HOUSE BILL No. 6287

 

September 29, 2004, Introduced by Reps. Bieda and Gleason and referred to the Committee on Health Policy.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 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 chapter 3A.                        

                                                                                

                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" means an individual under a court                 

                                                                                

21  order to receive assisted outpatient treatment.                             

                                                                                

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

                                                                                

23  categories of outpatient services ordered by the court under                

                                                                                

24  chapter 3A.  Assisted outpatient treatment includes intensive               

                                                                                

25  case management services or assertive community treatment team              

                                                                                

26  services to provide care coordination.  Assisted outpatient                 

                                                                                

27  treatment may include 1 or more of the following categories of              


                                                                                

1   services:  medication; periodic blood tests or urinalysis to                

                                                                                

2   determine compliance with prescribed medications; individual or             

                                                                                

3   group therapy; day or partial day programming activities;                   

                                                                                

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

                                                                                

5   alcohol or substance abuse treatment and counseling and periodic            

                                                                                

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

                                                                                

7   individual with a history of alcohol or substance abuse;                    

                                                                                

8   supervision of living arrangements; or other services within a              

                                                                                

9   local or unified services plan developed under this act                     

                                                                                

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 or the need for                           

                                                                                

14  hospitalization.                                                            

                                                                                

15      (8) "Assisted outpatient treatment program" means the system                

                                                                                

16  to arrange for and coordinate the provision of assisted                     

                                                                                

17  outpatient treatment, to monitor treatment compliance by assisted           

                                                                                

18  outpatients, to evaluate the condition or needs of assisted                 

                                                                                

19  outpatients, to take appropriate steps to address the needs of              

                                                                                

20  assisted outpatients, and to ensure compliance with court                   

                                                                                

21  orders.                                                                     

                                                                                

22      (9) "Assisted outpatient treatment program director" means an               

                                                                                

23  individual appointed by the director of a community mental health           

                                                                                

24  services program to operate, direct, or supervise an assisted               

                                                                                

25  outpatient treatment program or, if a community mental health               

                                                                                

26  service program does not exist in the community, an assisted                

                                                                                

27  outpatient treatment program regional coordinator.                          


                                                                                

1       (10) "Assisted outpatient treatment regional coordinator"                   

                                                                                

2   means an individual appointed by the director to act as a liaison           

                                                                                

3   between the department and local AOT programs and to perform                

                                                                                

4   certain duties as prescribed by the director and as prescribed in           

                                                                                

5   this chapter.                                                               

                                                                                

6       (11)  (6)  "Board" means the governing body of a community                  

                                                                                

7   mental health services program.                                             

                                                                                

8       (12)  (7)  "Board of commissioners" means a county board of                 

                                                                                

9   commissioners.                                                              

                                                                                

10      (13)  (8)  "Center" means a facility operated by the                        

                                                                                

11  department to admit individuals with developmental disabilities             

                                                                                

12  and provide habilitation and treatment services.                            

                                                                                

13      (14)  (9)  "Certification" means formal approval of a program               

                                                                                

14  by the department in accordance with standards developed or                 

                                                                                

15  approved by the department.                                                 

                                                                                

16      (15)  (10)  "Child abuse" and "child neglect" mean those                    

                                                                                

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

                                                                                

18  PA 238, MCL 722.622.                                                        

                                                                                

19      (16)  (11)  "Child and adolescent psychiatrist" means 1 or                  

                                                                                

20  more of the following:                                                      

                                                                                

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

                                                                                

22  child and adolescent psychiatry approved by the accreditation               

                                                                                

23  council for graduate medical education or the American                      

                                                                                

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

                                                                                

25  and adolescent psychiatric rotation and is enrolled in an                   

                                                                                

26  approved residency program as described in this subsection.                 

                                                                                

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


                                                                                

1   and adolescent psychiatrist with the department or a community              

                                                                                

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

                                                                                

3   education and clinical experience in the evaluation and treatment           

                                                                                

4   of children or adolescents with serious emotional disturbance.              

                                                                                

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

                                                                                

6   in the evaluation and treatment of children or adolescents with             

                                                                                

7   serious emotional disturbance who is approved by the director.              

                                                                                

8       (17)  (12)  "Children's diagnostic and treatment service"                   

                                                                                

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

                                                                                

10  mental health services program, that provides examination,                  

                                                                                

11  evaluation, and referrals for minors, including emergency                   

                                                                                

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

                                                                                

13  that has been certified by the department.                                  

                                                                                

14      (18)  (13)  "Community mental health authority" means a                     

                                                                                

15  separate legal public governmental entity created under                     

                                                                                

16  section 205 to operate as a community mental health services                

                                                                                

17  program.                                                                    

                                                                                

18      (19)  (14)  "Community mental health organization" means a                  

                                                                                

19  community mental health services program that is organized under            

                                                                                

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

                                                                                

21  MCL 124.501 to 124.512.                                                     

                                                                                

22      (20)  (15)  "Community mental health services program" means                

                                                                                

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

                                                                                

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

                                                                                

25  community mental health organization.                                       

                                                                                

26      (21)  (16)  "Consent" means a written agreement executed by a               

                                                                                

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


                                                                                

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

                                                                                

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

                                                                                

3   individual other than the individual providing treatment.                   

                                                                                

4       (22)  (17)  "County community mental health agency" means an                

                                                                                

5   official county or multicounty agency created under section 210             

                                                                                

6   that operates as a community mental health services program and             

                                                                                

7   that has not elected to become a community mental health                    

                                                                                

8   authority under section 205 or a community mental health                    

                                                                                

9   organization under the urban cooperation act of 1967, 1967                  

                                                                                

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

                                                                                

11      (23)  (18)  "Dependent living setting" means all of the                     

                                                                                

12  following:                                                                  

                                                                                

13      (a) An adult foster care facility.                                          

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

18      (24)  (19)  "Department" means the department of community                  

                                                                                

19  health.                                                                     

                                                                                

20      (25)  (20)  "Developmental disability" means either of the                  

                                                                                

21  following:                                                                  

                                                                                

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

                                                                                

23  severe, chronic condition that meets all of the following                   

                                                                                

24  requirements:                                                               

                                                                                

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

                                                                                

26  combination of mental and physical impairments.                             

                                                                                

27      (ii) Is manifested before the individual is 22 years  old  of                


                                                                                

1   age.                                                                        

                                                                                

2       (iii) Is likely to continue indefinitely.                                    

                                                                                

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

                                                                                

4   more of the following areas of major life activity:                         

                                                                                

5       (A) Self-care.                                                              

                                                                                

6       (B) Receptive and expressive language.                                      

                                                                                

7       (C) Learning.                                                               

                                                                                

8       (D) Mobility.                                                               

                                                                                

9       (E) Self-direction.                                                         

                                                                                

10      (F) Capacity for independent living.                                        

                                                                                

11      (G) Economic self-sufficiency.                                              

                                                                                

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

                                                                                

13  sequence of special, interdisciplinary, or generic care,                    

                                                                                

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

                                                                                

15  duration and are individually planned and coordinated.                      

                                                                                

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

                                                                                

17  a substantial developmental delay or a specific congenital or               

                                                                                

18  acquired condition with a high probability of resulting in                  

                                                                                

19  developmental disability as defined in subdivision (a) if                   

                                                                                

20  services are not provided.                                                  

                                                                                

21      (26)  (21)  "Director" or "department director" means the                   

                                                                                

22  director of the department or his or her designee.                          

                                                                                

23      (27)  (22)  "Discharge" means an absolute, unconditional                    

                                                                                

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

                                                                                

25  facility or a court.                                                        

                                                                                

26      (28)  (23)  "Eligible minor" means an individual less than                  

                                                                                

27  18 years of age who is recommended in the written report of a               


                                                                                

1   multidisciplinary team under rules promulgated by the department            

                                                                                

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

                                                                                

3       (a) Severely mentally impaired.                                             

                                                                                

4       (b) Severely multiply impaired.                                             

                                                                                

5       (c) Autistic impaired and receiving special education                       

                                                                                

6   services in a program designed for the autistic impaired under              

                                                                                

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

                                                                                

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

                                                                                

9   severely multiply impaired.                                                 

                                                                                

10      (29)  (24)  "Emergency situation" means a situation in which                

                                                                                

11  an individual is experiencing a serious mental illness or a                 

                                                                                

12  developmental disability, or a  child  minor is experiencing a              

                                                                                

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

                                                                                

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

                                                                                

15  future to physically injure himself, herself, or another                    

                                                                                

16  individual, either intentionally or unintentionally.                        

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

25  behavior as a result of the mental illness, developmental                   

                                                                                

26  disability, or emotional disturbance can reasonably be expected             

                                                                                

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


                                                                                

1   or to another individual.                                                   

                                                                                

2       (30)  (25)  "Executive director" means an individual                        

                                                                                

3   appointed under section 226 to direct a community mental health             

                                                                                

4   services program or his or her designee.                                    

                                                                                

5       Sec. 161.  In conjunction with community mental health                      

                                                                                

6   services programs, the department shall conduct annually and                

                                                                                

7   forward to the governor and the house and senate appropriations             

                                                                                

8   committees, and the senate and house committees with legislative            

                                                                                

9   oversight of  social  human services and mental health, an                  

                                                                                

10  evaluation of the family support subsidy program that shall                 

                                                                                

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

                                                                                

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

                                                                                

13  children covered by this act in facilities and residential care             

                                                                                

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

                                                                                

15  of families who choose not to participate.                                  

                                                                                

16      (b) Case reviews of families who voluntarily terminate                      

                                                                                

17  participation in the family support subsidy program for any                 

                                                                                

18  reason, particularly  when  if the eligible minor is placed out             

                                                                                

19  of the family home, including the involvement of the department             

                                                                                

20  and community mental health services programs in offering                   

                                                                                

21  suitable alternatives.                                                      

                                                                                

22      (c) Sample assessments of families receiving family support                 

                                                                                

23  subsidy payments including adequacy of subsidy and need for                 

                                                                                

24  services not available.                                                     

                                                                                

25      (d) The efforts to encourage program participation of                       

                                                                                

26  eligible families.                                                          

                                                                                

27      (e) The geographic distribution of families receiving subsidy               


                                                                                

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

                                                                                

2   be eligible for family support subsidy payments.                            

                                                                                

3       (f) Programmatic and legislative recommendations to further                 

                                                                                

4   assist families in providing care for eligible minors.                      

                                                                                

5       (g) Problems that arise in identifying eligible minors                      

                                                                                

6   through diagnostic evaluations performed under rules promulgated            

                                                                                

7   by the department of education.                                             

                                                                                

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

                                                                                

9   care facilities serving severely mentally, multiply, and autistic           

                                                                                

10  impaired children when the children return home to their natural            

                                                                                

11  families as a result of the subsidy program.                                

                                                                                

12      (i) Caseload figures by eligibility category as  defined                    

                                                                                

13  described in section  100a(23)  100a(28).                                   

                                                                                

14                              CHAPTER 3A                                      

                                                                                

15                    ASSISTED OUTPATIENT TREATMENT                             

                                                                                

16      Sec. 350.  As used in this chapter:                                         

                                                                                

17      (a) "Court" means that term as defined in section 400.                      

                                                                                

18      (b) "Material change" means an addition to or a deletion from               

                                                                                

19  a category of assisted outpatient treatment from a court order              

                                                                                

20  issued under this chapter.                                                  

                                                                                

21      Sec. 351.  Each director of a community mental health                       

                                                                                

22  services program shall operate, direct, and supervise an assisted           

                                                                                

23  outpatient treatment program as provided in this chapter.                   

                                                                                

24  Directors of community mental health services programs may                  

                                                                                

25  satisfy the provisions of this section by operating joint                   

                                                                                

26  assisted outpatient treatment programs.  This section does not              

                                                                                

27  prohibit the combination or coordination of efforts between local           


                                                                                

1   community mental health services programs and hospitals in                  

                                                                                

2   providing and coordinating assisted outpatient treatment.  Upon             

                                                                                

3   approval by the department director, a hospital director may                

                                                                                

4   operate, direct, and supervise an assisted outpatient treatment             

                                                                                

5   program as provided in this chapter.                                        

                                                                                

6       Sec. 353.  (1) An individual may be ordered to obtain                       

                                                                                

7   assisted outpatient treatment if a court finds all of the                   

                                                                                

8   following:                                                                  

                                                                                

9       (a) The individual is 18 years of age or older.                             

                                                                                

10      (b) The individual is suffering from a mental illness.                      

                                                                                

11      (c) Based on a clinical determination, the individual is                    

                                                                                

12  unlikely to survive safely in the community without supervision.            

                                                                                

13      (d) The individual has a history of lack of compliance with                 

                                                                                

14  treatment for mental illness or as a result of his or her mental            

                                                                                

15  illness, the individual is unlikely to voluntarily participate in           

                                                                                

16  treatment recommended in a treatment plan.                                  

                                                                                

17      (e) In view of the individual's treatment history and current               

                                                                                

18  behavior, the individual needs assisted outpatient treatment in             

                                                                                

19  order to prevent a relapse or deterioration that is likely to               

                                                                                

20  result in serious harm to the individual or others.                         

                                                                                

21      (f) The individual is incapable of making an informed medical               

                                                                                

22  decision.                                                                   

                                                                                

23      (g) It is likely that the individual will benefit from                      

                                                                                

24  assisted outpatient treatment.                                              

                                                                                

25      (2) If the individual has executed a durable power of                       

                                                                                

26  attorney or an advance directive, the directions included in the            

                                                                                

27  durable power of attorney or advance directive shall be taken               


                                                                                

1   into account by the court in creating a written treatment plan.             

                                                                                

2       Sec. 355.  Nothing in this chapter prevents an individual                   

                                                                                

3   with a durable power of attorney or advance directive from being            

                                                                                

4   subject to a petition under this chapter.                                   

                                                                                

5       Sec. 357.  (1) A petition for an order authorizing assisted                 

                                                                                

6   outpatient treatment may be filed with the court by an individual           

                                                                                

7   18 years of age or older.                                                   

                                                                                

8       (2) At a minimum, the petition shall state both of the                      

                                                                                

9   following:                                                                  

                                                                                

10      (a) Each of the criteria for assisted outpatient treatment                  

                                                                                

11  required under section 353, including the facts that support the            

                                                                                

12  petitioner's belief that the individual who is the subject of the           

                                                                                

13  petition meets each criterion.                                              

                                                                                

14      (b) That the subject of the petition is present, or is                      

                                                                                

15  reasonably believed to be present, in the county in which the               

                                                                                

16  petition is filed.                                                          

                                                                                

17      (3) The petition shall be accompanied by an affidavit of a                  

                                                                                

18  physician or licensed psychologist other than the petitioner.               

                                                                                

19  The affidavit shall state that either of the following has                  

                                                                                

20  occurred:                                                                   

                                                                                

21      (a) Not more than 10 days before the petition is filed, both                

                                                                                

22  of the following occurred:                                                  

                                                                                

23                                                                               (i) The physician or licensed psychologist has personally                           

                                                                                

24  examined the individual who is the subject of the petition.                 

                                                                                

25      (ii) The physician or licensed psychologist recommends                       

                                                                                

26  assisted outpatient treatment for the subject of the petition.              

                                                                                

27      (b) Not more than 10 days before the petition is filed, both                


                                                                                

1   of the following occurred:                                                  

                                                                                

2                                                                                (i) The physician or licensed psychologist or his or her                            

                                                                                

3   designee has made appropriate attempts to elicit the subject of             

                                                                                

4   the petition's cooperation but has not been successful in                   

                                                                                

5   persuading the subject to submit to an examination.                         

                                                                                

6       (ii) The physician or licensed psychologist has reason to                    

                                                                                

7   suspect that the subject of the petition meets the criteria for             

                                                                                

8   assisted outpatient treatment.                                              

                                                                                

9       Sec. 359.  (1) The petitioner shall cause written notice of                 

                                                                                

10  the petition to be given to the subject of the petition.  Notice            

                                                                                

11  shall also be given to individuals who are required to receive              

                                                                                

12  notice in a hearing under section 453, the subject of the                   

                                                                                

13  petition's legal counsel, the patient advocate appointed by the             

                                                                                

14  subject of the petition, if a patient advocate is known to the              

                                                                                

15  petitioner or the community mental health services program                  

                                                                                

16  director, and the community mental health services program                  

                                                                                

17  director in the county in which the subject of the petitioner               

                                                                                

18  resides, if that community mental health director is not the                

                                                                                

19  petitioner.                                                                 

                                                                                

20      (2) Unless an appearance has been entered on behalf of the                  

                                                                                

21  subject of a petition, the court shall, within 48 hours after               

                                                                                

22  receipt of a petition together with the other documents required            

                                                                                

23  by section 357, appoint counsel to represent the subject of the             

                                                                                

24  petition.  The appointment of counsel and the appointed counsel             

                                                                                

25  are subject to the provisions of section 454.                               

                                                                                

26      Sec. 361.  (1) Upon receipt by the court of a petition under                

                                                                                

27  this chapter, the court shall promptly set a date for a hearing             


                                                                                

1   at a time not later than 7 days after the date on which the court           

                                                                                

2   receives the petition, excluding Sundays and holidays.  An                  

                                                                                

3   adjournment of a hearing under this section is permitted only for           

                                                                                

4   good cause.  In granting an adjournment, the court shall consider           

                                                                                

5   the need for further examination by a physician or licensed                 

                                                                                

6   psychologist and the potential need to provide assisted                     

                                                                                

7   outpatient treatment expeditiously.  The court shall cause the              

                                                                                

8   subject of the petition, any other individual receiving notice,             

                                                                                

9   the petitioner, the physician or licensed psychologist whose                

                                                                                

10  affidavit accompanied the petition, the appropriate community               

                                                                                

11  mental health services program director, and other individuals as           

                                                                                

12  the court determines necessary to be advised of the adjournment             

                                                                                

13  and new hearing date, if a new hearing date has been set.                   

                                                                                

14      (2) The court shall hear testimony on a petition under this                 

                                                                                

15  chapter.  The court may examine the subject alleged to be in need           

                                                                                

16  of assisted outpatient treatment in or out of court.  If the                

                                                                                

17  subject of the petition does not appear at the hearing and                  

                                                                                

18  appropriate attempts to elicit the subject of the petition's                

                                                                                

19  attendance have failed, the court may conduct the hearing in the            

                                                                                

20  subject's absence.  If the hearing is conducted without the                 

                                                                                

21  subject of the petition present, the court shall set forth the              

                                                                                

22  factual basis for conducting the hearing without the presence of            

                                                                                

23  the subject of the petition.                                                

                                                                                

24      Sec. 363.  (1) The subject of a petition under this chapter                 

                                                                                

25  has the right in a proceeding under this chapter to present                 

                                                                                

26  documents and witnesses and to cross-examine witnesses.                     

                                                                                

27      (2) The rules of evidence in civil actions are applicable,                  


                                                                                

1   except to the extent that specific exceptions have been provided            

                                                                                

2   for in this chapter or elsewhere by statute or court rule.                  

                                                                                

3       Sec. 365.  (1) The court shall not order assisted outpatient                

                                                                                

4   treatment unless an examining physician or licensed psychologist,           

                                                                                

5   who has personally examined the subject of a petition under this            

                                                                                

6   chapter within the time period commencing 10 days before the                

                                                                                

7   filing of the petition, submits an affidavit that includes, at a            

                                                                                

8   minimum, all of the information required under section 367.                 

                                                                                

9       (2) If the subject of a petition under this chapter refuses                 

                                                                                

10  to be examined by a physician or licensed psychologist, the court           

                                                                                

11  may request the subject to consent to an examination by a                   

                                                                                

12  physician or licensed psychologist appointed by the court.  If              

                                                                                

13  the subject of the petition does not consent and the court finds            

                                                                                

14  reasonable cause to believe that the allegations in the petition            

                                                                                

15  are true, the court may order peace officers to take the subject            

                                                                                

16  of the petition into custody and transport him or her to a                  

                                                                                

17  hospital for examination by a physician or licensed                         

                                                                                

18  psychologist.  The subject of the petition may be retained under            

                                                                                

19  a court order issued under this subsection for not more than 24             

                                                                                

20  hours.                                                                      

                                                                                

21      (3) The examination of the subject of a petition under this                 

                                                                                

22  chapter may be performed by either the physician or licensed                

                                                                                

23  psychologist whose affidavit accompanied the petition or by                 

                                                                                

24  another physician or licensed psychologist who plans to submit an           

                                                                                

25  affidavit as the examining physician or licensed psychologist at            

                                                                                

26  a hearing initiated under this chapter, if that physician or                

                                                                                

27  licensed psychologist is granted privileges by that hospital or             


                                                                                

1   otherwise authorized by that hospital to do so.                             

                                                                                

2       Sec. 367.  (1) An affidavit submitted by a physician or                     

                                                                                

3   licensed psychologist under section 365 shall state all of the              

                                                                                

4   following:                                                                  

                                                                                

5       (a) The facts that support the allegation that the subject of               

                                                                                

6   the petition meets each of the criteria for assisted outpatient             

                                                                                

7   treatment.                                                                  

                                                                                

8       (b) The treatment is the least restrictive alternative.                     

                                                                                

9       (c) A recommended plan for assisted outpatient treatment.                   

                                                                                

10      (2) If the recommended assisted outpatient treatment plan                   

                                                                                

11  includes medication, the physician's or licensed psychologist's             

                                                                                

12  affidavit shall describe the types or classes of medication that            

                                                                                

13  may be authorized and the beneficial and possible detrimental               

                                                                                

14  physical and mental effects of the medication.  The physician's             

                                                                                

15  or licensed psychologist's affidavit shall also recommend whether           

                                                                                

16  the medication shall be self-administered or administered by                

                                                                                

17  authorized personnel.                                                       

                                                                                

18      Sec. 369.  (1) The court shall not order assisted outpatient                

                                                                                

19  treatment unless an examining physician or licensed psychologist            

                                                                                

20  appointed by the assisted outpatient treatment program director             

                                                                                

21  develops and provides to the court a proposed written treatment             

                                                                                

22  plan.  The proposed treatment plan shall include case management            

                                                                                

23  services or assertive community treatment teams to provide care             

                                                                                

24  coordination.                                                               

                                                                                

25      (2) If a proposed treatment plan includes medication, the                   

                                                                                

26  proposed treatment plan shall state whether the medication should           

                                                                                

27  be self-administered or administered by authorized personnel and            


                                                                                

1   shall specify the type or types of medication most likely to                

                                                                                

2   provide maximum benefit for the subject of the petition under               

                                                                                

3   this chapter.                                                               

                                                                                

4       (3) In developing a proposed treatment plan, the physician or               

                                                                                

5   licensed psychologist shall provide an opportunity to actively              

                                                                                

6   participate in the development of the plan to all of the                    

                                                                                

7   following individuals:                                                      

                                                                                

8       (a) The subject of the petition.                                            

                                                                                

9       (b) If applicable, the subject of the petition's guardian.                  

                                                                                

10      (c) If applicable, the psychiatrist, physician, or licensed                 

                                                                                

11  psychologist who has been providing services to the subject of              

                                                                                

12  the petition.                                                               

                                                                                

13      (d) Upon the request of the subject of the petition, an                     

                                                                                

14  individual designated by the subject of the petition.                       

                                                                                

15      (e) A relative, a close friend, or an individual otherwise                  

                                                                                

16  concerned with the welfare of the subject of the petition.                  

                                                                                

17      (f) If applicable, the patient advocate.                                    

                                                                                

18      (4) If the petitioner is a director of a community mental                   

                                                                                

19  health services program or his or her designee, the proposed                

                                                                                

20  treatment plan shall be provided to the court before the hearing            

                                                                                

21  on the petition.  If the petitioner is an individual other than             

                                                                                

22  the director of a community mental health services program or his           

                                                                                

23  or her designee, the proposed treatment plan shall be provided to           

                                                                                

24  the court no later than the date set by the court under section             

                                                                                

25  373.                                                                        

                                                                                

26      Sec. 371.  The court shall not order assisted outpatient                    

                                                                                

27  treatment unless a physician or licensed psychologist submits an            


                                                                                

1   affidavit to explain the proposed treatment plan.  The                      

                                                                                

2   physician's or licensed psychologist's affidavit shall state the            

                                                                                

3   categories of assisted outpatient treatment recommended, the                

                                                                                

4   rationale for each category, facts that establish that the                  

                                                                                

5   treatment is the least restrictive alternative, and, if the                 

                                                                                

6   recommended assisted outpatient treatment includes medication,              

                                                                                

7   the types or classes of medication recommended, the beneficial              

                                                                                

8   and possible detrimental physical and mental effects of the                 

                                                                                

9   medication, and whether the medication shall be self-administered           

                                                                                

10  or administered by an authorized professional.                              

                                                                                

11      Sec. 373.  (1) If, after hearing all relevant evidence, the                 

                                                                                

12  court finds that the subject of a petition under this chapter               

                                                                                

13  does not meet the criteria for assisted outpatient treatment, the           

                                                                                

14  court shall dismiss the petition.                                           

                                                                                

15      (2) If, after hearing all relevant evidence, the court finds                

                                                                                

16  by clear and convincing evidence that the subject of a petition             

                                                                                

17  under this chapter meets the criteria for assisted outpatient               

                                                                                

18  treatment and that there is no appropriate less restrictive                 

                                                                                

19  alternative, the court may order the subject of the petition to             

                                                                                

20  receive assisted outpatient treatment for an initial period not             

                                                                                

21  to exceed 6 months.  The order shall set forth an assisted                  

                                                                                

22  outpatient treatment plan that shall include all of the                     

                                                                                

23  categories of assisted outpatient treatment that the subject of             

                                                                                

24  the petition shall receive.  The court shall not order treatment            

                                                                                

25  that has not been recommended by the examining physician or                 

                                                                                

26  licensed psychologist or included in the proposed treatment plan            

                                                                                

27  for assisted outpatient treatment.                                          


                                                                                

1       (3) If, after hearing all relevant evidence, the court finds                

                                                                                

2   by clear and convincing evidence that the subject of a petition             

                                                                                

3   under this chapter meets the criteria for assisted outpatient               

                                                                                

4   treatment but has not yet been provided with a proposed treatment           

                                                                                

5   plan and an affidavit as required under this chapter, the court             

                                                                                

6   shall order the community mental health services program director           

                                                                                

7   or his or her designee to provide the court with the proposed               

                                                                                

8   treatment plan and affidavit not later than 6 days after the date           

                                                                                

9   of the order, excluding Sundays and holidays.  The court may                

                                                                                

10  order the subject of the petition to be retained for an                     

                                                                                

11  examination by a physician or licensed psychologist designated by           

                                                                                

12  the community mental health services program director or his or             

                                                                                

13  her designee.  The subject of the petition may be retained under            

                                                                                

14  a court order issued under this subsection for not more than 24             

                                                                                

15  hours.  After receiving a proposed treatment plan and an                    

                                                                                

16  affidavit, the court may order assisted outpatient treatment as             

                                                                                

17  provided in this chapter.                                                   

                                                                                

18      Sec. 375.  A court may order the subject of a petition to                   

                                                                                

19  self-administer psychotropic drugs or accept the administration             

                                                                                

20  of psychotropic drugs by authorized personnel.  The order may               

                                                                                

21  specify the types of psychotropic drugs.  The order is effective            

                                                                                

22  for the duration of the assisted outpatient treatment.                      

                                                                                

23      Sec. 377.  A court order for assisted outpatient treatment                  

                                                                                

24  issued under this chapter shall direct the community mental                 

                                                                                

25  health services program director or his or her designee to                  

                                                                                

26  provide or arrange for all categories of assisted outpatient                

                                                                                

27  treatment for the assisted outpatient throughout the period                 


                                                                                

1   specified in the order.                                                     

                                                                                

2       Sec. 379.  The assisted outpatient treatment program                        

                                                                                

3   director shall provide a written report to the applicable                   

                                                                                

4   community mental health services program director within 5 days             

                                                                                

5   after the date the court order is issued.  The written report               

                                                                                

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

                                                                                

7       (a) A copy of the court order.                                              

                                                                                

8       (b) A copy of the written treatment plan.                                   

                                                                                

9       (c) The identity of the case manager or assertive community                 

                                                                                

10  treatment team, including the name and contact data of the                  

                                                                                

11  organization that the case manager or assertive community                   

                                                                                

12  treatment team member represents.                                           

                                                                                

13      (d) The identity of the service providers.                                  

                                                                                

14      (e) The date on which services began or will begin.                         

                                                                                

15      Sec. 381.  The assisted outpatient treatment program                        

                                                                                

16  director or his or her designee shall petition the court for                

                                                                                

17  approval before instituting a proposed material change in the               

                                                                                

18  assisted outpatient treatment order unless the change is                    

                                                                                

19  addressed in the order.  A change that is not a material change             

                                                                                

20  may be instituted by the assisted outpatient treatment program              

                                                                                

21  director without prior court approval.  Notice of a petition                

                                                                                

22  filed under this section shall be served on the individuals                 

                                                                                

23  required to be served under section 359.                                    

                                                                                

24      Sec. 383.  (1) If the assisted outpatient treatment program                 

                                                                                

25  director or his or her designee determines that the assisted                

                                                                                

26  outpatient requires further assisted outpatient treatment, the              

                                                                                

27  assisted outpatient treatment program director or his or her                


                                                                                

1   designee shall petition the court before the expiration of the              

                                                                                

2   period of assisted outpatient treatment ordered by the court for            

                                                                                

3   a subsequent order authorizing continued assisted outpatient                

                                                                                

4   treatment for a period of not more than 1 year from the                     

                                                                                

5   expiration date of the original order for assisted outpatient               

                                                                                

6   treatment.  If the assisted outpatient treatment program director           

                                                                                

7   has not petitioned the court for a subsequent order under this              

                                                                                

8   section within 15 days before the expiration date of the period             

                                                                                

9   of assisted outpatient treatment ordered by the court, a parent,            

                                                                                

10  guardian, spouse, sibling, or child of an assisted outpatient may           

                                                                                

11  petition for a subsequent order.  The period of a subsequent                

                                                                                

12  order obtained under this section shall not exceed 1 year.                  

                                                                                

13      (2) Except as provided in subsection (3), the procedure for                 

                                                                                

14  obtaining an order under this section shall be in accordance with           

                                                                                

15  the provisions of obtaining an original order for assisted                  

                                                                                

16  outpatient treatment.                                                       

                                                                                

17      (3) If the petitioner is an assisted outpatient treatment                   

                                                                                

18  program director and the assisted outpatient informs the court by           

                                                                                

19  affidavit that he or she agrees to continued assisted outpatient            

                                                                                

20  treatment, the court may order continued assisted outpatient                

                                                                                

21  treatment under this section without a hearing.                             

                                                                                

22      (4) If a petition for a subsequent assisted outpatient                      

                                                                                

23  treatment order has been filed, the initial order for assisted              

                                                                                

24  outpatient treatment remains in effect until a hearing is held on           

                                                                                

25  that petition.                                                              

                                                                                

26      Sec. 385.  In addition to another right or remedy available                 

                                                                                

27  by law with respect to an order for assisted outpatient                     


                                                                                

1   treatment, on notice to the assisted outpatient treatment program           

                                                                                

2   director and the original petitioner, the patient, his or her               

                                                                                

3   guardian, or his or her legal counsel may apply to the court to             

                                                                                

4   stay, vacate, or modify the order.                                          

                                                                                

5       Sec. 387.  (1) If, in the clinical judgment of a physician                  

                                                                                

6   or licensed psychologist, an assisted outpatient has failed or              

                                                                                

7   refused to comply with the treatment ordered by the court and               

                                                                                

8   efforts have been made to solicit compliance, the assisted                  

                                                                                

9   outpatient treatment program director or his or her designee                

                                                                                

10  shall direct a peace officer to take into protective custody and            

                                                                                

11  transport the assisted outpatient to a facility designated to               

                                                                                

12  receive assisted outpatients by the community mental health                 

                                                                                

13  services program director for an examination to determine if the            

                                                                                

14  assisted outpatient has a mental illness for which involuntary              

                                                                                

15  mental health treatment is necessary under this act.  A peace               

                                                                                

16  officer contacted under this subsection shall carry out this                

                                                                                

17  directive.                                                                  

                                                                                

18      (2) If an assisted outpatient is taken into protective                      

                                                                                

19  custody under this section, the assisted outpatient may be                  

                                                                                

20  retained for up to 72 hours for observation, care, and treatment            

                                                                                

21  and for further examination in the hospital to allow a physician            

                                                                                

22  or licensed psychologist to determine whether the assisted                  

                                                                                

23  outpatient has a mental illness and is in need of involuntary               

                                                                                

24  mental health treatment in a hospital in accordance with this               

                                                                                

25  act.  Continued involuntary hospitalization after the initial               

                                                                                

26  72-hour period shall be in accordance with the provisions of this           

                                                                                

27  act relating to the involuntary hospitalization of an                       


                                                                                

1   individual.  If at any time during the 72-hour period the                   

                                                                                

2   assisted outpatient is determined not to meet the involuntary               

                                                                                

3   hospitalization provisions of this act and does not agree to stay           

                                                                                

4   in the hospital as a voluntary or informal patient, he or she               

                                                                                

5   shall be released.                                                          

                                                                                

6       Sec. 389.  (1) An assisted outpatient may be medicated or                   

                                                                                

7   tested over his or her objection if both of the following occur:            

                                                                                

8       (a) The assisted outpatient fails or refuses to take                        

                                                                                

9   medication or submit to testing as required by a court order                

                                                                                

10  issued under this chapter.                                                  

                                                                                

11      (b) The assisted outpatient treatment program's physician or                

                                                                                

12  licensed psychologist determines that there have been sufficient            

                                                                                

13  efforts to solicit the assisted outpatient's compliance with the            

                                                                                

14  requirements of the court order described in subdivision (a).               

                                                                                

15      (2) If it is necessary to enforce a court order under the                   

                                                                                

16  condition set forth in subsection (1), that enforcement may occur           

                                                                                

17  either at the assisted outpatient's residence or at a treatment             

                                                                                

18  center designated by the community mental health services program           

                                                                                

19  director or his or her designee, whichever location the assisted            

                                                                                

20  outpatient chooses.                                                         

                                                                                

21      (3) An assisted outpatient who physically resists treatment                 

                                                                                

22  or testing as described in subsection (1) shall be transported to           

                                                                                

23  a treatment center designated by the community mental health                

                                                                                

24  services program director or his or her designee where a                    

                                                                                

25  physician or licensed psychologist shall administer the                     

                                                                                

26  medication or testing in a manner that is clinically appropriate,           

                                                                                

27  safe, and consistent with the assisted outpatient's dignity and             


                                                                                

1   privacy.  Subsequent retention of an assisted outpatient shall              

                                                                                

2   only be made according to other provisions of this act.                     

                                                                                

3       (4) Upon request of an assisted outpatient's assisted                       

                                                                                

4   outpatient treatment program physician or licensed psychologist,            

                                                                                

5   an assisted outpatient treatment program director, or an assisted           

                                                                                

6   outpatient treatment director's designee, a peace officer shall             

                                                                                

7   take the assisted outpatient into protective custody and                    

                                                                                

8   transport him or her to a treatment center designated by the                

                                                                                

9   community mental health services program director or his or her             

                                                                                

10  designee.  An assisted outpatient may be retained at a treatment            

                                                                                

11  center for only the time period reasonably necessary to                     

                                                                                

12  administer treatment or testing as provided under this section.             

                                                                                

13      Sec. 391.  The determination by a court that an individual                  

                                                                                

14  is in need of assisted outpatient treatment under this chapter is           

                                                                                

15  not a determination that the individual is an incapacitated                 

                                                                                

16  individual as defined in section 1105 of the estates and                    

                                                                                

17  protected individuals code, 1998 PA 386, MCL 700.1105.                      

                                                                                

18      Sec. 393.  An individual making a false statement or                        

                                                                                

19  providing false information or false testimony in a petition or             

                                                                                

20  hearing under this chapter is subject to criminal prosecution.              

                                                                                

21      Sec. 395.  Nothing in this chapter affects the ability of a                 

                                                                                

22  hospital director to receive, admit, or retain patients who                 

                                                                                

23  otherwise meet the provisions of this act regarding receipt,                

                                                                                

24  retention, or admission.                                                    

                                                                                

25      Sec. 397.  The department, in consultation with the state                   

                                                                                

26  court administrative office, shall prepare educational and                  

                                                                                

27  training materials on the use of this chapter that shall be made            


                                                                                

1   available to local governmental units, providers of mental health           

                                                                                

2   services, judges, court personnel, law enforcement officials, and           

                                                                                

3   the general public.