An Act amending Titles 40 (Insurance) and 42 (Judiciary and Judicial Procedure) of the Pennsylvania Consolidated Statutes, providing for behavioral health benefits for justice-involved children; and, in juvenile matters, further providing for definitions and for costs and expenses of care of child, providing for mandatory intake conference and screening in cases alleging delinquency and further providing for informal adjustment and for powers and duties.

PRINTER'S NO. 3327
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2477
Session of
2026
INTRODUCED BY HANBIDGE, KINKEAD, McNEILL, SANCHEZ, WAXMAN,
TIBURCIO, MAYES, HILL-EVANS, POWELL, KHAN, OTTEN, BOROWSKI,
HOHENSTEIN, DOUGHERTY, CEPEDA-FREYTIZ, KENYATTA, STEELE, BOYD
AND INGLIS, APRIL 29, 2026
REFERRED TO COMMITTEE ON JUDICIARY, APRIL 29, 2026
AN ACT
Amending Titles 40 (Insurance) and 42 (Judiciary and Judicial
Procedure) of the Pennsylvania Consolidated Statutes,
providing for behavioral health benefits for justice-involved
children; and, in juvenile matters, further providing for
definitions and for costs and expenses of care of child,
providing for mandatory intake conference and screening in
cases alleging delinquency and further providing for informal
adjustment and for powers and duties.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Title 40 of the Pennsylvania Consolidated
Statutes is amended by adding a chapter to read:
CHAPTER 44
BEHAVIORAL HEALTH BENEFITS FOR
JUSTICE-INVOLVED CHILDREN
Sec.
4401. Definitions.
4402. Coverage for screenings, assessments and services.
§ 4401. Definitions.
The following words and phrases when used in this chapter
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shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Agreement with the Department of Human Services." As
defined in section 2102 of the act of May 17, 1921 (P.L.682,
No.284), known as The Insurance Company Law of 1921.
"Authorized representative." Any of the following:
(1) A person, including a behavioral health provider, to
whom a covered person or enrollee has given express written
consent to represent the covered person or enrollee in a
complaint, grievance, adverse benefit determination, internal
appeal or external review process.
(2) A person authorized by law to provide substituted
consent for a covered person or enrollee.
(3) A family member or behavioral health provider
involved in providing behavioral health services to a covered
person or enrollee if the covered person or enrollee is
incapacitated or unable to provide consent due to a medical
emergency or as necessary to prevent a serious and imminent
threat to the health or safety of the covered person or
enrollee.
"Behavioral health assessment." A face-to-face interview
with an individual that includes an evaluation of the behavioral
health, medical, psychological, social, vocational and
educational factors important to the individual.
"Behavioral health condition." Includes:
(1) A mental health condition.
(2) A substance use disorder.
"Behavioral health provider."
(1) Any of the following:
(i) A professional who specializes in the treatment
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and management of behavioral health conditions.
(ii) An individual who manages or supports
behavioral health conditions whether or not the
individual has a medical background.
(2) The term includes a psychologist, psychiatrist,
nurse, peer, patient navigator, therapist, substance use
disorder treatment and mental health counselor, recovery
coach, case worker, social worker, psychiatric aide or
technician or paraprofessional working in a psychiatric
rehabilitation or substance use recovery field.
"Behavioral health service." A covered treatment, admission,
procedure, medical supply or equipment or other service,
prescribed or otherwise provided or proposed to be provided by a
behavioral health provider to a covered person or enrollee for
the diagnosis, prevention, treatment, cure or relief of a
behavioral health condition under the terms of a health
insurance policy or an agreement with the Department of Human
Services.
"Covered person." As defined in section 2102 of The
Insurance Company Law of 1921.
"Enrollee." As defined in section 2102 of The Insurance
Company Law of 1921.
"Government program."
(1) The Commonwealth's medical assistance program
established under the act of June 13, 1967 (P.L.31, No.21),
known as the Human Services Code.
(2) The program for comprehensive health care for
uninsured children established under Article XXIII-A of The
Insurance Company Law of 1921.
"Health care service." As defined in section 2102 of The
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Insurance Company Law of 1921.
"Health insurance policy." As defined in section 2102 of The
Insurance Company Law of 1921.
"Insurer." As defined in section 2102 of The Insurance
Company Law of 1921.
"Mental health condition." A condition that involves changes
in thinking, mood or behavior that can make daily activities
difficult and impair an individual's ability to work, interact
with family and fulfill other major life functions.
"Screening." As defined in 42 Pa.C.S. § 6302 (relating to
definitions).
"Substance use disorder." A health condition characterized
by a cluster of cognitive, behavioral and physiological symptoms
that describe an individual's compulsive use of a substance
despite significant adverse problems associated with the use.
"Treatment plan." An individualized plan of treatment as
described in section 107 of the act of July 9, 1976 (P.L.817,
No.143), known as the Mental Health Procedures Act, which
imposes the least restrictive alternative consistent with
affording an individual adequate and appropriate treatment for
the individual's condition.
§ 4402. Coverage for screenings, assessments and services.
(a) Coverage required.--On or after the effective date of
this subsection, the following shall provide coverage for
screenings, behavioral health assessments and behavioral health
services in conjunction with procedures under 42 Pa.C.S. §§ 6320
(relating to mandatory intake conference and screening in cases
alleging delinquency), 6323 (relating to informal adjustment)
and 6340 (relating to consent decree):
(1) A health insurance policy offered, issued or renewed
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in this Commonwealth to a covered person.
(2) A government program to an enrollee.
(b) Limitations.--Coverage under this section shall be
subject to copayment, deductible and coinsurance provisions and
any other general exclusions or limitations of a health
insurance policy or government program to the same extent as
other health care services covered by the policy or program are
subject to these provisions.
(c) Contract required.--An insurer shall be required to
contract with and accept as a participating provider behavioral
health providers within its service area and enrolled in the
Commonwealth's medical assistance program that agree to accept
the payment levels, terms and conditions applicable to the
insurer's other participating providers for behavioral health
services.
(d) Treatment plan review.--An insurer may review a
treatment plan once every six months, subject to the insurer's
utilization review requirements, including case management,
concurrent review and other managed care provisions. The insurer
and behavioral health provider developing the treatment plan may
agree upon a more or less frequent review.
(e) Review of denial.--
(1) Upon denial or partial denial by an insurer of a
claim for a screening, behavioral health assessment or
behavioral health service under this section, a covered
person or authorized representative shall be entitled to an
expedited internal review process in accordance with Article
XXI of the act of May 17, 1921 (P.L.682, No.284), known as
The Insurance Company Law of 1921, followed by an expedited
independent external review process, which the Insurance
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Department shall establish and administer.
(2) An insurer, covered person or authorized
representative may appeal to a court of competent
jurisdiction a decision following the expedited independent
external review process that provides for the denial or
partial denial by an insurer of a claim for a screening,
behavioral health assessment or behavioral health service
under this section. Pending a ruling of the court, the
insurer shall pay for the screening, behavioral health
assessment or behavioral health service that has been
authorized or ordered.
(f) Rules and regulations.--The Insurance Commissioner may
establish rules and the Insurance Department may promulgate
regulations as may be necessary or appropriate to implement and
administer this chapter.
(g) Reports.--No later than January 1, 2029, and on each
January 1 thereafter, each insurer shall make a report to the
Insurance Department, in a form and manner as determined by the
Insurance Department, to evaluate the implementation of this
section.
(h) Construction.--This section shall not be construed to
limit benefits that are otherwise available to an individual
under a health insurance policy or government program.
(i) Applicability.--This section shall apply as follows:
(1) For health insurance policies for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, this section shall apply to
policies for which a form or rate is first filed on or after
the effective date of this paragraph.
(2) For health insurance policies for which neither
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rates nor forms are required to be filed with the Federal
Government or the Insurance Department, this section shall
apply to policies issued or renewed on or after 180 days
after the effective date of this paragraph.
Section 2. The definitions of "child" and "screening" in
section 6302 of Title 42 are amended and the section is amended
by adding definitions to read:
§ 6302. Definitions.
The following words and phrases when used in this chapter
shall have, unless the context clearly indicates otherwise, the
meanings given to them in this section:
* * *
"Behavioral health assessment." As defined in 40 Pa.C.S. §
4401 (relating to definitions).
"Behavioral health condition." As defined in 40 Pa.C.S. §
4401.
"Behavioral health provider." As defined in 40 Pa.C.S. §
4401.
"Behavioral health service." As defined in 40 Pa.C.S. §
4401.
* * *
"Child." An individual who:
(1) is under the age of 18 years;
(2) is under the age of 21 years who committed an act of
delinquency before reaching the age of 18 years; or
(3) is under the age of 21 years and was adjudicated
dependent before reaching the age of 18 years, who has
requested the court to retain jurisdiction and who remains
under the jurisdiction of the court as a dependent child
because the court has determined that the child is:
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(i) completing secondary education or an equivalent
credential;
(ii) enrolled in an institution which provides
postsecondary or [vocational] career and technical
education;
(iii) participating in a program actively designed
to promote or remove barriers to employment;
(iv) employed for at least 80 hours per month; or
(v) incapable of doing any of the activities
described in subparagraph (i), (ii), (iii) or (iv) due to
a medical or behavioral health condition, which is
supported by regularly updated information in the
permanency plan of the child.
* * *
"Screening." A process, regardless of whether it includes
the administration of a formal instrument, that is designed to
identify a child who is at increased risk of having mental
health, substance abuse or co-occurring mental health and
substance abuse disorders that warrant immediate attention,
intervention or more comprehensive assessment. The term includes
a behavioral health assessment.
* * *
"Substance abuse disorder." As the term "substance use
disorder" is defined in 40 Pa.C.S. § 4401.
Section 3. Section 6306 of Title 42 is amended to read:
§ 6306. Costs and expenses of care of child.
(a) Payment for care.--The costs and expenses of the care of
the child shall be paid as provided by sections 704.1 and 704.2
of the act of June 13, 1967 (P.L.31, No.21), known as the
["Public Welfare Code."] Human Services Code.
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(b) Payment for behavioral health matters.--The costs and
expenses of screenings, behavioral health assessments and
behavioral health services in conjunction with procedures
developed in accordance with sections 6320 (relating to
mandatory intake conference and screening in cases alleging
delinquency), 6323 (relating to informal adjustment) and 6340
(relating to consent decree) shall be paid as provided under 40
Pa.C.S. Ch. 44 (relating to behavioral health benefits for
justice-involved children).
Section 4. Subchapter B of Chapter 63 of Title 42 is amended
by adding a section to read:
§ 6320. Mandatory intake conference and screening in cases
alleging delinquency.
(a) Requirement.--In all cases alleging delinquency, a
juvenile probation officer shall conduct an intake conference
following the submission of a written allegation and before a
petition for delinquency is filed under section 6334 (relating
to petition).
(b) Screening.--At the intake conference, or at any time
before a petition for delinquency is filed, the probation
officer of the child alleged to be delinquent or other officer
designated by the court shall conduct a screening approved by
the Juvenile Court Judges' Commission under section 6373
(relating to powers and duties), to determine whether a
behavioral health assessment would be in the best interest of
the public and the child. If the probation officer determines
that a behavioral health assessment is in the best interest of
the public and the child, the probation officer or other
designated officer shall refer the child and the child's parent,
guardian or other custodian to a public or private social agency
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to conduct a behavioral health assessment as provided for under
section 6323(a.1) (relating to informal adjustment).
Section 5. Section 6323(a)(2) of Title 42 is amended and the
section is amended by adding subsections to read:
§ 6323. Informal adjustment.
(a) General rule.--
* * *
(2) Similarly, the probation officer may in the case of
[a delinquent child, or] a dependent child where the
jurisdiction of the court is permitted under paragraph (6) of
the definition of "dependent child" in section 6302, refer
the child and his parents to an agency for assisting in the
matter.
* * *
(a.1) Behavioral health assessments.--Except as provided
under subsection (a.2), upon receipt of a referral under section
6320(b) (relating to mandatory intake conference and screening
in cases alleging delinquency), the receiving public or private
social agency shall indicate whether the agency will accept the
child and perform a behavioral health assessment and shall
report back to the referring officer within three months of
receipt of the referral concerning the status of the referral.
If a receiving agency accepts the child, the following apply:
(1) Prior to conducting the behavioral health
assessment, the agency shall obtain the consent of the child
and the child's parent, guardian or other custodian.
(2) Except as provided in paragraph (3), the agency
shall complete the behavioral health assessment within 30
days of receipt of the consents under paragraph (1).
(3) Notwithstanding paragraph (2), if a behavioral
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health assessment has been completed within the prior six
months, the agency shall provide the referring officer with
the report and recommendations from prior assessments.
(4) If the behavioral health assessment conducted under
this subsection reveals that the child has complex behavioral
health needs and is at risk of placement away from the
child's parent, guardian or other custodian, or is already
involved in multiple service systems, the agency shall refer
the child and the child's parent, guardian or other custodian
for behavioral health services.
(5) Following the behavioral health assessment, the
agency shall prepare a report with recommendations. The
report:
(i) Shall be provided to the following:
(A) The child.
(B) The child's parent, guardian or other
custodian.
(C) The child's attorney.
(D) The referring officer.
(ii) Must include:
(A) The agency's specific recommendation
regarding whether a petition alleging delinquency
should be filed and what process would be in the best
interest of the public and the child.
(B) Any r ecommendations for the treatment of a
behavioral health condition.
(C) Whether the agency referred the child for
behavioral health services.
(6) Unless the child, following consultation with the
child's attorney, gives consent, the report and related
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documents, records and statements made by the child or others
providing information for the purpose of a behavioral health
assessment:
(i) may not be used by law enforcement during its
investigation; and
(ii) shall not be admissible at an adjudicatory
hearing or an adult criminal proceeding.
(7) Prior to filing a petition alleging delinquency, the
referring officer or prosecutor shall review the agency's
report to screen the petition for participation in other
voluntary services or diversion program.
(8) If a petition alleging delinquency is filed
following referral and the court adjudicates the child
delinquent, with the consent of the child following
consultation with the child's attorney, the report under this
subsection shall be admissible at the dispositional hearing
and subsequent hearings for the purpose of determining
appropriate behavioral health services.
(a.2) Exception.--
(1) A petition alleging delinquency may be filed prior
to the completion of the behavioral health assessment if:
(i) the prosecutor or referring officer determines
there is a need to request an order from the court for
immediate detention or placement to protect the child or
the community; or
(ii) the child or the child's parent, guardian or
other custodian does not consent to the behavioral health
assessment.
(2) If the child or the child's parent, guardian or
other custodian does not consent to the behavioral health
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assessment:
(i) The agency shall report to the referring officer
or prosecutor that the behavioral health assessment was
declined.
(ii) The prosecutor may proceed with a petition
alleging delinquency and inform the court that the
behavioral health assessment was declined.
(3) The petitioner under this subsection shall identify
why behavioral health services were not an appropriate
disposition prior to seeking court involvement.
(4) If the petition under this subsection is filed prior
to the referral and behavioral health assessment and the
child alleged to be delinquent has not had a behavioral
health assessment in the prior six months, the agency shall
make the behavioral health assessment available to the child
or the child's parent, guardian or other custodian after the
petition is filed. The confidentiality and admissibility of
the report and related documents, records or statements shall
be treated the same as behavioral health assessments
completed prior to the filing of the petition.
* * *
Section 6. Section 6373 of Title 42 is amended by adding
paragraphs to read:
§ 6373. Powers and duties.
The commission shall have the power and is required to do the
following:
* * *
(5) Approve a screening tool for the use of law
enforcement officers, probation officers and other officers
designated by the court under section 6320 (relating to
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mandatory intake conference and screening in cases alleging
delinquency).
(6) Develop screening, referral and behavioral health
assessment procedures under sections 6320, 6323 (relating to
informal adjustment) and 6340 (relating to consent decree).
(7) Produce informational materials regarding the
screening tool and procedures under paragraphs (5) and (6)
and make the materials available to all law enforcement
agencies, probation officers and other officers of the court
in this Commonwealth who work with children alleged to be
delinquent.
Section 7. This act shall take effect in 60 days.
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