2023-2024 Regular Session HB 2560 PN 3597 Bill Text (HTM)

PRINTER'S NO. 3597

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

2560

Session of

2024

INTRODUCED BY PICKETT, D. WILLIAMS, KINSEY, HILL-EVANS,

M. MACKENZIE, SCHLOSSBERG, SANCHEZ, CURRY AND DALEY,

SEPTEMBER 10, 2024

REFERRED TO COMMITTEE ON HUMAN SERVICES, SEPTEMBER 10, 2024

AN ACT

Amending the act of May 31, 2018 (P.L.123, No.25), entitled "An

act providing for outpatient psychiatric oversight," further

providing for definitions and for requirements; and

abrogating regulations.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. The definitions of "advanced practice

professional" and "telebehavioral health technology" in section

2 of the act of May 31, 2018 (P.L.123, No.25), known as the

Outpatient Psychiatric Oversight Act, are amended and the

section is amended by adding definitions to read:

Section 2. Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Advanced practice professional." [A person who:

(1) (i) holds a current Pennsylvania license as a

certified registered nurse practitioner with a mental

health certification; or

(ii) obtains a mental health certification within

two years of being hired by an outpatient psychiatric

clinic or within two years of the effective date of this

section, whichever is later; or

(2) (i) holds a current Pennsylvania license as a

physician assistant with a mental health certification;

(ii) obtains a mental health certification within

two years of being hired by an outpatient psychiatric

clinic or within two years of the effective date of this

section, whichever is later.] A person who holds a

current Pennsylvania license as a certified registered

nurse practitioner or a physician assistant and:

(1) holds a mental health certification; or

(2) obtains a mental health certification within two

years of being hired by an outpatient psychiatric clinic.

* * *

"Mental health professional." As defined in 55 Pa. Code §

1153.2 (relating to definitions).

"Mental health worker." As defined in 55 Pa. Code § 1153.2.

* * *

["Telebehavioral health] "Telehealth technology." As

follows:

(1) Any of the following:

(i) Real-time interactive audio and video

communication using technology that conforms to industry-

wide standards and is in compliance with Federal and

State privacy and security laws.

(ii) Real-time interactive audio-only

20240HB2560PN3597 - 2 -

telecommunication, provided that the use of audio-only

telecommunication technology is consistent with Federal

and State laws, guidance and requirements.

(2) The term does not include technology solely using

voicemail, electronic mail messages, facsimile transmissions

or instant messaging, or a combination thereof.

Section 2. Section 3 of the act is amended to read:

Section 3. Requirements.

[The following shall apply:

(3) Required psychiatric time may be provided in person

or by the use of telebehavioral health technology by

psychiatrists, as specified by department regulations.

Advanced practice professionals may also provide a portion of

the psychiatric time, as specified by department regulations,

either in person or by the use of telebehavioral health

technology.

(4) Nothing in this section shall be construed to limit

the ability of the department to issue a waiver pursuant to

regulation.]

(a) Provision of services.--Except as permitted in

subsection (c), 50% of the aggregate treatment provided by a

psychiatrist or an advanced practice professional shall be

provided with the psychiatrist or advanced practice professional

being physically present in the outpatient psychiatric clinic,

with the remainder of time being permitted to be provided by

telehealth technology.

(b) Supervision of services.--Supervision provided by either

a psychiatrist or an advanced practice professional may be

provided with the psychiatrist or advanced practice professional

either being physically present in the outpatient psychiatric

20240HB2560PN3597 - 3 -

clinic or by telehealth technology. The supervision of services

must equal at least two hours of time per week for each full-

time equivalent mental health professional and mental health

worker providing clinical services.

(1) An outpatient psychiatric clinic may submit a

written waiver request to the department to provide services

by telehealth technology in excess of the 50% requirement

under subsection (a).

(2) The department may grant a waiver request under this

subsection under the following conditions:

(i) There is no jeopardy to the health, safety or

well-being of an individual receiving services at the

outpatient psychiatric clinic.

(ii) An individual receiving services at the

outpatient psychiatric clinic is provided in-person

services at the outpatient psychiatric clinic when

requested or as clinically appropriate.

(iii) If the outpatient psychiatric clinic requests

to provide 100% of services by telehealth technology, the

outpatient psychiatric clinic must enter into and

maintain a written agreement with a geographically

proximate outpatient psychiatric clinic that operates a

physical facility and provides in-person services at the

outpatient psychiatric clinic. For purposes of this

subparagraph:

(A) The phrase "geographically proximate" means

that the physical facility is within 40 miles or 60

minutes travel from the residence of the individual

receiving services or as otherwise updated by

20240HB2560PN3597 - 4 -

departmental guidance.

(B) The written agreement must include a

provision that a referred individual must be seen by

the geographically proximate outpatient psychiatric

clinic within 10 days of the referral.

(d) Notice.--If the department grants a waiver to an

outpatient clinic following the waiver request under subsection

(c), the outpatient psychiatric clinic shall provide written

notice to each individual receiving services, upon the

commencement of services and annually thereafter, of the right

to receive in-person services when requested or clinically

appropriate.

(e) Medical assistance.--A waiver granted under this

section:

(1) Pertains to a waiver of a licensure requirement.

(2) Does not supersede medical assistance payment

requirements.

(f) Guidance.--The department may issue guidance regarding

the use of telehealth technology, which shall be exempt from all

of the following:

(1) Section 612 of the act of April 9, 1929 (P.L.177,

No.175), known as The Administrative Code of 1929.

(2) Sections 201, 202, 203, 204 and 205 of the act of

July 31, 1968 (P.L.769, No.240), referred to as the

Commonwealth Documents Law.

(3) Sections 204(b) and 301(10) of the act of October

15, 1980 (P.L.950, No.164), known as the Commonwealth

Attorneys Act.

(4) The act of June 25, 1982 (P.L.633, No.181), known as

the Regulatory Review Act.

20240HB2560PN3597 - 5 -

(g) Direction.--

(1) The direction of an outpatient psychiatric clinic

shall be by a psychiatrist.

(2) The direction under this subsection shall, at a

minimum, include the following:

(i) Establishment of appropriate standards for

treatment and prescribing practices.

(ii) Involvement in the quality management process.

(iii) Participation in clinical staff meetings two

times per month. The psychiatric outpatient clinic shall

maintain written documentation of clinical staff

meetings, including attendance.

(iv) Consultation to all clinical staff, which may

be in person or by telehealth technology. The psychiatric

outpatient clinic shall maintain documentation of the

consultation, regardless of the manner in which the

consultation occurred.

Section 3. The following regulations are abrogated:

(1) 55 Pa. Code § 1153.52(d)(4).

(2) 55 Pa. Code § 1153.53(6).

(3) 55 Pa. Code § 5200.52(b)(1).

Section 4. This act shall take effect in 60 days.

20240HB2560PN3597 - 6 -