May 7, 2008, Introduced by Reps. Ball, Kathleen Law, Miller, Amos, Meisner, Simpson, Leland, Robert Jones, Vagnozzi, Young, Byrnes, Rick Jones, Green, Polidori, Gonzales, Garfield, Wenke, Meadows, Alma Smith, Jackson and Clack and referred to the Committee on Health Policy.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 116 and 206 (MCL 330.1116 and 330.1206),
section 116 as amended by 1998 PA 67 and section 206 as amended by
1995 PA 290.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 116. (1) Consistent with section 51 of article IV of the
state constitution of 1963, which declares that the health of the
people of the state is a matter of primary public concern, and as
required by section 8 of article VIII of the state constitution of
1963, which declares that services for the care, treatment,
education, or rehabilitation of those who are seriously mentally
disabled shall always be fostered and supported, the department
shall continually and diligently endeavor to ensure that adequate
and appropriate mental health services are available to all
citizens
throughout the state. To this end, the department shall
have
has the general powers and duties described in this
section.
(2) The department shall do all of the following:
(a) Direct services to individuals who have a serious mental
illness, developmental disability, or serious emotional
disturbance. The department shall give priority to the following
services:
(i) Services for individuals with the most severe forms of
serious mental illness, serious emotional disturbance, or
developmental disability.
(ii) Services for individuals with serious mental illness,
serious emotional disturbance, or developmental disability who are
in urgent or emergency situations.
(b) Administer the provisions of chapter 2 so as to promote
and maintain an adequate and appropriate system of community mental
health services programs throughout the state. In the
administration of chapter 2, it shall be the objective of the
department to shift primary responsibility for the direct delivery
of public mental health services from the state to a community
mental health services program whenever the community mental health
services program has demonstrated a willingness and capacity to
provide an adequate and appropriate system of mental health
services for the citizens of that service area.
(c) Annually publish, list on its website, and include in its
contracts with community mental health services programs all
elements of section 206(2).
(d) (c)
Engage in planning for the purpose
of identifying,
assessing, and enunciating the mental health needs of the state.
(e) (d)
Submit to the members of the house
and senate standing
committees and appropriation subcommittees with legislative
oversight of mental health matters an annual report summarizing its
assessment of the mental health needs of the state and
incorporating information received from community mental health
services programs under section 226. The report shall include an
estimate of the cost of meeting all identified needs. Additional
information shall be made available to the legislature upon
request.
(f) (e)
Endeavor to develop and establish
arrangements and
procedures for the effective coordination and integration of all
public mental health services, and for effective cooperation
between public and nonpublic services, for the purpose of providing
a unified system of statewide mental health care.
(g) (f)
Review and evaluate the relevance,
quality,
effectiveness, and efficiency of mental health services being
provided by the department and assure the review and evaluation of
mental health services provided by community mental health services
programs. The department shall establish and implement a structured
system to provide data necessary for the reviews and evaluations.
(h) (g)
Implement those provisions of law
under which it is
responsible for the licensing or certification of mental health
facilities or services.
(i) (h)
Establish standards of training and
experience for
executive directors of community mental health services programs.
(j) (i)
Support research activities.
(k) (j)
Support evaluation and quality
improvement activities.
(l) (k)
Support training, consultation, and
technical
assistance regarding mental health programs and services and
appropriate prevention and mental health promotion activities,
including those that are culturally sensitive, to employees of the
department, community mental health services programs, and other
nonprofit agencies providing mental health services under contract
with community mental health services programs.
(m) (l) Support
multicultural services.
(3) The department may do all of the following:
(a) Direct services to individuals who have mental disorders
that meet diagnostic criteria specified in the most recent
diagnostic and statistical manual of mental health disorders
published by the American psychiatric association and approved by
the department and to the prevention of mental disability and the
promotion of mental health. Resources that have been specifically
appropriated for services to individuals with dementia, alcoholism,
or substance abuse, or for the prevention of mental disability and
the promotion of mental health shall be utilized for those specific
purposes.
(b) Provide, on a residential or nonresidential basis, any
type of patient or client service including but not limited to
prevention, diagnosis, treatment, care, education, training, and
rehabilitation.
(c) Operate mental health programs or facilities directly or
through contractual arrangement.
(d) Institute pilot projects considered appropriate by the
director to test new models and concepts in service delivery or
mental health administration. Pilot projects may include, but need
not be limited to, both of the following:
(i) Issuance of a voucher to a recipient of public mental
health services in accordance with the recipient's individual plan
of services and guidelines developed by the department.
(ii) Establishment of revolving loans to assist recipients of
public mental health services to acquire or maintain affordable
housing. Funding under this subparagraph shall only be provided
through an agreement with a nonprofit fiduciary in accordance with
guidelines and procedures developed by the department related to
the use, issuance, and accountability of revolving loans used for
recipient housing.
(e) Enter into an agreement, contract, or arrangement with any
individual or public or nonpublic entity that is necessary or
appropriate to fulfill those duties or exercise those powers that
have by statute been given to the department.
(f) Accept gifts, grants, bequests, and other donations for
use in performing its functions. Any money or property accepted
shall be used as directed by its donor and in accordance with law
and the rules and procedures of the department.
(g) The department has any other power necessary or
appropriate to fulfill those duties and exercise those powers that
have been given to the department by law and that are not otherwise
prohibited by law.
Sec. 206. (1) The purpose of a community mental health
services
program shall be is to provide a comprehensive array of
mental
health services appropriate to conditions of individuals
adults and minors who are located within its geographic service
area, regardless of an individual's ability to pay or medicaid
status. Services shall be effective and necessary to impact an
individual's qualifying condition and its effects on the
individual's
life. The array of mental health
services shall
include
available to individuals who
qualify for service
consideration includes, at a minimum, all of the following:
(a)
Crisis stabilization and response including a 24-hour, 7-
day
per week, crisis emergency service that is prepared to respond
to
persons experiencing acute emotional, behavioral, or social
dysfunctions,
and the provision of inpatient or other protective
environment
for treatment.
(b)
Identification, assessment, and diagnosis to determine the
specific
needs of the recipient and to develop an individual plan
of
services.
(c)
Planning, linking, coordinating, follow-up, and monitoring
to
assist the recipient in gaining access to services.
(d)
Specialized mental health recipient training, treatment,
and
support, including therapeutic clinical interactions,
socialization
and adaptive skill and coping skill training, health
and
rehabilitative services, and pre-vocational and vocational
services.
(e)
Recipient rights services.
(f)
Mental health advocacy.
(g)
Prevention activities that serve to inform and educate
with
the intent of reducing the risk of severe recipient
dysfunction.
(h)
Any other service approved by the department.
(2)
Services shall promote the best interests of the
individual
and shall be designed to increase independence, improve
quality
of life, and support community integration and inclusion.
Services
for children and families shall promote the best interests
of
the individual receiving services and shall be designed to
strengthen
and preserve the family unit if appropriate. The
community
mental health services program shall deliver services in
a
manner that demonstrates they are based upon recipient choice and
involvement,
and shall include wraparound services when
appropriate.
(a) Treatment and support, that includes, at a minimum, all of
the following:
(i) Clinical assessment, diagnostic, planning, and therapeutic
services.
(ii) Crisis response and stabilization that is available 24
hours a day, 7 days a week.
(iii) Inpatient care.
(iv) Intensive community-based services that provide
alternatives to or step-downs from inpatient care.
(v) Services promoting community inclusion and integration and
maintaining community tenure.
(vi) Supportive services that promote resiliency and recovery
through peer and family-to-family involvement and interaction.
(vii) Any other service specified in the department's contract
with community mental health services programs.
(b) Referral to and coordination and collaboration with other
health care, human service, and education systems as needed to
access medically necessary service covered by this section.
(c) Recipient and family services, including, at a minimum,
consumer and family orientation and involvement, consumer and
family information and education, mental health advocacy, and
mechanisms for consumer appeals and resolutions of consumer
complaints and grievances.
(2) The department shall publish annually, list on its
website, and include in its contracts with community mental health
services programs all of the following:
(a) The subelements of the service categories specified in
subsection (1).
(b) Uniform standards and protocols for community mental
health services programs to follow in case-finding outreach,
screening, and access determinations.
(c) Categories of adults and minors eligible for prevention
initiatives related to special risk factors for emotional
disturbance or mental illness and their consequences.
(d) A listing of service selection guideline principles to aid
consumers, families, providers, and service managers in the
matching of treatment and support options to a recipient’s needs,
desires, and circumstances. The list of principles shall minimally
include all of the following:
(i) Treatment planning, including initial and revised service
plans, shall be person-centered or family-centered, with
involvement of all appropriate parties facilitated as quickly as
possible.
(ii) Recipients shall be offered the most clinically and
culturally relevant and effective treatment and support for their
condition. Services for minors and families shall promote the best
interests of the individual receiving services, shall be designed
to strengthen and preserve the family unit, and shall include
wraparound services when appropriate.
(iii) Medical necessity criteria utilized shall be consistent
with subsection (2)(d)(ii). These criteria shall be transparent and
open to public review, uniform across the state, and updated
regularly to reflect advances in diagnosis and treatment.
(iv) Protocols for responding to acute psychiatric crises shall
be well-defined and uniformly applied across the state.
(v) Service selection criteria and protocols for individuals
meriting priority consideration under section 208 shall be well-
defined and uniformly applied across the state.
(vi) Service selection criteria and protocols shall be
identical for both medicaid and non-medicaid recipients.
(vii) Service selection criteria and protocols shall cover both
adults and minors.
(viii) Service selection criteria and protocols for individuals
who have neither acute psychiatric crisis nor severe mental
disorder shall be well-defined and uniformly applied across the
state.
(ix) Criteria for continuation of a service shall be flexible
so that clinically appropriate and effective decisions can be made
according to recipient needs and circumstances.
(x) Discharge from a given service shall not occur if a
medically necessary and clinically appropriate and effective
alternative service is not available.
(xi) Individuals with a co-occurring mental illness and
substance use disorder shall be offered integrated treatment.
(xii) Service selection guidelines shall address collaborative
and boundary issues between mental health and other public and
private human service systems.
(xiii) Service selection guidelines shall be uniform throughout
the state and readily understandable, across demographic,
socioeconomic, and cultural groups, by consumers and their
advocates or representatives and families.
(3) An individual who has qualified for priority service
provision in any community mental health services program shall
retain that eligibility over time and across any other community
mental health services program for any medically necessary service
in the array established in subsection (1).