HOUSE BILL NO. 4925

May 26, 2021, Introduced by Reps. Whiteford, Brann, Thanedar, O'Malley, Hammoud, Green, LaFave, Beson, Rendon, Marino, Markkanen, Griffin, Meerman, Wozniak, Bezotte, Bellino, Allor, Howell, Aiyash, Camilleri, Puri and Whitsett and referred to the Committee on Health Policy.

"Mental health code,"

by amending sections 100a, 100c, 100d, 116, 206, 208, 210, 232, 269, 270, 271, 273, 274, 275, and 281c (MCL 330.1100a, 330.1100c, 330.1100d, 330.1116, 330.1206, 330.1208, 330.1210, 330.1232, 330.1269, 330.1270, 330.1271, 330.1273, 330.1274, 330.1275, and 330.1281c), section 100a as amended by 2020 PA 402, section 100c as amended by 2020 PA 285, section 100d as amended by 2020 PA 99, section 116 as amended by 1998 PA 67, sections 206 and 232 as amended by 1995 PA 290, sections 208 and 210 as amended and sections 269, 270, 271, 273, 274, and 275 as added by 2012 PA 500, and section 281c as added by 2014 PA 200, and by adding sections 110a and 117; and to repeal acts and parts of acts.

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.

(d) Social skills.

(e) Community use.

(f) Self-direction.

(g) Health and safety.

(h) Functional academics.

(i) Leisure.

(j) Work.

(4) "Administrative services organization" or "ASO" means a contracted third-party organization with special expertise in behavioral health systems management that contracts with the department under section 117 to provide certain specified administrative services necessary to manage the public behavioral health system, including Medicaid specialty supports and services, on the state's behalf.

(5) (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.

(6) (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 significant others, and individuals who could potentially develop a substance use disorder.

(7) (6) "Applicant" means an individual or his or her legal representative who makes a request for mental health services.

(8) (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 department or the single administrative services organization and approved by the federal government to deliver a service or combination of services for the treatment of incapacitated individuals.

(9) (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 be provided under the supervision of a psychiatrist.

(10) (9) "Board" means the governing body of a community mental health services program.

(11) (10) "Board of commissioners" means a county board of commissioners.

(12) (11) "Center" means a facility operated by the department to admit individuals with developmental disabilities and provide habilitation and treatment services.

(13) (12) "Certification" means formal approval of a program by the department in accordance with standards developed or approved by the department.

(14) (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.

(15) (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.

(16) (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.

(17) (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.

(18) (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.

(19) (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.

(20) (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.

(21) (20) "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.

(22) (21) "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.

(23) (22) "Department" means the department of health and human services.

(23) "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.

(24) "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.

(25) "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.

(26) "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.

(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.

(27) "Director" means the director of the department or his or her designee.

(28) "Discharge" means an absolute, unconditional release of an individual from a facility by action of the facility or a court.

(29) "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 and receiving special education services in a program designed for the autistic impaired under R 340.1758 of the Michigan Administrative Code or in a program designed for the severely mentally impaired or severely multiply impaired.

(30) "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, or another individual, either intentionally or unintentionally.

(b) The individual is unable to provide himself or herself 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 judgment so that the individual is unable to understand his or her need for treatment and presents a risk of harm.

(31) "Executive director" means an individual appointed under section 226 to direct a community mental health services program or his or her designee.

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 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.

(3) "Person requiring treatment" means an individual who meets the criteria described in section 401.

(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.

(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.

(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.

(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.

(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, in an inpatient setting to individuals under age 21.

(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.

(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.

(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.

(12) "Public behavioral health provider" means a provider or provider entity properly credentialed either by licensure, certification, or other department-approved process and contracted with the department or its single administrative services organization to provide services to residents of this state who have mental illness, emotional disturbance, intellectual or developmental disability, or substance use disorder.

(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.

(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.

(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.

(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.

(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.

(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.

(14) "Supplemental security income" means the program authorized under title XVI of the social security act, 42 USC 1381 to 1383f.

(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.

(16) "Transfer facility" means a facility selected by the department-designated community mental health entity, department or the administrative services organization, 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.

(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.

(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.

(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.

(20) "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. 110a. (1) The behavioral health oversight council is created within the department to advise the department in developing and executing public behavioral health policies, programs, and services. The council shall equitably reflect the geographic and demographic characteristics of individuals served by the public behavioral health system with at least 33% of the membership being primary recipients of the public behavioral health system or their families or guardians, or individuals in recovery from behavioral health conditions served by the public behavioral health system. The council must also reflect experience and expertise in administering and delivering public-funded behavioral health services to children and adults with mental illness, emotional disturbance, intellectual or developmental disability, or substance use disorder. The council must include a behavioral health or physical health medical professional.

(2) The behavioral health oversight council consists of the following members:

(a) Fifteen voting members as follows:

(i) Five members who are recipients of the public behavioral health system, a family member or guardian of a recipient of the public behavioral health system, or an individual who is in recovery from a behavioral health condition. At least 3 of the members appointed under this subparagraph must be current recipients of the public behavioral health system.

(ii) One member from each of the 10 prosperity regions who are not members of the group identified under subparagraph (i). As used in this subparagraph, "prosperity region" means each of the 10 prosperity regions identified by the department of technology, management, and budget on the effective date of the amendatory act that added this section.

(b) Up to 4 nonvoting members appointed by the director of the department who represent the department and departmental agencies pertinent to delivering public behavioral health and intellectual or developmental disability services. This includes, but is not limited to, representatives of the behavioral health and developmental disabilities administration, the children's services agency, the developmental disabilities council, the medical services administration, and the state hospital administration.

(3) Voting members of the behavioral health oversight council under subsection (2)(a) shall be appointed as follows:

(a) Three by the governor.

(b) Three by the senate majority leader.

(d) Three by the senate minority leader.

(e) Three by the house minority leader.

(4) The voting members first appointed to the behavioral health oversight council must be appointed within 60 days after the effective date of the amendatory act that added this section. The members of the behavioral health oversight council shall serve a term of 3 years or until a successor is appointed, whichever is later. A member of the behavioral health oversight council may serve up to 2 terms. A vacancy on the behavioral health oversight council must be filled for the unexpired term in the same manner as the original appointment. The chairperson of the behavioral health oversight council may remove a member of the council for incompetence, dereliction of duty, malfeasance, misfeasance, or nonfeasance during his or her tenure in office, or any other good cause, on a motion that is approved by the majority of the members of the behavioral health oversight council.

(5) The director of the department or his or her designee shall call the first meeting of the behavioral health oversight council 90 days after the effective date of the amendatory act that added this section. At the first meeting, the behavioral health oversight council shall elect from among its members a chairperson and other officers as it considers necessary or appropriate. After the first meeting, the behavioral health oversight council shall meet at least quarterly, or more frequently at the call of the chairperson or if requested by 2/3 or more members. A majority of the voting members of the behavioral health oversight council constitute a quorum for the transaction of business at a meeting of the council. A majority of the members present and serving are required for official action of the council.

(6) The business that the council may perform must be conducted at a public meeting of the council held in compliance with the open meetings act, 1976 PA 267, MCL 15.261 to 15.275. A writing prepared, owned, used, in the possession of, or retained by the council in the performance of an official function is subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

(7) Members of the behavioral health oversight council serve without compensation. Members of the behavioral health oversight council may be reimbursed for their actual and necessary expenses incurred in the performance of their official duties as members of the council.

(8) The behavioral health oversight council shall make specific recommendations on matters related to the planning and execution of public behavioral health services, including, but not limited to, each of the following:

(a) Review of behavioral health services under chapter 2 and 2A and any other pertinent law or regulation for the provision of public behavioral health services.

(b) Review of periodic reports on the program activities, finances, and outcomes, including reports on achievement of service delivery system goals.

(c) Report annually to the legislature regarding the council's activities and the administrative services organization that includes service outcomes for individuals served.

(9) The behavioral health oversight council shall establish standing and ad hoc committees or subcommittees to carry out its duties. Standing committees must include, but are not limited to, the following:

(a) A substance use disorder oversight policy committee that performs the following functions:

(i) Provide advice and recommendations regarding the department's or administrative services organization's dissemination of funding for substance use disorder treatment, prevention, or recovery services in the context of state, federal, and local laws or regulations.

(ii) Provide advice and recommendations to ensure an adequate network of substance use disorder treatment, prevention, or recovery providers.

(b) A clinical oversight committee that must consist of an independent expert panel including, but not limited to, independent experts in psychiatry, pediatrics, and internal medicine, and representatives from the consumer oversight committee. The clinical oversight committee must perform the following functions:

(i) Based on a review of the current literature, develop treatment protocols for the diagnoses or conditions being treated by the local behavioral health service providers to ensure that quality care is available to all consumers.

(ii) Provide oversight regarding required clinical and person-centered outcomes that are to be included in service delivery models.

(iii) Along with the department, and after a review of the current literature and consultation with national experts as needed, develop a model for front-line integration of physical and behavioral health care. Provide advice and recommendations regarding integrated care.

(iv) Present the committee's report to the legislature. The report must include the treatment protocols and model of integration, as well as the outcome measures and recommendations for improvements if needed.

(d) A consumer oversight committee.

Sec. 116. (1) Consistent with section 51 of article IV of the state constitution of 1963, which declares that the health of the people of the state is a matter of primary public concern, and as required by section 8 of article VIII of the state constitution of 1963, which declares that services for the care, treatment, education, or rehabilitation of those who are seriously mentally disabled shall always be fostered and supported, the department shall continually and diligently endeavor to ensure that adequate and appropriate mental health services are available to all citizens throughout the state. To this end, the department shall have the general powers and duties described in this section.

(2) The department shall do all of the following:

(a) Direct services to individuals who have a serious mental illness, intellectual or developmental disability, or serious emotional disturbance, or substance use disorder. The department shall give priority to the following services:prioritize services for individuals with the most severe forms of these conditions and individuals with these conditions who are in urgent, crisis, or emergency situations. The department may promulgate rules to carry out this section and further describe priority populations to be served.

(i) Services for individuals with the most severe forms of serious mental illness, serious emotional disturbance, or developmental disability.

(ii) Services for individuals with serious mental illness, serious emotional disturbance, or developmental disability who are in urgent or emergency situations.

(b) Administer the provisions of chapter 2 so as to promote and maintain an adequate and appropriate system of community mental health services programs throughout the state. In the administration of chapter chapters 2 and 2A, it shall be the department's objective of the department is to shift primary responsibility for the direct delivery of public mental health behavioral services from the state to a community mental health services program, whenever the community mental health services program has demonstrated a willingness and capacity to provide an adequate and appropriate system of mental health services for the citizens of that service area.approved services program, or other public behavioral health service provider. The department or the single administrative services organization established in section 117 may provide, directly or through a contract, any service or set of services to ensure that this state has an adequate network of public behavioral health services.

(d) Submit to the members of the house and senate standing committees and appropriation subcommittees with legislative oversight of mental health matters an annual report summarizing its assessment of the mental health needs of the state and incorporating information received from community mental health services programs under section 226. The report shall include an estimate of the cost of meeting all identified needs. Additional information shall be made available to the legislature upon request.

(e) Endeavor to develop and establish arrangements and procedures for the effective coordination and integration of all public mental health services, and for effective cooperation between public and nonpublic services, for the purpose of providing a unified system of statewide mental health care.

(f) Review and evaluate the relevance, quality, effectiveness, and efficiency of mental health services being provided by the department and assure ensure the review and evaluation of mental health services provided by community mental health services programs. The department shall establish and implement a structured system to provide data necessary for the reviews and evaluations.

(g) Implement those provisions of law under which it is responsible for the licensing or certification of mental health facilities or services.

(h) Establish standards of training and experience for executive directors of community mental health services programs.

(i) Support research activities.

(j) Support evaluation and quality improvement activities.

(k) Support training, consultation, and technical assistance regarding mental health programs and services and appropriate prevention and mental health promotion activities, including those that are culturally sensitive, to employees of the department, community mental health services programs, and other nonprofit agencies providing mental health services under contract with community mental health services programs.

(l) Support multicultural services.

(3) The department may do all of the following:

(a) Direct services to individuals who have mental disorders that meet diagnostic criteria specified in the most recent diagnostic and statistical manual of mental health disorders published by the American psychiatric association and approved by the department and to the prevention of mental disability and the promotion of mental health. Resources that have been specifically appropriated for services to individuals with dementia, alcoholism, or substance abuse, or for the prevention of mental disability and the promotion of mental health shall be utilized for those specific purposes.

(b) Provide, on a residential or nonresidential basis, any type of patient or client service including but not limited to prevention, diagnosis, treatment, care, education, training, and rehabilitation.

(d) Institute pilot projects considered appropriate by the director to test new models and concepts in service delivery or mental health administration. Pilot projects may include, but need not be limited to, both of the following:

(i) Issuance of a voucher to a recipient of public mental health services in accordance with the recipient's individual plan of services and guidelines developed by the department.

(ii) Establishment of revolving loans to assist recipients of public mental health services to acquire or maintain affordable housing. Funding under this subparagraph shall only be provided through an agreement with a nonprofit fiduciary in accordance with guidelines and procedures developed by the department related to the use, issuance, and accountability of revolving loans used for recipient housing.

(e) Enter into an agreement, contract, or arrangement with any individual or public or nonpublic entity that is necessary or appropriate to fulfill those duties or exercise those powers that have by statute been given to the department.

(f) Accept gifts, grants, bequests, and other donations for use in performing its functions. Any money or property accepted shall be used as directed by its donor and in accordance with law and the rules and procedures of the department.

(g) The department has any other power necessary or appropriate to fulfill those duties and exercise those powers that have been given to the department by law and that are not otherwise prohibited by law.

(4) To carry out the powers and duties under this section, the department shall utilize a self-insured financing and delivery system structure to administer and provide the services required under this section including, but not limited to, providing behavioral health and intellectual or developmental disability specialty supports and services directly or by contracting with a single administrative services organization in accordance with section 117 and section 109f of the social welfare act, 1939 PA 280, MCL 400.109f.

(5) The department shall provide operational oversight of the administrative services organization established in section 117 through contract, policy, administrative rules, or other means necessary to carry out its oversight function. This includes, but is not limited to, all of the following:

(a) Develop a comprehensive plan for monitoring the performance of administrative services organizations which shall include data on service authorizations, individual outcomes, appeals, outreach and accessibility, and comments from program participants and community partners including, but not limited, to health systems, primary care providers, representatives from the criminal justice system, and education compiled from written surveys and face-to-face interviews.

(b) Establish policies to coordinate public behavioral health benefits with other benefits received under Medicaid, including coordinated delivery of physical and behavioral health care with guidance from the clinical oversight committee and its recommendations.

(c) Develop consumer and provider appeal procedures. These procedures must include, but are not limited to, procedures for a consumer or any provider, including a primary care physician, acting on behalf of a consumer to appeal a denial or determination. The department shall establish time frames for appealing decisions made by the single administrative services organization, including an expedited review in emergency situations. Any procedure for appeals shall require that an appeal be heard not later than 30 days after the appeal is filed and shall be decided not later than 45 days after the appeal is filed. Nothing in this subdivision precludes any other right of repeal provided under state or federal law.

(6) The department shall develop policies and procedures for the reimbursement of public behavioral health services, including developing initial rates, reducing existing rates, and changes in rate methodology.

(7) The department may promulgate rules and establish Medicaid policy to carry out the duties established under this section.

Sec. 117. (1) The department may enter into a contract with a single administrative services organization to carry out its powers and duties under section 116 by issuing a request for proposal.

(2) The single administrative services organization selected under this section must be organized as a nonprofit organization or a public or quasi-public entity. The single administrative services organization cannot be a community mental health services program, a group of community mental health services programs under the urban cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 to 124.512, or any other group or confederation of community mental health services programs. The administrative services organization must have a full-time medical director.

(3) The contract entered under this section must require the administrative services organization to perform, at least, all of the following duties and functions:

(a) Eligibility verification.

(b) Utilization management.

(d) Quality management.

(e) Coordination of medical and behavioral health services.

(f) Provider network development and management.

(g) Recipient rights and provider services and reporting.

(h) Customer services.

(i) Corporate compliance that includes adherence to all applicable state and federal civil rights statutes and regulations.

(j) Clinical management services not retained by the department.

(4) The administrative services organization shall authorize services based on policy and guidelines set forth by the department. Exceptions to the department policy or guidelines may be made when requested by a recipient of public behavioral health services, a recipient's legal guardian, or a recipient's service provider, and determined by the administrative services organization to be in the best interest of the recipient. Decisions regarding the interpretation of guidelines must be made by the department. An administrative services organization shall not have any financial incentive to approve, deny, or reduce services. Administrative services organizations shall ensure that service providers and individuals seeking services have timely access to program information and timely responses to inquiries, including inquiries concerning the clinical guidelines for services and expected outcomes.

(5) The administrative services organization shall oversee and utilize the Michigan crisis and access line to fulfill these duties and functions on behalf of the department.

(6) The business that the administrative services organization board or any committee of the administrative services organization board may perform must be conducted at a public meeting of the council held in compliance with the open meetings act, 1976 PA 267, MCL 15.261 to 15.275.

(7) A writing prepared, owned, used, in the possession of, or retained by an administrative services organization board or committees of the administrative services organization board in the performance of an official function is subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

Sec. 206. (1) The purpose of a community mental health services program shall be is to provide a comprehensive array of mental health services appropriate to conditions of individuals who are located within its geographic service area, regardless of an individual's ability to pay. The array of mental health services shall include, at a minimum, all of the following:

(a) Crisis stabilization and response including a 24-hour, Twenty-four-hour, 7-day per week, crisis emergency service that is prepared to respond to persons individuals experiencing acute emotional, behavioral, or social dysfunctions, and the provision of providing inpatient or other protective environment for treatment provided by the administrative services organization, the Michigan crisis and access line or MiCAL, community mental health services programs, approved service programs, and other public behavioral health providers under the direction of the department. These services must include, but are not limited to, the following:

(i) Coordination with MiCAL. MiCAL shall serve as the statewide crisis and access line accepting all calls and dispatching support based on the assessed need of the caller.

(ii) Providing, either directly or by contract, mobile crisis teams staffed or contracted by community mental health services programs that are dispatched at the direction of MiCAL to wherever the need is in the community.

(iii) Providing, either directly or by contract, crisis stabilization units that serve everyone in need from all referral sources, including MiCAL.

(b) Identification, assessment, and diagnosis to determine the specific needs of the recipient and to develop an individual plan of services.

(d) Specialized mental health recipient training, treatment, and support, including therapeutic clinical interactions, socialization and adaptive skill and coping skill training, health and rehabilitative services, and pre-vocational and vocational services.

(e) Recipient rights services.

(f) Mental health advocacy.

(g) Prevention activities that serve to inform and educate with the intent of reducing the risk of severe recipient dysfunction.

(h) Any other service approved by the department.

(2) Services shall must promote the best interests of the individual and shall must be designed to increase independence, improve quality of life, and support community integration and inclusion. Services for children and families shall must promote the best interests of the individual receiving services and shall must be designed to strengthen and preserve the family unit if appropriate. The community mental health services program shall must deliver services in a manner that demonstrates they are based upon recipient choice and involvement, and shall must include wraparound services when appropriate.

(3) The department may promulgate rules and establish Medicaid policy to carry out the provisions of this section.

Sec. 208. (1) Services provided by a community mental health services program shall must be directed to individuals who have a serious mental illness, serious emotional disturbance, intellectual or developmental disability, or substance use disorder.

(2) Services may be directed to individuals who have other mental disorders that meet criteria specified in the most recent diagnostic and statistical manual of mental health disorders published by the American psychiatric association and may also be directed to the prevention of mental disability and the promotion of mental health. Resources that have been specifically designated to community mental health services programs for services to individuals with dementia, alcoholism, or substance use disorder or for the prevention of mental disability and the promotion of mental health shall be utilized for those specific purposes.

(2) (3) Priority shall be given to the provision of services to individuals with the most severe forms of serious mental illness, serious emotional disturbance, and developmental disability. Priority shall also be given to the provision of services to individuals with a serious mental illness, serious emotional disturbance, or developmental disability in urgent or emergency situations.for services must follow the provisions set forth in section 116(2)(a)(i) and (ii).

(3) (4) An individual shall not be denied a service because an individual who is financially liable is unable to pay for the service.

Sec. 210. (1) Any single county or any combination of adjoining counties may elect to establish a community mental health services program by a majority vote of each county board of commissioners.

(2) A department-designated community mental health entity The department or the administrative services organization shall coordinate the provision of providing substance use disorder services in its region and shall ensure services are available for individuals with substance use disorder.

Sec. 232. The department shall or the administrative services organization must review each community mental health services program's annual plan, needs assessment, request for funds, annual contract, and operating budget and approve or disapprove state funding in whole or in part. Eligibility for state financial support shall be is contingent upon an approved contract and operating budget and certification in accordance with section 232a. Prior to Before the beginning of each state fiscal year, the department shall allocate state appropriated funds to the community mental health service programs in accordance with the approved contracts and budgets.

Sec. 269. The department-designated community mental health entity and its community mental health services program provider network department or the administrative services organization may contract for and spend funds for the prevention of substance use disorder and for the counseling and treatment of individuals with substance use disorder. A department-designated community mental health entity and other community mental health services program may make contracts with the governing bodies of other department-designated community mental health entities and other community mental health services programs and other persons for these purposes.

Sec. 270. The department shall do all of the following:

(a) Administer and coordinate state administered funds for substance use disorder treatment and rehabilitation services and substance use disorder prevention services.

(b) Use appropriations of revenues from taxes imposed by the Michigan liquor control code of 1998, 1998 PA 58, MCL 436.1101 to 436.2303, exclusively for the purposes provided in that act.

(c) Recommend directly to the governor, after review and comment, budget and grant requests for public funds to be allocated for substance use disorder services including education, research, treatment, rehabilitation, and prevention activities.

(d) Provide technical assistance to department-designated community mental health entities the administrative services organization and community mental health services programs and to treatment, rehabilitation, and prevention agencies for the purposes of program development, administration, and evaluation.

(e) Develop annually a comprehensive state plan through the use of federal, state, local, and private resources of adequate services and facilities for the prevention and control of substance use disorder and the diagnosis, treatment, and rehabilitation of individuals with substance use disorder.

(f) Evaluate, in cooperation with appropriate state departments and agencies, the effectiveness of substance use disorder services in the state funded by federal, state, local, and private resources, and annually during the month of November, report a summary of the detailed evaluation to the governor and the legislature.

Sec. 271. The department shall do both of the following:

(a) Cooperate with agencies of the federal government and receive and use federal funds for purposes authorized by the legislature.

(b) Prior to the expenditure of Before expending funds appropriated to other state agencies receiving appropriations for substance use disorder treatment and rehabilitation services and substance use disorder prevention services, have a contract signed with the receiving department-designated community mental health entity. administrative services organization, if applicable. The department shall submit a copy of each agreement to the governor and the appropriations committees of the senate and house of representatives.

Sec. 273. (1) The department shall do all of the following:

(a) Annually establish program priority for funding for the next fiscal year.

(b) Establish guidelines for project applications.

(c) Promulgate rules concerning matching requirements for state alcoholism and drug abuse treatment grants. The rules shall be reviewed every 2 years.

(2) The department-designated community mental health entities and community mental health services program provider networks department or the administrative services organization shall ensure that applicants for state administered funds are licensed, unless exempt, as substance use disorder service programs under part 62 of the public health code, 1978 PA 368, MCL 333.6230 to 333.6251.

(3) The department may issue licenses; require reports; establish standards and procedures; and make inspections necessary to enforce this chapter and rules promulgated under this chapter; and provide technical assistance for the guidance of substance use disorder service programs in complying with the requirements and rules promulgated under this chapter.

Sec. 274. A department-designated community mental health entity designated by the director to assume responsibility for providing substance use disorder services for a county or multicounty region, with assistance from its community mental health services program provider network, The department or the administrative services organization shall do all of the following:

(a) Develop comprehensive plans for substance use disorder treatment and rehabilitation services and substance use disorder prevention services consistent with guidelines established by the department.

(b) Review and comment to the department of licensing and regulatory affairs on applications for licenses submitted by local treatment, rehabilitation, and prevention organizations.

(d) Collect and transfer data and financial information from local programs to the department of licensing and regulatory affairs.

(e) Submit an annual budget request to the department for use of state administered funds for its substance use disorder treatment and rehabilitation services and substance use disorder prevention services in accordance with guidelines established by the department.

(f) Make contracts necessary and incidental to the performance of the department-designated community mental health entity's and community mental health services program's department's or administrative services organization's functions. The contracts may be made with public or private agencies, organizations, associations, and individuals to provide for substance use disorder treatment and rehabilitation services and substance use disorder prevention services. Priority must be given to community mental health services programs able and willing to provide substance use disorder prevention, treatment, and rehabilitation services.

(g) Annually evaluate and assess substance use disorder services in the department-designated community mental health entity provided in accordance with department policies guidelines. established by the department.

Sec. 275. (1) Subject to subsection (2), if a department-designated community mental health entity under this chapter the administrative services organization maintains a waiting list for services, the department-designated community mental health entity shall administrative services organization must place a parent whose child has been removed from the home under the child protection laws of this state or is in danger of being removed from the home under the child protection laws of this state because of the parent's substance use disorder in a priority position on the waiting list above all other applicants with substantially similar clinical conditions.

(2) If a department-designated community mental health entity the department receives federal substance abuse prevention and treatment block grant funds, the priority department or its administrative services organization must prioritize the position of the parent on the waiting list granted under subsection (1) will come to come after a priority position on the waiting list granted under the conditions of the federal block grant. If the parent qualifies for priority status on the waiting list under the conditions of the federal block grant, the department-designated community mental health entity shall department or its administrative services organization must place the parent in that priority position on the waiting list.

Sec. 281c. (1) Following an examination by a health professional under section 281b and a certification by that health professional that the requirements of section 281a(1) are met, a court may order the respondent held for treatment for a period not to exceed 72 hours if the court finds by clear and convincing evidence that the person individual presents an imminent danger or imminent threat of danger to self, family, or others as a result of a substance use disorder. However, if If the hearing to be held under section 281b will not be held within that 72-hour period, the court may order the respondent held for treatment until the hearing. In making its order, the court shall inform the respondent that the respondent may immediately make a reasonable number of telephone calls or use other reasonable means to contact an attorney, a physician, or a health professional; to contact any other person to secure representation by counsel; or to obtain medical or psychological assistance and that the respondent will shall be provided assistance in making calls if the assistance is needed and requested.

(2) A program in which a respondent is being held pursuant according to subsection (1) shall release the respondent from the program immediately upon the expiration of the time period established by the court for the treatment under subsection (1). If determined appropriate by the court with the assistance of health professionals, a respondent may be transferred from a more-restrictive program setting to a less-restrictive program setting for the treatment ordered under this section.

(3) A respondent ordered held under this section shall not be held in jail pending transportation to the program or evaluation unless the court previously has found the respondent to be in contempt of court for either failure to undergo treatment or failure to appear at the examination ordered under section 281b.

(4) If a court is authorized to issue an order that the respondent be transported to a program, the court may issue a summons. If the respondent fails to attend an examination scheduled before the hearing under section 281b, the court shall issue a summons. The court shall direct a summons issued to the respondent and shall command the respondent to appear at a time and place specified in the summons. If the respondent who has been summoned fails to appear at the program or the examination, the court may order a peace officer to transport the respondent to a program on the list provided under subsection (5) for treatment. The peace officer shall transport the respondent to the program. The transportation costs of the peace officer shall be included in the costs of treatment for substance use disorder to be paid as provided in section 281a(4).

(5) A department-designated community mental health entity The department or administrative services organization on at least an annual basis shall must submit each of the following lists to the clerk of the court in each county served by the department-designated community mental health entity:department or administrative services organization:

(a) A list of all programs in the counties served by the department-designated community mental health entity department or administrative services organization that are able and willing to take respondents ordered held for treatment under subsection (1).

(b) A list of programs and health professionals in the counties served by the department-designated community mental health entity department or administrative services organization that are able and willing to provide treatment for a substance use disorder that is ordered under section 281b.

Enacting section 1. Sections 110, 204b, 232b, and 287 of the mental health code, 1974 PA 258, MCL 330.1110, 330.1204b, 330.1232b, and 330.1287, are repealed.

Enacting section 2. This amendatory act does not take effect unless Senate Bill No.____ or House Bill No. 4926 (request no. 02615'21) of the 101st Legislature is enacted into law.