November 9, 2000, Introduced by Reps. Brater, Price, Hansen, Woodward, Jacobs, Jamnick, DeHart, Bovin, LaForge, Martinez, Hager, Thomas and Kilpatrick and referred to the Committee on Health Policy. A bill to amend 1974 PA 258, entitled "Mental health code," by amending section 100a (MCL 330.1100a), as amended by 1998 PA 497, and by adding section 208a. 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 tal- 3 ents and acquired proficiencies. 4 (2) "Abuse" means nonaccidental physical or emotional harm 5 to 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 9 health services program, or a licensed hospital or by an employee 10 or volunteer of a service provider under contract with the 06261'00 * LTB 2 1 department, community mental health services program, or licensed 2 hospital. 3 (3) "Adaptive skills" means skills in 1 or more of the fol- 4 lowing areas: 5 (a) Communication. 6 (b) Self-care. 7 (c) Home living. 8 (d) Social skills. 9 (e) Community use. 10 (f) Self-direction. 11 (g) Health and safety. 12 (h) Functional academics. 13 (i) Leisure. 14 (j) Work. 15 (4) "Adult foster care facility" means an adult foster care 16 facility licensed under the adult foster care facility licensing 17 act, 1979 PA 218, MCL 400.701 to 400.737. 18 (5) "Applicant" means an individual or his or her legal rep- 19 resentative who makes a request for mental health services. 20 (6) "Board" means the governing body of a community mental 21 health services program. 22 (7) "Board of commissioners" means a county board of 23 commissioners. 24 (8) "Center" means a facility operated by the department to 25 admit individuals with developmental disabilities and provide 26 habilitation and treatment services. 06261'00 * 3 1 (9) "Certification" means formal approval of a program by 2 the department in accordance with standards developed or approved 3 by the department. 4 (10) "Child abuse" and "child neglect" mean those terms as 5 defined in section 2 of the child protection law, 1975 PA 238, 6 MCL 722.622. 7 (11) "Child and adolescent psychiatrist" means 1 or more of 8 the following: 9 (a) A physician who has completed a residency program in 10 child and adolescent psychiatry approved by the accreditation 11 council for graduate medical education or the American osteo- 12 pathic association, or who has completed 12 months of child and 13 adolescent psychiatric rotation and is enrolled in an approved 14 residency program as described in this subsection. 15 (b) A psychiatrist employed by or under contract as a child 16 and adolescent psychiatrist with the department or a community 17 mental health services program on March 28, 1996, who has educa- 18 tion and clinical experience in the evaluation and treatment of 19 children or adolescents with serious emotional disturbance. 20 (c) A psychiatrist who has education and clinical experience 21 in the evaluation and treatment of children or adolescents with 22 serious emotional disturbance who is approved by the director. 23 (12) "Children's diagnostic and treatment service" means a 24 program operated by or under contract with a community mental 25 health services program, that provides examination, evaluation, 26 and referrals for minors, including emergency referrals, that 06261'00 * 4 1 provides or facilitates treatment for minors, and that has been 2 certified by the department. 3 (13) "Community mental health authority" means a separate 4 legal public governmental entity created under section 205 to 5 operate as a community mental health services program. 6 (14) "Community mental health organization" means a commu- 7 nity mental health services program that is organized under the 8 urban cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 9 to 124.512. 10 (15) "Community mental health services program" means a pro- 11 gram operated under chapter 2 as a county community mental health 12 agency, a community mental health authority, or a community 13 mental health organization. 14 (16) "Consent" means a written agreement executed by a 15 recipient, a minor recipient's parent, or a recipient's legal 16 representative with authority to execute a consent, or a verbal 17 agreement of a recipient that is witnessed and documented by an 18 individual other than the individual providing treatment. 19 (17) "County community mental health agency" means an offi- 20 cial county or multicounty agency created under section 210 that 21 operates as a community mental health services program and that 22 has not elected to become a community mental health authority 23 under section 205 or a community mental health organization under 24 the urban cooperation act of 1967, 1967 (Ex Sess) PA 7, 25 MCL 124.501 to 124.512. 26 (18) "Dependent living setting" means all of the following: 06261'00 * 5 1 (a) An adult foster care facility. 2 (b) A nursing home licensed under article 17 of the public 3 health code, 1978 PA 368, MCL 333.20101 to 333.22260. 4 (c) A home for the aged licensed under article 17 of the 5 public health code, 1978 PA 368, MCL 333.20101 to 333.22260. 6 (19) "Department" means the department of community health. 7 (20) "Developmental disability" means either of the 8 following: 9 (a) If applied to an individual older than 5 years OLD, a 10 severe, chronic condition that meets all of the following 11 requirements: 12 (i) Is attributable to a mental or physical impairment or a 13 combination of mental and physical impairments. 14 (ii) Is manifested before the individual is 22 years old. 15 (iii) Is likely to continue indefinitely. 16 (iv) Results in substantial functional limitations in 3 or 17 more of the following areas of major life activity: 18 (A) Self-care. 19 (B) Receptive and expressive language. 20 (C) Learning. 21 (D) Mobility. 22 (E) Self-direction. 23 (F) Capacity for independent living. 24 (G) Economic self-sufficiency. 25 (v) Reflects the individual's need for a combination and 26 sequence of special, interdisciplinary, or generic care, 06261'00 * 6 1 treatment, or other services that are of lifelong or extended 2 duration and are individually planned and coordinated. 3 (b) If applied to a minor from birth to 5 YEARS OF age, a 4 substantial developmental delay or a specific congenital or 5 acquired condition with a high probability of resulting in devel- 6 opmental disability as defined in subdivision (a) if services are 7 not provided. 8 (21) "Director" means the director of the department or his 9 or her designee. 10 (22) "Discharge" means an absolute, unconditional release of 11 an individual from a facility by action of the facility or a 12 court. 13 (23) "Eligible minor" means an individual less than 18 years 14 of age who is recommended in the written report of a multidisci- 15 plinary team under rules promulgated by the department of educa- 16 tion to be classified as 1 of the following: 17 (a) Severely mentally impaired. 18 (b) Severely multiply impaired. 19 (c) Autistic impaired and receiving special education serv- 20 ices in a program designed for the autistic impaired under 21 subsection (1) of R 340.1758 of the Michigan administrative code 22 or in a program designed for the severely mentally impaired or 23 severely multiply impaired. 24 (24) "Emergency situation" means a situation in which an 25 individual is experiencing a serious mental illness or a develop- 26 mental disability, or a child MINOR is experiencing a serious 27 emotional disturbance, and 1 of the following applies: 06261'00 * 7 1 (a) The individual can reasonably be expected within the 2 near future to physically injure himself, herself, or another 3 individual, either intentionally or unintentionally. 4 (b) The individual is unable to provide himself or herself 5 food, clothing, or shelter or to attend to basic physical activi- 6 ties such as eating, toileting, bathing, grooming, dressing, or 7 ambulating, and this inability may lead in the near future to 8 harm to the individual or to another individual. 9 (c) The individual's judgment is so impaired that he or she 10 is unable to understand the need for treatment and, in the opin- 11 ion of the mental health professional, his or her continued 12 behavior as a result of the mental illness, developmental dis- 13 ability, or emotional disturbance can reasonably be expected in 14 the near future to result in physical harm to the individual or 15 to another individual. 16 (D) THE MINOR DISPLAYS BEHAVIOR THAT SUGGESTS THE MINOR HAS 17 AN IMPAIRMENT INVOLVING PERSONALITY DEVELOPMENT, INDIVIDUAL 18 ADJUSTMENT, SOCIAL ADJUSTMENT, OR EMOTIONAL GROWTH THAT COULD BE 19 TREATED THROUGH SERVICES PROVIDED UNDER THIS ACT. 20 (25) "Executive director" means an individual appointed 21 under section 226 to direct a community mental health services 22 program or his or her designee. 23 SEC. 208A. (1) FOR THE PURPOSE OF MAKING A PRIORITY REFER- 24 RAL ACCORDING TO SECTION 208(3), A SCHOOL DISTRICT MAY MAKE A 25 DETERMINATION THAT A MINOR IS IN AN URGENT OR EMERGENCY 26 SITUATION. A SCHOOL DISTRICT MAY DESIGNATE A MENTAL HEALTH 06261'00 * 8 1 PROFESSIONAL TO MAKE A DETERMINATION AUTHORIZED UNDER THIS 2 SECTION. 3 (2) UPON RECEIPT OF A REFERRAL MADE BY A SCHOOL DISTRICT 4 UNDER SUBSECTION (1), A CMHSP SHALL EVALUATE THE REFERRED MINOR 5 AND MAKE A RECOMMENDATION REGARDING A PLAN OF SERVICES TO BE 6 IMPLEMENTED BY EITHER THE CMHSP, THE REFERRING SCHOOL DISTRICT, 7 OR BOTH. NOT MORE THAN 48 HOURS AFTER RECEIVING THE REFERRAL, 8 THE CMHSP SHALL SEND A COPY OF THE RECOMMENDATION REGARDING THE 9 REFERRED MINOR TO THE REFERRING SCHOOL DISTRICT AND THE REFERRED 10 MINOR'S PARENT OR GUARDIAN. 11 (3) IF THE REFERRING SCHOOL DISTRICT AND THE REFERRED 12 MINOR'S PARENT OR GUARDIAN AGREE WITH THE CMHSP'S RECOMMENDED 13 PLAN OF SERVICES, THE REFERRING SCHOOL DISTRICT SHALL NOTIFY THE 14 CMHSP. EITHER THE CMHSP OR THE REFERRING SCHOOL DISTRICT SHALL 15 IMPLEMENT THE AGREED UPON PLAN OF SERVICES ACCORDING TO THE PLAN 16 RECOMMENDATION. IF THE PLAN RECOMMENDATION CALLS FOR THE CMHSP 17 ALONE TO IMPLEMENT THE PLAN OF SERVICES, THE EXPENSE FOR THE PLAN 18 IMPLEMENTATION SHALL NOT BE CHARGED TO THE REFERRING SCHOOL 19 DISTRICT. 20 (4) IF A CMHSP'S RECOMMENDATION INCLUDES A PLAN OF SERVICES 21 THAT THE REFERRING SCHOOL DISTRICT OR A REFERRED MINOR'S PARENT 22 OR GUARDIAN BELIEVES IS INAPPROPRIATE OR INADEQUATE FOR THE 23 REFERRED MINOR, THE CMHSP AND THE REFERRING SCHOOL DISTRICT AND 24 THE REFERRED MINOR'S PARENT OR GUARDIAN SHALL WORK TOGETHER TO 25 DEVELOP A COORDINATED PLAN OF SERVICES THAT IS ACCEPTABLE TO THE 26 SCHOOL DISTRICT, THE CMHSP, AND THE MINOR'S PARENT OR GUARDIAN. 06261'00 * 9 1 (5) IF A CMHSP'S RECOMMENDATION IS THAT THE REFERRED MINOR 2 DOES NOT NEED SERVICES PROVIDED BY THE CMHSP OR IF THE CMHSP, THE 3 REFERRING SCHOOL DISTRICT, AND THE REFERRED MINOR'S PARENT OR 4 GUARDIAN ARE UNABLE TO AGREE ON A COORDINATED PLAN OF SERVICES AS 5 REQUIRED UNDER SUBSECTION (4), THE REFERRING SCHOOL DISTRICT, 6 PARENT, OR GUARDIAN MAY PETITION THE COURT FOR AN EMERGENCY HEAR- 7 ING TO DETERMINE IF THE MINOR MEETS THE CRITERIA OF AN INDIVIDUAL 8 REQUIRING SERVICES UNDER SECTION 2 08. THE COURT SHALL MAKE A 9 DETERMINATION AS TO WHETHER THE MINOR MEETS THE CRITERIA OF AN 10 INDIVIDUAL REQUIRING SERVICES UNDER SECTION 208. IN MAKING THAT 11 DETERMINATION, THE COURT MAY CONSIDER INFORMATION PRESENTED BY A 12 PARENT OR GUARDIAN, THE REFERRING SCHOOL DISTRICT, AND THE 13 CMHSP. AT THE COURT'S DISCRETION, THE COURT MAY CONSIDER INFOR- 14 MATION PROVIDED AS THE RESULT OF AN INDEPENDENT EVALUATION BY AN 15 EXPERT CHOSEN BY THE COURT. 16 (6) ACCORDING TO SUBSECTION (5), IF THE COURT DETERMINES 17 THAT THE MINOR MEETS THE CRITERIA OF AN INDIVIDUAL REQUIRING 18 SERVICES UNDER SECTION 208, THE COURT SHALL ORDER THE REFERRING 19 SCHOOL DISTRICT AND THE CMHSP TO COOPERATE WITH THE MINOR'S 20 PARENT OR GUARDIAN TO DEVELOP A COORDINATED PLAN OF SERVICES FOR 21 THE MINOR. IF THE PLAN OF SERVICES DEVELOPED UNDER THIS SUBSEC- 22 TION REQUIRES PROVIDING MENTAL HEALTH SERVICES BY A COMMUNITY 23 MENTAL HEALTH SERVICES PROGRAM, THE SERVICES PROVIDED BY THAT 24 PROGRAM SHALL BE PAID FOR ACCORDING TO THE PROVISIONS OF 25 CHAPTER 8. 26 (7) AS USED IN THIS SECTION: 06261'00 * 10 1 (A) "CMHSP" MEANS COMMUNITY MENTAL HEALTH SERVICES PROGRAM 2 AS DEFINED IN SECTION 100A. 3 (B) "SCHOOL DISTRICT" MEANS A SCHOOL DISTRICT ORGANIZED 4 UNDER THE REVISED SCHOOL CODE, 1976 PA 451, MCL 380.1 TO 5 380.1852, OR A DISTRICT GOVERNED BY A SPECIAL OR LOCAL ACT. 06261'00 * Final page. LTB