HB-4674, As Passed House, October 20, 2015

SUBSTITUTE FOR

HOUSE BILL NO. 4674

A bill to amend 1974 PA 258, entitled

"Mental health code,"

by amending sections 100a, 100c, 202, 401, 404, 420, 422, 423, 425,

426, 427, 429, 431, 434, 435, 447, 448, 449, 451, 452, 453, 454,

455, 461, 463, 468, 469a, 472a, 474, 474a, and 475 (MCL 330.1100a,

330.1100c, 330.1202, 330.1401, 330.1404, 330.1420, 330.1422,

330.1423, 330.1425, 330.1426, 330.1427, 330.1429, 330.1431,

330.1434, 330.1435, 330.1447, 330.1448, 330.1449, 330.1451,

330.1452, 330.1453, 330.1454, 330.1455, 330.1461, 330.1463,

330.1468, 330.1469a, 330.1472a, 330.1474, 330.1474a, and 330.1475),

section 100a as amended by 2012 PA 500, section 100c as amended by

2015 PA 59, sections 202, 420, 423, 425, 426, 427, 429, 431, 434,

435, 448, 449, 451, 452, 453, 454, 455, 461, 463, and 468 as

amended by 1995 PA 290, section 401 as amended by 2004 PA 496,

section 422 as amended by 2004 PA 317, section 469a as amended by

2004 PA 497, sections 472a and 475 as amended by 2004 PA 498, and

sections 474 and 474a as added by 1996 PA 588, and by adding

section 400b; 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) "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 significant others, and individuals who could

potentially develop a substance use disorder.

(6) "Applicant" means an individual or his or her 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 ~~433~~ 468 or 469a. Assisted outpatient treatment ~~includes~~ may

include case management services to provide care coordination.

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.

(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~~ Accreditation Council for Graduate

Medical Education or the American ~~osteopathic association,~~

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.

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, or a recipient's legal

representative with authority to execute a consent, or a verbal

agreement of a recipient that is witnessed and documented by an

individual other than the individual providing treatment.

(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.

(21) "Department" means the department of ~~community~~ health and

human services.

(22) "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.

(23) "Dependent living setting" means all of the following:

(a) An adult foster care facility.

(b) A nursing home licensed under article 17 of the public

health code, 1978 PA 368, MCL 333.20101 to 333.22260.

public health code, 1978 PA 368, MCL 333.20101 to 333.22260.

(24) "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.

under part 170 or 175 of the public health code, 1978 PA 368, MCL

333.17001 to 333.17084 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.

(25) "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.

(26) "Director" means the director of the department or his or

her designee.

(27) "Discharge" means an absolute, unconditional release of

an individual from a facility by action of the facility or a court.

(28) "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.

in a program designed for the autistic impaired under subsection

(1) of R 340.1758 of the Michigan administrative code or in a

program designed for the severely mentally impaired or severely

multiply impaired.

(29) "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.

~~unable to understand the need for treatment and, in the opinion of~~

~~the mental health professional, his or her continued behavior as a~~

~~result of the mental illness, developmental disability, or~~

~~emotional disturbance can reasonably be expected in the near future~~

~~to result in physical harm to the individual or to another~~

~~individual.~~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 that impaired judgment, on the basis

of competent clinical opinion, presents a substantial risk of harm

to the individual or others in the near future.

(30) "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 the

prevention and detection of crime and enforcement of the criminal

laws of this state. For the purposes of sections 408, 426, 427a,

and ~~427,~~ 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 333.17084, 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 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.

(9) "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.

her time to the practice of psychiatry and is approved by the

director.

(10) "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.

(11) "Recipient" means an individual who receives mental

health services 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.

(12) "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.

(13) "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.

(14) "Regional entity" means an entity established under

section 204b to provide specialty services and supports.

(15) "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.

(16) "Resident" means an individual who receives services in a

facility.

(17) "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.

(18) "Rule" means a rule promulgated under the administrative

procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.

Sec. 202. (1) The state shall financially support, in

accordance with chapter 3, community mental health services

programs that have been established and that are administered

~~pursuant~~ according to the provisions of this chapter.

(2) A community mental health services program shall determine

an individual's eligibility for a private health insurer, Medicaid,

or Medicare and shall bill the private health insurer, Medicaid, or

Medicare first before expending money from the state general fund

for providing treatment and services under this act to that

individual.

Sec. 400b. A reference to a time frame under this chapter of

12 hours to 168 hours or an equivalent amount of days excludes

Sundays and legal holidays.

Sec. 401. (1) As used in this chapter, "person requiring

treatment" means (a), (b), (c), or (d):

(a) An individual who has mental illness, and who as a result

of that mental illness can reasonably be expected within the near

future to intentionally or unintentionally seriously physically

injure himself, herself, or another individual, and who has engaged

in an act or acts or made significant threats that are

substantially supportive of the expectation.

(b) An individual who has mental illness, and who as a result

of that mental illness is unable to attend to those of his or her

basic physical needs such as food, clothing, or shelter that must

be attended to in order for the individual to avoid serious harm in

the near future, and who has demonstrated that inability by failing

to attend to those basic physical needs.

impaired by that mental illness that he or she is unable to

understand his or her need for treatment, and ~~whose continued~~

~~behavior as the result of this mental illness can reasonably be~~

~~expected,~~ whose impaired judgment, on the basis of competent

clinical opinion, ~~to result in significant physical~~ presents a

substantial risk of harm to ~~himself, herself,~~ the individual or

others in the near future. ~~This individual shall receive~~

~~involuntary mental health treatment initially only under the~~

~~provisions of sections 434 through 438.~~

(d) An individual who has mental illness, whose understanding

of the need for treatment is impaired to the point that he or she

is unlikely to voluntarily participate in or adhere to treatment

~~voluntarily, who is currently noncompliant with treatment that has~~

~~been recommended by a mental health, professional and~~ that has been

determined ~~to be~~ necessary to prevent a relapse or harmful

deterioration of his or her condition, and whose noncompliance with

treatment has been a factor in the individual's placement in a

psychiatric hospital, prison, or jail at least 2 times within the

last 48 months or whose noncompliance with treatment has been a

factor in the individual's committing 1 or more acts, attempts, or

threats of serious violent behavior within the last 48 months. An

individual under this subdivision is only eligible to receive

assisted outpatient treatment. ~~under section 433 or 469a.~~

(2) An individual whose mental processes have been weakened or

impaired by a dementia, an individual with a primary diagnosis of

epilepsy, or an individual with alcoholism or other drug dependence

is not a person requiring treatment under this chapter unless the

individual also meets the criteria specified in subsection (1). An

individual described in this subsection may be hospitalized under

the informal or formal voluntary hospitalization provisions of this

chapter if he or she is considered clinically suitable for

hospitalization by the hospital director.

Sec. 404. ~~The~~ Except as provided in this section, the

department shall prescribe the forms to be used under this chapter,

and all hospitals shall use department forms. ~~Forms that may be~~

~~used in court proceedings under this chapter shall be subject to~~

~~the approval of the supreme court.~~At the direction of the supreme

court, the state court administrative office shall prescribe the

forms used for court proceedings under this chapter.

Sec. 420. If a written notice of termination of

hospitalization is given to a hospital under section 419, if the

notice is not withdrawn, and if the hospital director determines

that the patient is a person requiring treatment ~~as defined in~~

~~section 401~~ and should remain in the hospital, the hospital

director or other suitable person shall within 3 days ~~, excluding~~

~~Sundays and holidays,~~ after the hospital's receipt of the notice,

file ~~an application~~ a petition with the court that complies with

section ~~423.~~ 434. The ~~application~~ petition shall be accompanied by

1 clinical certificate executed by a psychiatrist and 1 clinical

certificate executed by either a physician or a licensed

psychologist. If ~~an application~~ a petition is filed, the hospital

may continue hospitalization of the patient pending hearings

convened ~~pursuant to~~ under sections 451 to 465.

Sec. 422. (1) Each community mental health services program

shall designate the hospitals with which it has a contract to

receive and detain individuals under section 426, 427, ~~or 428.~~435,

436, or 438.

(2) Each community mental health services program shall give

notice of the hospitals designated under subsection (1) to the

department and to the probate court of each county in the program's

service area.

(3) The department shall designate ~~those~~ any additional

hospitals that are required to receive and detain individuals

presented for examination under section 426, 427, ~~or 428.~~435, 436,

or 438.

Sec. 423. A hospital designated by the department or by a

community mental health services program shall hospitalize an

individual presented to the hospital, pending receipt of a clinical

certificate by a psychiatrist stating that the individual is a

person requiring treatment, if ~~an application,~~ a petition, a

physician's or a licensed psychologist's clinical certificate, and

an authorization by a preadmission screening unit have been

executed. For an individual hospitalized under this section, a

petition shall have been executed not more than 10 days before the

presentation of the individual to the hospital, and the petition

must meet the conditions set forth in section 434(1) and (2).

Sec. 425. A physician's or a licensed psychologist's clinical

certificate required for hospitalization of an individual under

section 423 shall have been executed after personal examination of

the individual named in the clinical certificate, and within 72

hours before the time the clinical certificate is ~~filed with~~

received by the hospital. The clinical certificate may be executed

by any physician or licensed psychologist, including a physician or

licensed psychologist who is a staff member or employee of the

hospital ~~with which~~ that received the ~~application and~~ clinical

certificate. ~~are filed.~~

Sec. 426. Upon delivery to a peace officer of ~~an application~~ a

petition and a physician's or licensed psychologist's clinical

certificate, the peace officer shall take the individual named in

the ~~application~~ petition into protective custody and transport the

individual immediately to the preadmission screening unit or

hospital designated by the community mental health services program

for hospitalization under section 423. If the individual taken to a

preadmission screening unit meets the requirements for

hospitalization, then unless the community mental health services

program makes other transportation arrangements, the peace officer

shall take the individual to a hospital designated by the community

mental health services program. Transportation to another hospital

due to a transfer is the responsibility of the community mental

health services program.

Sec. 427. (1) If a peace officer observes an individual

conducting himself or herself in a manner that causes the peace

officer to reasonably believe that the individual is a person

requiring treatment, ~~as defined in section 401,~~ the peace officer

may take the individual into protective custody and transport the

individual to a preadmission screening unit designated by a

community mental health services program for examination under

section 429 or for mental health intervention services. The

preadmission screening unit shall provide those mental health

intervention services that it considers appropriate or shall

provide an examination under section 429. The preadmission

screening services may be provided at the site of the preadmission

screening unit or at a site designated by the preadmission

screening unit. Upon arrival at the preadmission screening unit or

site designated by the preadmission screening unit, the peace

officer shall execute ~~an application~~ a petition for hospitalization

of the individual. As soon as practical, the preadmission screening

unit shall offer to contact an immediate family member of the

recipient to let the family know that the recipient has been taken

into protective custody and where he or she is located. The

preadmission screening unit shall honor the recipient's decision as

to whether an immediate family member is to be contacted and shall

document that decision in the recipient's record. In the course of

providing services, the preadmission screening unit may provide

advice and consultation to the peace officer, which may include a

recommendation ~~to transport the individual to a hospital for~~

~~examination under section 429, or~~ to release the individual from

protective custody. ~~However,~~ In all cases where a peace officer has

executed a petition, the preadmission screening unit shall ensure

that an examination is conducted by a physician or licensed

psychologist. ~~prior to a recommendation to release the individual.~~

The preadmission screening unit shall ensure provision of follow-up

counseling and diagnostic and referral services if needed if it is

determined under section 429 that the person does not meet the

requirements for hospitalization.

(2) A peace officer is not financially responsible for the

cost of care of an individual for whom a peace officer has executed

~~an application~~ a petition under subsection (1).

(3) A hospital receiving an individual under subsection (1)

who has been referred by a community mental health services

program's preadmission screening unit shall notify that unit of the

results of an examination of that individual conducted by the

hospital.

Sec. 429. (1) A hospital designated under section 422 shall

receive and detain an individual presented for examination under

section 426, 427, 435, 436, or ~~428~~ 438, for not more than 24 hours.

During that time the individual shall be examined by a physician or

a licensed psychologist unless a clinical certificate has already

been presented to the hospital. If the examining physician or

psychologist does not certify that the individual is a person

requiring treatment, the individual shall be released immediately.

If the examining physician or psychologist executes a clinical

certificate, the individual may be hospitalized under section 423.

(2) If a preadmission screening unit provides an examination

under section 409, 410, or 427, ~~or 428,~~ the examination shall be

conducted as soon as possible after the individual arrives at the

preadmission screening site, and the examination shall be completed

within 2 hours, unless there are documented medical reasons why the

examination cannot be completed within that time frame or other

arrangements are agreed upon by the peace officer and the

preadmission screening unit.

Sec. 431. (1) Within 24 hours after receipt of a clinical

certificate by a psychiatrist ~~pursuant~~ according to section 430,

the hospital director shall transmit a notice to the court that the

patient has been hospitalized. The notice shall be accompanied by a

~~copy of the application~~ the petition and ~~copies of~~ the 2 clinical

certificates that were executed.

(2) A copy of the ~~application,~~ petition, a copy of the 2

clinical certificates, and a statement of the right of the patient

to court hearings under sections 451 to 465 shall also be given or

mailed to the patient's nearest relative, his or her guardian, if

any, and to his or her attorney.

(3) The patient shall be asked if he or she desires that the

documents listed in subsection (2) be sent to any other persons,

and at least 2 of any persons the patient designates shall be sent

the documents.

Sec. 434. (1) Any individual 18 years of age or over may file

with the court a petition that asserts that an individual is a

person requiring treatment. ~~as defined in section 401.~~

(2) The petition shall contain the facts that are the basis

for the assertion, the names and addresses, if known, of any

witnesses to the facts, and, if known, the name and address of the

nearest relative or guardian, or, if none, a friend, if known, of

the individual.

(3) ~~The~~ Except as provided in subsection (6), the petition

shall be accompanied by the clinical certificate of a physician or

a licensed psychologist, unless after reasonable effort the

petitioner could not secure an examination. If a clinical

certificate does not accompany the petition, an affidavit setting

forth the reasons an examination could not be secured shall also be

filed. The petition may also be accompanied by a second clinical

certificate. If 2 clinical certificates accompany the petition, at

least 1 clinical certificate shall have been executed by a

psychiatrist.

(4) Except as otherwise provided in subsection (6) and section

455, a clinical certificate that accompanies a petition shall have

been executed within 72 hours before the filing of the petition,

and after personal examination of the individual.

(5) The petition described in this section may assert that the

subject of the petition should receive assisted outpatient

treatment in accordance with section 468(2)(e).

(6) A petition that does not seek hospitalization but only

requests that the subject of the petition receive assisted

outpatient treatment is not subject to subsection (3) or (4).

Sec. 435. (1) If the petition is accompanied by 1 clinical

certificate, the court shall order the individual to be examined by

a psychiatrist.

(2) If the petition is not accompanied by a clinical

certificate, and if the court is satisfied a reasonable effort was

made to secure an examination, the court shall order the individual

to be examined by a psychiatrist and either a physician or a

licensed psychologist.

(3) The individual may be received and detained at the place

of examination as long as necessary to complete the examination or

examinations, but not more than 24 hours.

(4) After ~~any~~ an examination ordered under ~~this section, the~~

~~examining physician or licensed psychologist~~ subsection (1), the

examining psychiatrist shall either transmit a clinical certificate

to the court or report to the court that execution of a clinical

certificate is not warranted. After each examination ordered under

subsection (2), the examining psychiatrist, or the examining

physician or licensed psychologist, as applicable, shall either

transmit a clinical certificate to the court or report to the court

that execution of a clinical certificate is not warranted.

(5) If 1 examination was ordered and the examining ~~physician~~

~~or licensed psychologist~~ psychiatrist reports that execution of a

clinical certificate is not warranted, or if 2 examinations were

ordered and 1 of the examining physicians or the licensed

psychologist reports that execution of a clinical certificate is

not warranted, the court shall dismiss the petition or order the

individual to be examined by a psychiatrist, or if a psychiatrist

is not available, by a physician or licensed psychologist. If a

third examination report states that execution of a clinical

certificate is not warranted, the court shall dismiss the petition.

(6) This section does not apply to a petition filed under

section 434(6).

Sec. 447. Immediately after an individual is received at a

hospital for hospitalization under section 423 or 438, or for

examination under any provision of this chapter, he or she shall be

allowed to complete a reasonable number of telephone calls to

persons of his or her own choice. In no event shall the calls be

limited to less than 2. If the individual has insufficient funds on

his or her person, at least 2 calls shall be allowed at the expense

of the hospital.

Sec. 448. (1) Not later than 12 hours after an individual is

hospitalized under section 423 or 438, the hospital director shall

ensure that the individual receives all of the following:

(a) A copy of the ~~application or~~ petition that asserted that

the individual is a person requiring treatment.

(b) A written statement explaining that the individual will be

examined by a psychiatrist within 24 hours after his or her

hospitalization. ~~, excluding legal holidays.~~

of the individual to a full court hearing ~~pursuant~~ according to

sections 451 to 465, to be present at the hearing, to be

represented by legal counsel, to a jury trial, and to an

independent clinical evaluation.

(2) If the individual is unable to read or understand the

written materials, every effort shall be made to explain them to

him or her in a language he or she understands, and a note of the

explanation and by whom made shall be entered into his or her

patient record.

(3) An individual awaiting a court hearing mandated ~~pursuant~~

to under section 452 may sign a form provided by the department

accepting psychotropic drugs and other treatment without having to

consent to the hospitalization, unless the hospital director has

reason to believe the individual is not capable of giving informed

consent to treatment.

Sec. 449. The hospital director shall ensure that an

individual who is hospitalized ~~pursuant to~~ under section 423 or 438

receives a copy of each clinical certificate executed in connection

with the individual's hospitalization. Each clinical certificate

shall be delivered to the individual within 24 hours of either the

clinical certificate's completion or ~~the~~ receipt of the clinical

certificate by the hospital.

Sec. 451. Court hearings convened under authority of this

chapter ~~shall be~~ are governed by sections 452 to 465, except that

sections 453(2), 453a, and 455(3) to (11) do not apply to a

petition seeking only assisted outpatient treatment.

Sec. 452. (1) The court shall fix a date for every hearing

convened under this chapter. ~~The~~ Except as provided in subsection

(2), the hearing shall be convened promptly, but not more than 7

days ~~, excluding Sundays and holidays,~~ after the court's receipt of

any of the following:

~~(a) An application for hospitalization, which shall serve as a~~

~~petition for a determination that an individual is a person~~

~~requiring treatment, a clinical certificate executed by a physician~~

~~or a licensed psychologist, and a clinical certificate executed by~~

~~a psychiatrist.~~

(a) ~~(b)~~ A petition for a determination that an individual is a

person requiring treatment, a clinical certificate executed by a

physician or a licensed psychologist, and a clinical certificate

executed by a psychiatrist.

(b) ~~(c)~~ A petition for a determination that an individual

continues to be a person requiring treatment and a clinical

certificate executed by a psychiatrist.

~~(e) A petition for discharge filed under section 485 and a~~

~~physician's or a licensed psychologist's clinical certificate.~~

(d) ~~(f)~~ A demand or notification that a hearing that has been

temporarily deferred under section ~~455(5)~~ 455(6) be convened.

(2) A hearing for a petition under section 434(6) shall be

convened not more than 28 days after the filing of the petition,

unless the petition was filed while the subject of the petition was

an inpatient at a psychiatric hospital, in which case the hearing

shall be convened within 7 days of the filing of the petition.

Sec. 453. (1) The court shall cause notice of a petition and

of the time and place of any hearing to be given to the subject of

the petition, his or her attorney, the petitioner, the prosecuting

or other attorney provided for in section 457, the hospital

director of any hospital in which the subject of a petition is

hospitalized, the spouse of the subject of the petition if his or

her whereabouts are known, the guardian, if any, of the subject of

the petition, and other relatives or persons as the court may

determine. Notice shall be given at the earliest practicable time

and sufficiently in advance of the hearing date to permit

preparation for the hearing.

(2) Within 4 days of the court's receipt of the documents

described in section ~~452(b),~~ 452(1)(a), the court shall cause the

subject of the petition to be given a copy of the petition, a copy

of each clinical certificate executed in connection with the

proceeding, notice of the right to a full court hearing, notice of

the right to be present at the hearing, notice of the right to be

represented by legal counsel, notice of the right to demand a jury

trial, and notice of the right to an independent clinical

evaluation.

Sec. 454. (1) Every individual who is the subject of a

petition is entitled to be represented by legal counsel.

(2) Unless an appearance has been entered on behalf of the

subject of a petition, the court shall, within 48 hours after its

receipt of any petition together with the other documents required

by section 452, appoint counsel to represent the subject of the

petition, except that if an individual has been hospitalized, ~~under~~

~~section 423 or 438,~~ counsel shall be appointed within 24 hours

after the hospitalization.

(3) If, after consultation with appointed counsel, the subject

of a petition desires to waive his or her right to counsel, he or

she may do so by notifying the court in writing.

(4) If the subject of a petition prefers counsel other than

the initially appointed counsel, the preferred counsel agrees to

accept the appointment, and the court is notified of the preference

by the subject of the petition or the preferred counsel, the court

shall replace the initially appointed counsel with the preferred

counsel.

(5) If the subject of a petition is indigent, the court shall

compensate appointed counsel from court funds in an amount that is

reasonable and based upon time and expenses.

(6) The supreme court may, by court rule, establish the

compensation to be paid for counsel of indigents and may require

that counsel be appointed from a system or organization established

for the purpose of providing representation in proceedings governed

by this chapter.

(7) Legal counsel shall consult in person with the subject of

a petition at least 24 hours before the time set for a court

hearing.

(8) Legal counsel for the subject of a petition under section

~~452(a) or (b)~~ 452(1)(a) who is hospitalized pending the court

hearing shall consult in person with the individual for the first

time not more than 72 hours ~~, excluding Sundays and holidays,~~ after

the petition and 2 clinical certificates have been filed with the

court.

(9) After the consultation required in subsection (7) or (8),

counsel promptly shall file with the court a certificate stating

that he or she personally has seen and has consulted with the

subject of a petition as required by this section.

Sec. 455. (1) The subject of a petition has the right to be

present at all hearings. This right may be waived by a waiver of

attendance signed by the subject of a petition, witnessed by his or

her legal counsel, and filed with the court or it may be waived in

open court at a scheduled hearing. The subject's right to be

present at a hearing is considered waived by the subject's failure

to attend the hearing after receiving notice required by section

453 and any applicable court rule, providing the subject has had an

opportunity to consult with counsel as required under section 454.

The court may exclude the subject from a hearing if the subject's

behavior at the hearing makes it impossible to conduct the hearing.

The court shall enter on the record its reasons for excluding the

subject of a petition from the hearing. The subject's presence may

be waived by the court if there is testimony by a physician or

licensed psychologist who has recently observed the subject that

the subject's attendance would expose him or her to serious risk of

physical harm.

(2) The subject of the petition under section 434, after

consultation with counsel, may stipulate to the entry of any order

for treatment.

(3) ~~(2)~~ The subject of a petition under section ~~452(a) or (b)~~

434 who is hospitalized pending the court hearing, within 72 hours

~~, excluding Sundays and holidays,~~ after the petition and clinical

certificates have been filed with the court, shall meet with legal

counsel, a treatment team member assigned by the hospital director,

a person assigned by the executive director of the responsible

community mental health services program or other program as

designated by the department, and, if possible, a person designated

by the subject of the petition, in order to be informed of all of

the following:

(a) The proposed plan of treatment in the hospital.

(b) The nature and possible consequences of commitment

procedures.

of either an alternative to hospitalization or a combination of

hospitalization and alternative treatment with hospitalization not

to exceed 60 days.

(d) The right to request that the hearing be temporarily

deferred, with a continuing right to demand a hearing during the

deferral period. The deferral period shall be 60 days if the

individual chooses to remain hospitalized, or 90 days if the

individual chooses alternative treatment or a combination of

hospitalization and alternative treatment.

(4) ~~(3)~~ The person designated by the subject of the petition

under subsection ~~(2)~~ (3) may be any person who is willing and able

to attend the meeting, including a representative of an advocacy

group or the recipient rights adviser of the hospital.

(5) ~~(4)~~ The hospital in which the subject of a petition under

section ~~452(a) or (b)~~ 434 is hospitalized shall notify the

participants of the meeting required by subsection ~~(2).~~(3).

(6) ~~(5)~~ The subject of a petition under section ~~452(a) or (b)~~

434 who is hospitalized pending the court hearing may file with the

court a request to temporarily defer the hearing for not longer

than 60 days if the individual chooses to remain hospitalized, or

90 days if the individual chooses alternative treatment or a

combination of hospitalization and alternative treatment. The

request shall include a stipulation that the individual agrees to

remain hospitalized and to accept treatment as may be prescribed

for the deferral period, or to accept and follow the proposed plan

of treatment as described in subsection ~~(2)(c)~~ (3)(c) for the

deferral period, and further agrees that at any time the individual

may refuse treatment and demand a hearing under section 452. The

request to temporarily defer the hearing shall be on a form

provided by the department and signed by the individual in the

presence of his or her legal counsel and shall be filed with the

court by legal counsel.

(7) ~~(6)~~ Upon receipt of the request and stipulation under

subsection (6), the court shall temporarily defer the hearing.

During the deferral period, both the original petition and the

clinical certificates remain valid. ~~However, if~~ If the hearing is

convened, the court may require additional clinical certificates

and information from the provider. The court shall retain

continuing jurisdiction during the deferral period.

(8) ~~(7)~~ Upon receipt of a copy of the request to temporarily

defer the hearing under subsection ~~(5),~~ (6), if the individual has

agreed to remain hospitalized, ~~as described in subsection (2)(a) or~~

~~(c),~~ the hospital director shall treat the individual as a formal

voluntary patient without requiring the individual to sign formal

voluntary admission forms. If the individual, at any time during

the period in which the hearing is being deferred, refuses the

prescribed treatment or requests a hearing, either in writing or

orally, treatment shall cease, the hospitalized individual shall

remain hospitalized with the status of the subject of a petition

under section ~~452(a) or (b),~~ 434, and the court shall be notified

to convene a hearing under section ~~452(f).~~452(1)(d).

(9) ~~(8)~~ Upon receipt of a copy of the request to temporarily

defer the hearing under subsection ~~(5),~~ (6), if the individual has

agreed to participate in an alternative to hospitalization in the

community, the hospital director shall release the individual from

the hospital to the alternative treatment provider. If the

individual, at any time during the deferral period, refuses the

prescribed treatment or requests a hearing, either in writing or

orally, treatment shall cease and the court shall be notified to

convene a hearing under section ~~452(f).~~ 452(1)(d). Upon

notification, the court shall, if necessary, order a peace officer

to transport the individual to the hospital where the individual

shall remain until the hearing is convened. The individual shall be

given the status of the subject of a petition under section ~~452(a)~~

~~or (b).~~434.

(10) ~~(9)~~ If the individual has remained hospitalized and if,

not earlier than 14 days nor later than 7 days before the

expiration of the deferral period, the hospital director believes

that the condition of the individual is such that he or she

continues to require treatment, and believes that the individual

will not agree to sign a formal voluntary admission request or is

considered by the hospital not to be suitable for voluntary

admission, the hospital director shall notify the court to convene

a hearing under section ~~452(f).~~452(1)(d).

(11) ~~(10)~~ If the individual is participating in an alternative

to hospitalization in the community as described in subsection

~~(2)(c)~~ (3)(c) and if, not earlier than 14 days nor later than 7

days before the expiration of the deferral period, the executive

director of the community mental health services program

responsible for the treatment that is an alternative to

hospitalization believes that the condition of the individual is

such that he or she continues to require treatment, and believes

that the individual will not agree to accept treatment voluntarily

or is considered by the alternative treatment program provider not

suitable for voluntary treatment, the executive director shall

notify the court to convene a hearing under section

~~452(f).~~452(1)(d).

Sec. 461. (1) An Except as otherwise provided in this section,

an individual may not be found to require treatment unless at least

1 physician or licensed psychologist who has personally examined

that individual testifies in person or by written deposition at the

hearing.

(2) For a petition filed under section 434(6) that was not

accompanied by, or that has not subsequently been supplemented by,

a psychiatrist's clinical certificate, an individual may not be

found to require treatment unless at least 1 physician or licensed

psychologist and 1 psychiatrist who have personally examined that

individual testify in person or by written deposition at the

hearing.

(3) The examinations required under this section for a

petition filed under section 434(6) shall be arranged by the court

and the local community mental health services program or other

entity as designated by the department.

(4) A written deposition may be introduced as evidence at the

hearing only if the attorney for the subject of the petition was

given the opportunity to be present during the taking of the

deposition and to cross-examine the deponent. This testimony or

deposition may be waived by the subject of a petition. An

individual may be found to require treatment even if the petitioner

does not testify, as long as there is competent evidence from which

the relevant criteria in section 401 can be established.

Sec. 463. (1) If requested before the first scheduled hearing

or at the first scheduled hearing before the first witness has been

sworn on ~~an application or~~ a petition, the subject of a petition in

a hearing under this chapter has the right at his or her own

expense, or if indigent, at public expense, to secure an

independent clinical evaluation by a physician, psychiatrist, or

licensed psychologist of his or her choice relevant to whether he

or she requires treatment, whether he or she should be hospitalized

or receive treatment other than hospitalization, and whether he or

she is of legal capacity.

(2) Compensation for an evaluation performed by a physician or

a licensed psychologist shall be in an amount that is reasonable

and based upon time and expenses.

(3) The independent clinical evaluation described in this

section is for the sole use of the subject of the petition. The

independent clinical evaluation or the testimony of the individual

performing the evaluation shall not be introduced into evidence

without the consent of the subject of the petition.

Sec. 468. (1) If For a petition filed under section 434, if

the court finds that an individual is not a person requiring

treatment, the court shall enter a finding to that effect and, if

the person has been hospitalized before the hearing, shall order

that the person be discharged immediately.

(2) If For a petition filed under section 434, if an

individual is found to be a person requiring treatment, the court

shall do 1 of the following:

(a) Order the individual hospitalized in a hospital

recommended by the community mental health services program or

other entity as designated by the department.

(b) Order the individual hospitalized in a private or veterans

administration hospital at the request of the individual or his or

her family, if private or federal funds are to be utilized and if

the hospital agrees. If the individual is hospitalized in a private

or ~~veterans administration~~ Veterans Administration hospital

~~pursuant to~~ under this subdivision, any financial obligation for

the hospitalization shall be satisfied from funding sources other

than the community mental health services program, the department,

or other state or county funding.

that is an alternative to hospitalization and that is recommended

by the community mental health services program or other entity as

designated by the department.

(d) Order the individual to undergo a program of combined

hospitalization and alternative treatment or hospitalization and

assisted outpatient treatment, as recommended by the community

mental health services program or other entity as designated by the

department.

(e) Order the individual to receive assisted outpatient

treatment through a community mental health services program, or

other entity as designated by the department, capable of providing

the necessary treatment and services to assist the individual to

live and function in the community as specified in the order. The

court may include case management services and 1 or more of the

following:

(i) Medication.

(ii) Blood or urinalysis tests to determine compliance with or

effectiveness of prescribed medication.

(iii) Individual or group therapy, or both.

(iv) Day or partial day programs.

(v) Educational or vocational training.

(vi) Supervised living.

(vii) Assisted community treatment team services.

(viii) Substance use disorder treatment.

(ix) Substance use disorder testing for individuals with a

history of alcohol or substance use and for whom that testing is

necessary to assist the court in ordering treatment designed to

prevent deterioration. A court order for substance use testing is

subject to review once every 180 days.

(x) Any other services prescribed to treat the individual's

mental illness and either to assist the individual in living and

functioning in the community or to help prevent a relapse or

deterioration that may reasonably be predicted to result in suicide

or the need for hospitalization.

(3) In developing an assisted outpatient treatment order, the

court shall consider any preference or medication experience

reported by the individual or his or her designated representative,

whether or not the individual has an existing individual plan of

services under section 712, and any direction included in a durable

power of attorney or advance directive that exists.

(4) Before an order of assisted outpatient treatment expires,

if the individual has not previously designated a patient advocate

or executed a durable power of attorney or an advance directive,

the responsible community mental health services program or other

entity as designated by the department shall ascertain whether the

individual desires to establish a durable power of attorney or an

advance directive. If so, the community mental health services

program or other entity as designated by the department shall

direct the individual to the appropriate community resource for

assistance in developing a durable power of attorney or an advance

directive.

(5) If an order for assisted outpatient treatment conflicts

with the provisions of an existing durable power of attorney,

advance directive, or individual plan of services developed under

section 712, the assisted outpatient treatment order shall be

reviewed for possible adjustment by a psychiatrist not previously

involved with developing the assisted outpatient treatment order.

If an order for assisted outpatient treatment conflicts with the

provisions of an existing advance directive, durable power of

attorney, or individual plan of services developed under section

712, the court shall state the court's findings on the record or in

writing if the court takes the matter under advisement, including

the reason for the conflict.

Sec. 469a. (1) ~~Before~~ Except for a petition filed as described

under section 434(6), before ordering a course of treatment for an

individual found to be a person requiring treatment, the court

shall review a report on alternatives to hospitalization that was

prepared under section 453a not more than 15 days before the court

issues the order. After reviewing the report, the court shall do

all of the following:

(a) Determine whether a treatment program that is an

alternative to hospitalization or that follows an initial period of

hospitalization is adequate to meet the individual's treatment

needs and is sufficient to prevent harm that the individual may

inflict upon himself or herself or upon others within the near

future.

(b) Determine whether there is an agency or mental health

professional available to supervise the individual's alternative

treatment program.

alternatives to hospitalization.

(2) If the court determines that there is a treatment program

that is an alternative to hospitalization that is adequate to meet

the individual's treatment needs and prevent harm that the

individual may inflict upon himself or herself or upon others

within the near future and that an agency or mental health

professional is available to supervise the program, the court shall

issue an order for alternative treatment or combined

hospitalization and alternative treatment in accordance with

section 472a. The order shall state the community mental health

services program or, if private arrangements have been made for the

reimbursement of mental health treatment services in an alternative

setting, the name of the mental health agency or professional that

is directed to supervise the individual's alternative treatment

program. The order may provide that if an individual refuses to

comply with a 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) If the court orders assisted outpatient treatment as the

alternative to hospitalization, the order shall ~~require assisted~~

~~outpatient treatment through a community mental health services~~

~~program or any other publicly-funded entity necessary for~~

~~fulfillment of the assisted outpatient treatment plan. The order~~

~~shall include case management services. The order for assisted~~

~~outpatient treatment may include 1 or more of the following:~~be

consistent with the provisions of section 468(2)(e).

~~(a) Medication.~~

~~(b) Blood or urinalysis tests to determine compliance with~~

~~prescribed medications.~~

~~(c) Individual or group therapy.~~

~~(d) Day or partial day programs.~~

~~(e) Educational and vocational training.~~

~~(f) Supervised living.~~

~~(g) Assertive community treatment team services.~~

~~(h) Alcohol or substance abuse treatment, or both.~~

~~(i) Alcohol or substance abuse testing, or both, for~~

~~individuals with a history of alcohol or substance abuse and for~~

~~whom that testing is necessary to prevent a deterioration of their~~

~~condition. A court order for alcohol or substance abuse testing~~

~~shall be subject to review every 6 months.~~

~~(j) Any other services prescribed to treat the individual's~~

~~mental illness and to either assist the individual in living and~~

~~functioning in the community or to help prevent a relapse or~~

~~deterioration that may reasonably be predicted to result in suicide~~

~~or the need for hospitalization.~~

~~(4) In developing an order under this section, the court shall~~

~~consider any preferences and medication experiences reported by the~~

~~subject of the petition or his or her designated representative,~~

~~whether or not the subject of the petition has an existing~~

~~individual plan of services under section 712, and any directions~~

~~included in a durable power of attorney or advance directive that~~

~~exists. If the subject of the petition has not previously executed~~

~~a durable power of attorney or an advance directive, the~~

~~responsible community mental health services program shall, before~~

~~the expiration of the assisted outpatient treatment order,~~

~~ascertain whether the subject of the petition desires to establish~~

~~an advance directive. If so, the community mental health services~~

~~program shall offer to provide assistance in developing an advance~~

~~directive.~~

~~(5) If an assisted outpatient treatment order conflicts with~~

~~the provisions of an existing advance directive, durable power of~~

~~attorney, or individual plan of services developed under section~~

~~712, the assisted outpatient treatment order shall be reviewed for~~

~~possible adjustment by a psychiatrist not previously involved with~~

~~developing the assisted outpatient treatment order. If an assisted~~

~~outpatient treatment order conflicts with the provisions of an~~

~~existing advance directive, durable power of attorney, or~~

~~individual plan of services developed under section 712, the court~~

~~shall state the court's findings on the record or in writing if the~~

~~court takes the matter under advisement, including the reason for~~

~~the conflict.~~

Sec. 472a. (1) Upon the ~~receipt of an application under~~

~~section 423 or~~ filing of a petition under section 434 and a finding

that an individual is a person requiring treatment, the court shall

issue an initial order of involuntary mental health treatment that

shall be limited in duration as follows:

(a) An initial order of hospitalization shall not exceed 60

days.

(b) Except as provided in subdivision (d), an initial order of

alternative treatment shall not exceed 90 days.

combined hospitalization and alternative treatment shall not exceed

90 days. The hospitalization portion of the initial order shall not

exceed 60 days.

(d) An initial order of assisted outpatient treatment shall

not exceed 180 days.

(e) An initial order of combined hospitalization and assisted

outpatient treatment shall not exceed 180 days. The hospitalization

portion of the initial order shall not exceed 60 days.

(2) Upon the receipt of a petition under section 473 before

the expiration of an initial order under subsection (1) and a

finding that the individual continues to be a person requiring

treatment, the court shall issue a second order for involuntary

mental health treatment that shall be limited in duration as

follows:

(a) A second order of hospitalization shall not exceed 90

days.

(b) A second order of alternative treatment or assisted

outpatient treatment shall not exceed 1 year.

treatment or hospitalization and assisted outpatient treatment

shall not exceed 1 year. The hospitalization portion of the second

order shall not exceed 90 days.

(3) Upon the receipt of a petition under section 473 before

the expiration of a second order under subsection (2) and a finding

that the individual continues to be a person requiring treatment,

the court shall issue a continuing order for involuntary mental

health treatment that shall be limited in duration as follows:

(a) A continuing order of hospitalization shall not exceed 1

year.

(b) A continuing order of alternative treatment or assisted

outpatient treatment shall not exceed 1 year.

alternative treatment or hospitalization and assisted outpatient

treatment shall not exceed 1 year. The hospitalization portion of a

continuing order for combined hospitalization and alternative

treatment or hospitalization and assisted outpatient treatment

shall not exceed 90 days.

(4) Upon the receipt of a petition under section 473 before

the expiration of a continuing order of involuntary mental health

treatment, including a continuing order issued under section 485a

or a 1-year order of hospitalization issued under former section

472, and a finding that the individual continues to be a person

requiring treatment, the court shall issue another continuing order

for involuntary mental health treatment as provided in subsection

(3) for a period not to exceed 1 year. The court shall continue to

issue consecutive 1-year continuing orders for involuntary mental

health treatment under this section until a continuing order

expires without a petition having been filed under section 473 or

the court finds that the individual is not a person requiring

treatment.

(5) If a petition for an order of involuntary mental health

treatment is not brought under section 473 at least 14 days before

the expiration of an order of involuntary mental health treatment

as described in subsections (2) to (4), a person who believes that

an individual continues to be a person requiring treatment may file

a petition under section 434 for an initial order of involuntary

mental health treatment as described in subsection (1).

~~(6) An individual who on March 28, 1996 was subject to an~~

~~order of continuing hospitalization for an indefinite period of~~

~~time shall be brought for hearing no later than 15 days after the~~

~~date of the second 6-month review that occurs after March 28, 1996.~~

~~If the court finds at the hearing that the individual continues to~~

~~be a person requiring treatment, the court shall enter a continuing~~

~~order of involuntary mental health treatment as described in~~

~~subsection (3).~~

Sec. 474. (1) If an individual is subject to a combined order

of hospitalization and either alternative treatment or assisted

outpatient treatment, the decision to release the individual from

the hospital to the alternative treatment program or assisted

outpatient treatment program shall be a clinical decision made by a

psychiatrist designated by the hospital director in consultation

with the director of the alternative treatment program or the

assisted outpatient treatment program. If the hospital is operated

by or under contract with the department or a community mental

health services program and private payment arrangements have not

been made, the decision shall be made in consultation with the

treatment team designated by the executive director of the

community mental health services program. Notice of the return of

the individual to the alternative treatment program or to the

assisted outpatient treatment program shall be provided to the

court with a statement from a psychiatrist explaining the belief

that the individual is clinically appropriate for alternative

treatment or assisted outpatient treatment. At least 5 days before

releasing an individual from the hospital to the alternative

treatment program or assisted outpatient treatment program, the

hospital director shall notify the agency or mental health

professional that is responsible to supervise the individual's

alternative treatment program or assisted outpatient treatment

program that the individual is about to be released. The hospital

shall share relevant information about the individual with the

supervising agency or professional for the purpose of providing

continuity of treatment.

(2) If there is a disagreement between the hospital and the

executive director regarding the decision to release the individual

to the alternative treatment program or assisted outpatient

treatment program, either party may appeal in writing to the

department director within 24 hours of the decision. The department

director shall designate the psychiatrist responsible for clinical

affairs in the department, or his or her designee, who shall also

be a psychiatrist, to consider the appropriateness of the release

and make a decision within 48 hours after receipt of the written

appeal. Either party may appeal the decision of the department to

the court in writing within 24 hours ~~, excluding Sundays and~~

~~holidays,~~ after the department's decision.

(3) If private arrangements have been made for the

reimbursement of mental health treatment services in an alternative

setting and there is a disagreement between the hospital and the

director of the alternative treatment program or assisted

outpatient treatment program regarding the decision to release the

individual, either party may petition the court for a determination

of whether the individual should be released from the hospital to

the alternative treatment program or assisted outpatient treatment

program.

(4) The court shall make a decision within 48 hours ,

~~excluding Sundays and holidays,~~ after receipt of a written appeal

under subsection (2) or a petition under subsection (3). The court

shall consider information provided by both parties and may appoint

a psychiatrist to provide an independent clinical examination.

Sec. 474a. During the period of an order of combined

hospitalization and alternative treatment or combined

hospitalization and assisted outpatient treatment, hospitalization

may be used as clinically appropriate and when ordered by a

psychiatrist, for up to the maximum period for hospitalization

specified in the order. Subject to section 475, the decision to

hospitalize the individual shall be made by the director of the

alternative treatment program or assisted outpatient treatment

program, who shall notify the court when the individual is

hospitalized. The notice to the court shall include a statement

from a psychiatrist explaining the need for hospitalization.

Sec. 475. (1) During the period of an order for alternative

treatment or combined hospitalization and alternative treatment, if

the agency or mental health professional who is supervising an

individual's alternative treatment program determines that the

individual is not complying with the court order or that the

alternative treatment has not been or will not be sufficient to

prevent harm that the individual may inflict on himself or herself

or upon others, then the supervising agency or mental health

professional shall notify the court immediately. If the individual

believes that the alternative 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 alternative treatment or combined

hospitalization and alternative treatment is not complying with the

order, that the alternative 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 alternative treatment program is

not appropriate, the court may do either of the following without a

hearing and based upon 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

alternative treatment for the duration of the order.

(b) Modify the order to direct the individual to undergo

hospitalization or combined hospitalization and alternative

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 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 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 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.

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.

Enacting section 1. Sections 116a, 424, 428, and 433 of the

mental health code, 1974 PA 258, MCL 330.1116a, 330.1424, 330.1428,

and 330.1433, are repealed.

Enacting section 2. This amendatory act takes effect 90 days

after the date it is enacted into law or April 1, 2016, whichever

is later.