Opinion ID: 2191635
Heading Depth: 2
Heading Rank: 1

Heading: Respondents, their representatives, agents and assigns, together with all persons acting in concert therewith, are hereby restrained from;

Text: 1. Removing or transferring any resident of Retreat State Hospital to any other medical or nursing facility without the express consent of that resident or his guardian. 2. Initiating conversation or activity relating to transfer or, inducing or requesting from any resident at Retreat State Hospital or his guardian consent to transfer to another facility. Provided : that nothing in this order shall prohibit Respondents, their agents, and assigns (a) from answering questions, supplying resident or his guardian to solicit consent, to provide information, and to prepare the patient for transfer where consent is obtained. D. Respondents shall have a wide range of discretion in the methods utilized in the solicitation process but shall not use coercion or harassment. 1. Coercion is defined as the use of physical or moral force to compel to act or consent. Websters Third International Dictionary 439 (1966). 2. Harassment is defined as the act or instance of vexing, troubling, or annoying continually or chronically. Websters Third International Dictionary 1031 (1966). E. Inquiries of residents or their guardians relating to transfer or a proposed transfer site shall be reported by employees in accordance with hospital procedures, to those persons specified by the Respondents and noted in the resident's medical chart. F. Employees, their agents, assigns, and representatives, together with any party acting on their behalf, are hereby restrained from: 1. Soliciting or in any way requesting or encouraging a resident or his guardian to withhold consent or to revoke consent once consent to transfer is given. 2. Impeding, hindering or in any way failing to cooperate in the care, treatment and transport of any resident, where consent to transfer has been obtained. G. Where a resident is believed to be incompetent this order shall not prohibit Respondents, their representatives, agents, and assigns, together with all persons acting in concert therewith, from petitioning the Common Pleas Court of the County of residence for a determination of competency and the appointment of a guardian. H. Where chronically disabled persons 70 years of age or older have been continuously hospitalized in a state operated facility for at least 10 years and are unable to give a rational informed consent: 1. Section 102 of the Mental Health Procedures Act, Act of July 6[9], 1976, as amended, P.L. 817, 50 P.S. § 7102, shall not exempt such persons from the orders of this Court except as set forth below. 2. Consent to transfer provided by the treating physician may be substituted for the actual express consent of the resident where, after examination of the resident and the resident's medical records, the treating physician deems it to be in the best medical interest of the resident to transfer, provided, however; a. The resident is informed of the recommendation of his doctor for transfer to another facility and the reasons for such recommendation including the status of his present medical condition, the nature of care necessary to maintain or improve that status, and the type of care available at the proposed transfer site. b. The resident is informed of his right to object to the transfer and to remain at Retreat State Hospital. 3. Where an individual lodges an objection either at the time of the recommendation for transfer or any time prior to transfer, the resident shall not be transferred until a guardian is appointed by the Common Pleas Court and said guardian consents to said transfer. 4. Where a guardian is appointed, solicitation of the guardian may only proceed in accordance with the terms of this order. 5. Nothing in this section shall be construed to apply to chronically disabled persons 70 years of age or older who have been continuously hospitalized in a State operated facility for a least 10 years and who are competent to give a rational informed consent. Express consent shall be required of such resident. 6. Disputes as to competency may be raised by either party at any time. 7. Where written notice is received by Respondents that a dispute as to competency has been raised under this section, solicitation shall cease and the resident may not be transferred until final disposition of said dispute in accordance with subsection 8 below. 8. Where there is a dispute concerning a resident's competency to provide informed rational consent, upon notification in writing to Respondents, the resident shall be examined by three (3) psychiatrists who shall evaluate the resident's competency. a. The three psychiatrists shall be selected as follows: (1) One by the Petitioners. (2) One by the Respondents. (3) One by mutual agreement of the parties. b. Where two or more psychiatrists are of the opinion that the resident is competent to give a rational informed consent, then the resident shall be deemed competent and the terms of this section shall not apply. Otherwise, substitute consent as provided at subparagraph 2 shall be effective. I. Respondents, their agents and assigns shall be permitted to utilize involuntary commitment proceedings in accordance with Sections 301-306 of the Mental Health Procedures Act, Act of July 9, 1976, as amended, P.L. 817, 50 P.S. §§ 7301-7306. Provided : that such procedures are not utilized with the purpose of intent of circumventing the consent provisions of section A of this order. J. Any appeal taken by Respondent of this Order shall not operate as an automatic supercedeas pursuant to Rule 1736, Pa.R.A.P. /s/ JAMES C. CRUMLISH, President Judge