THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY DINNIMAN, GREENLEAF, BREWSTER, COSTA, ERICKSON, FONTANA, RAFFERTY, STACK, TARTAGLIONE AND VANCE, FEBRUARY 9, 2011

REFERRED TO PUBLIC HEALTH AND WELFARE, FEBRUARY 9, 2011  

AN ACT

Amending the act of October 20, 1966 (3rd Sp.Sess., P.L.96,

No.6), entitled "An act relating to mental health and mental

retardation; authorizing county programs and amending,

revising and changing the laws relating thereto and making an

appropriation," updating and modernizing certain terminology.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The title of the act of October 20, 1966 (3rd

Sp.Sess., P.L.96, No.6), known as the Mental Health and Mental

Retardation Act of 1966, is amended to read:

AN ACT

Relating to mental health and [mental retardation] intellectual

disability; authorizing county programs and amending,

revising and changing the laws relating thereto and making an

appropriation.

Section 2.  Sections 101, 102, 201, 202, 301, 302, 303, 304,

305, 401 and 404 of the act are amended to read:

Section 101.  Short Title.--This act shall be known and may

be cited as the "Mental Health and [Mental Retardation]

Intellectual Disability Act of 1966."

Section 102.  Definitions.--As used in this act:

"Administrator" means the person appointed to carry out the

duties specified in section 305 of this act.

"Aftercare" means services rendered to a person after his

release from a facility, designed to assist such person in

establishing and maintaining himself as a member of society,

including foster home placement, home visiting, observation,

halfway houses and outpatient care.

"Attorney for the Commonwealth" means district attorney, the

Attorney General, or any attorney representing the interests of

the Commonwealth.

"Benefit period" means, with respect to any individual, a

period of consecutive days beginning with the first day not

included in a previous benefit period on which he is furnished

inpatient hospital care, and ending with the last day of the

first sixty-day period thereafter during each day of which he is

not an inpatient in a hospital.

"County" means a county, or a first class city.

"County program" means a mental health and [mental

retardation] intellectual disability program established by a

county, or two or more counties acting in concert and includes a

complex of services providing a continuum of care in the

community for the mentally disabled.

"Department" means the Department of Public Welfare.

"Designated facility" means a State operated facility named

by the department, or other facility named by the administrator,

for certain purposes or as a place of reception.

"Director" means the administrative head of a facility and

includes superintendents.

"Facility" means any mental health establishment, hospital,

clinic, institution, center, day care center or other

organizational unit, or part thereof, which is devoted primarily

to the diagnosis, treatment, care, rehabilitation or detention

of mentally disabled persons.

"Inpatient services" means diagnosis, evaluation,

classification, care, treatment or rehabilitation rendered to a

mentally disabled person admitted or committed to a facility for

a continuous period of twenty-four hours, or longer.

"Intellectual disability" means significantly subaverage

general intellectual functioning that is accompanied by

significant limitations in adaptive functioning in at least two

of the following skill areas: communication, self-care, home

living, social and interpersonal skills, use of community

resources, self-direction, functional academic skills, work,

leisure, health and safety. The onset must occur before the

individual's twenty-second birthday.

"Issuing authority" means any public official having the

power and authority of an alderman, justice of the peace or

magistrate.

"Local authorities" means the county commissioners of a

county, or the city councils and the mayors of the first class

cities, or two or more of these acting in concert.

"Mental disability" means any mental illness, mental

impairment[, mental retardation,] or mental deficiency, which so

lessens the capacity of a person to use his customary self-

control, judgment and discretion in the conduct of his affairs

and social relations as to make it necessary or advisable for

him to be under care as provided in this act. [It shall include

conditions and terms heretofore defined as "insanity,"

"unsoundness of mind," "lunacy," "mental disease," "mental

disorder," "feebleminded," "moron," "idiot" and "imbecile."]

This term shall not include senility, unless mental illness or

[mental retardation] an intellectual disability is superimposed.

"Mental hospital" means a residential facility for the

diagnosis, care and treatment of the mentally disabled other

than the mentally retarded.

["Mental retardation" means subaverage general intellectual

functioning which originates during the developmental period and

is associated with impairment of one or more of the following:

(1) maturation, (2) learning and (3) social adjustment.]

"Outpatient services" means diagnosis, evaluation,

classification, counseling care, treatment or rehabilitation

rendered under this act at a facility, to a mentally disabled

person not admitted or committed thereto.

"Partial hospitalization" means diagnosis, evaluation,

classification, care, treatment or rehabilitation rendered to a

mentally disabled person admitted or committed to a facility for

some portion of one or more twenty-four hour periods.

"Physician" means a physician licensed to practice in

Pennsylvania.

"Psychiatrist" means a physician who by years of study,

training and experience has achieved professional recognition

and standing in the field of psychiatry.

"Psychologist" means a person who by years of study, training

and experience has achieved professional recognition and

standing in the field of clinical psychology.

"Secretary" means the Secretary of Public Welfare.

"Social worker" means a person who by years of study,

training and experience has achieved professional recognition

and standing in the field of social work.

Section 201.  General Powers and Duties of the Department.--

The department shall have power, and its duty shall be:

(1)  To assure within the State the availability and

equitable provision of adequate mental health and [mental

retardation] intellectual disability services for all persons

who need them, regardless of religion, race, color, national

origin, settlement, residence, or economic or social status.

(2)  To make, with the advice of the Advisory Committee for

Mental Health and [Mental Retardation] Intellectual Disability 

and enforce all regulations necessary and appropriate to the

proper accomplishment of the mental health and [mental

retardation] intellectual disability duties and functions

imposed by this act. Such regulations shall not become effective

until the department shall have given the local authorities

thirty days written notice of the proposed regulations and

afforded the local authorities the opportunity for a hearing

before the department on the proposed regulations.

(3)  To consult with and assist each county in carrying out

mental health and [mental retardation] intellectual disability 

duties and functions and where necessary after thirty days

written notice to the counties affected and an opportunity for

such counties for a hearing before the department and with the

advice of the Advisory Committee for Mental Health and [Mental

Retardation] Intellectual Disability to require two or more

counties to join in establishing a program to provide the

services required by this act.

(4)  To adopt State-wide plans for the operation of all State

operated facilities under the jurisdiction of the department and

to assign to each facility or portion thereof, such duties for

the care of the mentally disabled, as the secretary shall

prescribe. The assignments herein referred to shall be made with

due regard to geographical location and population distribution.

(5)  To establish and maintain working relationships with

other governmental bodies and public and private agencies,

institutions and organizations so as to assure maximum

utilization of services and facilities which each such

governmental body and public and private agency, institution and

organization may have, which may be of benefit to the mentally

disabled.

(6)  To appoint such regional mental health and [mental

retardation] intellectual disability boards as may be necessary

to advise the department in the establishment, administration

and review of mental health and [mental retardation]

intellectual disability programs.

(7)  To make grants, pay subsidies, purchase service and

provide reimbursement for mental health and [mental retardation]

intellectual disability services in accordance with this act.

(8)  To supervise mental health and [mental retardation]

intellectual disability facilities, services and programs as

provided by law.

Section 202.  State Facilities.--(a)  The department shall

operate all State facilities and shall assign such functions to

each as the secretary shall prescribe.

(b)  The department is hereby authorized to establish,

extend, operate and maintain additional facilities and provide

mental health and [mental retardation] intellectual disability 

services therein. The department may also lease or otherwise

acquire, through the Department of Property and Supplies, other

additional facilities.

Section 301.  General Powers and Duties of Local Authorities;

Mental Health and [Mental Retardation] Intellectual Disability 

Program and Services.--(a)  The local authorities of each county

separately or in concert with another county or counties, as the

secretary may approve, shall establish a county mental health

and [mental retardation] intellectual disability program for the

prevention of mental disability, and for the diagnosis, care,

treatment, rehabilitation and detention of the mentally disabled

and shall have power to make appropriations for such purposes.

Such program shall conform with regulations of the department

promulgated under section 202(2).

(b)  To insure the operation of a county mental health and

[mental retardation] intellectual disability program in each

county, the secretary subject to the provisions of section

201(3) shall have the power to direct the local authorities of

any county to join with the local authorities of any other

county to establish such program or become a part of a program

existing in such other county or counties.

(c)  To operate such county mental health and [mental

retardation] intellectual disability program, the local

authorities shall employ such personnel as are necessary. The

selection, appointment and retention of such employes, and the

termination of their employment shall be on the basis of a merit

system which shall conform to minimum standards established by

the department with the advice of the Advisory Committee for

Mental Health and [Mental Retardation] Intellectual Disability.

Such minimum standards shall not become effective until the

department shall have given the local authorities thirty days'

written notice of the proposed standards and afforded the local

authorities the opportunity for a hearing before the department

on the proposed minimum standards.

(d)  Subject to the provisions of sections 508 and 509(5) it

shall be the duty of local authorities in cooperation with the

department to insure that the following mental health and

[mental retardation] intellectual disability services are

available:

(1)  Short term inpatient services other than those provided

by the State.

(2)  Outpatient services.

(3)  Partial hospitalization services.

(4)  Emergency services twenty-four hours per day which shall

be provided by, or available within at least one of the types of

services specified heretofore in this paragraph.

(5)  Consultation and education services to professional

personnel and community agencies.

(6)  Aftercare services for persons released from State and

County facilities.

(7)  Specialized rehabilitative and training services

including sheltered workshops.

(8)  Interim care of mentally retarded persons who have been

removed from their homes and who having been accepted, are

awaiting admission to a State operated facility.

(9)  Unified procedures for intake for all county services

and a central place providing referral services and information.

(e)  Such local authorities shall also have the power to

establish the following additional services or programs for the

mentally disabled:

(1)  Training of personnel.

(2)  Research.

(3)  Any other service or program designed to prevent mental

disability or the necessity of admitting or committing the

mentally disabled to a facility.

(f)  Services herein required or authorized may be provided

either directly or by purchase of such services, except that the

services required in section 301(d)(9) shall be provided

directly through the county administrator.

(g)  To establish local mental health and [mental

retardation] intellectual disability boards in accordance with

provisions of section 302.

Section 302.  Establishment of County Mental Health and

[Mental Retardation] Intellectual Disability Board.--(a)  Except

in cities of the first class, the local authorities of a county

or of two or more counties participating in concert in a county

mental health and [mental retardation] intellectual disability 

program shall appoint a Mental Health and [Mental Retardation]

Intellectual Disability Board, hereinafter called the board,

which shall consist of thirteen residents including, from each

county, a representative of the board of county commissioners.

At least two members thereof shall be physicians, and where

possible one shall be a psychiatrist and the other a

pediatrician. There shall also be appropriate representation

drawn from:

(1)  The professional fields of psychology, social work,

nursing, education and religion;

(2)  Local citizens' organizations active in the field of

mental health;

(3)  Local citizens' organizations active in the field of

[mental retardation] intellectual disability;

(4)  Local health and welfare planning organizations;

(5)  Local general hospitals; and

(6)  Other interested community groups.

Where two or more counties are participating in concert in said

program, the members of said board shall be selected

substantially on a proportionate basis as to population,

providing however that each county, irrespective of population,

shall have at least one member on the board.

(b)  Each member shall be appointed for a period of three

years. The initial appointment of members of the board shall be

for overlapping periods of three, two and one years. In making

the initial appointments, in so far as possible, one-third of

the members shall be appointed to each of the overlapping

periods. Any vacancies occurring in the membership of the board

shall be filled by the local authorities for the unexpired

period. The local authorities may remove any member of the board

during his period of service for cause only. The members shall

serve without compensation other than reimbursement for travel

and other actual expenses incurred in connection with called

meetings of the board.

(c)  A majority of the board members shall constitute a

quorum. The members shall select a chairman from among

themselves. Each board shall meet at least once each quarter,

and may, by majority vote of the membership, establish more

frequent regular meetings not exceeding one per month. Special

meetings shall be held on call of the chairman, and it shall be

the duty of the chairman to call a special meeting upon the

written request of one-third or more of the members, not

including vacancies of the board.

(d)  In cities of the first class, a mental health and

[mental retardation] intellectual disability board shall be

appointed, and the members shall hold office, under the

provisions of the city charter.

Section 303.  Duties of the County Mental Health and [Mental

Retardation] Intellectual Disability Board.--(a)  The County

Mental Health and [Mental Retardation] Intellectual Disability 

Board shall have the power and its duty shall be:

(1)  To review and evaluate the county's mental health and

[mental retardation] intellectual disability needs, services,

facilities and special problems in relation to the local health

and welfare needs, services and programs.

(2)  Except in cities of the first class, to recommend to

local authorities not less than two persons for the position of

administrator. Such persons shall meet the standards of

professional skill and experience as the department may

establish by regulation.

(3)  To develop, together with the administrator, annual

plans for the mental health and [mental retardation]

intellectual disability programs required by sections 301 and

509.

(4)  To make recommendations to the local authorities

regarding the program and any other matters relating to mental

health and [mental retardation] intellectual disability services

in the county, including purchase of service contracts and the

extent of funds required to implement the program.

(5)  To review performance under the mental health and

[mental retardation] intellectual disability program and to

recommend a system of program evaluation.

(b)  The functions of this board may be performed by a multi-

purpose board acting in the health and welfare field, if the

local authorities so elect with appropriate representation as

specified in section 302(a), in so far as possible, and subject

to the approval of the department.

Section 304.  County Mental Health and [Mental Retardation]

Intellectual Disability Administrator; Appointment.--Except in

cities of the first class, where the administrator shall be

appointed under the merit system, the local authorities shall

appoint a county mental health and [mental retardation]

intellectual disability administrator from a list of not less

than two names submitted by the County Mental Health and [Mental

Retardation] Intellectual Disability Board. If, thirty days

after the county board has submitted a list to the local

authorities, an appointment has not been made because of a tie

vote or other failure of the local authorities to make such

appointment, the same shall be made by the secretary after

consultation with the local authorities. The appointment of the

administrator, by whomever made, may be terminated by the local

authorities, provided, that no appointment made by the secretary

under this section shall be terminated without the approval of a

majority of the County Mental Health and [Mental Retardation]

Intellectual Disability Board.

Section 305.  Duties of the Administrator.--The county mental

health and [mental retardation] intellectual disability 

administrator shall have the power and his duty shall be:

(1)  To administer the county mental health and [mental

retardation] intellectual disability program.

(2)  To insure that county mental health and [mental

retardation] intellectual disability services required by this

act are available.

(3)  To provide staff services to the County Mental Health

and [Mental Retardation] Intellectual Disability Board.

(4)  To make such reports to the department in such form and

containing such information as the department may require.

(5)  To develop, together with the County Mental Health and

[Mental Retardation] Intellectual Disability Board, annual plans

for the mental health and [mental retardation] intellectual

disability programs required by this act.

(6)  To submit to local authorities annual plans and

estimated costs for the provision of services, establishment and

operation of facilities, and other related matters for review,

approval and transmittal to the department.

(7)  To review and evaluate facilities, and to cooperate with

the department in the maintenance of established standards.

(8)  To maintain effective liaison with governmental and

private community health and welfare agencies and organizations

and State operated facilities.

(9)  To submit an annual report to the local authorities, the

board and the department reporting all activities of the program

and his administration thereof.

(10)  To analyze and evaluate mental health and [mental

retardation] intellectual disability needs and services in the

county and recommend improvements to the County Mental Health

and [Mental Retardation] Intellectual Disability Board and local

authorities, conduct such research studies, and take such steps

and adopt such measures as are necessary for the proper

discharge of his duties.

Section 401.  Applications for Admission or Commitment; to

Whom Made.--(a)  Any mentally disabled person who desires care

in a facility may make appropriate application directly to any

facility willing and able to receive him, or to the

administrator of the county where the person is or resides, for

placement in a facility.

(b)  Any person authorized by this act to do so may make

application on behalf of a mentally disabled person directly to

any facility willing and able to receive such person. If no such

facility is available, or if public funds will or may be

expended to pay all or part of the cost of care of such person

under a county mental health and [mental retardation]

intellectual disability program, application shall be made to

the administrator of the county where the person is or resides

for placement in a facility, except that applications for

detention under section 405 must be made to the administrator.

(c)  Whenever a court commits any person under any provision

of this act, it may commit such person directly to a facility

willing and able to receive him; otherwise, the court shall

commit to a designated local or State facility, or to the

Veterans Administration or other agency of the United States

upon receipt of a certificate that the person is eligible for

such hospitalization and there is available space for his care.

Section 404.  Commitment on Application by Relative, etc.;

Physicians' Certificates; Review.--(a)  A written application

for commitment to a facility may be made in the interest of any

person who appears to be mentally disabled and in need of care.

It may be made by a relative, guardian, friend, individual

standing in loco parentis to the person to be committed, or by

the executive officer or an authorized agent of a governmental

or recognized nonprofit health or welfare organization or agency

or any responsible person.

(b)  Such application shall be accompanied by the

certificates of two physicians who have examined the person

whose commitment is sought, within one week of the date of the

certificates, and who have found that, in their opinion, such

person is mentally disabled and in need of care. In the case of

a mentally retarded person, the physician's certification shall

be accompanied by the report of a psychologist. No person shall

be committed hereunder if any certificate is dated more than

thirty days prior to the date of commitment, except that if the

mental disability consists of [mental retardation] intellectual

disability, the certificates may be dated not more than three

months prior to the date of commitment. The application,

certificates and the report, if any, shall be signed and sworn

to or affirmed.

(c)  The director may receive the person named in the

application and detain him until discharge in accordance with

the provisions of this act. When application is made by any

person other than a relative or guardian, the director upon

reception of the person named in the application shall notify

the appropriate relative or guardian of such person of the

commitment.

(d)  Every commitment made under this section except those to

the Veterans Administration or other agency of the United States

Government, shall be reviewed at least annually by a committee

appointed by the director from the professional staff of the

facility wherein the person is detained, to determine whether

continued care and commitment is necessary. Said committee shall

make written recommendations to the director which shall be

filed at the facility, and be open to inspection and review by

the department, and such other persons as the secretary, by

regulation, may permit.

Section 3.  Section 509 of the act, amended May 17, 1972

(P.L.300, No.78), is amended to read:

Section 509.  State and County Grants and Payments.--The

department, subject to the provisions of section 503, shall have

the power, and its duty shall be:

(1)  From State and Federal funds, to make annual grants to

counties to defray part of the cost of county programs

authorized by this act and approved by the department, in the

amount of ninety percent of the excess of all such approved

expenditures for such programs over the amount paid for the same

purpose from any public or private source directly to

participating counties, facilities or individuals.

(2)  To prescribe the time at which the counties shall submit

to the department annual plans and annual estimates of

expenditures, and revisions thereof, to carry out mental health

and [mental retardation] intellectual disability programs. Such

plans and estimates shall contain such information as the

secretary by regulation shall prescribe.

(3)  Upon approval of an annual plan and the estimated

expenditures for a mental health and [mental retardation]

intellectual disability program, to compute an annual grant in

accordance with the formula established in clause (1) of this

section.

(4)  To pay the annual grant in four quarterly installments.

The moneys received in any quarter may be used at any time

during the year. The first installment shall be for the quarter

beginning July 1 and ending September 30; the second installment

shall be for the quarter beginning October 1 and ending December

31; the third installment shall be for the quarter beginning

January 1 and ending March 31; and the fourth installment shall

be for the quarter beginning April 1 and ending June 30. Each

installment shall be paid at the beginning of the quarter only

if the department is satisfied that the county is complying with

the regulations of the department prescribing minimum mental

health and [mental retardation] intellectual disability 

services, minimum standards of performance of mental health and

[mental retardation] intellectual disability services and

minimum standards of mental health and [mental retardation]

intellectual disability personnel administration on a merit

basis.

(5)  In the event that sufficient funds to pay the full

amount of the grants to which the counties may be entitled under

the provisions of this section have not been appropriated, to

distribute State funds among the counties by a formula

reasonably designed to achieve the objectives of this act,

provided however, that in such event the counties' financial

obligations under this act shall be reduced in accordance with

the same formula and the counties shall be required to provide

only those services for which sufficient funds are available.

(6)  To review grants against actual expenditures at any time

and to make appropriate adjustments in subsequent grants. If a

grant overpayment cannot be recovered through such an adjustment

for any reason, the department shall effect a refund of such

overpayment from the county.

(7)  For the purpose of this act, the contribution with

respect to services, equivalent to the employer's tax

established by the Federal Social Security Act shall be the

first obligation against any State funds received by the

counties for their use or authorized under this act and shall

first be paid therefrom.

Section 4.  Sections 510 and 511 of the act are amended to

read:

Section 510.  Supplemental Grants.--The department may make

additional grants to any county participating in an approved

mental health and [mental retardation] intellectual disability 

plan to assist in establishing the services provided for in such

plan, for the first three years of operation of such plan. Said

grant shall be supplemental to grants authorized by section 509

but shall not exceed in any one year, ten percent of the grant

made under that section.

Section 511.  Interim Grants for Mental Health and [Mental

Retardation] Intellectual Disability Services.--(a)  From State

and Federal funds, the department may make grants to any county,

or combination of counties, or to any facility for all or part

of the cost of services designed to carry out the provisions of

article III of this act.

(b)  Such grants, whose amounts shall be calculated in

accordance with a formula to be determined by the department,

shall terminate with respect to a particular county, or

combination of counties, on the approval of the initial plan for

a mental health and [mental retardation] intellectual disability 

program or on the deadline for the establishment of all such

programs, as provided in section 512, whichever is earlier.

Section 5.  Section 512 of the act, amended June 28, 1968

(P.L.280, No.135), is amended to read:

Section 512.  Deadline for Establishment of County Mental

Health and [Mental Retardation] Intellectual Disability Program;

Failure to Comply with Minimum Standards; Penalties.--(a)  Each

county acting alone or in participation with other counties as

provided in section 301 shall, by January 1, 1969, submit to the

department for approval a plan for a county mental health and

[mental retardation] intellectual disability program. The

information and material upon which such plan shall be

formulated for submission to the department shall be published

and distributed to the counties by the Advisory Committee for

Mental Health and [Mental Retardation] Intellectual Disability 

on or before August 1, 1968.

(b)  If, by July 1, 1969, any county has not submitted any

plan or if although it shall have submitted a plan, it has not

made such alterations or additions to such plan as to secure

approval by the department, the department shall provide mental

health and [mental retardation] intellectual disability services

for such county.

(c)  If at any time after the approval of a plan, the

department determines, after hearing, that such county or

combination of participating counties is not complying with

regulations promulgated under section 202(2) and that, as a

result, the needs of the mentally disabled persons are not being

adequately met, the department shall provide mental health and

[mental retardation] intellectual disability services for such

county or counties.

(d)  When in pursuance of this section, the department shall

provide the mental health and [mental retardation] intellectual

disability services of a county or counties, such county or

counties shall be charged and shall pay the county share

computed in accordance with section 509, and, to compensate the

State for its expenses incident to the administration of the

county program, an additional fifteen percent of the net cost to

the Commonwealth for the county program. The amount due the

Commonwealth shall be paid by the county or counties within

twelve months after receipt of the department's notice of the

amount due. All sums collected from the county under this

section, in whatever manner such collections are made, shall be

paid into the State Treasury and shall be credited to the

current appropriations to the department to carry out State

obligations under this section.

(e)  The department shall relinquish the administration of

the mental health and [mental retardation] intellectual

disability program of the county upon establishment or

reinstatement as the case may be, of an approved county mental

health and [mental retardation] intellectual disability program

in compliance with this act and thereafter grants and payments

authorized herein may be made by the department.

Section 6.  This act shall take effect immediately.