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Completed by:

The Unsilenced Policy Team

Pennsylvania Legislation Report

2022

2022

Introduction

The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.

Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.

Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.

An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.

It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.

Introduction

The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.

Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.

Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.

An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.

It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.

Pennsylvania Legislation

General Oversight and Transparency Title 55 Chapter 3800
Oversight Agency Department of Human Services
Which state agency oversees investigations? Office of Children, Youth, and Families
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? Yes, except for child residential facilities operated directly by the department
Is a list of licensed facilities available to the public? Yes
Can complaints be filed online? Is the reporting portal easy to find? No
Does the state conduct unannounced site visits? How many per year? Yes. Annually
Are background checks required, including volunteers? Yes for staff. No for volunteers.
Is a full-time licensed clinician required to be on staff? Yes. §3800.54. Child care supervisor (d) The child care supervisor shall have one of the following: (1) A bachelor’s degree from an accredited college or university and 1 year work experience with children. (2) An associate’s degree or 60 credit hours from an accredited college or university and 3 years work experience with children.
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? Yes when possible. However, not required in an emergency
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? 24-hours is not specified
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No
Does the state require mandatory child abuse response training for all staff working with children in residential settings? No
Does the state require medical response training for all staff working with children in residential settings? Yes. Required before working alone with children and within 120 days of being hired
Does the state require 1:4 staffing ratio or higher? Yes, but ratio varies depending on age of children and if they are sleeping.
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? Yes. There is a requirement for a placement process in which the facility assesses and documents the needs and circumstances of the child and if that facility can meet those needs and provide service.
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? Yes. §3800.31
Does the State define institutional abuse and neglect? No
Are there civil penalties for violations of institutional child abuse and neglect? No Information
Does the State prohibit mail censorship? Censorship is prohibited for outgoing mail but incoming mail from people other than state, federal or county officials and the child's lawyer may be opened and read if there is reasonable suspicion of contraband or material that may jeopardize the child's well being. § 3800.32
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? No. Youth have the right to communicate with others by telephone but it is subject to "reasonable facility policy and written instructions from contracting agency or court."
Does the state require that children be allowed visitors in private during normal visiting hours? No. Not private unless the visitor is the child's attorney
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? An ISP (Individual Service Plan) is developed for the youth but whether mental health treatment that is evidence-based is not specified
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? No Information
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? Yes, a Department of Education-approved school program or one under contract with local public school district
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No Information
Are youth provided with access to advocacy services and representation? No Information
Does the state require parental consent to all treatment received? No. Whenever possible, general written consent is to be obtained during admissions. For non-routine treatments, if a parent is not able to consent than it can be ordered by court. Emergency treatment does not need parental consent.
Is a grievance procedure required for youth and families? Yes, the child and parents have the right to lodge grievances without a fear of retaliation - Child's Rights, 3800.31
Is youth consent required for all treatment received? It depends on age and type of treatment. Under the Mental Health Procedures Act (50 P. S. § § 7101—7503), a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication.
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? Yes. §3800.102
Does the state prohibit aversion therapy? Yes
Is physical restraint prohibited? No. Applying pressure or weight on the respiratory system is prohibited. The prone position (face down on the floor) is not permitted on pregnant girls. The position of the physical restraint or the staff member applying the restraint must be changed every 10 consecutive minutes. A person not involved in the physical restraint must observe and document the physical and emotional condition of the child at least every ten consecutive minutes during the whole physical restraint. 3800.211, Manuel Restraints
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-adminstering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Educational component: Act 14 Article XIII; Child residential component: Title 55 Ch. 3800
Oversight Agency The PA State Department of Education oversees educational component. DHS for the residential component. Accreditation/Registration/Licensing/Approval: Bureau of Family Health/Division of Child & Adult Health Services, specifically the Adolescent Health Program. Accreditation is optional. Private academic schools may choose to become accredited rather that licensed. Schools accredited by accrediting associations approved by the State Board of Education do not need to be licensed. 24 P.S. §6705
Which state agency oversees investigations? Office of Children, Youth, and Families
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? No. All private schools can choose to be either licensed by the state or accredited by a state-approved organization. Religious schools are exempt.
Is a list of licensed facilities available to the public? Yes
Can complaints be filed online? Is the reporting portal easy to find? No
Does the state conduct unannounced site visits? How many per year? No. The state is permitted to but not required.
Are background checks required, including volunteers? All school employees must be screened by the Department of Public Welfare for criminal history and basic background checks. Anyone not receiving a clearance from the department is not eligible for hire (23 Pa. Cons. Stat. §6355). Volunteer background checks required only if volunteers are going to have direct contact with children.
Is a full-time licensed clinician required to be on staff? No
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? No
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? No
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No
Does the state require mandatory child abuse response training for all staff working with children in residential settings? Not all staff are required to undergo mandated training. Act 126 of 2012 (""Child Abuse Recognition and Reporting Training"") amended the Public School Code of 1949 to mandate that all school entities and independent contractors of school entities provide their employees who have direct contact with children with a minimum of three hours of training every five years on child abuse and sexual misconduct recognition and reporting
Does the state require medical response training for all staff working with children in residential settings? No
Does the state require 1:4 staffing ratio or higher? No
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? No
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? No. §3800.31 while rights are informed to both parent/child, only child is given materials on the process of reporting
Does the State define institutional abuse and neglect? No
Are there civil penalties for violations of institutional child abuse and neglect? No
Does the State prohibit mail censorship? No
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? No. Youth have the right to communicate with others by telephone but it is subject to reasonable facility policy and written instructions from contracting agency or court.
Does the state require that children be allowed visitors in private during normal visiting hours? No. Not private unless the visitor is the child's attorney
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? No
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? Yes
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? Only for a Department of Education-approved school program or one under contract with local public school district
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No
Are youth provided with access to advocacy services and representation? No
Does the state require parental consent to all treatment received? No. Whenever possible, general written consent is to be obtained during admissions. For non-routine treatments, if a parent is not able to consent than it can be ordered by court. Emergency treatment does not require parental consent.
Is a grievance procedure required for youth and families? Yes. The child and parents have the right to lodge grievances without a fear of retaliation. Child's Rights, 3800.31
Is youth consent required for all treatment received? Depends on age and type of treatment. Under the Mental Health Procedures Act (50 P. S. § § 7101—7503), a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? Yes
Does the state prohibit aversion therapy? No
Is physical restraint prohibited? The state no longer allows prone restraints, but does allow supine and other physical restraints 22 Pa. Code § 12.5. Corporal punishment (is prohibited). (a) Corporal punishment is defined as physically punishing a student for an infraction of the discipline policy. Use of corporal punishment is prohibited. (b) Teachers and school authorities may use reasonable force under the following circumstances: (1) To quell a disturbance. (2) To obtain possession of weapons or other dangerous objects. (3) For the purpose of self-defense. (4) For the protection of persons or property.
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Title 55 Chapter 3800
Oversight Agency Department of Human Services
Which state agency oversees investigations? Office of Children, Youth, and Families
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? Yes
Is a list of licensed facilities available to the public? Yes
Can complaints be filed online? Is the reporting portal easy to find? No
Does the state conduct unannounced site visits? How many per year? No. The state is permitted to visit but not required to.
Are background checks required, including volunteers? Yes for staff. No for volunteers.
Is a full-time licensed clinician required to be on staff? §3800.54. Child care supervisor (d) The child care supervisor shall have one of the following: (1) A bachelor’s degree from an accredited college or university and 1 year work experience with children. (2) An associate’s degree or 60 credit hours from an accredited college or university and 3 years work experience with children.
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? Yes, when possible. However, it is not required in an emergency
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? No
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No requirement of mental health evaluation
Does the state require mandatory child abuse response training for all staff working with children in residential settings? No
Does the state require medical response training for all staff working with children in residential settings? At least one staff person shall be present with the children at all times who has current certification from a hospital or other recognized health care organization in first aid, Heimlich techniques and cardiopulmonary resuscitation
Does the state require 1:4 staffing ratio or higher? Staffing requirements are different and there are exceptions with outdoor and mobile programs. Supervision during sleeping hours does not apply if there is 12 or fewer children and one of the following conditions are met: (1) Each of the children has lived at any facility within the legal entity for at least 6 months and each child’s health and safety assessment indicates there are no high risk behaviors during sleeping hours. (2) There are live-in staff persons at the facility.
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? Yes but it is not very specific. There is a requirement for a placement process in which the facility assesses and documents the needs and circumstances of the child and if that facility can meet those needs and provide service.
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? Yes
Does the State define institutional abuse and neglect? No
Are there civil penalties for violations of institutional child abuse and neglect? No
Does the State prohibit mail censorship? Censorship is prohibited for outgoing mail but incoming mail from people other than state, federal or county officials and the child's lawyer may be opened and read if there is reasonable suspicion of contraband or material that may jeopardize the child's well-being §3800.32
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? No. 3800.293 (5) Section 3800.90
Does the state require that children be allowed visitors in private during normal visiting hours? No. Visits are not private unless the visitor is the child's attorney
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? No. An ISP (Individual Service Plan) is developed for the youth but mental health treatment that is evidence-based is not specified
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? No Information
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? Yes, a Department of Education-approved school program or one under contract with local public school district
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No Information
Are youth provided with access to advocacy services and representation? No Information
Does the state require parental consent to all treatment received? No. Whenever possible, general written consent is to be obtained during admissions. For non-routine treatments, if a parent is not able to consent than it can be ordered by court. Emergency treatment does not need parental consent. 3800.19
Is a grievance procedure required for youth and families? Yes, the child and parents have the right to lodge grievances without a fear of retaliation - Child's Rights, 3800.31
Is youth consent required for all treatment received? No. Depends on age and type of treatment. Under the Mental Health Procedures Act 50 P. S. §7101—7503, a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? Yes. §3800.303. Additional requirements. (c) The following additional requirement applies for mobile and outdoor programs that operate from stationary settings such as tepees and cabins: The maximum capacity specified on the certificate of compliance shall be based on 30 square feet per child, including measurement of all floor space.
Does the state prohibit aversion therapy? Yes
Is physical restraint prohibited? No. Applying pressure or weight on the respiratory system is prohibited. The prone position (face down on the floor) is not permitted on pregnant girls. The position of the physical restraint or the staff member applying the restraint must be changed every 10 consecutive minutes. A person not involved in the physical restraint must observe and document the physical and emotional condition of the child at least every ten consecutive minutes during the whole physical restraint - 3800.211, Manual Restraints
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Title 55 Ch. 5300 & Title 55 Ch. 5100 - Provider Participation - §1151.31. Participation requirements Medicaid
Oversight Agency The Department will accept, as sufficient for licensure, accreditation by the Joint Commission on Accreditation of Hospitals (JCAH), Medicare Certification or approval by other national accreditation bodies which are designated as acceptable by the Secretary, if the hospital is also in compliance with the applicable sections of Chapter 5100
Which state agency oversees investigations? If a private psychiatric hospital is not nationally accredited or certified under § 5300.1 (relating to accreditation), the Department will apply the JCAH standards as well as applicable sections of Chapter 5100 (relating to mental health procedures). Can apply for exemption from approval standards shall submit a written request to the Deputy Secretary of Mental Health
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? No. Facilities can requesting an exemption from approval standards
Is a list of licensed facilities available to the public? No. Psychiatric facilities can be found through state but a list of licensed private psychiatric facilties is not available
Can complaints be filed online? Is the reporting portal easy to find? No
Does the state conduct unannounced site visits? How many per year? No
Are background checks required, including volunteers? No
Is a full-time licensed clinician required to be on staff? No. It is not required unless deemed necessary under evaluation and/or inspection - 151.77
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? No. It is listed only a recommendation: "Guardian...should be consulted"" - 55 Pa. Code § 5100.15 Contents of Treatment Plan
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? No
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No 24 hour requirement. Only requires notification for admittance and facility transfer
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No
Does the state require mandatory child abuse response training for all staff working with children in residential settings? No
Does the state require medical response training for all staff working with children in residential settings? No
Does the state require 1:4 staffing ratio or higher? No
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? If receiving payment from Medicaid, §1151.62 - Certification of Need for admission. (b) If a recipient under 21 years of age is being admitted, an independent team shall certify at the time of admission the need for acute psychiatric services in a private psychiatric hospital and document this in the medical record
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? Yes for patient. No for parents. For the patients, they are required to give them a manual of their rights. For parents, they have a manual of rights provided upon request
Does the State define institutional abuse and neglect? No. Only defers to general CPS laws where only Institutional sexual assault is mentioned
Are there civil penalties for violations of institutional child abuse and neglect? No. Only civil penalties for violating CPS codes generally. No specific code for institutional child abuse and neglect
Does the State prohibit mail censorship? No. Right to receive and send unopened letters and to have outgoing letters stamped and mailed. Incoming mail may be examined for good reason in your presence for contraband. Contraband means specific property which entails a threat to your health and welfare or to the hospital community
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? Yes. 55 §5100.54(b)
Does the state require that children be allowed visitors in private during normal visiting hours? Yes. 55 §5100.54(b)
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? No
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? No
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? No Information
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No Information
Are youth provided with access to advocacy services and representation? Yes. 55 §5100.54 (c) Every patient has the right to see or telephone his attorney in private at any reasonable time, regardless of visiting hours.
Does the state require parental consent to all treatment received? No
Is a grievance procedure required for youth and families? Yes. The child and parents have the right to lodge grievances without a fear of retaliation - Child's Rights, 3800.31
Is youth consent required for all treatment received? Depends on the age. While the patient does not have the capacity to give informed consent to the treatment, the law currently depends on age and type of treatment. Under the Mental Health Procedures Act (50 P. S. § § 7101—7503), a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication.
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? No
Does the state prohibit aversion therapy? Yes
Is physical restraint prohibited? The state no longer allows prone restraints, but does allow supine and other physical restraints 22 Pa. Code § 12.5. Corporal punishment (is prohibited). (a) Corporal punishment is defined as physically punishing a student for an infraction of the discipline policy. Use of corporal punishment is prohibited. (b) Teachers and school authorities may use reasonable force under the following circumstances: (1) To quell a disturbance. (2) To obtain possession of weapons or other dangerous objects. (3) For the purpose of self-defense. (4) For the protection of persons or property.
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Title 55 Ch. 3800 (3800.271)
Oversight Agency Department of Human Services
Which state agency oversees investigations? Department of Human Services
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? Yes
Is a list of licensed facilities available to the public? Yes
Can complaints be filed online? Is the reporting portal easy to find? Yes
Does the state conduct unannounced site visits? How many per year? No. The state is permitted to but not required to visit
Are background checks required, including volunteers? Yes for staff and volunteers (every 5 years) UNLESS continuous residency in PA affidavit obtained. PA CPS Law Act 153 requires employees, volunteers and other individuals who interact with minors to obtain three different clearances: (1) Pennsylvania Access to Criminal History (PATCH) (2) Pennsylvania Child Abuse History (PACA) (3) FBI Criminal History Background Check (FBI Fingerprint)
Is a full-time licensed clinician required to be on staff? Yes
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? When possible at admission into program and for non-routine procedures, written consent by legal guardian (if none, by court order) is required. Emergency is not required
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? Not unless it involves the child missing
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No requirement of mental health evaluation
Does the state require mandatory child abuse response training for all staff working with children in residential settings? No
Does the state require medical response training for all staff working with children in residential settings? Yes, it is required prior to working alone with children and within 120 days of being hired - §3800.58
Does the state require 1:4 staffing ratio or higher? No. 1:6 during the day; 1:12 at night. It largely depends on age of youngest child, how many children, time of day, etc
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? Yes. §3800.272
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? Yes. §3800.31
Does the State define institutional abuse and neglect? No
Are there civil penalties for violations of institutional child abuse and neglect? No
Does the State prohibit mail censorship? No. Censorship is prohibited for outgoing mail but incoming mail from people other than state, federal or county officials and the child's lawyer may be opened and read if there is reasonable suspicion of contraband or material that may jeopardize the child's well-being - §3800.32
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? Yes. 55 §5100.54(b)
Does the state require that children be allowed visitors in private during normal visiting hours? Yes. 55 §5100.54(a)
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? No
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? No
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? No Information
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No Information
Are youth provided with access to advocacy services and representation? Yes. (c) Every patient has the right to see or telephone his attorney in private at any reasonable time, regardless of visiting hours - 55 §5100.54
Does the state require parental consent to all treatment received? No. However whenever possible, general written consent is to be obtained during admissions. For non-routine treatments, if a parent is not able to consent than it can be ordered by court. Emergency treatment does not need parental consent - 3800.19
Is a grievance procedure required for youth and families? Yes. The child and parents have the right to lodge grievances without a fear of retaliation - Child's Rights, 3800.31
Is youth consent required for all treatment received? Depends on age and type of treatment. Under the Mental Health Procedures Act (50 P. S. § § 7101—7503), a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? No
Does the state prohibit aversion therapy? No
Is physical restraint prohibited? The state no longer allows prone restraints, but does allow supine and other physical restraints 22 Pa. Code § 12.5. Corporal punishment (is prohibited). (a) Corporal punishment is defined as physically punishing a student for an infraction of the discipline policy. Use of corporal punishment is prohibited. (b) Teachers and school authorities may use reasonable force under the following circumstances: (1) To quell a disturbance. (2) To obtain possession of weapons or other dangerous objects. (3) For the purpose of self-defense. (4) For the protection of persons or property.
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Title 55 Ch. 3800 (3800.271)
Oversight Agency Department of Human Services
Which state agency oversees investigations? Department of Human Services
Are investigations and outcomes visible to the public online? No
Is this type of program required to be licensed by the state? Yes
Is a list of licensed facilities available to the public? Yes
Can complaints be filed online? Is the reporting portal easy to find? Yes
Does the state conduct unannounced site visits? How many per year? No. The state is permitted to but not required to visit
Are background checks required, including volunteers? Yes for staff and volunteers (every 5 years) UNLESS continuous residency in PA affidavit obtained. PA CPS Law Act 153 requires employees, volunteers and other individuals who interact with minors to obtain three different clearances: (1) Pennsylvania Access to Criminal History (PATCH) (2) Pennsylvania Child Abuse History (PACA) (3) FBI Criminal History Background Check (FBI Fingerprint)
Is a full-time licensed clinician required to be on staff? No
Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? When possible at admission into program and for non-routine procedures, written consent by legal guardian (if none, by court order) is required. Emergency is not required
Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? Not unless it involves the child missing
Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? No
Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? No requirement of mental health evaluation
Does the state require mandatory child abuse response training for all staff working with children in residential settings? No
Does the state require medical response training for all staff working with children in residential settings? Yes, it is required prior to working alone with children and within 120 days of being hired - §3800.58
Does the state require 1:4 staffing ratio or higher? No. 1:6 during the day; 1:12 at night. It largely depends on age of youngest child, how many children, time of day, etc
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state have regulations on admissions processes that require well-defined admissions criteria and demonstrated needs based policies for acceptance? Yes. §3800.272
Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? Yes. §3800.31
Does the State define institutional abuse and neglect? No
Are there civil penalties for violations of institutional child abuse and neglect? No
Does the State prohibit mail censorship? No. Censorship is prohibited for outgoing mail but incoming mail from people other than state, federal or county officials and the child's lawyer may be opened and read if there is reasonable suspicion of contraband or material that may jeopardize the child's well-being - §3800.32
Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? Yes. 55 §5100.54(b)
Does the state require that children be allowed visitors in private during normal visiting hours? Yes. 55 §5100.54(a)
Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? No
Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? No
Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? No Information
Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? No Information
Are youth provided with access to advocacy services and representation? Yes. (c) Every patient has the right to see or telephone his attorney in private at any reasonable time, regardless of visiting hours - 55 §5100.54
Does the state require parental consent to all treatment received? No. However whenever possible, general written consent is to be obtained during admissions. For non-routine treatments, if a parent is not able to consent than it can be ordered by court. Emergency treatment does not need parental consent - 3800.19
Is a grievance procedure required for youth and families? Yes. The child and parents have the right to lodge grievances without a fear of retaliation - Child's Rights, 3800.31
Is youth consent required for all treatment received? Depends on age and type of treatment. Under the Mental Health Procedures Act (50 P. S. § § 7101—7503), a child who is 14 years of age or older can consent to mental health treatment, including the administration of psychotropic medication
Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? No
Does the state prohibit aversion therapy? No
Is physical restraint prohibited? The state no longer allows prone restraints, but does allow supine and other physical restraints 22 Pa. Code § 12.5. Corporal punishment (is prohibited). (a) Corporal punishment is defined as physically punishing a student for an infraction of the discipline policy. Use of corporal punishment is prohibited. (b) Teachers and school authorities may use reasonable force under the following circumstances: (1) To quell a disturbance. (2) To obtain possession of weapons or other dangerous objects. (3) For the purpose of self-defense. (4) For the protection of persons or property.
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Title 55 Ch. 3800 (3800.281)
Oversight Agency Department of Human Services
Which state agency oversees investigations? Department of Human Services
Are investigations and outcomes visible to the public online? No
Can complaints be filed online? Is the reporting portal easy to find? No
Does the state conduct unannounced site visits? How many per year? No. The state is permitted to but not required to visit
Ban on Conversion Therapy for LGBTQA+ youth? No
Does the state prohibit aversion therapy? No
Is physical restraint prohibited? The state no longer allows prone restraints, but does allow supine and other physical restraints 22 Pa. Code § 12.5. Corporal punishment (is prohibited). (a) Corporal punishment is defined as physically punishing a student for an infraction of the discipline policy. Use of corporal punishment is prohibited. (b) Teachers and school authorities may use reasonable force under the following circumstances: (1) To quell a disturbance. (2) To obtain possession of weapons or other dangerous objects. (3) For the purpose of self-defense. (4) For the protection of persons or property.
Is chemical restraint prohibited? No. For emergency use only. The drug must be ordered by a licensed physician and must be administered by a licensed/certified/registered medical personnel on an emergency basis. Immediately prior to administering the drug, the physician must have examined the child and given a written order. This is also a must for re-administering the drug. Vitals must be monitored and documented by physician at least once per hour. Physical needs of child must also be met. 3800.209, Chemical Restraints
Is mechanical restraint prohibited? Yes. Mechanical restraint is prohibited. Devices that are used to help support body positioning or balance after a medical procedure is permitted. This is includes helmets and wheelchair belts and are not considered mechanical restraints for the purpose of keeping the patient safe.
Is seclusion prohibited? Yes. Prohibited, a restrictive procedure may be used only to prevent a child from injuring himself or others.§ 3800.202. Appropriate use of restrictive procedures. Seclusion in a locked room is prohibited
Is there a Bill of Rights for youth in care? No

General Oversight and Transparency Section 3140.47
Oversight Agency Department of Human Services: Juvenile Justice Services
Which state agency oversees investigations? Department of Human Services: Juvenile Justice Services
Ban on Conversion Therapy for LGBTQA+ youth? No

General Oversight and Transparency Title 55 Chapter 3800 (3800.291)
Oversight Agency Department of Human Services
Which state agency oversees investigations? Department of Human Services
Can complaints be filed online? Is the reporting portal easy to find? No
Ban on Conversion Therapy for LGBTQA+ youth? No

General Oversight and Transparency Title 55 Chapter 3700
Oversight Agency Department of Human Services
Which state agency oversees investigations? Department of Human Services
Ban on Conversion Therapy for LGBTQA+ youth? No

Additional Information

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