
25 minor no longer is in need of treatment, consent to treatment
26 has been revoked under paragraph (5), or at the end of the time
27 period of the order, whichever occurs first. If the attending
28 physician determines that continued inpatient treatment will be
29 necessary at the end of the time period of the order and the
30 minor does not consent to continued inpatient treatment, the
20030H0826B3908 - 4 -
1 court shall, prior to the end of the time period of the order,
2 conduct a review hearing in accordance with this subsection to
3 determine whether to:
4 (i) release the minor; or
5 (ii) make a subsequent order for inpatient mental health
6 treatment for a period not to exceed sixty days subject to
7 discharge of the minor whenever the attending physician
8 determines that the minor no longer is in need of treatment or
9 if consent to treatment has been revoked under paragraph (5).
10 (10) The procedure for a sixty-day period of treatment under
11 paragraph (9)(ii) shall be repeated until the court determines
12 to release the minor or the minor is discharged in accordance
13 with paragraph (9).
14 (c) Nothing in subsections (a) and (b) is intended to
15 restrict the rights of a minor who satisfies the conditions of
16 section 1 to consent to mental health treatment nor to enlarge
17 the rights of parents to consent to mental health treatment for
18 such minors.
19 (d) As used in this section, the following words and phrases
20 shall have the meanings given to them in this subsection:
21 "Court of common pleas" means the court of common pleas in
22 the county where the subject of the proceeding is being treated.
23 "Facility" means any mental health establishment, hospital,
24 clinic, institution, center, day-care center, base service unit,
25 community mental health center, or part thereof, that provides
26 for the diagnosis, treatment, care or rehabilitation of mentally
27 ill persons.
28 "Inpatient treatment" means all mental health treatment that
29 requires full-time or part-time residence in a facility that
30 provides mental health treatment.
20030H0826B3908 - 5 -
1 "Mental health treatment" means a course of treatment,
2 including evaluation, diagnosis, therapy and rehabilitation,
3 designed and administered to alleviate an individual's pain and
4 distress and to maximize the probability of recovery from mental
5 illness. The term also includes care and other services which
6 supplement treatment and aid or promote recovery.
7 Section 1.2. Release of Medical Records.--(a) When a parent
8 or legal guardian has consented to treatment of a minor fourteen
9 years of age or older under section 1.1(a)(2) or (b)(1), the
10 following shall apply to release of the minor's medical records
11 and information:
12 (1) The parent or legal guardian may consent to release of
13 the minor's medical records and information, including, but not
14 limited to, records of prior mental health treatment, to the
15 minor's mental health treatment providers. If deemed pertinent
16 by the minor's mental health treatment providers, the release
17 may also include records of prior mental health treatment for
18 which the minor had provided consent to treatment. Release of
19 mental health records and information shall be limited to
20 release directly from one provider of treatment to another.
21 (2) The parent or legal guardian may consent to release of
22 the minor's mental health records and information to the primary
23 care provider, and those records shall be provided if, in the
24 judgment of the minor's mental health treatment provider, the
25 transfer would not be detrimental to the minor. Release of
26 mental health records and information shall be limited to
27 release directly from the provider of mental health treatment or
28 the facility to the primary care provider.
29 (3) The parent or legal guardian shall have the right to
30 information necessary for providing consent to the minor's
20030H0826B3908 - 6 -
1 mental health treatment, including, but not limited to, the
2 symptoms and conditions to be treated, medications and other
3 treatments to be provided, risks, benefits and expected results.
4 (4) Except to the extent set forth above, the minor shall
5 control the release of the minor's mental health records and
6 information to the extent allowed by law.
7 (b) Consent to release of mental health records for all
8 purposes and in all circumstances other than those provided for
9 in subsection (a) shall be subject to the provisions of the act
10 of July 9, 1976 (P.L.817, No.143), known as the "Mental Health
11 Procedures Act," and other applicable Federal and State statutes
12 and regulations. Subject to the provisions of subsection (a)(1),
13 when a minor has provided consent to outpatient mental health
14 treatment under section 1.1(a)(1), the minor shall control the
15 records of treatment to the same extent as the minor would
16 control records of inpatient care or involuntary outpatient care
17 under the "Mental Health Procedures Act" and its regulations.
18 Section 1.3. Court Reporting.--(a) Each court of common
19 pleas shall report annually to the Administrative Office of
20 Pennsylvania Courts the number of:
21 (1) Petitions filed under section 1.1(b)(7).
22 (2) Petitions resulting in minors ordered to undergo
23 treatment.
24 (3) Subsequent treatment period ordered per minor.
25 (b) The Administrative Office of Pennsylvania Courts shall
26 compile the figures reported under this section and report its
27 findings, within sixty days of the receipt of the last report,
28 to the JUDICIARY COMMITTEE AND THE Public Health and Welfare <--
29 Committee of the Senate and the JUDICIARY COMMITTEE AND THE <--
30 Health and Human Services Committee of the House of
20030H0826B3908 - 7 -
1 Representatives.
2 (c) This section shall expire March 1, 2005.
3 SECTION 2. WITHIN TWELVE MONTHS FOLLOWING THE EFFECTIVE DATE <--
4 OF THIS ACT, THE LEGISLATIVE BUDGET AND FINANCE COMMITTEE SHALL
5 PREPARE A REPORT ON THE MENTAL HEALTH SYSTEM FOR CHILDREN AND
6 YOUTH IN THIS COMMONWEALTH. THE REPORT SHALL EVALUATE THE
7 CONTINUUM OF MENTAL HEALTH SERVICES FOR CHILDREN AND THEIR
8 FAMILIES AND INCLUDE A REVIEW OF THE AVAILABILITY OF COMMUNITY-
9 BASED OUTPATIENT AND INPATIENT MENTAL HEALTH SERVICES ACROSS
10 THIS COMMONWEALTH; STATISTICAL INFORMATION ON THE NUMBER OF
11 CHILDREN NEEDING MENTAL HEALTH SERVICES; THE TIMELINESS AND
12 EXTENT OF SERVICES; COSTS FOR VARIOUS TYPES OF MENTAL HEALTH
13 SERVICES FOR CHILDREN AND YOUTH; THE EXTENT TO WHICH PUBLIC AND
14 PRIVATE HEALTH INSURANCE, INCLUDING MEDICAL ASSISTANCE, PROVIDES
15 COVERAGE FOR DIFFERENT MENTAL HEALTH TREATMENT AND SERVICES;
16 GAPS IN MENTAL HEALTH SERVICES FOR CHILDREN AND YOUTH; AND THE
17 IMPACT AND EFFECTIVENESS OF THIS ACT IN RESPECT TO PROVIDING
18 MENTAL HEALTH TREATMENT FOR CHILDREN AND YOUTH. THE LEGISLATIVE
19 BUDGET AND FINANCE COMMITTEE SHALL REPORT ITS FINDINGS AND
20 RECOMMENDATIONS TO THE JUDICIARY COMMITTEE AND THE PUBLIC HEALTH
21 AND WELFARE COMMITTEE OF THE SENATE AND THE JUDICIARY COMMITTEE
22 AND THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE HOUSE OF
23 REPRESENTATIVES.
24 Section 2 3. This act shall take effect in 60 days. <--
B14L35MSP/20030H0826B3908 - 8 -