Bill Text: MI HB4841 | 2023-2024 | 102nd Legislature | Introduced
Bill Title: Human services: adult foster care; enhanced standards on adult foster care facilities; provide for. Amends secs. 3, 4, 5, 6, 7, 13, 24 & 31 of 1979 PA 218 (MCL 400.703 et seq.) & adds secs. 9a, 28, 28a, 28b, 28c, 28d & 28e.
Spectrum: Partisan Bill (Democrat 32-0)
Status: (Introduced) 2023-06-27 - Bill Electronically Reproduced 06/22/2023 [HB4841 Detail]
Download: Michigan-2023-HB4841-Introduced.html
HOUSE BILL NO. 4841
A bill to amend 1979 PA 218, entitled
"Adult foster care facility licensing act,"
by amending sections 3, 4, 5, 6, 7, 13, 24, and 31 (MCL 400.703, 400.704, 400.705, 400.706, 400.707, 400.713, 400.724, and 400.731), sections 3, 4, 5, 7, and 13 as amended by 2018 PA 557, section 6 as amended by 2017 PA 156, section 24 as amended by 2018 PA 558, and section 31 as amended by 1994 PA 150, and by adding sections 9a, 28, 28a, 28b, 28c, 28d, and 28e.
the people of the state of michigan enact:
Sec. 3. (1) "Abuse" means willfully inflicting injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. Abuse includes mental abuse, physical abuse, sexual abuse, and verbal abuse.
(2) (1) "Adult" means 1 of the following:
(a) A person An individual 18 years of age or older.
(b) A person An individual who is placed in an adult foster care family home or an adult foster care small group home according to section 5(6) or (8) of 1973 PA 116, MCL 722.115.
(3) (2) "Adult foster care camp" or "adult camp" means an adult foster care facility with the approved capacity to receive more than 4 adults to be provided foster care. An adult foster care camp is a facility located in a natural or rural environment.
(4) (3) "Adult foster care congregate facility" means an adult foster care facility with the approved capacity to receive more than 20 adults to be provided with foster care.
(5) (4) "Adult foster care facility" means a home or facility that provides foster care to adults. Subject to section 26a(1), adult foster care facility includes facilities and foster care family homes for adults who are aged, mentally ill, developmentally disabled, or physically disabled who require supervision on an ongoing basis but who do not require continuous nursing care. Adult foster care facility does not include any of the following:
(a) A nursing home licensed under part 217 of the public health code, 1978 PA 368, MCL 333.21701 to 333.21799e.
(b) A home for the aged licensed under part 213 of the public health code, 1978 PA 368, MCL 333.21301 to 333.21335.
(c) A hospital licensed under part 215 of the public health code, 1978 PA 368, MCL 333.21501 to 333.21571.
(d) A hospital for the mentally ill or a facility for the developmentally disabled operated by the department of health and human services under the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.
(e) A county infirmary operated by a county department of health and human services under section 55 of the social welfare act, 1939 PA 280, MCL 400.55.
(f) A child caring institution, children's camp, foster family home, or foster family group home licensed or approved under 1973 PA 116, MCL 722.111 to 722.128, if the number of residents who become 18 years of age while residing in the institution, camp, or home does not exceed the following:
(i) Two, if the total number of residents is 10 or fewer.
(ii) Three, if the total number of residents is not less than 11 and not more than 14.
(iii) Four, if the total number of residents is not less than 15 and not more than 20.
(iv) Five, if the total number of residents is 21 or more.
(g) A foster family home licensed or approved under 1973 PA 116, MCL 722.111 to 722.128, that has a person an individual who is 18 years of age or older placed in the foster family home under section 5(7) of 1973 PA 116, MCL 722.115.
(h) An establishment commonly described as an alcohol or a substance use disorder rehabilitation center, except if licensed as both a substance use disorder program and an adult foster care facility and approved as a co-occurring enhanced crisis residential program, a residential facility for persons individuals released from or assigned to adult correctional institutions, a maternity home, or a hotel or rooming house that does not provide or offer to provide foster care.
(i) A facility created by former 1885 PA 152. , MCL 36.1 to 36.12.
(j) An area excluded from the definition of adult foster care facility under section 17(3) of the continuing care community disclosure act, 2014 PA 448, MCL 554.917.
(k) A private residence with the capacity to receive at least 1 but not more than 4 adults who all receive benefits from a community mental health services program if the local community mental health services program monitors the services being delivered in the residential setting.
(6) (5) "Adult foster care family home" means a private residence with the approved capacity to receive at least 3 but not more than 6 adults to be provided with foster care. The adult foster care family home licensee must be a member of the household and an occupant of the residence.
(7) (6) "Adult foster care large group home" means an adult foster care facility with the approved capacity to receive at least 13 but not more than 20 adults to be provided with foster care.
(8) (7) "Adult foster care small group home" means an adult foster care facility with the approved capacity to receive at least 3 but not more than 12 adults to be provided with foster care.
(9) (8) "Aged" means an adult whose chronological age is 60 years of age or older or whose biological age, as determined by a physician, is 60 years of age or older.
(10) (9) "Assessment plan" means a written statement prepared in cooperation with a responsible agency or person that identifies the specific care and maintenance, services, and resident activities appropriate for each individual resident's physical and behavioral needs and well-being and the methods of providing the care and services taking into account the preferences and competency of the individual.
(11) (10) "Board" means food service provided at the adult foster care facility.
Sec. 4. (1) "Certified nurse assistant" means an individual who is certified through the nurse aide training program administered by the department and whose certification has been verified by the management of the adult foster care facility.
(2) (1) "Co-occurring enhanced crisis residential program" means a program approved by the department of health and human services for providing short-term intensive mental health and substance use disorder services that is able to address the mental health needs, substance use disorder needs, or both of an individual through enhanced programming and staffing patterns that are reviewed and approved by the department of health and human services.
(3) (2) "Council" means the adult foster care licensing advisory council created in section 8.
(4) (3) "Department" means the department of licensing and regulatory affairs.
(5) (4) "Developmental disability" means that term as defined in section 100a of the mental health code, 1974 PA 258, MCL 330.1100a.
(6) (5) "Direct access" means access to a resident or to a resident's property, financial information, medical records, treatment information, or any other identifying information.
(7) (6) "Director" means the director of the department.
(8) (7) "Do-not-resuscitate order" means a document executed under the Michigan do-not-resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067, directing that, in the event a resident suffers cessation of both spontaneous respiration and circulation, no resuscitation will be initiated.
(9) (8) "Foster care" means the provision of providing supervision, personal care, and protection in addition to room and board, for 24 hours a day, 5 or more days a week, and for 2 or more consecutive weeks for compensation provided at a single address. Providing room under a landlord and tenant arrangement does not, by itself, exclude a person from the licensure requirement under this act.
Sec. 5. (1) "Good moral character" means good moral character as defined in and determined under 1974 PA 381, MCL 338.41 to 338.47.
(2) "Licensed hospice program" means a health care program that provides a coordinated set of services rendered at home or in an outpatient or institutional setting for individuals suffering from a disease or condition with a terminal prognosis and that is licensed under article 17 of the public health code, 1978 PA 368, MCL 333.20101 to 333.22260.
(3) "Licensed practical nurse" means an individual who is licensed or otherwise authorized to engage in the practice of nursing as a licensed practical nurse under part 172 of the public health code, 1978 PA 368, MCL 333.17201 to 333.17242.
(4) "Licensed staff" means a health care provider licensed under article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18868. Licensed staff includes a registered nurse and a licensed practical nurse.
(5) (3) "Licensee" means the agency, association, corporation, organization, person, or department or agency of the state, county, city, or other political subdivision, that has been issued a license to operate an adult foster care facility.
(7) "Mental abuse" means a willful act directed at a resident that is likely to result in mental distress or mental anguish. Mental abuse includes humiliation, harassment, threat of punishment, or threat of deprivation.
(8) (5) "Mental illness" means a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life.
(9) "Neglect" means failure to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish, mental stress, or emotional distress.
(10) (6) "New construction" means a newly constructed facility or a facility that has been completely renovated for use as an adult foster care facility.
Sec. 6. (1) "Personal care" means personal assistance provided by a licensee or an agent or employee of a licensee to a resident who requires assistance with dressing, personal hygiene, grooming, maintenance of maintaining a medication schedule as directed and supervised by the resident's physician, or the development of developing those personal and social skills required to live in the least restrictive environment.
(2) "Physical abuse" means a willful act directed at a resident that is likely to result in injury or pain. Physical abuse includes, but is not limited to, slapping, pinching, kicking, shoving, corporal punishment, rough handling during caregiving or when moving a resident, isolating a resident from visitors or other residents, and abandonment.
(3) (2) "Physical disability" means a determinable physical characteristic of an individual that may result from disease, injury, congenital condition of birth, or functional disorder.
(4) (3) "Physical plant" means the structure in which a facility is located and all physical appurtenances to the facility.
(5) (4) "Physician orders for scope of treatment form" or "POST form" means that term as defined in section 5674 of the public health code, 1978 PA 368, MCL 333.5674.
(6) (5) "Protection", subject to section 26a(2), sections 26a(3) and 31(4)(c), means the continual responsibility of the licensee to take reasonable action to ensure the health, safety, and well-being of a resident, including protection from physical harm, emotional harm, mental harm, humiliation, intimidation, and social, moral, financial, and personal exploitation while on the premises, while under the supervision of the licensee or an agent or employee of the licensee, or when the resident's assessment plan states that the resident needs continuous supervision.
(7) (6) "Provisional license" means a license issued to a facility that has previously been licensed under this act or an act repealed by this act but is temporarily unable to conform to the requirements of a regular license prescribed in this act or rules promulgated under this act.
(8) (7) "Quality of care" means the foster care of residents of a facility and other similar items not related to the physical plant that address themselves to the general physical and mental health, welfare, and well-being of residents.
Sec. 7. (1) "Regular license" means a license issued to an adult foster care facility that is in compliance with this act and the rules promulgated under this act.
(2) "Related" means any of the following relationships by marriage, blood, or adoption: spouse, child, parent, brother, sister, grandparent, grandchild, aunt, uncle, stepparent, stepbrother, stepsister, or cousin.
(3) "Resident" includes a vulnerable adult.
(4) "Resident designee" means the person designated by the resident in writing or by a court order with legal authority to act on the resident's behalf.
(5) "Self-administration of medication" means the removal and understanding of the correct dosage from the pharmaceutical container, understanding the reason for medication, and self-injecting, self-ingesting, or self-applying the medication by the resident with no assistance. Qualified personnel of the facility may assist with providing reminders of frequency, opening containers, pouring medication, and physically bringing medication to the resident.
(6) "Sexual abuse" means sexually oriented behavior directed at a resident by a staff member, sexually oriented behavior between residents that is not fully and freely consented to by both residents involved, sexually oriented behavior between residents when either or both residents are incapable of consenting to the behavior, or any sexually oriented behavior by a visitor directed at a resident incapable of consenting to the behavior.
(7) (3) "Short-term operation" means an adult foster care facility that operates for a period of time less than 6 months within a calendar year.
(8) "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 by the adult foster care facility directly from the Medicaid program for personal care services for a resident, or payment received under the supplemental security income program under title XVI of the social security act, 42 USC 1381 to 1383f.
(9) (4) "Special license" means a license issued for the duration of the operation of an adult foster care facility if the licensee is a short-term operation.
(10) (5) "Specialized program" means a program of services or treatment provided in an adult foster care facility licensed under this act that is designed to meet the unique programmatic needs of the residents of that home as set forth in the assessment plan for each resident and for which the facility receives special compensation.
(6) "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 by the adult foster care facility directly from the Medicaid program for personal care services for a resident, or payment received under the supplemental security income program under title XVI of the social security act, 42 USC 1381 to 1383f.
(11) (7) "Supervision" means guidance of a resident in the activities of daily living, including 1 or more of the following:
(a) Reminding a resident to maintain his or her medication schedule, as directed by the resident's physician.
(b) Reminding a resident of important activities to be carried out.
(c) Assisting a resident in keeping appointments.
(d) Being aware of a resident's general whereabouts even though the resident may travel independently about the community.
(12) (8) "Temporary license" means a license issued to a facility that has not previously been licensed under this act or under former 1972 PA 287.
(13) "Verbal abuse" means using oral, written, or gestured language that willfully includes disparaging or derogatory terms to residents or their families, or that is used or uttered within hearing distance of residents or their families, regardless of their age, ability to comprehend, or disability.
(14) "Vulnerable adult" means that term as defined in section 145m of the Michigan penal code, 1931 PA 328, MCL 750.145m.
Sec. 9a. (1) The department shall provide the following information to the public in compliance with the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246:
(a) Facility ownership information, including the owner's name, address, telephone number, and whether the facility is profit or nonprofit.
(b) The adult foster care facility's name, address, and telephone number, and the administrator's name.
(c) The staff-to-resident ratio.
(d) The total number of beds in a facility.
(e) A list of services and specialty services provided by the adult foster care facility.
(f) The number of current violations for which the adult foster care facility has been cited for violating a specific rule promulgated under this act.
(g) A link to a detailed report of the adult foster care facility's violations or a special investigation report regarding the adult foster care facility.
(h) The education requirements of the staff.
(i) Certifications required for staff members.
(j) The number of complaints filed against the adult foster care facility.
(k) The number of violations that have been repeated more than 1 time.
(2) The department must post the information listed in subsection (1) online to be accessed as part of the adult foster care facility search tool.
Sec. 13. (1) A person, partnership, corporation, association, or a department or agency of the state, county, city, or other political subdivision shall not establish or maintain an adult foster care facility unless licensed by the department.
(2) Application for a license shall must be made on forms provided and in the manner prescribed by the department. The application shall must be accompanied by the fee prescribed in section 13a.
(3) Before issuing or renewing a license, the department shall must investigate the activities and standards of care of the applicant and shall make an on-site evaluation of the facility. On-site inspections conducted in response to the application may be conducted without prior notice to the applicant. On-site inspections conducted for renewing a license may be conducted within 12 months before the expiration date of the current license without impact on the license renewal date or the license fee. The department staff conducting an inspection upon license renewal must include a registered nurse licensed or otherwise authorized under part 172 of the public health code, 1978 PA 368, MCL 333.17201 to 333.17242, a dietitian, and a social worker licensed or otherwise authorized to engage in the practice of social work under part 185 of the public health code, 1978 PA 368, MCL 333.18501 to 333.18518. Subject to subsections (9), (10), and (11), the department shall issue or renew a license if satisfied as to all of the following:
(a) The financial stability of the facility.
(b) The applicant's compliance with this act and rules promulgated under this act.
(c) The good moral character of the applicant, or owners, partners, or directors of the facility, if other than an individual. Each of these persons shall must be not less than 18 years of age.
(d) The physical and emotional ability of the applicant, and the person responsible for the daily operation of the facility to operate an adult foster care facility.
(e) The good moral character of the licensee or licensee designee, owner, partner, director, and person responsible for the daily operation of the facility. The applicant is responsible for assessing the good moral character of the employees of the facility. The person responsible for the daily operation of the facility shall must be not less than 18 years of age.
(4) The department shall require an applicant or a licensee to disclose the names, addresses, and official positions of all persons who have an ownership interest in the adult foster care facility. If the adult foster care facility is located on or in real estate that is leased, the applicant or licensee shall must disclose the name of the lessor of the real estate and any direct or indirect interest that the applicant or licensee has in the lease other than as lessee.
(5) Each license shall must state the maximum number of persons individuals to be received for foster care at 1 time.
(6) If applicable, a license shall must state the type of specialized program for which certification has been received from the department.
(7) A license shall be issued to a specific person for a facility at a specific location and is nontransferable.
(8) An applicant or licensee proposing a sale of an adult foster care facility or home to another owner shall must provide the department with advance notice of the proposed sale in writing. The applicant or licensee and other parties to the sale shall must arrange to meet with specified department representatives and shall obtain before the sale a determination of the items of noncompliance with applicable law and rules that shall must be corrected. The department shall must notify the respective parties of the items of noncompliance before the change of ownership, shall must indicate that the items of noncompliance shall must be corrected as a condition of issuance of a license to the new owner, and shall must notify the prospective purchaser of all licensure requirements.
(9) The department shall not issue a license to or renew the license of an owner, partner, or director of the applicant, who has regular direct access to residents or who has on-site facility operational responsibilities, or an applicant or the licensee designee, if any of those individuals have been convicted of 1 or more of the following:
(a) A felony under this act or under chapter XXA of the Michigan penal code, 1931 PA 328, MCL 750.145m to 750.145r.
(b) A misdemeanor under this act or under chapter XXA of the Michigan penal code, 1931 PA 328, MCL 750.145m to 750.145r, within the 10 years immediately preceding the date of the application.
(c) A misdemeanor involving abuse, neglect, assault, battery, or criminal sexual conduct or involving fraud or theft against a vulnerable adult as that term is defined in section 145m of the Michigan penal code, 1931 PA 328, MCL 750.145m, or a state or federal crime that is substantially similar to a misdemeanor described in this subdivision within the 10 years immediately preceding the date of the application.
(10) If the department has revoked, suspended, or refused to renew a person's license, or denied an application for a license, for an adult foster care facility according to section 22, the department may refuse to issue a license to or renew a license of that person for a period of 5 years after the suspension, revocation, or nonrenewal of the license, or denial of the application.
(11) The department may refuse to issue a license to or renew the license of an applicant if the department determines that the applicant has a relationship with a former licensee whose license under this act has been suspended, revoked, or nonrenewed under subsection (9) or section 22, or a convicted person to whom a license has been denied under subsection (9), or a person whose license was not renewed due to not meeting the requirements of subsection (27). This subsection applies for 5 years after the suspension, revocation, or nonrenewal of the former licensee's license or the denial of the convicted person's license. For purposes of this subsection, an applicant has a relationship with a former licensee or convicted person if the former licensee or convicted person is involved with the facility in 1 or more of the following ways:
(a) Participates in the administration or operation of the facility.
(b) Has a financial interest in the operation of the facility.
(c) Provides care to residents of the facility.
(d) Has contact with residents or staff on the premises of the facility.
(e) Is employed by the facility.
(f) Resides in the facility.
(12) If the department determines that an unlicensed facility is an adult foster care facility, the department shall must notify the owner or operator of the facility that it is required to be licensed under this act. A person receiving the notification required under this section who does not apply for a license within 30 days is subject to the penalties described in subsection (13).
(13) Subject to subsection (12), a person who violates subsection (1) is guilty of a misdemeanor, punishable by imprisonment for not more than 2 years or a fine of not more than $50,000.00, or both. A person who has been convicted of a violation of subsection (1) who commits a second or subsequent violation is guilty of a felony, punishable by imprisonment for not more than 5 years or a fine of not more than $75,000.00, or both.
(14) The department shall must issue an initial or renewal license 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 an agency or department of this state. If the application is considered incomplete by the department, the department shall must 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. If the department identifies a deficiency or requires the fulfillment of a corrective action plan, the 6-month period is tolled until either of the following occurs:
(a) Upon notification by the department of a deficiency, until the date the requested information is received by the department.
(b) Upon notification by the department that a corrective action plan is required, until the date the department determines the requirements of the corrective action plan have been met.
(15) The determination of the completeness of an application does not operate as an approval of the application for the license and does not confer eligibility of an applicant determined otherwise ineligible for issuance of a license.
(16) If the department fails to issue or deny a license within the time required by this section, the department shall must return the license fee and shall must 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 processing an application. The completed application shall must 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 an application based on the fact that the application fee was refunded or discounted under this subsection.
(17) If, on a continual basis, inspections performed by a local health department delay the department in issuing or denying licenses under this act within the 6-month period, the department may use department staff to complete the inspections instead of the local health department causing the delays.
(18) The department director shall must 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 human services issues. The department director shall must include all of the following information in the report concerning the preceding fiscal year:
(a) The number of initial and renewal applications the department received and completed within the 6-month time period described in subsection (14).
(b) The number of applications requiring a request for additional information.
(c) The number of applications rejected.
(d) The number of licenses not issued within the 6-month period.
(e) The average processing time for initial and renewal licenses granted after the 6-month period.
(19) An applicant, if an individual, or an owner, partner, or director of the applicant who has regular direct access to residents or who has on-site facility operational responsibilities shall must give written consent at the time of original license application and a licensee designee shall must give written consent at the time of appointment for the department of state police to conduct both of the following:
(a) A criminal history check.
(b) A criminal records check through the Federal Bureau of Investigation.
(20) An owner, partner, or director of the applicant who has regular direct access to residents or who has on-site facility operational responsibilities is exempt from the requirements of subsection (19) if he or she has already submitted consent described in subsection (19) and were continuously affiliated with a licensed adult foster care facility as an applicant, owner, partner, or director.
(21) The department shall require the applicant, if an individual, the licensee designee, owner, partner, or director of the applicant who has regular direct access to residents or who has on-site facility operational responsibilities to submit his or her fingerprints to the department of state police for the criminal history check and criminal records check described in subsection (19).
(22) The department shall request a criminal history check and criminal records check required under this section in the manner prescribed by the department of state police. The department of state police shall must conduct the criminal history check and provide a report of the results to the licensing or regulatory bureau of the department. The report shall must contain any criminal history information on the person maintained by the department of state police and the results of the criminal records check from the Federal Bureau of Investigation. The department of state police may charge the person on whom the criminal history check and criminal records check are performed under this section a fee that does not exceed the actual and reasonable cost of conducting the checks.
(23) Beginning March 13, 2012, if If an applicant or licensee designee or person described in subsection (20) applies for a license or to renew a license to operate an adult foster care facility and he or she or the licensee designee previously underwent a criminal history check and criminal records check required under subsection (19) or under section 134a of the mental health code, 1974 PA 258, MCL 330.1134a, and has remained continuously licensed or continuously employed under section 34b or under section 20173a of the public health code, 1978 PA 368, MCL 333.20173a, after the criminal history check and criminal records check have been performed, that person is not required to submit to another criminal history check or criminal records check upon renewal of the license obtained under subsection (3).
(24) The department of state police shall must store and maintain all fingerprints submitted under this act in an automated fingerprint identification system database that provides for an automatic notification at the time of a subsequent criminal arrest fingerprint card submitted into the system that matches a set of fingerprints previously submitted in accordance with this act. Upon notification, the department of state police shall immediately notify the department and the department shall take the appropriate action.
(25) A licensee, licensee designee, owner, partner, or director of the licensee shall not be permitted on the premises of an adult foster care facility or have direct access to residents or resident records if he or she has been convicted of any of the following: adult abuse, neglect, or financial exploitation; or listed offenses as defined in section 2 of the sex offenders registration act, 1994 PA 295, MCL 28.722.
(26) An adult foster care family care home, an adult foster care large group home, or an adult foster care small group home shall not be concurrently licensed as a group child care home or a family child care home.
(27) In addition to the license renewal requirements under this section, the department must also consider the following when a licensee applies for renewal:
(a) The licensee's training plan for direct care staff and direct care staff's completion of that training and completion of mandated continuing education core classes as required in section 28c(1) and yearly competency tests.
(b) Successful completion of annual training and educational assessments by each of the direct care staff.
(c) Posting in a conspicuous area of the contact information for all agencies that investigate complaints regarding an adult foster care facility and contact information for adult protective services.
(d) The number of new and repeated violations since the last license renewal.
(e) Civil penalties and any late fines assessed by the department currently unpaid at the time of renewal.
(f) Any incomplete corrective action plan past the completion date. If so, the license may be renewed for a 3-month period, at which time the corrective action plan must be completed in order for the license to be renewed. If the corrective action plan is still incomplete at the end of the 3-month period, the license shall not be renewed.
(g) Resident satisfaction survey results from residents, residents' family, or a resident's designee.
(h) Interviews with residents and family councils where applicable.
(i) Staff satisfaction surveys.
(28) For the owner or licensee of 1 adult foster care group home or family home, the department may waive certain requirements if the department determines those requirements will cause the facility financial hardship.
(29) (27) As used in this section, "completed application" means an application complete on its face with all requested information provided and answers to all questions provided 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. A completed application does not include a health inspection performed by a local health department.
Sec. 24. (1) A person who believes that this act or a rule promulgated under this act may have been violated may request an investigation of an adult foster care facility. The request shall must be submitted to the department in writing or the department shall must assist the person in reducing an oral complaint to writing within 7 days after the oral request is made.
(2) The substance of the complaint shall must be provided to the licensee not earlier than at the commencement of the on-site inspection of the adult foster care facility that takes place according to the complaint.
(3) The complaint, a copy of the complaint, or a record published, released, or otherwise disclosed to the adult foster care facility shall not disclose the name of the complainant or an adult resident named in the complaint unless the complainant or an adult resident consents in writing to the disclosure or the investigation results in an administrative hearing or a judicial proceeding, or unless disclosure is considered essential to the investigation by the department. If disclosure is considered essential to the investigation, the complainant shall must be given the opportunity to withdraw the complaint before disclosure.
(4) Upon receipt of a complaint, the department shall determine, based on the allegations presented, whether this act or a rule promulgated under this act has been, is, or is in danger of being violated. The department shall investigate the complaint according to the urgency determined by the department. The initiation of a complaint investigation shall must commence within 15 days after receipt of the written complaint by the department.
(5) The department shall must inform the complainant of its findings. Within 30 days after the receipt of a complaint, the department shall must provide the complainant a copy, if any, of the written determination or a status report indicating when these documents may be expected. The final report shall must include a copy of the original complaint. The complainant may request additional copies of the documents listed in this subsection and shall must reimburse the department for the copies according to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(6) The department shall must inform the licensee of the department's findings at the same time that the department informs the complainant under subsection (5).
(7) A written determination concerning a complaint shall be available for public inspection, but the name of the complainant or adult resident shall not be disclosed without the complainant's or adult resident's or the resident's designee's consent.
(8) A complainant who is dissatisfied with the determination or investigation by the department may request an administrative review by the department. A request shall must be submitted in writing to the director within 30 days after the mailing of the department's findings as described in subsection (5). The administrative review shall be conducted based on pertinent documentation or a verifiable statement submitted in writing by the complainant. The department shall send the results of the administrative review to the complainant. If the administrative review results in reconsideration of a complaint against the adult foster care facility, the department shall must reopen the complaint investigation.
(9) Notwithstanding subsection (3) and sections 5 and 7(2) of the child protection law, 1975 PA 238, MCL 722.625 and 722.627, information or records in the possession of the department of health and human services or the department may be shared to the extent necessary for the proper functioning of the department of health and human services or the department in administering adult welfare or adult foster care licensing under this act or in an investigation conducted under section 43b of the social welfare act, 1939 PA 280, MCL 400.43b. Information or records shared under this subsection shall not be released by the department of health and human services or the department unless otherwise permitted under this act or other state or federal law.
(10) The department complaint process must include all of the following:
(a) A clear and concise overview of the complaint process, including how to file a complaint, the steps in the process, and information on how the complainant shall be kept informed on every step of the process.
(b) Escalation procedures if the complainant is not satisfied at any step of the process.
(c) The ability for a complainant to participate and give verbal input for each step of the complaint process, including the administrative review process.
(d) A complainant satisfaction survey at the completion or closure of a complaint or investigation, including the administrative review process.
(e) The appeals process for a complainant if the complainant is not satisfied with the outcome of an investigation.
Sec. 28. (1) A licensee must identify the facility as an adult foster care facility in all legal and marketing documents.
(2) Before a resident is admitted to an adult foster care facility, the licensee must inform the resident or the resident's designee, verbally and in a written copy that is signed by both the licensee and resident or the resident's designee, of all of the following:
(a) The facility's designation as an adult foster care facility governed by the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737, and the rules promulgated under this act. This notification must be made both in writing and verbally.
(b) The resident's rights and the right to file a complaint without intimidation, retaliation, or threat of retaliation. This notification must be made both in writing and verbally in a manner that is easily understandable and must be communicated in a language that is understood by the resident and the resident's designee.
(c) The facility's complaint policy, process, contact information, and website information for the following entities:
(i) The adult foster care facility's internal complaint department.
(ii) The local long-term care ombudsman.
(iii) The department's bureau of community and health systems.
(iv) The local law enforcement agency.
(d) All violations currently pending and cited against the adult foster care facility.
(e) The licensee's medication administration policy and standards.
(f) The staff-to-resident ratio.
(g) Information regarding staff training, education, and certification.
(3) Each adult foster care facility must establish and maintain a structured and documented internal complaint policy and process. This internal complaint policy and process must include all of the following:
(a) Designating a staff person who is responsible for receiving complaints and determining resolution of complaints.
(b) Investigating and resolving complaints. The adult foster care facility must respond in writing to a complainant within 7 business days after receiving the complaint.
(c) Maintaining a log of all complaints and resolutions of complaints. This log must be made available to the department at the time of its review of the adult foster care facility's next licensing renewal application.
Sec. 28a. (1) An adult foster care facility must meet all of the following staffing requirements:
(a) The facility administrator must be competent in the following areas:
(i) Knowledge of the physical, emotional, and mental health needs of the facility's residents being housed and cared for.
(ii) Knowledge of residents' rights.
(iii) Capable of developing training and education courses for direct care staff in order for them to understand the physical, emotional, mental, and social needs of the residents they are hired to serve.
(b) Maintain a licensed practical nurse on duty on the premises 24 hours per day, 5 days per week.
(c) Maintain a staff member on duty on the premises 24 hours per day, 7 days per week who holds a valid certification in cardiopulmonary resuscitation issued by the American Heart Association, American Red Cross, or a similar nationally recognized association.
(d) Maintain a social worker who is licensed, registered, or otherwise authorized under part 185 of the public health code, 1978 PA 368, MCL 333.18501 to 333.18518, on staff with a minimum availability for 1 hour per week for each resident.
(2) Except for a registered nurse, only a staff member who has successfully completed a department-approved diabetic continuing education course may administer an insulin injection.
Sec. 28b. (1) In addition to the rights, benefits, and privileges guaranteed by other provisions of law, the state constitution of 1963, and the Constitution of the United States, a resident has the rights guaranteed by this section unless otherwise restricted by law.
(2) The resident or the resident's designee must be provided with a written copy of the resident's rights described in this section and a written copy of the complaint process. The documents required under this subsection must be signed by both the resident or the resident's designee and an individual representing the adult foster care facility.
(3) A licensee must conspicuously post in an area of the adult foster care facility accessible to residents, employees, and visitors the resident's rights, the adult foster care facility's internal complaint process, and the contact information and website information for the entities listed in section 28(2)(c).
(4) A licensee must accept and respond to, without retaliation or threat of retaliation, an oral or written complaint from any source regarding an alleged violation of a resident's rights, quality of care, or any other matter.
(5) A licensee must conspicuously post on the premises contact information for all agencies that investigate complaints regarding an adult foster care facility and contact information for adult protective services.
(6) A resident or a resident's designee has the right to request meals be delivered to his or her room. A resident cannot be forced to accept or eat a meal in a dining room.
(7) A resident or a resident's designee must be given 60 days' notice before a new rule or update to a rule takes effect.
(8) A resident must not be deprived of his or her rights under this act. A waiver of a resident's rights is void and unenforceable. A resident's rights must not be used as a reward or sanction.
(9) An adult foster care facility must ensure a resident's physical, emotional, and mental health needs are met and that the resident is protected from Neglect and abuse, including physical abuse, mental abuse, verbal abuse, and sexual abuse. Additionally, the adult foster care facility must ensure that a resident's rights are protected.
(10) This section does not affect any right of a resident to damages under any other law.
(11) An adult foster care facility must ensure a resident is treated with dignity and respect.
Sec. 28c. (1) In addition to in-service training or on-the-job training, a direct care staff member, who is not a certified nurse assistant, must be educated to understand the physical and emotional needs of the population the direct care staff member is hired to serve by completing the following continuing education core classes within 90 days after the date of hire:
(a) Empathy and simulation of the aging process. The course must provide staff members with the experience of sensory challenges related to aging and the emotional challenges that come with the loss of independence, home, and relationships with family and friends. The preferred method of delivery for this course is in person. A direct care staff member must demonstrate comprehension by passing an examination related to the course content.
(b) Dignity and sensitivity. The course must include basic techniques for effectively and compassionately communicating with the elderly, including those experiencing hearing loss, dementia, or other issues that impair communication for the population being served, and how to handle and defuse difficult situations in a respectful manner. The preferred method of delivery for this course is in person. A direct care staff member must demonstrate comprehension by passing an examination related to the course content.
(c) Death and dying. The course must provide basic understanding of end-of-life issues and the impact on the resident, including appropriate behavior and communication with the resident and resident's family. The preferred method of delivery for this course is in person. A direct care staff member must demonstrate comprehension by passing an examination related to the course content.
(d) Resident rights. The course must instruct staff members on all rights granted to the resident. The preferred method of delivery for this course is in person. The staff member must demonstrate comprehension by passing an examination related to the course content.
(f) Understanding dementia. The course must instruct the staff member on the fundamentals of dementia, including how to recognize signs of dementia, effects on the resident, effective communication, and proper care standards of a resident with dementia. The preferred method of delivery for this course is in person. The staff member must demonstrate comprehension by passing an examination related to the course content.
(g) Identifying and reporting abuse, neglect, and exploitation. The preferred method of delivery for this course is in person.
(2) An adult foster care facility must conduct training assessments annually, separate from examinations given upon completion of a training or educational course to ensure that staff members recall what they learned during training and educational programs and are implementing this knowledge appropriately while providing care.
(3) A staff member shall not have unsupervised contact with a resident before completing the training and educational course requirements.
(4) A licensee must maintain a written training plan for all staff members and a record of all training and educational requirements that must be retained for a period of 3 years, including all of the following:
(a) The staff member's name and title.
(b) The date the course was taken and completed.
(c) The source of the course.
(d) The course name, instructor's name, instructor's qualifications, and course location.
(e) Documentation of successful completion of the course.
(5) Acceptable sponsors of the training required in this section include any of the following:
(a) Training offered by a nationally recognized or state-recognized health-related organization.
(b) Training offered by, or in conjunction with, a state or federal agency.
(c) Training obtained in an educational program that has been approved by any board created under article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838, except under part 188 of the public health code, 1978 PA 368, MCL 333.18801 to 333.18838, for initial licensure or registration or for the accumulation of continuing education credits.
(d) Training offered by an accredited college or university.
(e) Training offered by an organization specializing in diversity, equity, and inclusion issues.
(6) Acceptable modalities of the training required in this section include any of the following:
(a) A teleconference or webinar that allows live synchronous interaction that provides for the opportunity for participants to interact with the instructor and other participants.
(b) A live presentation that provides for the opportunity for participants to interact with the instructor and other participants.
(c) An asynchronous teleconference or webinar.
(7) After 1 year of employment at a facility, a direct care worker, who is not a certified nurse assistant, must annually complete an additional 8 hours of continuing education. The subject matter of the continuing education must address the unique needs of residents in an adult foster care facility.
Sec. 28d. (1) The department must create resident satisfaction surveys and staff surveys to be presented to residents and staff of an adult foster care facility.
(2) The resident satisfaction surveys described in subsection (1) must measure the following:
(a) Satisfaction with the facility's physical environment, including, but not limited to, the resident's room, dining facilities, and social gathering places.
(b) The staff's competency, kindness, and empathy.
(c) Whether the facility and staff are meeting the resident's physical and emotional needs.
(d) If the resident feels safe and cared for in the facility.
(e) If the resident feels respected and honored in the facility.
(f) Satisfaction with the quality of the facility's meals and snacks provided to the resident.
(g) Satisfaction with the quality and quantity of activities available to the resident.
(3) The staff surveys described in subsection (1) must measure the following:
(a) Whether the staff feels sufficiently trained or educated to care for residents.
(b) Whether staff feel supported by management.
(c) Staff's job satisfaction.
(d) Staff's challenges on the job.
(4) An adult foster care facility must present the resident satisfaction survey described in subsection (1) to each resident or resident designee annually and upon discharge from the adult foster care facility. A resident or resident designee must be able to complete the resident satisfaction survey anonymously.
(5) The adult foster care facility must present the staff surveys described in subsection (1) to staff on an annual basis. The staff must be allowed to complete the surveys anonymously.
(6) The adult foster care facility must maintain the surveys and make them available to the department for review upon license renewal. The adult foster care facility must maintain the surveys described in subsection (1) for a period of 3 years.
Sec. 28e. (1) Medication shall be administered only by licensed staff or, under the direction of the resident or resident's delegate, a certified nurse assistant. A certified nurse assistant may administer medication only if the certified nurse assistant has successfully completed a certified medication aide training program and passed the examination that meets the medication assistant certified model curriculum adopted by the National Council of State Boards of Nursing.
(2) Unlicensed staff may assist a resident with self-administration of medication only if both of the following occur:
(a) It is done under the direction of a registered nurse or licensed practical nurse.
(b) The unlicensed staff has completed all training and education requirements under this act and as required by the department.
Sec. 31. (1) Except as otherwise provided in section 13 or section 22, a person, adult foster care facility, agency, or representative or officer of a corporation, association, or organization who violates this act is guilty of a misdemeanor, punishable by imprisonment for not more than 1 year or a fine of not more than $1,000.00, or both.
(2) A person convicted of a misdemeanor under this act or under chapter XXA of the Michigan penal code, Act No. 328 of the Public Acts of 1931, being sections 750.145m to 750.145r of the Michigan Compiled Laws, 1931 PA 328, MCL 750.145m to 750.145r, shall not be involved with an adult foster care facility for a period of 5 years after the conviction in any of the following ways:
(a) Participate in the administration or operation of the facility.
(b) Have a financial interest in the operation of the facility.
(c) Provide care to residents of the facility.
(d) Have contact with residents or staff on the premises of the facility.
(e) Be employed by the facility.
(f) Reside in the facility.
(3) A person convicted of a felony under this act or under chapter XXA of Act No. 328 of the Public Acts of 1931 the Michigan penal code, 1931 PA 328, MCL 750.145m to 750.145r, shall not be involved with an adult foster care facility in any of the following ways:
(a) Participate in the administration or operation of the facility.
(b) Have a financial interest in the operation of the facility.
(c) Provide care to residents of the facility.
(d) Have contact with residents or staff on the premises of the facility.
(e) Be employed by the facility.
(f) Reside in the facility.
(4) The department may assess a civil penalty of not less than $500.00 and not more than $5,000.00 for each occurrence or act by the facility that does any of the following:
(a) Inflicts on the resident, willfully or not, physical harm or injury, emotional distress, or mental anguish.
(b) Violates a resident's rights.
(c) Fails to ensure the resident's safety or protection.
(d) Fails to ensure the resident is treated with dignity and respect.
(e) Neglects a resident.
(f) Abuses a resident physically, mentally, verbally, financially, or sexually.
(5) A facility may appeal a decision to impose a civil penalty under subsection (4). An appeal must be filed no later than 14 days after the civil penalty is assessed. A hearing for an appeal under this section must be conducted as a contested case under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328. Once an appeal has been heard, if the appeal determination upholds the assessed civil penalty, the facility must pay the civil penalty not later than 14 days after the date of the appeal determination.
(6) A civil penalty assessed under this section must be paid within 30 days after the date the civil penalty was assessed if an appeal has not been filed. If the civil penalty is not paid by the due date, a late fee of 1.5% shall be assessed for every day the payment is late. A licensee shall not avoid payment of a civil penalty by closing, selling, or otherwise transferring the license to a third party.
(7) Civil penalties and fees assessed by the department that are collected under this section shall be credited to the general fund of the state to be appropriated by the legislature to the department for the purpose of adequate staffing to conduct inspections that are either scheduled or resulting from a complaint and for managing and administering the civil penalty and appeals process.
(8) When a violation has been cited, a licensee must submit a specific, measurable, achievable realistic time-bound corrective action plan that does all of the following:
(a) Describes the issue that needs to be corrected.
(b) Establishes what caused the issue.
(c) Determines and implements action to prevent the issue from reoccurring.
(d) Provides a method for measuring compliance with and effectiveness of the corrective action plan.
(9) Not later than 30 days after the implementation date of the corrective action plan required under subsection (8), the department must follow up with the licensee. Failure of the licensee to comply with the corrective action plan within 30 days after the plan's implementation date shall result in an additional 10% fine of the amount described in subsection (1).
(10) Documentation of a violation, including special investigation reports, must remain on the licensee's record for public disclosure for at least 7 years.
