Session of 2022
No. 2022-101
 
HB 220
 
AN ACT
 
Amending the act of April 9, 1929 (P.L.177, No.175), entitled "An act providing for
            and reorganizing the conduct of the executive and administrative work of the Commonwealth
            by the Executive Department thereof and the administrative departments, boards, commissions,
            and officers thereof, including the boards of trustees of State Normal Schools, or
            Teachers Colleges; abolishing, creating, reorganizing or authorizing the reorganization
            of certain administrative departments, boards, and commissions; defining the powers
            and duties of the Governor and other executive and administrative officers, and of
            the several administrative departments, boards, commissions, and officers; fixing
            the salaries of the Governor, Lieutenant Governor, and certain other executive and
            administrative officers; providing for the appointment of certain administrative officers,
            and of all deputies and other assistants and employes in certain departments, boards,
            and commissions; providing for judicial administration; and prescribing the manner
            in which the number and compensation of the deputies and all other assistants and
            employes of certain departments, boards and commissions shall be determined," in powers
            and duties of the Department of Drug and Alcohol Programs, further providing for powers
            and duties; in powers and duties of the Department of Health and its departmental
            administrative and advisory boards, providing for death review teams; imposing duties
            on the Department of Health; and making an editorial change.
         
 
The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:
 
Section 1.  Section 2301-A(1)(xviii) of the act of April 9, 1929 (P.L.177, No.175), known as The
            Administrative Code of 1929, is amended to read:
         
Section 2301-A.  Powers and duties.
The Department of Drug and Alcohol Programs shall have the power and its duty shall
            be:
         
(1)  To develop and adopt a State plan for the control, prevention, intervention, treatment,
            rehabilitation, research, education and training aspects of drug and alcohol abuse
            and dependence problems. The State plan shall include, but not be limited to, provisions
            for:
         
* * *
(xviii)  Providing standards for the approval by the relevant State agency for all private
            and public treatment and rehabilitative facilities, which may include, but are not
            limited to, State hospitals and institutions, public and private general hospitals,
            community mental health centers or their contracting agencies and public and private
            drug or alcohol dependence and drug and alcohol abuse and dependence treatment and
            rehabilitation centers. The standards  shall prohibit private and public treatment and rehabilitation facilities from denying addiction treatment to an individual solely due to a negative result on a drug test.
* * *
Section 2.  Article XXI of the act is amended by adding a subarticle heading to read:
(a)  General Provisions
Section 3.  Article XXI of the act is amended by adding a subarticle to read:
(b)  Death Review Teams
Section 2127.  Definitions.
The following words and phrases when used in this subarticle shall have the meanings
            given to them in this section unless the context clearly indicates otherwise:
         
"County."  A county of the first class, second class, second class A, third class, fourth class,
            fifth class, sixth class, seventh class and eighth class.
         
"Death review team."  A suicide or overdose death review team established under section 2128.
"Deceased individual."  An individual who died by suicide or fatal overdose.
"Department."  The Department of Health of the Commonwealth.
"Drug."  A substance which produces a physiological effect when ingested or introduced into
            the body. The term includes an illicit or legal substance.
         
"EMS provider."  The term includes the following:
(1)  An emergency medical responder.
(2)  An emergency medical technician.
(3)  An advanced emergency medical technician.
(4)  A paramedic.
(5)  A prehospital registered nurse.
(6)  A prehospital physician extender.
(7)  A prehospital EMS physician.
(8)  An individual prescribed by regulation of the department to provide specialized EMS.
"Health care provider."  A physician, advanced practice nurse practitioner or physician assistant who is licensed
            to practice medicine in this Commonwealth.
         
"Hospital."  An institution having an organized medical staff established for the purpose of providing
            to inpatients, by or under the supervision of physicians, diagnostic and therapeutic
            services for the care of individuals who are injured, disabled, pregnant, diseased,
            sick or mentally ill or rehabilitation services for the rehabilitation of individuals
            who are injured, disabled, pregnant, diseased, sick or mentally ill. The term includes
            facilities for the diagnosis and treatment of disorders within the scope of specific
            medical specialties.
         
"Law enforcement agency."  The Pennsylvania State Police, a  local law enforcement agency or the Office of Attorney General.
"Local department of health."  Any of the following:
(1)  A local department of health established by a municipality under the act of August
            24, 1951 (P.L.1304, No.315), known as the Local Health Administration Law.
         
(2)  A single-county department of health or joint-county department of health established
            under the Local Health Administration Law.
         
"Local law enforcement agency."  A police department of a city, borough, incorporated town or township.
"Mental health provider."  A psychiatrist, psychologist, advanced practice nurse practitioner with a specialty
            in psychiatric mental health, clinical social worker, professional clinical counselor
            or marriage and family therapist who is licensed to practice in this Commonwealth.
         
"Multicounty team."  A multidisciplinary and multiagency suicide or overdose death review team jointly
            created by two or more counties in this Commonwealth.
         
"Municipality."  A county, city, borough, incorporated town or township.
"Overdose."  An alcohol or substance overdose.
"Overdose death."  A fatality resulting from one or more substances taken in excessive amounts.
"Overdose death review."  A process in which a multiagency, multidisciplinary team performs a series of individual
            overdose death reviews to effectively identify system gaps and innovative community-specific
            overdose prevention and intervention strategies.
         
"School."  A facility providing elementary, secondary or postsecondary educational services.
            The term includes the following:
         
(1)  A school of a school district.
(2)  An area career and technical school.
(3)  A joint school.
(4)  An intermediate unit.
(5)  A charter school or regional charter school.
(6)  A cyber charter school.
(7)  A private school licensed under the act of January 28, 1988 (P.L.24, No.11), known
            as the Private Academic Schools Act.
         
(8)  A private school accredited by an accrediting association approved by the State Board
            of Education.
         
(9)  A nonpublic school.
(10)  An institution of higher education.
(11)  A private school licensed under the act of December 15, 1986 (P.L.1585, No.174), known
            as the Private Licensed Schools Act.
         
(12)  A private residential rehabilitative institution as defined in section 914.1-A(c)
            of the act of March 10, 1949 (P.L.30, No.14), known as the Public School Code of 1949.
         
"Substance use disorder."  A pattern of use of alcohol or other drugs leading to clinical or functional impairment.
"Substance use disorder treatment provider."  An individual or entity who is licensed, registered or certified within this Commonwealth
            to treat substance use disorders or who has a drug addiction treatment waiver under
            section 303(g) of the Controlled Substances Act (Public Law 91-513, 84 Stat. 1236)
            from the Substance Abuse And Mental Health Services Administration to treat individuals
            with substance use disorder using medications approved for that indication by the
            United States Food and Drug Administration.
         
"Suicide death."  A fatality caused by injuring oneself with the intent to die.
Section 2128.  Suicide or overdose death review teams.
(a)  Establishment.--A county, or two or more counties, may establish a suicide death review
            team, an overdose death review team, or both, for the purposes of collecting and examining
            information and records concerning suicide or overdose fatalities in this Commonwealth
            to improve community resources and systems of care to reduce suicide or overdose fatalities.
            The following shall apply:
         
(1)  A county may establish an independent county death review team or jointly with other
            counties. If a joint county death review team is established, the multicounty team
            members shall execute a memorandum of understanding between participating counties
            regarding team membership, staffing and operations.
         
(2)  Upon the establishment of a death review team, the death review team shall notify
            the department of the establishment of the team.
         
(3)  A death review team shall be multidisciplinary and culturally diverse and include
            professionals and representatives from organizations that provide services or community
            resources for families in the community served by the death review team.
         
(b)  Membership.--
(1)  In counties where there is a local health department, the local health department
            shall be the lead organization to oversee and coordinate the death review team in
            a form and manner as prescribed by the department. In counties choosing to establish
            a death review team, if there is not a local health department, an organization interested
            in being selected as the lead organization shall submit an application, in a form
            and manner as prescribed by the department, for review and approval. Prior to submitting
            an application, a county's commissioners shall approve the submission of an organization
            as a lead organization.
         
(2)  The lead organization shall select the membership of the death review team. The following
            shall apply:
         
(i)  Members of the overdose death review team shall be selected from any of the following
            categories:
         
(A)  A coroner or medical examiner.
(B)  A pathologist.
(C)  A psychologist licensed under the act of March 23, 1972 (P.L.136, No.52), known as
            the Professional Psychologists Practice Act.
         
(D)  A physician licensed under the act of December 20, 1985 (P.L.457, No.112), known as
            the Medical Practice Act of 1985, or a physician licensed under the act of October
            5, 1978 (P.L.1109, No.261), known as the Osteopathic Medical Practice Act, who practices
            as a psychiatrist.
         
(E)  A local behavioral health representative.
(F)  An individual who is a member of the education community with experience regarding
            existing and potential overdose prevention efforts for students in primary and secondary
            schools.
         
(G)  An individual who is a member of the law enforcement community with experience regarding
            existing and potential overdose prevention efforts for individuals who are involved
            with the law enforcement system.
         
(H)  A representative of an organization that advocates for individuals with behavioral
            health issues and their family members.
         
(I)  A representative of an organization that advocates for individuals with substance
            use disorders and their family members.
         
(J)  A representative from a single county authority.
(K)  The county health officer, or the officer's designee, if applicable.
(L)  The director of the local office responsible for human services or the director's
            designee.
         
(M)  The local district attorney or the district attorney's designee.
(ii)  Members of the suicide death review team shall be selected from any of the following
            categories:
         
(A)  At least three mental health providers specializing in trauma, youth mental health,
            veteran and military mental health or another relevant specialty.
         
(B)  A crisis counselor specializing in suicide prevention.
(C)  An advocate for the prevention of suicide fatalities.
(D)  A medical examiner or coroner responsible for recording fatalities.
(E)  A family medicine specialist or other relevant medical specialty.
(F)  An individual who is a member of the education community with experience regarding
            existing and potential suicide prevention efforts for students in primary and secondary
            schools.
         
(G)  An individual who is a member of the law enforcement community with experience regarding
            existing and potential suicide prevention efforts for individuals who are involved
            with the law enforcement system.
         
(H)  The county health officer or the officer's designee, if applicable.
(I)  The director of the local office responsible for human services or the director's
            designee.
         
(3)  In addition to the members selected under paragraph (2), the lead organization may
            select additional members for a death review team as deemed necessary by the lead
            organization to administer the death review team's duties under section 2129, including
            individuals with experience and knowledge in the following areas:
         
(i)  Physical health services.
(ii)  Social services.
(iii)  Law enforcement.
(iv)  Education.
(v)  Emergency medicine.
(vi)  Behavioral health services.
(vii) Juvenile delinquency.
(viii)  Adult or juvenile probation.
(ix)  Drug and alcohol substance use disorder.
(c)  Chair, vacancies and meetings.--A death review team shall select a chair by a majority
            vote of a quorum of the death review team's members. A majority of a death review
            team's selected members shall constitute a quorum. The death review team shall meet
            at least quarterly to conduct business and review suicide deaths and overdose deaths.
            A vacancy on the death review team shall be filled in accordance with subsection (b).
         
Section 2129.  Duties of death review team.
(a)  Authorization.--Upon receipt of a report of a suicide death or overdose death, a death
            review team may perform the following:
         
(1)  Inquire into the cause of death upon receipt of a report of a qualifying death.
(2)  Conduct a multidisciplinary review of available information collected regarding a
            deceased individual.
         
(3)  Establish policies and procedures for collecting and reviewing available information
            and records under section 2131 regarding the deceased individual from State, county
            and local agencies, law enforcement and private entities.
         
(4)  Identify points of contact between the deceased individual and health care systems,
            social services systems, criminal justice systems and other systems involved with
            the deceased individual.
         
(5)  Identify the risk factors that put individuals at risk for an overdose or suicide
            within the death review team's jurisdiction.
         
(6)  Promote cooperation and coordination across State, county and local agencies involved
            in overdose or suicide investigations.
         
(7)  Recommend improvements in sources of information relating to investigating reported
            overdose or suicide deaths, including standards for the uniform and consistent reporting
            of overdose or suicide deaths by law enforcement or other emergency service responders
            within the death review team's jurisdiction.
         
(8)  Recommend improvements to State laws and local partnerships, policies and practices
            to prevent overdose and suicide deaths.
         
(b)  Interviews.--If a death review team opts to contact a family member or caregiver of
            a deceased individual to conduct an interview, the death review team shall develop
            protocols for initiating the contact and conducting the interview. The protocols shall
            be based on trauma-informed care principles and shall address all of the following:
         
(1)  The death review team's collection, use and disclosure of information and records
            from the family member or caregiver.
         
(2)  Providing notice to the family member or caregiver that the interview is voluntary.
(3)  Ensuring that information and records attained from the interview is confidential.
(c)  Annual report.--A death review team shall prepare and submit to the department an
            annual report. The team shall publish the annual report on the local department of
            health's or local government's publicly accessible Internet website for the purpose
            of evaluations, policy considerations and health care program enhancements. The annual
            report shall comply with confidentiality requirements under this subarticle and shall
            include all of the following information:
         
(1)  A summary of the aggregated, nonindividually identifiable findings of the death review
            team for the previous year.
         
(2)  Recommendations to improve systems of care and community resources to reduce fatal
            suicides or overdoses in the death review team's jurisdiction.
         
(3)  Proposed solutions for inadequacies in the systems of care.
(4)  Recommendations to improve sources of information regarding the investigation of reported
            suicides and overdose deaths, including standards for the uniform and consistent reporting
            of fatal suicides and overdoses by law enforcement or other emergency service responders
            within the death review team's jurisdiction.
         
(5)  Recommendations for improvements to State laws and local partnerships, policies and
            practices to prevent suicide and overdose fatalities.
         
Section 2130.  Duties of department.
The department, in consultation with State or local government agencies, shall have
            all of the following duties:
         
(1)  Provide technical assistance to a death review team in conducting suicide and overdose
            death reviews.
         
(2)  Facilitate communication between death review teams.
(3)  Transmit available information to the appropriate death review team regarding a fatal
            suicide or overdose in the death review team's jurisdiction, including all of the
            following information:
         
(i)  The deceased individual's age, race, gender, county of residence and county of death.
(ii)  The date, manner, cause and specific circumstances of the suicide or overdose death
            as recorded on the deceased individual's completed death certificate.
         
(4)  Promulgate regulations as necessary to implement this subarticle.
(5)  Submit an annual report to the Governor and the General Assembly by September of each
            year which includes a summary of reports received from local death review teams and
            recommendations relating to the reduction of risk of death by suicide and overdose.
         
Section 2131.  Authority to access records.
To the extent permitted by Federal law, a death review team may access records as
            follows:
         
(1)  If deemed necessary for its review, the death review team may petition the court for
            leave to review and inspect all files and records of the court relating to a deceased
            individual pursuant to a proceeding under 42 Pa.C.S. Ch. 63 (relating to juvenile
            matters) in accordance with 42 Pa.C.S.  6307 (relating to inspection of court files
            and records). This paragraph shall not apply to a file and record of the court subject
            to a child fatality or near fatality review under 23 Pa.C.S. Ch. 63 (relating to child
            protective services).
         
(2)  Notwithstanding any other provision of law and consistent with the Health Insurance
            Portability and Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936) and
            42 CFR Pt. 2 (relating to confidentiality of substance use disorder patient records),
            persons or entities that provide substance use disorder treatment services shall provide
            to an overdose death review team the records of a deceased individual under review
            without need for authorization of any person, including the executor, administrator
            or personal representative of the deceased individual for purposes of review under
            this subarticle.
         
(3)  Notwithstanding any other provision of law and consistent with the Health Insurance
            Portability and Accountability Act of 1996, the team may review and inspect mental
            health care service files and records of a deceased individual under review without
            the need for authorization of any person, including the executor, administrator or
            personal representative of the deceased individual for purposes of review under this
            subarticle.
         
(4)  Notwithstanding any other provision of law and consistent with the Health Insurance
            Portability and Accountability Act of 1996, health care facilities and health care
            providers, pharmacies and mental health care providers shall provide medical records
            of a deceased individual under review without the need for authorization of any person,
            including the executor, administrator or personal representative of the deceased individual
            for purposes of review under this subarticle.
         
(5)  Other records pertaining to the deceased under review for the purposes of this subarticle
            shall be open to inspection as permitted by law.
         
Section 2132.  Requests for records.
(a)  Request for information and records by a death review team.--Notwithstanding any other
            provision of law, the following shall be provided to a death review team on written
            request of the lead organization or chair of a death review team:
         
(1)  Records regarding the treatment for substance use disorder, maintained by a Federally
            assisted substance use disorder treatment provider, for a deceased individual under
            review by a death review team, as permitted to be shared in accordance with Federal
            law, including 42 CFR Pt. 2 (relating to confidentiality of substance use disorder
            patient records).
         
(2)  Records regarding the physical health and mental health, maintained by a health care
            provider, hospital or health system, for a deceased individual under review by a death
            review team.
         
(3)  Records maintained by a State or local government agency or entity, including death
            investigative information, medical examiner investigative information, law enforcement
            investigative information, emergency medical services reports, fire department records,
            prosecutorial records, parole and probation information and records, court records,
            school records and information and records of a social services agency, including
            the Department of Human Services, if the agency or entity previously provided services
            to the deceased individual under review by a death review team.
         
(4)  The following shall comply with a records request by a death review team made under
            this subsection:
         
(i)  Coroner or medical examiner.
(ii)  Fire department.
(iii)  Health system.
(iv)  Hospital.
(v)  Law enforcement agency.
(vi)  State or local governmental agency, including the department, the Department of Human
            Services and the Department of Corrections.
         
(vii)  Mental health provider.
(viii)  Health care provider.
(ix)  Substance use disorder treatment provider.
(x)  School.
(xi)  EMS provider.
(xii)  Social services provider.
(xiii)  Prescription drug monitoring program representative.
(xiv)  Any other person or entity who is in possession of records pertinent to the overdose
            death review team investigation of an overdose death.
         
(b)  Cost to provide records.--A person or entity subject to a records request by a death
            review team under subsection (a) may charge the death review team a reasonable fee
            for the service of duplicating any records requested by the death review team for
            which duplication is required.
         
(c)  Disclosure of substance use disorder records.--The disclosure or redisclosure of a
            medical record developed in connection with the provision of substance use treatment
            services, without the authorization of a person in interest, shall be subject to any
            limitations that exist under section 8 of the act of April 14, 1972 (P.L.221, No.63),
            known as the Pennsylvania Drug and Alcohol Abuse Control Act, section 543 of the Public
            Health Service Act (58 Stat. 682, 42 U.S.C. 290dd-2) or 42 CFR Pt. 2.
         
(d)  Provision of information.--Information, if requested by the lead organization or chair
            of the death review team, shall be provided within five business days of receipt of
            the written request, excluding weekends and holidays, unless an extension is granted
            by the lead organization or chair. Written requests may include a request submitted
            via email or facsimile transmission.
         
(e)  Administrative subpoena.--Notwithstanding any other provision of law, a death review
            team shall not need an administrative subpoena or other form of legal compulsion to
            receive requested records under this subarticle. This subsection shall not negate
            any right the death review team has to obtain an administrative subpoena or other
            form of legal compulsion.
         
(f)  Sharing of information.--Information received by the lead organization or chair in
            response to a request under this section may be shared at a death review team meeting
            in accordance with section 2133.
         
(g)  Prohibition.--A record may not be released during the pendency of an investigation
            if the release of the record would hinder the progress of an active investigation
            or criminal proceeding.
         
(h)  Applicability.--This section shall apply to the extent permitted by Federal law.
Section 2133.  Confidentiality of death review team records and meetings.
(a)  Meetings.--A death review team meeting shall be closed to the public and information
            discussed at the meeting shall be confidential.
         
(b)  Records.--
(1)  The proceedings, records and information maintained by and shared with a death review
            team may not be:
         
(i)  Disclosed under the act of February 14, 2008 (P.L.6, No.3), known as the Right-to-Know
            Law.
         
(ii)  Subject to discovery, subpoena or introduction into evidence in a criminal or civil
            proceeding.
         
(2)  Information presented in or opinions formed as a result of a meeting of a death review
            team may not be subject to subpoena or discovery or admissible in evidence in a civil
            or criminal action. Nothing under this subsection shall be construed to prevent a
            member of a death review team from testifying in a criminal or civil proceeding to
            information obtained independently of participation in the death review team or to
            information which is publicly available.
         
Section 2134.  Criminal and civil liability protections.
(a)  Confidentiality.--An individual not a member of a death review team may, in good faith,
            provide information to a death review team for the purposes of this subarticle. A
            member of a death review team may discuss confidential matters during a meeting of
            the death review team. The following shall apply:
         
(1)  A member of a death review team shall comply with applicable Federal and State laws
            regarding confidentiality.
         
(2)  Except as provided under subsection (b), a member of a death review team or an individual
            who, in good faith, provides information to a death review team may not be disciplined,
            criminally prosecuted or held administratively or civilly liable for complying with
            the provisions of this subarticle.
         
(b)  Liability.--The immunity specified under subsection (a)(2) shall not apply to a member
            of a death review team or an individual providing information to a death review team
            by invitation who either rediscloses confidential information in a manner not in accordance
            with Federal or State law or who discloses confidential information to the death review
            team with malice, in bad faith or in a negligent manner.
         
Section 4.  The provisions of this act are severable. If any provision of this act or its application
            to any person or circumstance is held invalid, the invalidity shall not affect other
            provisions or applications of this act which can be given effect without the invalid
            provision or application.
         
Section 5.  This act shall take effect as follows:
(1)  This section shall take effect immediately.
(2)  The amendment of section 2301-A(1)(xviii) shall take effect in 60 days.
(3)  The remainder of this act shall take effect in 30 days.
 
APPROVED--The 3rd day of November, A.D. 2022.
 
TOM WOLF