April 14, 2015, Introduced by Rep. Afendoulis and referred to the Committee on Appropriations.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 100c, 100d, 134, 135, 136, 137, 138, 139, 143,
143a, 148, 149, and 149b (MCL 330.1100c, 330.1100d, 330.1134,
330.1135, 330.1136, 330.1137, 330.1138, 330.1139, 330.1143,
330.1143a, 330.1148, 330.1149, and 330.1149b), sections 100c and
100d as amended by 2014 PA 200, sections 134, 136, 143, 143a, 148,
149, and 149b as amended by 1994 PA 137, sections 135 and 139 as
amended by 1995 PA 290, section 137 as amended by 2004 PA 259, and
section 138 as amended by 2006 PA 207.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 100c. (1) "Peace officer" means an officer of the
department of state police or of a law enforcement agency of a
county, township, city, or village who is responsible for the
prevention and detection of crime and enforcement of the criminal
laws of this state. For the purposes of sections 408 and 427, peace
officer
also includes an officer of the United States secret
service
Secret Service with the officer's consent and a police
officer
of the veterans' administration medical center
reservation.Veterans' Administration Medical Center
Reservation.
(2) "Peer review" means a process, including the review
process required under section 143a, in which mental health
professionals of a state facility, licensed hospital, or community
mental health services program evaluate the clinical competence of
staff and the quality and appropriateness of care provided to
recipients. Peer review evaluations are confidential in accordance
with section 748(9) and are based on criteria established by the
facility or community mental health services program itself, the
accepted standards of the mental health professions, and the
department.
(3) "Person requiring treatment" means an individual who meets
the criteria described in section 401.
(4) "Physician" means an individual licensed or otherwise
authorized to engage in the practice of medicine under part 170 of
the public health code, 1978 PA 368, MCL 333.17001 to 333.17084, or
to engage in the practice of osteopathic medicine and surgery under
part 175 of the public health code, 1978 PA 368, MCL 333.17501 to
333.17556.
(5) "Primary consumer" means an individual who has received or
is receiving services from the department or a community mental
health services program or services from the private sector
equivalent to those offered by the department or a community mental
health services program.
(6) "Priority" means preference for and dedication of a major
proportion of resources to specified populations or services.
Priority does not mean serving or funding the specified populations
or services to the exclusion of other populations or services.
(7) "Protective custody" means the temporary custody of an
individual by a peace officer with or without the individual's
consent for the purpose of protecting that individual's health and
safety, or the health and safety of the public, and for the purpose
of transporting the individual under section 276, 408, or 427 if
the individual appears, in the judgment of the peace officer, to be
a person requiring treatment or is a person requiring treatment.
Protective custody is civil in nature and is not an arrest.
(8)
"Psychiatric partial hospitalization program" means a
nonresidential
treatment program that provides psychiatric,
psychological,
social, occupational, nursing, music therapy, and
therapeutic
recreational services under the supervision of a
physician
to adults diagnosed as having serious mental illness or
minors
diagnosed as having serious emotional disturbance who do not
require
24-hour continuous mental health care, and that is
affiliated
with a psychiatric hospital or psychiatric unit to which
clients
may be transferred if they need inpatient psychiatric care.
(8) (9)
"Psychiatric unit" means
a unit of a general hospital
that provides inpatient services for individuals with serious
mental illness or serious emotional disturbance. As used in this
subsection, "general hospital" means a hospital as defined in
section 20106 of the public health code, 1978 PA 368, MCL
333.20106.
(9) (10)
"Psychiatrist" means 1 or
more of the following:
(a) A physician who has completed a residency program in
psychiatry
approved by the accreditation council for graduate
medical
education or the American osteopathic association,
Accreditation Council for Graduate Medical Education or the
American Osteopathic Association, or who has completed 12 months of
psychiatric rotation and is enrolled in an approved residency
program as described in this subdivision.
(b) A psychiatrist employed by or under contract with the
department or a community mental health services program on March
28, 1996.
(c) A physician who devotes a substantial portion of his or
her time to the practice of psychiatry and is approved by the
director.
(10) (11)
"Psychologist" means an
individual who is licensed
or otherwise authorized to engage in the practice of psychology
under part 182 of the public health code, 1978 PA 368, MCL
333.18201 to 333.18237, and who devotes a substantial portion of
his or her time to the diagnosis and treatment of individuals with
serious mental illness, serious emotional disturbance, substance
use disorder, or developmental disability.
(11) (12)
"Recipient" means an
individual who receives mental
health services from the department, a community mental health
services program, or a facility or from a provider that is under
contract with the department or a community mental health services
program. For the purposes of this act, recipient does not include
an individual receiving substance use disorder services under
chapter 2A unless that individual is also receiving mental health
services under this act in conjunction with substance use disorder
services.
(12) (13)
"Recipient rights advisory
committee" means a
committee of a community mental health services program board
appointed under section 757 or a recipient rights advisory
committee appointed by a licensed hospital under section 758.
(13) (14)
"Recovery" means a highly
individualized process of
healing and transformation by which the individual gains control
over his or her life. Related services include recovery management,
recovery support services, recovery houses or transitional living
programs, and relapse prevention. Recovery involves the development
of a new meaning, purpose, and growing beyond the impact of
addiction or a diagnosis. Recovery may include the pursuit of
spiritual, emotional, mental, or physical well-being.
(14) (15)
"Regional entity" means
an entity established under
section 204b to provide specialty services and supports.
(15) (16)
"Rehabilitation" means
the act of restoring an
individual to a state of mental and physical health or useful
activity through vocational or educational training, therapy, and
counseling.
(16) (17)
"Resident" means an
individual who receives services
in a facility.
(17) (18)
"Responsible mental health
agency" means the
hospital, center, or community mental health services program that
has primary responsibility for the recipient's care or for the
delivery of services or supports to that recipient.
(18) (19)
"Rule" means a rule
promulgated under the
administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to
24.328.
Sec. 100d. (1) "Service" means a mental health service or a
substance use disorder service.
(2) "Serious emotional disturbance" means a diagnosable
mental, behavioral, or emotional disorder affecting a minor that
exists or has existed during the past year for a period of time
sufficient to meet diagnostic criteria specified in the most recent
diagnostic
and statistical manual of mental disorders Diagnostic
and Statistical Manual of Mental Disorders published by the
American
psychiatric association Psychiatric
Association and
approved by the department and that has resulted in functional
impairment that substantially interferes with or limits the minor's
role or functioning in family, school, or community activities. The
following disorders are included only if they occur in conjunction
with another diagnosable serious emotional disturbance:
(a) A substance use disorder.
(b) A developmental disorder.
(c)
"V" codes in the diagnostic and statistical manual of
mental
disorders.Diagnostic and
Statistical Manual of Mental
Disorders.
(3) "Serious mental illness" means a diagnosable mental,
behavioral, or emotional disorder affecting an adult that exists or
has existed within the past year for a period of time sufficient to
meet
diagnostic criteria specified in the most recent diagnostic
and
statistical manual of mental disorders Diagnostic and
Statistical Manual of Mental Disorders published by the American
psychiatric
association Psychiatric
Association and approved by the
department and that has resulted in functional impairment that
substantially interferes with or limits 1 or more major life
activities. Serious mental illness includes dementia with
delusions, dementia with depressed mood, and dementia with
behavioral disturbance but does not include any other dementia
unless the dementia occurs in conjunction with another diagnosable
serious mental illness. The following disorders also are included
only if they occur in conjunction with another diagnosable serious
mental illness:
(a) A substance use disorder.
(b) A developmental disorder.
(c)
A "V" code in the diagnostic and statistical manual of
mental
disorders.Diagnostic and
Statistical Manual of Mental
Disorders.
(4) "Special compensation" means payment to an adult foster
care facility to ensure the provision of a specialized program in
addition to the basic payment for adult foster care. Special
compensation does not include payment received directly from the
medicaid
Medicaid program for personal care services for a
resident, or payment received under the supplemental security
income program.
(5) "Specialized program" means a program of services,
supports, or treatment that are provided in an adult foster care
facility to meet the unique programmatic needs of individuals with
serious mental illness or developmental disability as set forth in
the resident's individual plan of services and for which the adult
foster care facility receives special compensation.
(6) "Specialized residential service" means a combination of
residential care and mental health services that are expressly
designed to provide rehabilitation and therapy to a recipient, that
are provided in the residence of the recipient, and that are part
of a comprehensive individual plan of services.
(7) "State administered funds" means revenues appropriated by
the legislature exclusively for the purposes provided for in regard
to substance use disorder services and prevention.
(8) "State facility" means a center or a hospital operated by
the department.
(9) "State recipient rights advisory committee" means a
committee appointed by the director under section 756 to advise the
director and the director of the department's office of recipient
rights.
(10) "Substance abuse" means the taking of alcohol or other
drugs at dosages that place an individual's social, economic,
psychological, and physical welfare in potential hazard or to the
extent that an individual loses the power of self-control as a
result of the use of alcohol or drugs, or while habitually under
the influence of alcohol or drugs, endangers public health, morals,
safety, or welfare, or a combination thereof.
(11) "Substance use disorder" means chronic disorder in which
repeated use of alcohol, drugs, or both, results in significant and
adverse consequences. Substance use disorder includes substance
abuse.
(12) "Substance use disorder prevention services" means
services that are intended to reduce the consequences of substance
use disorders in communities by preventing or delaying the onset of
substance abuse and that are intended to reduce the progression of
substance use disorders in individuals. Substance use disorder
prevention is an ordered set of steps that promotes individual,
family, and community health, prevents mental and behavioral
disorders, supports resilience and recovery, and reinforces
treatment principles to prevent relapse.
(13) "Substance use disorder treatment and rehabilitation
services"
means the providing of identifiable recovery-oriented
services including:
(a) Early intervention and crisis intervention counseling
services for individuals who are current or former individuals with
substance use disorder.
(b) Referral services for individuals with substance use
disorder, their families, and the general public.
(c) Planned treatment services, including chemotherapy,
counseling, or rehabilitation for individuals physiologically or
psychologically dependent upon or abusing alcohol or drugs.
(14) "Supplemental security income" means the program
authorized under title XVI of the social security act, 42 USC 1381
to 1383f.
(15) "Transfer facility" means a facility selected by the
department-designated community mental health entity, which
facility is physically located in a jail or lockup and is staffed
by at least 1 designated representative when in use according to
chapter 2A.
(16) "Transition services" means a coordinated set of
activities for a special education student designed within an
outcome-oriented process that promotes movement from school to
postschool activities, including postsecondary education,
vocational training, integrated employment including supported
employment, continuing and adult education, adult services,
independent living, or community participation.
(17) "Treatment" means care, diagnostic, and therapeutic
services, including the administration of drugs, and any other
service for the treatment of an individual's serious mental
illness, serious emotional disturbance, or substance use disorder.
(18)
"Treatment position" means a unit of measure of the
client
capacity of a psychiatric partial hospitalization program.
Each
treatment position represents a minimum of 6 hours per day and
5
days per calendar week.
(18) (19)
"Urgent situation" means
a situation in which an
individual is determined to be at risk of experiencing an emergency
situation in the near future if he or she does not receive care,
treatment, or support services.
(19) (20)
"Wraparound services"
means an individually designed
set of services provided to minors with serious emotional
disturbance or serious mental illness and their families that
includes treatment services and personal support services or any
other supports necessary to foster education preparedness,
employability, and preservation of the child in the family home.
Wraparound services are to be developed through an interagency
collaborative approach and a minor's parent or guardian and a minor
age 14 or older are to participate in planning the services.
Sec. 134. (1) The director shall establish a comprehensive
system
of licensing for psychiatric hospitals
, and psychiatric
units ,
and psychiatric partial hospitalization programs in the
state
to protect the public by insuring ensuring that these
hospitals , and units ,
and programs provide the facilities
and the
ancillary supporting services necessary to maintain a high quality
of
patient care. Separate criteria shall be developed for the
licensing
of partial hospitalization treatment positions and
hospital beds for minors.
(2) The director shall coordinate all functions within state
government affecting psychiatric hospitals, and shall cooperate
with other state agencies that establish standards or requirements
for facilities providing mental health care to assure necessary,
equitable, and consistent state regulation of these facilities
without duplication of inspections or services. The director may
enter into agreements with other state agencies to accomplish this
purpose.
Sec.
135. (1) Subject to section 114a, the director, by rule,
shall
set standards that assure the provision of a quality
improvement
plan, utilization review, and the appropriate training
and
education of staff and that require documented policies and
procedures
for the administration of the services that are offered
by
a psychiatric partial hospitalization program.
(2)
(1) Subject to section 114a, the director shall
promulgate
rules
to define all of the following:
(a)
Psychiatric psychiatric hospitals and psychiatric hospital
services to clearly differentiate between the active intensive care
expected in psychiatric hospitals or psychiatric units and that
care which is characteristically expected in general hospitals,
long-term care facilities, or residential facilities.
(b)
Psychiatric partial hospitalization program to clearly
differentiate
between the active intensive care expected in a
psychiatric
partial hospitalization program and that care which is
characteristically
provided in a psychiatric outpatient program.
(c)
The relationship between a partial hospitalization program
and
its affiliated inpatient hospital or unit.
(2) (3)
Sections 134 to 150 do not cover
adult foster care
facilities
or child care organizations licensed under Act No. 116
of
the Public Acts of 1973, being sections 722.111 to 722.128 of
the
Michigan Compiled Laws.1973
PA 116, MCL 722.111 to 722.128.
Sec. 136. The director shall administer sections 134 through
150 and promulgate rules to implement the purposes of sections 134
through 150 for the maintenance and operation of psychiatric
hospitals , and psychiatric
units , and psychiatric partial
hospitalization
programs as necessary to enable
state or private
facilities, or both, to qualify for federal funds available for
patient care or for construction or remodeling of facilities. The
rules
shall be promulgated pursuant according
to the administrative
procedures
act of 1969, Act No. 306 of the Public Acts of 1969, as
amended,
being sections 24.201 to 24.328 of the Michigan Compiled
Laws.1969 PA 306, MCL 24.201 to 24.328.
Sec. 137. (1) A person shall not construct, establish, or
maintain
a psychiatric hospital , or
psychiatric unit ,
or
psychiatric
partial hospitalization program or
use the terms
psychiatric
hospital , or
psychiatric unit ,
or psychiatric partial
hospitalization
program, without first obtaining a
license. The
director shall require an applicant or a licensee to disclose the
names, addresses, and official positions of all persons who have an
ownership
interest in a psychiatric hospital
, or psychiatric unit.
,
or psychiatric partial hospitalization program. If the
psychiatric
hospital , or
psychiatric unit ,
or psychiatric partial
hospitalization
program is located on or in real
estate that is
leased, the applicant or licensee shall disclose the name of the
lessor and any direct or indirect interest that the applicant or
licensee
has in the lease other than as lessee. A nontransferable
license
shall be granted for 2 years no
longer than 1 year after
the date of issuance, unless otherwise provided in sections 134 to
150. The director may issue a provisional license for 1 year to
provide a licensee or applicant time to undertake remedial action
to correct programmatic or physical plant deficiencies. A
provisional license may be renewed for not longer than 1 additional
year. A violation of this section is a misdemeanor and is
punishable by a fine of not more than $1,000.00 for each violation.
(2)
Biennial Annual licensure of psychiatric hospitals , and
psychiatric
units , and psychiatric partial hospitalization
programs
shall be implemented by March 28,
1997. License fees shall
be prorated according to the period of time that the license will
be in force.
(3)
Beginning the effective date of the amendatory act that
added
this subsection, the The department shall issue an initial
license under this section not later than 6 months after the
applicant files a completed application. Receipt of the application
is considered the date the application is received by any agency or
department of this state. If the application is considered
incomplete by the department, the department shall notify the
applicant in writing or make notice electronically available within
30 days after receipt of the incomplete application, describing the
deficiency and requesting additional information. The 6-month
period is tolled upon notification by the department of a
deficiency until the date the requested information is received by
the department. The determination of the completeness of an
application is not an approval of the application for the license
and does not confer eligibility on an applicant determined
otherwise ineligible for issuance of a license.
(4) If the department fails to issue or deny a license or
registration within the time required by this section, the
department shall return the license fee and shall reduce the
license fee for the applicant's next renewal application, if any,
by 15%. Failure to issue or deny a license within the time period
required under this section does not allow the department to
otherwise delay the processing of the application. A completed
application shall be placed in sequence with other completed
applications received at that same time. The department shall not
discriminate against an applicant in the processing of the
application based on the fact that the application fee was refunded
or discounted under this subsection.
(5)
Beginning October 1, 2005, the The
director of the
department shall submit a report by December 1 of each year to the
standing committees and appropriations subcommittees of the senate
and house of representatives concerned with issues relating to
mental health. The director shall include all of the following
information in the report concerning the preceding fiscal year:
(a) The number of initial applications the department received
and completed within the 6-month time period described in
subsection (3).
(b) The number of applications rejected.
(c) The number of applicants not issued a license within the
6-month time period and the amount of money returned to licensees
under subsection (4).
(6) As used in this section, "completed application" means an
application complete on its face and submitted with any applicable
licensing fees as well as any other information, records, approval,
security, or similar item required by law or rule from a local unit
of government, a federal agency, or a private entity but not from
another department or agency of this state.
Sec.
138. Before the issuance of an original or biennial
annual
license, a psychiatric hospital , or psychiatric
unit , or
psychiatric
partial hospitalization program shall
be inspected by
the bureau of fire services created in section 1b of the fire
prevention code, 1941 PA 207, MCL 29.1b. A license shall not be
issued until the bureau of fire services approves the hospital or
unit.
Sec. 139. (1) An applicant for a license under this act shall
submit to the department with the application form, or license
renewal, a license fee of $600.00 $500.00 plus
$7.50 $10.00 per
patient
bed. or treatment position. The total license fee
shall not
exceed
$5,000.00.
(2) The license fee for a provisional license is the same as
the fee for a license. When the requirements for licensure are met,
the provisional license shall be replaced by a license without an
additional
fee for the balance of the 2-year 1-year period.
(3) An applicant for a construction permit shall submit to the
department with the application form a permit fee of $300.00.
(4) If an application for a license or permit is denied, or if
a license or permit is revoked before its expiration date, the fees
paid to the department shall not be refunded.
Sec.
143. (1) The governing body of a facility licensed under
sections 134 through 150 is responsible for the operation of the
facility, for the selection of the medical staff, and for the
quality
of care rendered by the facility. If a licensee contracts
with
another entity to operate a psychiatric partial
hospitalization
program, the governing body of the licensee is
responsible
for the operation of the facility, the selection of the
medical
staff, and the quality of care rendered by the facility.
The governing body shall cooperate with the director of mental
health in the enforcement of sections 134 through 150, and shall
insure that physicians and other personnel for whom a state license
or registration is required are currently licensed or registered.
(2)
A psychiatric partial hospitalization program shall
develop
and implement written policies, procedures, and agreements
to
ensure the direct transfer or hospitalization of clients between
the
partial hospitalization program and a psychiatric hospital or
psychiatric
unit.
Sec. 143a. (1) The owner, operator, and governing body of a
psychiatric
hospital , or
psychiatric unit ,
or psychiatric partial
hospitalization
program licensed under this chapter
or operated by
the department shall assure that licensed, registered, or certified
mental health professionals admitted to practice in the facility
are organized in order to enable an effective review of the
professional
practices in the psychiatric hospital
, or psychiatric
unit ,
or psychiatric partial hospitalization program for the
purpose of improving the quality of patient care provided in the
facility. This review shall include the quality and appropriateness
of the care provided.
(2) The records, data, and knowledge collected for or by
individuals or committees assigned a review function under
subsection (1) are confidential, shall be used only for the
purposes of review, are not public records, and are not subject to
court subpoena.
(3) This section does not prevent disclosure of individual
case
records pursuant to under section 748 or disclosure required
by federal law to the agency designated by the governor to provide
protection
and advocacy pursuant to under
section 931.
Sec.
148. The terms psychiatric hospital
, or psychiatric unit
,
or psychiatric partial hospitalization program shall not be used
to describe or refer to an institution or program, unless the
institution
or program is licensed by the director pursuant
according to sections 134 through 150.
Sec. 149. The director may maintain action in the name of the
people of the state to restrain or prevent the construction,
establishment,
management, or operation of a psychiatric hospital ,
or
psychiatric unit ,
or psychiatric partial hospitalization
program
without a license.
Sec.
149b. A psychiatric hospital , or
psychiatric unit ,
or
psychiatric
partial hospitalization program operated
or licensed by
the department shall comply with the medical waste regulatory act,
part
138 of the public health code, Act No. 368 of the Public Acts
of
1978, being sections 333.13801 to 333.13831 of the Michigan
Compiled
Laws.1978 PA 368, MCL
333.13801 to 333.13832.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.