PRINTER'S NO. 1317
No. 1146 Session of 1989
INTRODUCED BY CORNELL, TRELLO, VROON, DeLUCA, FOX, DEMPSEY,
CORRIGAN, BUNT, PETRARCA, LASHINGER AND ITKIN, APRIL 12, 1989
REFERRED TO COMMITTEE ON YOUTH AND AGING, APRIL 12, 1989
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 the Commonwealth of Pennsylvania to seek
10 to assure the provision of residential treatment services for
11 mentally ill children and youth who no longer require acute care
12 in a psychiatric hospital or care in State-operated mental
13 hospitals 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:
18 "Department." The Department of Public Welfare of the
1 Commonwealth.
2 "Residential treatment facility for mentally ill children and
3 youth." An inpatient psychiatric facility which provides active
4 treatment under the direction of a physician for individuals who
5 are under 21 years of age. A person who, during the course of
6 treatment, attains 21 years of age may continue to receive
7 services in a residential treatment facility for mentally ill
8 children and youth until that person reaches 22 years of age.
9 "Secretary." The Secretary of Public Welfare of the
10 Commonwealth.
11 Section 4. Residential treatment facilities for mentally ill
12 children and youth; establishment and operation.
13 (a) Authorization.--The department shall authorize the
14 operation of residential treatment facilities for mentally ill
15 children and youth. Authorized residential treatment facilities
16 may be operated only by nonprofit organizations.
17 (b) Licensing.--The department shall establish standards and
18 licensing requirements for residential treatment facilities for
19 children and youth and shall be responsible for:
20 (1) Visitation, inspection and supervision of the
21 facilities.
22 (2) Enforcement of the conditions for licensing the
23 facilities by the department.
24 (3) Protection of the confidentiality of clinical
25 information regarding patients at the residential treatment
26 facilities.
27 (c) Facility information.--Operators of facilities licensed
28 by the department shall provide to the department such
29 financial, statistical and program information as the department
30 may determine to be necessary. The department shall have the
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1 power to conduct onsite audits of books and records of the
2 facilities.
3 (d) Administration.--The Office of Mental Health within the
4 department shall have primary responsibility for the
5 administration of the provisions of this act, in consultation
6 with the Office of Children, Youth and Families of the
7 Department of Public Welfare and the Department of Education.
8 Section 5. Preadmission committee.
9 (a) General rule.--All applications for voluntary or
10 involuntary admission of patients to residential treatment
11 facilities for children and youth or for transfer of patients to
12 such facilities shall be reviewed by the preadmission
13 certification committee serving the facility in accordance with
14 this section. Any interested party may apply to the preadmission
15 certification committee for admission to a residential treatment
16 facility for mentally ill children and youth.
17 (b) Designation of committees.--The department shall
18 designate preadmission certification committees for defined
19 geographic areas to evaluate each person proposed for admission
20 or transfer to a residential treatment facility for children and
21 youth. When designating persons to serve on preadmission
22 certification committees, the department shall assure that the
23 interests of the people residing in the area to be served by
24 each committee are represented. Each committee shall include a
25 person designated by the Office of Mental Health, a person
26 designated by the Office of Children, Youth and Families, and a
27 person designated by the Secretary of Education. The department
28 shall consult with county mental health/mental retardation
29 administrators and shall consult with county children and youth
30 administrators in the area to be served by a committee prior to
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1 designating persons to serve on a committee. Membership of
2 preadmission certification committees shall be limited to
3 persons who are licensed to practice medicine, nursing or
4 psychology or who have graduate degrees in social welfare. In
5 the event the persons originally designated to a committee do
6 not include a physician, the department shall designate a
7 physician to serve as an additional member of the committee.
8 (c) Applications for admission.--Applications for admission
9 shall include an assessment of the individual's psychiatric,
10 medical and social needs prepared in accordance with a uniform
11 assessment method specified by the regulations of the
12 department. The committee may, in its discretion, refer an
13 applicant to a hospital or other appropriate facility for an
14 additional assessment. In the event of an additional assessment
15 of the individual's needs, the facility conducting the
16 assessment shall attempt to receive all third-party insurance or
17 Federal reimbursement available as payment for the assessment.
18 The Commonwealth shall pay the balance of the fees which may be
19 charged by the provider in accordance with applicable provisions
20 of the act of October 20, 1966 (3rd Sp.Sess., P.L.96, No.6),
21 known as the Mental Health and Mental Retardation Act of 1966.
22 In addition, if necessary, the preadmission certification
23 committee shall obtain an evaluation of the educational needs of
24 the child from the school district of residence.
25 (d) Review period.--The preadmission certification committee
26 shall review all requests for evaluation and certification
27 within 30 days of receipt of a complete application and any
28 additional assessments it may require. Using a uniform
29 assessment method specified by regulation of the department, the
30 preadmission certification committee shall evaluate the
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1 psychiatric, medical and social needs of the applicant and shall
2 certify each of the following:
3 (1) The individual's need for services in a residential
4 treatment facility for mentally ill children and youth.
5 (2) The immediacy of that need, giving consideration to
6 the availability of such services in the area and the needs
7 of other children who have been evaluated by the committee
8 and certified as eligible for admission to a residential
9 treatment facility for mentally ill children and youth and
10 who have not yet been admitted to such a facility.
11 (e) Essential findings.--A preadmission certification
12 committee shall not certify an individual for admission unless
13 it finds that:
14 (1) Available ambulatory care resources and other
15 residential placements do not meet the treatment needs of the
16 individual.
17 (2) Proper treatment of the individual's psychiatric
18 condition requires inpatient care and treatment under the
19 direction of a physician.
20 (3) Care and treatment in a residential treatment
21 facility for mentally ill children and youth can reasonably
22 be expected to improve the individual's condition or prevent
23 further regression so that services will no longer be needed,
24 provided that a poor prognosis shall not in itself constitute
25 grounds for a denial of certification if treatment can be
26 expected to effect a change in prognosis.
27 (4) Sufficient funds are available to pay for the
28 services.
29 (f) Determinations to be unanimous.--All decisions of the
30 committee to recommend admission or priority of admission shall
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1 be based on the unanimous vote of those present. The decision of
2 the committee shall be reported to the applicant. In the event a
3 committee evaluates a child who is the subject of a proceeding
4 currently pending in juvenile court, the committee shall report
5 its decision to the court.
6 (g) Review of clinical records.--Notwithstanding any other
7 provision of law, preadmission certification committees shall be
8 entitled to review clinical records maintained by any person or
9 entity which pertain to an individual on whose behalf an
10 application is made for admission to a residential treatment
11 facility for children and youth. Any clinical record received by
12 a preadmission certification committee and all assessments
13 submitted to the committee shall be kept confidential.
14 (h) SSI determination.--The preadmission certification
15 committee shall have the authority and responsibility for making
16 determinations of eligibility for Supplemental Security Income
17 for applicants for admission to residential treatment facilities
18 in accordance with the provisions of a cooperative agreement
19 between the Department of Public Welfare and the Department of
20 Labor and Industry delegating such authority to the preadmission
21 certification committees, consistent with applicable Federal and
22 State law and regulation.
23 Section 6. Admissions.
24 (a) General rule.--Subject to the requirements of section 5,
25 the director of any residential treatment facility shall receive
26 for care and treatment:
27 (1) Any suitable person in need of care and treatment,
28 whether admitted voluntarily or involuntarily, as provided
29 for under Article II or III of the act of July 9, 1976
30 (P.L.817, No.143), known as the Mental Health Procedures Act.
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1 (2) Any person who has been certified as needing care
2 and treatment by the preadmission certification committee
3 serving the facility, in accordance with priorities for
4 admission established by such committee.
5 (b) Restriction.--No residential treatment facility for
6 children and youth shall admit a person who has not been
7 certified as suitable for admission by the appropriate
8 preadmission certification committee. Residential treatment
9 facilities shall admit children in accordance with priorities
10 for admission of children most immediately in need of such
11 services established by the preadmission certification committee
12 serving the facility, in accordance with standards established
13 by the department.
14 Section 7. Discharge.
15 (a) General rule.--Whenever the commissioner or the director
16 of a residential treatment facility for mentally ill children
17 and youth finds that care and treatment of a child is no longer
18 suitable in a residential treatment facility for mentally ill
19 children and youth, he shall certify and discharge the child to
20 the custody of the child himself, his parents, his legal
21 guardian, his county children and youth agency, or juvenile
22 court, as appropriate, except that, so long as there is a valid
23 order of the juvenile court placing the child with the court or
24 the children and youth agency, the child shall be returned to
25 the care and custody pursuant to the court order.
26 (b) Discharge plan.--No child shall be discharged without an
27 appropriate discharge plan that provides for at least the
28 following:
29 (1) Aftercare mental health services for the child and
30 his family.
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1 (2) An appropriate educational or vocational plan.
2 (3) A coordinated plan with other county agencies
3 responsible for the child, including identification of
4 financial responsibility where appropriate.
5 Section 8. Rules and regulations.
6 The department shall adopt rules and regulations to
7 effectuate the provisions of this act. The rules and regulations
8 shall include, but not be limited to, provisions relating to:
9 (1) The establishment of a uniform Statewide system of
10 reports and audits relating to the quality of care provided.
11 (2) Facility utilization.
12 (3) Costs of providing services.
13 (4) Licensing standards consistent with those developed
14 by the Joint Commission for the Accreditation of Hospitals
15 for residential treatment facilities for mentally ill
16 children and youth.
17 (5) Operation of residential treatment facilities for
18 mentally ill children and youth shall at least require, as a
19 condition of issuance or retention of an operating
20 certificate, that admission of children into these facilities
21 be in accordance with priorities for admission of children
22 most immediately in need of services as established by the
23 preadmission certification committee serving the facility.
24 (6) The department, in consultation with the Secretary
25 of Education, shall adopt rules and regulations governing the
26 operation of the preadmission certification committees
27 required under section 5.
28 Section 9. Effective date.
29 This act shall take effect January 1, 1990.
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