SENATE BILL NO. 915
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 401, 427, 430, 461, 468, 472a, and 475 (MCL 330.1401, 330.1427, 330.1430, 330.1461, 330.1468, 330.1472a, and 330.1475), sections 401, 461, 468, 472a, and 475 as amended by 2018 PA 593, section 427 as amended by 2016 PA 320, and section 430 as amended by 1995 PA 290.
the people of the state of michigan enact:
Sec. 401. (1) As used in this chapter, "person requiring treatment" means (a), (b), or (c):any of the following individuals:
(a) An individual who has mental illness, and who as a result of that mental illness can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure himself, herself, themselves or another individual, and who has engaged in an act or acts or made significant threats that are substantially supportive of the expectation.
(b) An individual who has mental illness, and who as a result of that mental illness is unable to attend to those of his or her the individual's basic physical needs such as food, clothing, or shelter that must be attended to in order for the individual to avoid serious harm in the near future, and who has demonstrated that inability by failing to attend to those basic physical needs.
(c) An individual who has mental illness, whose judgment is so impaired by that mental illness, and whose lack of understanding of the need for treatment has caused him or her the individual to demonstrate an unwillingness to voluntarily participate in or adhere to treatment that is necessary , on the basis of competent clinical opinion, to prevent a relapse or harmful deterioration of his or her the individual's condition, and presents a substantial risk of significant physical or mental harm to the individual or others.
(2) An individual whose mental processes have been weakened or impaired by a dementia, an individual with a primary diagnosis of epilepsy, or an individual with alcoholism or other drug dependence is not a person requiring treatment under this chapter unless the individual also meets the criteria specified in subsection (1). An individual described in this subsection may be hospitalized under the informal or formal voluntary hospitalization provisions of this chapter if he or she the individual is considered clinically suitable for hospitalization by the hospital director.
Sec. 427. (1) If a peace officer observes an individual conducting himself or herself in a manner that causes the peace officer has reasonable cause to reasonably believe that the an individual is a person requiring treatment, the peace officer may take the individual into protective custody and transport the individual to a preadmission screening unit designated by a community mental health services program for examination under section 429 or for mental health intervention services. The preadmission screening unit shall provide those mental health intervention services that it considers appropriate or shall provide an examination under section 429. The preadmission screening services may be provided at the site of the preadmission screening unit or at a site designated by the preadmission screening unit. Upon arrival at the preadmission screening unit or site designated by the preadmission screening unit, the peace officer shall execute a petition for hospitalization of the individual. As soon as practical, the preadmission screening unit shall offer to contact an immediate family member of the recipient to let the family know that the recipient has been taken into protective custody and where he or she the individual is located. The preadmission screening unit shall honor the recipient's decision as to whether an immediate family member is to be contacted and shall document that decision in the recipient's record. In the course of providing services, the preadmission screening unit may provide advice and consultation to the peace officer, which may include a recommendation to release the individual from protective custody. In all cases where a peace officer has executed a petition, the preadmission screening unit shall ensure that an examination is conducted by a physician or licensed psychologist. The preadmission screening unit shall ensure the provision of follow-up counseling and diagnostic and referral services if needed if it is determined under section 429 that the person individual does not meet the requirements for hospitalization.
(2) A peace officer is not financially responsible for the cost of care of an individual for whom a peace officer has executed a petition under subsection (1).
(3) A hospital receiving an individual under subsection (1) who has been referred by a community mental health services program's preadmission screening unit shall notify that unit of the results of an examination of that individual conducted by the hospital.
Sec. 430. If a patient is hospitalized under section 423, a psychiatrist shall examine the patient shall be examined by a psychiatrist as soon after hospitalization as is practicable, but not later than 24 hours, excluding legal holidays, after hospitalization. The examining psychiatrist shall not be the same physician upon whose clinical certificate the patient was hospitalized. If the psychiatrist does not certify that the patient is a person requiring treatment, the patient shall must be released immediately. If the psychiatrist does certify certifies that the patient is a person requiring treatment, including a person requiring treatment in the form of hospitalization, the patient's hospitalization may continue pending hearings convened pursuant to under sections 451 to 465. If the psychiatrist certifies that the patient is a person requiring treatment in the form of assisted outpatient treatment, a referral must be made to the community mental health services program serving the community where the patient resides and hearings may be convened under sections 451 to 465.
Sec. 461. (1) An For a petition filed under section 434(1) to (6), an individual may not be found to require treatment unless at least 1 physician or licensed psychologist who has personally examined that individual testifies in person or by written deposition at the hearing.
(2) For a petition filed under section 434(7), that does not seek hospitalization before the hearing, an individual may not be found to require treatment unless a psychiatrist who has personally examined that individual testifies. A psychiatrist's testimony is not necessary if a psychiatrist signs the petition. If a psychiatrist signs the petition, at least 1 physician or licensed psychologist who has personally examined that individual must testify. if a physician, psychologist, or a psychiatrist nurse practitioner or physician assistant working under the supervision of a psychiatrist has personally examined the individual and testifies that the individual requires treatment. The requirement for testimony may be waived by the subject of the petition. If the testimony given in person is waived, a clinical certificate completed by a physician, licensed psychologist, or psychiatrist must be presented to the court before or at the initial hearing.
(3) The examinations required under this section for a petition filed under section 434(7) shall must be arranged by the court and the local community mental health services program or other entity as designated by the department.
(4) A written deposition may be introduced as evidence at the hearing only if the attorney for the subject of the petition was given the opportunity to be present during the taking of the deposition and to cross-examine the deponent. This testimony or deposition may be waived by the subject of a petition. An individual may be found to require treatment even if the petitioner does not testify, as long as there is competent evidence from which the relevant criteria in section 401 can be established.
Sec. 468. (1) For a petition filed under section 434, if the court finds that an individual is not a person requiring treatment, the court shall enter a finding to that effect and, if the person individual has been hospitalized before the hearing, shall order that the person individual be discharged immediately.
(2) For a petition filed under section 434, if an individual is found to be a person requiring treatment, the court shall do 1 of the following:
(a) Order the individual hospitalized in a hospital recommended by the community mental health services program or other entity as designated by the department.
(b) Order the individual hospitalized in a private or veterans administration Veterans Administration hospital at the request of the individual or his or her the individual's family, if private or federal funds are to be utilized and if the hospital agrees. If the individual is hospitalized in a private or Veterans Administration hospital under this subdivision, any financial obligation for the hospitalization shall must be satisfied from funding sources other than the community mental health services program, the department, or other state or county funding.
(c) Order the individual to undergo a program of combined hospitalization and assisted outpatient treatment, as recommended by the community mental health services program or other entity as designated by the department.
(d) Order the individual to receive assisted outpatient treatment through a community mental health services program, or other entity as designated by the department, capable of providing the necessary treatment and services to assist the individual to live and function in the community as specified in the order. The court may include a case management plan and case management services and 1 or more of the following:
(i) Medication.
(ii) Blood or urinalysis tests to determine compliance with or effectiveness of prescribed medication.
(iii) Individual or group therapy, or both.
(iv) Day or partial day programs.
(v) Educational or vocational training.
(vi) Supervised living.
(vii) Assertive community treatment team services.
(viii) Substance use disorder treatment.
(ix) Substance use disorder testing for individuals with a history of alcohol or substance use and for whom that testing is necessary to assist the court in ordering treatment designed to prevent deterioration. A court order for substance use testing is subject to review hearing once every 180 days.
(x) Any other services prescribed to treat the individual's mental illness and either to assist the individual in living and functioning in the community or to help prevent a relapse or deterioration that may reasonably be predicted to result in suicide or the need for hospitalization.
(3) In developing an assisted outpatient treatment plan, a psychiatrist shall supervise the preparation and implementation of the assisted outpatient treatment plan. The assisted outpatient treatment plan shall must be completed within 30 days after entry of the court's order of assisted outpatient treatment and a copy shall certificate of completion of the assisted outpatient treatment plan must be forwarded to the probate court for filing within 3 days after completion of the plan to be maintained in the court file.
(4) In developing an assisted outpatient treatment order, the court shall consider any preference or medication experience reported by the individual or his or her the individual's designated representative, whether or not the individual has an existing individual plan of services under section 712, and any direction included in a durable power of attorney or advance directive that exists.
(5) Before an order of assisted outpatient treatment expires, if the individual has not previously designated a patient advocate or executed a durable power of attorney or an advance directive, the responsible community mental health services program or other entity as designated by the department shall ascertain whether the individual desires to establish a durable power of attorney or an advance directive. If so, the community mental health services program or other entity as designated by the department shall direct the individual to the appropriate community resource for assistance in developing a durable power of attorney or an advance directive.
(6) If an order for assisted outpatient treatment conflicts with the provisions of an existing durable power of attorney, advance directive, or individual plan of services developed under section 712, the assisted outpatient treatment order shall be reviewed for possible adjustment by a psychiatrist not previously involved with developing the assisted outpatient treatment order. If an order for assisted outpatient treatment conflicts with the provisions of an existing advance directive, durable power of attorney, or individual plan of services developed under section 712, the court shall state the court's findings on the record or in writing if the court takes the matter under advisement, including the reason for the conflict.
Sec. 472a. (1) Upon the filing of a petition under section 434 and a finding that an individual is a person requiring treatment, the court shall issue an initial order of involuntary mental health treatment that shall must be limited in duration as follows:
(a) An initial order of hospitalization shall must not exceed 60 days.
(b) An initial order of assisted outpatient treatment shall must not exceed 180 days.
(c) An initial order of combined hospitalization and assisted outpatient treatment shall must not exceed 180 days. The hospitalization portion of the initial order shall must not exceed 60 days.
(2) Upon the receipt of a petition under section 473 before the expiration of an initial order under subsection (1) and a finding that the individual continues to be a person requiring treatment, the court shall issue a second order for involuntary mental health treatment that shall must be limited in duration as follows:
(a) A second order of hospitalization must not exceed 90 days.
(b) A second order of assisted outpatient treatment must not exceed 1 year.
(c) A second order of combined hospitalization and assisted outpatient treatment must not exceed 1 year. The hospitalization portion of the second order must not exceed 90 days.
(3) Upon the receipt of a petition under section 473 before the expiration of a second order under subsection (2) and a finding that the individual continues to be a person requiring treatment, the court shall issue a continuing order for involuntary mental health treatment that shall must be limited in duration as follows:
(a) A continuing order of hospitalization must not exceed 1 year.
(b) A continuing order of assisted outpatient treatment must not exceed 1 year.
(c) A continuing order of combined hospitalization and assisted outpatient treatment must not exceed 1 year. The hospitalization portion of a continuing order for combined hospitalization and assisted outpatient treatment must not exceed 90 days.
(4) Upon the receipt of a petition under section 473 before the expiration of a continuing order of involuntary mental health treatment, including a continuing order issued under section 485a or a 1-year order of hospitalization issued under former section 472, and a finding that the individual continues to be a person requiring treatment, the court shall issue another continuing order for involuntary mental health treatment as provided in subsection (3) for a period not to exceed 1 year. The court shall continue to issue consecutive 1-year continuing orders for involuntary mental health treatment under this section until a continuing order expires without a petition having been filed under section 473 or the court finds that the individual is not a person requiring treatment.
(5) If a petition for an order of involuntary mental health treatment is not brought under section 473 at least 14 days before the expiration of an order of involuntary mental health treatment as described in subsections (2) to (4), a person who believes that an individual continues to be a person requiring treatment may file a petition under section 434 for an initial order of involuntary mental health treatment as described in subsection (1).
Sec. 475. (1) During the period of an order for assisted outpatient treatment or combined hospitalization and assisted outpatient treatment, if the agency or mental health professional who is supervising an individual's assisted outpatient treatment program determines that the individual is not complying with the court order or that the assisted outpatient treatment has not been or will not be sufficient to prevent harm that the individual may inflict on himself or herself the individual or upon on others, then the supervising agency or mental health professional shall notify the court immediately. If the individual believes that the assisted outpatient treatment program is not appropriate, the individual may notify the court of that fact.
(2) If it comes to the attention of the court that an individual subject to an order of assisted outpatient treatment or combined hospitalization and assisted outpatient treatment is not complying with the order, that the assisted outpatient treatment has not been or will not be sufficient to prevent harm to the individual or to others, or that the individual believes that the assisted outpatient treatment program is not appropriate, the court may do either any of the following without a hearing and based upon the record and other available information:
(a) Consider other alternatives to hospitalization and modify the order to direct the individual to undergo another program of assisted outpatient treatment for the duration of the order.
(b) Modify the order to direct the individual to undergo hospitalization or combined hospitalization and assisted outpatient treatment. The duration of the hospitalization, including the number of days the individual has already been hospitalized if the order being modified is a combined order, shall must not exceed 60 days for an initial order or 90 days for a second or continuing order. The modified order may provide that if the individual refuses to comply with the psychiatrist's order to return to the hospital, a peace officer shall take the individual into protective custody and transport the individual to the hospital selected.
(c) Convene a status conference with the supervising agency and the individual to review the individual's compliance with the order.
(3) During the period of an order for assisted outpatient treatment or a combination of hospitalization and assisted outpatient treatment, if the agency or mental health professional who is supervising an individual's assisted outpatient treatment determines that the individual is not complying with the court order, the supervising agency or mental health professional shall notify the court immediately.
(4) If it comes to the attention of the court that an individual subject to an order of assisted outpatient treatment or a combination of hospitalization and assisted outpatient treatment is not complying with the order, the court may require 1 or more of the following, without a hearing:
(a) That the individual be taken to the preadmission screening unit established by the community mental health services program serving the community in which the individual resides.
(b) That the individual be hospitalized for a period of not more than 10 days.
(c) Upon On recommendation by the community mental health services program serving the community in which the individual resides, that the individual be hospitalized for a period of more than 10 days, but not longer than the duration of the order for assisted outpatient treatment or a combination of hospitalization and assisted outpatient treatment, or not longer than 90 days, whichever is less.
(5) The court may direct peace officers to transport the individual to a designated facility or a preadmission screening unit, as applicable, and the court may specify conditions under which the individual may return to assisted outpatient treatment before the order expires.
(6) An individual hospitalized without a hearing as provided in subsection (4) may object to the hospitalization according to the provisions of section 475a.