Regulation detail

Pa. Code 5100.86

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Pa. Code 5100.86 active

Involuntary emergency examination and treatment not to exceed 120 hours

Jurisdiction: PA Agency: Pennsylvania Department of Human Services (OMHSAS) and Department of Drug and Alcohol Programs (DDAP)
PSYCH_FACILITY (80%)
Plain-English summary

This regulation governs the procedures for involuntary emergency examination and treatment under Section 302 of Pennsylvania's Mental Health Procedures Act, limited to a maximum of 120 hours. It specifies required forms (MH-783, MH-782, MH-783-A, MH-783-B), conditions under which State-operated facilities may accept Section 302 applications, patient rights notifications (including right to counsel and telephone use), and the responsibilities of county administrators and designated treatment facilities for transportation, bed designation, and protective services for patients' dependents. Facility operators must follow prescribed procedures for intake, examination, notification of the administrator, and documentation of all actions taken.

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Regulation text
55 Pa. Code § 5100.86 - Involuntary emergency examination and treatment not to exceed 120 hours 

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(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.

Notes

55

 Pa. Code §
 
5100.86

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