HOUSE BILL No. 5827 April 9, 2002, Introduced by Reps. Bernero, George, Raczkowski, Vander Veen, Van Woerkom and Lemmons and referred to the Committee on Health Policy. A bill to amend 1974 PA 258, entitled "Mental health code," (MCL 330.1001 to 330.2106) by adding sections 369, 371, 373, 375, 377, 379, 381, 383, 385, 387, 389, 391, 393, 395, and 397. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 369. (1) THE COURT SHALL NOT ORDER ASSISTED OUTPATIENT 2 TREATMENT UNLESS AN EXAMINING PHYSICIAN OR LICENSED PSYCHOLOGIST 3 APPOINTED BY THE ASSISTED OUTPATIENT TREATMENT PROGRAM DIRECTOR 4 DEVELOPS AND PROVIDES TO THE COURT A PROPOSED WRITTEN TREATMENT 5 PLAN. THE PROPOSED TREATMENT PLAN SHALL INCLUDE CASE MANAGEMENT 6 SERVICES OR ASSERTIVE COMMUNITY TREATMENT TEAMS TO PROVIDE CARE 7 COORDINATION. 8 (2) IF A PROPOSED TREATMENT PLAN INCLUDES MEDICATION, THE 9 PROPOSED TREATMENT PLAN SHALL STATE WHETHER THE MEDICATION SHOULD 10 BE SELF-ADMINISTERED OR ADMINISTERED BY AUTHORIZED PERSONNEL AND 03917'01 LTB 2 1 SHALL SPECIFY THE TYPE OR TYPES OF MEDICATION MOST LIKELY TO 2 PROVIDE MAXIMUM BENEFIT FOR THE SUBJECT OF THE PETITION UNDER 3 THIS CHAPTER. 4 (3) IN DEVELOPING A PROPOSED TREATMENT PLAN, THE PHYSICIAN 5 OR LICENSED PSYCHOLOGIST SHALL PROVIDE AN OPPORTUNITY TO ACTIVELY 6 PARTICIPATE IN THE DEVELOPMENT OF THE PLAN TO ALL OF THE FOLLOW- 7 ING INDIVIDUALS: 8 (A) THE SUBJECT OF THE PETITION. 9 (B) IF APPLICABLE, THE SUBJECT OF THE PETITION'S GUARDIAN. 10 (C) IF APPLICABLE, THE PSYCHIATRIST, PHYSICIAN, OR LICENSED 11 PSYCHOLOGIST WHO HAS BEEN PROVIDING SERVICES TO THE SUBJECT OF 12 THE PETITION. 13 (D) UPON THE REQUEST OF THE SUBJECT OF THE PETITION, AN 14 INDIVIDUAL DESIGNATED BY THE SUBJECT OF THE PETITION. 15 (E) A RELATIVE, A CLOSE FRIEND, OR AN INDIVIDUAL OTHERWISE 16 CONCERNED WITH THE WELFARE OF THE SUBJECT OF THE PETITION. 17 (F) IF APPLICABLE, THE PATIENT ADVOCATE. 18 (4) IF THE PETITIONER IS A DIRECTOR OF A COMMUNITY MENTAL 19 HEALTH SERVICES PROGRAM OR HIS OR HER DESIGNEE, THE PROPOSED 20 TREATMENT PLAN SHALL BE PROVIDED TO THE COURT BEFORE THE HEARING 21 ON THE PETITION. IF THE PETITIONER IS AN INDIVIDUAL OTHER THAN 22 THE DIRECTOR OF A COMMUNITY MENTAL HEALTH SERVICES PROGRAM OR HIS 23 OR HER DESIGNEE, THE PROPOSED TREATMENT PLAN SHALL BE PROVIDED TO 24 THE COURT NO LATER THAN THE DATE SET BY THE COURT UNDER SECTION 25 373. 26 SEC. 371. THE COURT SHALL NOT ORDER ASSISTED OUTPATIENT 27 TREATMENT UNLESS A PHYSICIAN OR LICENSED PSYCHOLOGIST SUBMITS AN 03917'01 3 1 AFFIDAVIT TO EXPLAIN THE PROPOSED TREATMENT PLAN. THE 2 PHYSICIAN'S OR LICENSED PSYCHOLOGIST'S AFFIDAVIT SHALL STATE THE 3 CATEGORIES OF ASSISTED OUTPATIENT TREATMENT RECOMMENDED, THE 4 RATIONALE FOR EACH CATEGORY, FACTS THAT ESTABLISH THAT THE TREAT- 5 MENT IS THE LEAST RESTRICTIVE ALTERNATIVE, AND, IF THE RECOM- 6 MENDED ASSISTED OUTPATIENT TREATMENT INCLUDES MEDICATION, THE 7 TYPES OR CLASSES OF MEDICATION RECOMMENDED, THE BENEFICIAL AND 8 POSSIBLE DETRIMENTAL PHYSICAL AND MENTAL EFFECTS OF THE MEDICA- 9 TION, AND WHETHER THE MEDICATION SHALL BE SELF-ADMINISTERED OR 10 ADMINISTERED BY AN AUTHORIZED PROFESSIONAL. 11 SEC. 373. (1) IF, AFTER HEARING ALL RELEVANT EVIDENCE, THE 12 COURT FINDS THAT THE SUBJECT OF A PETITION UNDER THIS CHAPTER 13 DOES NOT MEET THE CRITERIA FOR ASSISTED OUTPATIENT TREATMENT, THE 14 COURT SHALL DISMISS THE PETITION. 15 (2) IF, AFTER HEARING ALL RELEVANT EVIDENCE, THE COURT FINDS 16 BY CLEAR AND CONVINCING EVIDENCE THAT THE SUBJECT OF A PETITION 17 UNDER THIS CHAPTER MEETS THE CRITERIA FOR ASSISTED OUTPATIENT 18 TREATMENT AND THAT THERE IS NO APPROPRIATE LESS RESTRICTIVE 19 ALTERNATIVE, THE COURT MAY ORDER THE SUBJECT OF THE PETITION TO 20 RECEIVE ASSISTED OUTPATIENT TREATMENT FOR AN INITIAL PERIOD NOT 21 TO EXCEED 6 MONTHS. THE ORDER SHALL SET FORTH AN ASSISTED OUTPA- 22 TIENT TREATMENT PLAN THAT SHALL INCLUDE ALL OF THE CATEGORIES OF 23 ASSISTED OUTPATIENT TREATMENT THAT THE SUBJECT OF THE PETITION 24 SHALL RECEIVE. THE COURT SHALL NOT ORDER TREATMENT THAT HAS NOT 25 BEEN RECOMMENDED BY THE EXAMINING PHYSICIAN OR LICENSED PSYCHOLO- 26 GIST OR INCLUDED IN THE PROPOSED TREATMENT PLAN FOR ASSISTED 27 OUTPATIENT TREATMENT. 03917'01 4 1 (3) IF, AFTER HEARING ALL RELEVANT EVIDENCE, THE COURT FINDS 2 BY CLEAR AND CONVINCING EVIDENCE THAT THE SUBJECT OF A PETITION 3 UNDER THIS CHAPTER MEETS THE CRITERIA FOR ASSISTED OUTPATIENT 4 TREATMENT BUT HAS NOT YET BEEN PROVIDED WITH A PROPOSED TREATMENT 5 PLAN AND AN AFFIDAVIT AS REQUIRED UNDER THIS CHAPTER, THE COURT 6 SHALL ORDER THE COMMUNITY MENTAL HEALTH SERVICES PROGRAM DIRECTOR 7 OR HIS OR HER DESIGNEE TO PROVIDE THE COURT WITH THE PROPOSED 8 TREATMENT PLAN AND AFFIDAVIT NOT LATER THAN 6 DAYS AFTER THE DATE 9 OF THE ORDER, EXCLUDING SUNDAYS AND HOLIDAYS. THE COURT MAY 10 ORDER THE SUBJECT OF THE PETITION TO BE RETAINED FOR AN EXAMINA- 11 TION BY A PHYSICIAN OR LICENSED PSYCHOLOGIST DESIGNATED BY THE 12 COMMUNITY MENTAL HEALTH SERVICES PROGRAM DIRECTOR OR HIS OR HER 13 DESIGNEE. THE SUBJECT OF THE PETITION MAY BE RETAINED UNDER A 14 COURT ORDER ISSUED UNDER THIS SUBSECTION FOR NOT MORE THAN 24 15 HOURS. AFTER RECEIVING A PROPOSED TREATMENT PLAN AND AN AFFIDA- 16 VIT, THE COURT MAY ORDER ASSISTED OUTPATIENT TREATMENT AS PRO- 17 VIDED IN THIS CHAPTER. 18 SEC. 375. A COURT MAY ORDER THE SUBJECT OF A PETITION TO 19 SELF-ADMINISTER PSYCHOTROPIC DRUGS OR ACCEPT THE ADMINISTRATION 20 OF PSYCHOTROPIC DRUGS BY AUTHORIZED PERSONNEL. THE ORDER MAY 21 SPECIFY THE TYPES OF PSYCHOTROPIC DRUGS. THE ORDER IS EFFECTIVE 22 FOR THE DURATION OF THE ASSISTED OUTPATIENT TREATMENT. 23 SEC. 377. A COURT ORDER FOR ASSISTED OUTPATIENT TREATMENT 24 ISSUED UNDER THIS CHAPTER SHALL DIRECT THE COMMUNITY MENTAL 25 HEALTH SERVICES PROGRAM DIRECTOR OR HIS OR HER DESIGNEE TO PRO- 26 VIDE OR ARRANGE FOR ALL CATEGORIES OF ASSISTED OUTPATIENT 03917'01 5 1 TREATMENT FOR THE ASSISTED OUTPATIENT THROUGHOUT THE PERIOD 2 SPECIFIED IN THE ORDER. 3 SEC. 379. THE ASSISTED OUTPATIENT TREATMENT PROGRAM DIREC- 4 TOR SHALL PROVIDE A WRITTEN REPORT TO THE APPLICABLE COMMUNITY 5 MENTAL HEALTH SERVICES PROGRAM DIRECTOR WITHIN 5 DAYS AFTER THE 6 DATE THE COURT ORDER IS ISSUED. THE WRITTEN REPORT SHALL 7 INCLUDE, BUT IS NOT LIMITED TO, ALL OF THE FOLLOWING: 8 (A) A COPY OF THE COURT ORDER. 9 (B) A COPY OF THE WRITTEN TREATMENT PLAN. 10 (C) THE IDENTITY OF THE CASE MANAGER OR ASSERTIVE COMMUNITY 11 TREATMENT TEAM, INCLUDING THE NAME AND CONTACT DATA OF THE ORGAN- 12 IZATION THAT THE CASE MANAGER OR ASSERTIVE COMMUNITY TREATMENT 13 TEAM MEMBER REPRESENTS. 14 (D) THE IDENTITY OF THE SERVICE PROVIDERS. 15 (E) THE DATE ON WHICH SERVICES BEGAN OR WILL BEGIN. 16 SEC. 381. THE ASSISTED OUTPATIENT TREATMENT PROGRAM DIREC- 17 TOR OR HIS OR HER DESIGNEE SHALL PETITION THE COURT FOR APPROVAL 18 BEFORE INSTITUTING A PROPOSED MATERIAL CHANGE IN THE ASSISTED 19 OUTPATIENT TREATMENT ORDER UNLESS THE CHANGE IS ADDRESSED IN THE 20 ORDER. A CHANGE THAT IS NOT A MATERIAL CHANGE MAY BE INSTITUTED 21 BY THE ASSISTED OUTPATIENT TREATMENT PROGRAM DIRECTOR WITHOUT 22 PRIOR COURT APPROVAL. NOTICE OF A PETITION FILED UNDER THIS SEC- 23 TION SHALL BE SERVED ON THE INDIVIDUALS REQUIRED TO BE SERVED 24 UNDER SECTION 359. 25 SEC. 383. (1) IF THE ASSISTED OUTPATIENT TREATMENT PROGRAM 26 DIRECTOR OR HIS OR HER DESIGNEE DETERMINES THAT THE ASSISTED 27 OUTPATIENT REQUIRES FURTHER ASSISTED OUTPATIENT TREATMENT, THE 03917'01 6 1 ASSISTED OUTPATIENT TREATMENT PROGRAM DIRECTOR OR HIS OR HER 2 DESIGNEE SHALL PETITION THE COURT BEFORE THE EXPIRATION OF THE 3 PERIOD OF ASSISTED OUTPATIENT TREATMENT ORDERED BY THE COURT FOR 4 A SUBSEQUENT ORDER AUTHORIZING CONTINUED ASSISTED OUTPATIENT 5 TREATMENT FOR A PERIOD OF NOT MORE THAN 1 YEAR FROM THE EXPIRA- 6 TION DATE OF THE ORIGINAL ORDER FOR ASSISTED OUTPATIENT 7 TREATMENT. IF THE ASSISTED OUTPATIENT TREATMENT PROGRAM DIRECTOR 8 HAS NOT PETITIONED THE COURT FOR A SUBSEQUENT ORDER UNDER THIS 9 SECTION WITHIN 15 DAYS BEFORE THE EXPIRATION DATE OF THE PERIOD 10 OF ASSISTED OUTPATIENT TREATMENT ORDERED BY THE COURT, A PARENT, 11 GUARDIAN, SPOUSE, SIBLING, OR CHILD OF AN ASSISTED OUTPATIENT MAY 12 PETITION FOR A SUBSEQUENT ORDER. THE PERIOD OF A SUBSEQUENT 13 ORDER OBTAINED UNDER THIS SECTION SHALL NOT EXCEED 1 YEAR. 14 (2) EXCEPT AS PROVIDED IN SUBSECTION (3), THE PROCEDURE FOR 15 OBTAINING AN ORDER UNDER THIS SECTION SHALL BE IN ACCORDANCE WITH 16 THE PROVISIONS OF OBTAINING AN ORIGINAL ORDER FOR ASSISTED OUTPA- 17 TIENT TREATMENT. 18 (3) IF THE PETITIONER IS AN ASSISTED OUTPATIENT TREATMENT 19 PROGRAM DIRECTOR AND THE ASSISTED OUTPATIENT INFORMS THE COURT BY 20 AFFIDAVIT THAT HE OR SHE AGREES TO CONTINUED ASSISTED OUTPATIENT 21 TREATMENT, THE COURT MAY ORDER CONTINUED ASSISTED OUTPATIENT 22 TREATMENT UNDER THIS SECTION WITHOUT A HEARING. 23 (4) IF A PETITION FOR A SUBSEQUENT ASSISTED OUTPATIENT 24 TREATMENT ORDER HAS BEEN FILED, THE INITIAL ORDER FOR ASSISTED 25 OUTPATIENT TREATMENT REMAINS IN EFFECT UNTIL A HEARING IS HELD ON 26 THAT PETITION. 03917'01 7 1 SEC. 385. IN ADDITION TO ANOTHER RIGHT OR REMEDY AVAILABLE 2 BY LAW WITH RESPECT TO AN ORDER FOR ASSISTED OUTPATIENT 3 TREATMENT, ON NOTICE TO THE ASSISTED OUTPATIENT TREATMENT PROGRAM 4 DIRECTOR AND THE ORIGINAL PETITIONER, THE PATIENT, HIS OR HER 5 GUARDIAN, OR HIS OR HER LEGAL COUNSEL MAY APPLY TO THE COURT TO 6 STAY, VACATE, OR MODIFY THE ORDER. 7 SEC. 387. (1) IF, IN THE CLINICAL JUDGMENT OF A PHYSICIAN 8 OR LICENSED PSYCHOLOGIST, AN ASSISTED OUTPATIENT HAS FAILED OR 9 REFUSED TO COMPLY WITH THE TREATMENT ORDERED BY THE COURT AND 10 EFFORTS HAVE BEEN MADE TO SOLICIT COMPLIANCE, THE ASSISTED OUTPA- 11 TIENT TREATMENT PROGRAM DIRECTOR OR HIS OR HER DESIGNEE SHALL 12 DIRECT A PEACE OFFICER TO TAKE INTO PROTECTIVE CUSTODY AND TRANS- 13 PORT THE ASSISTED OUTPATIENT TO A FACILITY DESIGNATED TO RECEIVE 14 ASSISTED OUTPATIENTS BY THE COMMUNITY MENTAL HEALTH SERVICES PRO- 15 GRAM DIRECTOR FOR AN EXAMINATION TO DETERMINE IF THE ASSISTED 16 OUTPATIENT HAS A MENTAL ILLNESS FOR WHICH INVOLUNTARY MENTAL 17 HEALTH TREATMENT IS NECESSARY UNDER THIS ACT. A PEACE OFFICER 18 CONTACTED UNDER THIS SUBSECTION SHALL CARRY OUT THIS DIRECTIVE. 19 (2) IF AN ASSISTED OUTPATIENT IS TAKEN INTO PROTECTIVE CUS- 20 TODY UNDER THIS SECTION, THE ASSISTED OUTPATIENT MAY BE RETAINED 21 FOR UP TO 72 HOURS FOR OBSERVATION, CARE, AND TREATMENT AND FOR 22 FURTHER EXAMINATION IN THE HOSPITAL TO ALLOW A PHYSICIAN OR 23 LICENSED PSYCHOLOGIST TO DETERMINE WHETHER THE ASSISTED OUTPA- 24 TIENT HAS A MENTAL ILLNESS AND IS IN NEED OF INVOLUNTARY MENTAL 25 HEALTH TREATMENT IN A HOSPITAL IN ACCORDANCE WITH THIS ACT. 26 CONTINUED INVOLUNTARY HOSPITALIZATION AFTER THE INITIAL 72-HOUR 27 PERIOD SHALL BE IN ACCORDANCE WITH THE PROVISIONS OF THIS ACT 03917'01 8 1 RELATING TO THE INVOLUNTARY HOSPITALIZATION OF AN INDIVIDUAL. IF 2 AT ANY TIME DURING THE 72-HOUR PERIOD THE ASSISTED OUTPATIENT IS 3 DETERMINED NOT TO MEET THE INVOLUNTARY HOSPITALIZATION PROVISIONS 4 OF THIS ACT AND DOES NOT AGREE TO STAY IN THE HOSPITAL AS A VOL- 5 UNTARY OR INFORMAL PATIENT, HE OR SHE SHALL BE RELEASED. 6 SEC. 389. (1) AN ASSISTED OUTPATIENT MAY BE MEDICATED OR 7 TESTED OVER HIS OR HER OBJECTION IF BOTH OF THE FOLLOWING OCCUR: 8 (A) THE ASSISTED OUTPATIENT FAILS OR REFUSES TO TAKE MEDICA- 9 TION OR SUBMIT TO TESTING AS REQUIRED BY A COURT ORDER ISSUED 10 UNDER THIS CHAPTER. 11 (B) THE ASSISTED OUTPATIENT TREATMENT PROGRAM'S PHYSICIAN OR 12 LICENSED PSYCHOLOGIST DETERMINES THAT THERE HAVE BEEN SUFFICIENT 13 EFFORTS TO SOLICIT THE ASSISTED OUTPATIENT'S COMPLIANCE WITH THE 14 REQUIREMENTS OF THE COURT ORDER DESCRIBED IN SUBDIVISION (A). 15 (2) IF IT IS NECESSARY TO ENFORCE A COURT ORDER UNDER THE 16 CONDITION SET FORTH IN SUBSECTION (1), THAT ENFORCEMENT MAY OCCUR 17 EITHER AT THE ASSISTED OUTPATIENT'S RESIDENCE OR AT A TREATMENT 18 CENTER DESIGNATED BY THE COMMUNITY MENTAL HEALTH SERVICES PROGRAM 19 DIRECTOR OR HIS OR HER DESIGNEE, WHICHEVER LOCATION THE ASSISTED 20 OUTPATIENT CHOOSES. 21 (3) AN ASSISTED OUTPATIENT WHO PHYSICALLY RESISTS TREATMENT 22 OR TESTING AS DESCRIBED IN SUBSECTION (1) SHALL BE TRANSPORTED TO 23 A TREATMENT CENTER DESIGNATED BY THE COMMUNITY MENTAL HEALTH 24 SERVICES PROGRAM DIRECTOR OR HIS OR HER DESIGNEE WHERE A PHYSI- 25 CIAN OR LICENSED PSYCHOLOGIST SHALL ADMINISTER THE MEDICATION OR 26 TESTING IN A MANNER THAT IS CLINICALLY APPROPRIATE, SAFE, AND 27 CONSISTENT WITH THE ASSISTED OUTPATIENT'S DIGNITY AND PRIVACY. 03917'01 9 1 SUBSEQUENT RETENTION OF AN ASSISTED OUTPATIENT SHALL ONLY BE MADE 2 ACCORDING TO OTHER PROVISIONS OF THIS ACT. 3 (4) UPON REQUEST OF AN ASSISTED OUTPATIENT'S ASSISTED OUTPA- 4 TIENT TREATMENT PROGRAM PHYSICIAN OR LICENSED PSYCHOLOGIST, AN 5 ASSISTED OUTPATIENT TREATMENT PROGRAM DIRECTOR, OR AN ASSISTED 6 OUTPATIENT TREATMENT DIRECTOR'S DESIGNEE, A PEACE OFFICER SHALL 7 TAKE THE ASSISTED OUTPATIENT INTO PROTECTIVE CUSTODY AND TRANS- 8 PORT HIM OR HER TO A TREATMENT CENTER DESIGNATED BY THE COMMUNITY 9 MENTAL HEALTH SERVICES PROGRAM DIRECTOR OR HIS OR HER DESIGNEE. 10 AN ASSISTED OUTPATIENT MAY BE RETAINED AT A TREATMENT CENTER FOR 11 ONLY THE TIME PERIOD REASONABLY NECESSARY TO ADMINISTER TREATMENT 12 OR TESTING AS PROVIDED UNDER THIS SECTION. 13 SEC. 391. THE DETERMINATION BY A COURT THAT AN INDIVIDUAL 14 IS IN NEED OF ASSISTED OUTPATIENT TREATMENT UNDER THIS CHAPTER IS 15 NOT A DETERMINATION THAT THE INDIVIDUAL IS AN INCAPACITATED INDI- 16 VIDUAL AS DEFINED IN SECTION 1105 OF THE ESTATES AND PROTECTED 17 INDIVIDUALS CODE, 1998 PA 386, MCL 700.1105. 18 SEC. 393. AN INDIVIDUAL MAKING A FALSE STATEMENT OR PROVID- 19 ING FALSE INFORMATION OR FALSE TESTIMONY IN A PETITION OR HEARING 20 UNDER THIS CHAPTER IS SUBJECT TO CRIMINAL PROSECUTION. 21 SEC. 395. NOTHING IN THIS CHAPTER AFFECTS THE ABILITY OF A 22 HOSPITAL DIRECTOR TO RECEIVE, ADMIT, OR RETAIN PATIENTS WHO OTH- 23 ERWISE MEET THE PROVISIONS OF THIS ACT REGARDING RECEIPT, RETEN- 24 TION, OR ADMISSION. 25 SEC. 397. THE DEPARTMENT, IN CONSULTATION WITH THE STATE 26 COURT ADMINISTRATIVE OFFICE, SHALL PREPARE EDUCATIONAL AND 27 TRAINING MATERIALS ON THE USE OF THIS CHAPTER THAT SHALL BE MADE 03917'01 10 1 AVAILABLE TO LOCAL GOVERNMENTAL UNITS, PROVIDERS OF MENTAL HEALTH 2 SERVICES, JUDGES, COURT PERSONNEL, LAW ENFORCEMENT OFFICIALS, AND 3 THE GENERAL PUBLIC. 4 Enacting section 1. This amendatory act does not take 5 effect unless all of the following bills of the 91st Legislature 6 are enacted into law: 7 (a) Senate Bill No. _____ or House Bill No. 5825 (request 8 no. 00734'01). 9 (b) Senate Bill No. _____ or House Bill No. 5826 (request 10 no. 05114'01). 03917'01 Final page. LTB