Regulation text
55 Pa. Code § 5100.23 - Written application, petitions, statements and certifications
State Regulations
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(a)
Written
application, petitions, statements and certifications required under this
chapter shall be made upon forms issued or approved by the
Department.
(b)
The forms listed in
§
5100.41
(relating to forms) have
been issued by the Department, and their use is mandated. No substitute for
such forms is permitted without prior written authorization of the Deputy
Secretary of Mental Health.
(c)
Other forms required under this chapter may be developed by the administrator
or the facility, but are subject to the approval of the Department.
(d)
Unsworn falsification-all statements
written under all applications, petitions and certifications required under the
act on Departmentally issued or approved forms MH 781, 783, 784, 785, 786 and
787, shall contain the following notice-old forms may be utilized until the
supply is exhausted:
ANY PERSON WHO KNOWINGLY PROVIDES ANY FALSE INFORMATION
WHEN COMPLETING THIS FORM MAY BE SUBJECT TO PROSECUTION.
(e)
When a person is admitted for voluntary
treatment and only when no part of his treatment is provided with public funds,
the new voluntary admission Form MH-788 may be used. This form will be
identical to Form MH-781 with the exception that the notice concerning the
penalty for giving false information will be deleted. Until form MH-788 is
printed and distributed, existing Form MH-781 may be utilized for this group of
persons. Each facility may make the necessary deletion on Form MH-781 to
conform with section 110(c) of the act (
50 P. S. §
7110(c)
).
(f)
Submission to county administrator:
(1)
Except as set forth in paragraphs
(2)-(5), Forms MH 781, 783, 784, 785, 786 and 787, shall be provided to the
administrator under section 110 of the act (
50 P. S. §
7110
).
(2)
No Form MH-788 need be provided to the
administrator on behalf of a patient admitted for voluntary treatment when
reimbursement for treatment provided the patient will not include public
monies. This shall not affect in any way the applicability to such patients of
the rights and procedures afforded voluntary patients by the act and this
chapter. For admission to a State facility forms must be provided to the
administrator.
(3)
The
administrator shall review all applications, petitions, statements and
certifications provided to the administrator's office to determine whether the
services needed are available and to assure a continuity of care.
(4)
The administrator may designate a place
other than his office for filing of the forms mentioned in this
section.
(5)
Mental health
facilities shall file such statistical reports of activities and services
required by the act and the Mental Health and Mental Retardation Act of 1966 as
the Department from time to time may require, so long as the data does not
identify individual patients.
Notes
55
Pa. Code §
5100.23
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