PRINTER'S NO. 844
No. 767 Session of 1991
INTRODUCED BY CORNELL, GODSHALL, SCHULER, CORRIGAN, TRELLO,
JAROLIN, STABACK, HALUSKA, NAHILL, GIGLIOTTI, ADOLPH,
E. Z. TAYLOR, ITKIN AND FOX, MARCH 13, 1991
REFERRED TO COMMITTEE ON AGING AND YOUTH, MARCH 13, 1991
AN ACT
1 Providing for residential treatment services for mentally ill
2 children and youth.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Mentally Ill
7 Children and Youth Residential Treatment Services Act.
8 Section 2. Statement of policy.
9 It is the policy of this Commonwealth to seek to assure the
10 provision of residential treatment services for mentally ill
11 children and youth who no longer require acute care in a
12 psychiatric hospital or care in State-operated mental hospitals
13 or units.
14 Section 3. Definitions.
15 The following words and phrases when used in this act shall
16 have the meanings given to them in this section unless the
17 context clearly indicates otherwise:
1 "Department." The Department of Public Welfare of the
2 Commonwealth.
3 "Residential treatment facility for mentally ill children and
4 youth." An inpatient psychiatric facility which provides active
5 treatment under the direction of a physician for individuals who
6 are under 21 years of age. A person who, during the course of
7 treatment, attains 21 years of age may continue to receive
8 services in a residential treatment facility for mentally ill
9 children and youth until that person reaches 22 years of age.
10 "Secretary." The Secretary of Public Welfare of the
11 Commonwealth.
12 Section 4. Residential treatment facilities for mentally ill
13 children and youth; establishment and operation.
14 (a) Authorization.--The department shall authorize the
15 operation of residential treatment facilities for mentally ill
16 children and youth. Authorized residential treatment facilities
17 may be operated only by nonprofit organizations.
18 (b) Licensing.--The department shall establish standards and
19 licensing requirements for residential treatment facilities for
20 children and youth and shall be responsible for:
21 (1) Visitation, inspection and supervision of the
22 facilities.
23 (2) Enforcement of the conditions for licensing the
24 facilities by the department.
25 (3) Protection of the confidentiality of clinical
26 information regarding patients at the residential treatment
27 facilities.
28 (c) Facility information.--Operators of facilities licensed
29 by the department shall provide to the department such
30 financial, statistical and program information as the department
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1 may determine to be necessary. The department shall have the
2 power to conduct onsite audits of books and records of the
3 facilities.
4 (d) Administration.--The Office of Mental Health within the
5 department shall have primary responsibility for the
6 administration of the provisions of this act, in consultation
7 with the Office of Children, Youth and Families of the
8 Department of Public Welfare and the Department of Education.
9 Section 5. Preadmission certification committees.
10 (a) General rule.--All applications for voluntary or
11 involuntary admission of patients to residential treatment
12 facilities for children and youth or for transfer of patients to
13 those facilities shall be reviewed by the preadmission
14 certification committee serving the facility in accordance with
15 this section. Any interested party may apply to the preadmission
16 certification committee for admission to a residential treatment
17 facility for mentally ill children and youth.
18 (b) Designation of preadmission certification committees.--
19 The department shall designate preadmission certification
20 committees for defined geographic areas to evaluate each person
21 proposed for admission or transfer to a residential treatment
22 facility for children and youth. When designating persons to
23 serve on preadmission certification committees, the department
24 shall assure that the interests of the people residing in the
25 area to be served by each preadmission certification committee
26 are represented. Each preadmission certification committee shall
27 include a person designated by the Office of Mental Health, a
28 person designated by the Office of Children, Youth and Families,
29 and a person designated by the Secretary of Education. The
30 department shall consult with county mental health/mental
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1 retardation administrators and shall consult with county
2 children and youth administrators in the area to be served by a
3 preadmission certification committee prior to designating
4 persons to serve on a preadmission certification committee.
5 Membership of preadmission certification committees shall be
6 limited to persons who are licensed to practice medicine,
7 nursing or psychology or who have graduate degrees in social
8 welfare. In the event the persons originally designated to a
9 preadmission certification committee do not include a physician,
10 the department shall designate a physician to serve as an
11 additional member of the preadmission certification committee.
12 (c) Applications for admission.--Applications for admission
13 shall include an assessment of the individual's psychiatric,
14 medical and social needs prepared in accordance with a uniform
15 assessment method specified by the regulations of the
16 department. The preadmission certification committee may, in its
17 discretion, refer an applicant to a hospital or other
18 appropriate facility for an additional assessment. In the event
19 of an additional assessment of the individual's needs, the
20 facility conducting the assessment shall attempt to receive all
21 third-party insurance or Federal reimbursement available as
22 payment for the assessment. The Commonwealth shall pay the
23 balance of the fees which may be charged by the provider in
24 accordance with applicable provisions of the act of October 20,
25 1966 (3rd Sp.Sess., P.L.96, No.6), known as the Mental Health
26 and Mental Retardation Act of 1966. In addition, if necessary,
27 the preadmission certification committee shall obtain an
28 evaluation of the educational needs of the child from the school
29 district of residence.
30 (d) Review period.--The preadmission certification committee
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1 shall review all requests for evaluation and certification
2 within 30 days of receipt of a complete application and any
3 additional assessments it may require. Using a uniform
4 assessment method specified by regulation of the department, the
5 preadmission certification committee shall evaluate the
6 psychiatric, medical and social needs of the applicant and shall
7 certify each of the following:
8 (1) The individual's need for services in a residential
9 treatment facility for mentally ill children and youth.
10 (2) The immediacy of that need, giving consideration to
11 the availability of such services in the area and the needs
12 of other children who have been evaluated by the preadmission
13 certification committee and certified as eligible for
14 admission to a residential treatment facility for mentally
15 ill children and youth and who have not yet been admitted to
16 such a facility.
17 (e) Essential findings.--A preadmission certification
18 committee shall not certify an individual for admission unless
19 it finds that:
20 (1) Available ambulatory care resources and other
21 residential placements do not meet the treatment needs of the
22 individual.
23 (2) Proper treatment of the individual's psychiatric
24 condition requires inpatient care and treatment under the
25 direction of a physician.
26 (3) Care and treatment in a residential treatment
27 facility for mentally ill children and youth can reasonably
28 be expected to improve the individual's condition or prevent
29 further regression so that services will no longer be needed,
30 provided that a poor prognosis shall not in itself constitute
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1 grounds for a denial of certification if treatment can be
2 expected to effect a change in prognosis.
3 (4) Sufficient funds are available to pay for the
4 services.
5 (f) Determinations to be unanimous.--All decisions of the
6 preadmission certification committee to recommend admission or
7 priority of admission shall be based on the unanimous vote of
8 those present. The decision of the preadmission certification
9 committee shall be reported to the applicant. In the event a
10 preadmission certification committee evaluates a child who is
11 the subject of a proceeding currently pending in juvenile court,
12 the preadmission certification committee shall report its
13 decision to the court.
14 (g) Review of clinical records.--Notwithstanding any other
15 provision of law, preadmission certification committees shall be
16 entitled to review clinical records maintained by any person or
17 entity which pertain to an individual on whose behalf an
18 application is made for admission to a residential treatment
19 facility for children and youth. Any clinical record received by
20 a preadmission certification committee and all assessments
21 submitted to the preadmission certification committee shall be
22 kept confidential.
23 (h) Supplemental Security Income determination.--The
24 preadmission certification committee shall have the authority
25 and responsibility for making determinations of eligibility for
26 Supplemental Security Income for applicants for admission to
27 residential treatment facilities in accordance with the
28 provisions of a cooperative agreement between the Department of
29 Public Welfare and the Department of Labor and Industry
30 delegating such authority to the preadmission certification
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1 committees, consistent with applicable Federal and State law and
2 regulation.
3 Section 6. Admissions.
4 (a) General rule.--Subject to the requirements of section 5,
5 the director of any residential treatment facility shall receive
6 for care and treatment:
7 (1) Any suitable person in need of care and treatment,
8 whether admitted voluntarily or involuntarily, as provided
9 for under Article II or III of the act of July 9, 1976
10 (P.L.817, No.143), known as the Mental Health Procedures Act.
11 (2) Any person who has been certified as needing care
12 and treatment by the preadmission certification committee
13 serving the facility, in accordance with priorities for
14 admission established by the preadmission certification
15 committee.
16 (b) Restriction.--No residential treatment facility for
17 children and youth shall admit a person who has not been
18 certified as suitable for admission by the appropriate
19 preadmission certification committee. Residential treatment
20 facilities shall admit children in accordance with priorities
21 for admission of children most immediately in need of those
22 services established by the preadmission certification committee
23 serving the facility, in accordance with standards established
24 by the department.
25 Section 7. Discharge.
26 (a) General rule.--Whenever the commissioner or the director
27 of a residential treatment facility for mentally ill children
28 and youth finds that care and treatment of a child is no longer
29 suitable in a residential treatment facility for mentally ill
30 children and youth, he shall certify and discharge the child to
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1 the custody of the child himself, his parents, his legal
2 guardian, his county children and youth agency, or juvenile
3 court, as appropriate, except that, so long as there is a valid
4 order of the juvenile court placing the child with the court or
5 the children and youth agency, the child shall be returned to
6 the care and custody pursuant to the court order.
7 (b) Discharge plan.--No child shall be discharged without an
8 appropriate discharge plan that provides for at least the
9 following:
10 (1) Aftercare mental health services for the child and
11 his family.
12 (2) An appropriate educational or vocational plan.
13 (3) A coordinated plan with other county agencies
14 responsible for the child, including identification of
15 financial responsibility where appropriate.
16 Section 8. Rules and regulations.
17 The department shall adopt rules and regulations to
18 effectuate the provisions of this act. The rules and regulations
19 shall include, but not be limited to, provisions relating to:
20 (1) The establishment of a uniform Statewide system of
21 reports and audits relating to the quality of care provided.
22 (2) Facility utilization.
23 (3) Costs of providing services.
24 (4) Licensing standards consistent with those developed
25 by the Joint Commission on Accreditation of Hospitals for
26 residential treatment facilities for mentally ill children
27 and youth.
28 (5) Operation of residential treatment facilities for
29 mentally ill children and youth shall at least require, as a
30 condition of issuance or retention of an operating
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1 certificate, that admission of children into these facilities
2 be in accordance with priorities for admission of children
3 most immediately in need of services as established by the
4 preadmission certification committee serving the facility.
5 (6) The department, in consultation with the Secretary
6 of Education, shall adopt rules and regulations governing the
7 operation of the preadmission certification committees
8 required under section 5.
9 Section 9. Effective date.
10 This act shall take effect January 1, 1992.
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