Bill Text: MI HB5353 | 2021-2022 | 101st Legislature | Introduced
Bill Title: Mental health: other; revisions to the Michigan crisis and access line; provide for. Amends secs. 100b, 100c & 100d of 1974 PA 258 (MCL 330.1100b et seq.) & adds secs. 166, 166a, 166b & 166c. TIE BAR WITH: HB 5354'21
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2021-10-05 - Bill Electronically Reproduced 09/30/2021 [HB5353 Detail]
Download: Michigan-2021-HB5353-Introduced.html
HOUSE BILL NO. 5353
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 100b, 100c, and 100d (MCL 330.1100b, 330.1100c, and 330.1100d), section 100b as amended by 2020 PA 402, section 100c as amended by 2020 PA 285, and section 100d as amended by 2020 PA 99, and by adding sections 166, 166a, 166b, and 166c.
the people of the state of michigan enact:
Sec. 100b. (1) Except as otherwise provided in this subsection, "facility" means a residential facility for the care or treatment of individuals with serious mental illness, serious emotional disturbance, or developmental disability that is either a state facility or a licensed facility. Facility includes a preadmission screening unit established under section 409 that is operating a crisis stabilization unit.
(2) "Family" as used in sections 156 to 161 means an eligible minor and his or her parent or legal guardian.
(3) "Family member" means a parent, stepparent, spouse, sibling, child, or grandparent of a primary consumer, or an individual upon whom a primary consumer is dependent for at least 50% of his or her financial support.
(4) "Federal funds" means funds received from the federal government under a categorical grant or similar program and does not include federal funds received under a revenue sharing arrangement.
(5) "Functional impairment" means both of the following:
(a) With regard to serious emotional disturbance, substantial interference with or limitation of a minor's achievement or maintenance of 1 or more developmentally appropriate social, behavioral, cognitive, communicative, or adaptive skills.
(b) With regard to serious mental illness, substantial interference or limitation of role functioning in 1 or more major life activities including basic living skills such as eating, bathing, and dressing; instrumental living skills such as maintaining a household, managing money, getting around the community, and taking prescribed medication; and functioning in social, vocational, and educational contexts.
(6) "Guardian" means a person appointed by the court to exercise specific powers over an individual who is a minor, legally incapacitated, or developmentally disabled.
(7) "Hospital" or "psychiatric hospital" means an inpatient program operated by the department for the treatment of individuals with serious mental illness or serious emotional disturbance or a psychiatric hospital or psychiatric unit licensed under section 137.
(8) "Hospital director" means the chief administrative officer of a hospital or his or her designee.
(9) "Hospitalization" or "hospitalize" means to provide treatment for an individual as an inpatient in a hospital.
(10) "Incapacitated" means that an individual, as a result of the use of alcohol or other drugs, is unconscious or has his or her mental or physical functioning so impaired that he or she either poses an immediate and substantial danger to his or her own health and safety or is endangering the health and safety of the public.
(11) "Individual plan of services" or "plan of services" means a written individual plan of services developed with a recipient as required by section 712.
(12) "Individual representative" means a recipient's legal guardian, minor recipient's parent, or other person authorized by law to represent the recipient in decision-making related to the recipient's services and supports.
(13) "Intellectual disability" means a condition manifesting before the age of 18 years that is characterized by significantly subaverage intellectual functioning and related limitations in 2 or more adaptive skills and that is diagnosed based on the following assumptions:
(a) Valid assessment considers cultural and linguistic diversity, as well as differences in communication and behavioral factors.
(b) The existence of limitation in adaptive skills occurs within the context of community environments typical of the individual's age peers and is indexed to the individual's particular needs for support.
(c) Specific adaptive skill limitations often coexist with strengths in other adaptive skills or other personal capabilities.
(d) With appropriate supports over a sustained period, the life functioning of the individual with an intellectual disability will generally improve.
(14) "Licensed facility" means a facility licensed by the department under section 137 or an adult foster care facility.
(15) "Licensed psychologist" means a doctoral level psychologist licensed under section 18223(1) of the public health code, 1978 PA 368, MCL 333.18223.
(16) "Mediation" means a confidential process in which a neutral third party facilitates communication between parties, assists in identifying issues, and helps explore solutions to promote a mutually acceptable resolution. A mediator does not have authoritative decision-making power.
(17) "Medicaid" means the program of medical assistance established under section 105 of the social welfare act, 1939 PA 280, MCL 400.105.
(18) "Medical director" means a psychiatrist appointed under section 231 to advise the executive director of a community mental health services program.
(19) "Mental health professional" means an individual who is trained and experienced in the area of mental illness or developmental disabilities and who is 1 of the following:
(a) A physician.
(b) A psychologist.
(c) A registered professional nurse licensed or otherwise authorized to engage in the practice of nursing under part 172 of the public health code, 1978 PA 368, MCL 333.17201 to 333.17242.
(d) A licensed master's social worker licensed or otherwise authorized to engage in the practice of social work at the master's level under part 185 of the public health code, 1978 PA 368, MCL 333.18501 to 333.18518.
(e) A licensed professional counselor licensed or otherwise authorized to engage in the practice of counseling under part 181 of the public health code, 1978 PA 368, MCL 333.18101 to 333.18117.
(f) A marriage and family therapist licensed or otherwise authorized to engage in the practice of marriage and family therapy under part 169 of the public health code, 1978 PA 368, MCL 333.16901 to 333.16915.
(20) "Minor" means an individual under the age of 18 years.
(21) "Mobile crisis team" or "MCT" includes a behavioral health professional or peer who provides professional on-site community-based intervention including, but not limited to, de-escalation and stabilization for an individual who is experiencing a behavioral health crisis.
(22) (21) "Multicultural services" means specialized mental health services for multicultural populations such as African-Americans, Hispanics, Native Americans, Asian and Pacific Islanders, and Arab/Chaldean-Americans.
(23) "National Suicide Prevention Lifeline" or "NSPL" means a national network of local crisis centers providing free and confidential emotional support to individuals in suicidal crisis or emotional distress 24 hours a day, 7 days a week. Membership as an NSPL center requires nationally recognized certification that includes evidence-based training for all staff and volunteers in managing calls.
(24) (22) "Neglect" means an act or failure to act committed by an employee or volunteer of the department, a community mental health services program, or a licensed hospital; a service provider under contract with the department, a community mental health services program, or a licensed hospital; or an employee or volunteer of a service provider under contract with the department, a community mental health services program, or a licensed hospital, that denies a recipient the standard of care or treatment to which he or she is entitled under this act.
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 preventing and detecting crime and enforcing the criminal laws of this state. For the purposes of sections 408, 426, 427a, and 427b, peace officer also includes an officer of the United States Secret Service with the officer's consent and a police officer of the Veterans' Administration Medical Center Reservation.
(2) "Peer" means an individual employed based on his or her personal lived experience of mental illness or addiction and recovery who meets this state's peer certification requirements where applicable.
(3) (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.
(4) (3) "Person requiring treatment" means an individual who meets the criteria described in section 401.
(5) (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 333.17097, 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.
(6) (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.
(7) (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.
(8) (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.
(9) (8) "Psychiatric residential treatment facility" or "PRTF" means a facility other than a hospital that provides psychiatric services, as described in 42 CFR 441.151 to 441.182, 441.184, in an inpatient setting to individuals under age 21.
(10) (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.
(11) (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, 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.
(12) (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.
(13) (12) "Public patient" means an individual approved for mental health services by a community mental health services program. Public patient includes an individual who is admitted as a patient under section 423, 429, or 438.
(14) (13) "Recipient" means an individual who receives mental health services, either in person or through telemedicine, 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.
(15) (14) "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.
(16) (15) "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.
(17) (16) "Regional entity" means an entity established under section 204b to provide specialty services and supports.
(18) (17) "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.
(19) (18) "Resident" means an individual who receives services in a facility.
(20) (19) "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.
(21) (20) "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 published by the American 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.
(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 published by the American 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.
(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 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 recipient's residence, 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.of those.
(11) "Substance abuse and mental health services administration" or "SAMHSA" means the agency within the United States Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.
(12) (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.
(13) (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.
(14) (13) "Substance use disorder treatment and rehabilitation services" means providing identifiable recovery-oriented services including the following:
(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.
(15) (14) "Supplemental security income" means the program authorized under title XVI of the social security act, 42 USC 1381 to 1383f.
(16) (15) "Telemedicine" means the use of an electronic media to link patients with health care professionals in different locations. To be considered telemedicine under this section, the health care professional must be able to examine the patient via a health insurance portability and accountability act of 1996, Public Law 104-191 compliant, secure interactive audio or video, or both, telecommunications system, or through the use of store and forward online messaging.
(17) (16) "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.
(18) (17) "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.
(19) (18) "Treatment" means care, diagnostic, and therapeutic services, including administration of drugs, and any other service for treatment of an individual's serious mental illness, serious emotional disturbance, or substance use disorder.
(20) (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.
(21) "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. 166. The Michigan crisis and access line is designated as the state's crisis hotline center to provide crisis intervention services and crisis care coordination to individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline from any jurisdiction 24 hours a day, 7 days a week.
Sec. 166a. (1) The Michigan crisis and access line must have an active agreement with the administrator of the National Suicide Prevention Lifeline to participate within the network.
(2) The Michigan crisis and access line must meet the National Suicide Prevention Lifeline requirements and best practices guidelines for operational and clinical standards.
(3) The Michigan crisis and access line must provide data to, report to, and participate in evaluations and related quality improvement activities as required by the 9-8-8 administrator. As used in this subsection, "9-8-8 administrator" means the administrator of the 9-8-8 suicide prevention and mental health crisis hotline.
(5) The department shall promulgate rules to allow appropriate information crisis and emergency response systems for the purpose of real-time crisis care coordination, including, but not limited to, deployment of crisis and outgoing services and linked, flexible services specific to crisis response.
(6) The Michigan crisis and access line may deploy crisis and outgoing services, including mobile crisis teams, and coordinate access to crisis stabilization units or other local resources as appropriate and according to guidelines and best practices established by the National Suicide Prevention Lifeline.
(7) The Michigan crisis and access line must actively collaborate with mental health and substance use disorder treatment providers, including hospital emergency departments and inpatient psychiatric settings, prepaid inpatient health plans, community mental health services programs, certified community behavioral health clinics, crisis stabilization units, and mobile crisis teams throughout this state, to coordinate linkages for individuals contacting the 9-8-8 suicide prevention and behavioral health crisis hotline with ongoing care needs, establishing formal agreements when appropriate. The Michigan crisis and access line shall coordinate access to crisis stabilization units for individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline through appropriate information sharing regarding availability of services.
(8) The department, having primary oversight over suicide prevention and crisis service activities, including the suicide prevention and behavioral health crisis hotline, must work in concert with the National Suicide Prevention Lifeline and the Veterans Crisis Line networks for the purposes of ensuring consistency of public messaging about 9-8-8 services.
(9) The Michigan crisis and access line must meet the requirements set forth by the National Suicide Prevention Lifeline for serving high-risk and specialized populations as identified by the substance abuse and mental health services administration, including training requirements and policies for transferring the callers to an appropriate specialized center or subnetworks within or external to the National Suicide Prevention Lifeline network. This shall include, but is not limited to, minorities, rural individuals, and other high-risk populations as well as those with co-occurring substance use, and providing linguistically and culturally competent care.
(10) The Michigan crisis and access line must provide follow-up services to individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline consistent with guidance and policies established by the National Suicide Prevention Lifeline.
(11) The department must provide an annual report of the 9-8-8 suicide prevention and behavioral health crisis hotline's usage and services to the legislature and the substance abuse and mental health services administration.
Sec. 166b. The department shall provide and fund, directly or through contract, on-site response services to crisis calls utilizing state-funded, locally funded, or both, mobile crisis teams as specified in department policy and rules. Mobile crisis teams must meet the following minimum requirements:
(a) The composition of the mobile crisis teams must be as follows:
(i) Designed in partnership with community members, including people with lived experience utilizing crisis services.
(ii) Be comprised of either community-based behavioral health teams including licensed behavioral health professionals and including peers, or behavioral health teams embedded in emergency medical services and including peers.
(iii) Be staffed by personnel who reflect the demographics of the community served.
(iv) Include police as co-responders in behavioral health teams with licensed behavioral health professionals and peers, only as needed to respond in high-risk situations that cannot be managed without law enforcement.
(b) Collaborate with local law enforcement agencies, hospitals, emergency departments, and providers of behavioral health services.
(c) Collect customer service data from individuals served by demographic requirements, including race and ethnicity, set forth by the substance abuse and mental health services administration and consistent with the state block grant requirements for continuous evaluation and quality improvement.
Sec. 166c. (1) The department shall fund treatment for crisis stabilization and crisis stabilization units using money from the fund created in the 9-8-8 suicide prevention and mental health crisis hotline fund act according to the following:
(a) For Medicaid recipients, the fund shall be used to cover the state share of Medicaid-funded mobile crisis team services and crisis stabilization unit services. The department must seek and maximize available federal financial participation for Medicaid services.
(b) For an uninsured individual, or if the crisis stabilization service is not a covered service by the individual's health coverage or a third-party payer, the fund shall be used to offset the cost of mobile crisis team services and crisis stabilization unit services only after the department exhausts all other allowable non-Medicaid federal funding for mobile crisis team services and crisis stabilization unit costs and services, including, but not limited to, the crisis set-aside expenditure requirements of the substance abuse and mental health services administration mental health and substance abuse block grant.
(2) The state must determine how payment will be made to the provider of service.
Enacting section 1. This amendatory act does not take effect unless Senate Bill No.____ or House Bill No. 5354 (request no. 04111'21) of the 101st Legislature is enacted into law.
