Bill Text: MI SB0806 | 2023-2024 | 102nd Legislature | Introduced
Bill Title: Health facilities: hospitals; psychological evaluation on a minor in a hospital emergency room longer than a certain period of time due to a mental health episode; require. Amends secs. 409 & 972 of 1974 PA 258 (MCL 330.1409 & 330.1972).
Spectrum: Partisan Bill (Republican 4-0)
Status: (Introduced) 2024-04-09 - Referred To Committee On Health Policy [SB0806 Detail]
Download: Michigan-2023-SB0806-Introduced.html
SENATE BILL NO. 806
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 409 and 972 (MCL 330.1409 and 330.1972), section 409 as amended by 2022 PA 214 and section 972 as added by 2020 PA 402.
the people of the state of michigan enact:
Sec. 409. (1) Each community mental health services program must 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 community mental health services program shall must 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 (4), 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 shall must 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 Within 3 hours after being notified by a hospital, or by a hospital as that term is defined in section 20106 of the public health code, 1978 PA 368, MCL 333.20106, for an assessment, a preadmission screening unit shall must assess an 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, the preadmission screening unit shall must authorize voluntary admission to the hospital.
(4) If the preadmission screening unit is unable to complete the assessment within 3 hours after the notice described in subsection (3), a clinically qualified individual may perform the assessment 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, or any other entity under contract to perform assessment and screening services required under this act. The preadmission screening unit is responsible for the costs of performing any assessment under this subsection.
(5) 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 complete the assessment described in this section.
(6) (4) If the preadmission screening unit of the community mental health services program denies hospitalization, the individual or the person making the application may request a second opinion from the executive director. The executive director shall must arrange for an additional evaluation by a psychiatrist, other physician, or licensed psychologist to be performed within 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 must 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 must provide appropriate referral services.
(7) (5) If an individual is assessed and found not to be clinically suitable for hospitalization, the preadmission screening unit shall must provide information regarding alternative services and the availability of those services, and make appropriate referrals.
(8) (6) A preadmission screening unit shall must assess and examine, or refer to a hospital for examination, an individual who is brought to the preadmission screening unit 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 must designate the hospital to which the individual shall be admitted. The preadmission screening unit shall must consult with the individual and, if the individual agrees, the preadmission screening unit must consult with the individual's family member of choice, if available, as to the preferred hospital for the individual's admission. of the individual.
(9) (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 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 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.
(10) (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.
(11) (9) If the individual chooses a hospital not under contract with a community mental health services program, and the hospital agrees to the admission, the preadmission screening unit shall must refer the individual to the hospital that is requested by the individual. 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.
Sec. 972. The department shall establish minimum standards and requirements for certifying a crisis stabilization unit. Standards and requirements 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 implementation of voluntary and involuntary admission consistent with section 409.
(c) A prohibition from holding itself 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 maximum length of stay at a crisis stabilization unit with discharge planning upon intake to a clinically appropriate level of care consistent with section 409(7).409(9).
(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 a psychiatric hospital or psychiatric unit setting.
(l) Standards requiring 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 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.
Enacting section 1. This amendatory act takes effect 90 days after the date it is enacted into law.
