September 24, 2009, Introduced by Senators BRATER, JACOBS, CLARK-COLEMAN, CLARKE, SCOTT, CHERRY, OLSHOVE, ANDERSON, BASHAM, SWITALSKI and THOMAS and referred to the Committee on Health Policy.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 116, 232a, and 232b (MCL 330.1116, 330.1232a,
and 330.1232b), section 116 as amended by 1998 PA 67, section 232a
as added by 1995 PA 290, and section 232b as added by 2002 PA 597.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 116. (1) Consistent with section 51 of article IV of the
state constitution of 1963, which declares that the health of the
people of the state is a matter of primary public concern, and as
required by section 8 of article VIII of the state constitution of
1963, which declares that services for the care, treatment,
education, or rehabilitation of those who are seriously mentally
disabled shall always be fostered and supported, the department
shall continually and diligently endeavor to ensure that adequate
and appropriate mental health services are available to all
citizens
throughout the state. To this end, the department shall
have
has the general powers and duties described in this
section.
(2) The department shall do all of the following:
(a) Direct services to individuals who have a serious mental
illness, developmental disability, or serious emotional
disturbance. The department shall give priority to the following
services:
(i) Services for individuals with the most severe forms of
serious mental illness, serious emotional disturbance, or
developmental disability.
(ii) Services for individuals with serious mental illness,
serious emotional disturbance, or developmental disability who are
in urgent or emergency situations.
(b) Administer the provisions of chapter 2 so as to promote
and maintain an adequate and appropriate system of community mental
health services programs throughout the state. In the
administration of chapter 2, it shall be the objective of the
department to shift primary responsibility for the direct delivery
of public mental health services from the state to a community
mental health services program whenever the community mental health
services program has demonstrated a willingness and capacity to
provide
do both of the following:
(i) Provide an adequate and appropriate system of mental health
services for the citizens of that service area.
(ii) Comply with regulatory requirements of the department.
(c) Engage in planning for the purpose of identifying,
assessing, and enunciating the mental health needs of the state.
(d) Submit to the members of the house and senate standing
committees and appropriation subcommittees with legislative
oversight of mental health matters an annual report summarizing its
assessment of the mental health needs of the state and
incorporating information received from community mental health
services programs under section 226. The report shall include an
estimate of the cost of meeting all identified needs. Additional
information shall be made available to the legislature upon
request.
(e) Endeavor to develop and establish arrangements and
procedures for the effective coordination and integration of all
public mental health services, and for effective cooperation
between public and nonpublic services, for the purpose of providing
a unified system of statewide mental health care.
(f) Review and evaluate the relevance, quality, effectiveness,
and efficiency of mental health services being provided by the
department and assure the review and evaluation of mental health
services provided by community mental health services programs. The
department shall establish and implement a structured system to
provide data necessary for the reviews and evaluations.
(g) Implement those provisions of law under which it is
responsible for the licensing or certification of mental health
facilities or services.
(h) Establish standards of training and experience for
executive directors of community mental health services programs.
(i) Support research activities.
(j) Support evaluation and quality improvement activities.
(k) Support training, consultation, and technical assistance
regarding mental health programs and services and appropriate
prevention and mental health promotion activities, including those
that are culturally sensitive, to employees of the department,
community mental health services programs, and other nonprofit
agencies providing mental health services under contract with
community mental health services programs.
(l) Support multicultural services.
(3) The department may do all of the following:
(a) Direct services to individuals who have mental disorders
that meet diagnostic criteria specified in the most recent
diagnostic and statistical manual of mental health disorders
published by the American psychiatric association and approved by
the department and to the prevention of mental disability and the
promotion of mental health. Resources that have been specifically
appropriated for services to individuals with dementia, alcoholism,
or substance abuse, or for the prevention of mental disability and
the promotion of mental health shall be utilized for those specific
purposes.
(b) Provide, on a residential or nonresidential basis, any
type of patient or client service including but not limited to
prevention, diagnosis, treatment, care, education, training, and
rehabilitation.
(c) Operate mental health programs or facilities directly or
through contractual arrangement.
(d) Institute pilot projects considered appropriate by the
director to test new models and concepts in service delivery or
mental health administration. Pilot projects may include, but need
not be limited to, both of the following:
(i) Issuance of a voucher to a recipient of public mental
health services in accordance with the recipient's individual plan
of services and guidelines developed by the department.
(ii) Establishment of revolving loans to assist recipients of
public mental health services to acquire or maintain affordable
housing. Funding under this subparagraph shall only be provided
through an agreement with a nonprofit fiduciary in accordance with
guidelines and procedures developed by the department related to
the use, issuance, and accountability of revolving loans used for
recipient housing.
(e) Enter into an agreement, contract, or arrangement with any
individual or public or nonpublic entity that is necessary or
appropriate to fulfill those duties or exercise those powers that
have by statute been given to the department.
(f) Accept gifts, grants, bequests, and other donations for
use in performing its functions. Any money or property accepted
shall be used as directed by its donor and in accordance with law
and the rules and procedures of the department.
(g) The department has any other power necessary or
appropriate to fulfill those duties and exercise those powers that
have been given to the department by law and that are not otherwise
prohibited by law.
Sec. 232a. (1) Subject to section 114a, the department shall
promulgate rules to establish standards for certification and the
certification review process for community mental health services
programs. The standards shall include but not be limited to all of
the following:
(a) Matters of governance, resource management, quality
improvement, service delivery, and safety management.
(b) Promotion and protection of recipient rights.
(2) After reviewing a community mental health services
program, the department shall notify a program that substantially
complies with the standards established under this section that it
is certified by the department.
(3) The department may waive the certification review process
in whole or in part and consider the community mental health
services program to be in substantial compliance with the standards
established under this section if the program has received
accreditation from a national accrediting organization recognized
by the department that includes review of matters described in
subsection (1)(a).
(4) If the department certifies a community mental health
services program despite some items of noncompliance with the
standards established under this section, the notice of
certification shall identify the items of noncompliance and the
program shall correct the items of noncompliance. The department
shall require the community mental health board to submit a plan to
correct items of noncompliance before recertification or sooner at
the discretion of the department.
(5) Certification is effective for 3 years and is not
transferable. Requests for recertification shall be submitted to
the department at least 6 months before the expiration of
certification. Certification remains in effect after the submission
of a renewal request until the department conducts a review and
makes a redetermination.
(6) The department shall conduct an annual review of each
community mental health services program's recipient rights system
to ensure compliance with standards established under subsection
(1)(b). An on-site review shall be conducted once every 3 years.
(7) The community mental health services program shall
promptly notify the department of any changes that may affect
continued certification.
(8) The department may deny certification if the community
mental health services program cannot demonstrate substantial
compliance with the standards established under this section.
(9) In lieu of denying certification, the department may issue
a provisional certification for a period of up to 6 months upon
receiving a plan of correction submitted by the community mental
health services board. The department shall provide a copy of the
review and the approved plan of correction to the board of
commissioners of each county that established the county community
mental health agency or created the community mental health
organization or community mental health authority. A provisional
certification may be extended, but the entire provisional period
shall not exceed 1 year. The department shall conduct an on-site
review to determine the community mental health services program's
compliance with the plan of correction at least 30 days before the
expiration of the provisional certification. A provisional
certification automatically expires either on its original
expiration date or the expiration date of the extension granted.
(10) If a community mental health services program is denied
certification, fails to comply with an approved plan of correction
before the expiration of a provisional certification, or fails to
comply substantially with the standards established under this
section, the department shall notify the community mental health
services board and the board of commissioners of each county that
established the agency or created the organization or authority of
the department's intention to suspend, deny, or revoke
certification. The notice shall be sent by certified mail and shall
set forth the particular reasons for the proposed action and offer
an opportunity for a hearing with the director of the department's
division that manages contracts with community mental health
services programs. If it desires a hearing, the community mental
health services board shall request it in writing within 60 days
after receipt of the notice. The department shall hold the hearing
not less than 30 days or more than 60 days from the date it
receives the request for a hearing.
(11) The director of the department's division that manages
contracts with community mental health services programs shall make
a decision regarding suspension, denial, or revocation of
certification based on evidence presented at the hearing or on the
default of the community mental health services board. A copy of
the decision shall be sent by certified mail within 45 days after
the close of the hearing to the community mental health services
board and to the board of commissioners of each county that
established the agency or created the organization or authority.
(12) A community mental health services board may appeal a
decision made under subsection (11) as provided in chapter 4 of the
administrative
procedures act of 1969, Act No. 306 of the Public
Acts
of 1969, being sections 24.271 to 24.287 of the Michigan
Compiled
Laws 1969 PA 306, MCL 24.271
to 24.287.
(13) During the period of certification, the department may
conduct an unannounced review of a certified community mental
health services program. The department shall conduct an
unannounced review of a certified community mental health services
program in response to information that raises questions regarding
recipient health or safety. If the department finds based on its
review that the community mental health services program does not
substantially comply with the standards established under this
section, the department shall provide notice and a hearing under
subsections (10) and (11).
(14) During the appeal process described in this section, the
department may direct a community mental health services program to
take remedial action regarding issues that led to the department's
notice of noncompliance with standards. If the community mental
health services program does not adhere to the department's
direction under this subsection, the department may place the
administration of the community mental health services program or,
if recipient rights represent the area of contention, its recipient
rights office, under receivership with any expense necessary for
the receivership to be taken from the department's appropriation to
the community mental health services program.
(15)
(14) If a community mental health services program fails
to obtain or retain certification as a result of the department's
review, has exhausted the time period for provisional
certification, is not engaged in the process of appeal or appeal
has been unsuccessful, and if no agreement has been reached by the
department with the community mental health services program to
assure certification compliance within a specified time period, the
department
shall within 90 days do both either
of the following:
(a)
Cancel the state funding commitment to the community
mental
health services board.
(b)
Utilize the funds previously provided to the community
mental
health services board to do 1 or more of the following:
(a) Continue the state funding commitment to the community
mental health services program while placing it under receivership
until replacements are procured for any or all of the following
positions within the community mental health services program:
(i) Board members.
(ii) Executive director.
(iii) Medical director.
(iv) Recipient rights director.
(b) Cancel the state funding commitment to the community
mental health services program and utilize the funds previously
provided to the community mental health services program to do 1 or
more of the following:
(i) Secure services from other providers of mental health
services that the department has determined can operate in
substantial compliance with the standards established under this
section and continue the delivery of services within the county or
counties.
(ii) Provide the service.
(16) (15)
If state funding is canceled under
subsection (14)
(15) and the community mental health services program is an
authority created under section 205, the county or counties that
created the authority are financially liable only for the local
match formula established for the authority under chapter 3. If
state
funding is canceled under subsection (14) (15) and the
community mental health services program is a county community
mental health agency or a community mental health organization, the
county or counties that established the agency are financially
liable for local match for all services contractually or directly
provided by the department to residents of the county or counties
in accordance with chapter 3.
(17) (16)
The department shall not utilize
the certification
process under this section to require a community mental health
services program to become a community mental health authority.
Community mental health authority status is voluntary as provided
in section 205.
(17)
Subject to section 114a, the department shall submit
proposed
rules for certification to public hearing within 6 months
after
the effective date of the amendatory act that added this
section.
Sec. 232b. (1) The department shall establish standards for
community mental health services programs designated as specialty
prepaid health plans under the medicaid managed care program
described in section 109f of the social welfare act, 1939 PA 280,
MCL 400.109f. The standards established under this section shall
reference applicable federal regulations related to medicaid
managed care programs and specify additional state requirements for
specialty prepaid health plans. The standards established under
this section shall be published in a departmental bulletin or by an
updating insert to a departmental manual.
(2) As a condition for contracting and for receiving payment
under the medicaid managed care program, a community mental health
services program designated as a specialty prepaid health plan
shall certify both of the following:
(a) That the program is in substantial compliance with the
standards promulgated by the department and with applicable federal
regulations.
(b) That the program has established policies and procedures
to monitor compliance with the standards promulgated by the
department and with applicable federal regulations and to ensure
program integrity.
(3) The department shall conduct an annual review of all
community mental health services programs designated as specialty
prepaid health plans to verify the declarations made by the
community mental health services program and to monitor compliance
with the standards promulgated for specialty prepaid health plans
and with applicable federal regulations. The annual review process
established under this section shall be published in a departmental
bulletin or by an updating insert to a departmental manual.
(4) The department may conduct separate reviews of a specialty
prepaid health plan in response to beneficiary complaints,
financial status considerations, or health and safety concerns.
(5) Contracts with specialty prepaid health plans shall
indicate the sanctions that the department may invoke if it makes a
determination that a specialty prepaid health plan is not in
substantial compliance with promulgated standards and with
established federal regulations, that the specialty prepaid health
plan has misrepresented or falsified information reported to the
state or to the federal government, or that the specialty prepaid
health plan has failed substantially to provide necessary covered
services to recipients under the terms of the contract. Sanctions
may
include intermediate involve
actions including, but not limited
to,
a monetary penalty imposed on the administrative, and
management, or other operation of the specialty prepaid health
plan, imposition of temporary receivership or state management of a
community mental health services program operating as a specialty
prepaid health plan, or termination of the department's medicaid
managed care contract with the community mental health services
program.
(6)
Before When imposing a sanction on a community mental
health services program that is operating as a specialty prepaid
health plan, the department shall provide that specialty prepaid
health plan with timely written notice that explains both of the
following:
(a) The basis and nature of the sanction.
(b) The opportunity for a hearing to contest or dispute the
department's
findings and intended sanction, prior to before the
imposition of the sanction. A hearing under this section is subject
to the provisions governing a contested case under the
administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to
24.328, unless otherwise agreed to in the specialty prepaid health
plan contract. The period during which an appeal has been filed and
not yet resolved shall be governed by the provisions of section
232a(14).