reglab/statecodes huggingface dataset:
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter II - General Responsibilities of Mental Health Service Providers and General Provisions for Adults and Minors (§§ 6153 — 6153y) › § 6153v - Review committee

The review committee shall be constituted by a psychiatrist and an inter- or multidisciplinary team different from that which tends to the person, as defined in this chapter, to be appointed by the director of the institution. As part of this committee, a representative from an independent community-based organization shall be designated to represent the public interest. Said committee shall be empowered to review the determinations made by the medical director or his/her representative, when the reconsideration procedure has been followed pursuant to the provisions of § 6153u of this title. Once the request for review is received, the committee shall open a record of the proceedings, which shall form part of the person’s clinical record. The committee shall have two (2) working days to conduct a review hearing. The petitioner or his/her representative shall have the right to be heard and to present evidence in said hearing. Within forty-eight (48) hours after the hearing is held, the committee shall submit its findings of facts and conclusions in writing to the petitioner or his/her representative, and to the director of the institution. If the petitioner does not agree, he/she may file an injunction with the Court of First Instance.
When any of the members of the review committee is related with the situation to be considered, he/she shall disqualify him/herself from reviewing the case.
The committee shall conduct its proceedings so as to guarantee an impartial hearing and due process of law.
History —Oct. 2, 2000, No. 408, § 2.23; Aug. 6, 2008, No. 183, § 19.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter II - General Responsibilities of Mental Health Service Providers and General Provisions for Adults and Minors (§§ 6153 — 6153y) › § 6153w - Responsibility towards the family

Family members of the adult who receives mental health services shall be treated with respect and dignity. Family members shall have the opportunity to provide information to the professionals in charge of the treatment. They shall also receive educational information related to the nature of the disorders, medications and their side effects, support services available and support groups, as well as assistance in crisis management strategies. All providing institutions shall furnish this information.
History —Oct. 2, 2000, No. 408, § 2.24, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter II - General Responsibilities of Mental Health Service Providers and General Provisions for Adults and Minors (§§ 6153 — 6153y) › § 6153x - Presence of a family member

When a mental healthcare professional requires the presence of a family member or the legal guardian of an adult, or the parent with physical or legal custody or the legal guardian of a minor who receives mental healthcare services, the family member shall respond immediately. When the family member or legal guardian refuses to respond without any justified reason, after having been duly summoned on two (2) consecutive occasions, and such summons are so entered in the clinical record, the director of the institutional provider, by petition of the mental healthcare professional, may resort to the Court of First Instance to request that an order to appear be issued under penalty of contempt. Said order shall be served by a [courts] marshal not later than twenty-four (24) hours after its date of issue. The institutional provider shall notify the court whether or not the person so ordered appeared. If the person thus summoned should not appear, the court may impose a contempt order, as well as any other applicable measure.
History —Oct. 2, 2000, No. 408, § 2.25; Aug. 6, 2008, No. 183, § 20.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter II - General Responsibilities of Mental Health Service Providers and General Provisions for Adults and Minors (§§ 6153 — 6153y) › § 6153y - Duty to publish

The rights stated in this chapter shall be posted in a visible place at all institutions that provide mental health services, and [a] copy of these rights shall be delivered to the persons who receive services by virtue thereof. In addition, the responsibilities of the persons who receive mental health services shall be posted in a visible place.
History —Oct. 2, 2000, No. 408, § 2.26, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter III - Bill of Rights of Adults Who Receive Mental Health Services (§§ 6154 — 6154e) › § 6154 - Bill of rights

The provisions of this subchapter shall be interpreted so as to protect and promote the dignity of the human being through recognition of the essential rights for his/her treatment and rehabilitation.
History —Oct. 2, 2000, No. 408, § 3.01, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter III - Bill of Rights of Adults Who Receive Mental Health Services (§§ 6154 — 6154e) › § 6154a - Protection of constitutional rights

Any adult who receives mental health services shall continue to enjoy his/her rights, benefits and privileges pursuant to the Constitution of the United States of America and the Constitution of Puerto Rico, as well as state and federal laws, while receiving evaluation or treatment and rehabilitation, and during the process of admission, transfer or release in any providing institution.
History —Oct. 2, 2000, No. 408, § 3.02, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter III - Bill of Rights of Adults Who Receive Mental Health Services (§§ 6154 — 6154e) › § 6154b - Presumption of mental competency

It is presumed that all persons are mentally competent, except otherwise determined by a court. The judicial determination of disability under § 2342 of Title 31, shall be distinct and separate from the judicial proceeding to determine if an adult should be subject to involuntary admission.
It shall be presumed that any person with a mental or emotional disorders has the potential to recover and rehabilitate upon receiving mental health services adequate to his/her diagnosis and the severity of his/her symptoms and signs.
History —Oct. 2, 2000, No. 408, § 3.03, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter III - Bill of Rights of Adults Who Receive Mental Health Services (§§ 6154 — 6154e) › § 6154c - Limitation of rights

The rights established by this chapter for adults who receive mental health services are applicable to those adults serving a sentence or confined in penal or forensic-psychiatric institutions, as long as they are not in conflict with the security measures established in the institution.
History —Oct. 2, 2000, No. 408, § 3.04, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter III - Bill of Rights of Adults Who Receive Mental Health Services (§§ 6154 — 6154e) › § 6154d - General rights

Any adult who needs, requires and/or receives mental health services shall have the following rights:
(a) To receive medical, psychiatric and psychological attention in its preventive, clinical, recovery and rehabilitation phases for the protection of his/her health and general well-being.
(b) To practice a profession, occupation or trade, according to his/her knowledge and capacity, taking into consideration his/her mental disorder and level of functionality.
(c) To request employment and be employed within existing employment opportunities available, without being discriminated against for reason of mental disorder, and to participate in workshops and receive the technical or professional orientation and help that shall allow him/her to develop his/her potential.
(d) To have access to public services and benefits of housing, social welfare, health, food, transportation, education and employment.
(e) To act [individually] or collectively while searching for solutions to his/her problems and grievances.
(f) To be heard, listened to and consulted in all matters that affect his/her condition and progress.
(g) To receive ambulatory medical-hospital services without being discriminated for having a mental disorder.
History —Oct. 2, 2000, No. 408, § 3.05, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155 - Levels of care

Mental healthcare services shall be rendered in the level of care affording the greatest autonomy and therapeutically more effective within the mental healthcare system concept, as per the diagnosis and the severity of symptoms and signs at the time the person is evaluated. At any level of treatment, the use of medications may be required, as per the diagnosis and the severity of symptoms and signs at the time the person is evaluated.
Mental healthcare levels include services that range from the most intensive, such as the psychiatric hospital, to those according the greatest autonomy, such as outpatient services.
Levels of care in order of greatest intensity or greatest autonomy are:
(1) Psychiatric hospitals.
(2) Psychiatric quarters or wards in general hospitals, or psychiatric addiction or addictive medicine quarters or wards in general hospitals.
(3) Emergencies.
(4) Transitional and live-in services.
(5) Partial hospitalization.
(6) Intensive outpatient services.
(7) Outpatient services.
(8) Maintenance treatment, with or without medication.
History —Oct. 2, 2000, No. 408, § 4.01; Aug. 6, 2008, No. 183, § 22.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155a - Adults who require mental healthcare hospital services

Any adult with a mental disorder of which the severity of symptoms and signs at the time of the evaluation indicates that he/she may inflict physical harm to him or herself or others or damage property; or any such adult who has made significant threats that substantiate the same outcome; or any such adult requesting services whose condition could substantially deteriorate if not provided with adequate treatment on time, shall require mental healthcare hospital services pursuant to the proceedings established in this chapter.
Controlled substance and/or alcohol abuse or dependency, due to being considered a mental disorder, is hereby included in this provision, insofar as the conditions provided for in this section are present.
History —Oct. 2, 2000, No. 408, § 4.02; Aug. 6, 2008, No. 183, § 23.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155e - Electroconvulsive therapy

No adult shall receive electroconvulsive therapy treatment without having provided his or her informed consent and express authorization in writing.
In the event that this treatment is indicated for the adult, but that due to his/her condition, he/she is unable to give consent and does not have a designated legal guardian, it shall be necessary to hold a hearing for the court to determine whether the treatment is appropriate or not and issue an order to that effect. Said hearing shall be held summarily in the court closest to the institution, within eight (8) hours after the petition, when it is established under oath that if this modality of treatment is not employed, the person who receives mental healthcare services could be placed under danger of imminent harm.
The adult for whom electroconvulsive therapy treatment is considered and his/her legal guardian, if any, shall be notified of such intention at least forty-eight (48) hours prior to the treatment. Upon completion of all pertinent evaluations, the intervening therapeutic inter- or multidisciplinary team shall discuss the case and report its recommendations to the medical director. Every adult shall have the right to refuse this treatment in writing at any time, even after having accepted such treatment.
Every institutional provider of mental healthcare services that offers electroconvulsive therapy treatment shall have a protocol that includes the accepted standards of the American Psychiatric Association (APA) and the entities that regulate the administration of said therapy, in addition to the regulations that the Administration shall promulgate for these purposes. Said protocol shall be revised to conform to and to be contemporaneous with the revision of the American Psychiatric Association (APA). The institutional provider of mental healthcare services shall be responsible for keeping abreast of scientific advancements that might alter the procedures or the administration of this modality of treatment.
History —Oct. 2, 2000, No. 408, § 4.06; Aug. 6, 2008, No. 183, § 27.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155f - Voluntary admission

Every person of eighteen (18) years of age or more may request voluntary admission to a mental health service with a written petition signed by him/her and a psychiatrist, after an evaluation and discussion of the case with the inter- or multidisciplinary team determines that said adult should be admitted.
The written request for admission shall also contain a simple statement without technicalities stating that the adult understands he/she has the right to be released within the shortest term possible, except in those cases when during said term a petition is filed in court accompanied by a certificate stating that the adult shall be subject to involuntary admission.
History —Oct. 2, 2000, No. 408, § 4.07, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155g - Petition for release; change of status; hearing

Within twenty-four (24) hours after the petition for release, the adult shall be evaluated by a psychiatrist in consultation with the inter or multidisciplinary team, who shall determine if the adult represents a danger to the self or others, or to property, as an indicator of a mental disorder. If there is no evaluation, the adult shall be released immediately. If as a result of the petition for release, and after the evaluation, the psychiatrist, in consultation with the inter- or multidisciplinary team, determines that the adult represents danger, an order for involuntary admission shall be requested, which shall not exceed fifteen (15) days and the change of status from voluntary to involuntary, within the following twenty-four (24) hours. During this process, the adult shall remain hospitalized. The procedures of involuntary admission provided by this chapter shall be continued.
History —Oct. 2, 2000, No. 408, § 4.08, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155h - Renewal of consent; revision of record

The psychiatrist, along with the inter- or multidisciplinary team, in charge of the care and treatment of the adult shall have up to ten (10) days, after the involuntary admission, to conduct a re-evaluation in order to determine the need to continue with the hospital treatment, recovery and rehabilitation services or in another level of care. The result of said evaluation shall be notified to the adult and included in the clinical record. A written confirmation shall be requested from the adult in order to confirm the hospital service. This procedure shall continue every ten (10) days after the first revision is conducted while hospitalization lasts.
In those cases in which in the psychiatrist’s best judgment, and in consultation with the inter- or multidisciplinary team, it is determined that the adult represents immediate danger to the self or others, or to property and he/she does not give consent to continue receiving treatment services, a petition to order involuntary admission shall be requested from court, which shall exceed fifteen (15) days, and the change of status from voluntary to involuntary.
History —Oct. 2, 2000, No. 408, § 4.09, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155i - Other levels of care

The court, before determining whether the adult should be institutionalized involuntarily, shall consider other indicated levels of care according to the diagnosis and severity of symptoms and signs at the time. The court may order that the adult be submitted to treatment in any other level of care of the basic and complementary treatment, recovery and rehabilitation services at an institutional provider of mental healthcare services or a for-profit or nonprofit community-based organization, as defined in this chapter. Furthermore, the court shall consider the recommendations presented by the psychiatrist and the inter- or multidisciplinary team responsible for the adult’s initial evaluation. Said recommendations shall be detailed in the report, which in turn, shall include a comprehensive evaluation together with a preliminary individualized treatment, recovery and rehabilitation plan applicable to the level of care recommended, and any other information that the court may deem necessary. The regulations established by the Administration shall include specifications as to the contents and form of the individualized treatment, recovery and rehabilitation plan by level of care.
The court shall, however, have authority to modify an order for treatment in another level of care if the adult under such order does not observe the same or if the mental healthcare professionals determine that the response to treatment is not adequate, according to the condition. Before modifying the order, the court must receive a report from the director of the service or level of care specifying the reasons why the order should be modified. The court shall schedule a hearing, about which the adult shall be duly notified, and in which he/she shall have the opportunity to express his/her opinion when the order for mandatory treatment is reconsidered. The adult shall be accompanied by a legal representative during the hearing.
If the court revokes the order for mandatory treatment or orders that the adult be hospitalized, a marshal shall take all the necessary steps to coordinate transportation for the adult.
History —Oct. 2, 2000, No. 408, § 4.10; Aug. 6, 2008, No. 183, § 28.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155j - Compulsory treatment

Any person who, as a result of the initial evaluation, does not require the level of care of hospitalization intensity, but represents a risk to the self or others, and to property, and requires a level of care of greater autonomy, the psychiatrist, along with the inter- or multidisciplinary team of professionals, shall recommend to the court to order compulsory participation in a level of care with less intensity and greater autonomy, under penalty of contempt if he/she does not attend. The institution in charge of the administration of the compulsory treatment shall be bound to notify the court of the patient’s attendance and the progress of the treatment, or the evolution of the clinical condition. The reports shall be submitted to the court quarterly, until the person’s situation, by the symptoms and signs so justify it, and this report may move the court to determine that the person does not represent a risk to the self or others, or to property.
History —Oct. 2, 2000, No. 408, § 4.11, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155k - Involuntary admission; hospitalization

Any adult who meets the necessary requirements to receive mental health services, but does not allow it or is not able to allow it, shall be evaluated to determine involuntary admission to a providing institution. Said evaluation shall require the court’s intervention. The court shall order a direct evaluation by a psychiatrist in consultation with the inter or multidisciplinary team, who shall determine if the adult should receive treatment, recovery and rehabilitation for his/her mental disorder.
No person shall be admitted involuntarily, unless there exists clear and convincing evidence to the court’s satisfaction that he/she represents a risk to the self or others, or to property, and needs to be admitted.
History —Oct. 2, 2000, No. 408, § 4.12, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155o - Petition for release of involuntary admission

Any adult who has been admitted involuntarily in a providing institution through a court order may file a petition to the court requesting his/her release. The adult subject of involuntary admission, or a family member, legal guardian or representative, may file the petition for release. The petition shall include:
(a) Name of the person.
(b) A copy of the order(s) for involuntary admission issued by the court.
(c) An explanation or justification for petitioning to be released.
When a petition for release is filed, the court shall schedule a hearing within the next five (5) days as of the date the petition was filed. The court shall state the date, time and place the hearing shall be held, sending a copy to the adult-petitioner, his/her attorney, legal guardian and director of the providing institution.
If the court determines that the adult must not continue involuntarily admitted, he/she shall be released and said determination shall be notified to the adult, his/her attorney, legal guardian and the director of the institution.
If the court determines that the adult must continue involuntarily admitted, the original order may continue pursuant to the provisions of this chapter.
In those cases in which the court deems necessary, it may order to transfer the adult to the hospital institution in a vehicle adequate for his/her condition, depending on the severity of the symptoms and signs at the time, in a state, municipal, or private ambulance. The health insurance shall assume the cost for said services in the case of those persons who receive mental health services under the Health Reform.
History —Oct. 2, 2000, No. 408, § 4.16, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155p - Change of status

Before adjudicating the case in which involuntary admission is being discussed, the adult who receives mental health services who has been so admitted may request a change of status to a voluntary admission. The petition shall be accompanied by a certification by the psychiatrist or physician, as may apply, stating that the adult who receives mental health services and requests this change is capable of giving consent and has done so in a well-informed manner, as required by this chapter. If the court accepts this change of status, it shall then close the proceedings. The institution that provides mental health services, in turn, shall proceed pursuant to § 6155h of this title.
History —Oct. 2, 2000, No. 408, § 4.17, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155q - Hearings

(a) Hearings shall be held before a court with venue, pursuant to the provisions of the Rules of Civil Procedure in effect.
(b) The adult shall be present at the hearing, except when he/she has expressly waived to do so, or when he/she has agreed to waive his/her right and expressed so through his/her attorney.
(c) If the court, motu proprio, or upon petition from one of the parties with just force majeure, postpones the case, the adult shall remain hospitalized pending a subsequent order from the court. The postponement of the hearing shall not be extended for more than five (5) calendar days.
(d) The adult shall have the right to present all the evidence he/she deems convenient to contest the continuation of his/her involuntary admission. Said evidence may be oral or written. To that effect, the adult shall have the right to be examined by an independent mental health professional of his/her choice, or by one designated by the court, who shall conduct an evaluation and issue his/her recommendations to the court. The services of said professional shall be paid by the adult object of the petition for involuntary admission or change of status, by a close relative, if any, or by the state, if the adult is indigent.
History —Oct. 2, 2000, No. 408, § 4.18, renumbered as § 4.18(B) on Aug. 6, 2008, No. 183, § 30.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155r - Right to legal representation

Every adult object of a petition to order involuntary admission shall have the right to be represented by an attorney or family advocate, whoever is available. If the adult is indigent and has not been able to hire an attorney, the court shall appoint a public attorney. The attorney appointed by the court and the defendant should have reasonable time to prepare for the hearing.
History —Oct. 2, 2000, No. 408, § 4.19, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155t - Passes

In those mental health cases in which is it clinically necessary or beneficial, the psychiatrist may, jointly with the inter- or multidisciplinary team, grant [a] pass to the adult admitted voluntarily or involuntarily, even if he/she is not fit to be released. In these cases, the court shall not need to be notified, but the closest family member or the legal guardian shall be notified of the pass granted as soon as possible.
History —Oct. 2, 2000, No. 408, § 4.21, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155u - Releases

The psychiatrist in charge of treatment, recovery and rehabilitation may, at any time, release any adult admitted voluntarily or involuntarily, after having notified the inter- or multidisciplinary team.
The psychiatrist and the inter- or multidisciplinary team of the adult to be released shall explain to him/her, his/her family or legal guardian, his/her release plan and the options for recovery, notifying the court of the findings made in those cases where the court orders an involuntary admission.
History —Oct. 2, 2000, No. 408, § 4.22, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155v - Unauthorized abandonment of the institution; notices

When an adult subject to involuntary admission abandons the institution without having been released, the director shall immediately notify a police officer so that he/she may be apprehended and returned to the institution. In addition, he/she shall notify the adult’s family, legal guardian and the person who requested his/her admission.
When an adult subject to voluntary admission abandons the institution without having been released, the director shall immediately notify the adult’s family member or legal guardian.
History —Oct. 2, 2000, No. 408, § 4.23, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter V - Transitional Services For Adults (§§ 6156 — 6156d) › § 6156 - Purposes of the transitional services

Transitional services shall be designed to provide experiences that are structured, consistent and specialized in different levels of supervision according to the severity of the symptoms and signs of the disorder that apply, by age and gender, and to achieve that the adult becomes adapted to his/her environment and is able to participate in another level of care of greater autonomy, until he/she can reach his/her eventual independence within the community. Their main function shall be to render treatment, recovery and rehabilitation services emphasizing the adequate development of the person’s handling of daily life, in addition to offering care and custody in a safe and humane manner.
History —Oct. 2, 2000, No. 408, § 5.01, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter V - Transitional Services For Adults (§§ 6156 — 6156d) › § 6156a - Transitional services

Institutions that provide transitional services shall, as a minimum, provide the following:
(a) Safe and humane care and custody within an environment with the greatest autonomy possible according to the adult’s treatment, recovery and rehabilitation needs.
(b) The corresponding individualized treatment, recovery and rehabilitation, emphasizing the skills that are necessary for everyday life given his/her clinical condition, the severity of the symptoms and signs, the stage of life where the person is, and his/her potential for recovery and rehabilitation to achieve greater autonomy in his/her environment.
(c) An adequate coordination with government and private agencies to achieve comprehensive services for the person and his/her family, in order to reach a greater self-sufficiency.
(d) Attention to the mental and physical health condition of the adults admitted, as well as of their families.
(e) The promotion of family participation in the adult’s individualized treatment, recovery and rehabilitation plan, as well as orientation thereof.
(f) A balanced diet, according to the special needs of the participants of the programs.
(g) A rehabilitation, recreational, vocational and occupational plan, as may apply, to be implemented on the program or service in charge of specialized personnel.
History —Oct. 2, 2000, No. 408, § 5.02, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter V - Transitional Services For Adults (§§ 6156 — 6156d) › § 6156b - Services manuals

Every institution that provides transitional services shall have a services manual, which shall contain, as a minimum, the following:
(a) The admission criteria to be met by adults who request the services.
(b) The age, sex, disorder, diagnosis and level of functionality.
(c) An individualized treatment, recovery and rehabilitation plan prepared by an inter- or multidisciplinary team.
(d) The staffing pattern that the institution shall have, as well as the qualifications thereof.
(e) The program’s philosophy and a description of the institution’s environment.
(f) The corresponding therapeutic method or activity program.
(g) The evaluation protocol for suicide risks with its corresponding contingency provisions.
(h) The procedure for filing and processing claims and complaints describing in simple words the steps adults and their families shall take if they need to use these mechanisms.
History —Oct. 2, 2000, No. 408, § 5.03, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter V - Transitional Services For Adults (§§ 6156 — 6156d) › § 6156c - Levels, stages of services

Transitional services shall be developed by levels or stages of services, according to the needs, in the environment with the greatest autonomy possible, as it has been therapeutically indicated.
The levels or stages of service adopted by the institution that provide transitional services shall be designed in accordance with the severity of the symptoms and signs, the diagnosis and the degree of supervision required by the adult, with greater supervision, services with moderate supervision, services with minimum supervision and home services or independent being understood as such services.
It shall be permitted for adults to be directly referred to the level most appropriate for their condition, without having to go through all the levels or stages.
History —Oct. 2, 2000, No. 408, § 5.04, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter V - Transitional Services For Adults (§§ 6156 — 6156d) › § 6156d - Involuntary admission; compulsory treatment

Any adult who meets the necessary criteria to receive transitional services and represents an immediate risk to the self or others, or to property, according to the evaluations and recommendations of the psychiatrist and the inter- or multidisciplinary team, but who does not consent nor is capable of giving consent to such services, shall be object of a petition for compulsory treatment or involuntary admission before the court, pursuant to the proceedings provided in this chapter for to that effect.
History —Oct. 2, 2000, No. 408, § 5.05, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VI - Outpatient Mental Health Services for Adults (§§ 6157 — 6157d) › § 6157 - Outpatient mental healthcare services for adults

Any adult who resorts to an institutional provider of indirect mental healthcare services in order to start receiving outpatient services at the various levels of care and in the various modalities of treatment, rehabilitation, and recovery, shall receive, among others, the following services during the first seventy-two (72) hours:
(a) A physical examination, when clinically necessary to rule out physiological or organic conditions or as part of the outpatient clinical follow-up;
(b) a laboratory test, when clinically necessary to rule out physiological or organic conditions or as part of the outpatient clinical follow-up;
(c) a psychiatric evaluation conducted by a psychiatrist;
(d) a psychological screening conducted by a psychologist;
(e) an initial social evaluation conducted by a social worker, when clinically indicated;
(f) a psychiatric diagnosis in its five (5) axes, as per the DSM-IV-TR or the clinical manual in effect at the time;
[(g)] a substance screening conducted by an addiction counselor, when clinically indicated, to rule out or assess substance abuse and/or dependency;
[(h)] a clinical record.
The results of the tests, analyses, and evaluations shall form part of the adult’s clinical record and be used to establish the individualized treatment, recovery and rehabilitation plan at the corresponding greater-autonomy level of care. This plan shall be devised by an inter- or a multidisciplinary team not later than fifteen (15) days following the beginning of treatment and be reviewed every thirty (30) days pursuant to the standards for each level of care or when a substantial change occurs. These procedures shall be recorded as part of the regulations to be promulgated for these purposes.
The provisions of this section shall not apply in the case of private offices of mental healthcare professionals. In such cases, the mental healthcare professionals shall make sure to comply with the standards applicable to their respective professions, based on the clinical protocols and treatment guidelines recommended by the Administration.
History —Oct. 2, 2000, No. 408, § 6.01; Aug. 6, 2008, No. 183, § 32.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VI - Outpatient Mental Health Services for Adults (§§ 6157 — 6157d) › § 6157a - Family Planning Program

Any adult who, voluntarily or involuntarily, comes to a profit or non-profit entity that provides mental health and/or drug and/or alcohol rehabilitation services, shall receive from the agency, organization, institution, and/or drug dependent patients” program the following services:
(a) Family planning education provided by a physician or health care provider trained and extensively experienced in family planning. It shall include a minimum of 30 contact-minutes and the maximum contact time deemed necessary for the patient to understand.
(b) Preventive and diagnostic tests as indicated by the Clinical Preventive Guidelines, such as PAPs, mammograms, STD testing, and others.
(c) Methadone treatment for pregnant women who are dependent on opioid drugs, following the “Methadone Treatment for Pregnant Women” guidelines published by the U.S. Department of Health and Human Services.
(d) Coordination for contraceptive treatment with a gynecologist, in the case of women, and urologists, in the case of men, with a maximum term of 24 hours to answer the consultation request.
(e) Treatment shall be completely free of charge for the patient. This program shall be defrayed by the Department of Health, the Mental Health and Addiction Services Administration, Title X Federal Program of the Public Health Service Act (PHSA) created by Act 91-572 of 1970, in collaboration with any other prevention and health education program aimed at men and women with substance use disorders that operates with public funds.
(f) The physician and the patient shall determine the treatment together, taking into account the mental and physical health of the patient. Patients who are not able to make decisions shall be accompanied by their guardian. The patient’s participation in the treatment program shall be completely voluntary.
(g) Every agency, institution, or any other entity offering drug and alcohol rehabilitation services shall be bound to offer the patient the Family Planning Program during the dependent patient’s rehabilitation period, and not later than 48 to 72 hours before the patient is discharged.
(h) The institution shall be required to submit quarterly reports to the Department of Health.
History —Oct. 2, 2000, No. 408, added as § 6.02 on Aug. 25, 2012, No. 211, § 1.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VI - Outpatient Mental Health Services for Adults (§§ 6157 — 6157d) › § 6157b - Outpatient visits

The number of outpatient visits to mental healthcare services may not be limited by a direct or an indirect mental healthcare service provider, except as provided for in this chapter. The need for outpatient services on an ongoing basis shall be assessed by the inter- or multidisciplinary team or by the mental healthcare professional responsible for the care of the person receiving mental healthcare services. Outpatient visits include, among others, but are not limited to introductory visits, follow-up visits, and collateral visits.
History —Oct. 2, 2000, No. 408, added as § 6.02(A) on Aug. 6, 2008, No. 183, § 33.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VI - Outpatient Mental Health Services for Adults (§§ 6157 — 6157d) › § 6157c - Initial evaluation; treatment, recovery and rehabilitation plan at another level of care

In the case of adults who have been hospitalized or who received services at a level of care, when by recommendations of the psychiatrist and the inter- or multidisciplinary team of the service making the referral, it is found that such adults need treatment at another level of care with greater or lesser autonomy, the review of the discharge plan of such adults or of the recommendations ensuing from their evaluation shall be in order and the same shall be instituted within twenty-four (24) hours following placement, insofar as they are clinically qualified for such level of care.
The evaluation, the recommendations, or the discharge plan shall form part of the adult’s clinical record at the applicable level of care. Such results shall be used to establish the individualized treatment, recovery and rehabilitation plan, which shall be reviewed in light of the diagnosis and the severity of symptoms and signs for each level of care pursuant to the best practices of mental healthcare professionals and the treatment protocols and guidelines recommended by the Administration. This plan shall be devised by an inter- or a multidisciplinary team not later than fifteen (15) days following commencement of services and reviewed every thirty (30) days pursuant to the standards for each level of care or when a substantial change occurs. Once patients have achieved the objectives of their individualized treatment, recovery and rehabilitation plan, they shall continue to the next level of care that accords them greater autonomy, as their condition allows.
History —Oct. 2, 2000, No. 408, § 6.02, renumbered as § 6.02(B) and amended on Aug. 6, 2008, No. 183, § 34.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VI - Outpatient Mental Health Services for Adults (§§ 6157 — 6157d) › § 6157d - Service manuals

Every institutional provider of greater-autonomy services shall issue a service manual, which shall contain, at the least, the following:
(a) The admission criteria to be met by adults who request the services.
(b) The age, sex, disorder, diagnosis and level of functionality.
(c) An individualized treatment, recovery and rehabilitation plan prepared by an inter- or multidisciplinary team.
(d) The staffing pattern that the institution shall have, as well as the qualifications thereof.
(e) The program’s philosophy and a description of the institution’s environment.
(f) The corresponding therapeutic modality or activity program.
(g) The evaluation protocol for suicide risks with its corresponding contingency provisions.
(h) The procedure for filing and processing claims and complaints describing in simple words the steps adults and their families shall take if they need to use these mechanisms.
The provisions of this section shall not apply to mental healthcare professionals in the private practice. However, said professionals shall advise patients on the treatment options for their condition, the ones they recommend, which ones they can provide according to the patients’ symptoms and signs, and the diagnostic impression at the time of the initial evaluation.
History —Oct. 2, 2000, No. 408, § 6.03; Aug. 6, 2008, No. 183, § 35.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VII - Bill of Rights of Minors Who Receive Mental Health Services (§§ 6158 — 6158e) › § 6158 - Bill of rights

The provisions of this subchapter shall be interpreted so as to protect and promote the dignity of the human being through recognition of the essential rights for his/her treatment, recovery and rehabilitation.
History —Oct. 2, 2000, No. 408, § 7.01, eff. 90 days after Oct. 2, 2000.
2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter VII - Bill of Rights of Minors Who Receive Mental Health Services (§§ 6158 — 6158e) › § 6158a - Protection of constitutional rights

Any minor who receives mental health services shall continue to enjoy all his/her rights, benefits and privileges pursuant to the Constitution of the United States of America and the Constitution of Puerto Rico, as well as state and federal laws, while he/she is receiving treatment, recovery and rehabilitation, and during the process of admission, transfer or release in any providing institution.
History —Oct. 2, 2000, No. 408, § 7.02, eff. 90 days after Oct. 2, 2000.