July 13, 2016, Introduced by Reps. Inman, Kosowski, Heise, LaFontaine, Santana, Cox and Darany and referred to the Committee on Families, Children, and Seniors.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 100a, 142, 153, 209b, 241, 498d, 498h, 628,
748a, 778, 919, 922, 924, 938, 946, 1002a, 1004a, 1005f, 1006,
1026, 1032, and 1074 (MCL 330.1100a, 330.1142, 330.1153, 330.1209b,
330.1241, 330.1498d, 330.1498h, 330.1628, 330.1748a, 330.1778,
330.1919, 330.1922, 330.1924, 330.1938, 330.1946, 330.2002a,
330.2004a, 330.2005f, 330.2006, 330.2026, 330.2032, and 330.2074),
section 100a as amended by 2012 PA 500, sections 142, 153, 209b,
628, and 946 as amended and sections 241 and 778 as added by 1995
PA 290, sections 498d and 498h as amended and section 1074 as added
by 2012 PA 540, section 748a as added by 1998 PA 497, section 919
as added by 1995 PA 17, section 1004a as added and section 1005f as
amended by 1993 PA 252, and section 1006 as amended by 2014 PA 72;
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.
(c) Home living.
(d) Social skills.
(e) Community use.
(f) Self-direction.
(g) Health and safety.
(h) Functional academics.
(i) Leisure.
(j) Work.
(4) "Adult foster care facility" means an adult foster care
facility licensed under the adult foster care facility licensing
act, 1979 PA 218, MCL 400.701 to 400.737.
(5) "Alcohol and drug abuse counseling" means the act of
counseling, modification of substance use disorder related
behavior, and prevention techniques for individuals with substance
use disorder, their 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 or 469a. Assisted outpatient treatment includes 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
Accreditation
Council for graduate medical
education 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.
(c) A psychiatrist who has education and clinical experience
in the evaluation and treatment of children or adolescents with
serious emotional disturbance who is approved by the director.
(15) "Children's diagnostic and treatment service" means a
program operated by or under contract with a community mental
health services program, that provides examination, evaluation, and
referrals for minors, including emergency referrals, that provides
or facilitates treatment for minors, and that has been certified by
the department.
(16) "Community mental health authority" means a separate
legal public governmental entity created under section 205 to
operate as a community mental health services program.
(17) "Community mental health organization" means a community
mental health services program that is organized under the urban
cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 to
124.512.
(18) "Community mental health services program" means a
program operated under chapter 2 as a county community mental
health agency, a community mental health authority, or a community
mental health organization.
(19) "Consent" means a written agreement executed by a
recipient, a minor recipient's parent, 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.
(c) A home for the aged licensed under article 17 of the
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.
(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 333.17084 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.
(C) Learning.
(D) Mobility.
(E) Self-direction.
(F) Capacity for independent living.
(G) Economic self-sufficiency.
(v) Reflects the individual's need for a combination and
sequence of special, interdisciplinary, or generic care, treatment,
or other services that are of lifelong or extended duration and are
individually planned and coordinated.
(b) If applied to a minor from birth to 5 years of age, a
substantial developmental delay or a specific congenital or
acquired condition with a high probability of resulting in
developmental disability as defined in subdivision (a) if services
are not provided.
(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.
(c) Autistic impaired and receiving special education services
in a program designed for the autistic impaired under subsection
(1)
of R 340.1758 of the Michigan administrative code
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.
(c) The individual's judgment is so impaired that he or she is
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.
(30) "Executive director" means an individual appointed under
section 226 to direct a community mental health services program or
his or her designee.
Sec. 142. The governing body of a facility licensed under
sections
134 through 150 shall certify to the department of mental
health
licensing and regulatory
affairs that its policies,
procedures, and practices are consistent with the Americans with
disabilities
act of 1990, Public Law 101-336, 104 Stat. Stat 327,
the
rehabilitation act of 1973, Public Law 93-112, 87 Stat. Stat
355,
the Elliott-Larsen civil rights act, Act No. 453 of the Public
Acts
of 1976, being sections 37.2101 to 37.2804 of the Michigan
Compiled
Laws, 1976 PA 453, MCL
37.2101 to 37.2804, and the
Michigan
handicappers' persons with
disabilities civil rights act,
Act
No. 220 of the Public Acts of 1976, being sections 37.1101 to
37.1607
of the Michigan Compiled Laws. 1976
PA 220, MCL 37.1101 to
37.1607. The governing body shall direct the administrator of the
facility
to take such action as is necessary to assure ensure that
the facility adheres to all of the nondiscriminatory laws described
in this section.
Sec. 153. (1) Subject to section 114a, the department shall
promulgate rules for the placement of adults who have serious
mental illness or developmental disability into community based
dependent living settings by department agencies, community mental
health services programs, and by agencies under contract to the
department or to a community mental health services program. The
rules shall include, but not be limited to, the criteria to be used
to determine a suitable placement and the specific agencies
responsible for making decisions regarding a placement.
(2) Subject to section 114a, the department of licensing and
regulatory affairs shall promulgate rules for the certification of
specialized programs offered in an adult foster care facility to
individuals with serious mental illness or developmental
disability. The rules shall provide for an administrative appeal to
the department of licensing and regulatory affairs of a denial or
limitation of the terms of certification under chapter 4 of the
administrative
procedures act of 1969, Act No. 306 of the Public
Acts
of 1969, being sections 24.271 to 24.287 of the Michigan
Compiled
Laws.1969 PA 306, MCL 24.271
to 24.287.
(3) Upon receipt of a request from an adult foster care
facility for certification of a specialized program, the department
of licensing and regulatory affairs shall inspect the facility to
determine whether the proposed specialized program conforms with
the requirements of this section and rules promulgated under this
section. The department of licensing and regulatory affairs shall
provide
the department of social services with an inspection report
and a certification, denial of certification, revocation, or
certification with limited terms for the proposed specialized
program. The department of licensing and regulatory affairs shall
reinspect a certified specialized program not less than once
biennially
and notify the department of social services in the same
manner as for the initial certification. In carrying out this
subsection, the department of licensing and regulatory affairs or
the department may contract with a community mental health services
program or any other agency.
(4) This section does not prevent licensure of an adult foster
care facility or the placement of individuals with serious mental
illness or developmental disability into community based dependent
living settings pending the promulgation by the department of
licensing and regulatory affairs of rules under subsection (1) or
(2).
Sec. 209b. (1) Before an individual is placed in a supervised
community living arrangement, such as a foster home, group care
home, nursing home, or other community-based setting, the
prerelease or postrelease planning for the individual shall involve
the individual, the individual's legal guardian if a guardian has
been appointed; any family member, friend, advocate, and
professional the recipient chooses; the parents of a minor
individual; the state facility or licensed hospital; the
residential
care provider, if such a residential
care provider has
been selected; and, with the consent of the individual, the
appropriate local and intermediate school systems and the
department, of
social services, if appropriate. In each case, the
community mental health services program shall produce in writing a
plan for community placement and aftercare services that is
sufficient to meet the needs of the individual and shall document
any lack of available community services necessary to implement the
plan.
(2) Each community mental health services program, as
requested,
shall send to the department aggregate data , which
includes
that include a list of services that could not be provided
but
that were indicated on prerelease or
postrelease plans. , but
which
could not be provided.
Sec. 241. Expenditures for the maintenance and repair of adult
foster care facilities owned or leased by a community mental health
services program are eligible for state financial support. Expenses
incurred in renovating an adult foster care facility that is leased
or owned by a community mental health services program are also
eligible for state financial support if the expenses are incurred
for 1 or more of the following purposes:
(a) To correct physical plant deficiencies cited by the
department
of social services licensing
and regulatory affairs
under state licensing rules.
(b) To purchase and install fire safety equipment or make
physical
plant changes that measurably assure ensure a reasonable
level of fire protection for all of the residents who live in the
facility.
(c) To correct physical plant deficiencies in accordance with
state and federal certification standards.
(d) To restore the facility to its prelease condition, if the
facility's lease contains a clause stipulating that renovation is
the lessee's responsibility at the time the lease expires or is
terminated.
Sec. 498d. (1) Subject to section 498e and except as otherwise
provided in this chapter, section 1074, and section 18s of chapter
XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.18s, a
minor of any age may be hospitalized if both of the following
conditions are met:
(a) The minor's parent, guardian, or a person acting in loco
parentis for the minor or, in compliance with subsection (2) or
(3),
the department of human services or county juvenile agency, as
applicable, requests hospitalization of the minor under this
chapter.
(b) The minor is found to be suitable for hospitalization.
(2)
The department of human services may request
hospitalization
of a minor who is committed to the department of
human
services under 1935 PA 220, MCL
400.201 to 400.214.
(3)
As applicable, the department of human services may
request hospitalization of, or the county juvenile agency may
request an evaluation for hospitalization of, a minor who is 1 of
the following:
(a) A ward of the court under chapter X or XIIA of the probate
code of 1939, 1939 PA 288, MCL 710.21 to 710.70 and 712A.1 to
712A.32,
if the department of human services or county juvenile
agency is specifically empowered to do so by court order.
(b)
Committed to the department of human services or county
juvenile agency under the youth rehabilitation services act, 1974
PA 150, MCL 803.301 to 803.309, except that if the minor is
residing with his or her custodial parent, the consent of the
custodial parent is required.
(4) Subject to sections 498e, 498f, and 498j, and except as
provided in section 1074 and section 18s of chapter XIIA of the
probate code of 1939, 1939 PA 288, MCL 712A.18s, a minor 14 years
of age or older may be hospitalized if both of the following
conditions are met:
(a) The minor requests hospitalization under this chapter.
(b) The minor is found to be suitable for hospitalization.
(5) In making the determination of suitability for
hospitalization, a minor shall not be determined to be a minor
requiring treatment solely on the basis of 1 or more of the
following conditions:
(a) Epilepsy.
(b) Developmental disability.
(c) Brief periods of intoxication caused by substances such as
alcohol or drugs or by dependence upon or addiction to those
substances.
(d) Juvenile offenses, including school truancy, home truancy,
or incorrigibility.
(e) Sexual activity.
(f) Religious activity or beliefs.
(g) Political activity or beliefs.
(6) As used in this section, "county juvenile agency" means
that term as defined in section 2 of the county juvenile agency
act, 1998 PA 518, MCL 45.622.
Sec. 498h. (1) Except as provided in section 1074 and section
18s of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL
712A.18s, a minor's parent, guardian, or person in loco parentis
may request emergency admission of the minor to a hospital, if the
person making the request has reason to believe that the minor is a
minor requiring treatment and that the minor presents a serious
danger to self or others.
(2) If the hospital to which the request for emergency
admission is made is not under contract to the community mental
health services program, the request for emergency hospitalization
shall be made directly to the hospital. If the hospital director
agrees that the minor needs emergency admission, the minor shall be
hospitalized. If the hospital director does not agree, the person
making the request may request hospitalization of the minor under
section 498d.
(3) If the hospital to which the request for emergency
admission is made is under contract to the community mental health
services program, the request shall be made to the preadmission
screening unit of the community mental health services program
serving in the county where the minor resides. If the community
mental health services program has a children's diagnostic and
treatment service, the preadmission screening unit shall refer the
person making the request to that service. In counties where there
is no children's diagnostic and treatment service, the preadmission
screening unit shall refer the person making the request to the
appropriate hospital. If it is determined that emergency admission
is not necessary, the person may request hospitalization of the
minor under section 498d. If it is determined that emergency
admission is necessary, the minor shall be hospitalized or placed
in an appropriate alternative program.
(4) If a minor is assessed by the preadmission screening unit
and found not to be clinically suitable for hospitalization, the
preadmission screening unit shall inform the individual or
individuals requesting hospitalization of the minor of appropriate
available alternative services to which a referral should be made
and of the process for a request of a second opinion under
subsection (5).
(5) If the preadmission screening unit of the community mental
health services program denies hospitalization, a minor's parent or
guardian may request a second opinion from the executive director.
The executive director shall arrange for an additional evaluation
by a psychiatrist, other physician, or licensed psychologist to be
performed within 3 days, excluding Sundays and legal holidays,
after the executive director receives the request. If the
conclusion of the second opinion is different from the conclusion
of the preadmission screening unit, the executive director, in
conjunction with the medical director, shall make a decision based
on all clinical information available. The executive director's
decision shall be confirmed in writing to the individual who
requested the second opinion, and the confirming document shall
include the signatures of the executive director and medical
director or verification that the decision was made in conjunction
with the medical director.
(6) If a person in loco parentis makes a request for emergency
admission and the minor is admitted to a hospital under this
section, the hospital director or the executive director of the
community mental health services program immediately shall notify
the minor's parent or parents or guardian.
(7) If a minor is hospitalized in a hospital that is operated
under contract with a community mental health services program, the
hospital director shall notify the appropriate executive director
within 24 hours after the hospitalization occurs.
(8) If a peace officer, as a result of personal observation,
has reasonable grounds to believe that a minor is a minor requiring
treatment and that the minor presents a serious danger to self or
others and if after a reasonable effort to locate the minor's
parent, guardian, or person in loco parentis, the minor's parent,
guardian, or person in loco parentis cannot be located, the peace
officer may take the minor into protective custody and transport
the minor to the appropriate community mental health preadmission
screening unit, if the community mental health services program has
a children's diagnostic and treatment service, or to a hospital if
it does not have a children's diagnostic and treatment service.
After transporting the minor, the peace officer shall execute a
written request for emergency hospitalization of the minor stating
the reasons, based upon personal observation, that the peace
officer believes that emergency hospitalization is necessary. The
written request shall include a statement that a reasonable effort
was made by the peace officer to locate the minor's parent,
guardian, or person in loco parentis. If it is determined that
emergency hospitalization of the minor is not necessary, the minor
shall be returned to his or her parent, guardian, or person in loco
parentis if an additional attempt to locate the parent, guardian,
or person in loco parentis is successful. If the minor's parent,
guardian, or person in loco parentis cannot be located, the minor
shall be turned over to the protective services program of the
family independence agency. If it is determined that emergency
admission of the minor is necessary, the minor shall be admitted to
the appropriate hospital or to an appropriate alternative program.
The executive director immediately shall notify the minor's parent,
guardian, or person in loco parentis. If the hospital is under
contract with the community mental health services program, the
hospital director shall notify the appropriate executive director
within 24 hours after the hospitalization occurs.
(9) An evaluation of a minor admitted to a hospital under this
section shall begin immediately after the minor is admitted. The
evaluation shall be conducted in the same manner as provided in
section 498e. If the minor is not found to be suitable for
hospitalization, the minor shall be released into the custody of
his or her parent, guardian, or person in loco parentis, and the
minor shall be referred to the executive director who shall
determine if the minor needs mental health services. If it is
determined that the minor needs mental health services, the
executive director shall offer an appropriate treatment program for
the minor, if the program is available, or refer the minor to
another agency for services.
(10) A hospital director shall proceed under either the
estates and protected individuals code, 1998 PA 386, MCL 700.1101
to 700.8206, or chapter XIIA of the probate code of 1939, 1939 PA
288, MCL 712A.1 to 712A.32, as warranted by the situation and the
best interests of the minor, under any of the following
circumstances:
(a) The hospital director cannot locate a parent, guardian, or
person in loco parentis of a minor admitted to a hospital under
subsection (8).
(b) The hospital director cannot locate the parent or guardian
of a minor admitted to a hospital by a person in loco parentis
under this section.
Sec. 628. (1) The court may appoint as guardian of an
individual with a developmental disability any suitable individual
or agency, public or private, including a private association
capable of conducting an active guardianship program for an
individual with a developmental disability. The court shall not
appoint
the department of mental health as guardian or any other
agency, public or private, that is directly providing services to
the individual, unless no other suitable individual or agency can
be identified. In such instances, guardianship by the provider
shall
only continue until such the
time as that a
more suitable
individual or agency can be appointed.
(2) Before the appointment, the court shall make a reasonable
effort to question the individual concerning his or her preference
regarding the person to be appointed guardian, and any preference
indicated shall be given due consideration.
Sec. 748a. (1) If there is a compelling need for mental health
records or information to determine whether child abuse or child
neglect has occurred or to take action to protect a minor where
there
may be a substantial risk of harm, a family independence
agency
department caseworker or administrator directly involved in
the child abuse or child neglect investigation shall notify a
mental health professional that a child abuse or child neglect
investigation has been initiated involving a person who has
received services from the mental health professional and shall
request in writing mental health records and information that are
pertinent to that investigation. Upon receipt of this notification
and request, the mental health professional shall review all mental
health records and information in the mental health professional's
possession to determine if there are mental health records or
information that is pertinent to that investigation. Within 14 days
after receipt of a request made under this subsection, the mental
health professional shall release those pertinent mental health
records and information to the caseworker or administrator directly
involved in the child abuse or child neglect investigation.
(2) The following privileges do not apply to mental health
records or information to which access is given under this section:
(a) The physician-patient privilege created in section 2157 of
the revised judicature act of 1961, 1961 PA 236, MCL 600.2157.
(b) The dentist-patient privilege created in section 16648 of
the public health code, 1978 PA 368, MCL 333.16648.
(c) The licensed professional counselor-client and limited
licensed counselor-client privilege created in section 18117 of the
public health code, 1978 PA 368, MCL 333.18117.
(d) The psychologist-patient privilege created in section
18237 of the public health code, 1978 PA 368, MCL 333.18237.
(e) Any other health professional-patient privilege created or
recognized by law.
(3) To the extent not protected by the immunity conferred by
1964 PA 170, MCL 691.1401 to 691.1415, an individual who in good
faith gives access to mental health records or information under
this section is immune from civil or administrative liability
arising from that conduct, unless the conduct was gross negligence
or willful and wanton misconduct.
(4) A duty under this act relating to child abuse and child
neglect does not alter a duty imposed under another statute,
including the child protection law, 1975 PA 238, MCL 722.621 to
722.638, regarding the reporting or investigation of child abuse or
child neglect.
Sec. 778. (1) The office shall initiate investigation of
apparent or suspected rights violations in a timely and efficient
manner. Subject to delays involving pending action by external
agencies as described in subsection (5), the office shall complete
the investigation not later than 90 days after it receives the
rights complaint. Investigation shall be initiated immediately in
cases involving alleged abuse, neglect, serious injury, or death of
a recipient involving an apparent or suspected rights violation.
(2) Investigation activities for each rights complaint shall
be accurately recorded by the office.
(3) The office shall determine whether a right was violated by
using the preponderance of the evidence as its standard of proof.
(4) The office shall issue a written status report every 30
calendar days during the course of the investigation. The report
shall be submitted to the complainant, the respondent, and the
responsible mental health agency. A status report shall include all
of the following:
(a) Statement of the allegations.
(b) Statement of the issues involved.
(c) Citations to relevant provisions of this act, rules,
policies, and guidelines.
(d) Investigative progress to date.
(e) Expected date for completion of the investigation.
(5) Upon completion of the investigation, the office shall
submit a written investigative report to the respondent and to the
responsible mental health agency. Issuance of the written
investigative report may be delayed pending completion of
investigations that involve external agencies, including law
enforcement
agencies and the department. of social services. The
report shall include all of the following:
(a) Statement of the allegations.
(b) Statement of the issues involved.
(c) Citations to relevant provisions of this act, rules,
policies, and guidelines.
(d) Investigative findings.
(e) Conclusions.
(f) Recommendations, if any.
(6) A rights investigation may be reopened or reinvestigated
by the office if there is new evidence that was not presented at
the time of the investigation.
Sec. 919. (1) As used in this section:
(a) "County program" means a county community mental health
program.
(b)
"Department" means the department of mental health.
(b) (c)
"Individual" means an
individual requiring mental
health treatment services.
(c) (d)
"Receiving agency" means
a public or private agency or
county program that, under this section, provides treatment to
individuals from a state other than the state in which the agency
or county program is located.
(d) (e)
"Receiving state" means
the state in which a receiving
agency is located.
(e) (f)
"Sending agency" means a
public or private agency
located in a state that sends an individual to another state for
treatment under this section.
(f) (g)
"Sending state" means the
state in which a sending
agency is located.
(2) A county program may contract as provided under this
section with a public or private agency located in a state
bordering
Michigan this state to secure services under this act for
an individual who receives services through the county program.
(3) A county program may contract as provided under this
section with a public or private agency located in a state
bordering
Michigan this state to provide services under this act in
an approved treatment facility in this state for an individual who
is
a resident of the bordering state, except that such the services
may not be provided for an individual who is involved in criminal
proceedings.
(4) A contract entered into under this section may not be
validly executed until the department has reviewed and approved the
provisions of the contract and determined that the receiving agency
provides services in accordance with the standards of this state
and the attorney general has certified that the receiving state's
laws governing patient rights are substantially similar to those of
this state.
(5) An individual does not establish legal residence in the
state where the receiving agency is located while the individual is
receiving
services pursuant according
to a contract executed under
this section.
(6) Section 748 applies to treatment records of an individual
receiving
services pursuant according
to a contract executed under
this section through a receiving agency in this state, except that
the sending agency has the same right of access to the treatment
records of the individual as provided for the department under
section 748(4)(e).
(7) An individual who is detained, committed, or placed on an
involuntary basis under this act may be admitted and treated in
another
state pursuant according to a contract executed under this
section. An individual who is detained, committed, or placed under
the
civil law of a state bordering Michigan this state may be
admitted
and treated in this state pursuant according to a contract
executed under this section. Court orders valid under the law of
the sending state are granted recognition and reciprocity in the
receiving state for individuals covered by a contract executed
under this section to the extent that the court orders relate to
admission for the treatment or care of a mental disability. The
court orders are not subject to legal challenge in the courts of
the receiving state. An individual who is detained, committed, or
placed under the law of a sending state and who is transferred to a
receiving state under this section continues to be in the legal
custody of the authority responsible for the individual under the
law
of the sending state. Except in an emergency, such an the
individual may not be transferred, removed, or furloughed from a
facility of the receiving agency without the specific approval of
the authority responsible for the individual under the law of the
sending state.
(8)
While in the receiving state pursuant according to a
contract executed under this section, an individual is subject to
all of the laws and regulations applicable to an individual
detained,
committed, or placed pursuant according
to the
corresponding laws of the receiving state, except those laws and
regulations of the receiving state pertaining to length of
involuntary inpatient treatment, reexaminations, and extensions of
involuntary inpatient treatment and except as otherwise provided by
this section. The laws and regulations of the sending state
relating to length of involuntary inpatient treatment,
reexaminations, and extensions of involuntary inpatient treatment
apply.
An individual shall not be sent to another state pursuant
according to a contract executed under this section until the
receiving state has enacted a law recognizing the validity and
applicability of this state's laws as provided in this section.
(9) If an individual receiving treatment on a voluntary basis
pursuant
according to a contract executed under this section
requests discharge, the receiving agency shall immediately notify
the sending agency and shall return the individual to the sending
state as directed by the sending agency within 48 hours after the
request, excluding Saturdays, Sundays, and legal holidays, unless
other arrangements are made with the sending agency. The sending
agency shall immediately upon return of the individual either
arrange for the discharge of the individual or detain the
individual
pursuant according to the emergency detention laws of
the sending state.
(10)
If an individual receiving services pursuant according to
a contract executed under this section leaves the receiving agency
without authorization and the individual at the time of the
unauthorized leave is subject to involuntary inpatient treatment
under the laws of the sending state, the receiving agency shall use
all reasonable means to locate and return the individual. The
receiving agency shall immediately report the unauthorized leave of
absence to the sending agency. The receiving state has the primary
responsibility for, and the authority to direct, the return of
individuals
within its borders and is liable for the cost of such
that action to the extent that it would be liable for costs if an
individual who is a resident of the receiving state left without
authorization.
(11) An individual may be transferred between facilities of
the receiving state if transfers are permitted by the contract
executed under this section providing for the individual's care.
(12) Each contract executed under this section shall do all of
the following:
(a) Establish the responsibility for payment for each service
to be provided under the contract. Charges to the sending state
shall not be more or less than the actual cost of providing the
service.
(b) Establish the responsibility for the transportation of
individuals to and from receiving agencies.
(c) Provide for reports by the receiving agency to the sending
agency on the condition of each individual covered by the contract.
(d) Provide for arbitration of disputes arising out of the
contract that cannot be settled through discussion between the
contracting parties and specify how the arbitrators will be chosen.
(e) Include provisions ensuring the nondiscriminatory
treatment, as required by law, of employees, individuals receiving
services, and applicants for employment and services.
(f) Establish the responsibility for providing legal
representation for an individual receiving services in a legal
proceeding involving the legality of admission and the conditions
of involuntary inpatient treatment.
(g) Establish the responsibility for providing legal
representation for an employee of a contracting party in legal
proceedings initiated by an individual receiving treatment pursuant
to the contract.
(h) Include provisions concerning the length of the contract
and the means by which the contract can be terminated.
(i) Establish the right of 1 or more qualified employees or
representatives of the sending agency and sending state to inspect,
at all reasonable times, the records of the receiving agency and
its treatment facilities to determine if appropriate standards of
care are met for individuals receiving services under the contract.
(j) Require the sending agency to provide the receiving agency
with copies of all relevant legal documents authorizing involuntary
inpatient
treatment of an individual who is admitted pursuant to
under the laws of the sending state and is receiving services
pursuant
according to a contract executed under this section.
(k) Require each individual who seeks treatment on a voluntary
basis to agree in writing to be returned to the sending state upon
making a request for discharge as provided in subsection (9) and
require an agent or employee of the sending agency to certify that
the individual understands that agreement.
(l) Establish the responsibility for securing a reexamination
for an individual and for extending an individual's period of
involuntary inpatient treatment.
(m) Include provisions specifying when a receiving facility
can refuse to admit or retain an individual.
(n) Specify the circumstances under which an individual will
be permitted a home visit or granted a pass to leave the facility,
or both.
Sec.
922. The director of the department, of mental health, or
a duly authorized agent designated by him or her in writing to the
governor, shall perform the duties of the compact administrator
who, acting jointly with like officers of other states, shall
promulgate rules and adopt procedures to carry out more effectively
the terms of the compact. All rules promulgated by the compact
administrator
shall be pursuant to Act No. 306 of the Public Acts
of
1969, as amended.promulgated
according to the administrative
procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.
Sec. 924. (1) The compact administrator may enter into
supplementary agreements with appropriate officials of other states
pursuant
according to Articles VII and XI of the compact.
(2) The compact administrator shall cooperate with all
departments, agencies, and officers of and in the government of
this state and its subdivisions in facilitating the proper
administration of the compact or of any supplementary agreement
entered into by this state.
(3)
The department of mental health may enter into agreements
with authorities of other states for the arbitration of disputed
questions between those states and this state respecting the
residence of mentally ill and mentally deficient persons and their
return to their place of legal settlement.
Sec.
938. The department of mental health may provide to any
individual receiving mental health services from the department
written or oral notice of the availability of family planning
services and upon request of the individual offer education and
information on family planning. The notice shall state that receipt
of mental health services is in no way dependent upon a request or
nonrequest for family planning services.
Sec. 946. (1) If a patient communicates to a mental health
professional who is treating the patient a threat of physical
violence against a reasonably identifiable third person and the
recipient has the apparent intent and ability to carry out that
threat in the foreseeable future, the mental health professional
has a duty to take action as prescribed in subsection (2). Except
as provided in this section, a mental health professional does not
have a duty to warn a third person of a threat as described in this
subsection or to protect the third person.
(2) A mental health professional has discharged the duty
created under subsection (1) if the mental health professional,
subsequent to the threat, does 1 or more of the following in a
timely manner:
(a) Hospitalizes the patient or initiates proceedings to
hospitalize the patient under chapter 4 or 4a.
(b) Makes a reasonable attempt to communicate the threat to
the third person and communicates the threat to the local police
department or county sheriff for the area where the third person
resides or for the area where the patient resides, or to the state
police.
(c) If the mental health professional has reason to believe
that the third person who is threatened is a minor or is
incompetent by other than age, takes the steps set forth in
subdivision
(b) and communicates the threat to the department of
social
services in the county where the minor
resides and to the
third person's custodial parent, noncustodial parent, or legal
guardian, whoever is appropriate in the best interests of the third
person.
(3) If a patient described in subsection (1) is being treated
through team treatment in a hospital, and if the individual in
charge of the patient's treatment decides to discharge the duty
created in subsection (1) by a means described in subsection (2)(b)
or (c), the hospital shall designate an individual to communicate
the threat to the necessary persons.
(4) A mental health professional who determines in good faith
that a particular situation presents a duty under this section and
who complies with the duty does not violate section 750. A
psychiatrist who determines in good faith that a particular
situation presents a duty under this section and who complies with
the duty does not violate the physician-patient privilege
established under section 2157 of the revised judicature act of
1961,
Act No. 236 of the Public Acts of 1961, being section
600.2157
of the Michigan Compiled Laws. 1961
PA 236, MCL 600.2157.
A psychologist who determines in good faith that a particular
situation presents a duty under this section and who complies with
the duty does not violate section 18237 of the public health code,
Act
No. 368 of the Public Acts of 1978, being section 333.18237 of
the
Michigan Compiled Laws. 1978
PA 368, MCL 333.18237. A certified
social
worker, social worker, or social worker licensed bachelor's
social worker, licensed master's social worker, or social service
technician who determines in good faith that a particular situation
presents a duty under this section and who complies with the duty
does
not violate section 1610 of the occupational code, Act No. 299
of
the Public Acts of 1980, being section 339.1610 of the Michigan
Compiled
Laws. 18513 of the public
health code, 1978 PA 368, MCL
333.18513. A licensed professional counselor who determines in good
faith that a particular situation presents a duty under this
section and who complies with the duty does not violate section
18117
of the public health code, Act No. 368 of the Public Acts of
1978,
being section 333.18117 of the Michigan Compiled Laws. 1978
PA 368, MCL 333.18117. A marriage and family therapist who
determines in good faith that a particular situation presents a
duty under this section and who complies with the duty does not
violate
section 1509 of the occupational code, Act No. 299 of the
Public
Acts of 1980, being section 339.1509 of the Michigan
Compiled
Laws. 16911 of the public
health code, 1978 PA 368, MCL
333.16911. A music therapist who determines in good faith that a
particular situation presents a duty under this section and who
complies
with this duty does not violate section 4.11 3.12 of
the
professional
code of ethics of the national
association for music
therapy,
inc., or the clinical relationships section of the code of
ethics
of the certification board for music therapists.American
Music Therapy Association.
(5) This section does not affect a duty a mental health
professional may have under any other section of law.
Sec. 1002a. (1) For a person confined in a place of detention
operated by a political subdivision of the state and who requests
mental health services, mental health services shall be provided by
the
appropriate community mental health program pursuant according
to the responsibilities described in section 206.
(2)
The department of mental health shall promulgate rules
pursuant
to Act No. 306 of the Public Acts of 1969, as amended,
being
sections 24.201 to 24.315 of the Michigan Compiled Laws,
according to the administrative procedures act of 1969, 1969 PA
306, MCL 24.201 to 24.328, establishing a procedure for the
voluntary admission into a state mental health facility of a person
confined in a place of detention operated by a political
subdivision of the state.
(3) The involuntary admission into a state mental health
facility of a person confined in a place of detention operated by a
political
subdivision of the state shall be is governed by sections
423
to 444.439.
Sec. 1004a. (1) In addition to the rights, benefits, and
privileges guaranteed to prisoners by other provisions of law, the
state constitution of 1963, and the constitution of the United
States, a prisoner receiving services from the corrections mental
health program has the rights enumerated in this section. The
rights enumerated in this section do not replace or limit any other
rights, benefits, or privileges of a prisoner.
(2) The rights enumerated in this section pertain to the
manner in which mental health services are provided to the
prisoner. This section does not affect the regulations and policies
of the department of corrections relating to the operation of a
state correctional facility. In an instance in which a right
enumerated in this section conflicts with a regulation or policy of
the department of corrections affecting the security of a state
correctional facility or the protection of prisoners, employees, or
the public, the department of corrections regulation or policy
shall control.
(3) A prisoner is entitled to receive mental health services
suitable to his or her condition in a manner that protects and
promotes the basic human dignity of the prisoner.
(4) Subject to subsection (2), a prisoner receiving services
from the corrections mental health program is entitled to those
rights enumerated in sections 706, 710, 712, 714, 716, 722, 740,
742, 744, and 746.
(5) Information in the medical record of a prisoner receiving
services from the corrections mental health program and other
information acquired in the course of the prisoner's treatment in
the
program is confidential and shall is not be open to
public
inspection. The corrections mental health program is the holder of
the record and may disclose the information only in the
circumstances and under the conditions set forth in this
subsection. If information made confidential by this subsection is
disclosed, the identity of the individual to whom it pertains shall
be protected and shall not be disclosed unless it is germane to the
authorized
purpose for which disclosure was sought.
; and, if If
practicable, other information shall not be disclosed unless it is
germane to the authorized purpose for which disclosure was sought.
A person receiving information made confidential by this subsection
shall disclose the information to others only to the extent
consistent with the authorized purpose for which the information
was obtained. With the exception of records, data, and knowledge
generated by individuals or committees performing a peer review
function, which is not subject to disclosure, information
pertaining to a prisoner receiving mental health services from the
corrections mental health program may be disclosed under 1 or more
of the following circumstances:
(a)
Pursuant According to orders or subpoenas of a court of
record, or subpoenas of the legislature, unless the information is
made privileged by law.
(b) To an attorney for the prisoner, with the prisoner's
consent.
(c) If necessary to comply with another provision of law.
(d) To the department of corrections if the information is
necessary to protect the safety of the prisoner, other prisoners,
or the public, or to protect the prisoner's interactions with
others in the state correctional facility.
(e)
To the department of mental health if the information is
necessary for the department to discharge a responsibility placed
upon it by law.
(f) To the office of the auditor general if the information is
necessary for that office to discharge its constitutional
responsibility.
(g) As necessary to enable a prisoner or the prisoner's
surviving spouse or other related person to apply for or receive
benefits.
(h) As necessary for the purpose of outside research,
evaluation, accreditation, or statistical compilation, if the
prisoner can be identified from the disclosure only if that
identification is essential in order to achieve the purpose for
which the information is sought or if preventing that
identification would clearly be impractical, but in no event if the
prisoner is likely to be harmed by the identification.
(i) To providers of mental health or other health services or
a public agency, when there is a compelling need for disclosure
based upon a substantial probability of harm to the prisoner or to
other persons.
(j) To a representative of the protection and advocacy system
designated by the governor in section 931 if both of the following
apply:
(i) A complaint regarding the provision of mental health
services by the corrections mental health program has been received
by the protection and advocacy system from or on behalf of the
prisoner.
(ii) The prisoner does not have a legal guardian, or the state
or the designee of the state is the legal guardian of the prisoner.
Sec. 1005f. (1) A person may be transferred to the center for
forensic psychiatry program under this chapter and may be
transferred between state mental health facilities upon
authorization by the director of the center for forensic psychiatry
program. The person is entitled to an administrative hearing
pursuant
according to rules of the department of mental health
regarding the need and appropriateness of a transfer to another
state mental health facility upon receipt by the director of the
center for forensic psychiatry program of the person's objection to
the transfer. If an emergency transfer is required, and if
objection is made to the transfer, the hearing will be held at the
receiving facility.
(2) A person transferred to another state mental health
facility under this section shall not be commingled with other
recipients of mental health services except in cases in which it is
determined by the director of the center for forensic psychiatry
program, after consultation with the department of corrections, and
pursuant
according to rules promulgated by the department, of
mental
health, that the person and the
other recipients of mental
health services exhibit the same propensity for dangerous behavior
and require similar treatment plans and modalities.
(3) A person transferred under this section is entitled to all
the rights and privileges afforded to other mental health
recipients
pursuant to under chapter 7, except those rights and
privileges specifically excluded or modified by law.
Sec. 1006. (1) A prisoner admitted to the corrections mental
health
program according to section 1003a or section 1003b shall be
discharged from the program when 1 or both of the following occur:
(a) The prisoner ceases to require mental health services.
(b) The prisoner is paroled or discharged from prison.
(2) If a prisoner is to be discharged from the corrections
mental health program before the expiration of the prisoner's
criminal sentence, the director of the corrections mental health
program shall first notify the department of corrections of the
pending discharge, and shall transmit a full report on the
condition of the prisoner to the department of corrections.
(3) If the prisoner is paroled or discharged from prison, and
the corrections mental health program considers the prisoner to be
a person requiring treatment, as defined in section 401, or a
person who meets the criteria for judicial admission, as prescribed
in section 515, the director of the corrections mental health
program at least 14 days before the parole date or the date of
discharge shall file a petition under section 434 or section 516
asserting that the prisoner is a person requiring treatment or that
the prisoner meets the criteria for judicial admission. The
petition shall be filed with the probate court of the prisoner's
county of residence.
(4)
The department of community health is responsible for
assuring
ensuring that needed aftercare reintegration and
community-based mental health services are offered to mentally ill
and developmentally disabled persons who are leaving prison, upon
referral by the department of corrections. Upon request from the
department of corrections, community-based mental health services
shall
be provided by the department of community health throughout
the parole period.
Sec. 1026. (1) Upon a showing that the defendant may be
incompetent to stand trial, the court shall order the defendant to
undergo an examination by personnel of either the center for
forensic psychiatry or other facility officially certified by the
department
of mental health to perform examinations relating to the
issue of incompetence to stand trial. The defendant shall make
himself or herself available for the examination at the places and
times established by the center for forensic psychiatry or other
certified facility. If the defendant, after being notified, fails
to make himself or herself available for the examination, the court
may order his or her commitment to the center for forensic
psychiatry or other certified facility without a hearing.
(2) When the defendant is to be held in a jail or similar
place of detention pending trial, the center for forensic
psychiatry or other certified facility may perform the examination
in the jail or may notify the sheriff to transport the defendant to
the center for forensic psychiatry or other certified facility for
the examination, and the sheriff shall return the defendant to the
jail upon completion of the examination.
(3) Except as provided in subsection (1), when the defendant
is not to be held in a jail or similar place of detention pending
trial, the court shall commit him or her to the center for forensic
psychiatry or other certified facility only when the commitment is
necessary for the performance of the examination.
(4) The defendant shall be released by the center for forensic
psychiatry or other certified facility upon completion of the
examination.
Sec. 1032. (1) If the defendant is determined incompetent to
stand trial, and if the court determines that there is a
substantial probability that, if provided a course of treatment, he
or she will attain competence to stand trial within the time limit
established by section 1034, the court shall order him or her to
undergo treatment to render him or her competent to stand trial.
(2) The court shall appoint a medical supervisor of the course
of treatment. The medical supervisor may be any person or agency
willing
to supervise the course of treatment, or the department. of
mental
health.
(3) The court may commit the defendant to the custody of the
department, of
mental health, or to the custody of any other
inpatient mental health facility if it agrees, only if commitment
is necessary for the effective administration of the course of
treatment.
If the defendant, absent commitment to the department of
mental
health or other inpatient mental health facility, would
otherwise be held in a jail or similar place of detention pending
trial, the court may enter an order restricting the defendant in
his or her movements to the buildings and grounds of the facility
at which he or she is to be treated.
Sec. 1074. (1) If the juvenile is incompetent to proceed, but
the court finds that the juvenile may be restored to competency in
the foreseeable future, 1 of the following applies:
(a) If the offense is a traffic offense or a misdemeanor other
than a serious misdemeanor, the matter shall be dismissed.
(b) If the offense is a serious misdemeanor, the court may
dismiss the matter or suspend the proceedings against the juvenile.
(c) If the offense is a felony, the proceedings against the
juvenile shall be further suspended.
(2) If proceedings are suspended because the juvenile is
incompetent to proceed but the court finds that the juvenile may be
restored to competency in the foreseeable future, all of the
following apply:
(a) Before issuing a restoration order, the court shall hold a
hearing to determine the least restrictive environment for
completion of the restoration.
(b) The court may issue a restoration order that is valid for
60 days from the date of the initial finding of incompetency or
until 1 of the following occurs, whichever occurs first:
(i) The qualified forensic mental health examiner, based on
information provided by the qualified restoration provider, submits
a report that the juvenile has regained competency or that there is
no substantial probability that the juvenile will regain competency
within the period of the order.
(ii) The charges are dismissed.
(iii) The juvenile reaches 18 years of age.
(c) Following issuance of the restoration order, the qualified
restoration provider shall submit a report to the court and the
qualified forensic mental health examiner that includes the
information required under section 1066. The report shall be
submitted to the court and the qualified forensic mental health
examiner every 30 days, or sooner if and at the time either of the
following occurs:
(i) The qualified restoration provider determines that the
juvenile is no longer incompetent to proceed.
(ii) The qualified restoration provider determines that there
is no substantial probability that the juvenile will be competent
to proceed within the period of the order.
(3) Not later than 14 days before the expiration of the
initial 60-day order, the qualified restoration provider may
recommend to the court and the qualified forensic mental health
examiner that the restoration order be renewed by the court for
another 60 days, if there is a substantial probability that the
juvenile will not be incompetent to proceed within the period of
that renewed restoration order. The restoration order and any
renewed restoration order shall not exceed a total of 120 days.
(4) Except as otherwise provided in this section, upon receipt
of a report that there is a substantial probability that the
juvenile will remain incompetent to proceed for the foreseeable
future or within the period of the restoration order, the court
shall do both of the following:
(a) Determine custody of the juvenile as follows:
(i) The court may direct that civil commitment proceedings be
initiated, as allowed under section 498d.
(ii) If the court determines that commitment proceedings are
inappropriate, the juvenile shall be released to the juvenile's
parent, legal guardian, or legal custodian under conditions
considered appropriate to the court.
(b) Dismiss the charges against the juvenile.
(5) Upon receipt of a report from a qualified forensic mental
health examiner that there is a substantial probability that the
juvenile is unable to be restored due to serious emotional
disturbance, the court may in its discretion, except as provided
under the youth rehabilitation services act, 1974 PA 150, MCL
803.301 to 803.309, order that mental health services be provided
to the juvenile by the department, subject to the availability of
inpatient care, a community mental health services program, the
department, of
human services, a county department, of human
services,
or another appropriate mental
health services provider
for a period not to exceed 60 days. The court shall retain
jurisdiction over the juvenile throughout the duration of the
order. The entity ordered to provide services under this subsection
shall continue to provide services for the duration of the period
of treatment ordered by the court.
(6) Not later than 14 days before the expiration of an order
for treatment under this subsection or subsection (5), the entity
providing mental health services under that order shall submit a
report to the court and the qualified forensic mental health
examiner regarding the juvenile. Upon receipt of the report, the
court shall review the report and do either of the following:
(a) Renew the order for another period of treatment not to
exceed 60 days. The order for treatment and any renewed order shall
not exceed a total of 120 days.
(b) Determine custody of the juvenile and dismiss the charges
against the juvenile.
Enacting section 1. Sections 102 and 1006a of the mental
health code, 1974 PA 258, MCL 330.1102 and 330.2006a, are repealed.
Enacting section 2. This amendatory act takes effect 90 days
after the date it is enacted into law.