SB-0686, As Passed House, December 9, 2004

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 686

                                                                             A bill to amend 1974 PA 258, entitled                                             

"Mental health code,"                                                       

by amending sections 100a, 100b, and 161 (MCL 330.1100a,                    

330.1100b, and 330.1161), sections 100a and 161 as amended by               

1998 PA 497 and section 100b as added by 1995 PA 290, and by                

adding section 116a.                                                        

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1       Sec. 100a.  (1) "Abilities" means the qualities, skills, and                

2   competencies of an individual that reflect the individual's                 

3   talents and acquired proficiencies.                                         

4       (2) "Abuse" means nonaccidental physical or emotional harm to               

5   a recipient, or sexual contact with or sexual penetration of a              

6   recipient as those terms are defined in section 520a of the                 

7   Michigan penal code, 1931 PA 328, MCL 750.520a, that is committed           

8   by an employee or volunteer of the department, a community mental           

1   health services program, or a licensed hospital or by an employee           

2   or volunteer of a service provider under contract with the                  

3   department, community mental health services program, or licensed           

4   hospital.                                                                   

5       (3) "Adaptive skills" means skills in 1 or more of the                      

6   following areas:                                                            

7       (a) Communication.                                                          

8       (b) Self-care.                                                              

9       (c) Home living.                                                            

10      (d) Social skills.                                                          

11      (e) Community use.                                                          

12      (f) Self-direction.                                                         

13      (g) Health and safety.                                                      

14      (h) Functional academics.                                                   

15      (i) Leisure.                                                                

16      (j) Work.                                                                   

17      (4) "Adult foster care facility" means an adult foster care                 

18  facility licensed under the adult foster care facility licensing            

19  act, 1979 PA 218, MCL 400.701 to 400.737.                                   

20      (5) "Applicant" means an individual or his or her legal                     

21  representative who makes a request for mental health services.              

22  (6) "Assisted outpatient treatment" or "AOT" means the                      

23  categories of outpatient services ordered by the court under                

24  section 433 or 469a.  Assisted outpatient treatment includes case           

25  management services to provide care coordination.  Assisted                 

26  outpatient treatment may also include 1 or more of the following            

27  categories of services:  medication; periodic blood tests or                

Senate Bill No. 686 (H-1) as amended December 9, 2004

1   urinalysis to determine compliance with prescribed medications;             

2   individual or group therapy; day or partial day programming                 

3   activities; vocational, educational, or self-help training or               

4   activities; assertive community treatment team services; alcohol            

5   or substance abuse treatment and counseling and periodic tests              

6   for the presence of alcohol or illegal drugs for an individual              

7   with a history of alcohol or substance abuse; supervision of                

8   living arrangements; and any other services within a local or               

9   unified services plan developed under this act that are                     

10  prescribed to treat the individual's mental illness and to assist           

11  the individual in living and functioning in the community or to             

12  attempt to prevent a relapse or deterioration that may reasonably           

13  be predicted to result in suicide, the need for hospitalization,            

14  or serious violent behavior[.                                  

15                                                                              

16                                                                              

17 

18                                                       ].  The               

19  medical review and direction included in an assisted outpatient             

20  treatment plan shall be provided under the supervision of a                 

21  psychiatrist.                                                               

22      (7)  (6)  "Board" means the governing body of a community                   

23  mental health services program.                                             

24  (8)  (7)  "Board of commissioners" means a county board of                  

25  commissioners.                                                              

26  (9)  (8)  "Center" means a facility operated by the                         

27  department to admit individuals with developmental disabilities             

1   and provide habilitation and treatment services.                            

2   (10)  (9)  "Certification" means formal approval of a program               

3   by the department in accordance with standards developed or                 

4   approved by the department.                                                 

5   (11)  (10)  "Child abuse" and "child neglect" mean those                    

6   terms as defined in section 2 of the child protection law, 1975             

7   PA 238, MCL 722.622.                                                        

8   (12)  (11)  "Child and adolescent psychiatrist" means 1 or                  

9   more of the following:                                                      

10      (a) A physician who has completed a residency program in                    

11  child and adolescent psychiatry approved by the accreditation               

12  council for graduate medical education or the American                      

13  osteopathic association, or who has completed 12 months of child            

14  and adolescent psychiatric rotation and is enrolled in an                   

15  approved residency program as described in this subsection.                 

16      (b) A psychiatrist employed by or under contract as a child                 

17  and adolescent psychiatrist with the department or a community              

18  mental health services program on March 28, 1996, who has                   

19  education and clinical experience in the evaluation and treatment           

20  of children or adolescents with serious emotional disturbance.              

21      (c) A psychiatrist who has education and clinical experience                

22  in the evaluation and treatment of children or adolescents with             

23  serious emotional disturbance who is approved by the director.              

24  (13)  (12)  "Children's diagnostic and treatment service"                   

25  means a program operated by or under contract with a community              

26  mental health services program, that provides examination,                  

27  evaluation, and referrals for minors, including emergency                   

1   referrals, that provides or facilitates treatment for minors, and           

2   that has been certified by the department.                                  

3   (14)  (13)  "Community mental health authority" means a                     

4   separate legal public governmental entity created under                     

5   section 205 to operate as a community mental health services                

6   program.                                                                    

7   (15)  (14)  "Community mental health organization" means a                  

8   community mental health services program that is organized under            

9   the urban cooperation act of 1967, 1967 (Ex Sess) PA 7,                     

10  MCL 124.501 to 124.512.                                                     

11  (16)  (15)  "Community mental health services program" means                

12  a program operated under chapter 2 as a county community mental             

13  health agency, a community mental health authority, or a                    

14  community mental health organization.                                       

15  (17)  (16)  "Consent" means a written agreement executed by a               

16  recipient, a minor recipient's parent, or a recipient's legal               

17  representative with authority to execute a consent, or a verbal             

18  agreement of a recipient that is witnessed and documented by an             

19  individual other than the individual providing treatment.                   

20  (18)  (17)  "County community mental health agency" means an                

21  official county or multicounty agency created under section 210             

22  that operates as a community mental health services program and             

23  that has not elected to become a community mental health                    

24  authority under section 205 or a community mental health                    

25  organization under the urban cooperation act of 1967, 1967                  

26  (Ex Sess) PA 7, MCL 124.501 to 124.512.                                     

27  (19)  (18)  "Dependent living setting" means all of the                     

1   following:                                                                  

2       (a) An adult foster care facility.                                          

3       (b) A nursing home licensed under article 17 of the public                  

4   health code, 1978 PA 368, MCL 333.20101 to 333.22260.                       

5       (c) A home for the aged licensed under article 17 of the                    

6   public health code, 1978 PA 368, MCL 333.20101 to 333.22260.                

7   (20)  (19)  "Department" means the department of community                  

8   health.                                                                     

9   (21)  (20)  "Developmental disability" means either of the                  

10  following:                                                                  

11      (a) If applied to an individual older than 5 years of age, a                

12  severe, chronic condition that meets all of the following                   

13  requirements:                                                               

14                                                                               (i) Is attributable to a mental or physical impairment or a                         

15  combination of mental and physical impairments.                             

16      (ii) Is manifested before the individual is 22 years old.                    

17      (iii) Is likely to continue indefinitely.                                    

18      (iv) Results in substantial functional limitations in 3 or                   

19  more of the following areas of major life activity:                         

20      (A) Self-care.                                                              

21      (B) Receptive and expressive language.                                      

22      (C) Learning.                                                               

23      (D) Mobility.                                                               

24      (E) Self-direction.                                                         

25      (F) Capacity for independent living.                                        

26      (G) Economic self-sufficiency.                                              

27      (v) Reflects the individual's need for a combination and                    

1   sequence of special, interdisciplinary, or generic care,                    

2   treatment, or other services that are of lifelong or extended               

3   duration and are individually planned and coordinated.                      

4       (b) If applied to a minor from birth to  age  5 years of age,               

5   a substantial developmental delay or a specific congenital or               

6   acquired condition with a high probability of resulting in                  

7   developmental disability as defined in subdivision (a) if                   

8   services are not provided.                                                  

9   (22)  (21)  "Director" means the director of the department                 

10  or his or her designee.                                                     

11  (23)  (22)  "Discharge" means an absolute, unconditional                    

12  release of an individual from a facility by action of the                   

13  facility or a court.                                                        

14  (24)  (23)  "Eligible minor" means an individual less than                  

15  18 years of age who is recommended in the written report of a               

16  multidisciplinary team under rules promulgated by the department            

17  of education to be classified as 1 of the following:                        

18      (a) Severely mentally impaired.                                             

19      (b) Severely multiply impaired.                                             

20      (c) Autistic impaired and receiving special education                       

21  services in a program designed for the autistic impaired under              

22  subsection (1) of R 340.1758 of the Michigan administrative code            

23  or in a program designed for the severely mentally impaired or              

24  severely multiply impaired.                                                 

25  (25)  (24)  "Emergency situation" means a situation in which                

26  an individual is experiencing a serious mental illness or a                 

27  developmental disability, or a  child minor is experiencing a              

1   serious emotional disturbance, and 1 of the following applies:              

2       (a) The individual can reasonably be expected within the near               

3   future to physically injure himself, herself, or another                    

4   individual, either intentionally or unintentionally.                        

5       (b) The individual is unable to provide himself or herself                  

6   food, clothing, or shelter or to attend to basic physical                   

7   activities such as eating, toileting, bathing, grooming,                    

8   dressing, or ambulating, and this inability may lead in the near            

9   future to harm to the individual or to another individual.                  

10      (c) The individual's judgment is so impaired that he or she                 

11  is unable to understand the need for treatment and, in the                  

12  opinion of the mental health professional, his or her continued             

13  behavior as a result of the mental illness, developmental                   

14  disability, or emotional disturbance can reasonably be expected             

15  in the near future to result in physical harm to the individual             

16  or to another individual.                                                   

17  (26)  (25)  "Executive director" means an individual                        

18  appointed under section 226 to direct a community mental health             

19  services program or his or her designee.                                    

20      Sec. 100b.  (1) "Facility" means a residential facility for                 

21  the care or treatment of individuals with serious mental illness,           

22  serious emotional disturbance, or developmental disability that             

23  is either a state facility or a licensed facility.                          

24      (2) "Family" as used in sections 156 to 161 means an eligible               

25  minor and his or her parent or legal guardian.                              

26      (3) "Family member" means a parent, stepparent, spouse,                     

27  sibling, child, or grandparent of a primary consumer, or an                 

1   individual upon whom a primary consumer is dependent for at least           

2   50% of his or her financial support.                                        

3       (4) "Federal funds" means funds received from the federal                   

4   government under a categorical grant or similar program and does            

5   not include federal funds received under a revenue sharing                  

6   arrangement.                                                                

7       (5) "Functional impairment" means both of the following:                    

8       (a) With regard to serious emotional disturbance, substantial               

9   interference with or limitation of a minor's achievement or                 

10  maintenance of 1 or more developmentally appropriate social,                

11  behavioral, cognitive, communicative, or adaptive skills.                   

12      (b) With regard to serious mental illness, substantial                      

13  interference or limitation of role functioning in 1 or more major           

14  life activities including basic living skills such as eating,               

15  bathing, and dressing; instrumental living skills such as                   

16  maintaining a household, managing money, getting around the                 

17  community, and taking prescribed medication; and functioning in             

18  social, vocational, and educational contexts.                               

19      (6) "Guardian" means a person appointed by the court to                     

20  exercise specific powers over an individual who is a minor,                 

21  legally incapacitated, or developmentally disabled.                         

22      (7) "Hospital" or "psychiatric hospital" means an inpatient                 

23  program operated by the department for the treatment of                     

24  individuals with serious mental illness or serious emotional                

25  disturbance or a psychiatric hospital or psychiatric unit                   

26  licensed under section 137.                                                 

27      (8) "Hospital director" means the chief administrative                      

1   officer of a hospital or his or her designee.                               

2       (9) "Hospitalization" or "hospitalize" means to provide                     

3   treatment for an individual as an inpatient in a hospital.                  

4       (10) "Individual plan of services" or "plan of services"                    

5   means a written individualized plan of services developed with a            

6   recipient as required by section 712.                                       

7       (11) "Licensed facility" means a facility licensed by the                   

8   department under section 137 or an adult foster care facility.              

9       (12) "Licensed psychologist" means a doctoral level                         

10  psychologist licensed under section 18223(1) of the public health           

11  code,  Act No. 368 of the Public Acts of 1978, being section                

12  333.18223 of the Michigan Compiled Laws 1978 PA 368, MCL                   

13  333.18223.                                                                  

14      (13) "Medical director" means a psychiatrist appointed under                

15  section 231 to advise the executive director of a community                 

16  mental health services program.                                             

17      (14) "Mental health professional" means an individual who is                

18  trained and experienced in the area of mental illness or                    

19  developmental disabilities and who is 1 of the following:                   

20      (a) A physician who is licensed to practice medicine or                     

21  osteopathic medicine and surgery in this state under article 15             

22  of the public health code,  Act No. 368 of the Public Acts of               

23  1978, being sections 333.16101 to 333.18838 of the Michigan                 

24  Compiled Laws 1978 PA 368, MCL 333.16101 to 333.18838.                     

25      (b) A psychologist licensed to practice in this state under                 

26  article 15 of the public health code,  Act No. 368 of the Public            

27  Acts of 1978 1978 PA 368, MCL 333.16101 to 333.18838.                      

1       (c) A registered professional nurse licensed to practice in                 

2   this state under article 15 of the public health code,  Act                 

3   No. 368 of the Public Acts of 1978 1978 PA 368, MCL 333.16101 to           

4   333.18838.                                                                  

5       (d)  A certified social worker, a social worker, or a social                

6   worker technician registered in this state under article 16 of              

7   the occupational code, Act No. 299 of the Public Acts of 1980,              

8   being sections 339.1601 to 339.1610 of the Michigan Compiled                

9   Laws. Until July 1, 2005, a certified social worker registered             

10  under article 15 of the public health code, 1978 PA 368, MCL                

11  333.16101 to 333.18838.  Beginning July 1, 2005, a licensed                 

12  master's social worker licensed under article 15 of the public              

13  health code, 1978 PA 368, MCL 333.16101 to 333.18838.

14      (e) A licensed professional counselor licensed to practice in               

15  this state under article 15 of the public health code,  Act No.             

16  368 of the Public Acts of 1978 1978 PA 368, MCL 333.16101 to               

17  333.18838.                                                                  

18      (f) A marriage and family therapist licensed under article 15               

19  of the  occupational code, Act No. 299 of the Public Acts of                

20  1980, being sections 339.1501 to 339.1511 of the Michigan                   

21  Compiled Laws public health code, 1978 PA 368, MCL 333.16101 to            

22  333.18838.                                                                  

23      (15) "Mental retardation" means a condition manifesting                     

24  before the age of 18 years that is characterized by significantly           

25  subaverage intellectual functioning and related limitations in 2            

26  or more adaptive skills and that is diagnosed based on the                  

27  following assumptions:                                                      

1       (a) Valid assessment considers cultural and linguistic                      

2   diversity, as well as differences in communication and behavioral           

3   factors.                                                                    

4       (b) The existence of limitation in adaptive skills occurs                   

5   within the context of community environments typical of the                 

6   individual's age peers and is indexed to the individual's                   

7   particular needs for support.                                               

8       (c) Specific adaptive skill limitations often coexist with                  

9   strengths in other adaptive skills or other personal                        

10  capabilities.                                                               

11      (d) With appropriate supports over a sustained period, the                  

12  life functioning of the individual with mental retardation will             

13  generally improve.                                                          

14      (16) "Minor" means an individual under the age of 18 years.                 

15      (17) "Multicultural services" means specialized mental health               

16  services for multicultural populations such as African-Americans,           

17  Hispanics, Native Americans, Asian and Pacific Islanders, and               

18  Arab/Chaldean-Americans.                                                    

19      (18) "Neglect" means an act or failure to act committed by an               

20  employee or volunteer of the department, a community mental                 

21  health services program, or a licensed hospital; a service                  

22  provider under contract with the department, community mental               

23  health services program, or licensed hospital; or an employee or            

24  volunteer of a service provider under contract with the                     

25  department, community mental health services program, or licensed           

26  hospital, that denies a recipient the standard of care or                   

27  treatment to which he or she is entitled under this act.                    

1   Sec. 116a.  (1) The department shall make available on the                  

2   department's website an annual report concerning assisted                   

3   outpatient treatment services in this state.  The report shall              

4   include statewide information regarding the number of individuals           

5   receiving and completing assisted outpatient treatment and shall            

6   include the cost and benefit projections that are available                 

7   concerning assisted outpatient treatment in this state.                     

8       (2) The report shall include all of the following information               

9   regarding petitions filed under section 433:                                

10      (a) The number of assisted outpatient treatment petitions                   

11  filed.                                                                      

12  (b) The number of court rulings on petitions filed under                    

13  section 433 that resulted in an assisted outpatient treatment               

14  order.                                                                      

15      (c) The number of court rulings on petitions filed under                    

16  section 433 that did not result in an assisted outpatient                   

17  treatment order.                                                            

18      (3) To the extent possible if resources are available, when                 

19  evaluating the assisted outpatient treatment in this state, the             

20  department shall attempt to utilize expert assistance from                  

21  outside entities, including, but not limited to, state                      

22  universities.

23      Sec. 161.  In conjunction with community mental health                      

24  services programs, the department shall conduct annually and                

25  forward to the governor and the house and senate appropriations             

26  committees, and the senate and house committees with legislative            

27  oversight of  social human services and mental health, an                  

1   evaluation of the family support subsidy program that shall                 

2   include, but is not limited to, all of the following:                       

3       (a) The impact of the family support subsidy program upon                   

4   children covered by this act in facilities and residential care             

5   programs including, to the extent possible, sample case reviews             

6   of families who choose not to participate.                                  

7       (b) Case reviews of families who voluntarily terminate                      

8   participation in the family support subsidy program for any                 

9   reason, particularly when the eligible minor is placed out of the           

10  family home, including the involvement of the department and                

11  community mental health services programs in offering suitable              

12  alternatives.                                                               

13      (c) Sample assessments of families receiving family support                 

14  subsidy payments including adequacy of subsidy and need for                 

15  services not available.                                                     

16      (d) The efforts to encourage program participation of                       

17  eligible families.                                                          

18      (e) The geographic distribution of families receiving subsidy               

19  payments and, to the extent possible, eligible minors presumed to           

20  be eligible for family support subsidy payments.                            

21      (f) Programmatic and legislative recommendations to further                 

22  assist families in providing care for eligible minors.                      

23      (g) Problems that arise in identifying eligible minors                      

24  through diagnostic evaluations performed under rules promulgated            

25  by the department of education.                                             

26      (h) The number of beds reduced in state facilities and foster               

27  care facilities serving severely mentally, multiply, and autistic           

1   impaired children when the children return home to their natural            

2   families as a result of the subsidy program.                                

3       (i) Caseload figures by eligibility category as  defined

4   described in section  100a(23) 100a(24).                                   

5       Enacting section 1.  This amendatory act does not take                      

6   effect unless all of the following bills of the 92nd Legislature            

7   are enacted into law:                                                       

8       (a) Senate Bill No. 683.                                                    

9       (b) Senate Bill No. 684.                                                    

10      (c) Senate Bill No. 685.                                                    

11      (d) Senate Bill No. 1464.