Bill Text: MI HB6022 | 2025-2026 | 103rd Legislature | Introduced
Bill Title: Mental health: other; authority for prescreening individuals for mental health services; modify. Amends (See bill).
Sponsorship: Slight Partisan Bill (Republican 4-2)
Status: (Introduced) 2026-06-10 - Recommendation Concurred In [HB6022 Detail]
Download: Michigan-2025-HB6022-Introduced.html
HOUSE BILL NO. 6022
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 100a, 400, 409, 410, 439, 464, 475, 482, 498e, 498f, 498h, 498l, 498p, and 972 (MCL 330.1100a, 330.1400, 330.1409, 330.1410, 330.1439, 330.1464, 330.1475, 330.1482, 330.1498e, 330.1498f, 330.1498h, 330.1498l, 330.1498p, and 330.1972), section 100a as amended by 2023 PA 118, section 400 as amended by 2018 PA 595, section 409 as amended by 2022 PA 214, sections 410, 475, and 482 as amended by 2018 PA 593, section 439 as amended and section 972 as added by 2020 PA 402, sections 464, 498f, 498l, and 498p as amended by 1995 PA 290, and sections 498e and 498h as amended by 2012 PA 540.
the people of the state of michigan enact:
Sec. 100a. (1) "Abilities" means the qualities, skills, and competencies of an individual that reflect the individual's talents and acquired proficiencies.
(2) "Abuse" means nonaccidental physical or emotional harm to a recipient, or sexual contact with or sexual penetration of a recipient as those terms are defined in section 520a of the Michigan penal code, 1931 PA 328, MCL 750.520a, that is committed by an employee or volunteer of the department, a community mental health services program, or a licensed hospital or by an employee or volunteer of a service provider under contract with the department, community mental health services program, or licensed hospital.
(3) "Adaptive skills" means skills in 1 or more of the following areas:
(a) Communication.
(b) Self-care.
(c) Home living.
(d) Social skills.
(e) Community use.
(f) Self-direction.
(g) Health and safety.
(h) Functional academics.
(i) Leisure.
(j) Work.
(4) "Adult foster care facility" means an adult foster care facility licensed under the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.
(5) "Alcohol and drug abuse counseling" means the act of counseling, modification of substance use disorder related behavior, and prevention techniques for individuals with substance use disorder, their the individuals' significant others, and individuals who could potentially develop a substance use disorder.
(6) "Applicant" means an individual or his or her the individual's legal representative who makes a request for mental health services.
(7) "Approved service program" means a substance use disorder services program licensed under part 62 of the public health code, 1978 PA 368, MCL 333.6230 to 333.6251, to provide substance use disorder treatment and rehabilitation services by the department-designated community mental health entity and approved by the federal government to deliver a service or combination of services for the treatment of incapacitated individuals.
(8) "Assisted outpatient treatment" or "AOT" means the categories of outpatient services ordered by the court under section 468 or 469a. Assisted outpatient treatment may include a case management plan and case management services to provide care coordination under the supervision of a psychiatrist and developed in accordance with person-centered planning under section 712. Assisted outpatient treatment may also include 1 or more of the following categories of services: medication; periodic blood tests or urinalysis to determine compliance with prescribed medications; individual or group therapy; day or partial day programming activities; vocational, educational, or self-help training or activities; assertive community treatment team services; alcohol or substance use disorder treatment and counseling and periodic tests for the presence of alcohol or illegal drugs for an individual with a history of alcohol abuse or substance use disorder; supervision of living arrangements; and any other services within a local or unified services plan developed under this act that are prescribed to treat the individual's mental illness and to assist the individual in living and functioning in the community or to attempt to prevent a relapse or deterioration that may reasonably be predicted to result in suicide, the need for hospitalization, or serious violent behavior. The medical review and direction included in an assisted outpatient treatment plan shall must be provided under the supervision of a psychiatrist.
(9) "Board" means the governing body of a community mental health services program.
(10) "Board of commissioners" means a county board of commissioners.
(11) "Center" means a facility operated by the department to admit individuals with developmental disabilities and provide habilitation and treatment services.
(12) "Certification" means formal approval of a program by the department in accordance with standards developed or approved by the department.
(13) "Child abuse" and "child neglect" mean those terms as defined in section 2 of the child protection law, 1975 PA 238, MCL 722.622.
(14) "Child and adolescent psychiatrist" means 1 or more of the following:
(a) A physician who has completed a residency program in child and adolescent psychiatry approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association, or who has completed 12 months of child and adolescent psychiatric rotation and is enrolled in an approved residency program as described in this subsection.
(b) A psychiatrist employed by or under contract as a child and adolescent psychiatrist with the department or a community mental health services program on March 28, 1996, who has education and clinical experience in the evaluation and treatment of children or adolescents with serious emotional disturbance.
(c) A psychiatrist who has education and clinical experience in the evaluation and treatment of children or adolescents with serious emotional disturbance who is approved by the director.
(15) "Children's diagnostic and treatment service" means a program operated by or under contract with a community mental health services program, that provides examination, evaluation, and referrals for minors, including emergency referrals, that provides or facilitates treatment for minors, and that has been certified by the department.
(16) "Community mental health authority" means a separate legal public governmental entity created under section 205 to operate as a community mental health services program.
(17) "Community mental health organization" means a community mental health services program that is organized under the urban cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 to 124.512.
(18) "Community mental health services program" means a program operated under chapter 2 as a county community mental health agency, a community mental health authority, or a community mental health organization.
(19) "Consent" means a written agreement executed by a recipient, a minor recipient's parent, a recipient's legal representative with authority to execute a consent, or a full or limited guardian authorized under the estates and protected individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, with the authority to consent, or a verbal agreement of a recipient that is witnessed and documented by an individual other than the individual providing treatment.
(20) "Contracted health plan" means that term as defined in section 106 of the social welfare act, 1939 PA 280, MCL 400.106.
(21) (20) "Conversion therapy" means any practice or treatment by a mental health professional that seeks to change an individual's sexual orientation or gender identity, including, but not limited to, efforts to change behavior or gender expression or to reduce or eliminate sexual or romantic attractions or feelings toward an individual of the same gender. Conversion therapy does not include counseling that provides assistance to an individual undergoing a gender transition, counseling that provides acceptance, support, or understanding of an individual or facilitates an individual's coping, social support, or identity exploration and development, including sexual orientation-neutral intervention to prevent or address unlawful conduct or unsafe sexual practices, as long as the counseling does not seek to change an individual's sexual orientation or gender identity. As used in this subsection:
(a) "Gender identity" means "gender identity or expression" as that term is defined in section 103 of the Elliott-Larsen civil rights act, 1976 PA 453, MCL 37.2103.
(b) "Sexual orientation" means that term as defined in section 103 of the Elliot-Larsen civil rights act, 1976 PA 453, MCL 37.2103.
(22) (21) "County community mental health agency" means an official county or multicounty agency created under section 210 that operates as a community mental health services program and that has not elected to become a community mental health authority or a community mental health organization.
(23) (22) "Crisis stabilization unit" means a prescreening unit established under section 409 or a facility certified under chapter 9A that provides unscheduled clinical services designed to prevent or ameliorate a behavioral health crisis or reduce acute symptoms on an immediate, intensive, and time-limited basis in response to a crisis situation.
(24) (23) "Department" means the department of health and human services.
(25) (24) "Department-designated community mental health entity" means the community mental health authority, community mental health organization, community mental health services program, county community mental health agency, or community mental health regional entity designated by the department to represent a region of community mental health authorities, community mental health organizations, community mental health services programs, or county community mental health agencies.
(26) (25) "Dependent living setting" means all of the following:
(a) An adult foster care facility.
(b) A nursing home licensed under part 217 of the public health code, 1978 PA 368, MCL 333.21701 to 333.21799e.
(c) A home for the aged licensed under part 213 of the public health code, 1978 PA 368, MCL 333.21301 to 333.21335.
(27) (26) "Designated representative" means any of the following:
(a) A registered nurse or licensed practical nurse licensed or otherwise authorized under part 172 of the public health code, 1978 PA 368, MCL 333.17201 to 333.17242.
(b) A paramedic licensed or otherwise authorized under part 209 of the public health code, 1978 PA 368, MCL 333.20901 to 333.20979.
(c) A physician's assistant licensed or otherwise authorized under part 170 or 175 of the public health code, 1978 PA 368, MCL 333.17001 to 333.17097 and 333.17501 to 333.17556.
(d) An individual qualified by education, training, and experience who performs acts, tasks, or functions under the supervision of a physician.
(28) (27) "Developmental disability" means either of the following:
(a) If applied to an individual older than 5 years of age, a severe, chronic condition that meets all of the following requirements:
(i) Is attributable to a mental or physical impairment or a combination of mental and physical impairments.
(ii) Is manifested before the individual is 22 years old.
(iii) Is likely to continue indefinitely.
(iv) Results in substantial functional limitations in 3 or more of the following areas of major life activity:
(A) Self-care.
(B) Receptive and expressive language.
(C) Learning.
(D) Mobility.
(E) Self-direction.
(F) Capacity for independent living.
(G) Economic self-sufficiency.
(v) Reflects the individual's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are of lifelong or extended duration and are individually planned and coordinated.
(b) If applied to a minor from birth to 5 years of age, a substantial developmental delay or a specific congenital or acquired condition with a high probability of resulting in developmental disability as defined in subdivision (a) if services are not provided.
(29) (28) "Director" means the director of the department or his or her the director's designee.
(30) (29) "Discharge" means an absolute, unconditional release of an individual from a facility by action of the facility or a court.
(31) (30) "Eligible minor" means an individual less than 18 years of age who is recommended in the written report of a multidisciplinary team under rules promulgated by the department of education to be classified as 1 of the following:
(a) Severely mentally impaired.
(b) Severely multiply impaired.
(c) Autistic impaired Impaired by autism spectrum disorder and receiving special education services in a program designed for the autistic impaired students with autism spectrum disorder under R 340.1758 of the Michigan Administrative Code or in a program designed for the severely mentally impaired or severely multiply impaired.
(32) (31) "Emergency situation" means a situation in which an individual is experiencing a serious mental illness or a developmental disability, or a minor is experiencing a serious emotional disturbance, and 1 of the following applies:
(a) The individual can reasonably be expected within the near future to physically injure himself, herself, the individual's self or another individual, either intentionally or unintentionally.
(b) The individual is unable to provide himself or herself the individual's self with food, clothing, or shelter or to attend to basic physical activities such as eating, toileting, bathing, grooming, dressing, or ambulating, and this inability may lead in the near future to harm to the individual or to another individual.
(c) The individual has mental illness that has impaired his or her the individual's judgment so that the individual is unable to understand his or her the individual's need for treatment and presents a risk of harm.
(33) (32) "Executive director" means an individual appointed under section 226 to direct a community mental health services program or his or her the executive director's designee.
Sec. 400. As used in this chapter, unless the context requires otherwise:
(a) "Clinical certificate" means the written conclusion and statements of a physician or a licensed psychologist that an individual is a person requiring treatment, together with the information and opinions, in reasonable detail, that underlie the conclusion, on the form prescribed by the department or on a substantially similar form.
(b) "Competent clinical opinion" means the clinical judgment of a physician, psychiatrist, or licensed psychologist.
(c) "Court" means the probate court or the court with responsibility with regard to responsible for mental health services for the county of residence of the subject of a petition, or for the county in which the subject of a petition was found.
(d) "Formal voluntary hospitalization" means hospitalization of an individual based on both of the following:
(i) The execution of an application for voluntary hospitalization by the individual or by a patient advocate designated under the estates and protected individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, to make mental health treatment decisions for the individual.
(ii) The hospital director's determination that the individual is clinically suitable for voluntary hospitalization.
(e) "Informal voluntary hospitalization" means hospitalization of an individual based on all of the following:
(i) The individual's request for hospitalization.
(ii) The hospital director's determination that the individual is clinically suitable for voluntary hospitalization.
(iii) The individual's agreement to accept treatment.
(f) "Involuntary mental health treatment" means court-ordered hospitalization, assisted outpatient treatment, or combined hospitalization and assisted outpatient treatment as described in section 468. For the purpose of this chapter, involuntary mental health treatment does not include a full or limited guardian authorized under the estates and protected individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, with the authority to consent to mental health treatment for an individual found to be a legally incapacitated individual under the estates and protected individuals code, 1998 PA 386, MCL 700.1101 to 700.8206.
(g) "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.
(h) "Preadmission screening unit" means a any of the following:
(i) A service component of a community mental health services program established under section 409.
(ii) A contracted health plan or a contracted health plan's delegate.
(i) "Private-pay patient" means a patient whose services and care are paid for from funding sources other than the community mental health services program, the department, or other state or county funding.
(j) "Release" means the transfer of an individual who is subject to an order of for combined hospitalization and assisted outpatient treatment from 1 treatment program to another in accordance with his or her individual the individual's plan of services.
(k) "Subject of a petition" means an individual regarding whom a petition has been filed with the court asserting that the individual is or is not a person requiring treatment or for whom an objection to involuntary mental health treatment has been made under section 484.
Sec. 409. (1) Each community mental health services program must and contracted health plan shall establish 1 or more preadmission screening units with 24-hour availability to provide assessment and screening services for individuals being considered for admission into hospitals, assisted outpatient treatment programs, or crisis services on a voluntary basis. The preadmission screening unit of a contracted health plan is solely responsible for assessment and screening services if the contracted health plan is or could be responsible for a covered service. A community mental health services program is responsible for all other admission services. The community mental health services program or contracted health plan shall employ mental health professionals or licensed bachelor's social workers licensed under part 185 of the public health code, 1978 PA 368, MCL 333.18501 to 333.18518, to provide the preadmission screening services or contract with another agency that meets the requirements of this section. Preadmission Except as otherwise provided in subsection (6), preadmission screening unit staff shall must be supervised by a registered professional nurse or other mental health professional possessing at least a master's degree.
(2) Each community mental health services program and contracted health plan shall provide the address and telephone number of its preadmission screening unit or units to law enforcement agencies, the department, the court, hospital emergency rooms, and private security companies under contract with a county under section 170.
(3) A Not later than 3 hours after receiving notice from a hospital, or from a hospital as that term is defined in section 20106 of the public health code, 1978 PA 368, MCL 333.20106, of the need to assess an individual being considered for admission into a hospital operated by the department or under contract with the community mental health services program, a preadmission screening unit shall assess an the individual. being considered for admission into a hospital operated by the department or under contract with the community mental health services program. If the individual is clinically suitable for hospitalization according to the preadmission screening unit's criteria, the preadmission screening unit shall authorize the individual's voluntary admission to the hospital.
(4) If a preadmission screening unit of a contracted health plan denies hospitalization, the individual or the person making the application may request a second opinion from the contracted health plan. The contracted health plan shall arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed not later than 3 days, excluding Sundays and legal holidays, after the contracted health plan receives the request. If the conclusion of the second opinion is different from the conclusion of the preadmission screening unit, the contracted health plan, in conjunction with the medical director of the contracted health plan, shall make a decision based on all clinical information available. The contracted health plan's decision must be confirmed in writing to the individual who requested the second opinion, and the confirming document must include the signature of the medical director of the contracted health plan or verification that the decision was made in conjunction with the medical director of the contracted health plan.
(5) (4) If the a preadmission screening unit of the a community mental health services program denies hospitalization of an individual, the individual or the person making the application may request a second opinion from the executive director. The executive director shall arrange for an additional evaluation of the individual by a psychiatrist, other physician, or licensed psychologist to be performed within not later than 3 days, excluding Sundays and legal holidays, after the executive director receives the request. If the conclusion of the second opinion is different from the conclusion of the preadmission screening unit, the executive director, in conjunction with the medical director, shall make a decision based on all clinical information available. The executive director's decision shall must be confirmed in writing to the individual who requested the second opinion, and the confirming document shall must include the signatures of the executive director and medical director or verification that the decision was made in conjunction with the medical director. If an individual is assessed and found not to be clinically suitable for hospitalization, the preadmission screening unit shall provide appropriate referral services.
(6) If a preadmission screening unit is unable to assess an individual not later than 3 hours after the notice described in subsection (3), a clinically qualified individual may assess the individual for the hospital, hospital as that term is defined in section 20106 of the public health code, 1978 PA 368, MCL 333.20106, community mental health services program, crisis stabilization unit, contracted health plan, or other entity under contract to perform the assessment and screening services under this act. The preadmission screening unit is responsible for the costs of performing an assessment under this subsection.
(7) Telehealth service, as that term is defined in section 16283 of the public health code, 1978 PA 368, MCL 333.16283, may be used to assess an individual described in this section.
(8) (5) If an individual is assessed and found not to be clinically suitable for hospitalization according to a preadmission screening unit's criteria, the preadmission screening unit shall provide information regarding alternative services and the availability of those services, provide appropriate referral services, and make appropriate referrals.
(9) (6) A preadmission screening unit shall assess and examine, or refer to a hospital for examination, an individual who is brought to the preadmission screening unit a facility by a peace officer or security transport officer or ordered by a court to be examined. If the individual meets the requirements for hospitalization, the preadmission screening unit shall designate the hospital to which the individual shall must be admitted. The preadmission screening unit shall consult with the individual and, if the individual agrees, the preadmission screening unit must shall consult with the individual's family member of choice, if available, as to the preferred hospital for the individual's admission. of the individual.Nothing prohibits a contracted health plan from directing care to a participating health facility. As used in this subsection, "participating health facility" means that term as it is defined in section 24504 of the public health code, 1978 PA 368, MCL 333.24504.
(10) (7) A preadmission screening unit may operate a crisis stabilization unit under chapter 9A. A preadmission screening unit may provide crisis services to an individual , who, by through assessment and screening, is found to be a person requiring treatment. Crisis services at a crisis stabilization unit must entail an initial psychosocial assessment by a master's level mental health professional and a psychiatric evaluation within 24 hours to stabilize the individual. In this event, crisis services may be provided for a period of up to 72 hours, after which the individual must be provided with the clinically appropriate level of care, resulting in 1 of the following:
(a) The A decision that the individual is no longer a person requiring treatment.
(b) A referral to outpatient services for aftercare treatment.
(c) A referral to a partial hospitalization program.
(d) A referral to a residential treatment center, including crisis residential services.
(e) A referral to an inpatient bed.
(f) An order for involuntary treatment of the individual has been issued under section 281b, 281c, former 433, or 434, or former section 433.
(11) (8) A preadmission screening unit operating a crisis stabilization unit under chapter 9A may also offer crisis services to an individual who is not a person requiring treatment, but who is seeking crisis services on a voluntary basis.
(12) (9) If the an individual chooses a hospital not under contract with a community mental health services program, and the hospital agrees to the individual's admission, the preadmission screening unit shall refer the individual to the hospital that is requested by the individual requests. Any financial obligation for the services provided by the hospital shall must be satisfied from funding sources other than the community mental health services program, the department, or other state or county funding, or a contracted health plan.
(13) The preadmission screening unit of a contracted health plan may engage in assessment and screening services before discharge, at the point of discharge, or post-discharge. Assessment and screening services include, but are not limited to, an evaluation of all of the following:
(a) Clinical risk factors.
(b) Medication adherence.
(c) Care transitions.
(d) Access to outpatient and community-based behavioral health services.
(e) Social determinants of health.
(f) Prior utilization of health care services.
(14) The preadmission screening unit of a contracted health plan may use the results of an assessment or screening services conducted under this section to authorize, arrange, or coordinate medically necessary post-discharge services, including, but not limited to, all of the following:
(a) Care management.
(b) Case management.
(c) Outpatient behavioral health services.
(d) Crisis services.
(e) Peer support.
(f) Medication management.
(g) Other covered services designed to reduce the likelihood of avoidable psychiatric readmission.
Sec. 410. Except as otherwise provided in section 402a, an individual who requests, applies for, or assents to either informal or formal voluntary admission to a hospital or outpatient treatment program operated by the department or a hospital or outpatient treatment program under contract with a community mental health services program may be considered for admission by the hospital or outpatient treatment program only after authorization by a community mental health services the applicable preadmission screening unit.
Sec. 439. (1) A cause of action is not cognizable against a person who that in good faith files a petition under this chapter alleging that an individual is a person requiring treatment, unless the petition is filed as the result of an act or omission amounting to gross negligence or willful and wanton misconduct.
(2) A cause of action is not cognizable against a preadmission screening unit or its the preadmission screening unit's employees or contractors, or a crisis stabilization unit or its the crisis stabilization unit's employees or contractors, or a contracted health plan or the contracted health plan's employees or contractors, who in good faith makes a determination as to whether an individual is a person requiring treatment, or not, unless the determination is the result of an act or omission amounting to gross negligence or willful and wanton misconduct.
Sec. 464. Copies of court orders issued pursuant to under this chapter shall must be given to the all of the following:
(a) The individual who is the subject of the order. ; to the
(b) If a guardian has been appointed for the individual who is the subject of the order, the individual's guardian. , if a guardian has been appointed; to the individual's
(c) The attorney of the individual who is the subject of the order. ; to the
(d) As applicable, either the executive director of the community mental health services program or the contracted health plan responsible for payment of the treatment of the individual who is the subject of the order. ; and to the
(e) The hospital director of any hospital in which the individual is or will be a patient.
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 or upon the individual's self or 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 for 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 of the following without a hearing and based upon on 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.
(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 for 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 a 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.
Sec. 482. Each individual subject to a 1-year order of involuntary mental health treatment has the right to adequate and prompt review of his or her current the individual's status as a person requiring treatment. Six months from the date of a 1-year order of involuntary mental health treatment, the executive director of the community mental health services program responsible for treatment, the contracted health plan responsible for payment of treatment, or, if private arrangements for the reimbursement of mental health treatment services have been made, the hospital director or director of the assisted outpatient treatment program shall assign a physician or licensed psychologist to review the individual's clinical status as a person requiring treatment.
Sec. 498e. (1) Except as provided in section 1074 2074 and section 18s of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.18s, a minor requesting hospitalization or for whom a request for hospitalization was is made shall must be evaluated to determine the minor's suitability for hospitalization according to under this section as soon as possible after the request is made.
(2) The Subject to subsection (3), the executive director of the community mental health services program that is responsible for providing services in the county of residence of a minor requesting hospitalization or for whom a request for hospitalization was is made shall evaluate the minor to determine his or her the minor's suitability for hospitalization according to this section. In making a determination of a minor's suitability for hospitalization, the executive director shall utilize use the community mental health services program's children's diagnostic and treatment service. If a children's diagnostic and treatment service does not exist in the community mental health services program, the executive director shall, through written agreement, arrange to have a determination made by the children's diagnostic and treatment service of another community mental health services program, or by the appropriate hospital.
(3) If a minor is covered by a contracted health plan, the contracted health plan shall evaluate the minor using the contracted health plan's criteria to determine the minor's suitability for hospitalization under this section.
(4) (3) In evaluating a minor's suitability for hospitalization, the executive director or contracted health plan shall do all of the following:
(a) Determine both of the following:
(i) Whether the minor is a minor requiring treatment.
(ii) Whether the minor requires hospitalization and is expected to benefit from hospitalization.
(b) Determine whether there is an appropriate, available alternative to hospitalization, and if there is, refer the minor to that program.
(c) Consult with the appropriate school, hospital, and other public or private agencies.
(d) If the minor is determined to be suitable for hospitalization under subdivision (a), refer the minor to the appropriate hospital.
(e) If the minor is determined not to be suitable for hospitalization under subdivision (a), determine if the minor needs mental health services. If it the minor is determined that the minor needs to need mental health services, the executive director or contracted health plan shall offer an appropriate treatment program for the minor, if the program is available, or refer the minor to any other appropriate agency for services.
(f) If a minor is assessed and found not to be clinically suitable for hospitalization, the executive director or contracted health plan shall inform the individual or individuals requesting hospitalization of the minor of appropriate available alternative services to which a referral should be made and of the process for a request of requesting a second opinion under subsection (4).(5) or (6).
(5) (4) If the children's diagnostic and treatment service of the community mental health services program denies hospitalization, the parent or guardian of the minor may request a second opinion from the executive director. The executive director shall arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed within not later than 3 days, excluding Sundays and legal holidays, after the executive director receives the request. If the conclusion of the second opinion is different from the conclusion of the children's diagnostic and treatment service, the executive director, in conjunction with the medical director, shall make a decision based on all clinical information available. The executive director's decision shall must be confirmed in writing to the individual who requested the second opinion, and the confirming document shall must include the signatures of the executive director and medical director or verification that the decision was made in conjunction with the medical director.
(6) If the contracted health plan denies hospitalization, the parent or guardian of the minor may request a second opinion from the contracted health plan. The contracted health plan shall arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed not later than 3 days, excluding Sundays and legal holidays, after the contracted health plan receives the request. If the conclusion of the second opinion is different from the conclusion of the contracted health plan, the contracted health plan, in conjunction with the medical director of the contracted health plan, shall make a decision based on all clinical information available. The contracted health plan's decision must be confirmed in writing to the individual who requested the second opinion, and the confirming document must include the signature of the medical director of the contracted health plan or verification that the decision was made in conjunction with the medical director of the contracted health plan.
(7) (5) If a minor has been admitted to a hospital not operated by or under contract with the department, or a community mental health services program, or contracted health plan, as applicable, and the hospital considers it necessary to transfer the minor to a hospital under contract with a community mental health services program, or contracted health plan, as applicable, the hospital shall submit an application for transfer to the appropriate community mental health services program, or contracted health plan, as applicable. The executive director or contracted health plan shall determine if there is an appropriate, available alternative to hospitalization of the minor. If the executive director or contracted health plan determines that there is an appropriate, available alternative program, the minor shall must be referred to that program. If the executive director or contracted health plan determines that there is not an appropriate, alternative program, the minor shall must be referred to a hospital under contract with the community mental health services program or contracted health plan, as applicable.
(8) (6) Except as provided in subsections (1), and (5), (3), (6), and (7) this section only applies to hospitals operated under contract with a community mental health services program.
Sec. 498f. If a minor is referred to a hospital by an executive director pursuant to or contracted health plan under section 498e, the hospital director may accept the referral and admit the minor, or the hospital director may order an examination of the minor to confirm the minor's suitability for hospitalization. The examination shall must begin immediately. If the hospital director confirms the minor's suitability for hospitalization, the minor shall must be scheduled for admission to the hospital. If the minor cannot be admitted immediately because of insufficient space in the hospital, the minor shall must be placed on a waiting list and the executive director shall provide necessary interim services, including periodic reassessment of the minor's suitability for hospitalization. The minor may be referred to another hospital. If the hospital director does not confirm the minor's suitability for hospitalization, the minor shall must be referred to the executive director or contracted health plan, who shall offer an appropriate treatment plan for the minor or refer the minor to any other agency for services.
Sec. 498h. (1) Except as provided in section 1074 2074 and section 18s of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.18s, a minor's parent, guardian, or person in loco parentis may request emergency admission of the minor to a hospital, if the person making the request has reason to believe that the minor is a minor requiring treatment and that the minor presents a serious danger to the minor's self or others.
(2) If a minor is covered by a contracted health plan, a request for emergency admission to a hospital must be made to the contracted health plan's preadmission screening unit. If the contracted health plan's preadmission screening unit determines that emergency admission to a hospital is not necessary, the person making the request may request hospitalization of the minor under section 498d. If the preadmission screening unit determines that emergency admission to a hospital is necessary, the minor must be hospitalized or placed in an appropriate alternative program.
(3) (2) If the For a request for emergency admission not subject to subsection (2), if a hospital to which the request for emergency admission is made is not under contract to the a community mental health services program, the request for emergency hospitalization shall admission must be made directly to the hospital. If the hospital director agrees that the minor needs requires emergency admission, the minor shall must be hospitalized. If the hospital director does not agree, the person making the request may request hospitalization of the minor under section 498d.
(4) (3) If the For a request for emergency admission not subject to subsection (2), if a hospital to which the a request for emergency admission is made is under contract to the community mental health services program, the request shall must be made to the preadmission screening unit of the community mental health services program serving in the county where the minor resides. If the community mental health services program has a children's diagnostic and treatment service, the preadmission screening unit shall refer the person making the request to that service. In counties where there is no children's diagnostic and treatment service, the preadmission screening unit shall refer the person making the request to the appropriate hospital. If it is determined that emergency admission is not necessary, the person may request hospitalization of the minor under section 498d. If it is determined that emergency admission is necessary, the minor shall must be hospitalized or placed in an appropriate alternative program.
(5) (4) If a preadmission screening unit assesses a minor is assessed by the preadmission screening unit and found finds that the minor is not to be clinically suitable for hospitalization, the preadmission screening unit shall inform the individual or individuals requesting hospitalization of the minor of appropriate available alternative services to which a referral should be made and of the process for a request of a second opinion under subsection (5).(6) or (7).
(6) If a preadmission screening unit of a contracted health plan denies hospitalization, a minor's parent or guardian may request a second opinion from the contracted health plan. The contracted health plan shall arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed not later than 3 days, excluding Sundays and legal holidays, after the contracted health plan receives the request. If the conclusion of the second opinion is different from the conclusion of the preadmission screening unit, the contracted health plan, in conjunction with the medical director of the contracted health plan, shall make a decision based on all clinical information available. The contracted health plan's decision must be confirmed in writing to the individual who requested the second opinion, and the confirming document must include the signatures of the contracted health plan and medical director of the contracted health plan or verification that the decision was made in conjunction with the medical director of the contracted health plan.
(7) (5) If the a preadmission screening unit of the a community mental health services program denies hospitalization, a minor's parent or guardian may request a second opinion from the executive director. The executive director shall arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed within not later than 3 days, excluding Sundays and legal holidays, after the executive director receives the request. If the conclusion of the second opinion is different from the conclusion of the preadmission screening unit, the executive director, in conjunction with the medical director, shall make a decision based on all clinical information available. The executive director's decision shall must be confirmed in writing to the individual who requested the second opinion, and the confirming document shall must include the signatures of the executive director and medical director or verification that the decision was made in conjunction with the medical director.
(8) (6) If a person in loco parentis makes a request for emergency admission and the minor is admitted to a hospital under this section, the hospital director or the executive director of the community mental health services program immediately shall immediately notify the minor's parent or parents or guardian.
(9) (7) If a minor is hospitalized in a hospital that is operated under contract with a community mental health services program, the hospital director shall notify the appropriate executive director within not later than 24 hours after the hospitalization occurs.
(10) (8) If a peace officer, as a result of personal observation, has reasonable grounds to believe that a minor is a minor requiring treatment and that the minor presents a serious danger to the minor's self or others and if after a reasonable effort to locate the minor's parent, guardian, or person in loco parentis, the minor's parent, guardian, or person in loco parentis cannot be located, the peace officer may take the minor into protective custody and transport the minor to a facility, to the appropriate community mental health preadmission screening unit, if the community mental health services program has a children's diagnostic and treatment service, or to a hospital if it the community mental health services program does not have a children's diagnostic and treatment service. After transporting the minor, the peace officer shall execute a written request for emergency hospitalization of the minor stating the reasons, based upon on personal observation, that the peace officer believes that emergency hospitalization is necessary. The written request shall must include a statement that a reasonable effort was made by the peace officer to locate the minor's parent, guardian, or person in loco parentis. If it is determined that emergency hospitalization of the minor is not necessary, the minor shall must be returned to his or her the minor's parent, guardian, or person in loco parentis if an additional attempt to locate the parent, guardian, or person in loco parentis is successful. If the minor's parent, guardian, or person in loco parentis cannot be located, the minor shall must be turned over to the protective services program of the family independence agency. If it is determined that emergency admission of the minor is necessary, the minor shall must be admitted to the appropriate hospital or to an appropriate alternative program. The executive director immediately shall immediately notify the minor's parent, guardian, or person in loco parentis. If the hospital is under contract with the community mental health services program, the hospital director shall notify the appropriate executive director within not later than 24 hours after the hospitalization occurs.
(11) (9) An evaluation of a minor admitted to a hospital under this section shall must begin immediately after the minor is admitted. The evaluation shall must be conducted in the same manner as provided in section 498e. If the minor is not found to be suitable for hospitalization, the minor shall must be released into the custody of his or her the minor's parent, guardian, or person in loco parentis, and the minor shall must be referred to the executive director who shall determine if the minor needs mental health services. If it is determined the executive director determines that the minor needs mental health services, the executive director shall offer an appropriate treatment program for the minor, if the program is available, or refer the minor to another agency for services.
(12) (10) A hospital director shall proceed under either the estates and protected individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, or chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.1 to 712A.32, as warranted by the situation and the best interests of the minor, under any of the following circumstances:
(a) The hospital director cannot locate a parent, guardian, or person in loco parentis of a minor admitted to a hospital under subsection (8).(10).
(b) The hospital director cannot locate the parent or guardian of a minor admitted to a hospital by a person in loco parentis under this section.
Sec. 498l. (1) Not more than 90 days after the admission of a minor to a hospital pursuant to under this chapter, and at 60-day intervals after the expiration of the 90-day period, the hospital director of the hospital shall perform or arrange to have performed a review of the minor's suitability for hospitalization. If the minor is in a hospital under contract with a community mental health services program, the executive director shall participate in the reviews. If a minor is covered by a contracted health plan, the contracted health plan shall participate in the reviews.
(2) Subject to section 114a, the reviews of the minor's suitability for continued hospitalization shall must be conducted under rules promulgated by the department. Results of the reviews shall must be transmitted promptly to all of the following:
(a) The minor, if the minor is 14 years of age or older.
(b) The parent, guardian, or person in loco parentis of the minor.
(c) The As applicable, the executive director or the contracted health plan.
(d) The court, if there was a court hearing on the admission of the minor.
Sec. 498p. (1) Upon On periodic review of a hospitalized minor under section 498 l, 498l, or at any other time, if it is determined that the minor is no longer suitable for hospitalization, the hospital director of the hospital shall discharge the minor from the hospital.
(2) If a minor discharged under subsection (1) has been hospitalized under a court order, or if court proceedings are pending, the court shall must be notified of the minor's discharge from the hospital.
(3) The director of a hospital director shall notify the appropriate executive director or contracted health plan of the pending discharge of a minor not less than 7 days before the minor is discharged from the hospital.
(4) Before a minor is discharged from a hospital under subsection (1), the executive director or contracted health plan, with the assistance of the hospital, shall develop an individualized prerelease plan for the minor in accordance with section 209a.
(5) If the parent or guardian of a minor admitted to a hospital under this chapter refuses to assume custody of the minor upon on discharge of the minor from the hospital, the hospital director shall file or cause to be filed a petition in the juvenile division of the probate court alleging that the minor is within the provisions of subject to section 2(b) of chapter XIIA of Act No. 288 of the Public Acts of 1939, being section the probate code of 1939, 1939 PA 288, MCL 712A.2, of the Michigan Compiled Laws, to ensure that the minor is provided with appropriate management, care, and residence. Arrangements considered suitable by the hospital director and agreed to by the parent or guardian for care of the minor outside the home of the parent or guardian do not constitute a refusal to assume custody of the minor.
Sec. 972. The department shall establish minimum standards and requirements for certifying a crisis stabilization unit. Standards These standards and requirements must include, but are not limited to, all of the following:
(a) A standard requiring the capacity to carry out emergency receiving and evaluating functions but not to the extent that brings the crisis stabilization unit under the provisions of section 1867 of the social security act, 42 USC 1395dd.
(b) Standards requiring the implementation of voluntary and involuntary admission consistent with section 409.
(c) A prohibition from holding itself the crisis stabilization unit out as a hospital or from billing for hospital or inpatient services.
(d) Standards to prevent inappropriate referral between entities of common ownership.
(e) Standards regarding the maximum length of stay at a crisis stabilization unit with discharge planning upon on intake to a clinically appropriate level of care consistent with section 409(7).409(10).
(f) Standards of billing for services rendered at a crisis stabilization unit.
(g) Standards for reimbursement of services for uninsured individuals, underinsured individuals, or both, and Medicaid beneficiaries, including, but not limited to, formal agreements with community mental health services programs or regional entities for services provided to individuals utilizing public behavioral health funds, outreach and enrollment for eligible health coverage, annual rate setting, proper communication with payers, and methods for resolving billing disputes between providers and payers.
(h) Physician oversight requirements.
(i) Nursing services.
(j) Staff to client ratios.
(k) Standards requiring a minimum amount of psychiatric supervision of an individual receiving services in the crisis stabilization unit that are consistent with the supervision requirements applicable in to a psychiatric hospital or psychiatric unit setting.
(l) Standards requiring the implementation and posting of recipients' rights under chapter 7.
(m) Safety and emergency protocols.
(n) Pharmacy services.
(o) Standards addressing administration of medication.
(p) Standards for reporting to the department.
(q) Standards regarding a departmental complaint process and procedure affording patients the right to file complaints for failure to provide services in accordance with required certification standards. The complaint process and procedure must be established and maintained by the department, must remain separate and distinct from the providers delivering services under this chapter, and must not be a function delegated to a community mental health services program or an entity under contract with a community mental health services program. The complaint process must provide for a system of appeals and administrative finality.
