Current through Register Vol. 54, No. 44, November 2, 2024
(a) Written
applications, warrants, and written statements made under section 302 of the
act (50 P. S. §
7302), shall
be made on Form MH-783 issued by the Department.
(b) A State-operated facility shall not
accept an application for involuntary emergency examination and treatment
unless there is a preexisting agreement of waiver approved by the Deputy
Secretary of Mental Health, between the State facility and the administrator
which designates the State facility as the only provider of inpatient services
in the county program; or, there is a preexisting letter of agreement approved
by the regional commissioner of mental health, between the State facility and
the administrator which designates the State facility as:
(1) A substitute provider of inpatient
services when an emergency need arises and there are no other appropriate and
approved facilities available; or
(2) A provider of specialized forensic
inpatient services when a need for security arises. Such letters of agreement
shall define the nature of security to be available and the responsibilities of
both the State facility and the Administrator for specific services including
aftercare planning and referral.
(c) Any person authorized under section 302
of the act to take a person to a treatment facility for involuntary emergency
examination and treatment shall explain to the person in need of such
examination and treatment the nature and purpose of the action to be
undertaken.
(d) The escorting
individual shall make every effort to use the least force necessary and shall
act to the extent possible in a courteous manner toward such individual giving
attention to the dignity of the person. Transportation to and from a facility
remains the ultimate responsibility of the administrator.
(e) Upon arrival at a facility previously
designated as a provider of emergency examinations. Form MH-783 shall be
completed and Form MH-783-B shall be given to the person subject to the
examination. The person shall be informed of his right to counsel and be
advised that if he cannot afford counsel, counsel can be provided.
(f) If the examining physician determines
that the person is not severely mentally disabled or not in need of immediate
treatment, the administrator shall be notified of the results of the
examination and shall assure that the person is provided with transportation to
an appropriate location within the community, as he may request.
(g) If the person is determined to be
severely mentally disabled and in need of immediate treatment:
(1) The examining physician shall make
certain that the person has received a copy of forms MH-782, Bill of Rights,
and MH-783-A, Explanation of Rights Under Involuntary Emergency
Commitment.
(2) The facility shall
notify the administrator, if applicable, that:
(i) No warrant has been issued and there is
reasonable probability that a previous application, based upon the same
behavior, had been sought;
(ii) A
bed is needed at another facility; or
(iii) Public funding will be
involved.
(3) When the
examining facility recommends emergency involuntary treatment and has no bed
available, the administrator in designating a facility for treatment, shall
also authorize transportation between facilities.
(h) The administrator shall designate an
appropriate treatment facility which may be the examining facility or, if no
bed is available there, the nearest appropriate facility which is capable of
immediately providing such treatment. If county OMH funding is not involved,
the patient's choice of facilities is to be respected whenever an appropriate
bed is available.
(i) The
involuntary emergency treatment of the individual, or the arrangement of such,
shall be initiated immediately but shall be limited to:
(1) Conducting a physical
examination.
(2) Performing
diagnostic evaluations of the individual's mental health.
(3) Providing that necessary treatment
required to protect the health and safety of the individual and others. As a
first priority, the treating physician shall seek to respond to the emergency
condition necessitating commitment unless the individual consents to additional
treatment.
(j)
Examination preliminaries.
(1) The facility
shall deliver Forms MH-782, and MH-783-A to each person to be examined and
shall inform him or her of the purpose and nature of the examination.
(2) The person shall be requested to furnish
the names of up to three parties whom he may want notified and kept informed of
his status. The parties may, at the request of the patient, be informed of any
major change in the person's status, including transfer, escape, major change
in medical condition or discharge.
(3) The person shall be informed of his right
to counsel.
(4) Reasonable use of
the telephone shall mean at least three completed phone calls. If assistance is
required, the facility shall assist the individual in completing phone calls.
The cost of any toll calls shall be borne by the person in need of treatment,
although actual payment shall not be a precondition to the person's use of the
telephone.
(5) The treating
facility shall immediately undertake to obtain information regarding what steps
should be taken to assure that the health and safety needs of any dependents of
the person are safeguarded and that his personal property and premises are
secured.
(6) The facility shall
immediately communicate the information obtained to the office or person
designated by the administrator.
(7) Before any facility is designated as the
provider of involuntary emergency examination and treatment, the administrator
shall have specified in writing the procedures to be followed by his office and
those facilities to be designated in carrying out of the responsibilities of
section 302(c)(2) of the act (50 P. S. §
7302(c)(2)). These
procedures must specify what types of reasonable actions shall be taken, how
quickly they shall be taken, and who is responsible for them. Such procedures
shall be based on the availability of resources within the community.
(8) The administrator's office shall
coordinate and record any action taken in each case. At least annually the
administrator and each approved facility shall review and consider needed
amendments to the procedures.
(k) Reasonable steps to assure that the
health and safety needs of a person's dependents are met and the property is
secure.
(1) The actions of a facility director
or county administrator taken under section 302(c)(2) of the act should be well
defined, and reflective of local resources.
(2) Because of community differences, no one
Statewide plan can serve all possible contingencies. The act comtemplates that
reasonable efforts be taken to assure protection of person's dependents and
property. The efforts must, as a minimum include a documented assessment of the
patient's need for protective services. This would mean that those initially
working with a patient would attempt to determine what is needed by talking
with the patient or his family or friends. Once the information is gathered, it
should be transmitted to the person responsible for implementation of
protective services or if incomplete, this fact should be transmitted to those
responsible for a more thorough assessment. The act does not contemplate that
mental health professionals will actually provide all needed services for all
patients but relies upon professional linkage referral and follow-up to assure
that the needed protections are in fact, provided and maintained. The
implementation of protective services requires community organization efforts
by the county administrator's office in developing interagency liaison on
continuing basis.
(3) Each mental
health administrative unit should develop its own plan which addresses the most
typical or usual contingencies. State in the plan that deviations will be
handled on a case-by-case basis. The most essential element in meeting the
requirement of this section is for the county administrator to have a
well-developed local plan which shows the involvement of all possible
resources, such as local health, welfare, housing agencies, and protective
services determines which individuals, or agencies are responsible for
particular activities and when they are to be involved. The plan should show
initial procedures for involving the patient's family, legally responsible
relatives, or friends designated by the patient. Agencies should be utilized
only as necessary. The plan should define the communication flow and the
specific duties and responsibilities for action of the mental health provider
agencies, the administrator's office, and protective agencies. The plan should
also indicate general provisions for the resolution of problems and how
exceptional cases will be provided for.
(4) Once a referral is made and the
information is conveyed to the appropriate agencies, the only remaining
responsibility for the administrator is the periodic follow up necessary to
demonstrate that the protection continues to be made available to the patient
in need.
(5) Plans developed under
this section should be reviewed at least annually by the participating agencies
and will be subject to review and approval by the office of Mental
Health.
