May 24, 2018, Introduced by Reps. Green, Ellison, Liberati, Gay-Dagnogo and Elder and referred to the Committee on Health Policy.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 700 and 740 (MCL 330.1700 and 330.1740), as
amended by 1995 PA 290.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 700. As used in this chapter, unless the context requires
otherwise:
(a) "Chemical restraint" means a drug that is used for
discipline or convenience and is not required to treat a diagnosed
medical symptom. Chemical restraint may include a drug that is
administered to manage a resident's behavior in a way that reduces
the safety risk to the resident or others; a drug that has the
temporary effect of restricting the resident's freedom of movement;
or a drug that is not a standard treatment for the resident's
medical or psychiatric condition. As used in this subdivision:
(i) "Convenience" means an action taken to control a
resident's behavior with a lesser amount of effort and not in the
resident's best interest.
(ii) "Discipline" means an action taken to punish or penalize
a resident.
(iii) "Medical symptom" means an indication or characteristic
of a physical or psychological condition.
(b) (a)
"Criminal abuse" means 1
or more of the following:
(i) An assault that is a violation or an attempt or conspiracy
to commit a violation of sections 81 to 90 of the Michigan penal
code,
Act No. 328 of the Public Acts of 1931, being sections 750.81
to
750.90 of the Michigan Compiled Laws. 1931 PA 328, MCL 750.81 to
750.90. Criminal abuse does not include an assault or an assault
and
battery that is a violation of section 81 of Act No. 328 of the
Public
Acts of 1939, being section 750.81 of the Michigan Compiled
Laws
the Michigan penal code, 1931
PA 328, MCL 750.81, and that is
committed by a recipient against another recipient.
(ii) A criminal homicide that is a violation or an attempt or
conspiracy
to commit a violation of section 316, 317, or 321 of Act
No.
328 of the Public Acts of 1931, being sections 750.316,
750.317,
and 750.321 of the Michigan Compiled Laws the Michigan
penal code, 1931 PA 328, MCL 750.316, 750.317, and 750.321.
(iii) Criminal sexual conduct that is a violation or an
attempt or conspiracy to commit a violation of sections 520b to
520e
or 520g of Act No. 328 of the Public Acts of 1931, being
sections
750.520b to 750.520e and 750.520g of the Michigan Compiled
Laws
the Michigan penal code, 1931
PA 328, MCL 750.520b to 750.250e
and 750.520g.
(iv) Vulnerable adult abuse that is a violation or an attempt
or conspiracy to commit a violation of section 145n of the Michigan
penal
code, Act No. 328 of the Public Acts of 1931, being section
750.145n
of the Michigan Compiled Laws 1931
PA 328, MCL 750.145n.
(v) Child abuse that is a violation or an attempt or
conspiracy
to commit a violation of section 136b of Act No. 328 of
the
Public Acts of 1931, being section 750.136b of the Michigan
Compiled
Laws the Michigan penal code,
1931 PA 328, MCL 750.136b.
(c) (b)
"Health care corporation"
means a nonprofit health
care corporation operating under the nonprofit health care
corporation
reform act, Act No. 350 of the Public Acts of 1980,
being
sections 550.1101 to 550.1704 of the Michigan Compiled Laws
1980 PA 350, MCL 550.1101 to 550.1704.
(d) (c)
"Health care insurer"
means an insurer authorized to
provide health insurance in this state or a legal entity that is
self-insured and provides health care benefits to its employees.
(e) (d)
"Health maintenance
organization" means an
organization
licensed under part 210 of the public health code, Act
No.
368 of the Public Acts of 1978, being sections 333.21001 to
333.21098
of the Michigan Compiled Laws that
term as defined in
section 3501 of the insurance code of 1956, 1956 PA 218, MCL
500.3501.
(f) (e)
"Money" means any legal
tender, note, draft,
certificate of deposit, stock, bond, check, or credit card.
(g) (f)
"Nonprofit dental care
corporation" means a dental
care
corporation incorporated under Act No. 125 of the Public Acts
of
1963, being sections 550.351 to 550.373 of the Michigan Compiled
Laws
1963 PA 125, MCL 550.351 to
550.373.
(h) (g)
"Person-centered
planning" means a process for
planning and supporting the individual receiving services that
builds upon the individual's capacity to engage in activities that
promote community life and that honors the individual's
preferences, choices, and abilities. The person-centered planning
process involves families, friends, and professionals as the
individual desires or requires.
(i) (h)
"Privileged
communication" means a communication made
to a psychiatrist or psychologist in connection with the
examination, diagnosis, or treatment of a patient, or to another
person while the other person is participating in the examination,
diagnosis, or treatment or a communication made privileged under
other applicable state or federal law.
(j) (i)
"Restraint" means the use
of a physical device to
restrict an individual's movement. Restraint includes chemical
restraint or restraint or control by means of a drug not required
to treat a diagnosed medical symptom. Restraint does not include
the use of a device primarily intended to provide anatomical
support. As used in this subdivision, "medical symptom" means an
indication or characteristic or a physical or psychological
condition.
(k) (j)
"Seclusion" means the temporary
placement of a
recipient in a room, alone, where egress is prevented by any means.
(l) (k)
"Support plan" means a
written plan that specifies the
personal support services or any other supports that are to be
developed with and provided for a recipient.
(m) (l) "Treatment
plan" means a written plan that specifies
the goal-oriented treatment or training services, including
rehabilitation or habilitation services, that are to be developed
with and provided for a recipient.
Sec. 740. (1) A resident shall not be placed in physical
restraint or chemical restraint shall not be administered except in
the circumstances and under the conditions set forth in this
section or in other law.
(2) A resident may be restrained only as provided in
subsection (3), (4), or (5) after less restrictive interventions
have been considered, and only if restraint is essential in order
to prevent the resident from physically harming himself, herself,
or others, or in order to prevent him or her from causing
substantial property damage. Consideration of less restrictive
measures
shall must be documented in the medical record. If
restraint is essential in order to prevent the resident from
physically harming himself, herself, or others, the resident may be
physically held with no more force than is necessary to limit the
resident's movement, until a restraint may be applied.
(3) A resident may be temporarily restrained for a maximum of
30 minutes without an order or authorization in an emergency.
Immediately after imposition of the temporary restraint, a
physician
shall must be contacted. If, after being contacted, the
physician does not order or authorize the restraint, the restraint
shall
must be removed.
(4)
A resident may be restrained prior to before examination
pursuant
according to an authorization by a physician. An
authorized restraint may continue only until a physician can
personally examine the resident or for 2 hours, whichever is less.
If it is not possible for the physician to examine the resident
within 2 hours, a physician may reauthorize the restraint for
another 2 hours. Authorized restraint may not continue for more
than 4 hours.
(5)
A resident may be restrained pursuant according to an
order by a physician made after personal examination of the
resident. An ordered restraint shall continue only for that period
of time specified in the order or for 8 hours, whichever is less.
(6) A restrained resident shall continue to receive food,
shall be kept in sanitary conditions, shall be clothed or otherwise
covered, shall be given access to toilet facilities, and shall be
given the opportunity to sit or lie down.
(7)
Restraints shall A
restraint must be removed every 2 hours
for not less than 15 minutes unless medically contraindicated or
whenever
they are the restraint is no longer essential in order to
achieve
the objective which that justified their the initial
application of the restraint. Physical restraint and chemical
restraint shall not be used at the same time on a resident.
Chemical restraint shall be applied only after physical restraint
has been attempted and was unsuccessful.
(8) Each instance of restraint requires full justification for
its application, and the results of each periodic examination shall
be placed promptly in the record of the resident.
(9) If a resident is restrained repeatedly, the resident's
individual plan of services shall be reviewed and modified to
facilitate the reduction of the use of restraints.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.