HB-4444, As Passed Senate, June 3, 2015

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

HOUSE BILL NO. 4444

 

 

 

 

 

 

 

 

 

 

 

     A bill to amend 1974 PA 258, entitled

 

"Mental health code,"

 

by amending sections 100c, 100d, 134, 135, 136, 137, 138, 139, 143,

 

143a, 148, 149, and 149b (MCL 330.1100c, 330.1100d, 330.1134,

 

330.1135, 330.1136, 330.1137, 330.1138, 330.1139, 330.1143,

 

330.1143a, 330.1148, 330.1149, and 330.1149b), sections 100c and

 

100d as amended by 2014 PA 200, sections 134, 136, 143, 143a, 148,

 

149, and 149b as amended by 1994 PA 137, sections 135 and 139 as

 

amended by 1995 PA 290, section 137 as amended by 2004 PA 259, and

 

section 138 as amended by 2006 PA 207.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 100c. (1) "Peace officer" means an officer of the

 

department of state police or of a law enforcement agency of a

 

county, township, city, or village who is responsible for the

 

prevention and detection of crime and enforcement of the criminal

 

laws of this state. For the purposes of sections 408 and 427, peace

 

officer also includes an officer of the United States secret

 

service Secret Service with the officer's consent and a police

 

officer of the veterans' administration medical center

 

reservation.Veterans' Administration Medical Center Reservation.

 

     (2) "Peer review" means a process, including the review

 

process required under section 143a, in which mental health

 

professionals of a state facility, licensed hospital, or community

 

mental health services program evaluate the clinical competence of

 

staff and the quality and appropriateness of care provided to

 

recipients. Peer review evaluations are confidential in accordance

 

with section 748(9) and are based on criteria established by the

 

facility or community mental health services program itself, the

 

accepted standards of the mental health professions, and the

 

department.

 

     (3) "Person requiring treatment" means an individual who meets

 

the criteria described in section 401.

 

     (4) "Physician" means an individual licensed or otherwise

 

authorized to engage in the practice of medicine under part 170 of

 

the public health code, 1978 PA 368, MCL 333.17001 to 333.17084, or

 

to engage in the practice of osteopathic medicine and surgery under

 

part 175 of the public health code, 1978 PA 368, MCL 333.17501 to

 

333.17556.

 

     (5) "Primary consumer" means an individual who has received or

 

is receiving services from the department or a community mental

 

health services program or services from the private sector

 

equivalent to those offered by the department or a community mental

 

health services program.

 

     (6) "Priority" means preference for and dedication of a major

 

proportion of resources to specified populations or services.

 

Priority does not mean serving or funding the specified populations

 

or services to the exclusion of other populations or services.

 

     (7) "Protective custody" means the temporary custody of an

 

individual by a peace officer with or without the individual's

 

consent for the purpose of protecting that individual's health and

 

safety, or the health and safety of the public, and for the purpose

 

of transporting the individual under section 276, 408, or 427 if

 

the individual appears, in the judgment of the peace officer, to be

 

a person requiring treatment or is a person requiring treatment.

 

Protective custody is civil in nature and is not an arrest.

 

     (8) "Psychiatric partial hospitalization program" means a

 

nonresidential treatment program that provides psychiatric,

 

psychological, social, occupational, nursing, music therapy, and

 

therapeutic recreational services under the supervision of a

 

physician to adults diagnosed as having serious mental illness or

 

minors diagnosed as having serious emotional disturbance who do not

 

require 24-hour continuous mental health care, and that is

 

affiliated with a psychiatric hospital or psychiatric unit to which

 

clients may be transferred if they need inpatient psychiatric care.

 

     (8) (9) "Psychiatric unit" means a unit of a general hospital

 

that provides inpatient services for individuals with serious

 

mental illness or serious emotional disturbance. As used in this

 

subsection, "general hospital" means a hospital as defined in

 

section 20106 of the public health code, 1978 PA 368, MCL

 

333.20106.

 

     (9) (10) "Psychiatrist" means 1 or more of the following:

 

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

 

psychiatry approved by the accreditation council for graduate

 

medical education or the American osteopathic association,

 

Accreditation Council for Graduate Medical Education or the

 

American Osteopathic Association, or who has completed 12 months of

 

psychiatric rotation and is enrolled in an approved residency

 

program as described in this subdivision.

 

     (b) A psychiatrist employed by or under contract with the

 

department or a community mental health services program on March

 

28, 1996.

 

     (c) A physician who devotes a substantial portion of his or

 

her time to the practice of psychiatry and is approved by the

 

director.

 

     (10) (11) "Psychologist" means an individual who is licensed

 

or otherwise authorized to engage in the practice of psychology

 

under part 182 of the public health code, 1978 PA 368, MCL

 

333.18201 to 333.18237, and who devotes a substantial portion of

 

his or her time to the diagnosis and treatment of individuals with

 

serious mental illness, serious emotional disturbance, substance

 

use disorder, or developmental disability.

 

     (11) (12) "Recipient" means an individual who receives mental

 

health services from the department, a community mental health

 

services program, or a facility or from a provider that is under

 

contract with the department or a community mental health services

 

program. For the purposes of this act, recipient does not include

 

an individual receiving substance use disorder services under

 

chapter 2A unless that individual is also receiving mental health

 

services under this act in conjunction with substance use disorder

 

services.

 

     (12) (13) "Recipient rights advisory committee" means a

 

committee of a community mental health services program board

 

appointed under section 757 or a recipient rights advisory

 

committee appointed by a licensed hospital under section 758.

 

     (13) (14) "Recovery" means a highly individualized process of

 

healing and transformation by which the individual gains control

 

over his or her life. Related services include recovery management,

 

recovery support services, recovery houses or transitional living

 

programs, and relapse prevention. Recovery involves the development

 

of a new meaning, purpose, and growing beyond the impact of

 

addiction or a diagnosis. Recovery may include the pursuit of

 

spiritual, emotional, mental, or physical well-being.

 

     (14) (15) "Regional entity" means an entity established under

 

section 204b to provide specialty services and supports.

 

     (15) (16) "Rehabilitation" means the act of restoring an

 

individual to a state of mental and physical health or useful

 

activity through vocational or educational training, therapy, and

 

counseling.

 

     (16) (17) "Resident" means an individual who receives services

 

in a facility.

 

     (17) (18) "Responsible mental health agency" means the

 

hospital, center, or community mental health services program that

 

has primary responsibility for the recipient's care or for the

 

delivery of services or supports to that recipient.

 

     (18) (19) "Rule" means a rule promulgated under the

 

administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to

 

24.328.

 

     Sec. 100d. (1) "Service" means a mental health service or a

 

substance use disorder service.

 

     (2) "Serious emotional disturbance" means a diagnosable

 

mental, behavioral, or emotional disorder affecting a minor that

 

exists or has existed during the past year for a period of time

 

sufficient to meet diagnostic criteria specified in the most recent

 

diagnostic and statistical manual of mental disorders Diagnostic

 

and Statistical Manual of Mental Disorders published by the

 

American psychiatric association Psychiatric Association and

 

approved by the department and that has resulted in functional

 

impairment that substantially interferes with or limits the minor's

 

role or functioning in family, school, or community activities. The

 

following disorders are included only if they occur in conjunction

 

with another diagnosable serious emotional disturbance:

 

     (a) A substance use disorder.

 

     (b) A developmental disorder.

 

     (c) "V" codes in the diagnostic and statistical manual of

 

mental disorders.Diagnostic and Statistical Manual of Mental

 

Disorders.

 

     (3) "Serious mental illness" means a diagnosable mental,

 

behavioral, or emotional disorder affecting an adult that exists or

 

has existed within the past year for a period of time sufficient to

 

meet diagnostic criteria specified in the most recent diagnostic

 

and statistical manual of mental disorders Diagnostic and

 

Statistical Manual of Mental Disorders published by the American

 

psychiatric association Psychiatric Association and approved by the

 

department and that has resulted in functional impairment that

 

substantially interferes with or limits 1 or more major life

 

activities. Serious mental illness includes dementia with

 

delusions, dementia with depressed mood, and dementia with

 

behavioral disturbance but does not include any other dementia

 

unless the dementia occurs in conjunction with another diagnosable

 

serious mental illness. The following disorders also are included

 

only if they occur in conjunction with another diagnosable serious

 

mental illness:

 

     (a) A substance use disorder.

 

     (b) A developmental disorder.

 

     (c) A "V" code in the diagnostic and statistical manual of

 

mental disorders.Diagnostic and Statistical Manual of Mental

 

Disorders.

 

     (4) "Special compensation" means payment to an adult foster

 

care facility to ensure the provision of a specialized program in

 

addition to the basic payment for adult foster care. Special

 

compensation does not include payment received directly from the

 

medicaid Medicaid program for personal care services for a

 

resident, or payment received under the supplemental security

 

income program.

 

     (5) "Specialized program" means a program of services,

 

supports, or treatment that are provided in an adult foster care

 

facility to meet the unique programmatic needs of individuals with

 

serious mental illness or developmental disability as set forth in

 

the resident's individual plan of services and for which the adult

 

foster care facility receives special compensation.

 

     (6) "Specialized residential service" means a combination of

 

residential care and mental health services that are expressly

 

designed to provide rehabilitation and therapy to a recipient, that

 

are provided in the residence of the recipient, and that are part

 

of a comprehensive individual plan of services.

 

     (7) "State administered funds" means revenues appropriated by

 

the legislature exclusively for the purposes provided for in regard

 

to substance use disorder services and prevention.

 

     (8) "State facility" means a center or a hospital operated by

 

the department.

 

     (9) "State recipient rights advisory committee" means a

 

committee appointed by the director under section 756 to advise the

 

director and the director of the department's office of recipient

 

rights.

 

     (10) "Substance abuse" means the taking of alcohol or other

 

drugs at dosages that place an individual's social, economic,

 

psychological, and physical welfare in potential hazard or to the

 

extent that an individual loses the power of self-control as a

 

result of the use of alcohol or drugs, or while habitually under

 

the influence of alcohol or drugs, endangers public health, morals,

 

safety, or welfare, or a combination thereof.

 

     (11) "Substance use disorder" means chronic disorder in which

 

repeated use of alcohol, drugs, or both, results in significant and

 

adverse consequences. Substance use disorder includes substance

 

abuse.

 

     (12) "Substance use disorder prevention services" means

 

services that are intended to reduce the consequences of substance

 

use disorders in communities by preventing or delaying the onset of

 

substance abuse and that are intended to reduce the progression of

 

substance use disorders in individuals. Substance use disorder

 

prevention is an ordered set of steps that promotes individual,

 

family, and community health, prevents mental and behavioral

 

disorders, supports resilience and recovery, and reinforces

 

treatment principles to prevent relapse.

 

     (13) "Substance use disorder treatment and rehabilitation

 

services" means the providing of identifiable recovery-oriented

 

services including:

 

     (a) Early intervention and crisis intervention counseling

 

services for individuals who are current or former individuals with

 

substance use disorder.

 

     (b) Referral services for individuals with substance use

 

disorder, their families, and the general public.

 

     (c) Planned treatment services, including chemotherapy,

 

counseling, or rehabilitation for individuals physiologically or

 

psychologically dependent upon or abusing alcohol or drugs.

 

     (14) "Supplemental security income" means the program

 

authorized under title XVI of the social security act, 42 USC 1381

 

to 1383f.

 

     (15) "Transfer facility" means a facility selected by the

 

department-designated community mental health entity, which

 

facility is physically located in a jail or lockup and is staffed

 

by at least 1 designated representative when in use according to

 

chapter 2A.

 

     (16) "Transition services" means a coordinated set of

 

activities for a special education student designed within an

 

outcome-oriented process that promotes movement from school to

 

postschool activities, including postsecondary education,

 

vocational training, integrated employment including supported

 

employment, continuing and adult education, adult services,

 

independent living, or community participation.

 

     (17) "Treatment" means care, diagnostic, and therapeutic

 

services, including the administration of drugs, and any other

 

service for the treatment of an individual's serious mental

 

illness, serious emotional disturbance, or substance use disorder.

 

     (18) "Treatment position" means a unit of measure of the

 

client capacity of a psychiatric partial hospitalization program.

 

Each treatment position represents a minimum of 6 hours per day and

 

5 days per calendar week.

 

     (18) (19) "Urgent situation" means a situation in which an

 

individual is determined to be at risk of experiencing an emergency

 

situation in the near future if he or she does not receive care,

 

treatment, or support services.

 

     (19) (20) "Wraparound services" means an individually designed

 

set of services provided to minors with serious emotional

 

disturbance or serious mental illness and their families that

 

includes treatment services and personal support services or any

 

other supports necessary to foster education preparedness,

 

employability, and preservation of the child in the family home.

 

Wraparound services are to be developed through an interagency

 

collaborative approach and a minor's parent or guardian and a minor

 

age 14 or older are to participate in planning the services.

 

     Sec. 134. (1) The director shall establish a comprehensive

 

system of licensing for psychiatric hospitals , and psychiatric

 

units , and psychiatric partial hospitalization programs in the

 

state to protect the public by insuring ensuring that these

 

hospitals , and units , and programs provide the facilities and the

 

ancillary supporting services necessary to maintain a high quality

 

of patient care. Separate criteria shall be developed for the

 

licensing of partial hospitalization treatment positions and

 

hospital beds for minors.

 

     (2) The director shall coordinate all functions within state

 

government affecting psychiatric hospitals, and shall cooperate

 

with other state agencies that establish standards or requirements

 

for facilities providing mental health care to assure necessary,

 

equitable, and consistent state regulation of these facilities

 

without duplication of inspections or services. The director may

 

enter into agreements with other state agencies to accomplish this

 

purpose.

 

     Sec. 135. (1) Subject to section 114a, the director, by rule,

 

shall set standards that assure the provision of a quality

 

improvement plan, utilization review, and the appropriate training

 

and education of staff and that require documented policies and

 

procedures for the administration of the services that are offered

 

by a psychiatric partial hospitalization program.

 

     (2) (1) Subject to section 114a, the director shall promulgate

 

rules to define all of the following:

 

     (a) Psychiatric psychiatric hospitals and psychiatric hospital

 

services to clearly differentiate between the active intensive care

 

expected in psychiatric hospitals or psychiatric units and that

 

care which is characteristically expected in general hospitals,

 

long-term care facilities, or residential facilities.

 

     (b) Psychiatric partial hospitalization program to clearly

 

differentiate between the active intensive care expected in a

 

psychiatric partial hospitalization program and that care which is

 

characteristically provided in a psychiatric outpatient program.

 

     (c) The relationship between a partial hospitalization program

 

and its affiliated inpatient hospital or unit.

 

     (2) (3) Sections 134 to 150 do not cover adult foster care

 

facilities or child care organizations licensed under Act No. 116

 

of the Public Acts of 1973, being sections 722.111 to 722.128 of

 

the Michigan Compiled Laws.1973 PA 116, MCL 722.111 to 722.128.

 

     Sec. 136. The director shall administer sections 134 through

 

150 and promulgate rules to implement the purposes of sections 134

 

through 150 for the maintenance and operation of psychiatric

 

hospitals , and psychiatric units , and psychiatric partial

 

hospitalization programs as necessary to enable state or private

 

facilities, or both, to qualify for federal funds available for

 

patient care or for construction or remodeling of facilities. The

 

rules shall be promulgated pursuant according to the administrative

 

procedures act of 1969, Act No. 306 of the Public Acts of 1969, as

 

amended, being sections 24.201 to 24.328 of the Michigan Compiled

 

Laws.1969 PA 306, MCL 24.201 to 24.328.

 

     Sec. 137. (1) A person shall not construct, establish, or

 

maintain a psychiatric hospital , or psychiatric unit , or

 

psychiatric partial hospitalization program or use the terms

 

psychiatric hospital , or psychiatric unit , or psychiatric partial

 

hospitalization program, without first obtaining a license. The

 

director shall require an applicant or a licensee to disclose the

 

names, addresses, and official positions of all persons who have an

 

ownership interest in a psychiatric hospital , or psychiatric unit.

 

, or psychiatric partial hospitalization program. If the

 

psychiatric hospital , or psychiatric unit , or psychiatric partial

 

hospitalization program is located on or in real estate that is

 

leased, the applicant or licensee shall disclose the name of the

 

lessor and any direct or indirect interest that the applicant or

 

licensee has in the lease other than as lessee. A nontransferable

 

license shall be granted for 2 years no longer than 1 year after

 

the date of issuance, unless otherwise provided in sections 134 to

 

150. The director may issue a provisional license for 1 year to

 

provide a licensee or applicant time to undertake remedial action

 

to correct programmatic or physical plant deficiencies. A

 

provisional license may be renewed for not longer than 1 additional

 

year. A violation of this section is a misdemeanor and is

 

punishable by a fine of not more than $1,000.00 for each violation.

 

     (2) Biennial Annual licensure of psychiatric hospitals , and

 

psychiatric units , and psychiatric partial hospitalization

 

programs shall be implemented by March 28, 1997. License fees shall

 

be prorated according to the period of time that the license will

 

be in force.

 

     (3) Beginning the effective date of the amendatory act that

 

added this subsection, the The department shall issue an initial

 

license under this section not later than 6 months after the

 

applicant files a completed application. Receipt of the application

 

is considered the date the application is received by any agency or

 

department of this state. If the application is considered

 

incomplete by the department, the department shall notify the

 

applicant in writing or make notice electronically available within

 

30 days after receipt of the incomplete application, describing the

 

deficiency and requesting additional information. The 6-month

 

period is tolled upon notification by the department of a

 

deficiency until the date the requested information is received by

 

the department. The determination of the completeness of an

 

application is not an approval of the application for the license

 

and does not confer eligibility on an applicant determined

 

otherwise ineligible for issuance of a license.

 

     (4) If the department fails to issue or deny a license or

 

registration within the time required by this section, the

 

department shall return the license fee and shall reduce the

 

license fee for the applicant's next renewal application, if any,

 

by 15%. Failure to issue or deny a license within the time period

 

required under this section does not allow the department to

 

otherwise delay the processing of the application. A completed

 

application shall be placed in sequence with other completed

 

applications received at that same time. The department shall not

 

discriminate against an applicant in the processing of the

 

application based on the fact that the application fee was refunded

 

or discounted under this subsection.

 

     (5) Beginning October 1, 2005, the The director of the

 

department shall submit a report by December 1 of each year to the

 

standing committees and appropriations subcommittees of the senate

 

and house of representatives concerned with issues relating to

 

mental health. The director shall include all of the following

 

information in the report concerning the preceding fiscal year:

 

     (a) The number of initial applications the department received

 

and completed within the 6-month time period described in

 

subsection (3).

 

     (b) The number of applications rejected.

 

     (c) The number of applicants not issued a license within the

 

6-month time period and the amount of money returned to licensees

 

under subsection (4).

 

     (6) As used in this section, "completed application" means an

 

application complete on its face and submitted with any applicable

 

licensing fees as well as any other information, records, approval,

 

security, or similar item required by law or rule from a local unit

 

of government, a federal agency, or a private entity but not from

 

another department or agency of this state.

 

     Sec. 138. Before the issuance of an original or biennial

 

annual license, a psychiatric hospital , or psychiatric unit , or

 

psychiatric partial hospitalization program shall be inspected by

 

the bureau of fire services created in section 1b of the fire

 

prevention code, 1941 PA 207, MCL 29.1b. A license shall not be

 

issued until the bureau of fire services approves the hospital or

 

unit.

 

     Sec. 139. (1) An Until October 1, 2019, an applicant for a

 

license under this act shall submit to the department with the

 

application form, or license renewal, a license fee of $600.00

 

$500.00 plus $7.50 $10.00 per patient bed. or treatment position.

 

The total license fee shall not exceed $5,000.00.

 

     (2) The license fee for a provisional license is the same as

 

the fee for a license. When the requirements for licensure are met,

 

the provisional license shall be replaced by a license without an

 

additional fee for the balance of the 2-year 1-year period.

 

     (3) An applicant for a construction permit shall submit to the

 

department with the application form a permit fee of $300.00.

 

     (4) If an application for a license or permit is denied, or if

 

a license or permit is revoked before its expiration date, the fees

 

paid to the department shall not be refunded.

 

     Sec. 143. (1) The governing body of a facility licensed under

 

sections 134 through 150 is responsible for the operation of the

 

facility, for the selection of the medical staff, and for the

 

quality of care rendered by the facility. If a licensee contracts

 

with another entity to operate a psychiatric partial

 

hospitalization program, the governing body of the licensee is

 

responsible for the operation of the facility, the selection of the

 

medical staff, and the quality of care rendered by the facility.

 

The governing body shall cooperate with the director of mental

 

health in the enforcement of sections 134 through 150, and shall

 

insure that physicians and other personnel for whom a state license

 

or registration is required are currently licensed or registered.

 

     (2) A psychiatric partial hospitalization program shall

 

develop and implement written policies, procedures, and agreements

 

to ensure the direct transfer or hospitalization of clients between

 

the partial hospitalization program and a psychiatric hospital or

 

psychiatric unit.

 

     Sec. 143a. (1) The owner, operator, and governing body of a

 

psychiatric hospital , or psychiatric unit , or psychiatric partial

 

hospitalization program licensed under this chapter or operated by

 

the department shall assure that licensed, registered, or certified

 

mental health professionals admitted to practice in the facility

 

are organized in order to enable an effective review of the

 

professional practices in the psychiatric hospital , or psychiatric

 

unit , or psychiatric partial hospitalization program for the

 

purpose of improving the quality of patient care provided in the

 

facility. This review shall include the quality and appropriateness

 

of the care provided.

 

     (2) The records, data, and knowledge collected for or by

 

individuals or committees assigned a review function under

 

subsection (1) are confidential, shall be used only for the

 

purposes of review, are not public records, and are not subject to

 

court subpoena.

 

     (3) This section does not prevent disclosure of individual

 

case records pursuant to under section 748 or disclosure required

 

by federal law to the agency designated by the governor to provide

 

protection and advocacy pursuant to under section 931.

 

     Sec. 148. The terms psychiatric hospital , or psychiatric unit

 

, or psychiatric partial hospitalization program shall not be used

 

to describe or refer to an institution or program, unless the

 

institution or program is licensed by the director pursuant

 

according to sections 134 through 150.

 

     Sec. 149. The director may maintain action in the name of the

 

people of the state to restrain or prevent the construction,

 

establishment, management, or operation of a psychiatric hospital ,

 

or psychiatric unit , or psychiatric partial hospitalization

 

program without a license.

 

     Sec. 149b. A psychiatric hospital , or psychiatric unit , or

 

psychiatric partial hospitalization program operated or licensed by

 

the department shall comply with the medical waste regulatory act,

 

part 138 of the public health code, Act No. 368 of the Public Acts

 

of 1978, being sections 333.13801 to 333.13831 of the Michigan

 

Compiled Laws.1978 PA 368, MCL 333.13801 to 333.13832.

 

     Enacting section 1. This amendatory act takes effect October

 

1, 2015.