SB-0686, As Passed Senate, November 10, 2004                                












    SUBSTITUTE FOR                                                              


    SENATE BILL NO. 686                                                         










                                                                                 A bill to amend 1974 PA 258, entitled                                             


    "Mental health code,"                                                       


    by amending sections 100a and 161 (MCL 330.1100a and 330.1161),             


    as amended by 1998 PA 497, 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           


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


10  or volunteer of a service provider under contract with the                  



1   department, community mental health services program, or licensed           


2   hospital.                                                                   


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


4   following 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                     


19  representative who makes a request for mental health services.              


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


21  categories of outpatient services ordered by the court under                


22  section 433 or 469a.  Assisted outpatient treatment includes                


23  intensive case management services or assertive community                   


24  treatment team services to provide care coordination.  Assisted             


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


26  categories of services:  medication; periodic blood tests or                


27  urinalysis to determine compliance with prescribed medications;             


1   individual or group therapy; day or partial day programming                 


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


3   activities; alcohol or substance abuse treatment and counseling             


4   and periodic tests for the presence of alcohol or illegal drugs             


5   for an individual with a history of alcohol or substance abuse;             


6   supervision of living arrangements; and any other services within           


7   a local or unified services plan developed under this act that              


8   are prescribed to treat the individual's mental illness and to              


9   assist the individual in living and functioning in the community            


10  or to attempt to prevent a relapse or deterioration that may                


11  reasonably be predicted to result in suicide or the need for                


12  hospitalization.  The medical review and direction included in an           


13  assisted outpatient treatment plan shall be provided under the              


14  supervision of a psychiatrist.                                              


15      (7)  (6)  "Board" means the governing body of a community                   


16  mental health services program.                                             


17      (8)  (7)  "Board of commissioners" means a county board of                  


18  commissioners.                                                              


19      (9)  (8)  "Center" means a facility operated by the                         


20  department to admit individuals with developmental disabilities             


21  and provide habilitation and treatment services.                            


22      (10)  (9)  "Certification" means formal approval of a program               


23  by the department in accordance with standards developed or                 


24  approved by the department.                                                 


25      (11)  (10)  "Child abuse" and "child neglect" mean those                    


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


27  PA 238, MCL 722.622.                                                        


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


2   more of the following:                                                      


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


4   child and adolescent psychiatry approved by the accreditation               


5   council for graduate medical education or the American                      


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


7   and adolescent psychiatric rotation and is enrolled in an                   


8   approved residency program as described in this subsection.                 


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


10  and adolescent psychiatrist with the department or a community              


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


12  education and clinical experience in the evaluation and treatment           


13  of children or adolescents with serious emotional disturbance.              


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


15  in the evaluation and treatment of children or adolescents with             


16  serious emotional disturbance who is approved by the director.              


17      (13)  (12)  "Children's diagnostic and treatment service"                   


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


19  mental health services program, that provides examination,                  


20  evaluation, and referrals for minors, including emergency                   


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


22  that has been certified by the department.                                  


23      (14)  (13)  "Community mental health authority" means a                     


24  separate legal public governmental entity created under                     


25  section 205 to operate as a community mental health services                


26  program.                                                                    


27      (15)  (14)  "Community mental health organization" means a                  


1   community mental health services program that is organized under            


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


3   MCL 124.501 to 124.512.                                                     


4       (16)  (15)  "Community mental health services program" means                


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


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


7   community mental health organization.                                       


8       (17)  (16)  "Consent" means a written agreement executed by a               


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


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


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


12  individual other than the individual providing treatment.                   


13      (18)  (17)  "County community mental health agency" means an                


14  official county or multicounty agency created under section 210             


15  that operates as a community mental health services program and             


16  that has not elected to become a community mental health                    


17  authority under section 205 or a community mental health                    


18  organization under the urban cooperation act of 1967, 1967                  


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


20      (19)  (18)  "Dependent living setting" means all of the                     


21  following:                                                                  


22      (a) An adult foster care facility.                                          


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


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


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


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


27      (20)  (19)  "Department" means the department of community                  


1   health.                                                                     


2       (21)  (20)  "Developmental disability" means either of the                  


3   following:                                                                  


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


5   severe, chronic condition that meets all of the following                   


6   requirements:                                                               


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


8   combination of mental and physical impairments.                             


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


10      (iii) Is likely to continue indefinitely.                                    


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


12  more of the following areas of major life activity:                         


13      (A) Self-care.                                                              


14      (B) Receptive and expressive language.                                      


15      (C) Learning.                                                               


16      (D) Mobility.                                                               


17      (E) Self-direction.                                                         


18      (F) Capacity for independent living.                                        


19      (G) Economic self-sufficiency.                                              


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


21  sequence of special, interdisciplinary, or generic care,                    


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


23  duration and are individually planned and coordinated.                      


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


25  a substantial developmental delay or a specific congenital or               


26  acquired condition with a high probability of resulting in                  


27  developmental disability as defined in subdivision (a) if                   


1   services are not provided.                                                  


2       (22)  (21)  "Director" means the director of the department                 


3   or his or her designee.                                                     


4       (23)  (22)  "Discharge" means an absolute, unconditional                    


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


6   facility or a court.                                                        


7       (24)  (23)  "Eligible minor" means an individual less than                  


8   18 years of age who is recommended in the written report of a               


9   multidisciplinary team under rules promulgated by the department            


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


11      (a) Severely mentally impaired.                                             


12      (b) Severely multiply impaired.                                             


13      (c) Autistic impaired and receiving special education                       


14  services in a program designed for the autistic impaired under              


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


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


17  severely multiply impaired.                                                 


18      (25)  (24)  "Emergency situation" means a situation in which                


19  an individual is experiencing a serious mental illness or a                 


20  developmental disability, or a  child  minor is experiencing a              


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


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


23  future to physically injure himself, herself, or another                    


24  individual, either intentionally or unintentionally.                        


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


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


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


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


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


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


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


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


6   behavior as a result of the mental illness, developmental                   


7   disability, or emotional disturbance can reasonably be expected             


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


9   or to another individual.                                                   


10      (26)  (25)  "Executive director" means an individual                        


11  appointed under section 226 to direct a community mental health             


12  services program or his or her designee.                                    


13      Sec. 116a.  (1) The department shall submit to the members                  


14  of the senate and house standing committees, the senate and house           


15  appropriation subcommittees with legislative oversight of mental            


16  health matters, and the senate and house fiscal agencies an                 


17  annual report concerning assisted outpatient treatment services             


18  in this state.  The report shall include statewide information              


19  regarding the number of individuals receiving and completing                


20  assisted outpatient treatment and shall include the cost and                


21  benefit projections that are available concerning assisted                  


22  outpatient treatment in this state.                                         


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


24  regarding petitions filed under section 433:                                


25      (a) The number of assisted outpatient treatment petitions                   


26  filed.                                                                      


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


1   section 433 that resulted in an assisted outpatient treatment               


2   order.                                                                      


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


4   section 433 that did not result in an assisted outpatient                   


5   treatment order.                                                            


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


7   evaluating the assisted outpatient treatment in this state, the             


8   department shall attempt to utilize expert assistance from                  


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


10  universities.                                                               


11      Sec. 161.  In conjunction with community mental health                      


12  services programs, the department shall conduct annually and                


13  forward to the governor and the house and senate appropriations             


14  committees, and the senate and house committees with legislative            


15  oversight of  social  human services and mental health, an                  


16  evaluation of the family support subsidy program that shall                 


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


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


19  children covered by this act in facilities and residential care             


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


21  of families who choose not to participate.                                  


22      (b) Case reviews of families who voluntarily terminate                      


23  participation in the family support subsidy program for any                 


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


25  family home, including the involvement of the department and                


26  community mental health services programs in offering suitable              


27  alternatives.                                                               


1       (c) Sample assessments of families receiving family support                 


2   subsidy payments including adequacy of subsidy and need for                 


3   services not available.                                                     


4       (d) The efforts to encourage program participation of                       


5   eligible families.                                                          


6       (e) The geographic distribution of families receiving subsidy               


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


8   be eligible for family support subsidy payments.                            


9       (f) Programmatic and legislative recommendations to further                 


10  assist families in providing care for eligible minors.                      


11      (g) Problems that arise in identifying eligible minors                      


12  through diagnostic evaluations performed under rules promulgated            


13  by the department of education.                                             


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


15  care facilities serving severely mentally, multiply, and autistic           


16  impaired children when the children return home to their natural            


17  families as a result of the subsidy program.                                


18      (i) Caseload figures by eligibility category as  defined                    


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


20      Enacting section 1.  This amendatory act does not take                      


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


22  are enacted into law:                                                       


23      (a) Senate Bill No. 683.                                                    


24      (b) Senate Bill No. 684.                                                    


25      (c) Senate Bill No. 685.                                                    


26      (d) Senate Bill No. 1464.