Mich. Admin. Code (Health and Human Services) | Michigan Administrative Code — Department of Health and Human Services

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 325.81 to R 325.87 Michigan Physician Orders for Scope of Treatment

Mich. Admin. Code R 325.81 Definitions {#sec-r-325.81 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.81}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

POLICY AND PLANNING ADMINISTRATION

MICHIGAN PHYSICIAN ORDERS FOR SCOPE OF TREATMENT

(By authority conferred on the director of the department of health and human services by sections 2226, 2233, and 5676 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, and 333.5676)

Rule 81. (1) As used in these rules:

(a) “Advanced illness” means a medical or surgical condition with significant functional impairment that is not reversible by curative therapies and that is anticipated to progress toward death despite attempts at curative therapies or modulation.

(b) “Attending health professional” means a physician, physician’s assistant, or certified nurse practitioner, who has primary responsibility for the treatment of a patient and is authorized to issue the orders on a MI-POST form.

(c) “Change in level of care or care setting” results from a formal healthcare or needs assessment, or both, that supports the increase or decrease in care services required to provide a safe and least restrictive setting for the patient. A change in care setting does not refer to reassignments within the same facility.

(d) “Department” means the department of health and human services.

(e) “Emergency medical services personnel” or “EMS personnel” means that term as defined in section 20904 of the public health code, 1978 PA 368, MCL 333.20904, but does not include an emergency medical services instructor-coordinator.

(f) “Guardian” means a person with the powers and duties to make medical treatment decisions on behalf of a patient to the extent granted by court order under section 5314 of the estates and protected individuals code, 1998 PA 386, MCL 700.5314.

(g) “Patient advocate” means an individual presently authorized to make medical treatment decisions on behalf of a patient under sections 5506 to 5515 of the estates and protected individuals code, 1998 PA 386, MCL 700.5506 to 700.5515.

(h) “Patient representative” means a patient advocate or a guardian.

(i) “Physician orders for scope of treatment form" or "MI-POST " means a form created by the department to be used as part of an advance care planning process that, with medical orders, reflect both the patient's expressed wishes or best interests and the attending health professional's medical advice or recommendation. A MI-POST is not an advance health care directive.

(2) A term defined in the code has the same meaning when used in these rules.

History

History: 2022 AACS.

Mich. Admin. Code R 325.82 General Rules {#sec-r-325.82 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.82}

Rule 82. (1) MI-POST is intended only for those adult patients with advanced illness or frailty for whom, based on his or her current medical condition, death would occur within 1 year. A healthcare professional’s prognosis of life expectancy is not required.

(2) MI-POST cannot be required for admission to any healthcare or community facility setting.

(3) The standard form must be printed on pink 65-pound card stock, white card stock paper with a pink border, or paper of similar style and quality to make the form easily identifiable.

(4) The department must make available electronic blank copies.

(5) The original form in its most current version remains the property of the individual patient.

Copies, including paper, facsimile, and all digital versions, are permissible and valid. Health care facilities and physician offices must retain the most current copy of the patient’s MI-POST form in the patient’s medical record.

(6) The MI-POST is binding in any health care facility other than acute care. Acute care settings shall utilize the MI-POST as evidence of the patient’s healthcare decisions when evaluating the patient; however, treatments may differ according to the best clinical judgement of the healthcare professional currently treating the patient.

(7) The MI-POST directs the care provided by EMS. EMS must follow the protocol established by the department.

(8) Forms labeled “Michigan POST” or “MI-POST” are valid from 1 year of the most recent attending health professional signature date.

(9) MI-POST forms completed after June 30, 2023 must be completed on the MI-POST form created under the act.

(10) Orders indicated on a properly executed MI-POST are presumed to express the patient’s current decisions over a previously executed advanced directive.

(11) If a MI-POST is validly executed after a do-not-resuscitate order is executed under the Michigan do-not-resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067, the medical orders indicated on the MI-POST are presumed to express the patient’s current wishes.

History

History: 2022 AACS.

Mich. Admin. Code R 325.83 Completing the MI-POST {#sec-r-325.83 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.83}

Rule 83. (1) Prior to signing the MI-POST, the attending health professional must address the following with the patient:

(a) The patient information sheet regarding the MI-POST must be reviewed, signed, and placed in the patient’s permanent medical record.

(b) If the patient does not have a patient representative, the attending health professional shall recommend to the patient that the patient consider designating an individual to serve as patient advocate to make future medical decisions on behalf of the patient if the patient becomes unable to do so.

(2) A valid MI-POST must be signed by both:

(a) The patient, or the patient representative.

(b) The attending health professional.

(3) Either verbal or telephone medical orders are acceptable per policy and scope of practice, subject to all the following:

(a) The preparer shall complete the name, date, phone number, and, if applicable, name of collaborating physician and that physicians’ phone number.

(b) On the signature line, the form preparer must insert “verbal order” or “telephone order”.

(c) Within 10 calendar days, the attending health professional shall strikethrough “verbal order” or “telephone order” and sign and date the MI-POST form.

(4) The MI-POST is valid for 1 year from the date the order is authorized by the attending health professional.

History

History: 2022 AACS.

Mich. Admin. Code R 325.84 Reaffirming or Revoking the MI-POST; General {#sec-r-325.84 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.84}

Rule 84. (1) The MI-POST may be reaffirmed or revoked under either of the following circumstances:

(a) 1 year from the date since the form was last signed or reaffirmed.

(b) 30 days from a change in the patient’s attending health professional; or a change in the patient’s place of care, level of care, or care setting; or an unexpected change in the patient’s medical condition.

(2) The MI-POST can be reaffirmed or revoked by the patient or the patient representative at any time and in any manner that the patient or the patient representative is able to communicate.

(3) If the patient’s revocation is not in writing, an individual who witnesses the patient’s expressed intent to revoke the MI-POST shall describe in writing the circumstances of the revocation. This document must be signed by the witness and provided to the attending health professional, the health care facility, and the patient.

History

History: 2022 AACS.

Mich. Admin. Code R 325.85 Reaffirming the MI-POST {#sec-r-325.85 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.85}

Rule 85. (1) The MI-POST must be signed and dated by the attending health professional and the patient or patient representative on the corresponding affirmation line.

(2) The form must be reaffirmed if a previously blank section in the form is completed.

(3) Changes may not be made to previously completed sections. If changes are needed, a new MI-POST must be completed.

History

History: 2022 AACS.

Mich. Admin. Code R 325.86 Revoking the MI-POST {#sec-r-325.86 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.86}

Rule 86. (1) When revoking the MI-POST, the attending health professional or the patient or the patient’s representative shall write “revoked” over the most recent signatures of the patient or patient representative and the attending health professional.

(2) The individual revoking the form shall write “void” in large, bold ink diagonally across both sides of the form.

(3) If the patient or patient representative revokes the MI-POST, reasonable action must be taken to notify at least 1 of the following:

(a) The attending health professional.

(b) The health professional who is treating the patient.

(4) If a change in the patient’s medical condition makes the medical orders on the MI-POST contrary to generally accepted health care standards, the attending health professional may revoke the MI-POST form. If an attending health professional revokes a MI-POST under this subrule, he or she shall take reasonable actions to notify the patient or the patient representative of the revocation and the change in the patient’s medical condition that warranted the revocation of the MI-POST.

(5) The patient representative may revoke the MI-POST at any time the patient representative considers revoking the MI-POST to be consistent with the patient’s wishes or, if the patient’s wishes are unknown, in the patient’s best interest.

History

History: 2022 AACS.

Mich. Admin. Code R 325.87 Compliance with MI-POST Form {#sec-r-325.87 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.87}

Rule 87. EMS will treat patients according to the orders on a MI-POST per department- approved MI-POST emergency medical protocol unless any of the following apply:

(a) The services being provided are the result of an injury or medical condition that is unrelated to the diagnosis or medical condition that is indicated on the patient’s MI-POST.

(b) The valid MI-POST requests the initiation of resuscitation if the patient suffers cessation of both spontaneous respiration and circulation, and the emergency medical services personnel has actual notice of a do-not-resuscitate order that was executed under the Michigan do-not-resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067, after the MI-POST was validly executed.

History

History: 2022 AACS.

Public Health Administration Public Health Administration

R 325.951 to R 325.955 Anatomical Gifts

Mich. Admin. Code R 325.951 Definitions {#sec-r-325.951 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.951}

DEPARTMENT OF COMMUNITY HEALTH

COMMUNITY PUBLIC HEALTH AGENCY

ANATOMICAL GIFTS

(By authority conferred on the department of public health by sections 2226(d), 2233, 2659, and 2678 of Act No. 368 of the Public Acts of 1978, as amended, and section 9 of Act No. 380 of the Public Acts of 1965, as amended, being SS333.2226(d), 333.2233, 333.2659, 333.2678, and 16.109 of the Michigan Compiled Laws)

Rule 1. (1) As used in these rules:

(a) "Board" means the anatomy board created by section 2651 of the code.

(b) "Body" means a dead human body, or part thereof, which is subject to these rules and which is located within this state.

(c) "Code" means Act No. 368 of the Public Acts of 1978, as amended, being S333.1101 et seq. of the Michigan Compiled Laws.

(d) "Donated body" or "willed body" means a body given as a gift according to the indication of the decedent or by a member of the authorized class of persons associated with the decedent.

(e) "Educational use of a body" means the use of a body as a tool to help impart knowledge and understanding of the human body to medical, dental, and other medical- and healthrelated students.

(f) "Embalm" means to protect a body from unwanted deterioration processes in accordance with its use until its final disposition.

(g) "Receiving a body" means the acceptance of the responsibility to preserve and store a body, dispose of a body, and keep records of a body according to the code and these rules.

(h) "Receiving institution" means the university of Michigan, Michigan state university, or Wayne state university.

(i) "Scientific use of a body" means the use of a body in the production, advancement, and dissemination of knowledge and understanding that will ultimately benefit mankind through study and research, such as investigations into any of the following:

(A) Structure.

(B) Growth.

(D) Malformations.

(E) Bio-mechanics.

(F) Human tolerances to forces.

(G) Kinematics.

(H) Kinesiology.

(I) Functions.

(J) Human responses.

(K) Diseases.

(L) Illnesses.

(M) Injuries.

(N) Pathology.

(O) Preservation.

(P) Surgical procedures and techniques.

(Q) Dental procedures and techniques.

(R) Other related activities. The phrase does not include use of a body for therapy and transplantation.

(2) Unless the context requires otherwise, terms and phrases defined in the code have the same meaning when used in these rules.

History

History: 1981 AACS.

Mich. Admin. Code R 325.952 Applicability {#sec-r-325.952 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.952}

Rule 2. These rules apply to all bodies or parts of bodies designated for educational and scientific use and govern the allocation of the bodies or parts by the board to hospitals and educational institutions requiring them for use in medical instruction or for the purpose of instruction, study, and use in the promotion of education in the health sciences within this state.

History

History: 1981 AACS.

Mich. Admin. Code R 325.953 Bodies designated for educational and scientific use {#sec-r-325.953 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.953}

Rule 3. (1) A body subject to these rules shall be reported in writing to the board by the receiving institution in the next annual report required by the board. The report shall include the number of bodies received, their categorizations, their uses, and their final dispositions.A body subject to these rules shall be preserved and stored using methods approved by the board and, unless specifically indicated otherwise by the person donating the body, shall be received by members of the board at the university of Michigan, Michigan state university, or Wayne state university.

(2) When a body is donated to a receiving institution, it shall be received by, and be the responsibility of, that institution, unless special arrangements are made by that institution for the body to be received elsewhere. The anatomy department of each receiving institution may establish criteria for acceptance of bodies with the approval of the board.

(3) A receiving institution shall keep complete records of bodies in its charge and shall make the records available to the board at any time upon request. If the information is available, the records shall include all of the following:

(a) The date of receipt.

(b) Identification number.

(d) Cause of death.

(e) Physical condition upon receipt, including whether whole or autopsied.

(f) Preservation method.

(g) Use.

(h) Usage location.

(i) Disposition.

(j) Date of disposition.

(4) Bodies donated for the purpose of anatomical study shall be used for educational and scientific purposes.

(5) Before research is performed on any dead embryo, fetus or neonate, the consent of the mother shall be obtained in accordance with the provisions of part 101 of the code.

(6) Transportation of a body shall be by a vehicle equipped for such use. The body shall be carried on a covered cart or in a specifically designed suitable container so that it is not exposed to public view while in transportation. Not more than 1 whole body shall be placed on 1 cart or in 1 container and whole bodies shall not be stacked one on top of another without adequate external supports between them.

(7) Final disposition of the remains of a body shall be by cremation, unless reclaimed by relatives of the deceased through a funeral director.

History

History: 1981 AACS.

Mich. Admin. Code R 325.954 Unclaimed bodies {#sec-r-325.954 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.954}

Rule 4. (1) Each member of the board from receiving institutions that regularly receive bodies shall be assigned an area of the state by the board to request and receive unclaimed bodies from institutions in that area. These assignments shall be reviewed periodically.

(2) Member institutions of the board shall have the option of annually requesting in writing to be notified of unclaimed bodies from state or public institutions having such bodies in their assigned areas of the state.

(3) An unclaimed body shall be held embalmed for a 30-day waiting period from the date of receipt by the representative of the board before being used. After the waiting period, an unclaimed body shall be treated the same as any other body at the receiving institution.

(4) Any individual or institution authorizing an autopsy on an unclaimed body under section 2661 of the code shall be solely responsible for the disposal, cremation, or burial of the body at its own expense as though it had requested the body, if the body has been requested by, or is to be made available to, the board.

History

History: 1981 AACS.

Mich. Admin. Code R 325.955 Requests for, and distribution of, bodies {#sec-r-325.955 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.955}

Rule 5. (1) Written requests for bodies for educational uses from teaching institutions, hospitals, or persons other than members of the board shall be evaluated by a member of the board according to procedures and standards established by the board. If approved, appropriate bodies shall be dispatched. In evaluating requests, the board shall consider the educational standing of the requesting institution, the teaching staff, the number of students to be accommodated, and the character of the educational experience to be offered. The board shall require the submission of a definite proposal for the use of the bodies and a prospectus of the course in which the bodies are to be used.

(2) Written requests for bodies for scientific uses from institutions not represented on the board shall be evaluated by a member of the board after a detailed proposal outlining the precise uses of the bodies has been submitted to the board. If approved, appropriate bodies shall be dispatched. Those requests for bodies approved in this manner shall be reviewed at the next meeting of the board.

(3) Before a body or parts of bodies are dispatched, the requesting institution or person shall have facilities for the storage and handling of the bodies or body parts which are acceptable to the board.

(4) Bodies may be transferred between receiving institutions with the agreement of the respective board members without contacting the full board.

(5) For purposes of distribution to approved institutions and persons, the value of a body shall be determined by the expenses incurred plus the proportionate cost of the materials, labor, and overhead, as determined by the receiving institution.

(6) Bodies that have been distributed by a receiving institution shall be the sole responsibility of that institution, including final disposition of the bodies.

(7) If the supply of bodies within the state is inadequate to meet the approved demands, the board shall decide how to allocate the available bodies in a manner that will best meet the essential needs of the state.

(8) Teaching needs of undergraduate medical and dental courses shall have priority over other demands for bodies.

History

History: 1981 AACS.

Legal Affairs and Legislative Services Administration Legal Affairs and Legislative Services Administration

R 325.1211 to R 325.1211 Requests for Declaratory Rulings

Mich. Admin. Code R 325.1211 Requests for declaratory rulings {#sec-r-325.1211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.1211}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH POLICY, REGULATION & PROFESSIONS ADMINISTRATION

REQUESTS FOR DECLARATORY RULING

(By authority conferred on the department of community health by section 63 of 1969 PA 306, MCL 24.263 and Executive Reorganization Order No. 1996-1, MCL 330.3101)

Rule 1. (1) The following provisions set forth the form and procedure for the submission, consideration, and disposition of a request for declaratory ruling in the department of community health, hereinafter referred to as the "department":

(a) Any interested person, hereinafter referred to as "applicant," may request a declaratory ruling as to the applicability to an actual state of facts of a statute, rule, final order or decision administered, promulgated, or issued by any bureau, office, commission, council, board, or agency, hereinafter referred to as "agency," within the department. A request shall not relate to a hypothetical fact situation.

(b) An applicant shall submit an original and 1 copy of each request on a form similar to figure 1, or in writing, on 8 ½ by 11-inch paper. An applicant shall submit the request by mail or personal delivery to the current office of the director of the agency. An applicant shall not submit a request by facsimile or electronic means.

(i) Under a section labeled "Statement of Facts," a complete, accurate, and concise statement of the facts or situation upon which the request is based, which shall include all facts known to the applicant that are or may be relevant to a determination of the applicability of a statute, rule, final order, or decision.

(ii) Under a section labeled "Certification," a certification by the applicant as to the existence of the actual state of facts set forth and the submission of all relevant facts known to the applicant.

(iii) Under a section labeled "Laws/Rules/Orders," specific reference to all statutes, rules, final decisions, or orders that are to be considered.

(iv) Under a section labeled "Issues," a concise statement of the issues presented.

(v) Under a section labeled "Analysis and Conclusions," an analysis, legal brief, or memorandum of the issues presented, including reference to any legal authority relied upon, and the applicant's conclusions.

(vi) The applicant's full name, degree or title, if applicable, professional or occupational license number, if applicable, daytime telephone number, mailing address and identification of any legal counsel.

(d) An applicant shall submit 2 copies of all relevant documents as attachments to the request.

(e) Failure to follow the procedure in subdivisions (a) to (d) of this subrule may result in the return of the request for compliance or in denial as specified in subrule (8) of this rule.

(2) Figure 1 reads as follows:

Figure 1 - Declaratory Ruling Form Department of Community Health Request for Declaratory Ruling Applicant’s full name: Applicant’s degree or title (if applicable):

Applicant’s mailing address: Professional/occupational license no. (if applicable):

Daytime telephone no.: Name and address of legal counsel (if applicable):

Statement of facts: (Please provide a complete, accurate and concise statement of the facts or situation upon which the request is based. The statement shall include all facts known to you which are or may be relevant to a determination of the applicability of statute, rule, final order or decision.)

Laws/Rules/Orders: (Please provide references to all statutes, rules, final decisions or orders which are to be considered.)

Issues: (Please provide a concise statement of the issues presented.)

Analysis and Conclusions: (Please provide an analysis, legal brief or memorandum of the issues presented, including reference to any legal authority relied upon, and the applicant’s conclusions.)

Certification: I hereby certify the existence of the actual state of facts set forth and the submission of all relevant facts known to me:

Date: Signature:

(3) Before determining whether or not to issue a declaratory ruling, the agency, may receive comments, written or oral arguments, or information from interested persons, legal counsel, or any other source.

(4) Within 60 calendar days of the receipt of the request, the agency shall issue a written notification by regular first-class mail to the applicant and the applicant's legal counsel, if any, stating whether a declaratory ruling will be issued.

(5) If the agency determines that it will issue a declaratory ruling, then it shall do so within 90 calendar days of the notification date specified in subrule (4) of this rule, unless the agency advises the applicant, in writing, of the need for additional time, stating the reasons therefor.

(6) Before the issuance of the declaratory ruling, the agency may do 1 or more of the following:

(a) Request submission by the applicant of any additional information deemed necessary.

(b) Seek consultation, comments, or advice from legal counsel, experts within or outside the agency, local, state, or federal governmental agencies, or any other source.

(d) Request oral or written arguments from interested parties.

(e) Hold a public hearing upon proper notice to all interested parties.

(7) The agency may require that a contested case proceeding take place instead of issuing a declaratory ruling.

(8) The agency may deny a request for declaratory ruling if the applicant fails to follow the procedure for submission in this rule, if the statement of facts is incomplete or inaccurate, if the facts or circumstances relate to a changing situation, if the ruling would not be in the public interest or in furtherance of statutory objectives, or for any other stated reason. The agency shall set forth the reason or reasons for denial of the request in its written notification to the applicant.

(9) If a declaratory ruling is issued by the agency, it shall be in writing, mailed by regular first-class mail to the mailing address supplied by the applicant and to the applicant's identified legal counsel, if any, and contain all of the following:

(a) The specific facts upon which it is based.

(b) The legal authority upon which it is based.

(d) A statement that the ruling is limited to the specific facts presented and to the statute, rule, final decision, or order identified by the applicant or other statute, rule, final decision, or order identified by the agency.

(e) A statement that the ruling is binding on the agency and the applicant unless it is altered or set aside by any court.

(f) A statement that the agency may not retroactively change the ruling, but may prospectively do so in its discretion.

(g) A statement that the ruling is subject to judicial review in the same manner as an agency final decision or order in a contested case.

(10) This rule does not prohibit or restrict any interested person from informally discussing any actual or proposed activity with any agency. Informal discussions are not subject to the rule.

History

History: 1979 AC; 2008 AACS.

Public Health Administration Public Health Administration

R 325.2941 to R 325.2945 Blood Banks

Mich. Admin. Code R 325.2941 Definitions {#sec-r-325.2941 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2941}

DEPARTMENT OF COMMUNITY HEALTH

COMMUNITY PUBLIC HEALTH AGENCY

BLOOD BANKS

(By authority conferred on the director of public health by section 9133 of Act No. 368 of the Public Acts of 1978, being S333.9133 of the Michigan Compiled Laws)

Rule 1. As used in these rules:

(a) "Act" means Act No. 368 of the Public Acts of 1978, being S333.1101 et seq. of the Michigan Compiled Laws.

(b) "Blood bank" means a facility which provides through its ownership or operation a system for the collection of blood from donors for the purpose of transfusion or for the preparation of a component or product intended for transfusion.

(d) "Director" means the director of the department of public health.

(e) "Physician" means a person licensed to practice medicine or osteopathic medicine under the laws of this state.

History

History: 1979 AC.

Mich. Admin. Code R 325.2942 Federal standards; adoption by reference {#sec-r-325.2942 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2942}

Rule 2. The standards of the bureau of biologics, food and drug administration, being 21 C.F.R. SS600 to 680, dated April 1, 1978, are adopted by reference. Copies of the adopted standards may be obtained from the Superintendent of Documents, U.S. Government Printing Office, 710 North Capitol Street N.W., Washington, D.C. 20402, and from the Department of Public Health, Bureau of Disease Control and Laboratory Services, P.O.

Box 30035, Lansing, Michigan 48909, at a cost of $4.25.

History

History: 1979 AC.

Mich. Admin. Code R 325.2943 Annual report; inspections {#sec-r-325.2943 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2943}

Rule 3. (1) A blood bank collecting blood in this state or preparing components or products intended for transfusion shall file with the director an annual report as designated by the director.

(2) A representative of the director of public health may inspect a blood bank at any reasonable time.

History

History: 1979 AC.

Mich. Admin. Code R 325.2944 Performance of tests in licensed laboratories required; exceptions {#sec-r-325.2944 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2944}

Rule 4. Clinical laboratory tests performed in or for a blood bank subject to these rules shall be performed in a clinical laboratory licensed under sections 20501 to 20554 of Act No. 368 of the Public Acts of 1978, being SS333.20501 to 333.20554 of the Michigan Compiled laws. This rule does not apply to laboratory tests performed in any of the following when part of routine blood bank procedures:

(a) A blood bank operated exclusively as a donor center by the American red cross or other community-sponsored program holding a U.S. federal license issued by the bureau of biologics, food and drug administration.

(b) A plasmapheresis center holding a U.S. federal license issued by the bureau of biologics, food and drug administration.

(c) A clinical laboratory in another state holding an interstate clinical laboratory license in immunohematology issued by the federal government.

(d) A laboratory operated by the federal government.

History

History: 1979 AC.

Mich. Admin. Code R 325.2945 Rescission {#sec-r-325.2945 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2945}

Rule 5. R 325.2901 to R 325.2936 of the Michigan Administrative Code, appearing on pages 6611 to 6620 of the 1973 Annual Supplement to the Code and page 8563 of the 1976 Annual Supplement to the Code, are rescinded.

History

History: 1979 AC.

R 325.3251 to R 325.3267 Amendments to Vital Records

Mich. Admin. Code R 325.3251 Definitions {#sec-r-325.3251 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3251}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH ADMINISTRATION

OFFICE OF THE STATE REGISTRAR

AMENDMENTS TO VITAL RECORDS

(By authority conferred on the department of health and human services by sections 2226, 2233, 2235, and 2896 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, 333.2235, and 333.2896.)

Rule 1. (1) As used in these rules:

(a) "Addended record" means a replacement record containing the information as recorded on the registered record plus information added as an addendum to the record pursuant to section 2872 of the code, MCL 333.2872.

(b) "Amended record" means a replacement record that is marked "amended" and contains the date of the amendment and identifies the items amended.

(d) "Code" means the public health code, 1978 PA 368 MCL 333.1101 to 333.25211.

(e) "Date of application" means the date the application to correct a vital record document is received in the office of the state registrar.

(f) "New record" means a replacement record that is not marked to indicate changes made to the record.

(g) “Next of kin” means the adult individual or individuals most closely related to the registrant in the following order of priority:

(i) The registrant’s spouse.

(ii) The decedent's children.

(iii) The decedent's grandchildren.

(iv) The decedent's parents.

(v) The decedent's grandparents.

(vi) The decedent's siblings.

(h) "Registered record" means a record accepted by the state registrar for incorporation into the permanent official records of the system of vital statistics.

(i) "Registrant" means the individual to whom the record pertains.

(j) "Replacement record" means a record prepared by the department to replace an existing registered record.

(2) A term defined in the code has the same meaning when used in these rules.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3252 Certified copies of replacement records; requirements {#sec-r-325.3252 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3252}

Rule 2. (1) A certified copy of an addended record must show all the following on its face:

(a) The information from the registered record.

(b) The addended information.

(2) A certified copy of an amended record must show all amendment notations on its face and be marked "amended."

(3) A certified copy of a new record must not show evidence of the changes made on its face.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3253 Basis for preparing replacement records {#sec-r-325.3253 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3253}

Rule 3. To protect the integrity and accuracy of the system of vital statistics, a certificate or record registered under section 2821, 2827, 2829, 2834, 2841, or2846 of the code, MCL 333.2821, 333.2827, 333.2829, 333.2834, 333.2841, or 333.2846, may be replaced by an addended, amended, or new record only as prescribed by these rules.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3254 Replacement record request; content of application {#sec-r-325.3254 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3254}

Rule 4. (1) Unless otherwise specified in these rules or statute, all requests for changes to vital records documents must be made on an application to correct a vital record document as prescribed by the state registrar. The application must set forth all the following:

(a) All the information necessary to identify the registered record.

(b) The incorrect information as recorded on the registered record.

(2) The completed application must be accompanied by both of the following:

(a) The proper fee prescribed by law.

(b) The minimum supporting documentary evidence required by these rules.

(3) A request must bemade on an application form prescribed by the state registrar and must be accompanied by the required fee.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3255 Review of applications and evidence by state registrar; dismissals and denials of applications {#sec-r-325.3255 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3255}

Rule 5. (1) The state registrar shall evaluate each application and the evidence submitted in support of the request to change a registered vital record document.

(2) The state registrar may in the state registrar's discretion require the submission of additional documentary evidence to support a requested change.

(3) The state registrar shall dismiss an application when additional evidence requested is not received within 6 months after the request for the additional evidence. When an application is dismissed, the state registrar shall send a written notice of dismissal to the applicant. The state registrar shall retain the application fee.

(4) The state registrar shall deny an application when the applicant is not eligible to apply.

When an application is denied, a written notice of denial must be forwarded to the applicant that indicates the reason for the denial. The application fee must be refunded.

(5) If, after review of the application and the evidence, the state registrar is satisfied that the evidence supports the requested change, the state registrar shall prepare the appropriate replacement record and place it in the active files of the system of vital statistics.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3256 Supporting evidence; erasures, alterations, or changes {#sec-r-325.3256 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3256}

Rule 6. Documents submitted in support of a request to correct a vital record document which contain signs of erasure, alterations, or changes to the pertinent information shall not be accepted.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3257 Changes initiated by the state registrar {#sec-r-325.3257 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3257}

Rule 7. (1) The state registrar may make changes to items on a registered record for the purpose of making all items on the record consistent with the known facts.

(2) The state registrar may make changes to a registered record if it is discovered that an error was made by the office of a local registrar or the state registrar in the filing or registration of the record.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3258 Sealing of record and evidence used to prepare replacement record {#sec-r-325.3258 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3258}

Rule 8. (1) After preparation of a replacement record pursuant to sections 2831 and 2832 of the code, both of the following shall be complied with:

(a) The existing record, the existing copies of that record on file in the office of the state registrar and the offices of all local registrars, and the evidence used to prepare the replacement record shall be sealed.

(b) All records, evidence, and associated documents used as a basis for creating a replacement record pursuant to sections 2831 and 2832 of the code shall not be subject to inspection or copying, except upon order of a court of competent jurisdiction or by the state registrar for the purposes of properly administering the system of vital statistics.

(2) After preparation of a replacement record in all other instances:

(a) The existing record and the existing copies of that record on file in local registrars' offices and the office of the state registrar shall be sealed.

(b) The sealed record shall not be subject to inspection, except upon order of a court of competent jurisdiction.

(c) The state registrar may provide a copy of the application used as the basis to prepare the replacement record to a person eligible to receive a copy, a certified copy, or a certificate of registration of the record, as provided in section 2882 of the code, or to a person eligible under these rules to request preparation of a replacement record.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3259 Amendment of amended or court-establishedrecords {#sec-r-325.3259 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3259}

Rule 9. (1) Items on a record previously amended under these rules must not be amended again by the state registrar, unless it can be documented that the amendment was made in error by the office of the state registrar or upon order of a court of competent jurisdiction.

(2) Items on a record originally established, entered, or amended pursuant to a court order can only be amended upon order of a court of competent jurisdiction.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3260 Retention of previous amendment notations {#sec-r-325.3260 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3260}

Rule 10. Notations of amendments to items changed by the preparation of a replacement record shall be retained and shall appear on the subsequent preparation of a replacement record, unless the replacement record is prepared pursuant to sections 2831 and 2872(1) of the code.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3261 Rescission of replacement records {#sec-r-325.3261 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3261}

Rule 11. (1) If the state registrar becomes aware that a replacement record is invalid or that the evidence received in support of the preparation of the replacement record is false or invalid, the replacement record must be rescinded. A new record must be created containing the same facts as the original record.

(2) The state registrar shall notify the local registrar of the rescission of the replacement record.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3262 Change to birth or death records; notification of local registrar; local registrar duties {#sec-r-325.3262 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3262}

Rule 12. (1) When the state registrar makes a change to the official recording of a birth or death, the state registrar shall notify the local registrar who retains a record of the event of the change.

(2) Upon notification of a change to a registered record, the local registrar shall seal the existing record as directed by the state registrar.

(3) The local registrar shall properly record the change as directed by the state registrar.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3263 Preparation of replacement records {#sec-r-325.3263 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3263}

Rule 13. (1) The department shall prepare a new record as a replacement for a registered record when the state registrar receives any of the following:

(a) Documents described in sections 2831 and 2872 of the code, MCL 333.2831 and 333.2872, as evidence of 1 of the following:

(i) Adoption.

(ii) Paternity.

(iii) Legitimation.

(iv) Sex designation.

(v) Legal change of name of a minor.

(b) A request, within 12 months after the date of the event, for additions or minor amendments. These amendments are limited to the following:

(i) Obvious errors.

(ii) Transpositions of letters or numbers.

(iii) Omissions.

(iv) Changes to the registrant's given names or the addition of a surname suffix, for example: "Jr.," "II," or "III."

(c) A request received within 6 years after the date of the event and documentary evidence to add the registrant's given name to a birth record where the given name is missing on the registered record.

(d) An order issued by a court of competent jurisdiction requiring the department to prepare a new record.

(e) Documentation showing a change in an action of a court that is documented in the system of vital statistics.

(f) Evidence of an error in an entry made by the office of the state registrar or a local registrar.

(2) The department shall prepare an addended record as a replacement for a registered record when the state registrar receives documents described in section 2872(2) of the code, MCL 333.2872, as evidence of a legal change of name.

(3) An amended record must be prepared when it is not appropriate under these rules or the code to prepare an addended record or a new record.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3264 Rescinded {#sec-r-325.3264 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3264}

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3265 Replacement records; form {#sec-r-325.3265 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3265}

Rule 15. (1) A replacement record shall be on a form that conforms as closely as possible to the form in use at the time the replacement record is prepared.

(2) A record prepared pursuant to an adoption shall conform as closely as possible to the form in use at the time of preparation, except that only the name of the county of birth shall be shown as the place of birth.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3266 Requests for changes to vital records documents; eligible persons {#sec-r-325.3266 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3266}

Rule 16. (1) A change to a registered birth record may be requested by any of the following:

(a) The parents named on the record.

(b) A parent not named on the record who can establish that that individual may be named pursuant to section 2824 of the code, MCL 333.2824, for the purpose of having that individual’s name added to the record.

(d) The registrant, if 18 years of age or older or legally emancipated.

(e) An heir to the registrant with a court order to change the record.

(f) The individual or facility administrator responsible for filing the original certificate.

(g) A legal representative of any individual listed in subdivisions (a) to (f) of this subrule.

(2) A change to a registered death record may be requested by any of the following:

(a) The informant listed on the death certificate.

(b) The next of kin of the deceased within 5 years of the date of death. If next of kin cannot be determined or is disputed, or more than 5 years have passed since the date of death, a court order is required.

(d) The physician who certified to the cause of death, as follows:

(i) The physician who certified to the cause of death may only request a change to the following:

(A) The date of death.

(B) The place of death.

(ii) In cases where a physician has certified to the cause and manner of death in that physician’s capacity as a countymedical examiner or deputy countymedical examiner, requests to amend the cause or manner of death on the death record may be made by any of the following:

(A) The physician who certified to the cause of death.

(B) The county medical examiner.

(C) A deputy countymedical examiner, other than the original certifier, who is authorized by the county medical examiner to request a change to a registered record. The countymedical examiner shall provide the state registrar with a listing of the names of deputy county medical examiners authorized to request amendments to records for which they are not the certifier. The county medical examiner shall notify the state registrar when there are changes to the list of authorized deputy countymedical examiners.

(iii) In cases where the certifying physician is now deceased, requests may be made by a physician who attests to having knowledge of the facts of death.

(iv) In all cases where the physician who makes the request is not the certifying physician named on the registered record, the name of the certifying physician on the replacement record shall be changed to reflect the name of the new certifying physician.

(3) Marriage and divorce records are not subject to correction by the state registrar’s office.

History

History: 1981 AACS; 2025 AACS.

Mich. Admin. Code R 325.3267 Correction of vital record information; evidence required {#sec-r-325.3267 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3267}

Rule 17. (1) Before the sixth birthday of the registrant, documentary evidence is not required to correct the spelling of the registrant's first or middle name on a registered birth record if the request is made by all parents named on the birth record.

(2) To delete the name of a father recorded on a registered birth record, the department must receive a true or certified copy of a court orderrequiring removal of the father or a court determination of non-paternity.

(3) To change the cause or mode of death on a registered death record, the department must receivea certified copy of a court determination of the facts or the requestof a person named in R 325.3266(2)(a) to (d).

(4) Changes to the marital status or name of the surviving spouse on a registered death record require a court order naming the surviving spouse, except to make minor spelling corrections or where there is a demonstrated error by the funeral home.

(5) Except as otherwise specified by statuteor rule, a request to amend a vital record must be accompanied by a certified copy of a court order specifying the correct facts or items of documentary evidence that support the alleged facts. All documents presented must contain sufficient information to clearly indicate that they pertain to the registrant on the record for which the amendment or correction has beenrequested.Acceptable documents include, but are not limited to, the following:

(a) Certified copy of a marriage record.

(b) Certified copy of a live birth record of the registrant’s child.

(d) Social security records.

(e) Passports or visas.

(f) Military records.

(g) Federal government census records.

(h) Government agency records for benefit establishment such as social services, Medicaid, clinical services, or similar services.

(i) Medical records.

(j) Other documents deemed to be valid and adequate by the state registrar to support the requested change.

(6) For live birth records, the documents submitted must have been established before the registrant’s 18th birthday or at least 10 years before the date of application for the amendment or correction. The state registrar may make exceptions for other documents such as court orders, passports, or other evidence that clearly support the facts of live birth.

History

History: 1981 AACS; 2025 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 325.4151 to R 325.4156 Program Match Requirements

Mich. Admin. Code R 325.4151 Definitions {#sec-r-325.4151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4151}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PROGRAM MATCH REQUIREMENTS

(By authority conferred on the office of substance abuse services by section 6213 of Act No. 368 of the Public Acts of 1978, as amended, being S333.6231 of the Michigan Compiled Laws)

Rule 1. (1) As used in these rules:

(a) "Cash contribution" means the local cash outlay reflected in the program budget submitted to the office by a coordinating agency and subsequently supported by expenditure reports and records.

(b) "Code" means Act No. 368 of the Public Acts of 1978, as amended, being S333.1101 et seq. of the Michigan Compiled Laws.

(d) "Fees and collections" means funds derived from the provision of products, supplies, services, or patient, second party, or third party reimbursements or payments. Only those fees and collections derived from patient, second party, or third party reimbursements and payments may be carried over from one fiscal year to the next fiscal year.

(e) "In-kind contributions" means the value of authorized non-cash contributions justified by the coordinating agency and approved by the office according to R 325.4152.

(f) "Office" means office of substance abuse services.

(g) "Patient reimbursements and payments" means reimbursements and payments received from an individual for care or services rendered to that individual.

(h) "Program budget" means the total financial plan, including both state and non-state shares, submitted for approval to the office by a coordinating agency to carry out the purposes of the program plan.

(i) "Second party reimbursements and payments" means reimbursements and payments which are not patient or third party reimbursements and payments, but which are received from a person, including a governmental entity, in response to a charge for care or service to another individual, such as an employee of that person.

(j) "Third party reimbursements and payments" means reimbursements and payments received from a third party pay or, such as a private insurance company, or payments made under medicaid, medicare, or other provisions of the social security act, 42 U.S.C. S301 et seq., which are related to the cost of providing patient care or services.

(2) The terms defined in the code have the same meanings when used in these rules.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 325.4152 Allowable match {#sec-r-325.4152 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4152}

Rule 2. (1) The allowable match may consist of any of the following:

(a) Cash contributions.

(b) Fees and collections as defined in R 325.4151.

(c) In-kind contributions limited to facility and equipment use charges and other authorized non-cash contributions which are a direct benefit to the program and approved by the office.

(d) Local tax revenues.

(2) Local funds already used as match for some other state or federal program shall not be included in the allowable match under these rules.

(3) State reimbursements shall be limited to costs in excess of all allowable local matching funds, subject to the availability of funds and in accordance with the terms of the agreement.

(4) The type and basis for determining the value of in-kind contributions shall be documented by the coordinating agency and approved by the office. All approved in-kind contributions charged to the program shall directly benefit the program, be documented in the records of the coordinating agency, and be appropriately reported as prescribed by the office.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 325.4153 Coordinating agency program budget match requirements {#sec-r-325.4153 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4153}

Rule 3. (1) Except as otherwise provided in these rules, a coordinating agency program budget approved by the office shall include allowable match funds equal to not less than 10% of the total program budget, less direct federal and other state funds.

(2) If the total budget is modified during the project period, the total match shall be maintained at a level of not less than 10% of the total program budget, less federal and other state funds.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 325.4154 Rescinded {#sec-r-325.4154 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4154}

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 325.4155 Waiver of rules {#sec-r-325.4155 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4155}

Rule 5. (1) The office may grant a waiver from any of these rules if it determines that the action is necessary for continuity or quality of service delivery.

(2) A request for a waiver shall be submitted by the coordinating agency to the office, on forms provided by the office, before the beginning of the fiscal year to which it will apply, unless waived by the office.

(3) The office shall notify the coordinating agency in writing of the decision reached concerning each waiver requested.

(4) A waiver that is granted under this rule shall not be in effect longer than the specific fiscal year for which the waiver is approved.

History

History: 1981 AACS.

Mich. Admin. Code R 325.4156 Federal grant match requirements {#sec-r-325.4156 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4156}

Rule 6. These rules shall not be construed to negate specific federal grant match requirements entered into with the office by coordinating agencies or service-providing programs.

History

History: 1981 AACS.

Public Health Administration Public Health Administration

R 325.9071 to R 325.9077 Birth Defects Reporting

Mich. Admin. Code R 325.9071 Definitions {#sec-r-325.9071 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9071}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION FOR VITAL RECORDS AND HEALTH STATISTICS

BIRTH DEFECTS REPORTING

(By authority conferred on the department of health and human services by section 5721 of 1978 PA 368, MCL 333.5721 and Executive Reorganization Order No. 1996-1, MCL 330.3101.)

Rule 1. (1) As used in these rules:

(a) "Birth defect" means an abnormality of the body's structure or inherent function present at birth, whether the abnormality is detected in utero at the time of delivery or becomes apparent at a later date.

(b) "Birth defects registry" means the data base that contains individual case level demographic and diagnostic information maintained by the department.

(d) "Institutional Review Board for the Protection of Human Research Subjects (IRB)" means the board within the department of health and human services that is established under 45 CFR 46.

(e) "Registrant" means a child who is diagnosed with a reportable birth defect.

(f) "Reporting entity" means a hospital, clinical laboratory, physician, genetic counselor, health clinic, and other health professional or health facility required to report birth defects under R 325.9072.

(2) The terms "clinical laboratory" and "hospital," as defined in sections 20104 and 20106, 1978 PA 368, MCL 333.20104 and 333.20106 have the same meanings when used in these rules.

History

History: 1991 AACS; 2011 AACS; 2017 AACS.

Mich. Admin. Code R 325.9072 Reportable birth defects {#sec-r-325.9072 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9072}

Rule 2. (1) Reportable birth defects are those birth defects identified in the following list of medical conditions:

(a) Congenital anomalies of the central nervous system.

(b) Congenital anomalies of the eye.

(d) Congenital anomalies of the heart and circulatory system.

(e) Congenital anomalies of the respiratory system.

(f) Cleft palate and cleft lip.

(g) Congenital anomalies of the upper alimentary canal/ digestive system.

(h) Congenital anomalies of the genital and urinary systems.

(i) Congenital anomalies of the musculoskeletal system.

(j) Congenital anomalies of the integument.

(k) Chromosomal anomalies.

(2) Other congenital anomalies, including the following:

(a) Infectious conditions occurring in the perinatal period, including the following:

(i) Syphilis.

(ii) Congenital rubella.

(iii) Cytomegalovirus.

(iv) Listeriosis.

(v) Herpes simplex.

(vi) Malaria.

(vii) Toxoplasmosis.

(viii) Tuberculosis.

(ix) Zika.

(b) Familial/congenital neoplasms.

(d) Diseases of the blood and blood forming organs including the following:

(i) Hereditary hemolytic anemias.

(ii) Familial hypoplastic anemia.

(iii) Coagulation defects.

(iv) Primary thrombocytopenia.

(e) Diseases of the central and peripheral nervous system, including the following:

(i) Cerebral lipidoses.

(ii) Cerebral degeneration.

(iii) Hereditary spastic paraplegia.

(iv) Cerebral palsy.

(v) Werdnig-hoffman disease.

(vi) Disorders of the autonomic nervous system.

(vii) Cerebral palsy and spasms.

(viii) Cerebral cysts.

(ix) Polyneuritis cranialis.

(x) Hereditary and idiopathic peripheral neuropathy.

(xi) Myoneural disorders.

(xii) Muscular dystrophies and other myopathies.

(f) Diseases of the eye, including the following:

(i) Retinal disorders.

(ii) Chorioretinitis.

(iii) Blindness and low vision.

(iv) Hereditary optic atrophy and nystagmus.

(v) Any other irregular movement of the eye.

(g) Hearing deficiency, including structural and functional deficiencies.

(h) Diseases of the heart and circulatory system including the following:

(i) Cardiomyopathy.

(ii) Conductive cardiac disorders.

(iii) Dysrhythmias.

(iv) Occlusions of coronary arteries.

(v) Budd-chiari syndrome.

(i) Diseases of the gastrointestinal system, including the following:

(i) Anomalies of teeth, jaw, or hernia.

(ii) Stricture.

(iii) Volvulus.

(iv) Fistula of organs.

(j) Diseases of the genital and urinary systems involving fistula and obstruction.

(k) Fetal/placental anomalies.

(l) Musculoskeletal system diseases involving abnormal bone growth.

(m) Maternal causes of fetal morbidity, including the following:

(i) Infections, including those infections specified in subrule (2)(a) of this rule.

(ii) Alcohol use including fetal alcohol spectrum disorders.

(iii) Cocaine use, opioid use, and other toxic or medicinal agents affecting the fetus.

(n) Autism spectrum disorders, including Asperger syndrome and Rett syndrome.

(3) Diagnoses of birth defects that occur in children from birth to 2 years of age shall be reported to the department by those entities listed in subrules (3), (4), and (5) of this rule in a manner that is consistent with these rules. This subrule applies whether or not a child dies 2 years of age. The director of the department may designate the reporting of birth defects, diagnosed up to and including 12 years of age, for medical conditions that require surveillance and are commonly diagnosed after 2 years of age, including, but not limited to, any of the following:

(a) Fetal alcohol spectrum disorders.

(b) Cystic fibrosis.

(d) Autism.

(e) Cerebral palsy.

(4) Hospitals shall report diagnoses of birth defects. The administrative officer of each reporting facility shall establish the reporting procedures at that facility. These procedures shall ensure that every child from birth to 2 years of age, or up to 12 years of age for defects designated under subrule (2) of this rule, who is diagnosed either in the facility operated inpatient or outpatient setting as having a birth defect is reported to the birth defects registry. If a child is transported to another facility, the health care facility at which a reportable diagnosis is first made is responsible for reporting.

(5) Clinical laboratories shall report diagnoses of birth defects. The director of a laboratory that conducts postmortem examinations or cytogenetic tests shall report to the department any potential registrant who has a reportable birth defect.

(6) The director may designate diagnoses of birth defects to be reported by physicians, genetic counselors, health clinics, and other health professionals or health facilities involved in the diagnosis or treatment of children with birth defects as necessary to assure efficient and comprehensive surveillance of birth defects.

(7) Diagnoses of birth defects may be reported by local public health officials, other programs within the department, and by programs in other departments that provide treatment, services, medical, or other benefits to children with birth defects and their families.

(8) Reports shall be submitted within 30 days of a diagnosis in a form prescribed and approved by the department.

(9) Reports that are submitted on forms provided by the department or by electronic media shall meet data quality, format, and timeliness standards prescribed by the department, as described in the manual for completing the birth defects registry report form.

Editor's Note: An obvious error in R 325.9072 was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2017 MR 24. The memorandum requesting the correction was published in Michigan Register, 2018 MR 1.

History

History: 1991 AACS; 2011 AACS; 2017 AACS.

Mich. Admin. Code R 325.9073 Quality assurance {#sec-r-325.9073 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9073}

Rule 3. (1) For the purposes of assuring the quality of submitted data, each reporting entity shall allow the department or an authorized agent of the department, with not less than 5 working days' notice and during reasonable working hours, to inspect the parts of a patient's medical records as necessary to verify the accuracy of the submitted data.

(2) A reporting entity shall, upon the request of the department, supply missing information, if known, or clarify information submitted to the department.

(3) Upon mutual agreement between a reporting entity and the department, the reporting entity may elect to submit copies of medical records instead of on-site inspection of the records by the department. Each copy of a medical record or part thereof that is submitted to the department under this rule shall be used only for verification of corresponding reported data, shall not be recopied by the department, and shall be kept in a locked file cabinet when not being used. The copies shall be promptly destroyed following verification of the corresponding reported data or, if the reported data appears to be inaccurate, following clarification or correction of the reported data.

(4) Both of the following provisions shall be complied with to preserve the confidentiality of each patient's medical records:

(a) Each reporting entity, when requested, shall provide the department with, for inspection only, all of the following records and reports:

(i) Reports of diagnoses of birth defects and notations of the reasons for such diagnoses, including the primary clinician's reports and consultation reports.

(ii) Those parts of medical records that contain the specific information required to be reported.

(b) A reporting entity shall not be required by this rule to allow the inspection of any part of any patient's record other than those parts specified in subrule (1) of this rule. A reporting entity may allow the inspection of medical records from which parts, other than those specified, have been deleted, masked, crossed out, or otherwise rendered illegible.

History

History: 1991 AACS; 2011 AACS.

Mich. Admin. Code R 325.9074 Confidentiality of reports {#sec-r-325.9074 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9074}

Rule 4. (1) The department shall maintain the confidentiality of all reports of birth defects submitted to the department and shall not release such reports or any information which, because of name, identifying number, mark, or description, can be readily associated with a particular individual, except in accordance subrules (2), (3), (4), (5), and (6) of this rule.

The department shall not release any information that would indicate if the name of a particular person is listed in the registry, except in accordance with subrules (2), (3), (4), (5), and (6) of this rule.

(2) A report of birth defects that is submitted to the department concerning a particular individual, and any other information maintained in the birth defects registry reporting system which, because of name, identifying number, mark, or description, can be readily associated with a particular individual, shall be released only as follows:

(a) To the particular individual upon compliance with both of the following provisions:

(i) Receipt of a written request which is signed by the particular individual and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Presentation by the particular individual of suitable identification as required by subrule (4) of this rule.

(b) If the particular individual is a minor, to a parent of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the parent and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the parent of suitable identification as required by subrule (4) of this rule.

(c) If the particular individual has a court-appointed guardian or if the particular individual is deceased, then to the court-appointed guardian or to the executor or administrator of the particular individual's estate upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the court-appointed guardian, executor, or administrator and which is witnessed or notarized as required subrule (3) of this rule.

(ii) Receipt of a certified copy of the order or decree which appoints the guardian, executor, or administrator.

(iii) Presentation by the guardian, executor, or administrator of suitable identification as required by subrule (4) of this rule.

(d) To an attorney or other person who is designated by the particular individual upon compliance with both of the following provisions:

(i) Receipt of a written request which is signed by the particular individual, which is witnessed or notarized as required by subrule (3) of this rule, and which requests release of the information to the attorney or other person.

(ii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(e) To an attorney or other person who is designated by the court-appointed guardian of the particular individual or who is designated by the executor or administrator of the estate of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the court-appointed guardian, executor, or administrator, which is witnessed or notarized as required by subrule (3) of this rule, and which requests release of the information to the attorney or other person.

(ii) Receipt of a certified copy of the order or decree which appoints the guardian, executor, or administrator.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(f) If the particular individual is a minor, to an attorney or other person who is designated by the parent of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the parent, which is witnessed or notarized as required by subrule (3) of this rule, and which requests release of the information to the attorney or other person.

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(3) Every written request for the release of information that is submitted under subrule (2) of this rule shall be signed by the person who makes the written request. The signature shall comply with either of the following provisions:

(a) Be witnessed by an employee of the department who has been designated to witness such requests and to whom the person making the request presents suitable identification as required by subrule (4) of this rule.

(b) Be notarized by a notary public or magistrate.

(4) Any person who is required by subrule (2) or (3) of this rule to present suitable identification shall present an identification document, such as a driver's license, or other document which contains both a picture of the person and the signature or mark of the person.

(5) The director may, under R 325.9074 and R 325.9075, release information from the birth defects registry to an authorized representative of a study or research project that shall be reviewed by a scientific advisory panel, reviewed and approved by the department's IRB, and approved by the director. The process for release of information that identifies the registrant shall be as set forth in this subrule for any research proposals that require contact with the family of the child including direct contact with the child. After the proposal for the research has been reviewed and approved under R 325.9075, and before any information is released to the researcher, information shall be sent to the parent or parents or legal guardian of the registrant or to the registrant, if an adult, that describes the goals and process of the research project. The parent, parents, or legal guardian or registrant, as appropriate, shall be asked to indicate if he or she wishes to participate in the project. The name of the registrant shall only be released to the director of the research project when the parent, parents, or legal guardian grants approval for such release. The department shall not release any part of a patient's medical record obtained under R 325.9073.

(6) The director may authorize information from the birth defects registry to be used within the department or by an authorized agent of the department, including a local health department, to offer medical and other support services to the registrant. The department may contact the parent, parents, or legal guardian or registrant, if an adult, who is identified in the birth defects registry to offer referral to medical and other support services as appropriate. The department shall not release any part of a patient's medical record obtained under R 325.9073.

History

History: 1991 AACS; 2011 AACS.

Mich. Admin. Code R 325.9075 Scientific advisory panel; release of information for research {#sec-r-325.9075 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9075}

Rule 5. (1) The director of the department shall appoint a scientific advisory panel of not less than 3 scientists to review research proposals for which a release of information which is maintained by the department and which identifies an individual reported to have a diagnosis of a birth defect is required.

(2) The scientific advisory panel shall review a research proposal that requires the release of information that identifies an individual who has a reported diagnosis of a birth defect.

(3) The panel shall, in writing, advise the director on the merits of the study.

(4) The study or research project shall not publish the name of any individual who is or was the subject of a report of a birth defect that was submitted to the department. The study or research project shall not release any identifying number, mark, or description that can be readily associated with an individual who is or was the subject of a report of a birth defect that was submitted to the department. A formal memorandum of agreement that is signed by an authorized representative of the department and the director of the research project shall include all of the following provisions:

(a) That electronic files, optical files, or hard copy of the data provided by the department shall not be copied for retention, resold, or otherwise provided to another person or agency and will be returned to the department upon completion of processing of the study.

(b) That any reports or published papers relying in whole or in part on the data furnished by the department to the study or research project shall acknowledge the Michigan birth defects registry of the Michigan department of health and human services as the source of the data.

(c) That a prepublication copy of all resulting papers shall be sent to the department at least 15 days before to the expected date of publication.

History

History: 1991 AACS; 2017 AACS.

Mich. Admin. Code R 325.9076 Rescinded {#sec-r-325.9076 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9076}

History

History: 1991 AACS; 2011 AACS.

Mich. Admin. Code R 325.9077 Exchange of records {#sec-r-325.9077 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9077}

Rule 7. The department, by agreement, may transmit transcripts or copies of reports of birth defects diagnoses to state or national birth defects registries when the reports relate to residents of other states or countries. The agreement shall require that the transcripts or records be used only for statistical or research purposes, or to offer referrals to medical and other support services.

History

History: 2017 AACS.

R 325.9081 to R 325.9087 Blood Lead Analysis Reporting

Mich. Admin. Code R 325.9081 Definitions {#sec-r-325.9081 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9081}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF ENVIRONMENTAL HEALTH

BLOOD LEAD ANALYSIS REPORTING

(By authority conferred on the department of community health by sections 5111(1) and (2)(f), 5474(1)(c), and 20531 of the public health code, 1978 PA 368, MCL 333.5111, 333.5474, and 333.20531; and Executive Reorganization Order No. 2015-1, MCL 400.227.)

Rule 1. (1) As used in these rules:

(a) “Department” means the department of health and human services.

(b) “Limit of detection” means the lowest quantity of a substance that can be detected with reasonable certainty for a given laboratory analytical procedure.

(c)"Physician/provider" means a licensed professional who provides health care services and who is authorized to request the analysis of blood specimens. For this purpose, provider may also mean the local health department.

(d) “Portable blood lead analyzer” means a point-of-care blood lead testing instrument or similar device used to determine blood lead levels.

(e) “User” means a physician/provider, local health department, Head Start agency, community action agency, and any other agency or individuals who utilizes portable blood lead analyzers.

(2) The term "local health department," as defined in section 1105 of the public health code, 1978 PA 368, MCL 333.1105, has the same meaning when used in these rules.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9082 Reportable information {#sec-r-325.9082 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9082}

Rule 2. (1) Reportable information pertains to the analysis of blood samples submitted to clinical laboratories and the results from portable blood lead analyzers.

(2) Upon initiating a request for blood lead analysis, the physician/provider or user ordering the blood lead analysis shall collect the following information:

(a) All of the following information with respect to the individual tested:

(i) Name.

(ii) Sex.

(iii) The individual’s ethnic origin.

(iv) The individual’s race.

(v) Birthdate.

(vi) Address, including county.

(vii) Telephone number.

(viii) Social security number and Medicaid number, if applicable.

(ix) If the individual is a minor, the name of a parent or guardian.

(x) If the individual is an adult, the name of his or her employer.

(xi) A secondary contact for the individual tested or, if the individual is a minor, a secondary contact for the individual’s parent or guardian, including, to the extent available, name and phone number of the secondary contact.

(b) The date of the sample collection.

(d) The physician’s/provider’s or user’s name, name of practice or agency, (if applicable), telephone number, fax number, email address, and mailing address.

(3) The information collected in subrule (2) of this rule must be submitted with the sample for analysis to a clinical laboratory that performs blood lead analysis or a user of a portable blood lead analyzer.

(4) Upon receipt of the blood sample for lead analysis, the clinical laboratory or user of a portable blood lead analyzer shall collect the following additional information:

(a) The name, address, and phone number of the laboratory or testing entity.

(b) The date of analysis.

(d) The results of the blood lead analysis in micrograms of lead per deciliter of whole blood. If the result is below the limit of detection, report as less than the laboratory’s limit of detection for that analytical procedure.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9083 Reporting responsibilities {#sec-r-325.9083 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9083}

Rule 3. (1) All clinical laboratories and users of portable blood lead analyzers doing business in this state that analyze blood samples for lead shall report all blood lead results for adults and children to the department electronically consistent with rule (4). If a result and required reportable information under rule (2) cannot be reported electronically within the time frame specified by this rule, then the results must be submitted to the Michigan Department of Health and Human Services, Childhood Lead Poisoning Prevention Program (CLPPP), P.O. Box 30037, Lansing, MI 48909, or by fax to (517) 335-8509.

Reports must be made to the department within 5 working days after test completion.

Nothing in these rules prevents a person or entity required to report under these rules from reporting results to the department sooner than 5 working days.

(2) Nothing in this rule relieves a clinical laboratory or a user of a portable blood lead analyzer from reporting results of a blood lead analysis to the physician or other health care provider who ordered the test or to any other entity as required by state, federal, or local statutes or regulations or in accordance with accepted standard of practice, except that reporting in compliance with this rule satisfies the blood lead reporting requirements of section 5474(1)(c) of the public health code, 1978 PA 368, MCL 333.5474.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9084 Electronic communications {#sec-r-325.9084 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9084}

Rule 4. (1) A clinical laboratory or user of a portable blood lead analyzer shall submit the data required in Rules 2 and 3 electronically to the department.

(2) Reporting must utilize the data format specifications provided by the department.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9085 Quality assurance {#sec-r-325.9085 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9085}

Rule 5. For purposes of assuring the quality of submitted data, each clinical laboratory or user of a portable blood lead analyzer shall allow the department to inspect copies of the medical records or laboratory test results that will be submitted by the clinical laboratory or user of a portable blood lead analyzer to verify the accuracy of the submitted data. Only the portion of the medical record that pertains to the blood lead testing must be submitted.

The department shall protect the medical records submitted using reasonably appropriate privacy and security safeguards regardless of whether the medical records are received by the department in electronic or hard copy form.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9086 Confidentiality of reports {#sec-r-325.9086 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9086}

Rule 6. (1) Except as provided in subrule (2) of this rule, the department shall maintain the confidentiality of all reports of blood lead tests submitted to the department and shall not release reports or information that may be used to directly link the information to a particular individual.

(2) The department may release reports or information, otherwise protected under subrule (1) of this rule, under any of the following conditions:

(a) If the department has received written consent from the individual, or from the individual's parent or legal guardian, requesting the release of information.

(b) If necessary for law enforcement investigation or prosecution of a property manager, housing commission, or owner of a rental unit under section 5475a of the public health code, 2004 PA 434, MCL 333.5475a.

(c) If the director of the department determines that release is crucial to protect the public health against imminent threat or danger.

(d) As necessary for the department to carry out its duties under the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(e) If necessary for the purpose of research designed to develop or contribute to generalizable knowledge, with documented approval by the department’s institutional review board.

(f) If necessary for the purpose of public health activities designed to prevent or mitigate lead poisoning within a community.

(3) Medical and epidemiological information that is released to a legislative body must not contain information that identifies a specific individual.

(4) Aggregate epidemiological information concerning the public health that is released to the public for informational purposes only must not contain information that identifies a specific individual.

History

History: 1997 AACS; 2015 AACS; 2020 AACS.

Mich. Admin. Code R 325.9087 Rescinded {#sec-r-325.9087 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9087}

History

History: 1997 AACS; 2015 AACS.

Legal Affairs and Legislative Services Administration Legal Affairs and Legislative Services Administration

R 325.9101 to R 325.9553 Certificate of Need

Mich. Admin. Code R 325.9101 Definitions; A to D {#sec-r-325.9101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

POLICY, PLANNING AND LEGISLATIVE ADMINISTRATION

CERTIFICATE OF NEED

(By authority conferred on the department of health and human services by sections 2226, 2333, and 22255 of 1978 PA 368, MCL 333.2226, 333.2333, and 333.22255.)

PART 1. GENERAL PROVISIONS

Rule 101. As used in these rules:

(a) "Applicant" means the person, as defined in section 1106 of the code, or a governmental entity, as defined in section 1104 of the code, applying for a certificate of need and authorized to conduct business in this state.

(b) "Application" means the department forms, in electronic or in paper format, that are currently in effect at the time the application is submitted, and any information or documentation prespecified in the forms to be provided as attachments or supplements (c) "Appropriate regional certificate of need review agency" means the regional certificate of need review agency that the department designates under section 22226 of the code that is within the geographical review area where an applicant proposes to locate a project.

(d) "Bureau" means the administrative unit of the department that the director designates as responsible for the certificate of need program.

(e) "Code" means 1978 PA 368, MCL 333.1101 to 333.25211.

(f) "Comparative group" means the applications that have been grouped for the same type of project in the same planning area that are being reviewed comparatively according to these rules.

(g) "Completed application," except as provided in R 325.9229, means the application submitted by the applicant, including any additional information provided by the applicant on or before the date the application is deemed complete under R 325.9201(3).

(h) "Completed project" means a project that the department has determined both of the following:

(i) That all activities and construction necessary to offer the services, beds, facilities, or equipment approved by a certificate of need have been executed in compliance with the terms and conditions of the certificate of need.

(ii) That the project has been implemented as defined in R 325.9103(b).

(i) “Department” means the Michigan department of health and human services.

(j) “Director” means the director of the Michigan department of health and human services.

History

History: 1986 AACS; 1996 AACS; 2014 AACS; 2016 AACS.

Mich. Admin. Code R 325.9103 Definitions; I, L {#sec-r-325.9103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9103}

Rule 103. As used in these rules:

(a) "Incur an obligation" means entering into either of the following:

(i) An executed contract or contracts for the construction, acquisition, lease, or financing of all or substantially all, of the project, as determined by the department.

(ii) An executed contract or contracts for the construction, acquisition, lease, or finance of, a phased project. A phased project is a project accomplished in segments over a period of time in compliance with a project timetable acceptable to the department and approved in the certificate of need.

(b) "Implement", except as provided in R 325.9403(5), means 1 of the following:

(i) For a project that involves the performance of the first surgical procedure of either of the following:

(A) Extrarenal organ transplantation (heart, lung, liver, bone marrow).

(B) Open heart surgery.

(ii) For a project that involves any of the following, the performance of the first procedure or the signing of a contract that specifies the installation date of the equipment occuring within 24 months and the first procedure within 30 months of the effective date of the certificate of need:

(A) Urinary extracorporeal shock wave lithotripsy (UESWL).

(B) Megavoltage radiation therapy (MRT).

(D) Computed tomography (CT) scanning.

(E) Cardiac catheterization.

(F) Magnetic resonance imaging (MRI).

(G) Air ambulance services.

(iii) For a project that involves beds or surgical services, either of the following:

(A) The signing of a contract for the construction, renovation, purchase or lease of equipment or space to house the beds or operating rooms.

(B) The licensure or certification of the beds or operating rooms for use, whichever occurs first.

(iv) For a project that involves capital expenditures other than projects specified in paragraphs (i) to (iii) of this subdivision when an obligation is incurred or, if the certificate of need expressly defines a series of obligations for discrete components to be incurred over a period of more than 1 year, when each of the designated obligations is incurred.

(v) For a project that involves the acquisition of licensed health facilities, the issuance of a new license by the Michigan department of licensing and regulatory affairs.

(vi) For a project that is not specified in paragraphs (i) to (v) of this subdivision, the occurrence of the implementation event as defined in the applicable certificate of need review standards.

(c) "Letter of intent" means the department form, in electronic or paper format, to determine the reviewability, type of review, and appropriate application forms for a proposed project.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9105 Definitions; N to S {#sec-r-325.9105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9105}

Rule 105. As used in these rules:

(a) "Nonsubstantive review" means review of a project accepted for review under R 325.9205 and R 325.9206.

(b) "Offer" means to perform a procedure or serve a patient, as applicable, as authorized by a certificate of need.

(c) "Qualifying project" means each application in a comparative group which has been reviewed individually and which the department determines to satisfy all the requirements of section 22225 of the code, all other applicable requirements for approval in the code, and all applicable certificate of need review standards.

(d) “Recipient” means a person who validly holds a signed, approved certificate of need under the code and these rules.

(e) "Regional certificate of need review agency" means the agency designated by the department pursuant to section 22226 of the code.

(f) "Single project" means an activity that requires a certificate of need or, in the case of a capital expenditure, an activity or a group of activities involving a distinct physical area or areas of a health facility or involving the same service or similar services.

(g) “Site” means the physical location and address (or legal description of property) of a covered service or beds, unless otherwise defined in the applicable certificate of need review standards.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9109 Terms defined in code and certificate of need review standards; establishment of certificate of need review standards {#sec-r-325.9109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9109}

Rule 109. (1) Terms defined in the code and certificate of need review standards have the same meanings when used in these rules.

(2) All certificate of need review standards used in making determinations on applications under these rules shall be established by law.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9121 Computation of time deadline {#sec-r-325.9121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9121}

Rule 121. Any deadline falling on a nonworking day, will be extended to the next department working day.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9123 Designated application dates {#sec-r-325.9123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9123}

Rule 123. (1) The designated application date is the date that the rules set as the deadline for submitting applications for a certificate of need. An application is considered timely if it is received at the department’s Lansing office and date and time stamped as received before 4:00 p.m. on a designated application date. An application received,including electronic submissions, at the department's Lansing offices after 4:00 p.m. on a designated application date is not considered timely and shall be deemed submitted on the next designated application date.

(2) For an applicant seeking a nonsubstantive review under R 325.9205 and R 325.9206, the designated application date is the department working day that the department received the application.

(3) For an application that is not eligible for nonsubstantive review and not subject to comparative review, the designated application date isthe first department working day of each month.

(4) For an application that is subject to comparative review, the designated application dates are February 1, June 1, and October 1 of each year.

(5) An application is not considered submitted to the department until it is submitted to the appropriate regional certificate of need review agency.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9125 Extensions {#sec-r-325.9125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9125}

Rule 125. (1) The department may extend the date to issue a proposed or final decision on an application for not less than 30 days, but not more than 90 days, either under R 325.9229 or upon receipt of a written request from an applicant.

(2) An applicant’s written request for an extension shall specify either the date or the number of days being requested for an extension. The department may extend the date to issue a proposed or final decision if in either case, both of the following requirements, as applicable, are met:

(i) The extension will not result in a delay in the start of the review of similar applications filed subsequently as provided by R 325.9207(2)(b).

(ii) All applicants in the comparative group, for applications subject to comparative review request an extension of the same duration.

(3) The department may grant an extension for longer than 90 days if the applicant provides justification that the department considers satisfactory. The department’s decision to deny an extension request is not subject to administrative hearing or appeal.

PART 2. APPLICATIONS; REVIEWS

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9201 Letters of intent; applications; forms; copies; attachments and supplements; content; completeness; additional information; department's authority to consider relevant information not limited; notification of information considered relevant; public availability {#sec-r-325.9201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9201}

Rule 201. (1) Before applying for a certificate of need for a project, except for projects that are covered by section 22235 of the code, a person shall submit a letter of intent simultaneously to the department and the appropriate regional certificate of need review agency. The letter of intent shall be on a form supplied by the department. Within 15 days of receipt of a letter of intent, the department shall notify the person proposing the project whether the project requires a certificate of need and, if so, the type of review (nonsubstantive, substantive, potential comparative) and provide the applicant with appropriate forms. The department may decline to process a letter of intent if the same covered service or beds already exists at that site under a different entity that has submitted a letter of intent or application or has previous certificate of need approval before the new letter of intent, or would otherwise result in a conflicting or duplicative CON review. The department shall not review any application it receives before the department finishes processing the letter of intent for that application. A letter of intent expires if an application has not been submitted to the department within 1 year of receipt of the letter of intent by the department. The department shall provide the applicant with a copy of the current work plan of the certificate of need commission indicating the timing by which the certificate of need review standards are being revised or are scheduled to be revised by the commission.

(2) At the time of submission of an application, a person applying for a certificate of need shall simultaneously submit 3 copies of an application, or 3 copies of any supplemental documents for an electronic application, for a single project to the department and, if applicable, 1 additional copy to the appropriate regional certificate of need review agency.

The application shall be made on the application forms authorized and provided by the department. The application forms may include requirements for attachments and supplements specified by the department in the forms. An application shall clearly state the persons, buildings and properties to which it applies and clearly define the scope, nature, cost, time limits, and other aspects of the proposal. A letter of intent, application, or an amendment to an approved certificate of need shall be accompanied by the fee, if any, required by law and these rules. A letter of intent or an amendment not accompanied by the required fee if any, will not be processed until the bureau receives the required fee, if any. An application not accompanied by the required fee will not be considered timely and will be deemed submitted on the next designated application date after receipt of the required fee. An application received, including electronic submissions, that does not include statements addressing each of the review criteria listed in section 22225 of the code is not timely and will be deemed submitted on the next designated application date after receipt of the required documents. Statements addressing section 22225 are not required for proposed projects eligible for nonsubstantive reviews under R 325.9205.

(3) The department shall consider only those applications that it deems submitted on or before the designated application date and shall determine if the application is complete.

The department may request additional information and provide notification of a determination to the applicant and the appropriate regional certificate of need review agency within 15 days of receipt of the application. The applicant has 15 days from receipt of the department's notice to respond to the request to the department’s satisfaction. If the department does not request additional information the department shall consider the application to be complete as submitted by the applicant on the designated application date.

If additional information is requested for applications subject to nonsubstantive or substantive review, the department shall consider the application to be complete on the next designated application date with or without the additional information. If additional information is requested for applications subject to comparative review, the department shall consider the application to be complete on the first department working day of the next month, with or without the additional information.

(4) This rule does not limit the department's authority to consider all available information relevant to the department's review of an application.

(5) An applicant may request, and the department may allow, the submission of information after the date the application is deemed complete if the application is not subject to comparative review. When a request under this subrule is made, the department may require that the applicant authorizes an extension to the date a decision must be issued if the department determines that an extension is necessary to perform its review.

(6) The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(7) Before issuing a proposed decision, the bureau shall notify an applicant of all information that the department relied upon in conducting the department's review. If the department relies on information other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, the information it relied upon. The department shall make this information available to the public upon request.

(8) The department’s decision to request additional information is not subject to administrative hearing or appeal.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9203 Rescinded {#sec-r-325.9203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9203}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9204 Data and physician commitments {#sec-r-325.9204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9204}

Rule 204. (1) If a certificate of need review standard requires a data commitment, including Michigan inpatient data base (MIDB) data or cancer registry data, the health facility or freestanding facility committing the data shall be regularly admitting patients and providing services as of the date the director makes the final decision on an application under section 22231 of the code. Further, the department shall not consider any commitment if a health facility or freestanding facility withdrew its commitment before the final decision on an application.

(2) If a certificate of need review standard requires a physician commitment, then all of the following apply, unless otherwise specified in a review standard:

(a) The commitments shall be submitted at the time the application is submitted to the department.

(b) A commitment shall not be withdrawn after the date an application is deemed complete by the department and after a proposed decision to approve an application has been issued by the department.

History

History: 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9205 Nonsubstantive reviews; eligibility {#sec-r-325.9205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9205}

Rule 205. (1) A person may submit a letter of intentrequesting a nonsubstantive certificate of need review.

(2) The department shall approve the request as appropriate when the department is satisfied that all of the following conditions have been met:

(a) The completed project will not result in any of the following:

(i) An increase in the number of beds licensed to the applicant at the licensed site at which the project is proposed.

(ii) The initiation or expansion of a covered clinical service.

(iii) Beginning operation of a new health facility at a site that is not currently licensed for that type of health facility.

(iv) A capital expenditure in excess of a covered capital expenditure as defined in the code.

(b) The proposed project is not subject to comparative review under the code or the applicable certificate of need review standards.

(3) The department may accept other projects for nonsubstantive review under section 22233 of the code. The department shall maintain a public list of the types of projects eligible for nonsubstantive review under this rule.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9206 Nonsubstantive review; procedure; time for decision; notice; effect of denial of request for review; department decision to deny review not subject to administrative appeal; review period; submittal of regional certificate of need review agency's recommendations {#sec-r-325.9206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9206}

Rule 206. (1) The department shall determine whether an application submitted for nonsubstantive review is complete as provided by R 325.9201(3). The department shall notify the applicant of its decision and send a copy of the decision to the appropriate regional certificate of need review agency. The department's decision to deny nonsubstantive review of a project is not subject to administrative hearing or appeal.

(2) If a request for nonsubstantive review is denied, the application is deemed submitted for the purposes of substantive review on the next designated application date after the date of denial and the time frames to determine completeness for substantive review shall be those in R 325.9201(3).

(3) The department shall consider only those applications that are filed on or before the designated application date and will determine whether the application is complete or incomplete. The department shall provide notification of a determination to the applicant and the appropriate regional certificate of need review agency within 15 days of receipt of the application. The applicant has 15 days from receipt of the department's notice to provide additional information or otherwise complete the application. If additional information is not requested by the department, the department will consider the application to be complete as submitted by the applicant on the designated application date. If additional information is requested, the department will consider the application to be complete on the date the department receives the applicant’s responses. If the additional information requested is not received within 15 days, the application will be deemed complete.

(4) The period for the review of a nonsubstantive application shall be not more than 45 days from the date the application is deemed complete by the department. The appropriate regional certificate of need review agency shall submit its recommendations with respect to a nonsubstantive application within 30 days of the date the application is accepted for nonsubstantive review by the department so that the recommendations can be included in the department's review process. If new or revised certificate of need review standards applicable to a proposed project become effective before the issuance of a final decision by the director of the department, the review and issuance of proposed and final decisions shall be made according to the provisions of R 325.9229.

(5) The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(6) Before issuing a proposed decision, the bureau shall notify an applicant of all information that the department relied upon in conducting the department's review. If the department relies on information, other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, the information it relied upon. The department shall make this information available to the public upon request.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9207 Substantive individual or comparative review; scheduling of reviews; procedures {#sec-r-325.9207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9207}

Rule 207. (1) Projects subject to comparative review shall be designated under section 22229 of the code or the applicable certificate of need review standards. Proposed projects that are not subject to comparative review and are not eligible for nonsubstantive review will be subject to substantive individual review under this subrule and not subrule (2) of this rule. The bureau will issue a proposed decision on a certificate of need application within 120 days of the date an application is deemed complete under R 325.9201(3). The appropriate regional certificate of need review agency will concurrently review the application and submit its recommendations to the department within 90 days of the date the department determines the application is complete and the review period has commenced. If new or revised certificate of need review standards applicable to a proposed project become effective before the issuance of a final decision by the director of the department, the review and issuance of proposed and final decisions shall be made in accordance with R 325.9229. A review shall commence on the date an application is deemed complete by the department. The department, with the advice of the regional certificate of need review agency will determine if an application filed by each applicant meets all applicable requirements for approval under part 222 of the code.

(2) The following provisions shall apply to projects subject to comparative review under section 22229 of the code:

(a) Within 30 days after the date that all of the applications are deemed complete, the department shall place the timely applications into comparative groups and shall notify the appropriate regional certificate of need review agency and each applicant whether each comparative group will be subject to comparative review. For comparative reviews, the review period begins on the date in the notice under this subrule. In cases where a final decision on a prior review of similar projects, services or facilities in the same planning area has not yet been issued by the director, the review period begins only after the director issues a final decision on such prior review.

(i) For each comparative group subject to comparative review, the notice shall also include all of the following findings by the department:

(A) The projections of need for the proposed facilities, beds, or services.

(B) That the total proposed facilities beds or services in the comparative group are more than the projections of need.

(C) That the applications, when taken together, are mutually exclusive in that, under existing certificate of need review standards, the approval of 1 or more of the applications will necessarily result in the denial of other applications.

(ii) Applications that are not subject to comparative review shall be reviewed individually in the same manner as a project submitted under subrule (1) of this rule, with the 120-day and concurrent 90-day review periods commencing on the date on which the department determines that the applications are not subject to comparative review. The review period cannot commence when a final decision on a prior review ofsimilar projects, services, or facilities in the same planning area has not been issued by the director. In this case, the review period begins only after the director issues a final decision on such prior review.

(b) If upon review under subdivision (a) of this subrule, the department determines that an application could fall into more than l comparative group the department shall notify the applicant. The applicant shall notify the department that the project is amended so that the proposed project involves only services, facilities, equipment, or beds relative to a single comparative group or notify the department that the project in its entirety is withdrawn. If the applicant advises the department that it is amending the application, additional information related to the amendment may be submitted under R 325.9201(3).

In the absence of notification by an applicant, the original application is subject to comparative review in the comparative group determined by the department and the portion of the application involving the other comparative group or groups will not be considered by the department in its review of the application. The applicant may submit according to these rules, a separate application for the portion of the application not being considered.

(3) This rule does not limit the department's authority to consider all available information relevant to the department's review of an application.

(4) The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(5) Before issuing a proposed decision, the bureau shall notify an applicant of all information that the department relied upon in conducting the department's review. If the department relies on information other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, the information it relied upon. The department shall make all other information available to the public upon request.

History

History: 1986 AACS; 1987 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9208 Comparative reviews; procedures {#sec-r-325.9208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9208}

Rule 208. (1) For a comparative group, the department, with the advice of the regional certificate of need review agency, shall review the applications within the comparative group pursuant to the following procedure:

(a) A regional certificate of need review agency shall concurrently review the applications and submit its recommendations to the department as soon as practicable, but not later than 90 days after the notification of the start of a comparative review.

(b) The bureau shall concurrently review and issue a single proposed decision regarding the applications in the comparative group subject to comparative review as soon as practicable, but not later than 120 days after notification of the start of a comparative review. If new or revised certificate of need review standards applicable to a proposed project become effective before the director issues a final decision, then R 325.9229 applies to the review and issuance of proposed and final decisions.

(c) The bureau, with the advice of the regional certificate of need review agency, shall determine if the application filed by each applicant meets all applicable requirements for approval under part 222 of the code.

(d) The bureau shall rank all qualifying projects in the comparative group as provided by the applicable certificate of need review standards and shall issue a single proposed decision. The bureau shall approve the highest ranking applications that, in total do not exceed the amount of need as determined by section 22225(1) of the code. If a higher ranking application cannot be approved because its approval would exceed the amount of need, the bureau shall approve the remaining applications in the comparative group from highest to lowest score until the level of need is met. The bureau shall issue a proposed disapproval as part of the single decision for the remaining applications in the comparative group.

(2) This rule and R 325.9207 do not apply to certificates of need applied for and issued under sections 22233 and 22235 of the code.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9210 Finance Reviews; procedures {#sec-r-325.9210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9210}

Rule 210. (1) A person applying for a certificate of need for a project shall provide all of the following information as applicable:

(a) Audited financial statements for existing providers including balance sheet, income statement, statement of cash flow, and footnotes to the financial statements.

(b) For new providers, the department may accept evidence of secured capital funding or a letter of interest from a financial institution, if audited financial statements are not available.

(d) Signed vendor quote dated within 6 months of application submission for applications involving covered clinical equipment.

(e) All applicable proposed lease and purchase agreements.

(f) Designated funds specifying what type of funds are used (for example, cash, bond, etc.).

(g) The book value for the assets of a licensed health facility or covered clinical service verifiable by an unrelated party; as determined by the department.

(2) For construction projects, the applicant will competitively bid capital expenditures among qualified contractors or alternatively, the applicant is proposing an alternative to competitive bidding that will achieve substantially the same results as competitive bidding.

(3) An applicant utilizing future operations (for example, capital/operating lease) as a source of funds shall provide the following, as applicable:

(a) Current bank or financial institution statement or balance and dated within 30 days of submission of the application.

(b) Third party verification of a bank loan, HELP loan, or other equivalent source of funding.

(4) The department’s finance review shall be conducted using the completed application and any other information the department considers relevant to the decision and under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(5) Before issuing a proposed decision, the bureau must notify an applicant of all information that the department relied upon in conducting the department's review. Ifthe department relies on information, other than submitted by the applicant in its application, the bureau or department must cite in the proposed or final decision letter, as applicable, the information it relied upon. The department shall make this information available to the public upon request.

(6) This rule does not limit the department's authority to consider all available financial information relevant to the department's review of an application.

History

History: 2014 AACS.

Mich. Admin. Code R 325.9215 Amendments to applications before proposed decision is issued by the bureau {#sec-r-325.9215 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9215}

Rule 215. (1) An applicant shall not amend an application subject to a comparative review after the designated application date established under R 325.9123, except to the extent that additional information is requested by the department to make the application complete under R 325.9201 or R 325.9229(6) or as provided for in R 325.9207(2)(b). A person desiring to amend an application may do any of the following:

(a) Withdraw the amendment.

(b) Have the project considered under a new application on a subsequent designated application date.

(c) If the application is subject to comparative review, amend the application if all applicants in the comparative group agree to allow an amendment, if the amendment does not increase the scope of the project.

(2)An amendment to an application before a proposed decision is issued by the bureau shall not change the person, the site of a proposed health facility or covered clinical service, or increase the number of beds or covered clinical services proposed in a certificate of need.

(3) A request to amend an application shall be accompanied by the required fee if the amendment request results in higher costs under the fee schedule in section 20161 of the code for the proposed project that would have required a higher application fee when submitted originally. An amendment not accompanied by the required fee will not be processed by the department until the required fee is received.

(4) An application that is not subject to comparative review may be amended by the applicant up to 30 days in advance of the proposed decision date established by these rules.

If the department, with the advice of the appropriate regional certificate of need review agency, determines that the proposed amendment substantially changes the original application and that additional review by the department and the regional certificate of need review agency is required to adequately evaluate the proposal according to the code and these rules, the department shall require, as a condition of the amendment, that the applicant agree to extend the date for proposed decision as required to permit the additional review.

(5) The department may consider new or revised information submitted by an applicant for an application that is not being reviewed on a comparative basis, within 30 days of the proposed decision date or at any time after the proposed decision and before a final decision is issued, if an applicant requests an extension to the proposed or final decision date sufficient to allow the department and the appropriate regional certificate review agency, up to 30 days to review the new or revised information. The department may request from an applicant a longer extension, if it is necessary to review new or revised information. The applicant shall also simultaneously submit the new or revised information to the appropriate regional certificate of need review agency. The department shall make the new or revised information available to the public upon request.

(6) If an applicant for a project not originally subject to comparative review proposes to amend the application in such a way as to make it subject to a comparative review, the bureau shall notify the applicant of the need for comparative review. The applicant may then either withdraw the amendment or have the project considered under a new application on a subsequent designated application date.

History

History: 1986 AACS; 1996 AACS; 2014 AACS; 2016 AACS.

Mich. Admin. Code R 325.9227 Emergency review; request; denial {#sec-r-325.9227 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9227}

Rule 227. (1) A request for an emergency certificate of need review under section 22235 of the code may be made electronically or in paper format. The request shall include justification for the project and a statement of the nature and extent of the claimed emergency.

(2) If the department determines that a request filed under subrule (1) of this rule is not covered by section 22235 of the code, it shall inform the applicant, in writing, within 10 working days of receipt of the request, and deny the request for emergency review.

(3) The department’s decision to deny emergency review is not subject to administrative hearing or appeal.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9228 Extended care services program (swing bed) review; maximum number of patient days variation {#sec-r-325.9228 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9228}

Rule 228. (1) A request for extended care services program certificate of need review under section 22210 of the code may be made electronically or in paper format. The request shall include justification for the project and demonstration of compliance with the requirements in section 22210 of the code.

(2) Evidence that the hospital has had difficulty in placing patients in skilled nursing home beds during the 12 months immediately preceding the date of application include, but not limited to, evidence that the average occupancy rate for all existing and operating nursing homes within a 20 mile radius of the hospital has been at least 85% for the last 4 quarters based upon the department’s staffing/bed utilization ratios report.

(3) The department may grant a 1 year variation from the maximum number of patient days established under section 22210(3)(e) of the code if the applicant demonstrates immediate need for the project by showing that the average occupancy rate for all existing and operating nursing homes within a 100-mile radius of the hospital has been at least 85% for the last 4 quarters based upon the department’s Staffing/Bed Utilization Ratios Report.

History

History: 2014 AACS.

Mich. Admin. Code R 325.9229 New or revised certificate of need review standards approved by certificate of need commission {#sec-r-325.9229 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9229}

Rule 229. (1) If new or revised certificate of need review standards become effective between the time an application is filed and when the director issues a final decision on the application, then the bureau shall consider and process the application according to this rule.

(2) If the bureau is reviewing an application, other than on a comparative review basis, and the bureau has not issued a proposed decision before the effective date of the new or revised certificate of need review standards then either of the following apply:

(a) The applicant, within 15 days of the effective date of the new or revised certificate of needed review standards, may request, and the department may grant, an extension, under R 325.9125, of the date by which a proposed decision must be issued by the bureau under these rules and the code. During the extension period, the applicant may submit to the department and the appropriate regional certificate of need review agency, additional information to demonstrate that the application is in compliance with the new or revised certificate of need review standards.

(b) If an applicant requests an extension under this rule the bureau shall issue a proposed decision on the completed application, using the new or revised certificate of need review standards, on or before 45 days for nonsubstantive applications or 120 days for substantive applications, after receipt of the additional information.

(c) If the applicant does not request an extension under this, the bureau shall issue a proposed decision on the completed application reviewed according to the new or revised certificate of need standards and the proposed decision shall be issued according to the date established under R 325.9207.

(3) If the bureau has reviewed an application, other than on a comparative basis, and the bureau has issued a proposed decision, then either of the following applies:

(a) The applicant may request, within 15 days of the effective date of the new or revised certificate of need review standards, and the department may grant a remand of the proposed decision to the bureau. Upon such remand, the date a final decision must be issued by the director of the department is stayed and the applicant may submit, to the department and the appropriate regional certificate of need review agency, additional information to demonstrate that the application complies with the new or revised certificate of need review standards under R 325.9125. Upon remand, the bureau shall issue a proposed decision on the completed application according to the new or revised certificate of need review standards, on or before 45 days for nonsubstantive applications or 120 days for substantive applications, after receipt of the additional information.

(b) If the applicant does not request a remand under this rule, the director of the department shall issue a final decision on the completed application reviewed according to the new or revised certificate of need standards and the final decision shall be issued in accordance with the date established under these rules and the code.

(4) If the bureau has reviewed an application, other than on a comparative basis; the bureau has issued a proposed decision; and the applicant has requested a hearing on a proposed decision under section 22232(1) of the code, then regardless of the stage of the hearing, either of the following apply:

(a) The applicant may request that the matter be remanded to the bureau for further review according to subrule (3) of this rule.

(b) If the applicant does not request a remand under this subrule, the applicant may, within 60 days following the effective date of the new or revised certificate of need review standards augment, for introduction in the hearing its testimony evidence and exhibits in support of its application with regard to the new or revised certificate of need review standards.

(c) If an applicant does not request a remand under this subrule, the department shall submit, to the hearing officer, within 60 days of the effective date of the new or revised certificate of need review standards, or 60 days of the date an applicant has augmented the record, whichever comes later, an analysis of the applicant's compliance with the new or revised certificate of need review standards.

(5) If an application is in a comparative review, regardless whether it is in the process of being reviewed by the bureau or in any stage of a hearing, by the director of the department, any applicant in the comparative group, within 15 days of the effective date of the new or revised certificate of need standards, may request, and the department may grant an extension to review and issue a proposed decision on the comparative group according to the new or revised certificate of need review standards. Upon extension or remand and extension, each applicant in the comparative group may submit, within 60 days following the effective date of the new or revised certificate of need review standards to the department and the appropriate regional certificate of need review agency, additional information to demonstrate that its application complies with the new or revised certificate of need review standards. Upon such an extension or remand and extension, the bureau shall issue a single proposed decision on the completed applications, with the addition of any information submitted under this subrule from the comparative group, according to the new or revised certificate of need review standards on or before 120 days of the last date on which additional information may be submitted under this subrule. If none of the applicants request an extension or a remand and extension, for the review and issuance of a single decision on the comparative group will be based on each completed application reviewed pursuant to the new or revised certificate of need standards and the decision will be issued in accordance with the date established under these rules and the code.

(6) The bureau shall consider the recommendation of the appropriate regional certificate of need review agency if the recommendation is received more than 30 days before the bureau or department decision dates established under this rule.

PART 3. APPROVAL AND ISSUANCE; DISAPPROVAL

History

History: 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9301 Bureau and department decision to be written; issuance of 1 decision for all applications in comparative review; conditions and stipulations as integral parts of certificate of need; request for hearing deemed request for hearing on entire decision; issuance of final decision {#sec-r-325.9301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9301}

Rule 301. (1) The bureau shall issue only 1 proposed decision for all applications, including qualifying and nonqualifying projects, when a comparative group is determined to be subject to comparative review.

(2) The director shall issue only 1 decision for all applications including qualifying and nonqualifying projects, when a comparative group is determined to be subject to comparative review.

(3) A request for hearing filed under section 22231 or 22232 of the code related to any part of a decision, including conditions and stipulations, will be deemed a request for hearing on the entire decision.

(4) The director shall issue a final decision under all applicable requirements and provisions of the code.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9303 Effective date of certificate {#sec-r-325.9303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9303}

Rule 303. Unless otherwise specified in the final decision, a certificate of need is effective on the date director issues the final decision.

PART 4. TERMS AND CONDITIONS

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9401 Validity of certificate {#sec-r-325.9401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9401}

Rule 401. (1) A certificate of need is valid only as long as there is compliance with the provisions in the final or amended application, including project timetables except as expressly modified in the certificate of need and its amendments.

(2) As provided by section 20164(2) of the code, the certificate of need is not transferable and shall be valid only for the persons, buildings and properties stated in the certificate.

The recipient of a certificate of need shall comply with all of the following provisions:

(a) The certificate of need.

(b) The amendments to the certificate of need.

(3) Only the persons authorized by the certificate of need may offer the covered clinical services or beds listed in the certificate of need.

History

History: 1986 AACS; 2014 AACS.

Mich. Admin. Code R 325.9403 Term of certificate {#sec-r-325.9403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9403}

Rule 403. (1) Unless otherwise specified in a certificate of need review standard or final decision, a certificate of need expires 1 year from its effective date, unless the project is implemented as defined in R 325.9103(b).

(2) The bureau, upon written request of the recipient, may extend the implementation period established in subrule (1) of this rule or in a certificate of need review standard by not more than 6 months if the bureau determines all of the following:

(a) The terms of the certificate are not changed.

(b) Substantial progress has been made.

(3) Any extension granted under subrule (2) of this rule does not change the effective date of the certificate of need.

(4) At any time, the department may request, and the person holding the certificate of need shall immediately provide, any documentation, including project schedules, to determine whether the project is on schedule and within the estimated costs for the project.

(5) For projects subject to the provisions of R 325.9103(b)(i), (ii), or (vi), a certificate of need review standard may establish a term of the certificate other than as established in subrules (1) and (2) of this rule, in which case the certificate of need expires at the end of the time period specified in the standard.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9413 Amendments to approved certificates of need {#sec-r-325.9413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9413}

Rule 413. (1) A recipient may request the department to amend an approved certificate of need if the project is not a completed project. After consulting with the appropriate regional certificate of need review agency, the department shall decide whether the amendment requires another review. The department's decision to require another review or deny a request is not subject to the administrative hearing process in the Administrative Procedures Act of 1969, 1969 PA 306, MCL 24.201 to 24.328.

(2) A request to amend a certificate of need shall be accompanied by the required fee if the amendment request results in higher costs under the fee schedule in section 21601 of the code for the proposed project that would have required a higher fee when submitted originally. An amendment not accompanied by the required fee will not be processed by the department until the required fee is received.

(3) A certificate of need issued after a comparative review shall not be amended to change any of the following:

(a) The scope of the project.

(b) An increase in the cost of the project.

(d) The terms of financing the project, except where a recipient demonstrates to the satisfaction of the department, that an amendment to change the method or terms of financing offers a less costly alternative to the approved method or terms of financing the project.

(4) The department may allow an amendment requesting a change in the site of an approved health facility before completion of the project if both of the following criteria are met:

(a) Sufficient evidence is submitted and deemed reasonable by the bureau detailing an event that could not be reasonably foreseen that prevents the completion of an approved project at the approved site. The event that could not be reasonably foreseen must have occurred after the approval of the project.

(b) The site proposed in the amendment shall meet the exact criteria and scoring, if applicable, as the previously approved site and any new criteria in updated standards.

(5) An amendment for an approved health facility or covered clinical service shall not modify the person, purpose of the property, or the scope of the project. An amendment for an approved health facility or covered clinical service shall not increase the number of beds or clinical services approved in a certificate of need. An amendment cannot change the site of an approved covered clinical service for a nonlicensed facility.

(6) The department may allow an amendment requesting a change in the method and terms of financing, approved capital expenditures, for example, medical equipment, or other costs only in those instances where the recipient is able to demonstrate that the need for amendment arises from circumstances beyond its control or the amendment offers a better alternative as determined by the department with the advice of the appropriate regional certificate of need review agency.

(7) The department may request additional information regarding a proposed amendment under the time periods in R 325.9201(3).

(8) The review period for a request to amend an approved certificate of need shall not be longer than the original review period for the application. When reviewing a proposed amendment to an approved certificate of need, the bureau shall use the standards in effect at the time of the original approval of the certificate of need.

(9) The department may grant an extension to the date a decision will be issued for an amendment upon written request from a recipient. An extension may be granted for not less than 30 days, but not more than 90 days.

(10) Unless waived by the department, amendments to a certificate of need are subject to the same conditions and stipulations imposed on the original certificate and any new conditions and stipulations imposed on the amendment.

History

History: 1986 AACS; 1996 AACS; 2014 AACS; 2016 AACS.

Mich. Admin. Code R 325.9415 Amendment to approved certificates for an increase in project costs {#sec-r-325.9415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9415}

Rule 415. Anamendment to an approved certificate of need for increased project costs will not be required if the total amount of excess does not exceed the sum of 15% of the approved project costs up to $1,000,000.00 and 10% of the approved project costs in excess of $1,000,000.00.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9417 Certificate timetables {#sec-r-325.9417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9417}

Rule 417. (1) An application for a certificate of need shall specify the timetable the applicant will follow in making the health facility, beds, services or equipment available or for beginning and completing construction.

(2) The recipient shall begin construction within 24 months of the effective date of the certificate of need. A recipient may request to extend the time to begin any construction beyond the 24 month period, with an amendment request to the department. The department may approve to extend the period of time to begin construction if the department determines that circumstances justify an extension. Extending the 24-month period does not change the effective date of the certificate of need.

(3) The recipient shall install the medical equipment specified in the certificate of need within 24 months of the effective date of the certificate of need. A recipient may request to extend an installation beyond the 24-month period, with an amendment request to the department. The department may approve to extend the period of time for installation if the department determines that circumstances justify an extension. Extending the 24-month period does not change the effective date of the certificate of need.

(4) For medical equipment, the first procedure must be performed within 6 months of the installation date of the equipment specified in R 325.9103(b)(ii). The department may approve to extend the period of time for the first procedure to be performed if the department determines that circumstances justify an extension. This does not change the effective date of the certificate of need.

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9419 Monitoring compliance with approved certificates of need under section 22247 of the code. Rule 419. (1) If the department determines that a recipient has not complied with the terms, conditions, or stipulations of an approved certificate of need, the department shall notify the recipient. The department shall also specify the period of time during which the noncompliance occurred {#sec-r-325.9419 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9419}

(2) In determining the appropriate action to take according to section 22247(2) of the code, the department shall consider the extent and duration of the noncompliance.

(3) The department shall make available, to the public, on request, a list of all certificates of need determined not to be in compliance with the terms, conditions, or stipulations approved in a certificate of need. If required by the department, the recipient shall notify all payers of services provided by the recipient that the approved services are not being provided in compliance with the terms, conditions, or stipulations of an approved certificate of need.

(4) The department decision is final and binding.

PART 5. ADMINISTRATIVE APPEALS

History

History: 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9501 Rescinded {#sec-r-325.9501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9501}

History

History: 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9503 Rescinded {#sec-r-325.9503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9503}

History

History: 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9505 Rescinded {#sec-r-325.9505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9505}

History

History: 1986 AACS; 2014 AACS.

Mich. Admin. Code R 325.9507 Rescinded {#sec-r-325.9507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9507}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9509 Rescinded {#sec-r-325.9509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9509}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9511 Rescinded {#sec-r-325.9511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9511}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9513 Rescinded {#sec-r-325.9513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9513}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9515 Rescinded {#sec-r-325.9515 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9515}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9517 Rescinded {#sec-r-325.9517 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9517}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9519 Rescinded {#sec-r-325.9519 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9519}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9521 Rescinded {#sec-r-325.9521 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9521}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9523 Rescinded {#sec-r-325.9523 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9523}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9525 Rescinded {#sec-r-325.9525 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9525}

History

History: 1986 AACS; 1996 AACS; 2014 AACS.

Mich. Admin. Code R 325.9551 Hearing request; eligibility; effect {#sec-r-325.9551 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9551}

Rule 551. (1) An applicant that receives either (a) a proposed decision of the bureau which recommends denial of a certificate of need or (b) a notice of reversal by the director, may request a hearing, as authorized by the code. The purpose of the hearing is to allow the applicant the opportunity to demonstrate that the applicant’s completed application meets the requirements for approval under part 222 of the code. In a comparative review, approved applicants cannot request a hearing on a proposed decision regarding a different applicant.

History

History: 2014 AACS.

Mich. Admin. Code R 325.9552 Reconsideration {#sec-r-325.9552 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9552}

Rule 552. At any time during the appeals process the department may reconsider the original decision to determine compliance with applicable review standards and code.

R 325.9553. Issuance of final decision by the department director.

Rule 553. (1) If an applicant requests a hearing in accordance with Rule 551, after the hearing, and review of the record, the director shall issue a final decision or an order for further proceedings.

(2) The director shall serve copies of the final decision upon all parties.

(3) All appeals of applications that are part of a comparative review shall be decided in 1 final decision.

(4) An applicant may appeal the final decision of the director directly to the circuit court for the county where the applicant has its principal place of business in this state or the circuit court for Ingham county. Judicial review is governed by sections 101 to 103 of 1969 PA 306, MCL 24.301 to 24.306.

History

History: 2014 AACS.
History: 2014 AACS.

Public Health Administration Public Health Administration

R 330.101 to R 330.105 Mandatory Reporting of Amyotrophic Lateral Sclerosis (ALS) Cases

Mich. Admin. Code R 330.101 Definitions {#sec-r-330.101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EPIDEMIOLOGY AND POPULATION HEALTH

LIFECOURSE EPIDEMIOLOGY AND GENOMICS DIVISION

MANDATORY REPORTING OF AMYOTROPHIC LATERAL SCLEROSIS

CASES

(By authority conferred on the department of health and human services by sections 2226, 2233, and 5111 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, and 333.5111)

Rule 1. (1) As used in these rules:

(a) “ALS” or “Amyotrophic Lateral Sclerosis” or “Lou Gehrig’s disease” means a uniformly fatal disease with the average life span of 2 to 5 years following diagnosis, manifested as a progressive neurodegenerative disease.

(b) “ALS case abstraction form” means the form prescribed by the department to report the required reportable information for individuals with ALS and conditions related to ALS.

(d) "Conditions related to ALS” means diseases that manifest similarly to ALS, including the following:

(i) Progressive muscular atrophy.

(ii) Primary lateral sclerosis.

(iii) Flail arm.

(iv) Flail leg.

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

(f) “Health professional" means an individual licensed under article 15 of the code, MCL 333.16101 to 333.18838, to work as a physician, a physician's assistant, or a nurse practitioner.

(g) "Public health investigation" means the collection of medical, epidemiologic, exposure, and other information to determine the cause of illness or disability, which is used to determine appropriate actions to prevent or mitigate additional illness or disability.

(h) “Report” means documents or data containing health information provided to the department consistent with these rules.

(2) A term defined in the act has the same meaning when used in these rules.

History

History: 2025 AACS.

Mich. Admin. Code R 330.102 Reportable Information {#sec-r-330.102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.102}

Rule 2. (1) Health professionals and health facilities must provide reports in a format that ensures the inclusion of the following information, as applicable:

(a) If available, all of the following information, with respect to the patient, must be provided:

(i) Reporting facility name.

(ii) Reporting facility type or source, including hospital, clinic, or death records.

(iii) Medical record number.

(iv) Last and first name and middle initial.

(v) Birth date.

(vi) Death date, if applicable.

(vii) Sex.

(viii) Race.

(ix) Ethnicity.

(x) The primary diagnosis indicating ALS or a condition related to ALS, including the diagnostic code.

(xi) Date of diagnosis.

(xii) Current residential address.

(xiii) Telephone number.

(xiv) Email address.

(b) Upon receipt of a report, the department may request the collection of the following information, in addition to information specified in subdivision (a) of this subrule, if available:

(i) City, state, and country of birthplace.

(ii) Location of disease onset, if known.

(iii) Current occupation.

(iv) Military veteran status.

(v) Military branch of service, if applicable.

(vi) Duration of military service, if applicable.

(vii) Location of military service, if applicable.

(viii) Date of symptoms onset.

(ix) Family history of ALS.

(x) Family history of dementia.

(xi) Family history of psychiatric illness such as depression, bipolar disorder, or schizophrenia.

(xii) Secondary neurological diagnosis such as frontotemporal dementia, if applicable.

(xiii) Site of onset of progressive weakness if known, including, but not limited to the following:

(A) Bulbar.

(B) Truncal.

(D) Respiratory.

(E) Upper limb.

(F) Lower limb.

(c) Name, address, telephone number, email address, and other contact information of the health professional who diagnosed or treated the patient.

(d) Name, address, telephone number, email address, and other contact information of the reporting health professional or health facility.

(2) Reports submitted in electronic or physical format must meet data quality, format, and timeliness standards prescribed by the department.

History

History: 2025 AACS.

Mich. Admin. Code R 330.103 Reporting responsibilities {#sec-r-330.103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.103}

Rule 3. (1) Following the effective date of these rules, health professionals and health facilities must submit the reports, as described in R 330.102, within 3 months of diagnosis.

(2) Health professionals and health facilities may be asked by the department to provide follow-up information on individuals for the variables in R 330.102(1)(b) within 6 months after the follow-up.

(3) Health professionals and health facilities must submit the report required in R 330.102 when requested by the department. Additional reports may be made by health professionals and health facilities in the absence of a departmental request.

(4) Nothing in this rule relieves a health professional or health facility from reporting to another entity as required by state, federal, or local statutes or regulations or in accordance with accepted standard of practice, except that reporting in compliance with this rule satisfies the reporting requirements of the code.

History

History: 2025 AACS.

Mich. Admin. Code R 330.104 Investigation and quality assurance {#sec-r-330.104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.104}

Rule 4. (1) The department shall consult with local health departments in the development of procedures for processing ALS reports and conducting follow-up investigations to ensure an efficient, non-duplicative, and effective public health response.

(2) The department may make requests for individual medical and epidemiologic information to validate the completeness and accuracy of reports. Individuals or organizations that receive such requests must provide the information sought to the department promptly, no later than 30 days after the request is made.

History

History: 2025 AACS.

Mich. Admin. Code R 330.105 Confidentiality of reports {#sec-r-330.105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.105}

Rule 5. (1) To the maximum extent allowed by law, reports and health information collected under these rules are not public records and are exempt from disclosure under the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

(2) Reports and any health information collected under these rules are medical records for the purpose of section 13(1)(l) of the freedom of information act, 1976 PA 442, MCL 15.243.

(3) Medical and epidemiological information that identifies an individual and that is gathered in connection with an investigation is confidential and is not open to public inspection, except as provided in subrule (5) of this rule. All individuals in possession of reports and records collected under these rules shall maintain the confidentiality of reports, records, and data pertaining to testing, diagnosis, care, treatment, reporting, and research, and shall not reveal the identity of any individual.

(4) Medical and epidemiological information that is released to a legislative body must not contain information that identifies a specific individual.

(5) Information collected under this rule must be used for epidemiologic investigation and evaluation and the department and local health departments may release reports or information under any of the following conditions:

(a) If the department has received written consent from the individual, or from the individual’s legal guardian.

(b) As necessary for the department to carry out its duties under sections 2221(2) and 2637(1) of the code, MCL 333.2221 and 333.2637.

(c) If necessary for the purpose of research designed to contribute to generalizable knowledge, with documented approval by the department’s institutional review board.

History

History: 2025 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 330.1001 to R 330.1059 Mental Health and Substance Abuse Services - General Rules

Mich. Admin. Code R 330.1001 General definitions {#sec-r-330.1001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1001}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

GENERAL RULES

(By authority conferred on the department of mental health by sections 1 to 4 of Act No. 80 of the Public Acts of 1905, as amended, section 33 of Act No. 306 of the Public Acts of 1969, as amended, and sections 114, 130, 136, 157, 206, 244, 498n, 498r, 842, 844, 908, and 1002a of Act No. 258 of the Public Acts of 1974, as amended, being sections 19.141 to 19.144, 24.233, 330.1114, 330.1130, 330.1136, 330.1206, 330.1244, 330.1498n, 330.1498r, 330.1842, 330.1844, 330.1908, and 330.2002a of the Michigan Compiled Laws)

Rule 1001. As used in these rules, except as otherwise defined in a particular part or a subpart:

(1) "Act" means Act No. 258 of the Public Acts of 1974, as amended, being §330.1001 et seq. of the Michigan Compiled Laws.

(2) Terms defined in the act have the same meanings when used in these rules.

History

History: 1979 AC; 1981 AACS; 1983 AACS; 1986 AACS; 1998-2000 AACS.

Mich. Admin. Code R 330.1005 Gifts, grants, bequests, and donations; approval {#sec-r-330.1005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1005}

Rule 1005. (1) Gifts, grants, bequests, and donations with a value of more than $1,500.00 shall not be accepted by a department facility without approval by the director of the department.

(2) Gifts, grants, bequests, and donations accounts shall be composed of subaccounts which detail the specific purpose for which the gifts, grants, bequests, and donations were made. One of the subaccounts shall be a patient benefit fund.

(3) The patient benefit fund may be expended to improve the general welfare of all patients or a specific group of patients and, in special cases, may provide aid to indigent patients.

(4) A gift, grant, bequest, or donation shall not be accepted or expended which commits the state to complete or continue a program or project without authorization.

(5) All funds received shall be deposited with the state.

(6) An annual report shall be submitted to the department by department facilities identifying all gifts, grants, bequests, and donations.

History

History: 1979 AC; 1981 AACS; 1983 AACS.

Mich. Admin. Code R 330.1015 Research {#sec-r-330.1015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1015}

Rule 1015. Research initiated, conducted, or supported by the department, or engaged in by staff of department facilities, licensed or certified agencies, or agencies with whom it has contracts, shall be subject to administrative rules, department policies and procedures, and shall follow federal guidelines.

History

History: 1979 AC.

Mich. Admin. Code R 330.1017 Equality in employment {#sec-r-330.1017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1017}

Rule 1017. An otherwise qualified person shall not be subject to discrimination by the department, its hospitals, centers, or contractual parties in employment or training on the basis of race, color, nationality, religious or political belief, sex, handicap, or age, unless a requirement of sex or age is based on a bona fide occupational qualification.

SUBPART 2. COMMUNITY MENTAL HEALTH CENTERS

History

History: 1981 AACS.

Mich. Admin. Code R 330.1021 Definitions {#sec-r-330.1021 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1021}

Rule 1021. As used in this subpart:

(a) "Community mental health center" or "center" means either of the following:

(i) An organization of service which consists of 1 or more affiliated service entities, certified by the department, for the purpose of assuring a comprehensive range of mental health services to persons in a geographical area containing a population which meets federal requirements and funded under the community mental health centers act of 1963, 42 U.S.C. 2661 et seq., and the federal regulations issued thereunder.

(ii) An organization of services which consists of 1 or more affiliated service entities, certified by the department, for the purpose of assuring a comprehensive range of mental health services to persons within a service area, and which is designated by the department as a community mental health center.

(b) "Service element" means 1 of the mental health services listed in the federal regulations issued under Public Law 88-164, as amended.

The 5 essential elements are:

(1) inpatient services;

(2) outpatient services;

(3) partial hospitalization services, such as day care, night care, and weekend care;

(4) emergency services, 24 hours per day; and (5) consultation and educational services to community agencies and professional personnel.

Five additional elements are:

(1) diagnostic services;

(2) rehabilitative services, including vocational and educational programs;

(3) pre-care and aftercare services in the community, including foster home placement, home visiting, and halfway houses;

(4) training; and (5) research and evaluation.

(c) "Service entity" means an organization supplying 1 or more elements of mental health service as a part of a community mental health center.

History

History: 1979 AC.

Mich. Admin. Code R 330.1025 Designation of center; certification of service entity {#sec-r-330.1025 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1025}

Rule 1025. (1) Only an organization composed of 1 or more service entities that is certified by the department may be designated as a community mental health center. A service entity that supplies 1 or more service elements of a community mental health center shall be certified by the department pursuant to section 130 of the act. A service entity that is intended to function as a part of a community mental health center shall file an application with the department on forms prescribed and furnished by the department for a certificate of approval for the service elements the entity intends to supply.

(2) Certification as a service entity shall be based on the following requirements:

(a) A service entity shall insure that the service elements it provides are organized and related to insure continuity of care and to permit recipients to move easily from 1 type of service to another as recipient needs change.

(b) A service entity shall assure all of the following in its policies and procedures and in its delivery of service:

(i) That a person is not denied service on the basis of race, color, nationality, religious or political belief, sex, age, handicap, county of residence, or ability to pay. This assurance shall be specified in program statements of the service entity and in all contractual agreements.

(ii) That a person is not denied service on the basis that the person does not meet a requirement for a minimum period of residence in a service area.

(iii) That inpatient psychiatric services are licensed by the department pursuant to sections 134 to 150 of the act and administrative rules promulgated thereunder.

(iv) That recipients have the rights guaranteed by the act and the rules promulgated thereunder.

(v) That personnel policy and procedures do not discriminate against employees or applicants for employment with respect to hiring, tenure, terms, conditions or privileges of employment, or any matter directly or indirectly related to employment because of race, color, nationality, religious or political belief, sex, age, or handicap, unless a requirement of sex or age is based on a bona fide occupational qualification.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.1028 Service entity; records {#sec-r-330.1028 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1028}

Rule 1028. (1) A service entity shall maintain administrative records, including all of the following:

(a) Recipient contacts and referrals.

(b) Personnel policies and practices.

(d) Personnel procedures.

(2) A service entity shall maintain case records for each recipient, including, where appropriate:

(a) Identification data and consent forms.

(b) Personal history.

(d) Individualized treatment plans.

(e) Termination summaries.

History

History: 1979 AC.

Mich. Admin. Code R 330.1031 Service entity; provisional certificate of approval {#sec-r-330.1031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1031}

Rule 1031. If a service entity does not meet requirements for certification for a service element which it offers, the department may issue a provisional certificate of approval for a period not to exceed 6 months, based on a judgment that the service element in question will comply with these requirements before the end of the period of provisional certification.

History

History: 1979 AC.

Mich. Admin. Code R 330.1034 Service entity; biannual certificate of approval {#sec-r-330.1034 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1034}

Rule 1034. An eligible service entity shall be issued a certificate of approval biannually.

A service entity shall be subject to inspection and reevaluation by the department at any time. A certificate of approval is not transferable. A service entity shall notify the department of a change in sponsorship or operation of the service entity or of any service element. Existing approval shall be void on the date of change, and the service entity shall apply for a new certificate of approval.

History

History: 1979 AC.

Mich. Admin. Code R 330.1037 Contracts or agreements between service entities and service elements {#sec-r-330.1037 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1037}

Rule 1037. If service elements of a center are provided by more than 1 service entity, the relationship between the service entities and the service elements shall be by contract or formal written agreement, which shall make specific provision for assuring compliance with these rules. Copies of contracts and formal written agreements shall be included with applications for certification.

History

History: 1979 AC.

Mich. Admin. Code R 330.1041 Evidence of fire safety approval {#sec-r-330.1041 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1041}

Rule 1041. When applying for certification and during inspections, a service entity shall submit evidence that the facilities of service elements are approved for fire safety by the state fire marshal or a local fire safety authority, whichever has primary jurisdiction.

History

History: 1979 AC.

Mich. Admin. Code R 330.1045 Service element; staff; policies and procedures; space and facilities {#sec-r-330.1045 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1045}

Rule 1045. (1) A service element shall be staffed with qualified professional, nonprofessional, and supporting personnel.

(2) A service element shall have written policies and procedures which facilitate delivery of service as part of a comprehensive range of services, established and agreed to by the service element and the sponsoring service entity.

(3) A service element shall have space and facilities which meet the standards of the department.

History

History: 1979 AC.

Mich. Admin. Code R 330.1051 Center; location and accessibility of services {#sec-r-330.1051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1051}

Rule 1051. (1) Services of a center shall be conveniently located for the population of the defined service area. Factors such as density of population, geographic and chronological distances, and availability of public transportation shall be considered in the determination.

(2) A center shall be free of physical obstacles to recipients whose mobility is impaired by physical handicaps.

(3) A center shall offer services at times which are compatible with the schedules of its service population to enable recipients to receive services with a minimum of disruption to other essential aspects of their lives.

History

History: 1979 AC.

Mich. Admin. Code R 330.1053 Center; requirements generally {#sec-r-330.1053 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1053}

Rule 1053. (1) A center shall identify all of the following:

(a) Service agency which delivers services.

(b) Recipients.

(d) The type of service and rationale for services offered, including indirect services.

(2) A center shall insure:

(a) That policies and procedures governing protection of stored recipient information are developed, maintained, and followed.

(b) That copies of signed release-of-information forms are included in the case records of recipients.

(c) That there is periodic review of client case records to determine whether they contain the required service documentation and release-of-information records.

History

History: 1979 AC.

Mich. Admin. Code R 330.1055 Center; fiscal management {#sec-r-330.1055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1055}

Rule 1055. A center shall insure efficient distribution of funds according to procedures which include uniform accounting and purchasing policies, unit cost analyses, annual audits, contracts, and a preliminary plan of expenditures, and shall be based on the following:

(a) Clear, up-to-date records of expenditures.

(b) A unit cost analysis of services performed not less than annually.

(c) Purchasing policies which require systematic approval by responsible agency staff of expenditure for supplies, equipment, and contracted services.

(d) Spending reports made available annually to the department.

History

History: 1979 AC.

Mich. Admin. Code R 330.1057 Management information system; program evaluation; staff evaluation {#sec-r-330.1057 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1057}

Rule 1057. (1) A center shall have a management information system consistent with that of the department, and consistent with that of the local community mental health board when the board contracts with the centers, which provides sufficient information about the functioning of the center to help determine to what degree programs are meeting their goals, including mechanisms for collecting pertinent, accurate data; provisions for interpreting data in a form that is useful for decision makers; a means for communicating information to program managers; mechanisms for making program changes as needed; and mechanisms for refining program evaluation systems to improve usefulness, economy of effort, and accuracy.

(2) A center shall provide opportunities for users of the evaluation system to influence initial planning and ongoing refinement of the system.

(3) Information for program evaluation shall be based on data which is sufficiently current to facilitate program decisions.

(4) A center staff evaluation program shall provide periodic assessments of the degree to which each staff person is adequately performing the functions of his position. Assessments shall be clearly communicated to the evaluated staff person and program managers involved in staff placement and training.

History

History: 1979 AC.

Mich. Admin. Code R 330.1059 Center; duties {#sec-r-330.1059 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1059}

Rule 1059. (1) A center shall adopt purpose and service definitions that are in harmony with the needs of the population of the defined service area, contractual agreements with funding sources, limitations of resources, and legal and other constraints.

(2) A center shall coordinate its services with other mental health services and pertinent human services to assure that needs of the center's recipients are met in a comprehensive manner without fragmentation or duplication. To accomplish this, a center shall:

(a) Participate in community and regional planning, including health systems agency planning.

(b) Establish continuity of care agreements between appropriate service entities and with appropriate agencies providing services to the population of the center's service area, including department facilities.

(c) Whenever possible, provide the mental health component of health services established in the service area by health maintenance organizations and community health centers.

History

History: 1979 AC.

R 330.1601 to R 330.1656 Family Support Subsidy Program

Mich. Admin. Code R 330.1601 Definitions {#sec-r-330.1601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1601}

DEPARTMENT OF COMMUNITY HEALTH

POLICY AND LEGAL AFFAIRS ADMINISTRATION

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

FAMILY SUPPORT SUBSIDY PROGRAM

(By authority conferred on the department of community health by Executive Reorganization Order No. 1996-1, MCL 330.3101)

SUBPART 6. FAMILY SUPPORT SUBSIDY PROGRAM

Rule 1601. As used in these rules:

(a) "Autistic impaired" means an eligible minor who is determined to have an eligibility category of autism pursuant to R 340.1715 and who is receiving special education services in 1 of the following programs:

(i) Programs for students with autism as specified in R340.1758(1).

(ii) Programs for students with severe cognitive impairment as specified in R 340.1738.

(iii) Programs for students with severe multiple impairments as specified in R 340.1748.

(b) "Month of eligibility" means the month the family member, for whom application has been made, meets the requirements for participation in the program, regardless of the month the eligibility is verified by the community mental health program.

(c) "Severely mentally impaired" means an eligible minor who is determined to have an eligibility category of cognitive impairment pursuant to R 340.1705 and who shows development at a rate of approximately 4-1/2 or more standard deviations below the mean as determined through intellectual assessment.

(d) "Severely multiply impaired" means an eligible minor who is determined to have an eligibility category of severe multiple impairment pursuant to R 340.1714.

History

History: 1984 AACS; 2003 AACS.

Mich. Admin. Code R 330.1606 Rescinded {#sec-r-330.1606 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1606}

History

History: 1984 AACS; 2003 AACS.

Mich. Admin. Code R 330.1607 Diagnostic determination and classroom placement verification {#sec-r-330.1607 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1607}

Rule 1607. (1) An applicant for the family support subsidy program shall provide written verification from the public school which the family member attends or would attend if the family member were in the public school system which shall report the diagnostic category recommended for the family member by the school's multidisciplinary evaluation team.

(2) If the family member has been recommended by the multidisciplinary evaluation team for the diagnostic category of autistic impaired, then the parent or legal guardian shall ensure that the written verification includes the classroom or program placement that is required for family members who are determined to be autistic impaired.

History

History: 1990 AACS.

Mich. Admin. Code R 330.1611 Entitlement grants not income {#sec-r-330.1611 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1611}

Rule 1611. The family support subsidy program is an entitlement program which is administered by the department and county programs. The family support subsidy shall not be deemed to be income for the purposes of part 8 of these rules. Unless otherwise specifically funded by the legislature, utilization of the funds appropriated is restricted to the payment of actual grants.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1613 Program participants not recipients {#sec-r-330.1613 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1613}

Rule 1613. Family members, as defined in the act, will not be deemed recipients of mental health services solely by participation in the family support subsidy program, and therefore are not subject to the requirements or protections for recipients as provided in the act.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1616 Availability of forms {#sec-r-330.1616 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1616}

Rule 1616. Copies of blank application forms, parent report forms, the forms for changed family circumstances, and appeal forms shall be available from the community mental health program.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1621 Application; notice of changed family circumstances; failure to file {#sec-r-330.1621 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1621}

Rule 1621. (1) A parent or legal guardian may apply for a family support subsidy if he or she believes a family member is eligible for the subsidy or will become eligible in the near future.

(2) An applicant shall file a completed application and all required documentation with the community mental health board serving the county of residence.

(3) When a change of family circumstances occurs or is anticipated which affects the eligibility of the family member or administration of the program, such as income exceeding the statutory limit or a change of name, address, or living arrangement, the parent or legal guardian shall complete the prescribed form and file it with the community mental health program within 2 weeks of the change.

(4) Failure to file the form required under subrule (3) of this rule, when such failure allows an inappropriate continuation of eligibility, shall subject a family which continues to utilize the program to liability, and the family shall promptly repay the amount illegally received, together with interest at the rate authorized by section 6013(2) of Act No. 236 of the Public Acts of 1961, as amended, being S600.6013(2) of the Michigan Compiled Laws.

History

History: 1984 AACS; 1990 AACS.

Mich. Admin. Code R 330.1626 Parent report form {#sec-r-330.1626 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1626}

Rule 1626. To continue in the program, the parent or legal guardian shall submit the parent report form to the community mental health program during the month in which, or up to 90 days before, the family member's birthday occurs. If the family member's birthday occurs within 3 months of initial application, submission of the parent report form shall not be required until the birth month of the following year.

History

History: 1984 AACS; 1990 AACS.

Mich. Admin. Code R 330.1631 Ineligibility due to out-of-home placement {#sec-r-330.1631 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1631}

Rule 1631. (1) A family member becomes ineligible for the subsidy program if the family member resides out of the home in a publicly supported residential setting for more than a total of 15 days during each of 2 consecutive calendar months for reasons other than physical health care.

(2) Reapplication for family members who were deemed ineligible under this rule may occur in any month following the month that the family member became ineligible.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1636 One-time lump sum payment {#sec-r-330.1636 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1636}

Rule 1636. For the purpose of section 158(1)(c) of the act, a 1-time, lump sum payment will also be available to family members who had previously participated in the family support subsidy if both of the following provisions are met:

(a) Subsequent ineligibility was due to out-of-home placement.

(b) The family member's placement currently exists and has existed for more than 1 year.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1641 Application review {#sec-r-330.1641 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1641}

Rule 1641. A community mental health program shall review an application and promptly approve or deny the application and shall provide written notice to the applicant of its action and of the opportunity to administratively appeal the decision if the decision is to deny the application. If the denial is due to the insufficiency of the information on the application form or the required attachments, the board shall identify the insufficiency.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1643 Appeal {#sec-r-330.1643 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1643}

Rule 1643. If an application is denied or the subsidy terminated, a parent or legal guardian may file an appeal. The appeal shall be in writing and be presented to the community mental health program within 2 months of the notice of denial or termination.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1646 Program coverage; calculation {#sec-r-330.1646 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1646}

Rule 1646. Program coverage will be calculated on a monthly basis. If a family member becomes qualified for the program, coverage will start the calendar month following the month of eligibility or application, whichever occurs later. If eligibility terminates during a month, coverage will continue for that calendar month.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1651 Forms {#sec-r-330.1651 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1651}

Rule 1651. (1) The form for application for participation in the family support subsidy program shall meet the requirements of section 157 of the act and shall assist in the development of information necessary to administer the program.

(2) In addition to the application form specified in subrule (1) of this rule, the department shall also prescribe the following:

(a) The form for changed family circumstances.

(b) The parent report form.

(c) The format, the time for submission, and the instructions for the reporting of information by the community mental health program to the department for the general information which is necessary to comply with the provisions of section 161 of the act and with the contract allocation system.

History

History: 1984 AACS.

Mich. Admin. Code R 330.1656 Verification of income eligibility {#sec-r-330.1656 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1656}

Rule 1656. (1) Verification of income eligibility may be accomplished utilizing 1 of the following provisions:

(a) Examination of the taxable income line of the family's previous year Michigan income tax return.

(b) If a Michigan income tax form was not filed, the family's federal or other state's previous year income tax returns may be used.

(c) If the information specified in subdivisions (a) and (b) of this subrule is not available, then other evidence of current incomes may be used as verification from which a projection of family income can be made.

(d) For a new applicant, if the previous year's taxable income would make the family member ineligible, but the current year's taxable income would make the family member eligible, then verification of income eligibility shall be accomplished by examination of the evidence of current incomes from which a projection of family income shall be made.

(2) A family that loses eligibility for the family support subsidy program due to a taxable income of more than $60,000.00 shall not reapply until 1 year after the termination of the subsidy.

(3) A family in repayment status with this program shall not reapply until its debt is repaid.

History

History: 1984 AACS; 1990 AACS; 2003 AACS.

R 330.1701 to R 330.1704 Placement of Adults who have a Mental Illness or a Developmental Disability into Community Based Dependent Living Settings

Mich. Admin. Code R 330.1701 Definitions {#sec-r-330.1701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1701}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

SUBPART 7. PLACEMENT OF ADULTS WHO HAVE A MENTAL ILLNESS

OR A DEVELOPMENTAL DISABILITY INTO COMMUNITY BASED

DEPENDENT LIVING SETTINGS

Rule 1701. As used in these rules:

(a) "Client" means an individual who has a mental illness or a developmental disability and who receives services from the department, a county community mental health board or contracting agency.

(b) "Client services manager" means an employee of the department, a community mental health board, or an agency under contract with the department or a community mental health board who has primary responsibility for effectuating the placement of a client into a dependent setting and monitoring the provision of services called for in the client's treatment plan.

(d) "Placing agency" means an agency of the department, a county community mental health board, or an agency under contract to the county community mental health board or the department that is responsible for all of the following:

(i) Assessing a clients's need for placement into a dependent living setting.

(ii) Determining the type of dependent living setting required to meet the client's needs.

(iii) Developing the client's individual plan of service and supports.

(iv) Coordinating all necessary arrangements for the placement of the client into a dependent living setting.

(v) Monitoring and evaluating the provision of services to the client.

(vi) Protecting the rights of the client including informing clients/ guardian of how to file complaints against the licensee or placing agency.

History

History: 1996 AACS.

Mich. Admin. Code R 330.1702 Standards for placement of client into dependent living setting {#sec-r-330.1702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1702}

Rule 1702. A placing agency shall not place a client in a dependent living setting unless all of the following criteria are met before placement:

(a) An individual plan of service has been developed for the client.

(b) If a specialized program is called for in the client's individual plan of service, the dependent living setting is certified to provide the program.

(c) The placing agency has made an on"site inspection and determined that the dependent living setting has sufficient resources to provide all the services that the dependent living setting is required to provide in the client's individual plan of service.

(d) The consent of the client, or the client's guardian, has been obtained for the placement.

(e) The dependent living setting has written operating policies and procedures which are in place and enforced by the dependent living setting and which are in compliance with the requirements of section 752 of Act No.258 of the Public Acts of 1974, as amended, being §330.1752 of the Michigan Compiled Laws. The dependent living setting agrees to make the operating policies and procedures available to the client, provide the information in alternative formats and provide assistance to the client with understanding the language used in the procedures, if needed.

(f) The dependent living setting agrees to maintain and limit access to records that document the delivery of the services in the client's individual plan of service in accordance with all applicable statutes, rules, and confidentiality provisions. The dependent living setting agrees to make client's record available to the client or their representative, provide the record in alternative format and assist the client with understanding the language used, if needed.

History

History: 1996 AACS.

Mich. Admin. Code R 330.1703 Individual plan of service {#sec-r-330.1703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1703}

Rule 1703. A placing agency is responsible for the development of the client's individual plan of service and shall comply with the provisions of section 712 of Act No. 258 of the Public Acts of 1974, as amended, being §330.1712 of the Michigan Compiled Laws, and R 330.7199, except that the waiver provisions of R 330.7199(11) shall not apply. An initial individual plan of service shall be provided upon placement and a comprehensive plan developed within 30 days. The individual plan of service shall consist of a treatment plan, a support plan, or both. The individual plan of service shall focus on the needs and preferences of the client and be developed by a planning team comprised of the following entities:

(a) The client.

(b) Individuals of the client's choosing, for example, friends or relatives.

If the client is not satisfied with his or her individual plan of service or modifications made to the plan, the client may object and request a review of the objection by the client services manager in charge of implementing the plan. The review shall be initiated within 5 working days of receipt of the objection. Resolution shall occur in a timely manner. If the client is not satisfied with the resolution, the client may notify his or her client services manager of the client's wish to appeal the resolution to the placing agency. The placing agency shall initiate a review of the appeal within 5 working days and reach a resolution in a timely manner.

History

History: 1996 AACS.

Mich. Admin. Code R 330.1704 Modification of individual plan of service {#sec-r-330.1704 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1704}

Rule 1704. The placing agency shall promptly review, revise, or modify a client's plan of service because of any of the following:

(a) The client has achieved an objective set forth in the client's individual plan of service.

(b) The client has regressed or lost previously attained skills or otherwise experienced a change in condition.

(c) The client has failed to progress toward identified objectives despite consistent effort to implement the individual plan of service.

History

History: 1996 AACS.

R 330.2005 to R 330.2814 Community Mental Health Programs

Mich. Admin. Code R 330.2005 Minimum services to be provided {#sec-r-330.2005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2005}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BEHAVIORAL HEALTH & DEVELOPMENTAL DISABILITIES

ADMINISTRATION

COMMUNITY HEALTH PROGRAMS

These rules become effective immediately upon filing with the Secretary of State unless adopted under section 33, 44, 45a(6), or 48 of 1969 PA 306. Rules adopted under these sections become effective 7 days after filing with the Secretary of State.

SUBPART 1. COMMUNITY MENTAL HEALTH SERVICES

Rule 2005. A community mental health board shall ensure that the following minimum types and scopes of mental health services are provided to all age groups directly by the board, by contract, or by formal agreement with public or private agencies or individuals contingent on legislative appropriation of matching funds for provision of these services:

(a) Emergency intervention services.

(b) Prevention services.

(d) Aftercare services.

(e) Day program and activity services.

(f) Public information services.

(g) Inpatient services.

(h) Community/caregiver services.

History

History: 1979 AC; 1984 AACS; 1986 AACS.

Mich. Admin. Code R 330.2006 Emergency intervention services {#sec-r-330.2006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2006}

Rule 2006. (1) "Emergency intervention services” means those outpatient services provided to a person suffering from an acute problem of disturbed thought, behavior, mood, or social relationship which requires immediate intervention as defined by the client or the client’s family or social unit.

(2) Emergency intervention services include all the following:

(a) A telephone that is answered 24 hours a day for dealing with mental health emergencies. The number for this telephone shall be advertised through the telephone book, public information efforts, and by notifying the appropriate agencies of the telephone number and the services provided.

(b) Provision for face-to-face services to persons in the areas of crisis evaluation, intervention, and disposition.

(3) The community mental health services provider shall assign mental health professionals or trained mental health workers for telephone and walk-in services.

(4) Emergency care includes all the following:

(a) Evaluation, which means arrangements for determining the client's mental status, medical status and need for treatment, and, when indicated, medication status and family, job, or housing situations.

(b) Intervention, which means face-to-face counseling and initiation and monitoring of medication when indicated.

(i) Hospital emergency department services.

(ii) Psychiatric inpatient services.

(iii) Specific community-based services, such as the following examples:

(A) Respite care placement.

(B) Outpatient care.

(D) Aftercare.

(E) Day treatment/care.

(F) Drug or alcohol programming.

(G) Problem pregnancy help.

(H) Spouse and child abuse help.

(I) Children's services.

(J) Adolescent services.

(K) Geriatric services.

(L) Services for persons with intellectual and developmental disabilities.

(M) Social services.

(5) For the disposition of emergency intervention matters, the community mental health services provider shall provide all the following:

(a) Written referral procedures, available to the staff, for emergency care and voluntary and involuntary psychiatric hospitalization.

(b) Documented efforts to arrange for the transportation of the client, when necessary.

(c) A list of available dispositions within the community mental health area of service with special notations for those dispositions having 24-hour accessibility.

(6) In the administration of the emergency services, the community mental health services provider shall provide evidence of all of the following:

(a) Periodic testing with regard to the accessibility, availability, and effectiveness, of those emergency intervention services.

(b) Regular meetings of staff involved in emergency services to discuss administrative, supervisory, training, programmatic, and client management issues.

(c) Confidential records of all mental health emergency contacts, whether the contacts are by telephone or walk-in contact.

(d) Training or experience of the emergency intervention staff using such factors as professional credentials, licensure, descriptions of training experiences, in-service orientation, in-service education, and continuing education.

History

History: 1979 AC; 1983 AACS; 2018 AACS.

Mich. Admin. Code R 330.2007 Prevention services {#sec-r-330.2007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2007}

Rule 2007. (1) Prevention services are those services of the county program directed to at-risk populations and designed to reduce the incidence of behavioral, emotional, or cognitive dysfunction and the need for individuals to become mental health recipients of treatment services.

(2) Prevention services may be provided through individualized services, time-limited recipient training, or community/caregiver services.

(3) Prevention services shall include both of the following:

(a) Provision for responding to the mental health dimensions of community catastrophes.

(b) Attention to the needs of children living with severely mentally impaired adult recipients.

(4) Prevention services shall also include 1 of the following:

(a) Infant mental health services.

(b) Services to increase life-coping skills of children and adolescents.

(d) Services to reduce the stressful impact of life crises.

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.2008 Outpatient services {#sec-r-330.2008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2008}

Rule 2008. (1) Outpatient services include all the following:

(a) Diagnostic and evaluation service.

(b) Referral service.

(d) Service to families of individuals in mental hospitals or residential facilities, as appropriate and as requested.

(e) Life consultation and planning for the persons with intellectual disabilities, and persons with developmental disabilities as defined in section 100a of the act.

(f) Treatment service to individuals in mental hospitals or residential facilities when appropriate with the consent of the individual and the hospital or facility staff person in charge of the individual's plan of service.

(2) The community mental health services provider outpatient services shall be made available at times of the day and week appropriate to meet the needs of the population served.

(3) Outpatient services shall be accessible to the population served.

(4) Provision for adequate and appropriate space to deliver services, including provision for privacy and the special needs of children, adolescents, and physically handicapped persons shall be provided by the community mental health services provider.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.2009 Aftercare services {#sec-r-330.2009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2009}

Rule 2009. (1) Aftercare services shall only be provided with prior consent of an individual over the age of 18, a parent if the individual is under 18, or a legally empowered guardian.

(2) These aftercare services shall include both of the following:

(a) Follow-up services to assist individuals released from a hospital or facility or who have received other services from a community mental health program.

(b) Mental health services for individuals placed in foster care, family care, or community placement in the service area, unless otherwise provided. Collaborative programming and planning for provision of services shall take place before the time of placement.

(3) Aftercare services shall be available to individuals located within the service area regardless of whether or not the individual was a resident of the county or counties of the service area prior to admission to a hospital or facility.

(4) A county may be billed for services rendered to its residents pursuant to section 306 of the act.

(5) Aftercare services shall be offered by a community mental health agency without a request for service by a released individual, when authorized by the individual, and upon notification from a hospital or facility.

History

History: 1979 AC.

Mich. Admin. Code R 330.2010 Day program and activity services {#sec-r-330.2010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2010}

Rule 2010. Day program and activity services shall include providing habilitative and rehabilitative treatment and training activity for mentally ill children, mentally ill adults, children with intellectual disabilities, adults with intellectual disabilities, and persons with a developmental disability requiring services similar to those provided persons with intellectual disabilities.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.2011 Public information services {#sec-r-330.2011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2011}

Rule 2011. Public information services shall include all of the following:

(a) Coordinating with community agencies and individuals involved with the mental health and general health of the community to provide a unified mental health information service with the cooperation of the department information office.

(b) A program of increasing the visibility of community mental health services.

(c) Distribution and dissemination of relevant mental health information, including mental health trends and priority of mental health needs of the population served.

History

History: 1979 AC.

Mich. Admin. Code R 330.2012 Emergency services unit {#sec-r-330.2012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2012}

Rule 2012. (1) An emergency service unit, if established, shall be a component of a community mental health board emergency intervention services program. A mental health professional who has experience or training, or both, in crisis intervention shall be designated to be the person in charge of the emergency service unit.

(2) For client contacts that are made in protective custody situations pursuant to section 427 of the act, an emergency service unit shall include on-call staff who are able to go to the unit location or, if necessary, any other site agreed upon by the unit and the peace officer.

(3) The on-call staff of the unit shall be specially trained to evaluate persons who are involved in mental health emergencies. The training shall include all of the following:

(a) Contacting referral services.

(b) Involving the police to control the situation.

(c) Arranging for the transportation of the person by the police to an inpatient or emergency diagnostic facility, if appropriate.

(4) An emergency service unit shall document the training of the crisis intervention personnel. Documentation shall include the facts concerning professional credentials, licensure, descriptions of training experiences, in-service orientation, in-service education, and continuing education.

(5) For client contacts that are made in protective custody situations pursuant to section 427 of the act, the unit shall provide or arrange for follow-up contact with the client beginning not more than 10 days after referral, excluding Sundays and holidays, to ensure that the service to which the client was referred was delivered and that it met the client's needs. If contact with the client cannot be made, attempts to contact the client shall be documented. Follow-up contact may also be made with the agency to which the referral was made, with appropriate client consent.

(6) For client contacts which are made in protective custody situations and which result in a client's transfer to a state hospital or center, a receiving hospital or center shall disclose the following information to the emergency service unit within 24 hours of the transfer and shall document that disclosure. Unless consented to, or authorized by subsequent law, the information shall include only the following:

(a) Whether the person was admitted.

(b) If admitted, the anticipated length of stay.

(7) The community mental health board shall explain the operation of the emergency service unit to all law enforcement agencies having jurisdiction within the county or counties served by the unit and to other relevant agencies and persons. The board shall encourage law enforcement officers to cooperate with and use the service and shall promote knowledge of the service by others. All agreements with law enforcement agencies shall be in writing.

(8) The community mental health board shall provide documentation to the appropriate regional office of the department that the emergency service unit is in compliance with this rule and R 330.2006 before emergency intervention services are provided by the unit to persons in protective custody.

History

History: 1981 AACS.

Mich. Admin. Code R 330.2013 "Inpatient services" defined {#sec-r-330.2013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2013}

Rule 2013. "Inpatient services" means care, diagnosis, and therapeutic services for mentally ill persons in a psychiatric hospital or unit which is licensed or operated by the department and for developmentally disabled persons in a center for developmental disabilities.

History

History: 1984 AACS.

Mich. Admin. Code R 330.2014 Community/caregiver services {#sec-r-330.2014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2014}

Rule 2014. (1) Community/caregiver services are those services of the county program provided to agencies and community groups on behalf of client groups and at-risk populations by means of any of the following:

(a) Consultation relating to agency organization, program delivery, effectiveness of staff, or mental health needs of at-risk and treatment populations.

(b) Education and training of staff.

(2) The purposes of community/caregiver services shall be the facilitation of non-mental health services for developmentally disabled and chronically mentally ill clients and the reduction of service demands on the county program.

History

History: 1986 AACS.

Mich. Admin. Code R 330.2022 Waiver of minimum services {#sec-r-330.2022 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2022}

Rule 2022. (1) If a community mental health board cannot ensure minimum services to all age groups, the board shall request a waiver of type or scope of services, or both, from the director of the department. Emergency intervention services to all age groups shall not be waived. The board shall initiate a waived type or scope of service within 24 months after the date application for a waiver is approved, contingent upon the availability of funds. This may be accomplished with the cooperation of another board or boards. To the extent fiscally possible, the board shall make arrangements for referral of those residents needing a waived service and for follow-up and continuity of care services in order that residents of the service area may obtain minimum direct services during the waived period.

(2) An application for waiver of specific types or scopes of minimum services shall be included in the proposed program and budget request.

(3) An application for waiver shall include all of the following:

(a) The types or scopes of services to be waived.

(b) The justification for a waiver, in detail.

(d) A description of the manner in which waived services may be provided by the end of the waiver period, including plans and dates for their initiation.

(e) A description and plan as to how the residents of the service area may receive waived minimum services during the waiver period. Plans shall include arrangements for referral, follow-up, and continuity of care.

SUBPART 2. COMMUNITY MENTAL HEALTH BOARD REPORTS

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.2035 Community assessment report {#sec-r-330.2035 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2035}

Rule 2035. (1) One year from the establishment of a community mental health board pursuant to the act and on dates specified by the department, a community mental health board, with the assistance of the department, shall prepare a written assessment of community needs, including all of the following:

(a) A description of the population served, including demographic information, geographic descriptions, economic data, and estimates of the types and extent of significant social and health problems.

(b) A description of the human service systems serving the population.

(c) Estimates of the types and extent of mental health-related problems, including social indicator data, characteristics of case loads of mental health-related agencies, and observations by service agencies.

(d) An assessment of existing services dealing with the estimated mental health-related programs, including an evaluation of the degree to which the services match the estimated problems.

(e) A projection of the type and amount of mental health services required to adequately serve the comprehensive mental health needs of the client population, including a description of the methods and data used to project need.

(2) The community mental health board shall annually review and update as needed the community assessment report and submit this information as part of the proposed annual plan and budget to accurately reflect the current needs of the community.

History

History: 1979 AC.

Mich. Admin. Code R 330.2038 Annual program plan and proposed budget {#sec-r-330.2038 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2038}

Rule 2038. (1) A community mental health board shall prepare a written program plan and projected budget for continuing programs and proposed new programs for each fiscal year, which shall be submitted to the department on the date designated by the department and shall include all of the following:

(a) A service needs assessment by client groups and a description of how existing and proposed mental health programs fit service need projections, including the priority of new programs and estimated dates of implementation.

(b) A narrative description of the types and scopes of services.

(d) Breakdowns of the projected costs according to forms and procedures made available by the department.

(e) A statement of intent on the degree of the management of public mental health services the board wishes to assume.

(f) Other documents and data required in department policies, procedures, and guidelines.

(g) Certifications of endorsement or approval by both of the following:

(i) The county board of commissioners.

(ii) The community mental health services board.

(2) Copies of proposed operational contracts and contract revisions between the community mental health board and independent subagencies which supply services or operate mental health facilities shall be available for audit inspection. Such contracts and contract revisions shall be consistent with departmental criteria for state financing of community mental health services.

History

History: 1979 AC; 1983 AACS; 1986 AACS.

Mich. Admin. Code R 330.2039 Program plan review and approval {#sec-r-330.2039 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2039}

Rule 2039. (1) A program plan and budget proposed by a county community mental health board shall be reviewed by the department based on the standards contained in section 234 of the act.

(2) The department shall respond to the board as to the results of the review of the submitted plan.

(3) After receipt of the results of the department's review, the board and the department shall negotiate a contract which is consistent with the availability of appropriated funds to the department. The contract shall contain all of the following:

(a) An approved service summary and spending plan which constitutes the board's allocation.

(b) A listing of policies and procedures required by statute or rule or agreed upon by the parties which shall govern the obligations and responsibilities of the department and the board.

(c) The process for amending or terminating the service summary and spending plan or the procedural obligations and responsibilities of the parties.

(d) Other authority and responsibility of the board and the department.

History

History: 1986 AACS.

Mich. Admin. Code R 330.2041 Filing of documents {#sec-r-330.2041 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2041}

Rule 2041. The community mental health services provider shall keep the following documents current and on file with the department:

(a) Copies of the original resolution of the county board of commissioners, and revisions, which establish a community mental health program and community mental health board under the act and promulgated rules under the act.

(b) Copies of operational contracts, contract revisions, and agreements between the community mental health board and agencies which supply services or operate mental health or facilities for intellectual or developmental disabilities.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.2044 Department information {#sec-r-330.2044 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2044}

Rule 2044. The department shall provide written information annually to community mental health boards regarding all of the following:

(a) Program planning and development priorities based on community program data, findings, and evaluations.

(b) The availability of funds for programs and services.

(d) Instructions and forms for submitting program proposals.

(e) Cost guidelines to indicate acceptable levels of budgeted costs.

(f) Guidelines which will be the basis for approval or rejection of proposed programs.

SUBPART 3. DEPARTMENT REVIEW AND EVALUATION

History

History: 1979 AC.

Mich. Admin. Code R 330.2051 Determination of compliance {#sec-r-330.2051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2051}

Rule 2051. The department shall review and evaluate community mental health boards, including operations, programs, services, and facilities operated directly by the board and those providing services by contract with the board, receiving or requesting state aid.

Determination of compliance with the act, administrative rules, standards, and procedures shall be made. When there is a finding of noncompliance or demonstrable deficiency in a program or operating practice, the department shall list and describe deficiencies and make recommendations to the community mental health board.

History

History: 1979 AC.

Mich. Admin. Code R 330.2052 Withdrawal or reallocation of state funds {#sec-r-330.2052 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2052}

Rule 2052. (1) The department may withdraw state funds from a board for a program not being administered in accordance with an approved plan and budget after written notice and opportunity for response. The department shall review budgets and expenditures at least quarterly, and if funds are not needed or were not used for a program for which they were allocated for the period budgeted, it may withdraw the unused funds, with concurrence of the board.

(2) The department may reallocate unused state funds to other community mental health programs. Unused state funds on hand locally at the close of the fiscal year shall be returned to the state.

(3) A county director or a board may request a review by the director of the department of any department action proposing to make final disapproval, withdrawal, or allocation of funds to a county program.

History

History: 1979 AC.

Mich. Admin. Code R 330.2055 Visits, examinations, and inspections by department {#sec-r-330.2055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2055}

Rule 2055. (1) Authorized representatives of the department may visit, examine, and inspect at any time a service or facility operating directly or providing services by contract under the act for purposes of review and evaluation.

(2) Authorized representatives of the department may examine at any time the financial records and accounts of a community mental health board receiving or requesting state aid, or the financial records or accounts of a service or facility operated directly or providing services by contract with a community mental health board.

(3) Authorized representatives of the department may examine and review at any time clinical case records of a community mental health program or subagency receiving or requesting state aid, or the clinical case records of an agency providing services by contract with the board, if the examination and review is necessary in order for the department to discharge its responsibility to review and evaluate the relevancy, quality, effectiveness, and efficiency of the county program pursuant to section 244(b)(i) and section 748(4)(e) of the act. The department shall not collect information that would make it possible to identify by name an individual who receives a service from a county program.

(4) A contract between a community mental health board and an entity or program providing services shall contain provisions of this rule.

History

History: 1979 AC.

Mich. Admin. Code R 330.2058 Programs ineligible for state financial support {#sec-r-330.2058 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2058}

Rule 2058. Programs ineligible for state financial support shall include all of the following:

(a) Programs other than those directed at mental illness, intellectual disabilities, or developmental disabilities or concerned with the prevention of mental illness, intellectual disabilities, or developmental disabilities, if programs for the appraised and perceived needs of the community's mentally ill, intellectual disabilities, or developmentally disabled do not exist.

(b) Programs and services that directly or indirectly violate the act and the rules promulgated under the act.

(d) Programs determined by the department as unnecessary or inappropriate to ensure reasonable use of state funds and ensure a legitimate interest of the state.

SUBPART 4. COMMUNITY MENTAL HEALTH BOARD

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.2063 Roster of board membership {#sec-r-330.2063 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2063}

Rule 2063. The membership of a community mental health services board shall be appointed and maintained as prescribed in chapter 2 of the act and the department shall be provided a current roster of membership.

History

History: 1979 AC.

Mich. Admin. Code R 330.2067 Community mental health board responsibilities {#sec-r-330.2067 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2067}

Rule 2067. A community mental health board shall do all of the following:

(a) Ensure that a person is not denied service on the basis of race, color, nationality, religious or political belief, sex, age, handicap, county of residence, or ability to pay. This policy shall be stated in the program statements of the community mental health board and in contractual agreements.

(b) Operate under personnel practices that do not discriminate against an employee or an applicant for employment with respect to hiring, tenure, terms, conditions or privileges of employment, or any matter which is directly or indirectly related to employment because of race, color, religion, national origin, age, handicap, or sex, except if a requirement of age or sex is based on a bona fide occupational qualification.

(c) Report to the department on the types and scopes of services directly operated by the board, on services provided by contract with the board, and on expenditures and receipts on forms prescribed and furnished by the department.

(d) Require agencies which provide services by contract or agreement with the board and which receive state aid to furnish the board with an accounting of fee revenue received from patients or from persons paying on behalf of patients.

(e) Coordinate the board's services with other pertinent human services to ensure that the total needs of the population of the service area are met in a comprehensive manner without fragmentation or duplication of services. To accomplish this, a board shall do all of the following:

(i) Participate in community and regional planning, including health systems planning.

(ii) Establish, or cause to be established, continuity of care agreements between appropriate service entities and with appropriate agencies which provide services to the population served by the boards, including department facilities.

(iii) If possible, provide the mental health component of health services established in the service area by health maintenance organizations and community health centers.

(iv) If possible, collaborate with existing agencies rather than establishing competing services.

(f) Assure, on an annual basis, that none of its board members is in violation of the conflict of interest prohibition of section 222 of the act.

(g) Assure that each employee is made aware of the provisions concerning conflict of interest and attests to the absence of conflict of interest, and assure that each prospective employee is made aware of these provisions and is not offered employment if there is a conflict of interest as identified in Act No. 317 of the Public Acts of 1968, as amended, being S15.321 et seq. of the Michigan Compiled Laws.

(h) Require each of its contracts to contain mutual representations that, to the best of the respective parties knowledge, the entering into of the contract is free of conflict of interest as identified in Act No.317 of the Public Acts of 1968, as amended, being S15.321 et seq. of the Michigan Compiled Laws, and section 222 of the act.

History

History: 1979 AC; 1981 AACS; 1986 AACS.

Mich. Admin. Code R 330.2071 Full management board {#sec-r-330.2071 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2071}

Rule 2071. (1) The department shall annually designate those boards which have full financial responsibility for, and financial authority over, the public mental health services for the following:

(a) All persons located in a county served by such a board who are not residents of stateoperated facilities.

(b) All persons who are residents of state-operated or state-contracted facilities for whom such a board is financially liable under section 302 of the act.

(2) The department shall issue, under R 330.2044, the criteria for designation of boards which have full public mental health management responsibility and authority.

(3) Any disagreement regarding financial authority and responsibility pursuant to this rule, between a county community mental health board and a state-operated or statecontracted facility, shall be reviewed and decided by the department director after consultation with the affected facility administrator and county community mental health program director.

(4) The department shall notify, at least annually, the governor, the legislature, and probate judges of those county community mental health boards which have full public mental health services management responsibility and authority.

SUBPART 5. COMMUNITY MENTAL HEALTH DIRECTOR

History

History: 1986 AACS.

Mich. Admin. Code R 330.2081 Education and experience of a county director {#sec-r-330.2081 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2081}

Rule 2081. (1) The county director of a county community mental health program shall meet the education and experience requirements specified in either of the following provisions:

(a) Be a physician, psychologist, social worker, registered nurse, or other human services professional who has at least a master's degree, 3 years of professional experience in his or her field of training, and 1 year of experience in the administrative supervision of mental health programs.

(b) Be a person who possesses at least a master's degree in a field of management relevant to the administration of a county community mental health program with 3 years of professional experience in management and 1 year of experience in the management of human services programs. The areas of community mental health administration, hospital administration, public administration, institution management, business administration, or public health are deemed to be relevant fields of management.

(2) Notwithstanding the requirements specified in subrule (1) of this rule, if a person is a county director on the effective date of this rule, that person shall be deemed to meet the minimum education and experience requirements to be the county director of that or any other county program.

(3) If a candidate does not meet the minimum education and experience qualifications and the board requests review of this matter, the candidate may be deemed qualified by the department director to be a county director if the candidate is found to have substantially met the education and experience requirements of this rule.

SUBPART 6. CHILDREN'S DIAGNOSTIC AND TREATMENT SERVICE

History

History: 1990 AACS.

Mich. Admin. Code R 330.2105 Definitions {#sec-r-330.2105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2105}

Rule 2105. As used in this subpart:

(a) "Certified program" means a range of service, as required by this subpart, for which application for certification has been voluntarily made and which has been certified by the department as a children's diagnostic and treatment service.

(b) "Child mental health professional" means any of the following:

(i) A person who is trained and has 1 year of experience in the examination, evaluation, and treatment of minors and their families and who is one of the following:

(A) A physician.

(B) A psychologist.

(D) A registered professional nurse.

(ii) A person with at least a bachelor's degree in a mental health-related field from an accredited school who is trained, and has 3 years of supervised experience, in the examination, evaluation, and treatment of minors and their families.

(iii) A person with at least a master's degree in a mental health-related field from an accredited school who is trained, and has 1 year of experience, in the examination, evaluation, and treatment of minors and their families.

(c) "Emergency evaluation" means an immediate assessment by a child mental health professional who is available for a face-to-face contact for the purpose of determining if a minor is emotionally disturbed, as defined in section 498b of the act, and requires immediate intervention because of any of the following situations:

(i) The minor is dangerous to himself or herself or others.

(ii) The minor will not allow for the provision of care to meet his or her basic needs.

(iii) The minor has experienced a severe emotional trauma which is identified by his or her parent or, when the parent or guardian cannot be immediately contacted, by a person having physical custody of the minor.

(d) "Emergency referral" means a referral for the purpose of having services provided immediately to a minor or the minor's family pursuant to R 330.2006.

(e) "Initial screening" means providing for either a face-to-face or telephone interaction concerning a minor in which a preliminary judgment is made regarding the need for mental health services for the minor and whether the minor's situation is one requiring nonemergency mental health services or emergency evaluation.

(f) "Intake evaluation" means social and psychological assessments which are appropriate in identifying the problems of the minor, together with a mental history and other assessments as necessary to ascertain the mental health needs of the minor.

(g) "Plan of service" means the written plan of service developed pursuant to R 330.7045 by a child mental health professional with participation of the minor's family, where applicable, and is based upon the assessment, recommendations, and, where necessary, consultations with other professionals.

(h) "Primary therapist" means a child mental health professional who is responsible for the direct treatment of a minor for the agency providing direct treatment services.

(i) "Referral" means facilitating access for the minor and the minor's family to the services of the certified program or to the services of another agency for the purpose of meeting the minor's needs.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2110 Evaluation and screening {#sec-r-330.2110 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2110}

Rule 2110. (1) A certified program shall have the capacity to provide an initial screening, emergency evaluation, and intake evaluation to ascertain the mental health needs of a minor.

(2) A mental health professional shall be available, by telephone consultation, to emergency service staff on a 24-hour basis to respond to potentially life-threatening or physically or emotionally damaging situations identified in an initial screening. An emergency evaluation shall be completed by a child mental health professional on the next regular working day from the day of an emergency referral.

(3) Intake evaluations may occur during multiple contacts with the minor and his or her family and shall be conducted by a child mental health professional. These evaluations shall form the basis for the plan of service.

(4) Intake evaluations for a nonemergency situation should be completed not more than 4 weeks from the date of the initial screening. If this time period cannot be met, the staff of a certified program shall document any reasons for further delay. Nothing in this rule shall prevent a certified program from ranking requests for nonemergency services based on need for the service.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2115 Referrals {#sec-r-330.2115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2115}

Rule 2115. (1) The community mental health board from which emergency or short-term mental health services are requested from a minor shall be responsible for providing appropriate mental health services. However, if the minor is located in the county, but is a resident of a county served by another community mental health board, then the certified program may refer the minor to the appropriate community mental health board once the minor's immediate needs for protection or security are met.

(2) Each certified program shall maintain a written list of resources it utilizes which indicates the types of services provided, eligibility criteria, and names and locations of the referral sources.

(3) A certified program shall have written arrangements with public and private human service agencies which provide educational, judicial, child welfare, and other health services. These arrangements shall clarify the respective responsibilities for the coordination and provision of services.

(4) A waiver by the department of the requirement of subrule (3) of this rule shall be granted when it is documented that the community mental health board does not have a contractual relationship with the child's human services agency due to that agency's failure to execute a proposed contract.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2120 Range of services {#sec-r-330.2120 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2120}

Rule 2120. (1) A certified program shall develop mechanisms for coordinating the delivery of a necessary range of services specifically oriented to meet the needs of minors and their families. The available range of services shall, at a minimum, include all of the following:

(a) Diagnostic services sufficient to develop a plan of service.

(b) Client case management by a child mental health professional who shall be responsible for the development, coordination, implementation, and monitoring of the plan of service.

Client case management services shall assure that services are timely, appropriate, and updated in accordance with the minor's needs. Both the on-site review of the minor's progress and record documentation shall be conducted at least quarterly. The child mental health professional providing client case management shall attend interagency case conferences relating to the minor.

(c) Crisis stabilization and responses that reduce acute emotional disabilities and their physical and social manifestation in order to ensure the safety of the minor, his or her family, and others.

(d) Specialized mental health training and treatment, which shall include both of the following:

(i) A range of clinical therapies which can be provided to individuals, groups, and families.

(ii) Opportunities to learn, improve, and demonstrate specific skills that are appropriate to the child's needs, which may include problem-solving skills, communication skills, and acceptable social interaction.

(e) Out-of-home treatment, which includes both inpatient and community residential treatment.

(2) Mental health service locations shall be accessible through publicly available transportation, if any. A family that indicates an inability to transport a minor to the service locations shall be evaluated for other assistance in transportation as a part of the plan of service.

(3) In addition to traditional clinic locations, certified programs shall provide mental health services in the minor's home or other community settings, if appropriate.

(4) Services of a certified program shall be available in a barrier-free environment.

(5) The certified program shall provide mental health services to emotionally disturbed minors located within its service area who are any of the following:

(a) Hearing impaired.

(b) Visually impaired.

(d) Chronically ill.

(e) Physically handicapped.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2125 Staffing and training {#sec-r-330.2125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2125}

Rule 2125. (1) The certified program shall provide for the establishment of a formalized staff development program to assure professional development and training in identifying and treating the needs of minors and their families.

(2) Each full-time staff member in the certified program shall complete not less than 24 clock hours annually of formalized professional development and training.

(3) Staff shall receive training before performing initial screenings.

(4) For persons who are hired after the effective date of this rule, the certified program shall be clinically supervised by a child mental health professional who has at least a master's degree in a mental health-related field and 3 years of clinical experience working with minors and their families.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2130 Administration {#sec-r-330.2130 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2130}

Rule 2130. (1) The community mental health board shall have contracts with all individuals and agencies which provide services for each component of the certified program outside of the community mental health board. The contracts shall provide for coordinated program planning and continuity of service delivery and shall clearly identify the responsibilities of both parties.

(2) A certified program shall designate a child mental health professional to act as liaison with all out-of-home treatment facilities to which minors are referred for care.

(3) The community mental health board plan and budget shall delineate a separate and distinct part designated for the certified program.

(4) The community mental health board shall implement a public information program to facilitate community awareness of the certified program. The public information program shall provide all of the following information:

(a) The services that are available.

(b) Hours of operation.

(d) Access to public transportation, if any.

(e) Telephone numbers. Services provided shall be pursuant to the provisions of R 330.2011 and R 330.2005(f).

(5) The board shall establish procedures for evaluating its certified program, on an annual basis, which shall include client and agency consumer evaluations of services of the certified program. The opportunity for client and consumer agency input shall be a part of this evaluation. The method and results of the evaluation shall be available for departmental review at the time of certification renewal.

(6) The agencies under contract to the community mental health board which comprise the certified program shall have the capacity to share confidential client information in order to provide for the coordination of services for a minor or for the transition of the minor from one agency to another.

(7) Information to be shared with agencies having cooperative agreements with the certified program shall be provided through appropriate releases of information.

History

History: 1990 AACS.

Mich. Admin. Code R 330.2135 Certification process {#sec-r-330.2135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2135}

Rule 2135. (1) A request for certification for a children's diagnostic and treatment services program may be made to the department at any time by 1 or more county programs. If county programs propose a combined children's diagnostic and treatment services program, the county programs shall specify the administrative structure in the request and indicate who speaks for the proposed combined program before certification.

(2) The department shall provide technical assistance to boards seeking certification.

(3) The community mental health board shall designate all agencies and services included in the certified program.

(4) A determination on initial or renewal certification by the department shall be completed within 6 months of a request for certification and submission of all necessary documentation or a program shall be considered certified. Certification shall occur when a determination of substantial compliance with the requirements of the act and this part has been made. If a program is certified despite instances of noncompliance with the requirements of the act and this part, the certification shall identify the items of noncompliance and the items shall be corrected. The department shall require the county program to submit a plan to correct items of noncompliance before recertification or sooner if required by the department. If the correction of items of noncompliance is dependent on additional state or federal financial resources, recertification of a county program shall not be denied solely on that basis.

(5) Certification shall expire after 3 years. Renewal requests shall be submitted to the department 6 months before the certification expiration date.

(6) Certification is not transferable to another program or agency.

(7) The director of the department shall designate a person who is responsible for the process of certifying children's programs.

(8) An application for initial or renewal certification shall be on a form designated by the department. Before an on-site inspection or review is scheduled, all required information shall be completed and in the possession of the department. The department shall determine when an application is complete and shall notify the community mental health board of any additional information required to complete the application.

(9) By applying for or accepting certification, the community mental health board authorizes the department to conduct the reviews it deems necessary to determine compliance with these rules.

(10) The community mental health board shall promptly notify the department of any changes in the certified program.

(11) Reviews shall include at least both of the following:

(a) Inspections of the program to be certified and its operation.

(b) Inspection of program records, recipient clinical records, and other documents maintained by the program which may otherwise be privileged or confidential information.

(12) Certification may be denied, suspended, or revoked for 1 or more of the following reasons:

(a) Substantial violation by the certified program, its director, or staff of any rule relating to certification promulgated by the department.

(b) Conduct or practices found to be harmful to the welfare of a minor in the program or other family members.

(d) Failure of an applicant to cooperate with the department in connection with a certification review.

(13) When it has been determined that a certified program or an applicant for a certified program has committed an act or engaged in conduct or practices which justify the denial, suspension, or revocation of certification, the departmental certifying person shall notify the community mental health board, by certified mail, of the department's intent to suspend, deny, or revoke the certification.

(14) The notice required by subrule (13) of this rule shall set forth the particular reasons for the proposed action and offer a hearing, if so requested by the county program, before the director of the department or his or her designee. The date of the hearing shall be not less than 30 days from the date of receipt of the request for a hearing.

(15) The decision of the director of the department shall be based on the hearing or on the default of the board. A copy of the decision shall be sent, by certified mail, to the community mental health board not less than 45 days after the close of the hearing.

(16) The revocation or suspension of a certificate shall become final when the determination of the director of the department is mailed, unless the community mental health board, within 60 days of the mailing or service of the decision, appeals the decision to a court and obtains a stay.

(17) A reapplication for certification subsequent to a revocation or suspension of a certificate may be made. The application shall be accompanied by a description for certification and will be followed by an interview with the certifying staff of the department before commencement of the formal certification review process.

(18) The certification shall expire on the date shown on its face, unless application has been made for renewal and application has not been denied or unless certification is terminated in accordance with these rules.

(19) Instead of denying reapplication for certification, the department may issue provisional certification to a community mental health board for up to 6 months when the community mental health board has submitted a plan of correction and it has been accepted by the department. A provisional certificate shall expire on the date set forth on its face.

The holder of a provisional certificate shall be reinspected for compliance with these rules not less than 60 days before the expiration date of the provisional certificate. The department may extend a provisional certificate for a period of not more than 6 months. A provisional certificate which has not been extended or which has been extended 1 time shall expire automatically on its expiration date without notice or hearings.

SUBPART 7. CERTIFICATION PROCESS

History

History: 1990 AACS.

Mich. Admin. Code R 330.2701 Application process {#sec-r-330.2701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2701}

Rule 2701. (1) As a condition of state funding, a single overall certification is required for each community mental health services program.

(2) The certification process shall include a review of agencies or organizations that are under contract to provide mental health services on behalf of the mental health services program.

(3) The governing body of a community mental health services program shall request certification by submitting a completed application to the department. If the department is already in receipt of information required for application, then submission of that information may be waived by the department. The application shall be submitted in the format specified by the department and shall include all of the following information:

(a) The legal name of the community mental health services program.

(b) The address for legal notice and correspondence.

(d) The current annual budget, including all sources of revenue, of the community mental health services program.

(e) The organizational chart of the community mental health services program.

(f) The name of the executive director of the community mental health services program.

(g) A list of all contracts with other agencies or organizations that provide mental health services under the auspices of the community mental health services program.

(h) A description of the services provided by the community mental health services program, including any services provided by contract with another agency or organization.

(i) If applicable, documentation of the community mental health services program's accreditation, including accreditation of any contract agency or organization, by an accrediting body deemed acceptable by the department as specified in R 330.2702(2).

(4) Upon receipt of an application, the department shall determine if the application is complete. The department shall acknowledge receipt of an application. If an application is incomplete, the department shall notify the applicant within 30 days from date of receipt of any corrections or additions needed, may return the materials to the applicant, or both.

An incomplete application shall not be regarded as an application for certification. Return of the application materials or failure to take further action to issue a certificate shall not constitute denial of an application for certification.

(5) After the department's acceptance of a complete application, the department shall determine whether the applicant meets certification standards. The certification process may include conducting an on-site review.

(6) Failure of the community mental health services program to comply with the requirements of the certification process shall be grounds for the department to deny, suspend, revoke, or refuse to renew a program's certification.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2702 Deemed status {#sec-r-330.2702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2702}

Rule 2702. (1) The department will accept, in whole or in part, the accreditation of a national accrediting organization deemed acceptable by the department as documentation of the community mental health services program's equivalent compliance with certification standards.

(2) The department shall not grant deemed status for matters related to the safeguarding and protection of recipient rights.

(3) The community mental health services program shall request deemed status in writing and shall include all of the following documents:

(a) A copy of the official document indicating accreditation.

(b) A copy of the written survey report from the accrediting body.

(4) The department may deem the community mental health services program to be in compliance with certification standards, in whole or in part, after reviewing the submitted documents.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2703 Acceptance of licensure, certification, or other approval by governmental regulatory authority {#sec-r-330.2703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2703}

Rule 2703. The department may accept licensure, certification, or other regulatory approval by a government agency with regulatory jurisdiction in place of compliance with certification standards, or portions thereof, for any component of a community mental health services program.

SUBPART 8. CERTIFICATION STANDARDS

History

History: 1997 AACS.

Mich. Admin. Code R 330.2801 Compliance with certification standards {#sec-r-330.2801 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2801}

Rule 2801. The department shall assess compliance with the following certification standards by determining the degree to which all of the following provisions apply:

(a) The organization has established processes, policies, and procedures necessary to achieve the required result.

(b) The established processes, policies, and procedures are properly implemented.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2802 Governance {#sec-r-330.2802 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2802}

Rule 2802. (1) The governing body of the community mental health services program shall ensure the development of program policy, ensure that quality services are delivered, and ensure accountability to the community.

(2) The governing body of the program shall appoint an executive director to be responsible for program performance.

(3) The community mental health board, as the overall governing body, shall be composed as described in the act.

(4) The governing body of the program shall delineate its structure, responsibilities, and operational practices.

(5) The governing body of the program shall orient new members to their duties and to program operations and services.

(6) The governing body of the program shall keep minutes of all its public meetings. The minutes shall provide a record of attendance, the issues covered, and the decisions made.

(7) The governing body of the program shall ensure that the concerns of the consumers and interested parties are considered in the program's decision-making process.

(8) A program shall assess community needs as outlined in section 226 of the act.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2803 Mission statement {#sec-r-330.2803 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2803}

Rule 2803. The governing body of the community mental health services program shall adopt a mission statement that shall be reviewed at least annually and revised when appropriate.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2804 Community education {#sec-r-330.2804 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2804}

Rule 2804. (1) A community mental health services program shall undertake activities to educate the general community regarding all of the following:

(a) Mental illness.

(b) Serious emotional disturbance.

(d) Mental health.

(2) A program shall publicize the array of available mental health services and service eligibility criteria to the community.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2805 Improvement of program quality {#sec-r-330.2805 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2805}

Rule 2805. (1) A community mental health services program shall continuously evaluate and improve organizational processes and performance.

(2) A program shall continually solicit customer feedback on the quality of services and utilize this information to improve service delivery.

(3) A program shall compile, analyze, and use data on service outcomes to improve performance.

(4) A program shall promote consumer and family member participation in the design of programs and services.

(5) A program shall promote consumer and family member participation in the evaluation of programs and services.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2806 Personnel and resource management {#sec-r-330.2806 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2806}

Rule 2806. (1) A community mental health services program shall maintain job descriptions for all employees.

(2) Staff shall possess the appropriate qualifications as outlined in their job descriptions, including the qualifications for all of the following:

(a) Educational background.

(b) Relevant work experience.

(d) Certification, registration, and licensure as required by law.

(3) A program shall train new personnel with regard to their responsibilities, program policy, and operating procedures.

(4) A program shall identify staff training needs and provide in-service training, continuing education, and staff development activities.

(5) A program shall have personnel policies which address all of the following areas:

(a) Working conditions.

(b) Wages and benefits.

(d) Performance evaluation.

(e) Disciplinary and termination guidelines.

(f) Grievance procedures.

(g) Conflicts of interest.

(h) The use of volunteers and students.

(6) A program shall make its personnel policies available to staff in a handbook or other easily accessible medium.

(7) A program shall maintain personnel records for all staff. The personnel records shall contain all of the following documents:

(a) An employment application.

(b) An employee's current license, registration, and certification, as applicable.

(8) A program shall maintain a volunteer file for all volunteers. The volunteer file shall contain the volunteer’s current certification, registration, or license, if applicable.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2807 Physical/therapeutic environment {#sec-r-330.2807 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2807}

Rule 2807. (1) A community mental health services program’s facilities and equipment shall be in compliance with all applicable zoning, safety, health, and building codes.

(2) A program shall establish preventive maintenance, sanitation, and safety systems.

(3) A program’s services shall be physically accessible to all individuals.

(4) A program shall establish written emergency plans, which address all of the following areas:

(a) Natural disasters.

(b) Fires.

(d) Bomb threats.

(5) A program shall conduct, and document, training to familiarize personnel with evacuation plans on a regular basis.

(6) A program shall post safety and emergency rules and practices in conspicuous places.

(7) A program shall implement additional health and safety precautions as necessary to address individual needs.

(8) A program shall be in compliance with all MIOSHA requirements.

(9) A program shall establish policies that address the monitoring, identification, prevention, and control of infectious diseases.

(10) A program shall provide infection control training to staff.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2808 Fiscal management {#sec-r-330.2808 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2808}

Rule 2808. (1) The governing body of a community mental health services program shall plan and approve an annual operating budget for a program based on anticipated revenues and projected expenditures.

(2) The governing body of the community mental health services program shall establish procedures for interim modification of the annual operating budget.

(3) When applicable, a community mental health services program shall develop a capital expenditure plan, including detailed amortization schedules.

(4) An independent certified public accountant shall conduct an annual audit of the program's financial records and audit exceptions shall be corrected.

(5) A program shall establish policies and procedures for purchasing and competitive bidding.

(6) A program shall analyze per unit costs of services and establish appropriate service fees at least annually.

(7) A program shall comply with the ability to pay process as outlined in the act.

(8) When applicable, a program shall establish policies regarding the investment of funds.

(9) A program shall utilize generally accepted accounting principles and maintain detailed records of all revenues and expenses.

(10) A program shall restrict access to community mental health services program funds to appropriate personnel.

(11) A program shall control the disbursement of funds, the receipt of funds, and the use of credit.

(12) A program shall manage risk and reduce potential liability by purchasing insurance, pooling risk, or utilizing other appropriate mechanisms, or a combination of these methods.

(13) A program’s contracts shall specify, in measurable terms, the obligations of the parties.

(14) A program shall monitor a contract agency’s compliance with the provisions of the contractual agreement.

(15) A program shall maintain and control inventory.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2809 Consumer information, education, and rights {#sec-r-330.2809 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2809}

Rule 2809. (1) A program shall establish a system of rights protection as required by chapters 7 and 7A of the act.

(2) A program shall inform consumers about all of the following information at the time consumers apply for services:

(a) The type and nature of available services.

(b) The organization’s procedures for the development of an individualized plan of service.

(d) The consumer’s rights as specified in chapters 7 and 7A of the act.

(e) The consumer’s right to request second opinions on hospitalization as specified in chapter 4 of the act.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2810 Eligibility and initial screening {#sec-r-330.2810 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2810}

Rule 2810. (1) A community mental health services program shall establish and utilize an initial screening process to determine all of the following:

(a) An individual's eligibility for services.

(b) An individual's need for services.

(2) Service priority and eligibility criteria shall be consistent with the act.

(3) A program shall establish one or more preadmission screening units in accordance with section 409 of the act.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2811 Waiting lists; alternative services {#sec-r-330.2811 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2811}

Rule 2811. (1) A community mental health services program shall establish and manage waiting lists in accordance with section 124 of the act.

(2) A program shall review waiting lists periodically to ensure consistency with the community mental health services program’s established priorities and the priorities specified in the act.

(3) A program shall take action to reduce or eliminate waiting lists for services.

(4) A program shall recommend and refer individuals to alternative services when necessary to meet individual needs.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2812 Array of services {#sec-r-330.2812 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2812}

Rule 2812. A community mental health services program shall offer a full array of services as specified in chapter 2 of the act.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2813 Medication; control {#sec-r-330.2813 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2813}

Rule 2813. A community mental health services program shall control the storage, preparation, dispensation, and administration of medications.

History

History: 1997 AACS.

Mich. Admin. Code R 330.2814 Individual plan of service {#sec-r-330.2814 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2814}

Rule 2814. A community mental health services program shall develop individual plans of service using a person-centered process in accordance with section 712 of the act and R 330.7199.

History

History: 1997 AACS.

R 330.3005 to R 330.3017 State and County Financial Responsibility

Mich. Admin. Code R 330.3005 Inclusion of capital depreciation costs for state services {#sec-r-330.3005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3005}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

(By authority conferred on the department of mental health by sections 1 to 4 of Act No. 80 of the Public Acts of 1905, as amended, section 33 of Act No. 306 of the Public Acts of 1969, as amended, and sections 114, 130,136, 157, 206, 244, 498n, 498r, 842, 844, 908, and 1002a of Act No. 258 of the Public Acts of 1974, as amended, being sections 19.141 to 19.144, 24.233, 330.1114, 330.1130, 330.1136, 330.1206, 330.1244, 330.1498n, 330.1498r, 330.1842, 330.1844, 330.1908, and 330.2002a of the Michigan Compiled Laws)

PART 3. STATE AND COUNTY FINANCIAL RESPONSIBILITY

Rule 3005. For the purpose of determining county liability for the cost of services provided to county residents in accordance with section 304 of the act, the department shall include depreciation costs of equipment and capital investment in operating costs.

History

History: 1979 AC.

Mich. Admin. Code R 330.3007 Department definition of approved community mental health program costs {#sec-r-330.3007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3007}

Rule 3007. The department shall define in policy those programs and expenditures approvable for state financing in accordance with chapters 2 and 3 of the act. Those policies shall be contained in department program and budget development instructions and in the department allocations to community mental health boards of available state appropriations.

History

History: 1979 AC.

Mich. Admin. Code R 330.3009 Matchable financing of community mental health programs {#sec-r-330.3009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3009}

Rule 3009. The net costs of approved community mental health programs for which the state shall be proportionately financially responsible in accordance with sections 308, 310, and 318 of the act shall include those expenditures supported by appropriations and grants from local units of government, from the united fund, and from grants or contributions from private sources for purposes other than the care or treatment for an individual person.

Net costs of approved community mental health programs shall not include payments and reimbursements from state agencies, except for the state financed portion of payments made in behalf of individuals pursuant to the federal and state medical assistance program; the state financed portion of payments for social services provided to individuals pursuant to federal and state social services programs; and the state financing of local general government and local general education operations.

History

History: 1979 AC.

Mich. Admin. Code R 330.3013 Reporting of community mental health costs {#sec-r-330.3013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3013}

Rule 3013. For the purposes of determining net cost pursuant to section 310 of the act, the costs and revenues of community mental health boards shall be reported to the department in a manner specified by the department. The department may withhold state reimbursement pending complete submission of required reports.

History

History: 1979 AC.

Mich. Admin. Code R 330.3015 Determination of county financial responsibility in base year {#sec-r-330.3015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3015}

Rule 3015. The department shall determine the base year of county financial responsibility pursuant to section 318 of the act based upon the sum of the locally financed net approved expenditures for approved community mental health programs plus the county liability for state services to county residents, as a percentage of the sum of the net approved costs of approved community mental health programs plus the net costs of state services to county residents.

History

History: 1979 AC.

Mich. Admin. Code R 330.3016 Custodian of funds {#sec-r-330.3016 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3016}

Rule 3016. The county treasurer shall be the custodian of funds received and expended for the purpose of conducting community mental health programs and for payments of the state of county liability for the services by state programs to county residents. In the case of a multi-county health district, the treasurer of the county in which the district administration is situated shall be the custodian of funds.

History

History: 1979 AC.

Mich. Admin. Code R 330.3017 Determination of county of residence {#sec-r-330.3017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3017}

Rule 3017. (1) For the purpose of determining county financial liability for the net cost of services, the department shall determine the county of residence for patients receiving service from state mental health programs pursuant to section 306 of the act.

(2) When the department has determined a county of residence for financial liability, if the county forwards to the department information supporting the redetermination and a request for redetermination within 30 days of billing by the department, the department shall redetermine the county of residence.

(3) When the department has determined a county of residence for financial liability, if the county forwards to the department information supporting the redetermination and a request for redetermination after 30 days of billing by the department, the department may redetermine the county of residence.

History

History: 1979 AC; 1986 AACS.

R 330.4011 to R 330.4089 Administrative Action for Mentally Ill Persons

Mich. Admin. Code R 330.4011 Transfer between state hospitals {#sec-r-330.4011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4011}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PART 4. ADMINISTRATIVE ACTION FOR MENTALLY ILL PERSONS

SUBPART 2. TRANSFER REQUIREMENTS

Rule 4011. (1) A patient may be transferred between hospitals, including the university of Michigan neuropsychiatric institute or other facilities of the department which are not hospitals, for administrative reasons or for good and sufficient clinical reasons when approved by the department. Approval by the department shall be expressed by an order of transfer, a copy of which shall be forwarded to the director of each hospital involved. Prior to approval or denial of the transfer, the department shall consult with the contractually responsible county community mental health program. A request for a transfer may be submitted by a hospital director, a patient, or other interested person.

(2) Before an approved transfer is acted upon, the director of the hospital in which the patient is currently residing shall notify in writing, not less than 7 days prior to transfer, the patient and his guardian or his nearest relative and up to 2 other persons designated by the patient, except if the transfer is necessitated by an emergency as determined by the hospital director and documented in hospital records. Under emergency circumstances, the hospital director shall effect a transfer as soon as necessary and issue the appropriate notices not more than 24 hours after transfer.

(3) The notification period of not more than 7 days prior to transfer may be reduced if the patient or his guardian or nearest relative approves the transfer in person, by telephone, or in writing, and this approval is documented. Written approval shall be obtained as soon as administratively possible.

(4) Notice of transfer by a hospital director shall inform the patient and his guardian or nearest relative of the right to object to the transfer. Upon receipt of a written objection, an appeal hearing shall be held promptly, under procedures established by the department. If an objection is made, transfer shall be delayed until a ruling of the appeal hearing indorses it, unless an emergency as determined and documented by the hospital director necessitates an immediate transfer. An emergency transfer is revocable by decision of the director of the department or by order of the appeal referee.

(5) Administrative transfer of a patient to another department hospital for purposes of supervision in connection with convalescent leave or other community placement may be appealed if it is alleged that the supervision or administrative control of the leave or placement, by the hospital to which the administrative transfer is made, and not the leave or placement itself, would be detrimental to the patient.

(6) Each hospital shall establish procedures through which patients, guardians, or responsible relatives may participate in the planning or selection of a leave or placement.

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.4013 Transfer to a facility other than a state hospital {#sec-r-330.4013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4013}

Rule 4013. (1) A patient may be temporarily transferred to a non-department hospital or other facility for emergency medical reasons as determined and documented by a hospital director.

(2) With the written consent of an adult patient or the parent, legally authorized guardian, or person in loco parentis of a patient under the age of 18, a patient may be transferred from a departmental hospital to a hospital or facility in this state which is not operated by the department. If a patient objects to a transfer that has been consented to by a person in loco parentis, transfer will be delayed until an appeal hearing established by the department has made a determination.

(3) Transfer of a patient to or from a hospital or facility that is not a department designated hospital shall not constitute a discharge from an order of hospitalization from a probate court.

(4) Transfer of an involuntary patient out of state shall be governed by interstate compact agreements.

SUBPART 3. ADMISSION CONDITIONS

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.4031 Voluntary admission {#sec-r-330.4031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4031}

Rule 4031. (1) An application for voluntary admission shall not be considered as lacking voluntariness because an individual has agreed to that action as a result of a probate court proceeding.

(2) The hospital director or his designee shall evaluate an individual's clinical suitability for informal or formal voluntary admission and shall include the following criteria in making the determination.

(a) The individual has a condition that the hospital director determines can benefit from the inpatient treatment that is provided by the hospital.

(b) Appropriate alternatives to hospitalization have been considered by the hospital, and with the consent of the individual, the community mental health program in the individual's county of residence.

(c) Adequate alternative treatment is not available or suitable at the time of admission as determined by the hospital, and with the consent of the individual, the community mental health program in the individual's county of residence.

History

History: 1979 AC.

Mich. Admin. Code R 330.4039 Denial by director of voluntary admission {#sec-r-330.4039 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4039}

Rule 4039. (1) If the hospital director, or his or her designee, does not deem an individual clinically suitable for full hospitalization as an informal or formal voluntary patient, he or she shall deny the request and shall refer the individual to an appropriate community mental health or other service. The reason or reasons for denial shall be made known to the applicant, shall be documented, and a copy of the document shall be given to the applicant.

If the individual consents, the community mental health or other service shall be notified of the referral.

(2) If the hospital director denies admission, he or she may offer partial admission on a day, night, or weekend basis if the service is available and if the individual is deemed suitable for partial admission. The criteria for suitability for partial admission shall parallel that of other forms of voluntary admission.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.4045 Involuntary admissions {#sec-r-330.4045 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4045}

Rule 4045. (1) For the purpose of establishing the point at which hospitalization begins, 1 of the following conditions shall be met:

(a) An individual arrives at or is at a hospital and an application for hospitalization is completed and given to a hospital staff member with a completed certificate.

(b) An individual arrives at or is at a hospital under a court order for immediate hospitalization, other than an order to undergo an examination, after a petition has been filed with the court.

(c) An individual is at a hospital after giving written notice of an intention to terminate formal voluntary hospitalization and the director of the hospital or his or her designee has filed with a court an application for admission by certification and the required certificates.

(2) For the purpose of establishing when an individual may complete a reasonable number of telephone calls and when a preliminary hearing shall be convened if the person is not released, the time an individual is received for hospitalization by certification, or courtordered immediate hospitalization, is any time the individual arrives at the hospital. A formal voluntary patient who is being admitted as an involuntary patient by application of a hospital director is considered received for hospitalization at the time application and certificates are filed with a probate court.

(3) When an individual is presented to a hospital, the hospital shall do all of the following:

(a) Require that the application for hospitalization, if any, meet the requirements of section 424 of the act.

(b) Require that the certificate accompanying the application, if any, meet the requirements of section 400(K) of the act.

(c) Determine if the individual presented is clinically suitable for informal or formal voluntary hospitalization. If this determination is affirmative, immediately offer the individual the opportunity to apply for hospitalization as an informal or formal voluntary patient, and as many times thereafter as deemed appropriate by the hospital director until an order of hospitalization, alternative treatment, or discharge is received.

If the individual is hospitalized as a voluntary patient, the hospital director shall inform the court and recommend whether dismissal of pending proceedings would or would not be in the best interest of the individual or the public.

(d) Allow the individual to complete not less than 2 phone calls. If the individual does not have sufficient funds on his or her person, calls shall be made at hospital expense with the condition that they be limited to persons who are willing to receive the calls. The hospital director or his or her designee may determine the appropriateness of a call or calls that are at hospital expense and may limit their length to a reasonable duration, but a call shall not be limited to less than 5 minutes. If the hospital director or his or her designee restricts the call, appropriate written documentation of the reasons for the restriction shall be noted in the case record. Under circumstances in which the individual cannot make a call, or if it is necessary to restrict calls that are at hospital expense, the hospital shall place the calls for the individual if so requested.

(e) Provide to the individual, not more than 12 hours after hospitalization, a copy of the application for admission asserting that the individual is a person requiring treatment, a written statement that the individual will be examined by a psychiatrist within 24 hours of the hospitalization, and a written statement, in simple terms, explaining the right of the individual to request a preliminary hearing, to be present at the preliminary hearing, and to be represented by legal counsel, if the individual is certified as a person requiring treatment; a written statement, in simple terms, explaining the right of the individual to a full court hearing, to be present at the hearing, to be represented by legal counsel, to a jury trial, and to an independent evaluation; and a copy of each certificate executed in connection with the individual's hospitalization if available. Each certificate shall be delivered to the individual within 24 hours of either a certificate's completion or receipt of a certificate by the hospital from a source outside the hospital.

(f) 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 in the case record.

(g) The admission officer, as soon as administratively possible after receiving an individual by certification who has been certified as a person requiring treatment, shall do all of the following:

(i) Notify the probate court by phone.

(ii) Obtain, when available, the tentative date of the preliminary or full court hearing and the name and address of counsel appointed by the court.

(iii) Notify the patient of this information.

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.4047 Admission by certification {#sec-r-330.4047 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4047}

Rule 4047. (1) A state hospital, as designated in R 330.4005, shall receive and detain for examination by a psychiatrist any individual presented to the hospital who is accompanied by a certificate and an executed application. A psychiatrist, either from the hospital staff or from outside the hospital, shall examine an individual not more than 24 hours after admission. The hospital director shall provide a room and other equipment necessary to provide a complete examination.

(2) A psychologist or physician who has examined a patient shall be permitted, by the hospital director, adequate time to be deposed or to testify, if so required at a probate court hearing regarding that patient.

History

History: 1979 AC; 1983 AACS; 1986 AACS.

Mich. Admin. Code R 330.4049 Examination upon application by peace officer or court order {#sec-r-330.4049 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4049}

Rule 4049. (1) A state hospital, as designated in R 330.4005, shall receive and detain an individual for examination if that individual is presented to the hospital by a peace officer who has executed an application for admission. The hospital shall also receive and detain for examination any individual ordered by the court to be examined. A psychologist or physician, either from the hospital staff or from outside the hospital, shall examine the individual within 24 hours. A psychiatrist, either from the hospital staff or from outside the hospital, shall examine the individual, if necessary, within 24 hours of the completion of the first certificate. The hospital director shall provide a room and other equipment necessary to provide a complete examination.

(2) A psychologist or physician who has examined an individual presented shall be permitted by the hospital director adequate time to be deposed or to testify, if so required, at a probate court hearing.

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.4051 Admission by petition {#sec-r-330.4051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4051}

Rule 4051. An individual shall be admitted to a hospital on a petition pending a hearing only upon order of immediate hospitalization by a probate court. The hospital director shall have the individual examined within 24 hours of hospitalization. If the required examination has not been accomplished within 24 hours, the hospital director shall release the individual and document in the records the reasons the examination was not completed.

The hospital shall notify the probate court.

History

History: 1979 AC.

Mich. Admin. Code R 330.4055 Probate court hearings at hospital {#sec-r-330.4055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4055}

Rule 4055. (1) It shall be the hospital director's responsibility to provide adequate facilities on the hospital grounds in which to conduct probate court hearings on petitions for hospitalization, discharge, and to hear objections to voluntary admissions and appeals of returns.

(2) The hospital director shall provide prompt access to the patient by his attorney upon proper notice, and shall provide a room where the patient and his attorney may confer in private.

(3) The hospital director shall develop rules and procedures establishing visiting rights by attorneys and requirements for proper notice.

SUBPART 4. RELEASE AND DISCHARGE

History

History: 1979 AC.

Mich. Admin. Code R 330.4077 Discharge of voluntary patients {#sec-r-330.4077 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4077}

Rule 4077. (1) An informal, voluntary patient shall be discharged either during normal day shift hours or immediately, at the discretion of the hospital director, after either of the following:

(a) A request is made by the patient to terminate hospitalization.

(b) The hospital director deems it clinically suitable.

(2) A formal, voluntary patient shall be discharged as soon as possible, but not later than 3 days, excluding Sundays and holidays, after either of the following:

(a) Written notice of intent to terminate hospitalization is given by the patient.

(b) The hospital director deems that it would be clinically suitable.

(3) Even if a guardian has been appointed for a patient, only the patient may give written notice of an intention to terminate hospitalization.

History

History: 1979 AC; 1986 AACS; 1990 AACS.

Mich. Admin. Code R 330.4083 Unauthorized leave by voluntary patients {#sec-r-330.4083 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4083}

Rule 4083. (1) A patient who has been admitted as an informal, voluntary patient and who leaves a hospital without proper notification of intention to terminate shall be placed on unauthorized leave status for 24 hours. After this period, the hospital shall administratively discharge the patient.

(2) A patient who has been admitted as a formal, voluntary patient and who leaves a hospital without permission shall be placed on unauthorized leave status for not more than 3 days and shall be readmitted during that period without signing a new application for admission. If the patient does not return within 3 days, he or she shall be discharged.

(3) A patient who is absent from a hospital without having given notification of intention to terminate shall be designated as a missing person. Prompt and vigorous measures shall be taken to find the patient, including an immediate search by hospital employees as warranted by circumstances and notification, pursuant to section 748(6)(c) of the act, of other public agencies if there is a substantial probability of harm to the patient or other persons. Relatives or other interested parties shall be notified if the patient had given prior authorization to notify those persons in the event of an emergency. A record shall be kept of persons notified and the time of notification. Upon locating a missing patient, the hospital shall inform those notified and determine if any of the following provisions apply to the patient:

(a) He or she desires to return voluntarily.

(b) He or she desires to terminate hospitalization.

History

History: 1979 AC; 1990 AACS.

Mich. Admin. Code R 330.4089 Discharge of involuntary patient {#sec-r-330.4089 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4089}

Rule 4089. (1) Discharge shall constitute release of a patient from jurisdiction of a hospital, by action of the hospital director or by court order, or if the court rejects an application or petition or fails to hold a requested preliminary hearing or final hearing within the required time or a continuance was not granted. A patient discharged may not be returned to the hospital without a new order for admission or application for voluntary admission.

(2) When a patient is discharged, the hospital director shall report the change in status to the probate court which ordered admission and indicate in this report which of the following factors have brought about this discharge:

(a) Patient legally transferred out of state.

(b) Patient, in the opinion of the hospital director, not mentally ill.

(d) Patient no longer clinically suitable for this form of hospitalization.

(e) Death of patient.

(f) Patient, on an order of continuing hospitalization, after 1 year of continuous leave.

(g) Any other reason acceptable under the act or procedures of the department.

History

History: 1979 AC.

R 330.4501 to R 330.4661 Civil Admissions/Discharge Procedures for Minors

Mich. Admin. Code R 330.4501 Definitions {#sec-r-330.4501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4501}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PART 4A. CIVIL ADMISSION AND DISCHARGE PROCEDURES FOR

MINORS

SUBPART 1. GENERAL PROVISIONS

Rule 4501. As used in this part:

(a) "County program" means a county community mental health program.

(b) "Hospital operated by or under contract with the department or a community mental health board" means a hospital that is directly operated by, or that is under contract to, the department or a community mental health board servicing a minor.

SUBPART 2. ADMISSIONS

History

History: 1990 AACS.

Mich. Admin. Code R 330.4603 Request for admission {#sec-r-330.4603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4603}

Rule 4603. (1) A parent who has joint custody of a minor and who does not have a limitation on the right to medical decision-making may apply for admission for the minor.

When each parent resides in a separate county, has authority to consent to treatment, and requests admission, the parents shall be requested to name the county of residence for the minor, and the parent residing in the named county shall be requested to sign the application.

(2) A person who requests hospitalization for a minor under the specific authority of a power of attorney for consent to medical treatment given to the person by the parent of the minor shall be considered to have the same authority as the parent of the minor. The power of attorney shall expire at the end of 6 months. Before the 6-month expiration, the hospital will inform the person of the need to renew the power of attorney or the powers shall automatically revert back to the parent.

(3) If the juvenile court has assigned itself as temporary guardian of a minor, then the minor is a temporary ward of the court and the court is responsible for the care and supervision of the minor. If the court requests hospitalization of a minor who is its temporary ward, the court shall execute an order that specifies that the court worker, as designee of the court, has the authority to request hospitalization, authorize treatment and releases of information, and, when necessary, consent to the use of psychotropic medication. The name of the court worker shall be verified and documented by an official letter which is presented to the hospital from the court and which is reissued as designee modifications necessitate. Requests for hospitalization of a minor pursuant to this subrule shall be in accordance with the provisions of section 498e(2) of the act. The designee of the court shall be considered the minor's guardian.

(4) A peace officer or person in loco parentis may request emergency hospitalization of a minor, but does not have legal authority to authorize treatment or releases of information.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4611 Preadmission evaluations {#sec-r-330.4611 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4611}

Rule 4611. (1) A hospital shall document the basis for its determination of all of the following:

(a) A minor is emotionally disturbed and requires mental health treatment.

(b) A minor is expected to benefit from hospitalization.

(2) When a county program refers a minor for admission to a hospital operated by, or under contract with, the department or the county program, the county director is responsible for transmitting evaluation information, in writing, to the hospital. In addition to the information required in subrule (1) of this rule, such information shall include all of the following:

(a) A psychosocial history.

(b) The identifying information necessary concerning both the minor and the parent or guardian.

(c) The legal status of the minor with respect to the juvenile court and the department of social services, if appropriate.

(d) Other information the county director deems appropriate.

(3) In an emergency situation, the county director shall transmit as much of the information specified in subrules (1) and (2) of this rule as possible to the hospital when requesting that a minor be admitted. At a minimum, such information shall contain the basis for the determination that a minor is emotionally disturbed and an explanation justifying the request for an emergency admission. The remaining information shall be sent to the hospital within 7 days of admission.

SUBPART 4. CHANGE IN STATUS OF HOSPITALIZATION

History

History: 1990 AACS.

Mich. Admin. Code R 330.4620 Authority for terminating admission {#sec-r-330.4620 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4620}

Rule 4620. Only the person responsible for authorizing the hospital treatment for a minor or a minor who was admitted upon his or her own request may submit a notice of intent to terminate hospitalization to the hospital, unless there has been a legal change in the custody of the minor.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4626 Discharge, transfer, placement, or change in admission status of minor; report {#sec-r-330.4626 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4626}

Rule 4626. (1) When a minor is discharged, transferred, placed in another facility, or has a change in admission status, the hospital director shall report that fact to the responsible county program and shall report the factors which brought about the change.

(2) When a minor is under court-ordered continued hospitalization pursuant to the provisions of section 498n(2) or 498o(6) of the act, the hospital director shall report any discharge, transfer, or placement in another facility to the court which ordered the continued hospitalization and indicate in this report the factors which brought about this change in status.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4631 Authorized leave of absence {#sec-r-330.4631 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4631}

Rule 4631. (1) When, in the opinion of a hospital director, a minor would benefit from a temporary, short-term experience outside the hospital, the hospital director may authorize a leave of absence.

(2) A minor, while in the custody of the hospital, shall be allowed an authorized leave of absence only if the minor will be released into the custody and supervision of a responsible adult for a specified period of time and only with the consent of a parent or guardian.

(3) An authorized leave of absence to another state shall not be granted for a minor who is under court-ordered continued hospitalization, unless the leave of absence is approved by the court.

(4) A hospital shall not accept liability for expenses incurred by or for a minor on leave, unless the expense is authorized in advance.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4636 Unauthorized leave {#sec-r-330.4636 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4636}

Rule 4636. If a minor leaves the hospital without permission of the hospital or refuses a request to return to the hospital while on an authorized absence from the hospital, then both of the following provisions apply:

(a) If the parent, guardian, or person in loco parentis is unable to transport the minor and has attempted to arrange for other persons, including hospital staff, to transport the minor to the hospital and either the other persons declined such authorization or the transport of the child did not occur, then this information shall be included in any request submitted to the court for an order of transport under section 498k of the act.

(b) The hospital shall promptly notify the appropriate court if a minor is under court order for continued hospitalization.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4641 Expiration of court-ordered continued hospitalization order {#sec-r-330.4641 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4641}

Rule 4641. (1) Two weeks before the expiration of a 60-day court-ordered continued hospitalization order, if a minor remains suitable for hospitalization, the hospital director shall attempt to obtain a renewal of the written consent for treatment from the appropriate adult.

(2) If a parent or guardian refuses to consent to treatment, the hospital director may deem this as a notice of intent to terminate hospitalization. The hospital director shall then proceed pursuant to the provisions of section 498j or 498o of the act.

(3) If during the course of court-ordered continued hospitalization, a minor is deemed by the hospital director to be suitable for hospitalization without court order, the hospital director may offer the minor's parent or guardian the opportunity for renewal of the written consent to treatment. If such renewal is made, the hospital director shall inform the court and the court shall dismiss the order for continued hospitalization, unless it finds that dismissal would not be in the best interest of the minor or the public.

SUBPART 5. OBJECTION TO HOSPITALIZATION PROCESS

History

History: 1990 AACS.

Mich. Admin. Code R 330.4651 Notification of objection to hospitalization process {#sec-r-330.4651 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4651}

Rule 4651. A minor and his or her parent or guardian or a person in loco parentis shall be informed of the objection to the hospitalization process and its time frames at the time of either admission to the hospital or placement on a waiting list for hospitalization. A minor may not object to a court-ordered continued hospitalization pursuant to the provisions of section 498o(6) of the act.

History

History: 1990 AACS.

Mich. Admin. Code R 330.4661 Assistance in preparing objection to hospitalization; submission of objection to court: advocate for objecting minor under age 14 {#sec-r-330.4661 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4661}

Rule 4661. (1) An individual who is 14 years of age or older shall be assisted in preparing a proper written objection for the court by a person assigned by the hospital director.

(2) When an objection is complete, the hospital director or his or her designee shall submit it to the court within 24 hours, excluding Saturdays, Sundays, and holidays.

(3) Upon notification of an objection by an individual under the age of 14, the hospital director or his or her designee shall notify a person requested by the individual to ascertain the person's willingness to be an advocate on behalf of the individual and, if so willing, shall notify the probate court of the objection and request the court to determine if the person requested by the individual is suitable to submit an objection to hospitalization on behalf of the individual.

History

History: 1990 AACS.

R 330.5005 to R 330.5091 Administrative Action for Developmentally Disabled Persons

Mich. Admin. Code R 330.5005 Regional designation of residential facilities {#sec-r-330.5005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5005}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PART 5. ADMINISTRATIVE ACTION FOR DEVELOPMENTALLY DISABLED

PERSONS

SUBPART 1. DESIGNATED RESIDENTIAL FACILITIES

Rule 5005. (1) Acceptance of an application for a temporary or administrative admission shall be limited to a person having a domicile in the designated region of a facility. Except as otherwise provided in this rule, a probate court shall limit judicial admissions to persons who are located in counties which constitute a region for the facility. These facilities may admit an individual for preadmission examination with an application for temporary or administrative admission. Facility regional designation may be made by departmental policy or administrative rule.

(2) Facilities of the department or licensed or certified by the department are designated as regional diagnostic and treatment centers for the purposes of section 816 of Act No. 236 of the Public Acts of 1961, as amended, being S600.816 of the Michigan Compiled Laws.

A facility so designated shall provide an area so that court hearings may be held in these quarters.

SUBPART 2. TRANSFER REQUIREMENTS

History

History: 1979 AC; 1986 AACS.

Mich. Admin. Code R 330.5015 Transfer under the interstate compact {#sec-r-330.5015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5015}

Rule 5015. (1) An individual shall be admitted to a residential facility from another state under the interstate compact only if that individual meets the criteria for admission as specified in the act.

(2) An individual under 18 years of age shall be transferred to a facility of another state under the interstate compact if the parents of that individual establish residence in that state.

SUBPART 3. ADMISSION CONDITIONS

History

History: 1979 AC.

Mich. Admin. Code R 330.5031 Temporary and administrative admission {#sec-r-330.5031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5031}

Rule 5031. (1) An application for temporary or administrative admission shall not be considered as lacking in voluntariness because an individual has agreed to the action as a result of a probate court direction.

(2) If a legally empowered person applies for temporary or administrative admission of an individual under 18 years of age and the facility director, or his or her designee, determines that the individual is suitable for admission, the facility shall admit the individual and shall include the application as part of the case record. A person is legally empowered to execute an application for temporary admission if he or she is a parent, a guardian, or in their absence, a person in loco parentis.

(3) An individual, 18 years or older, competent and deemed suitable by the director, shall be admitted as an administrative admittee upon application. A guardian shall execute the application if the individual is not competent.

(4) An individual under 18 years of age shall be admitted as an administrative admission if deemed suitable by the facility director upon the application of a parent, guardian, or in their absence, a person in loco parentis.

(5) For the purpose of determining who may execute an application for temporary or administrative admission or who may file written notice to leave a facility:

(a) "Guardian" means a court-appointed plenary guardian or guardian of the person of an individual deemed legally incompetent or a guardian appointed for a minor by a court.

(b) "Parent" means the natural or adoptive parent, whether married or not. A parent whose parental rights have been terminated by the probate court or who has been deprived of legal custody by the probate or circuit court, or the equivalent in another state, is barred from executing an admission application.

(c) "Person in loco parentis" means a person who assumes the rights, duties, and responsibilities of a parent as demonstrated by the fact that the person exercises parental functions, such as the care and supervision of the child. Determination of status as a person in loco parentis shall be made by the facility director or his or her designee. The director or his or her designee may consider, in addition to the criteria already mentioned in this subdivision, any of the following criteria:

(i) The person is the sibling, adopted sibling, stepsibling, grandparent, blood aunt or uncle, nephew, niece, or first cousin of the individual minor.

(ii) The minor was placed by a parent or guardian in the keeping of a person to whom the child is not related as can be documented by some written authorization executed by the parent or guardian or by the sworn affidavits of 2 other adult persons that the minor was left in that person's keeping by the parent or guardian.

(iii) The person is a member of the household in which the minor resides.

(iv) The person is responsible for the maintenance of the minor's home.

(v) A probate court, juvenile division, has found the minor to be within the jurisdiction of that court.

(6) Action shall not be taken on an application for temporary or administrative admission of an individual under 18 years of age which is executed by a person in loco parentis until the facility director, or his or her representative, determines the whereabouts and legal responsibility of the parent or guardian. If the whereabouts or legal responsibility of the parents or guardian cannot be determined after reasonable effort, the director may proceed to take action.

(7) A mentally retarded or developmentally disabled individual may be deemed suitable for admission as a temporary or administratively admitted resident. The facility director shall determine suitability and may utilize documentation, previous test results, or a physician's statements in establishing these conditions for a temporary admission.

Suitability for an administrative admission shall be made with the assistance of a preadmission examination and in consultation with the community mental health agency serving the individual's county of residence or county of placement. A preadmission examination may be completed by a community mental health agency or private individual if the agency or individuals are under contract with the facility to provide this examination.

An individual shall not be administratively admitted unless the director concludes on the basis of the preadmission examination, department admission policies, and other available information that admission is suitable for the following reasons:

(a) The facility is the least restrictive setting feasible for the individual.

(b) Services and programs in the community cannot provide necessary adequate habilitation program or special service required by the individual.

(i) A severely or profoundly retarded person or substantially developmentally disabled.

(ii) A mildly or moderately retarded person with either multihandicapping conditions or specific maladaptive behavior or behavior problems.

(8) An individual who does not meet the criteria in subrule (7) of this rule may be admitted on a temporary basis at the discretion of the director.

(9) An individual may not be administratively admitted unless a preadmission examination, including mental, physical, social, and educational evaluations, is completed.

The facility director, in cooperation with the community mental health agency, shall designate a professional person to supervise the examination and to prepare a report regarding the individual's suitability for admission and the most appropriate living arrangement.

(10) The facility director shall effect, at least annually, a reexamination of each administratively admitted resident for the purpose of determining whether he or she continues to meet the criteria for administrative admission.

(11) If an individual under 18 years of age, who was admitted on a temporary or administrative basis, becomes 18 years of age, he or she shall be released or shall be offered the opportunity to request administrative admission if competent. A guardian may execute the application if the individual is not competent.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.5033 Respite care {#sec-r-330.5033 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5033}

Rule 5033. Temporary admission of an individual to a state facility for respite care services shall not be accepted unless it is accompanied by both of the following:

(a) An authorization from the admitting person for emergency medical care to provide for the health, safety, and medical well-being of the admitted individual.

(b) Address and telephone number information on how to contact the admitting person or a person who could act in loco parentis.

History

History: 1983 AACS.

Mich. Admin. Code R 330.5039 Denial by director of administrative admission {#sec-r-330.5039 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5039}

Rule 5039. (1) If the facility director or his designee does not deem an individual suitable for admission as a temporary or administrative admission, he shall deny the request. Reason for denial shall be made known to the applicant, and with consent, to the community mental health agency serving the county of the individual's residence and shall be documented in the record of the resident. A copy of the document shall be given to the applicant.

(2) If the director denies admission, he may offer partial admission on a day, night, or weekend basis if the service is available and the individual is deemed suitable for partial admission. The criteria for suitability for partial admission shall parallel that of other forms of temporary and administrative admission.

History

History: 1979 AC.

Mich. Admin. Code R 330.5043 Objection and appeal of an administrative admission of a minor {#sec-r-330.5043 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5043}

Rule 5043. (1) A minor resident informing the facility of a desire to object to his admission shall be assisted by a person assigned by the facility director in properly submitting the objection to the court.

(2) An individual not less than 13 years of age shall be assisted in preparing a proper written objection for the court and shall be made aware of the appropriate time intervals at which objection shall be made. When the objection is complete, the facility director or his designee shall submit it to the probate court within 24 hours, excluding Saturdays, Sundays, and holidays.

(3) Upon notification of an objection by an individual under the age of 13, the facility director or his designee shall notify the probate court of the objection and request the probate court appoint a guardian ad litem for the individual.

SUBPART 4. PERIODIC REVIEW

History

History: 1979 AC.

Mich. Admin. Code R 330.5067 Periodic review of administratively admitted resident {#sec-r-330.5067 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5067}

Rule 5067. A facility director shall evaluate not less than once every 12 months, each administratively admitted resident to determine whether he continues to meet the criteria for administrative admission. If the facility director determines that the resident does not meet the criteria, he shall discharge the resident. Results of this review shall be documented in the case record.

SUBPART 5. RELEASE AND DISCHARGE

History

History: 1979 AC.

Mich. Admin. Code R 330.5077 Discharge of administratively admitted residents {#sec-r-330.5077 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5077}

Rule 5077. (1) An administratively admitted resident shall be discharged as soon as possible, but not later than 3 days after either of the following:

(a) A written notice of intent to terminate admission is given by the person who executed the application for administrative admission.

(b) The facility director deems that it would be clinically suitable.

(2) An administratively admitted resident under the age of 18 who has had an objection to admission sustained by a court shall be discharged immediately upon notification to the facility by the court.

(3) A person other than the resident may give written notice of an intention to terminate administrative admission if the person is the individual who executed the application for admission.

(4) If a guardian has been appointed for a resident subsequent to the execution of an application for administrative admission, only the guardian may give written notice of an intention to terminate an administrative admission.

(5) If a parent or guardian of a resident dies subsequent to execution of an application for administrative admission or otherwise loses legal custody of the resident, the surviving parent of a minor, if any, or guardian appointed by a court to replace the deceased or departed parents or guardian, may give written notice of an intention to terminate administrative admission.

(6) If an application for administrative admission of an individual under 18 years of age has been executed by a proper person, notice of intention to terminate administrative admission may be made by the resident upon his eighteenth birthday unless a guardian of the resident has been appointed.

History

History: 1979 AC.

Mich. Admin. Code R 330.5086 Objection to return to facility by administratively admitted resident {#sec-r-330.5086 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5086}

Rule 5086. (1) An adult resident who is administratively admitted shall not be returned to a facility if he or she objects.

(2) If an adult, administratively admitted resident, who in the judgment of a facility director meets the criteria for judicial admission, leaves the facility without permission, the parent, guardian, or nearest relative shall be immediately notified. If the resident is not readily traceable and his or her whereabouts are unknown, the facility shall notify appropriate police authorities. If the resident is located and is unwilling to return to the facility, the facility director shall make application to an appropriate court for a determination as to whether the resident meets the criteria for a judicial admission. If judicial admission seems necessary and desirable, the facility shall continue admission status pending court hearing, after making application.

(3) A resident on authorized leave who was admitted to a facility on an application for administrative admission executed by someone other than himself or herself may be returned over his or her objection, unless the parent, guardian, or person in loco parentis objects.

(4) A resident who has been admitted upon the signed application of a parent, guardian, or person in loco parentis and who leaves the facility without permission shall be placed on unauthorized leave status until the facility director has secured from the parent, guardian, or person in loco parentis a written notice indicating a desire to withdraw the resident from the facility. After securing notice, the resident shall be discharged. A minor resident shall be permitted to re-enter the facility upon the original application until discharged. The notification shall be given to the community mental health program which serves the county of the individual's residence. If the resident is not discharged, the facility shall take action pursuant to R 330.5043.

(5) A resident who objects to returning to the facility shall be subject to the administrative review procedures established by the department of mental health.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.5089 Discharge of judicially admitted resident {#sec-r-330.5089 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5089}

Rule 5089. (1) Discharge shall constitute release of a resident from jurisdiction of a facility, by action of the facility director or by court order, or if the court rejects an application or petition or fails to hold a hearing within the required time. A resident discharged may not be returned to the facility as a resident without a new order for admission or application for administrative admission.

(2) When a resident is discharged, the facility director shall report the change in status to the probate court which ordered admission and indicate in this report which of the following factors have brought about this discharge:

(a) Resident legally transferred out of state.

(b) Resident, in the opinion of the facility director, is not mentally retarded.

(d) Death of resident.

(e) Resident, on a court order, after 1 year of continuous leave.

(f) Any other reason provided for in statutes or procedures of the department.

History

History: 1979 AC.

Mich. Admin. Code R 330.5091 Authorized leave of judicially admitted residents {#sec-r-330.5091 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.5091}

Rule 5091. (1) A leave for a visit constitutes a conditional and revocable release of a resident, granted for temporary purposes to provide a short-term experience outside the facility for an individual not yet thought to be capable of making a satisfactory adjustment on a long-term basis.

(2) Convalescent leave shall constitute a conditional and revocable release of a resident in his own custody or in the custody of another person, granted for purposes of continuing care and treatment by a facility while providing a longer term experience outside the facility for an individual not yet thought to be capable of making a satisfactory adjustment without this form of treatment. At the time a facility director determines the suitability of release for a judicially admitted resident, consideration for discharge shall have preference.

(3) A resident, while in the custody of a facility, shall not be permitted leave when in the judgment of the facility director it would be harmful to the resident or others.

(4) The department shall not be responsible for providing transportation for the return to a facility of a resident on convalescent leave. Exceptions to this may be made in special instances with the approval of the director of the department.

(5) Convalescent leave for a resident intending to go to another state shall not be granted without the approval of the director of the department.

(6) A facility shall not accept liability for expenses incurred by or for a resident on leave unless this expense is authorized in advance.

History

History: 1979 AC.

R 330.6006 to R 330.6031 Guardianship for Recipients of Mental Health Services

Mich. Admin. Code R 330.6006 Applicability {#sec-r-330.6006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6006}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BEHAVIORAL HEALTH & DEVELOPMENTAL DISABILITIES

ADMINISTRATION

GUARDIANSHIP FOR RECIPIENTS OF MENTAL HEALTH SERVICES

(By authority conferred on the department of health and human services by section 33 of 1969 PA 306, and sections 114, 136, 201, 206, 244, 498n, 842, and 1002a of 1974 PA 258, being MCL 24.233, MCL 330.1114, MCL 330.1136, MCL 330.1201, MCL 330.1206, MCL 330.1244, MCL 330.1498n, MCL 330.1842, and MCL 330.2002a.)

PART 6. GUARDIANSHIP FOR RECIPIENTS OF MENTAL HEALTH

SERVICES

Rule 6006. (1) These rules apply to persons designated developmentally and/or intellectually disabled as that term is defined in sections 100a and 100b of the mental health code, 1974 PA 258, MCL 330.1100a and MCL 330.1100b.

(2) A determination of need for guardianship proceedings may also be made under these rules for persons who are designated mentally ill. Upon a determination that a mentally ill recipient cannot give informed consent, a hospital or program director shall not cause a proceeding for guardianship to be commenced in the probate court but shall notify the persons indicated by these rules. When a person is not available to be notified or the notified persons refuse to take action and action is urgently needed, a hospital or program director may elect to commence appropriate probate court guardianship proceedings authorized by law if a suitable candidate to serve as guardian is available or the probate court has indicated a willingness to appoint a public guardian at county expense, request a probate court to consent to the performance of surgery or electroconvulsive therapy or other procedure intended to produce convulsion or coma in lieu of the person eligible to give consent, or resort to other emergency procedures listed in section 5312 of estates and protected individuals code, 1998 PA 386, MCL 700.5312.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.6008 Admission of residents to a facility by guardians {#sec-r-330.6008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6008}

Rule 6008. (1) A facility shall not admit a person of the age of 18 or over on a temporary or administrative admission basis on the application of a plenary or partial guardian unless a court order specifically empowers the guardian to place the person in a facility of the type to which application has been made.

(2) A facility shall not admit a person under the age of 18 on a temporary or administrative admission basis on the application of a plenary or partial guardian, appointed under the act unless a court order specifically empowers the guardian to place the person in a facility of the type to which application has been made. A facility may admit a person under the age of 18 on the application of a guardian appointed pursuant to other law without the required court order.

History

History: 1979 AC.

Mich. Admin. Code R 330.6011 Determination of need for guardianship proceedings {#sec-r-330.6011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6011}

Rule 6011. (1) The facility or program director shall presume a person of the age of 18 or over legally competent to make an application or give a consent, or to refuse to do so, except that:

(a) This presumption shall be conclusively rebutted when a plenary guardian of the person, or of the estate and of the person, or a partial guardian has been appointed for a person and a duration of the term of guardianship indicated in the court order has not expired.

(b) When a partial guardian has been appointed, a person shall be presumed legally competent except for:

(i) Areas designated as legal disabilities in the court order appointing a partial guardian.

(ii) Powers or duties granted to the guardian as specified in the court order appointing a partial guardian.

(2) The manner of determining need for guardianship proceedings required by these rules shall be part of the procedure followed by facilities in conducting evaluations of minor residents 6 months prior to an eighteenth birthday to determine whether a resident is competent to execute an application for administrative admission or otherwise requires the protective services of a guardian. An evaluation of need for other protective services of a guardian shall be made even if a decision has been made to discharge a resident by his eighteenth birthday.

(3) A staff member responsible for taking action concerning a person or for arranging for a person of the age of 18 or over to make application or give consent may decline to do so on the ground that the person is not capable of giving or refusing to give an informed consent in 1 or more of the following areas:

(a) Admission to a facility or participation in a program.

(b) Nonemergency surgery or other medical procedures not related to care and treatment for a person's mental condition.

(c) Nonemergency use of electro-convulsive therapy or other procedure intended to produce convulsion or coma for a resident or psychosurgery or other treatment of an experimental or extra hazardous nature for a voluntary resident.

(d) Consent to chemotherapy prior to final adjudication of a petition for involuntary admission.

(e) Financial matters, including payment for services and securing insurance and governmental benefits.

(f) Fingerprinting or photographing of a recipient.

(g) Disclosure of confidential information which requires consent.

(h) Resident labor or other employment which requires consent.

(i) Abortion procedures, surgical sterilization, and chemical or mechanical contraceptive measures.

(j) Other developments relating to a person's residence in a facility or participation in a mental health services program, other than care and treatment, training programs or services ordered by a probate court.

(4) A staff member declining to take action or make arrangements shall give to the facility or program director, in writing, reasons for a conclusion that a person is not capable of giving or refusing to give an informed consent.

History

History: 1979 AC.

Rule 6013. (1) Upon review, a facility or program director shall determine whether a staff member's written conclusion that a person is not capable of giving or refusing to give an informed consent is of substantial weight. A facility or program director shall, when possible, authorize staff to act upon an application, consent, or refusal of a person of the age of 18 or over who is presumed to be legally competent. If a facility or program director determines that a staff member's written conclusion that a person is not capable of giving or refusing to give an informed consent is of substantial weight, he or she shall convene an informed consent board.

(2) An informed consent board may either be a standing interdisciplinary body drawn from an existing interdisciplinary review board within a facility or program or may be appointed on a case-by-case basis. An informed consent board shall consist of the following:

(a) Two mental health professionals of different disciplines with appropriate clinical experience or training.

(b) A third person who is not employed by the facility or program but who is selected by the facility or program director from qualified volunteers with an interest in mental health or developmental and/or intellectual disability advocacy and services.

(3) One board member shall have had prior clinical contact with the person whose ability to give informed consent is at issue, but a board member shall not have been involved in either the action or application for which consent is needed or the decision to evaluate the need for guardianship proceedings.

(4) A board shall evaluate the capacity of a person to give or refuse to give the required informed consent by interviewing the person and other appropriate persons and by evaluating available clinical records and test results. A board shall submit a written report which states the board’s findings of fact, the person’s desires in the matter, when possible, a conclusion whether the consent or refusal is or will be informed, and the board's recommendation.

(5) Informed consent assumes all of the following:

(a) That a person has the capacity to make a decision and to understand rationally the nature of the procedure, its risks or other consequences, and other relevant information despite deprivations stemming from confinement and despite the negative effects of institutionalization.

(b) That a person has been made aware of the procedure, risks, or other direct ramifications, including benefits, reasonably to be expected and of an appropriate alternative which is advantageous to the person. There shall be an offer to answer further inquiries of the person.

(c) That a decision is or will be an exercise of free power of choice without intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion, including promises or assurances of freedom or privileges. The person shall be instructed that he or she is free to withdraw consent or to discontinue an ongoing activity or participation at any time without prejudice.

(6) A board shall recommend those mental, physical, social, or educational evaluations which it deems necessary to further ascertain the capacity of a person to give informed consent or the need of a minor who is approaching the age of 18 for protective services of a guardian, to determine if guardianship will promote and protect the well-being of the person, or to arrive at a suitable guardianship design.

(7) If a majority of an informed consent board concludes that a person does not have the capacity to make a decision or to rationally understand a situation, as required for an informed consent, and if the board concludes that guardianship can promote and protect the well-being of the person and recommends a guardianship request designed to encourage the development of maximum self-reliance and independence in the individual, then a director of the facility or program shall cause a proceeding for guardianship to be commenced in the probate court. Steps taken to cause a proceeding shall be in accordance with R 330.7003 and this rule on a facility's or program's role in guardianship proceedings.

(8) If a majority of an informed consent board concludes that informed consent is absent either because a person has not been made sufficiently aware of the procedures, risks, other ramifications, benefits, or alternatives or because a decision is not voluntary, as required for an informed consent, the director shall cause the individual to be provided necessary information or, when possible, an opportunity for voluntary choice.

(9) If a majority of an informed consent board concludes that a person can give or has given an informed consent or has the capacity to give an informed consent and has refused to consent, the facility or the program director shall authorize the staff to act accordingly.

(10) A parent or a responsible relative, a previously appointed current partial guardian, or other interested person or entity shall be notified by the informed consent board of a determination that a person cannot give an informed consent. More than 1 person or entity may be notified.

(11) A copy of an informed consent board's report shall be placed in the person's case record.

History

History: 1979 AC; 1981 AACS; 2018 AACS.

Mich. Admin. Code R 330.6015 Emergency guardianship {#sec-r-330.6015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6015}

Rule 6015. (1) Whenever the life of a person presumed legally competent is threatened, when there is doubt whether a person is capable of giving informed consent, and when it is deemed necessary to undertake measures other than surgery or electro-convulsive therapy or other procedures intended to produce convulsion or coma, a facility or program director, without convening an informed consent board, may petition the probate court of the county where the person is located to exercise the powers of a guardian or to summarily appoint a temporary guardian. The medical necessity for the procedure shall be documented and entered into the record of the person and provided to the probate court.

(2) This provision for emergency guardianship shall not preclude medical staff from taking life-saving or physical stabilization measures when the life of a person is threatened and there is not time to obtain consent. These measures may be performed without consent after the medical necessity has been documented and the documentation has been entered into the record of the recipient. Consent for necessary continued administration of the emergency procedures shall be sought as soon as possible.

(3) A facility or program director may petition a probate court to exercise powers of a guardian or to summarily appoint a temporary guardian whenever a decision should be made by a person presumed legally competent whose life is not threatened but whose capacity to give an informed consent is in doubt, and a time limit for taking action or otherwise making a decision does not allow sufficient time for an informed consent board to be convened and make a determination. A board shall subsequently complete an inquiry and if a majority concludes the person is capable of giving or refusing to give an informed consent, a probate court which has assumed or authorized emergency or temporary guardianship powers shall be informed by its next working day and asked to terminate the guardianship.

(4) If an emergency or temporary guardianship is terminated as a result of an informed consent board's inquiry, a facility or program director shall cause, whenever possible, steps taken under the guardianship to be revoked or adjusted in accordance with the person's expressed desires.

History

History: 1979 AC.

Mich. Admin. Code R 330.6019 Facility or program rule in guardianship proceedings {#sec-r-330.6019 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6019}

Rule 6019. (1) When guardianship is deemed necessary, a facility or program director shall endeavor to cause the petitioner to be an appropriate family member, friend, or public or private agency or association, other than an agency or association directly providing services to the person. The person may also be the petitioner.

(2) When the facility or program director or an authorized staff member petitions for appointment of a guardian, the petition shall not request, and a report provided by a department facility or a county program shall not recommend a greater scope or duration of guardianship powers and duties than is absolutely necessary to meet the needs presented by the person's actual mental and adaptive limitations and for which an informed consent board evaluated the ability of the person to consent or for which a minor approaching the age of 18 has been evaluated by an informed consent board as needing protective services of a guardian.

(3) A guardianship request shall be designed to encourage development of maximum self-reliance and independence in the person.

(4) If a petition previously filed on behalf of a facility or program resulted in appointment of a plenary guardian of the estate or a partial guardian or a refusal by a court to appoint any guardian, a facility or program director shall not authorize a subsequent petition unless there has been a significant deterioration in the person’s condition or other compelling change in circumstances. This requirement does not prevent action for emergency guardianship.

(5) Only when it is necessary for a court to summarily appoint a temporary guardian and then only when another person, agency, or association is not available to serve as guardian, shall a facility or program providing services to a person offer to serve as guardian.

(6) When a facility or program petitions for appointment of a guardian, a facility or program director shall cause, wherever possible, that an appropriate family member, friend, or public or private agency or association be considered by the probate court for appointment as guardian.

(7) Only on the request of a probate court and after all other possibilities have been exhausted may a department facility agree, on behalf of the department, to serve as a plenary or partial guardian.

(8) The department shall decline to serve as guardian for a person not receiving services from a department facility.

(9) A county community mental health program may accept an appointment as guardian for a person receiving services in a department facility, pursuant to these rules.

(10) Staff members of the department and of a community mental health program shall not personally act as guardians.

(11) Each facility director and community mental health director shall establish relationships with local associations for developmentally and/or intellectually disabled citizens and other appropriate public or private agencies or associations which can conduct an active guardianship program for a developmentally and/or intellectually disabled person to assist in obtaining individual or group guardians in cases where a family member or friends are not available.

(12) When a department facility or county community program staff member petitions for appointment of a guardian, on behalf of the facility or program, a facility shall provide, and a program shall provide or contract for, a report required by law. This report shall contain all of the following:

(a) Evaluations of the person’s mental, physical, social, and educational condition made not more than the 30 days prior to filing a petition.

(b) A recommendation proposing the type and scope of guardianship services needed.

(d) Signatures of all persons, 1 of whom shall be a physician or a psychologist, who performed evaluations upon which the report is based. Any number of evaluations by persons not on the staff of the facility or program may be utilized.

(13) If suitable, a facility may use a report of an informed consent board as part of a required report.

(14) When facility or program staff petition for appointment of a guardian, a petition shall be filed in the probate court for the county of residence or county in which a developmentally and/or intellectually disabled person was found as determined by any of the following factors:

(a) The county from which a person was admitted on the basis of a judicial admission or ordered to undergo a program of alternative care and treatment.

(b) The county from which a person was referred to a facility or program by a county community mental health program or other public or private agency.

(d) The county in which a person owns real estate suitable for residential use.

(e) The county with which a person has substantial service contacts as evidenced by such factors as recent or current enrollment in a public education system, recent or current employment, current voter or automobile registration, valid driver’s license, bank accounts, or ownership of substantial tangible personal property.

(f) A person's present residence if he or she resides outside a facility.

(15) If the county of residence or the county in which a person was found cannot be determined, a petition may be filed by facility or program staff in the probate court for the county in which the facility is located. If both the county of residence or in which the person was found are outside the facility’s or program's service area, a petition may be filed in the probate court for the county in which the facility or program is located with the permission of the probate court.

(16) Whenever a facility or program staff petitions for appointment of a guardian and there has previously been a guardian appointed for a person, the petition shall, where possible, be filed in the same probate court which previously appointed a guardian for the person, and in all cases the court shall be alerted by the petitioner to previous current or expired guardianship of which the petitioner has notice.

(17) Whenever the department is appointed guardian, a facility shall request that the court order that the report to the court be at intervals which coincide with periodic reviews scheduled for the resident.

(18) The guardian’s report to a court shall contain statements indicating all the following:

(a) The person’s current mental, physical, social, and educational condition.

(b) The person's present living arrangement.

(d) Other information requested by the court or necessary in the opinion of a guardian.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.6022 Guardianship for minors {#sec-r-330.6022 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6022}

Rule 6022. (1) When the parent or other guardian of a developmentally and/or intellectually disabled minor in a facility or county program cannot be found after diligent effort or cannot give informed consent on behalf of a minor, facility or program staff may cause or initiate guardianship proceedings under chapter 6 of the act in a manner consistent with provisions of these rules. This provision does not exclude neglect proceedings in a juvenile court.

(2) In areas where minors are authorized by law to give consent, and a parent does not give consent, or a minor’s desire to not involve parents, the capacity of a minor to give informed consent is in doubt, the measures authorized by these rules may be applied to arrange for a guardian to give consent on behalf of a minor.

History

History: 1979 AC; 2018 AACS.

Mich. Admin. Code R 330.6025 Testimony in guardianship proceedings {#sec-r-330.6025 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6025}

Rule 6025. A facility or program director shall permit not less than 1 staff member who performed an evaluation in connection with a required report adequate time to testify at a probate court hearing on a guardianship petition.

History

History: 1979 AC.

Mich. Admin. Code R 330.6027 Termination or modification of guardianship {#sec-r-330.6027 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6027}

Rule 6027. (1) A facility or program director shall assist residents in requesting a probate court to dismiss a guardian and name a successor guardian, or to dissolve a guardianship order.

(2) If a facility or program director determines that a guardian of a resident should be replaced or that a guardianship should be dissolved, he shall petition the probate court.

Procedures for making this determination shall be adopted by the governing body of a facility or program.

(3) A facility or program director shall periodically review the need for guardianship where a facility or program staff member petitioned on behalf of a facility or program or where an interested person or entity filed a petition at the request of a staff member. This review shall be conducted once annually in the same manner as a determination of need for guardianship proceedings. In facilities, the review shall be made at the time of a periodic review. When the duration indicated in a court order of such a guardianship expires or is soon to expire, a person's continued need for the same type and scope of guardianship may be reviewed in the same manner as a periodic review.

(4) A report of an informed consent board which concludes that an existing guardianship should be continued or renewed shall be made a part of the case record. Upon a recommendation that an expiring guardianship should be renewed, a facility or program director may cause a guardianship proceeding to be commenced pursuant to these rules.

(5) A guardianship periodic review report may be used to the extent appropriate as part of a guardian's report to a court when the department or a county program has been appointed guardian.

History

History: 1979 AC.

Mich. Admin. Code R 330.6031 Information on guardianship procedures {#sec-r-330.6031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.6031}

Rule 6031. A county community mental health program providing services to the developmentally disabled shall provide information on guardianship procedures and on obtaining evaluations for guardianship proceedings on request to persons in the communities it serves. A facility receiving similar requests shall refer a person inquiring to an appropriate county community mental health agency or, if none is available, to another appropriate community agency. It shall not itself provide guardianship information unless the subject of an inquiry is a resident or other recipient of services from the facility.

History

History: 1979 AC; 1986 AACS.

R 330.7001 to R 330.7260 Part 7. Rights of Recipients

Mich. Admin. Code R 330.7001 Definitions {#sec-r-330.7001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7001}

MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF MENTAL HEALTH & SUBSTANCE ABUSE SERVICES

RIGHTS OF RECIPIENTS

(By authority conferred on the director of the department of community health by sections 1 to 4 of 1905 PA 80, section 33 of 1969 PA 306, and sections 114, 136, 157, 206, 244, 498n, 842, and 1002a of 1974 PA 258, MCL 19.141 to MCL 19.144, MCL 24.233, MCL 330.1114, MCL 330.1136, MCL 330.1206, MCL 330.1244, MCL 330.1498n, MCL 330.1842, and MCL 330.2002a)

PART 7. RIGHTS OF RECIPIENTS

SUBPART 1. GENERAL PROVISIONS

Rule 7001. As used in this part:

(a) "Abuse class I" means a nonaccidental act or provocation of another to act by an employee, volunteer, or agent of a provider that caused or contributed to the death, or sexual abuse of, or serious physical harm to a recipient.

(b) "Abuse class II" means any of the following:

(i) A non accidental act or provocation of another to act by an employee, volunteer, or agent of a provider that caused or contributed to nonserious physical harm to a recipient.

(ii) The use of unreasonable force on a recipient by an employee, volunteer, or agent of a provider with or without apparent harm.

(iii) Any action or provocation of another to act by an employee, volunteer, or agent of a provider that causes or contributes to emotional harm to a recipient.

(iv) An action taken on behalf of a recipient by a provider who assumes the recipient is incompetent, despite the fact that a guardian has not been appointed, that results in substantial economic, material, or emotional harm to the recipient.

(v) Exploitation of a recipient by an employee, volunteer, or agent of a provider.

(c) "Abuse class III" means the use of language or other means of communication by an employee, volunteer, or agent of a provider to degrade, threaten, or sexually harass a recipient.

(d) "Act" means mental health code, 1974 PA 258, MCL 330.1001 et seq.

(e) "Anatomical support" means body positioning or a physical support ordered by a physical or occupational therapist for the purpose of maintaining or improving a recipient's physical functioning.

(f) "Bodily function" means the usual action of any region or organ of the body.

(g) "Emotional harm" means impaired psychological functioning, growth, or development of a significant nature as evidenced by observable physical symptomatology or as determined by a mental health professional.

(h) "Exploitation" means an action by an employee, volunteer, or agent of a provider that involves the misappropriation or misuse of a recipient's property or funds for the benefit of an individual or individuals other than the recipient.

(i) "Neglect class I" means either of the following:

(i) Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by law and/or rules, policies, guidelines, written directives, procedures, or individual plan of service and causes or contributes to the death, or sexual abuse of, or serious physical harm to a recipient.

(ii) The failure to report apparent or suspected abuse Class I or neglect Class I of a recipient.

(j) "Neglect class II" means either of the following:

(i) Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by law, rules, policies, guidelines, written directives, procedures, or individual plan of service and that cause or contribute to non serious physical harm or emotional harm to a recipient.

(ii) The failure to report apparent or suspected abuse Class II or neglect Class II of a recipient.

(k) "Neglect class III" means either of the following:

(i) Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by law and/or rules, policies, guidelines, written directives, procedures, or individual plan of service that either placed or could have placed a recipient at risk of physical harm or sexual abuse.

(ii) The failure to report apparent or suspected abuse Class III or neglect Class III of a recipient.

(l) "Nonserious physical harm" means physical damage or what could reasonably be construed as pain suffered by a recipient that a physician or registered nurse determines could not have caused, or contributed to, the death of a recipient, the permanent disfigurement of a recipient, or an impairment of his or her bodily functions.

(m) "Physical management" means a technique used by staff as an emergency intervention to restrict the movement of a recipient by direct physical contact to prevent the recipient from harming himself, herself, or others.

(n) "Protective device" means a device or physical barrier to prevent the recipient from causing serious self-injury associated with documented and frequent incidents of the behavior. A protective device as defined in this subdivision and incorporated in the written individual plan of service shall not be considered a restraint as defined in subdivision (q) of this subrule.

(o) "Provider" means the department, each community mental health services program, each licensed hospital, each psychiatric unit, and each psychiatric partial hospitalization program licensed under section 137 of the act, their employees, volunteers, and contractual agents.

(p) "Psychotropic drug" means any medication administered for the treatment or amelioration of disorders of thought, mood, or behavior.

(q) "Restraint" means the use of a physical device to restrict an individual's movement.

Restraint does not include the use of a device primarily intended to provide anatomical support.

(r) "Serious physical harm" means physical damage suffered by a recipient that a physician or registered nurse determines caused or could have caused the death of a recipient, caused the impairment of his or her bodily functions, or caused the permanent disfigurement of a recipient.

(s)"Sexual abuse" means any of the following:

(i) Criminal sexual conduct as defined by section 520b to 520e of 1931 PA 318, MCL 750.520b to MCL 750.520e involving an employee, volunteer, or agent of a provider and a recipient.

(ii) Any sexual contact or sexual penetration involving an employee, volunteer, or agent of a department operated hospital or center, a facility licensed by the department under section 137 of the act or an adult foster care facility and a recipient.

(iii) Any sexual contact or sexual penetration involving an employee, volunteer, or agent of a provider and a recipient for whom the employee, volunteer, or agent provides direct services.

(t) "Sexual contact" means the intentional touching of the recipient's or employee's intimate parts or the touching of the clothing covering the immediate area of the recipient's or employee's intimate parts, if that intentional touching can reasonably be construed as being for the purpose of sexual arousal or gratification, done for a sexual purpose, or in a sexual manner for any of the following:

(i) Revenge.

(ii) To inflict humiliation.

(iii) Out of anger.

(u) "Sexual harassment" means sexual advances to a recipient, requests for sexual favors from a recipient, or other conduct or communication of a sexual nature toward a recipient.

(v) "Sexual penetration" means sexual intercourse, cunnilingus, fellatio, anal intercourse, or any other intrusion, however slight, of any part of a person's body or of any object into the genital or anal openings of another person's body, but emission of semen is not required.

(w)"Therapeutic de-escalation" means an intervention, the implementation of which is incorporated in the individualized written plan of service, wherein the recipient is placed in an area or room, accompanied by staff who shall therapeutically engage the recipient in behavioral de-escalation techniques and debriefing as to the cause and future prevention of the target behavior.

(x)"Time out" means a voluntary response to the therapeutic suggestion to a recipient to remove himself or herself from a stressful situation in order to prevent a potentially hazardous outcome.

(y)"Treatment by spiritual means" means a spiritual discipline or school of thought that a recipient wishes to rely on to aid physical or mental recovery.

(z)"Unreasonable force" means physical management or force that is applied by an employee, volunteer, or agent of a provider to a recipient in one or more of the following circumstances:

(i) There is no imminent risk of serious or non-serious physical harm to the recipient, staff or others.

(ii) The physical management used is not in compliance with techniques approved by the provider and the responsible mental health agency.

(iii) The physical management used is not in compliance with the emergency interventions authorized in the recipient's individual plan of service.

(iv) The physical management or force is used when other less restrictive measures were possible but not attempted immediately before the use of physical management or force.

Editor's Note: An obvious error in R 330.7001 was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2007 MR 23. The memorandum requesting the correction was published in Michigan Register, 2007 MR 23.

History

History: 1979 AC; 1983 AACS; 1998 AACS; 2007 AACS; 2009 AACS.

Mich. Admin. Code R 330.7002 Rescinded {#sec-r-330.7002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7002}

History

History: 1979 AC; 1998 AACS.

Rule 7003. (1) All of the following are elements of informed consent:

(a) Legal competency. An individual shall be presumed to be legally competent. This presumption may be rebutted only by a court appointment of a guardian or exercise by a court of guardianship powers and only to the extent of the scope and duration of the guardianship. An individual shall be presumed legally competent regarding matters that are not within the scope and authority of the guardianship.

(b) Knowledge. To consent, a recipient or legal representative must have basic information about the procedure, risks, other related consequences, and other relevant information. The standard governing required disclosure by a doctor is what a reasonable patient needs to know in order to make an informed decision. Other relevant information includes all of the following:

(i) The purpose of the procedures.

(ii) A description of the attendant discomforts, risks, and benefits that can reasonably be expected.

(iii) A disclosure of appropriate alternatives advantageous to the recipient.

(iv) An offer to answer further inquiries.

(c) Comprehension. An individual must be able to understand what the personal implications of providing consent will be based upon the information provided under subdivision (b) of this subrule.

(d) Voluntariness. There shall be free power of choice without the intervention of an element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion, including promises or assurances of privileges or freedom. There shall be an instruction that an individual is free to withdraw consent and to discontinue participation or activity at any time without prejudice to the recipient.

(2) A provider shall establish written policies that include procedures for evaluating comprehension and for assuring disclosure of relevant information and measures to ensure voluntariness before obtaining consent. The policies and procedures shall specify for specific circumstances the types of information that shall be disclosed and steps that may be taken to protect voluntariness. The procedures shall include a mechanism for determining whether guardianship proceedings should be considered.

(3) Informed consent shall be reobtained if changes in circumstances substantially change the risks, other consequences, or benefits that were previously expected.

(4) A written agreement documenting an informed consent shall not include any exculpatory language through which the recipient, or a person consenting on the recipient's behalf, waives or appears to waive, a legal right, including a release of a provider or its agents from liability for negligence. The agreement shall embody the basic elements of informed consent in the particular context. The individual, guardian, or parent consenting shall be given adequate opportunity to read the document before signing it. The requirement of a written consent shall not eliminate, where essential to the individual’s understanding or otherwise deemed advisable, a reading of the document to the individual or an oral explanation in a language the individual understands. A note of the explanation and by whom made shall be placed in the record along with the written consent.

(5) A consent is executed when it is signed by the appropriate individual.

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7005 Applicant request for second opinion; response; documentation {#sec-r-330.7005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7005}

Rule 7005. A community mental health services program shall have written procedures to assure that an applicant's request for a second opinion regarding denial of services is responded to in a timely manner and documented in the clinical record.

SUBPART 2. RIGHTS OF RECIPIENTS OF MENTAL HEALTH SERVICES

History

History: 1998 AACS.

Mich. Admin. Code R 330.7009 Civil rights {#sec-r-330.7009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7009}

Rule 7009. (1) A provider shall establish measures to prevent and correct a possible violation of civil rights related to the service provision. A violation of civil rights shall be regarded as a violation of recipient rights and shall be subject to remedies established for recipient rights violations.

(2) A recipient shall be permitted, to the maximum extent feasible and in any legal manner, to conduct personal and business affairs and otherwise exercise all rights, benefits, and privileges not divested or limited.

(3) An adult recipient, and a minor when state law allows consent by a minor, shall be presumed legally competent. The presumption may be rebutted only by court appointment of a guardian or exercise by a court of guardianship powers and only to the extent of the scope and duration of that guardianship. A provider shall do all of the following:

(a) Presume the recipient is legally competent if he or she does not have a guardian. A provider shall also presume a recipient with a limited guardian is legally competent in all areas which are not specifically identified as being under the control or scope of the guardian.

(b) Not institute guardianship proceedings, unless there is sufficient reason to doubt the recipient's comprehension, as provided under these rules and the policies and procedures of the provider.

(c) When a recipient's comprehension is in doubt, justification for petitioning the probate court for guardianship consideration shall be entered in the recipient's clinical record.

(d) Not petition for, or otherwise cause the filing of, a petition for guardianship of greater scope than is essential.

(e) Petition or cause a petition to be filed with the court to terminate a recipient's guardian or narrow the scope of the guardian's powers when the recipient demonstrates he or she is capable of providing informed consent.

(4) A provider shall not interfere with the right of a recipient to enter into a marriage contract or obtain or oppose a divorce.

(5) The right of a recipient to participate in the electoral process, including primaries and special and recall elections shall not be abridged. An eligible recipient, including a recipient determined to be legally incompetent, shall have the right to exercise his or her franchise, except those the legislature may exclude from the electoral process by defining mental incompetence in any statute implementing article 2, section 2 of the state constitution of 1963. Facilities shall have procedures which assure all the following:

(a) All recipients 18 years of age or over are canvassed to ascertain their interest in registering to vote, obtaining absentee ballots, and casting ballots. The canvass shall be conducted to allow sufficient time for voter registration and acquisition of absentee ballot, or provided recipients with an opportunity to leave the premises to exercise voting privileges, or to register to vote, or a facility director may require supervisory personnel to accompany recipients and may require recipients to bear reasonable transportation costs.

(b) Arrangements with state and local election officials are made to provide voter registration and casting of ballots for interested recipients at the facility or may elect to encourage the use of absentee ballots.

(d) Facilities shall not prohibit a recipient from receiving campaign literature, shall permit campaigning by candidates, and may reasonably regulate the time, duration, and location of these activities. A facility director shall permit a recipient to place political advertisements in his or her personal quarters.

(6) A recipient shall be permitted access to religious services and worship on a nondiscriminatory basis. A recipient shall not be coerced into engaging in religious activity.

(7) A recipient's property or living area shall not be searched by a provider unless such a search is authorized in the recipient's plan of service or there is reasonable cause to believe that the recipient is in possession of contraband or property that is excluded from the recipient's possession by the written policies, procedures, or rules of the provider. The following conditions apply to all searches:

(a) A search of the recipient's living area or property shall occur in the presence of a witness. The recipient shall also be present unless he or she declines to be present.

(b) The circumstances surrounding the search shall be entered in the recipient's record, and shall include all the following:

(i) The reason for initiating the search.

(ii) The names of the individuals performing and witnessing the search.

(iii) The results of the search, including a description of the property seized.

History

History: 1979 AC; 1983 AACS; 1984 AACS; 1998 AACS; 2007 AACS.

Mich. Admin. Code R 330.7011 Notification of rights {#sec-r-330.7011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7011}

Rule 7011. At the time services are first requested, a provider shall inform a recipient, his or her guardian, or other legal representative or the parent with legal custody of a minor recipient of the recipient's lawful rights in an understandable manner. If a recipient is unable to read or understand the materials provided, a provider shall make a reasonable attempt to assist the recipient in understanding the materials. A note describing the explanation of the materials and who provided the explanation shall be entered in the recipient's record.

History

History: 1979 AC; 1998 AACS; 2007 AACS.

Mich. Admin. Code R 330.7012 Provider confidentiality obligations {#sec-r-330.7012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7012}

Rule 7012. Observing the rights of family members specified in section 711 of the act does not relieve the provider of observing the confidentiality obligations specified in sections 748 and 750 of the act.

History

History: 1998 AACS.

Mich. Admin. Code R 330.7014 Rescinded {#sec-r-330.7014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7014}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7017 Electroconvulsive therapy {#sec-r-330.7017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7017}

Rule 7017. (1) A provider shall comply with both of the following provisions when administering electroconvulsive therapy:

(a) A provider shall enter written documentation and signed consent in the clinical record.

(b) A provider shall obtain consent for a stated number of electroconvulsive treatments within a series during a stated time period. A provider shall inform a recipient or other legally empowered representative that he or she may withdraw his or her consent at any time during the stated time period.

(2) The responsible mental health agency shall notify a minor or an advocate designated by the minor of the right to object to a procedure as specified in section 717(5) of the act.

A provider shall place documentation of the notification, including the date and time notified in the clinical record.

(3) The responsible mental health agency shall assist a minor or an advocate designated by the minor who objects to an electroconvulsive procedure in properly submitting the objection to a court of competent jurisdiction.

History

History: 1998 AACS.

Mich. Admin. Code R 330.7029 Family planning and health information {#sec-r-330.7029 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7029}

Rule 7029. The individual in charge of the recipient’s written plan of service shall provide recipients, their guardians, and parents of minor recipients with notice of the availability of family planning, and health information services and, upon request, provide referral assistance to providers of such services. The notice shall include a statement that receiving mental health services does not depend in any way on requesting or not requesting family planning or health information services.

History

History: 1979 AC; 1986 AACS; 1998 AACS.

Mich. Admin. Code R 330.7032 Rescinded {#sec-r-330.7032 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7032}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7035 Abuse or neglect of recipients {#sec-r-330.7035 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7035}

Rule 7035. (1) Abuse or neglect of a recipient by an employee, volunteer, or agent of a provider shall subject the employee, volunteer, or agent of a provider, upon substantiated reports, to an appropriate penalty, including official reprimand, demotion, suspension, reassignment, or dismissal.

(2) A provider shall do both of the following:

(a) Establish written policies and procedures, which adopt and incorporate the definitions of abuse class I, abuse class II, or abuse class III and neglect as neglect class I, neglect class II, or neglect class III as described in rule 7001.

(b) Provide for a prompt and thorough review of charges of abuse that is fair to both the recipient alleged to have been abused and the charged employee, volunteer, or agent of a provider.

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7037 Rescinded {#sec-r-330.7037 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7037}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7045 Rescinded {#sec-r-330.7045 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7045}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7046 Summary reports of extraordinary incidents {#sec-r-330.7046 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7046}

Rule 7046. In addition to other information required to be contained in the clinical record of the recipient by statute and rule, the record shall contain a summary of any extraordinary incidents involving the recipient. The report is to be entered into the record by a staff member who has personal knowledge of the extraordinary incident. An incident or peer review report generated pursuant to MCL 330.1143a does not constitute a summary report as intended by this section and shall not be maintained in the clinical record of a recipient.

History

History: 1998 AACS; 2007 AACS.

Mich. Admin. Code R 330.7051 Confidentiality and disclosure {#sec-r-330.7051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7051}

Rule 7051. (1) A summary of section 748 of the act shall be made a part of each recipient file.

(2) A record shall be kept of disclosures and shall include all of the following information:

(a) The information released.

(b) To whom the information is released.

(c) The purpose claimed by the person for requesting the information and a statement disclosing how the disclosed information is germane to the purpose.

(d) The subsection of section 748 of the act, or other state law, under which a disclosure was made.

(e) A statement that the receiver of disclosed information was informed that further disclosure shall be consistent with the authorized purpose for which the information was released.

(3) Unless section 748(4) of the act applies to the request for information, the director of the provider may make a determination that disclosure of information may be detrimental to the recipient or others. If the director of the provider declines to disclose information because of possible detriment to the recipient or others, then the director of the provider shall determine whether part of the information may be released without detriment. A determination of detriment shall not be made if the benefit to the recipient from the disclosure outweighs the detriment. If the record of the recipient is located at the resident’s facility, then the director of the provider shall make a determination of detriment within 3 business days from the date of the request. If the record of the recipient is located at another location, then the director of the provider shall make a determination of detriment within 10 business days from the date of the request. The director of the provider shall provide written notification of the determination of detriment and justification for the determination to the person who requested the information. If a determination of detriment has been made and the person seeking the disclosure disagrees with that decision, he or she may file a recipient rights complaint with the office of recipient rights of the department, the community mental health services program, or licensed hospital, whichever was responsible for making the original determination.

(4) Information shall be provided to attorneys, other than prosecuting attorneys, as follows:

(a) An attorney who is retained or appointed by a court to represent a recipient and who presents identification and a consent or release executed by the recipient, by a legally empowered guardian, or by the parents of a minor shall be permitted to review, on the provider's premises, a record containing information concerning the recipient. An attorney who has been retained or appointed to represent a minor pursuant to an objection to hospitalization of a minor shall be allowed to review the records.

(b) Absent a valid consent or release, an attorney who does not represent a recipient shall not be allowed to review records, unless the attorney presents a certified copy of an order from a court directing disclosure of information concerning the recipient to the attorney.

(c) An attorney shall be refused written or telephoned requests for information, unless the request is accompanied or preceded by a certified copy of an order from a court ordering disclosure of information to that attorney or unless a consent or release has been appropriately executed. The attorney shall be advised of the procedures for reviewing and obtaining copies of recipient records.

(5) Information shall be provided to private physicians or psychologists appointed or retained to testify in civil, criminal, or administrative proceedings as follows:

(a) A physician or psychologist who presents identification and a certified true copy of a court order appointing the physician or psychologist to examine a recipient for the purpose of diagnosing the recipient's present condition shall be permitted to review, on the provider's premises, a record containing information concerning the recipient. Physicians or psychologists shall be notified before the review of records when the records contain privileged communication that cannot be disclosed in court under section 750(1) of the act.

(b) The court or other entity that issues a subpoena or order and the attorney general's office, when involved, shall be informed if subpoenaed or ordered information is privileged under a provision of law. Privileged information shall not be disclosed unless disclosure is permitted because of an express waiver of privilege or because of other conditions that, by law, permit or require disclosure.

(6) A prosecutor may be given nonprivileged information or privileged information that may be disclosed pursuant to section 750(2) of the act if it contains information relating to participation in proceedings under the act, including all of the following information:

(a) Names of witnesses to acts that support the criteria for involuntary admission (b) Information relevant to alternatives to admission to a hospital or facility.

(7) The holder of a record may disclose information that enables a recipient to apply for or receive benefits without the consent of the recipient or legally authorized representative only if the benefits shall accrue to the provider or shall be subject to collection for liability for mental health service.

SUBPART 3. ADDITIONAL RIGHTS OF RESIDENTS OF FACILITIES

History

History: 1979 AC; 1981 AACS; 1986 AACS; 1990 AACS; 1998 AACS.

Mich. Admin. Code R 330.7125 Rescinded {#sec-r-330.7125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7125}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7135 Treatment by spiritual means {#sec-r-330.7135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7135}

Rule 7135. (1) A provider shall permit a recipient to have access to treatment by spiritual means upon the request of the recipient, a guardian, if any, or a parent of a minor recipient.

(2) A provider shall assure that the opportunity for contact with agencies providing treatment by spiritual means is provided in the same manner as recipients are permitted to see private mental health professionals.

(3) Requests for printed, recorded, or visual material essential or related to treatment by spiritual means, and to a symbolic object of similar significance shall be honored and made available at the recipient’s expense.

(4) Treatment by spiritual means includes the right of recipients, guardians, or parents of a minor to refuse medication or other treatment on spiritual grounds that predate the current allegations of mental illness or disability, but does not extend to circumstances where either of the following provisions applies:

(a) A guardian or the provider has been empowered by a court to consent to or provide treatment and has done so.

(b) A recipient poses harm to himself or herself or others and treatment is essential to prevent physical injury.

(5) The right to treatment by spiritual means does not include the right to any of the following:

(a) To use mechanical devices or chemical or organic compounds that are physically harmful.

(b) To engage in activity prohibited by law.

(d) To engage in activity that is inconsistent with court-ordered custody or voluntary placement by a person other than the recipient.

(6) A provider shall develop written policies and procedures concerning treatment by spiritual means that include both of the following:

(a) Recourse to court proceedings if medication or other treatment for a minor is refused.

(b) Notice to a person who requests treatment by spiritual means of a denial of the request and the reasons for denial.

(7) A provider shall provide for the administrative review or appeal of a denial of treatment by spiritual means at the option of a person requesting such treatment.

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7139 Resident's right to entertainment materials, information, and news {#sec-r-330.7139 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7139}

Rule 7139. (1) A provider shall not prevent a resident from acquiring entertainment materials, information and news at his or her expense, or from reading written or printed material, or from viewing or listening to television, radio, recordings, or movies made available at a facility for reasons of, or similar to, censorship.

(2) A provider may limit access to entertainment materials, information, or news only if such a limitation is specifically approved in the resident’s individualized plan of service.

(3) A provider shall document each instance when a limitation is imposed in the resident’s record.

(4) A provider shall not limit access to entertainment materials, information or news when such limitations can no longer be clinically justified.

(5) Material not prohibited by law may be read or viewed by a minor unless there is an objection by the minor’s parent or guardian who has legal custody of the minor.

(6) A provider shall establish written policies and procedures that provide for all of the following:

(a) Any general program restrictions on access to material for reading, listening, or viewing.

(b) Determining a resident’s interest in, and provide for, a daily newspaper.

(c) Permit attempts by the staff person in charge of the plan of service to persuade a parent or guardian of a minor to withdraw objections to material desired by the minor.

(d) A mechanism for residents to appeal denial of their right to entertainment materials, information and news, and to remedy a wrongful denial.

(e) Any specific restrictions on a living unit or for the therapeutic benefit of the residents as a group.

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7142 Rescinded {#sec-r-330.7142 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7142}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7145 Rescinded {#sec-r-330.7145 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7145}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7151 Rescinded {#sec-r-330.7151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7151}

History

History: 1979 AC; 1990 AACS; 1998 AACS.

Mich. Admin. Code R 330.7158 Medication {#sec-r-330.7158 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7158}

Rule 7158. (1) A provider shall only administer medication at the order of a physician and in compliance with the provisions of section 719 of the act, if applicable.

(2) A provider shall assure that medication use conforms to federal standards and the standards of the medical community.

(3) A provider shall not use medication as punishment, for the convenience of the staff, or as a substitute for other appropriate treatment.

(4) A provider shall review the administration of a psychotropic medication periodically as set forth in the recipient's individual plan of service and based upon the recipient's clinical status.

(5) If an individual cannot administer his or her own medication, a provider shall ensure that medication is administered by or under the supervision of personnel who are qualified and trained.

(6) A provider shall record the administration of all medication in the recipient's clinical record.

(7) A provider shall ensure that medication errors and adverse drug reactions are immediately and properly reported to a physician and recorded in the recipient's clinical record.

(8) A provider shall ensure that the use of psychotropic medications is subject to the following restrictions:

(a) Unless the individual consents or unless administration of chemotherapy is necessary to prevent physical injury to the individual or to others psychotropic medications shall not be administered to:

(i) A recipient who has been admitted by medical certification or by petition until after a final adjudication as required under section 468(2) of the act.

(ii) A defendant undergoing examination at the center for forensic psychiatry or other certified facility to determine competency to stand trial.

(iii) A person acquitted of a criminal charge by reason of insanity while undergoing examination and evaluation at the center for forensic psychiatry.

(b) A provider may administer chemotherapy to prevent physical harm or injury after signed documentation of the physician is placed in the resident's clinical record and when the actions of a recipient or other objective criteria clearly demonstrate to a physician that the recipient poses a risk of harm to himself, herself, or others.

(c) Initial administration of psychotropic chemotherapy may not be extended beyond 48 hours unless there is consent. The duration of psychotropic chemotherapy shall be as short as possible and at the lowest possible dosage that is therapeutically effective. The chemotherapy shall be terminated as soon as there is little likelihood that the recipient will pose a risk of harm to himself, herself, or others.

(d) Additional courses of chemotherapy may be prescribed and administered if a recipient decompensates and again poses a risk to himself, herself, or others.

(9) A provider shall ensure that only medication that is authorized in writing by a physician is given to recipients upon his or her leave or discharge from the providers program and that enough medication is made available to ensure the recipient has an adequate supply until he or she can become established with another provider.

History

History: 1979 AC; 1981 AACS; 1986 AACS; 1998 AACS; 2007 AACS.

Mich. Admin. Code R 330.7161 Rescinded {#sec-r-330.7161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7161}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7165 Rescinded {#sec-r-330.7165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7165}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7171 Resident health, hygiene, and personal grooming {#sec-r-330.7171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7171}

Rule 7171. Provisions for resident health, hygiene, and personal grooming shall include assisting and training residents to exercise maximum capability in personal grooming practices, including bathing, tooth brushing, shampooing, hair grooming, shaving, and care of nails. In addition, a resident shall be provided with all of the following:

(a) Toilet articles.

(b) A toothbrush and dentifrice.

(d) The services of a barber or a beautician on a regular basis.

(e) If a male, the opportunity to shave daily.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.7175 Rescinded {#sec-r-330.7175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7175}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7181 Rescinded {#sec-r-330.7181 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7181}

History

History: 1979 AC; 1990 AACS; 1998 AACS.

Mich. Admin. Code R 330.7185 Rescinded {#sec-r-330.7185 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7185}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7188 Rescinded {#sec-r-330.7188 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7188}

History

History: 1979 AC; 1983 AACS; 1998 AACS.

Mich. Admin. Code R 330.7189 Rescinded {#sec-r-330.7189 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7189}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7191 Rescinded {#sec-r-330.7191 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7191}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7195 Rescinded {#sec-r-330.7195 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7195}

SUBPART 3. ADDITIONAL RIGHTS OF RESIDENTS OF FACILITIES

History

History: 1979 AC; 1990 AACS; 1998 AACS.

Mich. Admin. Code R 330.7199 Written plan of services {#sec-r-330.7199 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7199}

Rule 7199. (1) The individualized written plan of services is the fundamental document in the recipient's record. A provider shall retain all periodic reviews, modifications, and revisions of the plan in the recipient's record.

(2) The plan shall identify, at a minimum, all of the following:

(a) All individuals, including family members, friends, and professionals that the individual desires or requires to be part of the planning process.

(b) The services, supports, and treatments that the recipient requested of the provider.

(c) The services, supports, and treatments committed by the responsible mental health agency to honor the recipient's request specified in subdivision (b) of this subrule.

(d) The person or persons who will assume responsibility for assuring that the committed services and supports are delivered.

(e) When the recipient can reasonably expect each of the committed services and supports to commence, and, in the case of recurring services or supports, how frequently, for what duration, and over what period of time.

(f) How the committed mental health services and supports will be coordinated with the recipient's natural support systems and the services and supports provided by other public and private organizations.

(g) Limitations of the recipient's rights. Limitations of the recipient’s rights, any intrusive behavior treatment techniques, orany use of psycho-active drugs for behavior control purposesshall be reviewed and approved by a specially constituted body comprised of at least 3 individuals, 1 of whom shall be a fully- or limited- licensed psychologist with the formal training or experience in applied behavior analysis, and 1 of whom shall be a licensed physician/psychiatrist. Both of the following apply:

(i) Limitations of the recipient’s rights, any intrusive treatment techniques or any use of psychoactive drugs where the target behavior is due to an active substantiated Axis 1 psychiatric diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders need not be reviewed and approved by a specially constituted body described in this subdivision. DSM-IV-TR (Text Revision), 2000, published by the American Psychiatric Association, is adopted by reference and can be obtained from American Psychiatric Publishing Inc., 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209 at a cost of $60.00. This manual is also available from the Michigan Department of Community Health, Office of Psychiatric and Medical Services, 320 South Walnut, Lansing, MI 48913 for the cost noted above plus $20.00 shipping and handling.

(ii) Any limitation shall be justified, time-limited, and clearly documented in the plan of service. Documentation shall be included that describes attempts that have been made to avoid limitations, as well as what actions will be taken as part of the plan to ameliorate or eliminate the need for the limitations in the future.

(h) Strategies for assuring that a recipient hasaccess to needed and available supports identified through a review of his or her needs. Areas of possible need may include any of the following:

(i) Food.

(ii) Shelter.

(iii) Clothing.

(iv) Physical health care.

(v) Employment.

(vi) Education.

(vii) Legal services.

(viii) Transportation.

(ix) Recreation.

(i) A description of any involuntary procedures and the legal basis for performing them.

(j) A specific date or dates when the overall plan, and any of its subcomponents will be formally reviewed for possible modification or revision.

(3) The plan shall not contain privileged information or communications.

(4) Except as otherwise noted in subrule (5) of this rule, the individual plan of service shall be formally agreed to in whole or in part by the responsible mental health agency and the recipient, his or her guardian, if any, or the parent who has legal custody of a minor recipient. If the appropriate signatures are unobtainable, then the responsible mental health agency shall document witnessing verbal agreement to the plan. Copies of the plan shall be provided to the recipient, his or her guardian, if any, or the parent who has legal custody of a minor recipient.

(5) Implementation of a plan without agreement of the recipient, his or her guardian, if any, or parent who has legal custody of a minor recipient may only occur when a recipient has been adjudicated undersection 469a, 472a, 473, 515, 518, or 519 of the act.

However, if the proposed plan in whole or in part is implemented without the concurrence of the adjudicated recipient or his or her guardian, if any, or the parent who has legal custody of a minor recipient, then the stated objections of the recipient or his or her guardian or the parent who has legal custody of a minor recipient shall be included in the plan.

History

History: 1979 AC; 1984 AACS; 1986 AACS; 1990 AACS; 1998 AACS; 2007 AACS; 2009 AACS; 2012 AACS.

Mich. Admin. Code R 330.7205 Rescinded {#sec-r-330.7205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7205}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7227 Rescinded {#sec-r-330.7227 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7227}

History

History: 1979 AC; 1981 AACS; 1983 AACS; 1998 AACS.

Mich. Admin. Code R 330.7229 Rescinded {#sec-r-330.7229 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7229}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7231 Rescinded {#sec-r-330.7231 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7231}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7235 Rescinded {#sec-r-330.7235 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7235}

History

History: 1979 AC; 1983 AACS; 1998 AACS.

Mich. Admin. Code R 330.7239 Rescinded {#sec-r-330.7239 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7239}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7243 Restraint seclusion, and physical management {#sec-r-330.7243 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7243}

Rule 7243. (1) A provider shall keep a separate, permanent chronological record specifically identifying all instances when restraint or seclusion has been used. The record shall include all of the following information:

(a) The name of the recipient.

(b) The type of restraint or conditions of seclusion.

(d) The date and time placed in temporary, authorized, and ordered restraint or seclusion.

(e) The date and time the recipient was removed from temporary, authorized, and ordered restraint or seclusion.

(2) A recipient who is in restraint or seclusion shall be inspected at least once every 15 minutes by designated personnel.

(3) A provider shall ensure that documentation of staff monitoring and observation is entered into the medical record of the recipient.

(4) A recipient in restraint or seclusion shall be provided hourly access to a toilet.

(5) A recipient in restraint or seclusion shall have an opportunity to bathe, or shall be bathed as often as needed, but at least once every 24 hours.

(6) If an order for restraint or seclusion is to expire and the continued use of restraint or seclusion is clinically indicated and must be extended, then a physician's reauthorization or reordering of restraint or seclusion shall comply with both of the following provisions:

(a) If the restraint device is a cloth vest and is used to limit the resident's movement at night to prevent the recipient from injuring himself or herself in bed, the physician may reauthorize or reorder the continued use of the cloth vest device pursuant to section 740(4) and(5) of the act.

(b) Except as specified in subdivision (a) of this subrule, a physician who orders or reorders restraint or seclusion shall do so in accordance with sections 740(5) and 742(5) of the act. The required examination by a physician shall be conducted not more than 30 minutes before the expiration of the expiring order for restraint or seclusion.

(7) If a recipient is removed from restraint or seclusion for more than 30 minutes, then the order or authorization shall terminate.

(8) A provider shall ensure that a secluded or restrained recipient is given an explanation of why he or she is being secluded or restrained and what he or she needs to do to have the restraint or seclusion order removed. The explanation shall be provided in clear behavioral terms and documented in the record.

(9) For restrained recipients, a provider shall ensure that an assessment of the circulation status of restrained limbs is conducted and documented at 15-minute intervals or more often if medically indicated.

(10) For purposes of this rule, a time out or therapeutic de-escalation program, as defined in R 330.7001, is not a form of seclusion.

(11) Physical management as defined in R 330.7001 (m) may only be used in situations when a recipient is presenting an imminent risk of serious or non-serious physical harm to himself, herself or others and lesser restrictive interventions have been unsuccessful in reducing or eliminating the imminent risk of serious or non-serious physical harm. Both of the following shall apply:

(i) Physical management shall not be included as a component in a behavior treatment plan.

(ii) Prone immobilization of a recipient for the purpose of behavior control is prohibited unless implementation of physical management techniques other than prone immobilization is medically contraindicated and documented in the recipient's record.

History

History: 1979 AC; 1981 AACS; 1983 AACS; 1984 AACS; 1998 AACS; 2007 AACS; 2009 AACS.

Mich. Admin. Code R 330.7251 Rescinded {#sec-r-330.7251 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7251}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7253 Rescinded {#sec-r-330.7253 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7253}

History

History: 1979 AC; 1986 AACS; 1990 AACS; 1998 AACS.

Mich. Admin. Code R 330.7254 Rescinded {#sec-r-330.7254 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7254}

History

History: 1979 AC; 1998 AACS.

Mich. Admin. Code R 330.7260 Declaratory rulings {#sec-r-330.7260 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.7260}

Rule 7260. (1) A person who requests a decision concerning the applicability of a statute, rule, guideline, or order administered or issued by the department to an actual state of facts shall do so by means of a request for a declaratory ruling.

(2) The request for a declaratory ruling shall be made on the department's form 2447 which may be obtained from Office Services, Sixth Floor, Lewis Cass Building, Lansing, Michigan 48926.

(3) The completed request for a declaratory ruling shall be made to the director, Department of Mental Health, Lewis Cass Building, Lansing, Michigan 48926.

(4) The director may refer a request to the administrative tribunal of the department. An opinion on the request shall be rendered within 60 days of the receipt of that request.

History

History: 1981 AACS.

R 330.8005 to R 330.8284 Financial Liability for Mental Health Services

Mich. Admin. Code R 330.8005 Definitions {#sec-r-330.8005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8005}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITY

ADMINISTRATION

FINANCIAL LIABILITY FOR MENTAL HEALTH SERVICES

(By authority conferred on the department of health and human services by sections 114, 818, and 842 of the mental health code, 1974 PA 258, MCL 330.1114, 330.1818, and 330.1842)

PART 8. FINANCIAL LIABILITY FOR MENTAL HEALTH SERVICES

SUBPART 1. DEPARTMENT OF MENTAL HEALTH

Rule 8005. As used in this part:

(a) "Assets" means real and personal property that is owned, in whole or in part, by the responsible party and that has cash value or equity value.

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

(c) "Dependent" means an individual who is allowed as an exemption under section 30 of the income tax act of 1967, 1967 PA 281, MCL206.30.

(d) “Excess medical expenses” means medical and dental expenses that exceed the threshold dictated by section 16 of the internal revenue code of 1986, 26 USC 213, that would be allowed to be deducted on itemized tax returns, less expenses for medical health services for the individual paid to the department or community mental health services programs.

(e) “Family of 1” means the individual who has no dependent.

(f) “Family of 2” means the individual and their spouse.

(g) “Family size” means a family unit consisting of the individual, spouse, and dependents.

(h) “Individual” means the individual, minor or adult, that receives services from the department or a community mental health services program or from a provider under contract with the department or a community mental health services program.

(i) “Liquid asset” means an asset that can be easily converted to cash. Examples of liquid assets include, but are not limited to, the following:

(i) Checking and savings accounts.

(ii) Cash.

(iii) Certificates of deposit.

(iv) Treasury bills.

(v) Money market investments.

(vi) Bonds.

(vii) Marketable securities, including stocks and bonds.

(viii) Pensions.

(ix) Deferred compensation.

(x) Annuities.

(xi) Other funds that can be withdrawn or used as collateral for a loan.

(j) “Poverty guidelines” means the version of the poverty threshold as issued annually by the United States Department of Human Services.

(k) "Protected assets" means the portion of assets, as specified in these rules, that must not be considered when the total financial circumstance is used to determine financial liability.

(l) "Protected income" means the portion of income, as specified in these rules, that must not be considered when the total financial circumstance is used to determine financial liability.

(m) “Qualifying income” means income from whatever source derived, regardless of whether the source is reported on federal or state returns. Qualifying income includes, but is not limited to, the following:

(i) Earned and unearned income.

(ii) Government benefits.

(iii) Other entitlements.

(n) “Responsible party” means a person who is financially liable for services furnished to an individual, including the individual, and, as applicable, the individual’s spouse and parent or parents of a minor.

(o) "Spouse" means the legal marriage partner of the individual.

(p) "Undue financial burden" means a determination of ability-to-pay that would unduly impact the health and well-being of the individual or dependents to access the basic necessities of life, including, but not limited to, food, housing, clothing, and healthcare.

History

History: 1979 AC; 1981 AACS; 1997 AACS; 2022 AACS.

Mich. Admin. Code R 330.8008 Application of rules and policies {#sec-r-330.8008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8008}

Rule 8008. Financial liability for services approved for state financial support by the department and provided by the department or community mental health services programs directly or under contract shall be determined pursuant to these rules and stated in the department’s and community mental health services programs’ written policies and procedures.

History

History: 1979 AC; 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8012 Charges for invalid admission {#sec-r-330.8012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8012}

Rule 8012. The department shall charge counties and responsible parties for state services rendered to an involuntary patient or judicially admitted individual, unless it has been medically determined under the act that the individual is not a person requiring treatment or that the individual does not meet the criteria for judicial admission or unless it is determined that probable cause for involuntary admission does not exist.

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.8014 Review of financial liability determination {#sec-r-330.8014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8014}

Rule 8014. Determination of financial liability shall be reviewed not less often than annually after an initial determination. Services shall not be withheld pending review of financial liability.

History

History: 1979 AC.

Mich. Admin. Code R 330.8016 Limitations of individual and spouse financial liability {#sec-r-330.8016 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8016}

Rule 8016. Calculation of the total days of care as a resident in a facility for which a spouse is financially liable shall include the days of care for which the spouse alone or the spouse and individual jointly have been liable in accordance with all previous determinations of liability by the state or a county.

History

History: 1979 AC.

Mich. Admin. Code R 330.8018 Limitation of parental liability {#sec-r-330.8018 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8018}

Rule 8018. Calculation of the total liability of parents for care of children as residents in facilities shall include the days of care for which the parents have been liable in accordance with previous determinations of liability by the state or a county.

History

History: 1979 AC.

Mich. Admin. Code R 330.8021 Appeal of determination of financial liability {#sec-r-330.8021 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8021}

Rule 8021. An individual receiving services, his spouse, or his parent may appeal the amount of financial liability by notifying the director of the facility or county community mental health services board in writing or on a form provided by the department, within 30 days of obtaining a new determination.

History

History: 1979 AC.

Mich. Admin. Code R 330.8024 Payment of transcription costs of contested hearings {#sec-r-330.8024 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8024}

Rule 8024. A party who requests a transcription of a contested hearing at which oral evidence has been recorded shall pay for the reasonable costs of the production of that transcript. Reasonable costs for a transcript shall be the number of pages multiplied by the current department of management and budget transcription cost per page plus postage and handling.

SUBPART 2. COMMUNITY MENTAL HEALTH

History

History: 1981 AACS.

Mich. Admin. Code R 330.8201 Rescinded {#sec-r-330.8201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8201}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8204 Rescinded {#sec-r-330.8204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8204}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8205 Rescinded {#sec-r-330.8205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8205}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8206 Rescinded {#sec-r-330.8206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8206}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8207 Rescinded {#sec-r-330.8207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8207}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8208 Rescinded {#sec-r-330.8208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8208}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8209 Limitation on concurrent determinations of ability to pay {#sec-r-330.8209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8209}

Rule 8209. There shall be only 1 ability-to-pay determination in effect for a responsible party at any given time and there shall be a cooperative, collaborative effort among the department, the community mental health services programs, and the department’s and programs’ contractors to assure that the information is available to all appropriate service providers.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8210 Rescinded {#sec-r-330.8210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8210}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8214 Delay of emergency services prohibited {#sec-r-330.8214 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8214}

Rule 8214. The process of determining financial liability shall not delay the provision of required emergency mental health services.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8215 Explanation of financial liability process {#sec-r-330.8215 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8215}

Rule 8215. The department and the community mental health services programs shall provide an explanation of the financial liability process before the start of service or as soon as practical thereafter. The explanation shall be given orally and in writing in a language and manner understandable by the responsible party, and a service charge schedule shall be made available to the party.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8217 Minor seeking treatment under section 707 of the act {#sec-r-330.8217 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8217}

Rule 8217. A minor who is 14 years of age or older and who is seeking treatment under section 707 of the act shall be considered as the responsible party for the determination of ability to pay if the parents are not notified of the treatment.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8220 Rescinded {#sec-r-330.8220 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8220}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8224 Rescinded {#sec-r-330.8224 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8224}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8227 Rescinded {#sec-r-330.8227 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8227}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8229 Rescinded {#sec-r-330.8229 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8229}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8230 Rescinded {#sec-r-330.8230 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8230}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8234 Rescinded {#sec-r-330.8234 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8234}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8237 Rescinded {#sec-r-330.8237 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8237}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8238 Rescinded {#sec-r-330.8238 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8238}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8239 Determination of ability-to-pay for non-residential services; parents of an individual; member or non-member of the household {#sec-r-330.8239 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8239}

Rule 8239. (1) A responsible party’s ability-to-pay for nonresidential services must be the amount established by this rule’s non-residentialability-to-pay table based upon the responsible party’s qualifying income and the most current poverty guidelines. The responsible party’s ability-to-pay must be established on a per-session, monthly, or annual basis, and the basis selected, and methodology used must be identified and described in the department’s and community mental health services program’s written policies.

(2) The ability-to-pay for a parent of an individual must be determined, as follows:

(a) If the parents of an individual, or the individual and spouse, are members of the same household, the department or community mental health services program shall use the combined qualifying income to determine the ability-to-pay.

(b) If the parents of an individual, or the individual and spouse, are not members of the same household, the ability-to-pay of each parent or of the individual and their spouse is determined separately.

(c) A parent shall not be determined to have an ability-to-pay for more than 1 individual at any 1 time, and a parent's total liability for 2 or more individuals shall not exceed 18 years.

(d) If either parent or either spouse has been made solely responsible for an individual's medical and hospital expenses by a court order, the other parent or spouse is determined to have no ability-to-pay.

(e) The ability-to-pay of the parent or spouse made solely responsible by court order must be determined in accordance with this section. The ability-to-pay of a parent made solely responsible by court order must be reduced by the amount of child support the parent pays for the individual.

(f) If an individual receives services for more than 1 year, the department or community mental health services program m u s t annually redetermine the adult responsible parties' ability-to-pay.

(3) An ability-to-pay may be determined on a per-session basis for nonresidential services other than respite care services. During a calendar month, the per-session abilityto-pay must not be more than the monthly ability-to-pay amount determined from the nonresidential ability-to-pay process and table specified as follows:

(a) Determine the percent of poverty specified as the current federal minimum mandatory income level to qualify for medical assistance program or its successor, as specified in the patient protection and affordable care act of 2010, Public Law 111-148, or its successor.

(b) Multiply 100% of poverty guideline income for family size by the percentage determined in subdivision (a) of this subrule. The result is the income level at which the responsible party will have zero ability-to-pay from this table.

(d) Divide qualifying income by income calculated in subdivision (b) of this subrule and convert to a percentage.

(e) Match the percentage determined in subdivision (d) of this subrule to the table in subrule (4) of this rule to determine the percent of income to charge as the ability-to-pay.

(f) Deduct from qualifying income the poverty guideline income for family size determined in subrule (b) of this rule, at which the responsible party will have zero abilityto-pay. The result is income available for cost of care.

(g) Multiply the percentage determined in subrule (e) of this rule by income available for cost of care determined in subrule (f) of this rule. The result is the annual ability-to-pay.

(4) The following income and ability-to-pay crosswalk table must be used in the determination of the percent income for subrule (3)(e) of this rule.

Qualifying income as percent of applicable poverty guidelines charged as ability-to-pay Percentage of Income 100% 0% 101 - 125% 3% 126 - 150% 4% 151 - 175% 5% 176 - 200% 6% 201 - 225% 7% 226 - 250% 8% 251 - 275% 9% 276 - 300% 10% 301 - 325% 11% 326 - 350% 12% 351 - 375% 13% 376 - 400% 14% 401 + 15% (5) The per-session ability-to-pay is applicable to each session of service provided to all individuals for whom the responsible party has an obligation to pay under section 804 of the mental health code, 1974 PA 258, MCL 330.1804, but may not be, in aggregate, more than the monthly ability-to-pay amount.

(6) A responsible party who has been determined under the medical assistance program or its successor to be Medicaid eligible is determined to have a $0.00 ability- to-pay for all mental health services other than inpatient. The ability-to-pay for inpatient services must be the amount determined as the patient pay amount by the medical assistance program or its successor.

(7) If the ability-to-pay for parents is assessed separately and their combined ability-topay is more than the cost of services, then the charges must be prorated based on the ratio of each parent’s income.

(8) A responsible party may request a new determination, based on the party’s total financial circumstances, within 30 days after notification of the initial determination made from the ability-to-pay process and table specified in subrule (4) of this rule.

(9) Parents of children receiving public mental health services under the home and community-based waivers are determined to have a $0.00 ability-to-pay for the services provided as part of the community-based waivers for children. Parents shall independently arrange and pay for services that exceed or are not included in the services provided under the home and community-based waivers for children if the parent desires expanded services or those services are not included.

History

History: 1989 AACS; 1997 AACS; 2022 AACS.

Mich. Admin. Code R 330.8240 Determination of fee for respite services {#sec-r-330.8240 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8240}

Rule 8240. (1) The fee for respite services for a full day or any portion of the day must be determined by dividing the monthly ability-to-pay amount determined from the nonresidential table specified in R 330.8239 by 30 and rounding up to the nearest dollar but must not be more than the cost of services. A responsible party may request a new determination under R 330.8239(8).

(2) Respite fees charged during a calendar month may not be, in aggregate, more than the monthly ability-to-pay amount determined from the non-residential table.

History

History: 1989 AACS; 1997 AACS; 2022 AACS.

Mich. Admin. Code R 330.8241 Ability-to-pay method selected {#sec-r-330.8241 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8241}

Rule 8241. A per-session, monthly, or annual ability to pay shall apply to each program area, and the ability-to-pay method selected shall be identified in the department’s and community mental health services programs’ written policies and procedures.

History

History: 1997 AACS.

Mich. Admin. Code R 330.8242 Ability-to-pay determinations based on total financial circumstances {#sec-r-330.8242 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8242}

Rule 8242. (1) If a responsible party’s ability-to-pay is determined pursuant to section 819 of the mental health code, 1974 PA 258, MCL 330.1819, all the following provisions apply:

(a) The financial determination based on the responsible party’s total financial circumstances must consider all the following as specified in these process and table in subrule (2)(i) of this rule:

(i) Qualifying income and protected income.

(ii) Net liquid assets and protected assets.

(iii) Applicable poverty guidelines for family size.

(iv) Excess medical expenses.

(v) Court-ordered payments, including those payments from a divorce decree.

(vi) Student loan payments.

(vii) Additional tax obligations assessed by municipal, county, state, or federal taxing authorities.

(b) If the responsible party is the individual and is a family of 1 who has no expenses other than room and board expenses in an inpatient, specialized residential, or supported independent housing, an alternate full financial determination under subrule (2) of this rule must be completed that does not take into consideration all the provisions specified in R 330.8242. This alternate full financial determination must only include the following:

(i) Qualifying income and protected income.

(ii) Net liquid assets and protected assets.

(iii) The personal needs allowance under the medical assistance program or its successor.

(iv) Expense deduction equal to the provider payment rate for appropriate living arrangements allowed under the medical assistance program or its successor.

(c) When determining ability-to-pay for an individual receiving inpatient services, one half of any compensation paid to the individual for performing labor under section 736 of the mental health code, 1974 PA 258, MCL 330.1736, must be protected.

(d) Protected assets must be the same asset limit amounts allowed for the Medicaid group 2 category under the medical assistance program or its successor.

(e) The department shall develop policies, procedures, and other tools for use in calculating a responsible party’s ability-to-pay under these rules.

(2) The public mental health system full financial consideration ability-to-pay process and table is described as follows:

(a) Determine the percent of poverty specified as the current federal minimum mandatory income level to qualify for medical assistance programs or its successor as specified in the patient protection and affordable care act of 2010, Public Law 111-148, or its successor.

(b) Determine net assets by subtracting all costs incurred to liquidate liquid assets, including protected assets, from liquid assets.

(d) Deduct from qualifying income to determine total income available for cost of care for all the following:

(i) Protected income.

(ii) Poverty guideline for family size at percent or poverty determined in subdivision (a) of this subrule.

(iii) Excess medical expenses.

(iv) Court ordered payments, including a divorce decree.

(v) Student loan payments.

(vi) Additional tax obligations assessed by municipal, county, state, or federal taxing authority. The result is income available for cost of care.

(e) Divide qualifying income from subdivision (c) of this subrule by the poverty guidelines for family size at 100% of poverty and convert to a percentage.

(f) Match percentage determined in subdivision (e) of this subrule to the table in subrule (3) of this rule to determine the percent of income available for cost of care to charge as ability-to-pay.

(g) Multiply the percentage determined in subdivision (f) of this subrule by the income available for cost of care determined in subdivision (a) of this subrule. The result is the annual ability-to-pay from income.

(h) Add net assets from subdivision (b) of this subrule to the annual ability-to-pay from income determined from subdivision (g) of this subrule. The result is the annual ability-topay.

(3) The following income and ability-to-pay crosswalk table must be used in the determination of the percent income for subrule (2)(f) of this rule.

Qualifying Income as a Percent of applicable poverty guidelines. % Of Income charged as Ability- to-Pay 100%0% 101 -200% 10% 201 -250%15% 251 -300%20% 301 -400%25% 401+30% (4) The alternate calculation process for full financial consideration for ability-to-pay is as follows:

(a) Determine net assets by subtracting all costs incurred to liquidate liquid assets and protected assets from liquid assets.

(b) Determine qualifying income.

(i) Protected income.

(ii) Personal needs allocation.

(iii) Expense deduction equal to the provider payment rate for appropriate living arrangements as allowed under the medical assistance program or its successor. The result is the income available for the cost of care.

(d) Add net assets from subdivision (a) of this subrule to income available for cost of care from subdivision (c) of this subrule. The result is the annual ability-to-pay.

History

History: 1997 AACS; 2022 AACS.

Mich. Admin. Code R 330.8244 Rescinded {#sec-r-330.8244 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8244}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8250 Division of assets jointly owned in determining ability to pay {#sec-r-330.8250 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8250}

Rule 8250. In determining ability to pay, the value of assets that are jointly owned shall be divided equally among all owners, unless otherwise specified by an ownership agreement.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8251 Rescinded {#sec-r-330.8251 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8251}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8254 Rescinded {#sec-r-330.8254 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8254}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8256 Collection of ability-to-pay amounts {#sec-r-330.8256 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8256}

Rule 8256. The department and the community mental health services programs shall make a reasonable, bona fide collection effort and shall adopt policies that shall be consistently applied to all responsible parties for collection of determined ability-to-pay amounts. The amounts collected shall not be more than the determined ability to pay amount, plus any costs awarded by the court.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8257 Rescinded {#sec-r-330.8257 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8257}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8264 Rescinded {#sec-r-330.8264 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8264}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8267 Rescinded {#sec-r-330.8267 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8267}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8270 Installment payments; written policies and procedures {#sec-r-330.8270 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8270}

Rule 8270. The department and the community mental health services programs shall have written policies and procedures if installment payment plans are allowed.

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8273 Nominal therapeutic fees for nonresidential services {#sec-r-330.8273 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8273}

Rule 8273. Community mental health services programs may charge an individual a nominal therapeutic fee for nonresidential services if all of the following conditions are met:

(a) The community mental health services program has adopted a written therapeutic fee policy that is fair, equitable, and uniformly applied.

(b) The fee charged is $3.00 or less for each counseling session.

(d) The individual’s plan of service clinically substantiates the need for, and orders, a therapeutic fee to be assessed as specified in this rule.

History

History: 1997 AACS.

Mich. Admin. Code R 330.8275 Court orders {#sec-r-330.8275 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8275}

Rule 8275. A community mental health services program shall comply with the terms of a court order that is related to an individual’s obligation to pay for services rendered and that is issued before the individual presented for services. The amount shall not be less, but may be more, than the amount that would be determined by establishing the individual’s ability to pay in accordance with these rules.

History

History: 1997 AACS.

Mich. Admin. Code R 330.8277 Rescinded {#sec-r-330.8277 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8277}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8279 Undue financial burden {#sec-r-330.8279 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8279}

Rule 8279. A responsible party’s ability-to-pay must not create an undue financial burden that does either of the following:

(a) Unduly impacts the health and well-being of the individual or their dependents as determined by the ability to access the basic necessities of life, including, but not limited to, food, housing, clothing, and healthcare.

(b) Deprives the party and his or her dependents of the financial means to maintain or reestablish the individual in a reasonable and appropriate community-based setting.

History

History: 1997 AACS; 2022 AACS.

Mich. Admin. Code R 330.8280 Rescinded {#sec-r-330.8280 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8280}

History

History: 1989 AACS; 1997 AACS.

Mich. Admin. Code R 330.8284 Rescinded {#sec-r-330.8284 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.8284}

History

History: 1989 AACS; 1997 AACS.

R 330.9001 to R 330.9431 Part 9. Miscellaneous Provisions

Mich. Admin. Code R 330.9001 Rescinded {#sec-r-330.9001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9001}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PART 9. MISCELLANEOUS PROVISIONS

SUBPART 1. LAFAYETTE CLINIC

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9005 Rescinded {#sec-r-330.9005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9005}

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9007 Rescinded {#sec-r-330.9007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9007}

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9009 Rescinded {#sec-r-330.9009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9009}

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9011 Rescinded {#sec-r-330.9011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9011}

SUBPART 2. NUERO-PSYCHIATRIC INSTITUTE

History

History: 1979 AC; 1990 AACS; 1997 AACS.

Mich. Admin. Code R 330.9121 Rescinded {#sec-r-330.9121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9121}

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9123 Rescinded {#sec-r-330.9123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9123}

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9125 Rescinded {#sec-r-330.9125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9125}

SUBPART 3. ADMINISTRATIVE PROCEDURE

History

History: 1979 AC; 1997 AACS.

Mich. Admin. Code R 330.9201 Rescinded {#sec-r-330.9201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9201}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9205 Rescinded {#sec-r-330.9205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9205}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9208 Rescinded {#sec-r-330.9208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9208}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9210 Rescinded {#sec-r-330.9210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9210}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9215 Rescinded {#sec-r-330.9215 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9215}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9220 Rescinded {#sec-r-330.9220 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9220}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9222 Rescinded {#sec-r-330.9222 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9222}

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9225 Rescinded {#sec-r-330.9225 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9225}

SUBPART 4. IMPACT STATEMENTS

History

History: 1984 AACS; 1997 AACS.

Mich. Admin. Code R 330.9301 Definition {#sec-r-330.9301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9301}

Rule 9301. As used in this subpart, "compatibility-impact statement" means a report by the department director as to the benefit and detriment of any proposed changes to a use or proposed use of public property, in whole or in part, which is contiguous to land or buildings owned or used by the department in the delivery of mental health services utilizing those lands or buildings.

History

History: 1986 AACS.

Mich. Admin. Code R 330.9306 Compatibility-impact statement {#sec-r-330.9306 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9306}

Rule 9306. (1) If the preparation of a compatibility-impact statement is required by law, the procedure specified in this rule shall apply. If the compatibility-impact statement is not required by law, the procedure specified in this rule may apply at the discretion of the director.

(2) Upon receipt by the director of any official plan for reusing contiguous public land or buildings, the plan shall be officially dated as to its receipt.

(3) The director shall forward the reuse plan to the facility director responsible for administration of other land or buildings which are proposed for reuse or are contiguous to such land or buildings, and shall direct that an impact statement be prepared and transmitted to the director within 45 working days.

(4) The facility director shall schedule a hearing and provide notice to the public on when and where the reuse plan can be viewed and the hearing will be held. Notice shall be given not less than 10 working days before the hearing, shall include general notification to the public, and shall endeavor to provide, where appropriate, specific notation to all of the following affected entities:

(a) Community mental health boards.

(b) Substance abuse agencies.

(d) Law enforcement agencies.

(e) Employee organizations.

(f) Mental health advocacy organizations.

(g) Professional groups whose members provide services to the mental health recipients.

(h) Other educational, human service, or public interest organizations.

(5) The compatibility-impact statement prepared by the facility director shall provide a synopsis of the testimony, shall have copies of written testimony attached, shall list the perceived benefit and detriment, and shall make recommendations regarding additions to or deletions from the reuse plan to ensure compatibility with the mental health service environment.

(6) The director shall review the testimony and compatibility-impact statement material which is prepared by the facility director and shall prepare a report or shall issue a revised compatibility-impact statement report. A compatibility-impact statement shall be submitted to the state administrative board not more than 60 working days following official receipt of the reuse plan if such submission is required by law.

SUBPART 5. CONDUCT ON DEPARTMENT PROPERTY

History

History: 1986 AACS.

Mich. Admin. Code R 330.9401 Definitions {#sec-r-330.9401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9401}

Rule 9401. As used in this subpart:

(a) "Department" or "department grounds" means buildings and lands dedicated and appropriated to the public use over which the department has jurisdiction or control, including buildings or parts of buildings and other real estate occupied by the state as lessee.

(b) "Director" means the head of a facility as provided in section 120 of the act or his or her designee.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9406 Access to department buildings and property {#sec-r-330.9406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9406}

Rule 9406. (1) State employees are not permitted in department buildings or on department grounds at any time other than their normal working hours, unless appropriate authorization has been received. Proper identification of employees may be required and employees may be required to sign a registration sheet.

(2) Hours for visiting patients are adopted by each department facility. When required by the department facility, visitors shall be required to sign a registration sheet.

(3) Other entries by permittees or by the general public onto department property or into department buildings requires authorization by the director or the director of the department.

(4) Compliance with operational security measures established and enforced by the department facility shall be a condition of authorization for access to department buildings and property.

(5) In general, picketing or distributing literature is allowed at the entrance to department grounds if it does not interfere with access, ingress, or egress. Distribution of literature by employees or employee organizations shall be as provided in employment contracts or the employee relations policy adopted by the civil service commission and in department personnel policies.

(6) The department may lock entrances to any building at any time and may require that such entrances be used from within only as a means of egress in case of emergency. A person shall not enter or attempt to enter a state building through an entrance closed pursuant to this rule.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9411 Removal of property; inspections {#sec-r-330.9411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9411}

Rule 9411. (1) A person shall not remove state property from department buildings or grounds unless the removal has been previously authorized in writing by the director of the department or the director.

(2) Authorized staff may inspect briefcases, packages, or other items being transported into or out of department buildings, grounds, or parking facilities for the presence of state property.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9416 Items prohibited on department property; inspections; retention of prohibited items {#sec-r-330.9416 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9416}

Rule 9416. (1) A person shall not bring onto department grounds any alcoholic beverages or any weapons. A peace officer on official business may continue to possess a weapon, except in a resident living area. A department facility shall adopt a list of other particular kinds of items excluded from department grounds or resident living areas.

(2) A department facility shall post, in places that are readily visible to the public, lists of items excluded from department grounds or resident living areas.

(3) A person shall not provide to any resident any item which is excluded from the facility or a resident living area or which is subject to a limitation in the resident plan of service.

(4) A person shall not bring into any resident living area any medication or drugs, lawful knives, sharp objects, or other items excluded by facility policy, except as follows:

(a) Staff may bring the following into resident living areas:

(i) Medication, in appropriate dosages, which is necessary for health maintenance during the staff person's work hours.

(ii) Lawful knives or sharp objects which are not kept in an area accessible to residents.

(b) A visitor may bring medication into resident living areas, in appropriate dosages, which is for health maintenance of the visitor if the possession of the medication is disclosed and permission to so possess has been granted by authorized staff.

(5) Authorized staff may inspect briefcases, packages, or other items being transported into or out of department buildings or grounds, including parking facilities. Staff detaining a person entering department grounds or buildings shall inform the person that they have the option of permitting the inspection or leaving department grounds or buildings.

(6) A visitor or permittee who might possess items excluded from the grounds or resident living areas shall be informed that the items must be retained by authorized personnel and a receipt shall be given for the items during the time such a person is in a department building or on department grounds.

(7) Department lockers assigned to a particular staff member are subject, at any time, to inspections by an authorized person with a supervisor witness. The staff member who has been assigned the locker may be present during such inspections. A written report of any significant findings shall be prepared immediately following such an inspection for review and appropriate action.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9421 Obstructions; solicitations and sales {#sec-r-330.9421 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9421}

Rule 9421. (1) A person or a person's vehicle shall not occupy a corridor, sidewalk, areaway, driveway, or room in a department building or on department grounds in such manner as to hamper or obstruct the proper use or movement of personnel or vehicles, the care and treatment of patients or residents, the freedom of movement of patients or residents, or the proper conduct of department business.

(2) Other than authorized department staff, a person is not permitted in department buildings or on department grounds for the purpose of the solicitation of funds or the sale of any article, except that the department may authorize such conduct, confined to the entrances and lobby areas of department buildings, by charitable organizations.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9426 Animals; camping {#sec-r-330.9426 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9426}

Rule 9426. (1) Except as may be authorized in the course of department or facility business, animals are not permitted on department grounds. The owner or person having an animal under his or her control shall be legally and financially responsible for the acts of the animal. Guide, hearing, or service dogs used by handicappers are permitted on department grounds.

(2) A person shall not camp, erect a tent, or erect any other temporary structure on department grounds, except when permission has been granted by the department's authorized staff.

History

History: 1988 AACS.

Mich. Admin. Code R 330.9431 Enforcement {#sec-r-330.9431 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.9431}

Rule 9431. (1) A person openly and wilfully refusing to conform to these rules, in addition to criminal penalties provided by law, is subject to immediate removal from a department building or department grounds by the department's authorized personnel.

(2) Nothing contained in these rules shall be construed as limiting prosecution under penal law.

History

History: 1988 AACS.

R 330.10008 to R 330.10099 Criminal Provisions

Mich. Admin. Code R 330.10008 Aftercare for former prisoners {#sec-r-330.10008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10008}

DEPARTMENT OF COMMUNITY HEALTH

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

PART 10. CRIMINAL PROVISIONS

SUBPART 1. TRANSFER OF PRISONERS

Rule 10008. The department of corrections shall offer aftercare reintegration and community-based mental health services to a person leaving prison. If the prisoner accepts the offer, the community mental health program serving the area where the prisoner will reside shall tender an intake appointment date which shall be scheduled within 3 weeks of separation from prison, if the department of corrections has done both of the following:

(a) Made a referral of the person leaving prison to the program 4 weeks before separation from the prison.

(b) Provided the name and address of the department of corrections staff person to contact concerning the person leaving the prison.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.10009 Aftercare for parolees {#sec-r-330.10009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10009}

Rule 10009. (1) A community mental health program shall provide aftercare reintegration and community-based mental health services to a prisoner about to be paroled to the area served by the program if the department of corrections requests such services be provided for a prisoner about to be paroled, if the request is in writing to the director of the county community mental health program serving the community where the prisoner is to be paroled, if the request is made 4 weeks in advance of parole, and if the request includes the date of parole. The request shall be accompanied by a report which shall include, at a minimum, all of the following:

(a) The current mental status of the prisoner.

(b) A description of the prisoner's adjustment and performance within department of corrections.

(d) The current medications or other treatment modalities presently being provided to the prisoner by the department of corrections.

(e) An assessment of the parolee's willingness to participate in county community mental health programs.

(2) Upon receipt of the written notification and report described in subrule (1) of these rules, the community mental health program shall make an intake appointment date for the prospective parolee not later than 3 weeks following the date of the prisoner's parole. At the appointment, the community mental health program shall review the report and shall have the prisoner evaluated by clinical staff to determine what plan of follow-up care and treatment is needed. It shall be the responsibility of the prisoner to present himself or herself to the community mental health program for this evaluation appointment and any other appointment scheduled during the parole period. Upon failure to appear at a scheduled appointment, notification of that failure shall be made to the parole officer.

(3) After review of the report forwarded by the department of corrections or after an intake appointment, if the community mental health program serving the area where the parolee will reside has made an assessment that its program may be insufficient for the particular parolee, then the community mental health director shall do both of the following:

(a) Contact the director of the department for assistance.

(b) Give notice to the department of corrections of the assessment of possible program insufficiency and of the request for assistance from the department.

(4) If there is no community mental health program serving the area where the parolee is to reside, the department of corrections shall provide information of the situation to the director of the department who shall be responsible for locating other available communitybased mental health services which are sufficient for the particular parolee.

(5) Copies of all requests for aftercare services to parolees shall be forwarded by the department of corrections to the director of the department.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.10011 Commingling {#sec-r-330.10011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10011}

Rule 10011. (1) Before commingling a prisoner with other recipients of mental health services, the director of the center shall cause a full and thorough evaluation of the available physical facilities and of the prisoner to be made. The evaluation of the prisoner shall determine the prisoner's dangerousness and escape propensity, the treatment plans that are appropriate, and the recommended treatment modalities.

(2) The evaluation of the prisoner shall include, but not be limited to, a mental status evaluation, a physical status evaluation, and a full review of the prisoner's history.

(3) The director shall consult with the department of corrections concerning the security risks presented by the prisoner if a prisoner is to be commingled at the center or at any other facility of the department. The opinion of the department of corrections with regard to the security risks presented shall be heavily relied on.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.10013 Administrative hearing {#sec-r-330.10013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10013}

Rule 10013. (1) Before an approved transfer between facilities of the department of mental health is acted upon, the director of the hospital in which the prisoner is currently residing shall notify the prisoner in writing, not less than 7 days before transfer, of the facts of the approved transfer and of the right to object, except if the transfer is necessitated by an emergency as determined by the hospital director and as documented in hospital records.

Under emergency circumstances, the transfer shall occur as soon as necessary and appropriate notices shall be made not more than 24 hours after transfer.

(2) The transfer may occur before the expiration of the 7-day period if the prisoner approves of the transfer in writing.

(3) If the prisoner requests a hearing regarding the need and appropriateness of the transfer, the facility shall ensure completion, on a form prescribed by the department, of a request for administrative hearing and shall submit the request form to the Administrative Tribunal, Department of Mental Health, Lewis Cass Building, Sixth Floor, Lansing, Michigan 48926.

(4) The standard governing the determination on the appropriateness of the transfer shall be the same as that used under R 330.4011. The administrative hearing held under this rule shall be pursuant to the act, these rules, and chapter 4 of Act No. 306 of the Public Acts of 1969, as amended, being S24.271 et seq. of the Michigan Compiled Laws.

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.10014 Voluntary hospitalization of a locally incarcerated person {#sec-r-330.10014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10014}

Rule 10014. (1) A person who wishes voluntary hospitalization for mental health services and who is incarcerated in a place of detention operated by a political subdivision of the state shall give notice of the desire for transfer to the personnel operating the place of detention.

(2) The detention official charged with the care and custody of such an incarcerated person, or that official's designees, shall assist in the preparation of a written evaluation report by a physician or a mental health professional of the local community mental health program. The report shall contain a statement of all of the following:

(a) The incarcerated person's desire for voluntary hospitalization and the person's ability to consent.

(b) The incarcerated person's current legal status and potential for dangerousness.

(d) The services currently available to the person at the place of detention.

(3) If a community mental health program has a signed service integration agreement covering inpatient services for the type of mental health services needed by the incarcerated person, the determination of the need for hospitalization, clinical suitability, and the means of admission shall be pursuant to that agreement and the accompanying procedure agreements.

(4) If a community mental health program does not exist or if the program does not have a signed service integration agreement covering inpatient services, the report shall be forwarded to the regional department of mental health hospital or center for developmental disabilities for immediate preadmission examination and screening.

(5) If an incarcerated person requests hospitalization, but is also in need of the most restrictive and highly structured hospital setting which is not available at the regionally designated hospital or center for developmental disabilities, the report and the incarcerated person shall be transported to the center for forensic psychiatry for preadmission screening.

SUBPART 2. FORENSIC EXAMINATIONS

History

History: 1979 AC; 1981 AACS.

Mich. Admin. Code R 330.10055 Definitions {#sec-r-330.10055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10055}

Rule 10055. For the purposes of this subpart:

(a) "Certified forensic examiner" means a social worker, psychologist, or psychiatrist who is specially trained as a forensic clinician and who is certified by a director as having met the qualifying standards set forth in R 330.10056.

(b) "Consulting forensic examiner" means a psychologist or psychiatrist who is specially trained as a forensic clinician and who is certified by a director as having met the qualifying standards set forth in R 330.10057.

(d) "Examining facility" means the center for forensic psychiatry or an agency officially certified by the department to perform examinations related to the issue of incompetency to stand trial and the defense of insanity.

(e) "Qualified personnel" means either of the following:

(i) For the purposes of performing forensic examinations related to the issue of incompetency to stand trial, a certified forensic examiner or consulting forensic examiner.

(ii) For the purposes of performing forensic examinations related to the issue of the defense of insanity, a consulting forensic examiner.

History

History: 1979 AC; 1981 AACS; 1988 AACS.

Mich. Admin. Code R 330.10056 Certified forensic examiners; qualifications {#sec-r-330.10056 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10056}

Rule 10056. (1) An applicant for certification as a certified forensic examiner shall demonstrate to the examining facility attainment of the following educational, licensing, and experiential requirements:

(a) For social workers, both of the following:

(i) A master's degree or Ph.D. in social work from an accredited program in a curriculum substantially clinical in nature.

(ii) State of Michigan certification as a certified social worker.

(b) For psychologists, both of the following:

(i) A master's degree or Ph.D. in psychology from an accredited program in a curriculum substantially clinical in nature.

(ii) A State of Michigan license or limited license as a psychologist.

(i) A State of Michigan license to practice medicine or osteopathic medicine.

(ii) Completion of not less than 2 years of residency in an accredited psychiatry program.

(d) Familiarity with relevant literature and federal and Michigan cases pertaining to incompetency to stand trial.

(e) Knowledge of the court system, legal process, mental health law, and criminal law.

(f) Knowledge of relevant clinical and ethical issues pertinent to expert witness testimony and forensic practice.

(g) Observation and discussion of 5 examinations related to the issue of incompetency to stand trial with a certified or consulting forensic examiner.

(h) Performance of 5 examinations related to the issue of incompetency to stand trial conducted under the direct supervision of a certified or consulting forensic examiner, including attorney contacts, analysis of collateral material, and preparation of the cosigned court report.

(i) Observation and discussion of expert testimony presented by a certified or consulting forensic examiner.

(j) Performance in a mock trial as an expert witness under the observation and critique of a certified or consulting forensic examiner.

(k) Performance in court as an expert witness under the observation and critique of a certified or consulting forensic examiner.

(2) The examining facility may allow substantially similar experience to meet all or any of the requirements in subdivisions (g) to (k) of subrule (1) of this rule.

History

History: 1988 AACS.

Mich. Admin. Code R 330.10057 Consulting forensic examiner; qualifications {#sec-r-330.10057 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10057}

Rule 10057. (1) An applicant for certification as a consulting forensic examiner shall demonstrate to the examining facility attainment of the following educational, licensing, and experiential requirements:

(a) For psychologists, all of the following:

(i) A Ph.D. degree from an accredited psychology program in a curriculum substantially clinical in nature.

(ii) A State of Michigan license or limited license.

(iii) Certified forensic examiner status.

(b) For psychiatrists, all of the following:

(i) A State of Michigan license to practice medicine or osteopathic medicine.

(ii) Board certification or board eligibility in psychiatry.

(iii) Certified forensic examiner status.

(c) Familiarity with relevant literature and federal and Michigan cases pertaining to the defense of insanity and the issues of diminished capacity and guilty but mentally ill.

(d) Knowledge of the court system, legal process, mental health law, and criminal law.

(e) Knowledge of relevant clinical and ethical issues pertinent to expert witness testimony and forensic practice.

(f) Observation and discussion of 5 examinations related to the defense of insanity with a consulting forensic examiner.

(g) Performance of 5 examinations conducted under the direct supervision of a consulting forensic examiner related to the defense of insanity, including attorney contacts, analysis of collateral material, and preparation of the cosigned court report.

(h) Observation and discussion of expert testimony of a consulting forensic examiner.

(i) Performance in a mock trial as an expert witness under the observation and critique of a consulting forensic examiner.

(j) Performance in court as an expert witness under the observation and critique of a consulting forensic examiner.

(2) The examining facility may allow similar experience to meet any of the requirements in subdivisions (f) to (j) of subrule (1) of the rule.

History

History: 1988 AACS.

Mich. Admin. Code R 330.10058 Certification of examining facility {#sec-r-330.10058 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10058}

Rule 10058. (1) To attain certification as an examining facility, an agency shall apply to the center on forms provided by the center. The forms shall require all of the following information:

(a) The applicant's proposed service district.

(b) The maximum number of referrals to whom the applicant proposes to provide service on an annual basis.

(c) The proposed period of time, which shall not be less than 1 year, that the applicant will provide forensic examination services.

(2) The center shall acknowledge receipt of the application and, within 90 days of such receipt, shall do 1 of the following:

(a) Grant certification.

(b) Deny certification.

(3) An applicant which meets all of the following requirements shall be certified:

(a) Has an adequate number of qualified staff to maintain a continuum of timely service to the courts located within the proposed service district.

(b) Provides an assurance that qualified staff will participate in a continuing program of inservice education pertinent to forensic clinicians.

(d) Demonstrates adequate support staff, equipment, and ancillary resources necessary to meet the proposed service demand.

(4) The granting of provisional certification or the denial of certification shall be accompanied by a listing of the documented deficiencies and the required corrective actions.

(5) An examining facility shall be decertified and released from further obligation by the center 1 year after written notice to the center that the examining facility has decided to terminate service. The department may waive any part of the 1-year notice period.

(6) The center shall periodically review an examining facility to assure compliance with these rules and professional licensing and certification requirements. An examining facility that fails to meet such requirements shall be placed either on provisional status for a period of time not to exceed 1 year or be decertified. The center shall send written notice of any determination of noncompliance. The notice shall contain a statement of deficiencies that led to the determination of noncompliance.

(7) An examining facility that has been decertified may reapply for certification in accordance with this rule.

(8) An examining facility that has been placed on provisional status shall be decertified upon a determination by the center that cited deficiencies have not been corrected within the specified time.

(9) An examining facility that has been placed on provisional status shall be recertified upon a determination by the center that cited deficiencies have been corrected within the specified time.

(10) Any determination or action taken by the center under this rule concerning certification of an examining facility may be appealed by the examining facility to the director of the department pursuant to chapter 4 of Act No. 306 of the Public Acts of 1969, as amended, being S24.271 et seq. of the Michigan Compiled Laws.

History

History: 1988 AACS.

Mich. Admin. Code R 330.10059 Forensic examination {#sec-r-330.10059 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10059}

Rule 10059. (1) When a defendant is examined on an outpatient basis, the examining facility shall direct qualified personnel to conduct the examination at either the place of detention or at the examining facility. The examination shall be completed in 1 day, unless further information is needed, in which case the examining facility shall determine the place additional examinations shall be performed as expeditiously as possible.

(2) If a defendant is to be brought from a place of detention for outpatient examination, the examining facility shall notify the sheriff and the sheriff shall transport the defendant to the examining facility for the examination and wait until the conclusion of the examination whereupon the sheriff shall return the defendant to the place of detention.

(3) If a defendant who is ordered to undergo an examination is on bail or otherwise at liberty pending trial, the examining facility shall notify defense counsel and the court of the time and place of the outpatient examination. The defendant shall be responsible for making himself or herself available for the examination at the designated time and place.

(4) If a defendant fails to make himself or herself available for the examination at the designated time and place, the examining facility shall notify the court, the prosecuting attorney, and defense counsel.

(5) If the defendant is on bond or otherwise at liberty pending trial and qualified personnel determine, after initiating an examination, that the examination must be completed on an inpatient basis, such personnel shall notify the court, the defense and prosecuting attorneys, and the forensic center and request an immediate order for inpatient examination.

(6) When a defendant is to be examined on an inpatient basis, the director shall direct certified personnel to complete the examination as expeditiously as possible.

(7) Psychotropic medication and physical treatment during the 60-day evaluation and examination period shall be administered and prescribed in accordance with subpart 3 of part 7 of these administrative rules.

(8) As soon as administratively possible after completion of an examination, qualified personnel shall transmit the report required by law to the court, defense counsel, and prosecuting attorney.

History

History: 1979 AC; 1988 AACS.

Mich. Admin. Code R 330.10061 Inpatient rights {#sec-r-330.10061 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10061}

Rule 10061. (1) Within 24 hours of admission, the director shall inform the person of his rights and privileges as a resident of the facility.

(2) Rights and privileges shall be the same as those of other residents of a facility, except that security precautions appropriate to the conditions and circumstances of a resident may be taken to limit freedom of movement.

(3) Security precautions shall be in accordance with department administrative rules, policies, and procedures governing the rights of residents to mental health facilities.

History

History: 1979 AC.

Mich. Admin. Code R 330.10065 Testimony {#sec-r-330.10065 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10065}

Rule 10065. A certified examiner shall be permitted by the director adequate time to testify if required by subpoena.

History

History: 1979 AC.

Mich. Admin. Code R 330.10067 Custody {#sec-r-330.10067 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10067}

Rule 10067. Custody shall be the responsibility of the examining facility only during the period of inpatient evaluation.

History

History: 1979 AC.

Mich. Admin. Code R 330.10071 Discharge {#sec-r-330.10071 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10071}

Rule 10071. (1) After completion of an inpatient evaluation, a defendant shall be discharged by the director of the center.

(2) If a defendant is not on bail or otherwise at liberty pending trial, he shall be discharged only to the custody of a peace officer requested by the center to return the defendant to jail or similar place of detention or to another person authorized in writing by the committing court to take custody of the defendant. A defendant shall be discharged to his own custody if on bail or otherwise at liberty pending trial.

History

History: 1979 AC.

Mich. Admin. Code R 330.10079 Treatment of persons found incompetent to stand trial {#sec-r-330.10079 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10079}

Rule 10079. (1) Upon receipt of a court order committing a defendant to undergo treatment to achieve competency to stand trial, a hospital, facility, or other agency of the department providing treatment shall comply with department administrative rules and procedures for inpatient or outpatient treatment and with the following:

(a) When a court commits a defendant to the department to undergo treatment to render him competent to stand trial, placement by the department of the defendant for inpatient or outpatient treatment at a department hospital, facility, or agency, shall be made on the basis of a recommendation made by the center for forensic psychiatry.

(b) When a defendant is committed to the department, or otherwise ordered for treatment and the department is appointed medical supervisor of treatment, the director of the hospital facility or agency providing treatment shall perform the duties of medical supervisor of treatment.

(c) A medical supervisor of treatment shall submit the written report required by law to the court, prosecuting attorney, defense counsel, and the center, every 90 days and whenever he is of the opinion either that the defendant is no longer incompetent to stand trial or that there is not a substantial probability the defendant will obtain competence to stand trial within the time limits. In the report, the medical supervisor of treatment may also state an opinion as to the defendant's need for modified treatment to render him competent to stand trial.

(2) Mental health services shall be directed only toward the restoration of a defendant's competency to stand trial unless the defendant consents to additional services.

(3) A defendant ordered to undergo treatment at a department hospital, facility, or agency shall be discharged by the director upon recommendation of the treating clinician, or after 1 or more of the following:

(a) When the director is notified in writing by a committing court or by the prosecutor that charges against a defendant have been dropped.

(b) After certifying a defendant is competent to stand trial and upon release of the defendant to the custody of a peace officer or his own custody if on bail or otherwise at liberty pending trial.

(c) After 15 months from the date of the treatment order or 1/3 the maximum sentence the defendant would have received if he had been found guilty of the charge, whichever is lesser.

(d) Upon a court order directing the medical supervisor of treatment to discharge a defendant to another treatment agency or person.

(e) Upon transfer of a patient to another treatment agency or facility.

(4) If a defendant is to be discharged or released because of expiration of the treatment order or dismissal of the charges, the medical supervisor of treatment may file a petition prior to discharge, asserting that the defendant is a person requiring treatment or that the defendant meets the criteria for judicial admission with the probate court of the defendant's county of residence. Accompanying a petition asserting that a defendant is a person requiring treatment shall be 2 certificates, 1 of which shall have been executed by a psychiatrist.

(5) Whenever a medical supervisor of treatment is of an opinion that a defendant will not attain competence to stand trial within the time limit, he shall examine the defendant to form an opinion as to whether the individual meets the criteria as a person requiring treatment or for judicial admission. He shall report to the court the findings of the examination and the facts in reasonable detail upon which they are based, and include this in his written report to the court. Where appropriate, the medical supervisor of treatment shall also provide the necessary medical certificates.

SUBPART 3. DISPOSITION OF PERSONS FOUND NOT GUILTY BY REASON

OF INSANITY

History

History: 1979 AC.

Mich. Admin. Code R 330.10085 Admission {#sec-r-330.10085 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10085}

Rule 10085. Upon presentation of a court order, a person acquitted of a criminal charge by reason of insanity shall be admitted to the center for forensic psychiatry for a thorough examination and evaluation for a period not more than 60 days from the date of the order.

History

History: 1979 AC.

Mich. Admin. Code R 330.10087 Examination {#sec-r-330.10087 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10087}

Rule 10087. (1) A person admitted under this part shall be assigned a chief clinician who shall perform a clinical evaluation as soon as administratively possible.

(2) As soon as practical after the completion of the chief clinician's evaluation, the person shall be examined by 2 authorized examiners who shall examine the person to form independent opinions as to whether the individual meets the criteria as a person requiring treatment or for judicial admission.

(3) If the person is alleged to be mentally ill, the authorized examiners shall be 2 physicians, not less than 1 of which shall be a psychiatrist. If the person is alleged to be mentally retarded, the authorized examiners shall be 2 physicians or 1 physician and 1 psychologist.

(4) Upon completion of the examination of a person believed to be a person requiring treatment, each examiner shall execute a medical certificate as prescribed by the department for use in probate court proceedings, and file them with the director of the center. If the person is alleged to be mentally retarded the examiners shall submit a written report stating whether the person meets the criteria for judicial admission. The authorized examiners may submit other pertinent information or recommendations and include them as an addendum to the medical certificates or report.

(5) The director of the center shall review the case record and the examiners' medical certificates or report, and based upon that review, shall file a summary report, in addition to any medical certificates, with the court, prosecuting attorney, and defense counsel. The summary report shall contain:

(a) An opinion as to whether the person meets the criteria as a person requiring treatment for judicial admission, based upon the authorized examiners' medical certificates or report.

(b) Recommendations for treatment, including psychotropic medications.

(c) Where appropriate, recommendations for treatment placement at a specific department, hospital, or facility, based upon the person's treatment and supervision needs.

(d) Other facts, recommendations, or opinions pertinent to the examinations and evaluation.

History

History: 1979 AC.

Mich. Admin. Code R 330.10089 Emergency treatment {#sec-r-330.10089 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10089}

Rule 10089. Psychotropic medications and physical treatment during the 60-day evaluation and examination period shall be administered only in accordance with department administrative rules.

History

History: 1979 AC.

Mich. Admin. Code R 330.10091 Resident rights {#sec-r-330.10091 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10091}

Rule 10091. (1) Within 24 hours of admission, the director shall inform the person of his rights as a resident of the center. He shall have the same rights and privileges as other residents of a facility, except that security precautions appropriate to the condition and circumstances of a resident may be taken limiting freedom of movement.

(2) Security precautions shall be in accordance with department administrative rules governing rights of residents of mental health facilities.

History

History: 1979 AC.

Mich. Admin. Code R 330.10093 Custody {#sec-r-330.10093 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10093}

Rule 10093. During the 60-day examination and evaluation period, the person shall not leave the custody of the center without the approval of the director of the center and notification of the court.

History

History: 1979 AC.

Mich. Admin. Code R 330.10095 Discharge {#sec-r-330.10095 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10095}

Rule 10095. The director shall discharge a person admitted under this section after 1 of the following:

(a) Upon the expiration of the 60-day examination and evaluation period, if a petition has not been filed with a probate court by a prosecuting attorney.

(b) When a person is released to the custody of a peace officer for transport to a probate hearing, or at the conclusion of a probate court hearing held at the center, if an individual is found not to be a person requiring treatment or meeting the criteria for judicial admission.

History

History: 1979 AC.

Mich. Admin. Code R 330.10097 Consultation {#sec-r-330.10097 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10097}

Rule 10097. (1) When a person is ordered by the court to be hospitalized, admitted to a facility, or otherwise to receive treatment, the person shall not be discharged or placed on leave without prior consultation with the center.

(2) Consultation shall include exchange of written opinions between the center and the institution, agency, or professional person providing services and requesting discharge or leave for a person.

(3) An institution, agency, or professional person providing treatment shall file a report with the center for forensic psychiatry proposing plans for discharge or leaves.

(4) Upon receipt of a report proposing a discharge or leave, as soon as administratively possible, but not later than 30 days from the receipt date of the requesting report, the center shall submit a response to the institution, agency, or person requesting consultation. The center's response shall include an evaluation and recommendation based on the report and may include an examination of the person either, at the discretion of the forensic center, at the center or the facility or agency providing services. The center may request further information, the request explaining the need for the additional information.

(5) When the center does not concur with the proposed course of action, the requesting institution, agency, or professional person may file additional reports with the center or after any exchange of opinions may ask for a review of the matter by the director of the department.

(6) When a review is requested, the institution, agency, or professional person providing services shall send copies of the proposing reports and the center's responses to the director of the department. The director of the department shall either approve or disapprove the proposed course of action. Written approval or disapproval and an explanation of the reasons shall be sent to the agency, institution, or professional person requesting the proposed course of action and to the center.

SUBPART 4. CRIMINAL SEXUAL PSYCHOPATHS

History

History: 1979 AC.

Mich. Admin. Code R 330.10099 Criminal sexual psychopaths {#sec-r-330.10099 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.10099}

Rule 10099. (1) A person committed as a criminal sexual psychopath may be paroled to the community pursuant to department policies and procedures by the director of a facility if there are reasonable grounds to believe the person has recovered from the psychopathy and is not a menace to the safety of himself or others.

(2) A person committed as a criminal sexual psychopath who has been on parole in the community for a continuous period of not less than 2 years without recurrence of the criminal sexual psychopathic behavior which led to the original commitment shall be discharged by the director of a facility in accordance with section 942 of the act.

History

History: 1979 AC.

R 330.11001 to R 330.11017 Enforcement System for Long-Term Care Facilities

Mich. Admin. Code R 330.11001 Definitions {#sec-r-330.11001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11001}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH LEGISLATION AND POLICY DEVELOPMENT

GENERAL RULES

(By authority conferred on the department of community health by sections 1 to 4 of Act No. 80 of the Public Acts of 1905, as amended, sections 111 and 112 of Act No. 280 of the Public Acts of 1939, as amended, section 33 of Act No. 306 of the Public Acts of 1969, as amended, sections 114 and 114a of Act No. 258 of the Public Acts of 1974, as amended, and Executive Reorganization Order No. 1996-1, being §§19.141 to 19.144, 400.111, 400.112, 24.233, 330.1114, 330.1114a, and 330.3101 of the Michigan Compiled Laws)

PART 11. ENFORCEMENT SYSTEM FOR LONG-TERM CARE FACILITIES

Rule 11001. As used in this part:

(a) "Administrative or clinical advisor" means an additional remedy imposed upon a facility for the purpose of monitoring and mentoring the facility administrative staff or clinical staff or both through the period of corrective action.

(b) "Category" means a grouping of remedies used to address and correct a certain level of deficiency.

(c) "Civil money penalty" means a fiscal assessment amount which is within a range commensurate to the level of noncompliance, for example, immediate jeopardy or nonimmediate jeopardy, and which is levied against nursing facilities for certain findings of noncompliance. A civil money penalty is determined by multiplying an amount, based upon the finding of noncompliance, by the number of days of noncompliance. A daily civil money penalty shall be assessed up to and including the day before the state medicaid agency or the health care financing administration determines that the facility is in substantial compliance or up to and including the day that the civil money penalty is no longer warranted.

(d) "Date certain" means the last day of a specified time frame in which a nursing facility is allowed to correct deficiencies, generally without the application of remedies. A date certain may be allowed at the state medicaid agency’s discretion. A date certain shall not be allowed in cases involving an immediate-jeopardy situation or involving a poorperformer facility. If substantial compliance is not attained by the date certain, then the state medicaid agency shall impose 1 or more remedies after reviewing the determinations of the state survey agency.

(e) "Deficiency" means a nursing facility’s failure to meet any participation requirement as specified in section 1919 of the social security act of 1935, as amended, being 42 U.S.C. §1396r et seq. or in 42 C.F.R. §§483.5 to 485.75 (1992).

(f) "Department"” means the Michigan department of community health (MDCH).

(g) "HCFA" means the federal health care financing administration.

(h) "Immediate jeopardy" means a situation in which the nursing facility’s noncompliance with 1 or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.

(i) "Menu" means a grouping of remedy categories that takes into account facility history and the current level of nursing facility noncompliance or deficient practices.

(j) "Needing early review" means a facility identified for possible immediate imposition or recommendation of enforcement remedies by the state survey agency under its licensure authority.

(k) "Noncompliance" means the presence of any deficiency that causes a nursing facility to not be in substantial compliance.

(l) "Nursing facility" means a facility which provides long-term nursing care, which is enrolled in the state’s medicaid program, and which is not enrolled in the medicare program. The term excludes a facility owned by the state. The term includes a county medical care facility and a hospital long-term care unit if not enrolled in the medicare program.

(m) "OBRA" means the omnibus budget reconciliation act of 1987, as amended, being Public Law 100-203, 101 Stat. 1.

(n) "Plan of correction" means a plan accepted by the state survey agency that is mandatory for all deficiencies of scope and severity levels B through L on the remedy determination grid table 1 of this part, referred to in this part as the "quick reference chart." If a facility fails to obtain an accepted plan of correction, then the state medicaid agency shall impose remedies immediately.

(o) "Poor performer" means a federally identified poor-performing nursing facility. The state medicaid agency shall not afford a poor performer an opportunity to correct deficiencies before remedies are imposed.

(p) "Remedy" means a corrective action which is specified in federal or state law or these rules and which is taken by the state survey agency or the state medicaid agency against a nursing facility for findings of deficiencies.

(q) "Repeat deficiency" means a deficiency which is in the same regulatory grouping of requirements and which is found again at the next survey.

(r) "Repeated noncompliance" means a finding of substandard quality of care based on 3 consecutive standard surveys [standard survey as stated in section 1919(g)(2)(A) of the social security act of 1935, 42 U.S.C.§1396r(g)(2)(A)] regardless of whether the exact tag number of deficiency was repeated or that the substance of a deficiency was repeated.

(s) "State medicaid agency" means the Michigan department of community health, medical services administration.

(t) "State survey agency" means the Michigan department of consumer and industry services (MDCIS).

(u) "Substandard quality of care" or "SQC" means 1 or more deficiencies on the remedy determination grid in square f, h, i, j, k, or l of table 1 of this part that constitute any of the following related to participation requirements under 42 C.F.R. §483.13, resident behavior and facility practices, 42 C.F.R. §483.15, quality of life, or 42 C.F.R. §483.25, quality of care:

(i) Immediate jeopardy to resident health or safety.

(ii) A pattern of actual harm or widespread actual harm that is not immediate jeopardy.

(iii) A widespread potential for more than minimal harm, but less than immediate jeopardy, with no actual harm.

(v) "Substantial compliance" means a facility that does not have deficiencies which impose any greater risk than a potential for minimal harm.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11002 Department authority and duties {#sec-r-330.11002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11002}

Rule 11002. (1) The department is responsible for the implementation of an enforcement system for nursing facilities. The department’s duties include, but are not limited to, determining remedies for noncompliance with federal conditions of participation to be used instead of, or in addition to, termination of a facility’s participation in the medicaid program. These rules are promulgated in accordance with section 1919 of the social security act of 1935, 42 U.S.C. §1396(h)(2)(A). Section 1919 requires that a state establish, by law, whether by statute or by regulation, remedies for noncompliance.

(2) The department shall enter into an agreement or contract with the designated state survey agency. The designated state survey agency is responsible for all survey and medicaid certification functions assigned to it by the contract or agreement between MDCH and the designated state survey agency. Nothing in these rules shall be construed as restricting the remedies or authority otherwise available to the state survey agency under federal and state law to address a nursing facility’s deficiencies.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11003 Determining substantial compliance with regulations governing medicaid certification {#sec-r-330.11003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11003}

Rule 11003. (1) The state medicaid agency, based on the determinations and recommendations of the state survey agency or HCFA, on the basis of a standard, abbreviated, extended, or partial extended survey, shall determine whether a participating nursing facility is in substantial compliance with the regulations governing medicaid certification.

(2) Based on the determination of noncompliance, the department or HCFA may impose 1 or more remedies. Remedies may be based on any of the following:

(a) The welfare of the residents.

(b) The seriousness of the deficiency.

(d) The likelihood that the remedy will lead to quick and sustained compliance.

(3) The rules of this part have been designed to minimize the time between identification of the deficiencies and the application of the remedies.

(4) The department or HCFA shall assess progressively stronger remedies for repeated or uncorrected deficiencies.

(5) Enforcement remedies include federal and state enforcement options and these rules.

(6) If the state medicaid agency finds that a nursing facility currently meets the requirements, but previously was noncompliant, then the state medicaid agency may impose a remedy for the days it finds that the facility was not in substantial compliance.

(7) Nothing in this rule shall be construed as restricting the remedies available to any state agency to address a nursing facility’s deficiencies.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11004 Determining seriousness of deficiencies {#sec-r-330.11004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11004}

Rule 11004. (1) The state medicaid agency shall determine the seriousness of a deficiency for the purpose of selecting enforcement remedies based upon the scope and severity determinations and recommendations of the state survey agency. Scope represents how many residents are or may be affected by a specific deficiency. Severity represents the seriousness of the deficiency on resident outcome.

(2) Each scope and severity combination shall be assigned an alphabetic level. The most serious deficiency cited, which is based on the level of severity first, and then scope shall determine the category or categories of remedies that shall be applied.

(3) Any of the following additional factors may be included in the selection of remedies:

(a) Whether the deficiency poses immediate jeopardy to the resident’s health or safety.

(b) The relationship of one deficiency to other deficiencies.

(d) The likelihood that the selected remedy will achieve correction and continued compliance.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11005 Severity {#sec-r-330.11005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11005}

Rule 11005. The level of severity of a deficiency shall be categorized by the department or by HCFA as 1 of the following:

(a) "No actual harm with a potential for minimal harm." This level means that a deficiency has the potential for causing no more than a minor negative impact on the resident.

(b) "No actual harm with a potential for more than minimal harm, but not immediate jeopardy." This level means noncompliance that results in minimal physical, mental, or psychosocial discomfort to the resident or has the potential to compromise the resident’s ability to maintain or reach his or her highest practicable physical, mental, or psychosocial well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services.

(c) "Actual harm that is not immediate jeopardy." This level means noncompliance that results in a negative outcome that has compromised the resident’s ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services.

(d) "Immediate jeopardy to resident health or safety." This level means a situation in which immediate corrective action is necessary because the nursing facility’s noncompliance with 1 or more requirements of participation has caused, or is likely to cause, serious injury, serious harm, impairment, or death to a resident receiving care in the facility.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11006 Scope {#sec-r-330.11006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11006}

Rule 11006. The degree of scope is provided in the HCFA-issued state operations manual, appendix P, part I, section V, deficiency categorization, and is categorized as follows:

(a) Isolated. Scope is isolated if 1 or a very limited number of residents are affected or if 1 or a very limited number of staff are involved, or if the situation has occurred only occasionally or in a very limited number of locations, or both.

(b) Pattern. Scope is a pattern if more than a very limited number of residents are affected or if more than a very limited number of staff are involved, or both, or if the situation has occurred in several locations or the same residents have been affected by repeated occurrences of the same deficient practice, or both. The effect of the deficient practice is not found to be pervasive throughout the facility.

(c) Widespread. Scope is widespread if the problems causing the deficiencies are pervasive in the facility or represent systemic failure that affected, or has the potential to affect, a large portion or all of the facility’s residents.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11007 Remedies for deficiencies {#sec-r-330.11007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11007}

Rule 11007. (1) Remedies that may be imposed by the state medicaid agency, based upon determinations and recommendations of the state survey agency or HCFA, are specified in these rules. The state medicaid agency may accept an action by the state survey agency, under state licensure authority, as a remedy imposed under these rules.

(2) Remedies shall be grouped into 3 categories. The categories take into consideration the scope and severity of the deficiency. When the scope and severity increase, the number of categories available from which to select remedies also increases.

(3) Federally authorized remedies that the state medicaid agency may impose are described in federal rules as stated in 42 C.F.R. §488.400 et seq. and as further discussed in section 7400 of the health care financing administration (HCFA) state operations manual for medicaid and medicare certified facilities. The federally authorized remedies include, but are not limited to, 1 or more of the following:

(a) A denial of payment for new admissions.

(b) State monitoring.

(d) An administrative advisor or clinical advisor, or both.

(e) A directed plan of correction.

(f) Directed in-service training.

(g) Civil money penalties.

(h) Closure of a nursing facility or the transfer of residents, or both.

(i) Termination of a provider agreement.

(j) Denial of payment for all individuals. This remedy is imposed by HCFA.

(k) Public notice that is required under state licensure authority.

(5) The state medicaid agency may also accept 1 or more of the following enforcement actions by the state survey agency, under state licensure authority, as a remedy imposed under these rules:

(a) A correction notice or order requiring a temporary administrative or clinical advisor.

(b) An emergency order limiting, suspending, or revoking a license.

(d) A correction notice or order to ban admissions or readmissions, or both.

(e) A correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.

(f) A correction notice or order requiring a temporary manager.

(g) State patient rights penalties, if applicable.

(6) An administrative or clinical advisor who is allowed under federal enforcement as an additional remedy has been added to the enforcement tools available to the state medicaid agency. The responsibility of the administrative or clinical advisor is to monitor and mentor the facility administrative or clinical staff through the period of corrective action.

(7) The state medicaid agency shall consider whether a facility meets the federal definition of poor performer or has been subject to early review by the state survey agency under its state licensure authority and shall impose or accept 1 or more of the following remedies consistent with the following menus:

(a) Category 1:

(i) Directed plan of correction.

(ii) State monitoring.

(iii) Directed in-service training.

(b) Category 2:

(i) Denial of payment for new admissions.

(ii) Appointment of an administrative or clinical advisor.

(iii) Denial of payment for all medicaid residents imposed by HCFA.

(iv) Civil money penalties that can range from $50.00 up to a maximum of $3,000.00 per day in accordance with 42 C.F.R. §488.38.

(v) Any category 1 remedy, at the option of the state medicaid agency.

(i) Appointment of a temporary manager.

(ii) Termination of the provider agreement.

(iii) Civil money penalties that can range from $3050.00 up to a maximum of $10,000.00 per day in accordance with 42 C.F.R. §488.38.

(iv) Any category 1 or 2 remedies, at the option of the state medicaid agency.

(8) Representation of how remedies and categories are grouped into menus is provided in table 1 of this part. Table 1 illustrates how facility history and the seriousness of the deficiency determines the type and level of remedies to be applied. The most serious deficiency determines the menu of remedies to be applied. Different remedies are applied for deficiencies that are classified by HCFA as "SQC." A plan of correction (PoC) is required for all levels of deficiency, except for a level A deficiency. Table 1 reads as follows:

Table 1 Historically compliant or Poor performer or needing early needing early review with review with no date certain possible date certain L* PoC Menu 3 Menu 6 K* PoC Menu 3 Menu 6 J* PoC Menu 3 Menu 6 I PoC Menu 1 Menu 4 Menu 2 if SQC Menu 5 if SQC H PoC Menu 1 Menu 4 Menu 2 if SQC Menu 5 if SQC G PoC Menu 1 Menu 4 F PoC Menu 1 Menu 4 Menu 2 if SQC Menu 5 if SQC E PoC Menu 1 Menu 4 D PoC Menu1 Menu 4 C PoC Only PoC required Only PoC required B PoC Only PoC required Only PoC required A No remedies, no PoC required No remedies, no PoC required * Indicates immediate jeopardy Validation of removal of immediate jeopardy counts as a revisit.

If more than 1 menu is indicated by survey findings, then the highest appropriate menu shall be applied.

Menu 6 Immediate jeopardy Historical classification: poor performer or needing early review with no date certain.

Scope and severity classification: J, K, or L. Survey type *: any. Plan of correction: required.

Federally authorized enforcement remedies Category 3 (required):

A civil money penalty of $3,050.00 to $10,000.00 per day and 2. 23-day termination of provider agreement.
Temporary manager.

Category 2 (optional):

Denial of payment for new admissions.
Temporary administrative or clinical advisor or both.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.

State survey agency enforcement actions (1 or more may be accepted)

Emergency order limiting, suspending, or revoking licensure.
Notice of intent to revoke license.
Correction notice or order to ban admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
Correction notice or order requiring temporary manager or requiring clinical or administrative advisor or both.
State patient rights penalties, if applicable.

Menu 5 Substandard quality of care (SQC), but not immediate jeopardy Historical classification: poor performer or needing early review with no date certain.

Scope and severity classification: H, I, or F.

Survey type *: any.

Plan of correction: required.

Federally authorized enforcement remedies Category 2 (required):

Denial of payment for new admissions.
A civil money penalty of $50.00 to $3,000.00 per day.
Temporary administrative advisor or clinical advisor, or both.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.

State survey agency enforcement actions (1 or more may be accepted)

Notice of intent to revoke licensure.
Correction notice or order to ban admissions or readmissions or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary clinical advisor or administrative advisor, or both.
State patient rights penalties, if applicable.

If the SQC is not resolved by the first or subsequent revisit:

Denial of payment for new admissions (required federal remedy if noncompliance is on the ninetieth day).
Request the state survey agency to initiate receivership sale.
Additional enforcement action from menu 5.
Increase of civil money penalty within the specified range of $50.00 to $3000.00 per day.

Menu 4 Facility not in substantial compliance Historical classification: poor performer or needing early review with no date certain.

Scope and severity classification: D, E, F, or G.

Survey type: standard or abbreviated.

Plan of correction: required.

Federally authorized enforcement remedies Category 2 (required for classification F and G; optional for classification D and E):

Denial of payment for new admissions.
Administrative advisor or clinical advisor, or both.

Category 2 (optional)

A daily civil money penalty of $50.00 to $3,000.00.

Category 1 (optional for classification F and G; required for classification D and E):

Directed plan of correction.
Directed in-service training.
State monitoring.

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order to ban admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
State patient rights penalties, if applicable.

If substantial compliance is not achieved at the first or subsequent revisit:

Notice of intent to revoke license.
Denial of payment for new admissions (required federal remedy if noncompliance continues at the ninetieth day).
Additional enforcement action from menu 4.
Civil money penalty adjustment may occur if scope and severity change.

If substantial compliance is not achieved by the one hundred and eightieth day:

Termination, as required by federal law.
Request the state survey agency to initiate receivership sale.

Notes:

If a facility has met the federal definition of "poor performer, immediate imposition of remedies will occur during the current cycle using menu 4, 5, or 6 as appropriate to the level of noncompliance.

Denial of payment for new admissions and state monitoring will be imposed if a facility has been found to have provided substandard quality of care on 3 consecutive standard surveys.

Notice of termination for failure to achieve substantial compliance within 180 days is always included with notification of alternate remedies.

If more than 1 menu is indicated by the survey findings, then the highest appropriate menu will be applied.

Federal law, as specified in the social security act at sections 1819(f)(2)(B) and 1919(f)(2)(B), prohibits approval of nurse aide training and competency evaluation programs and nurse aide competency evaluation programs offered by, or in, a facility that, within the previous 2 years, has operated under a section 1819(b)(4)(C)(ii)(II) or section 1919(b)(4)(C)(ii) waiver; has been subject to an extended or partial extended survey as a result of a finding of substandard quality of care; has been assessed a total civil money penalty of not less than $5,000.00; has been subject to a denial of payment, the appointment of a temporary manager, or termination; or, in the case of an emergency, has been closed or had its residents transferred to other facilities, or both. Exceptions, as specified in Public Law 105-15, "Permitting Waiver of Prohibition of Offering Nurse Aide Training and Competency Evaluation Programs in Certain Facilities," will apply. *"Any survey" means an annual standard survey, abbreviated survey, or revisit survey. A standard survey includes both the health survey and life safety code survey findings.

Menu 3 If immediate jeopardy is found at any survey Historical classification: historically compliant or needing early review with possible date certain.

Scope and severity classification: J, K, or L.

Survey type *: any.

Plan of correction: required.

Federally authorized enforcement remedies Category 3 (required):

23-day termination of provider agreement.
Temporary manager.

Category 3 (optional):

A civil money penalty of $3050.00 to $10,000.00 per day.

Category 2 (optional):

Denial of payment for new admissions.
Administrative advisor or clinical advisor, or both.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.

State survey agency enforcement actions (1 or more may be accepted)

Emergency order limiting, suspending, or revoking a license.
Correction notice or order to ban admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
State patient rights penalties, if applicable.

If the substandard quality of care remains at the first revisit or thereafter:

Federally authorized enforcement remedies Category 2 (required):

Denial of payment for new admissions.
Administrative advisor or clinical advisor, or both.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.

Other:

Denial of payment for new admissions (required federal remedy for noncompliance at the ninetieth day).

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
Correction notice or order requiring ban on admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
State patient rights penalties, if applicable.
Notice of intent to revoke license.

If a facility is not in substantial compliance at the first revisit or thereafter:

Federally authorized enforcement remedies Category 2 (required for F and G levels; optional for D and E levels):

Denial of payment for new admissions.
Administrative advisor or clinical advisor, or both.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.

Other:

Denial of payment for new admissions (required federal remedy for noncompliance at the ninetieth day).

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
State patient rights penalties, if applicable.
Other licensure enforcement actions appropriate to the specific case, which may include a correction order, a notice to discontinue admissions or readmissions, transfer selected patients, reduce licensed capacity, or comply with specific requirements Menu 2 If substandard quality of care is found at any survey Historical classification: historically compliant or needing early review with possible date certain.

Scope and severity classification: H, I, or F.

Survey type *: any.

Plan of correction: required.

Federally authorized enforcement remedies Category 1 (optional):

Directed plan of correction.

Directed in-service training.

State monitoring.

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
State patient rights penalties, if applicable.
Correction notice or order to ban admissions or readmissions, or both.

If the SQC remains at the first revisit or thereafter:

Federally authorized enforcement remedies Category 2 (required):

Denial of payment for new admissions.
Administrative advisor or clinical advisor, or both.

Category 2 (optional):

A civil money penalty of $50.00 to $3,000.00 per day.

Category 1 (optional):

Directed plan of correction.
Directed in-service training.
State monitoring.
Denial of payment for new admissions (required remedy for noncompliance at the ninetieth day)

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
Correction notice or order to ban admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.
State patient rights penalties, if applicable.
Notice of intent to revoke license.

If a facility is not in substantial compliance at the first revisit or thereafter:

Federally authorized enforcement remedies Category 1 (required for D and E levels; optional for F, G, H, and I levels):

Directed plan of correction.
Directed in-service training.
State monitoring.

Category 2 (required for F, G, H, and I levels; optional for D and E levels):

Denial of payment for new admissions .
Temporary administrative advisor or clinical advisor, or both.

Category 2 (optional):

A daily civil money penalty of $50.00 to $3000.00.

Other:

Denial of payment for new admissions (required federal remedy for noncompliance at the ninetieth day).

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary administrative advisor or clinical advisor, or both.
State patient rights penalties, if applicable.
Other remedial enforcement actions appropriate to the specific case, which may include a correction notice or order to ban admissions or readmissions, or both.
Transfer selected patients, reduce licensed capacity, or comply with specific requirements.

Menu 1 Facility not in substantial compliance Historical classification: historically compliant or needing early review with possible date certain.

Scope and severity classification: D, E, G, F, H, or I if not SQC.

Survey type *: standard or abbreviated.

Plan of correction: required.

No remedies; date certain opportunity to correct is given.

If substantial compliance is not achieved at the first revisit or thereafter:

Federally authorized enforcement remedies Category 1 (required for D and E levels; optional for F, G, H, and I levels):

Directed plan of correction.
Directed in-service training.
State monitoring.

Category 2 (required for F, G, H, and I levels; optional for D and E levels):

Denial of payment for new admissions .
Administrative advisor or clinical advisor or both.

Category 2 (optional):

A daily civil money penalty of $50.00 to $3000.00 per day.

Other:

Denial of payment for new admissions (required federal remedy for noncompliance at the ninetieth day).

State survey agency enforcement actions (1 or more may be accepted)

Correction notice or order requiring appointment of a temporary manager.
Correction notice or order requiring appointment of a temporary manager or clinical advisor, or both.
State patient rights penalties, if applicable.
Other licensure enforcement actions appropriate to the specific case, which may include a correction notice or order to ban admissions or readmissions, or both.
Correction notice or order to transfer selected patients, reduce licensed capacity, or comply with specific requirements.

Notes:

Denial of payment for new admissions and state monitoring will be imposed if a facility has been found to have provided substandard quality of care on 3 consecutive standard surveys.

Notice of termination for failure to achieve substantial compliance within 180 days is always included with notification of alternate remedies. Federal law, as specified in the social security act at sections 1819(f)(2)(B) and 1919(f)(2)(B), prohibits approval of nurse aide training and competency evaluation programs and nurse aide competency evaluation programs offered by, or in, a facility that, within the previous 2 years, has operated under a section 1819(b)(4)(C)(ii)(II) or section 1919(b)(4)(C)(ii) waiver; has been subject to an extended or partial extended survey as a result of a finding of substandard quality of care; has been assessed a total civil money penalty of not less than $5,000.00; has been subject to a denial of payment, the appointment of a temporary manager, or termination; or, in the case of an emergency, has been closed or had its residents transferred to other facilities, or both. Exceptions as specified in Public Law 105-15, "Permitting Waiver of Prohibition of Offering Nurse Aide Training and Competency Evaluation Programs in Certain Facilities," will apply. *"Any survey" means an annual standard survey, abbreviated survey, or revisit survey. A standard survey includes both the health survey and life safety code survey findings.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11008 Facility classification {#sec-r-330.11008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11008}

Rule 11008. (1) A facility that meets the federal definition of "poor performer" shall not be given a date certain, that is an opportunity to correct before remedies are imposed.

Remedies shall be imposed immediately.

(2) In making a determination to impose remedies, the state medicaid agency shall consider whether the state survey agency has identified a nursing facility as needing early review under the state licensure authority.

(3) If a nursing facility is allowed a date certain, then the nursing facility may or may not have federal category 1 remedies imposed immediately.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11009 Assuring prompt facility certification compliance {#sec-r-330.11009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11009}

Rule 11009. (1) If a nursing facility is not found by the state survey agency to be in substantial compliance with certification requirements within 90 days after the date the facility is determined to be out of compliance, then the state medicaid agency shall deny payment for services provided to medicaid eligible individuals admitted to the nursing facility on or after that date.

(2) The nursing facility shall not bill the medicaid program for services provided to medicaid-eligible clients admitted to the facility on or after that date.

(3) A nursing facility that has deficiencies that constitute serious and immediate jeopardy shall not be allowed more than 23 days to correct the serious and immediate jeopardy and, depending on the situation, may be allowed less than 23 days before termination of the medicaid participation agreement.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11010 Failure to readmit qualified medicaid resident {#sec-r-330.11010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11010}

Rule 11010. (1) The state medicaid agency shall impose a daily civil money penalty of $400.00 on a nursing facility if the state medicaid agency is notified that the nursing facility unlawfully refuses to readmit a qualified medicaid resident after hospitalization.

(2) If a nursing facility unlawfully refused to readmit a qualified medicaid resident after hospitalization, then a date certain shall not be applied. The daily civil money penalty shall start on the date validated by the state survey agency that nursing home readmission should have occurred.

(3) The daily $400.00 penalty continues against the nursing facility until the resident is offered the next qualifying available medicaid bed.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11011 Substandard quality of care (SQC) {#sec-r-330.11011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11011}

Rule 11011. (1) If a nursing facility is cited for SQC, then, together with other remedies, the state medicaid agency shall apply the following additional remedies:

(a) Request the state survey agency to notify the attending physicians of residents identified during the survey process as having been affected by the SQC or by the deficient findings.

(b) Request the state survey agency to notify the state nursing home administrator’s licensure board of all findings of SQC.

(d) In the event of substandard quality of care, the state medicaid agency may assess a daily civil money penalty.

(2) If a nursing facility fails to correct the SQC by the ninetieth day, then, in addition to other appropriate remedies, the state medicaid agency shall deny payment for all new medicaid admissions.

(3) If a nursing facility fails to correct the SQC by the one hundred and eightieth day, then, in addition to other remedies, the state medicaid agency shall terminate the provider agreement.

(4) If a nursing facility has been found to have provided SQC on the last 3 consecutive standard surveys, then, together with other remedies, the state medicaid agency shall deny payment for new medicaid admissions and apply state monitoring.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11012 Immediate jeopardy {#sec-r-330.11012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11012}

Rule 11012. (1) If a nursing facility is cited for immediate jeopardy, then a date certain will not be allowed. The state medicaid agency shall request that the state survey agency take immediate action to ensure that the facility removes the jeopardy and corrects the deficiencies or the state medicaid agency shall terminate the facility’s participation under the medicaid state plan. Actions that may be taken or requested by the state medicaid agency include, but are not limited to, the following:

(a) Immediate termination under the 23-day serious and immediate threat policy.

(b) Additional actions, which may include 1 or more of the following:

(i) Request the state survey agency to order a temporary manager under its licensure authority.

(ii) Impose any category 1 or 2 remedies determined appropriate.

(iii) Impose a daily civil money penalty of $3,050.00 to $10,000.00.

(2) Impose or request additional remedies that can be applied pursuant to law based on the compliance history of the facility and to protect residents or assure compliance.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11013 Nursing facility not in substantial compliance; notice of termination {#sec-r-330.11013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11013}

Rule 11013. (1) If a facility’s deficiencies do not constitute immediate jeopardy, then the state medicaid agency may apply alternative remedies instead of termination of the provider agreement. However, even though the deficiencies do not constitute immediate jeopardy, a concurrent notice of termination shall be issued together with written notice of the deficiency.

(2) If a facility’s deficiencies are not corrected, then the notice of termination shall be effective not later than 180 days from the last date of survey.

(3) If an alternate remedy is chosen and the nursing facility did not come into substantial compliance within 180 days, then the state medicaid agency shall be liable to HCFA for payments made in the interim and the nursing facility shall be liable to the state medicaid agency.

(4) Concurrent notice of termination from the state medicaid agency is given to alert the nursing facility to the potential for nonpayment of services.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11014 Civil money penalty {#sec-r-330.11014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11014}

Rule 11014. (1) Prior notice is not required before a civil money penalty is imposed.

(2) A penalty equivalent to a 1-day penalty shall apply in all circumstances even if a facility deficiency is immediately corrected.

(3) The daily penalty shall end on the day before the determination of substantial compliance. Civil money penalties remain effective until the nursing facility achieves substantial compliance or until termination.

(4) The state medicaid agency shall accept the determination of the state survey agency as to the date a nursing facility has come into substantial compliance.

(5) Civil money penalty amounts shall be increased or decreased to reflect changes in levels of compliance at revisit.

(6) Civil money penalty amounts shall increase by 50% for repeat deficiencies.

(7) Continuing assessment of civil money penalties may cease if facility cooperation exists and 1 of the following occurs:

(a) The appointment of a receiver by a circuit court.

(b) Closure of a nursing facility as evidenced by the filing of a notice of discontinuance of operation with the Michigan department of consumer and industry services under section 21785 of Act No. 368 of the Public Acts of 1978, as amended, being §333.21785 of the Michigan Compiled Laws.

(8) Money collected by the department of as a result of civil money penalties shall be deposited into a special fund to be applied to the protection of the health and property of residents of any nursing facility that the state or HCFA finds deficient.

(9) Money withheld by the state medicaid agency from funds due a nursing facility because of a lack of payment of civil money penalties by the nursing facility shall also be deposited in the fund specified in subrule (8) of this rule.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11015 Notice of civil money penalty assessment {#sec-r-330.11015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11015}

Rule 11015. (1) The state medicaid agency shall obtain both of the following from the state survey agency:

(a) Notice of the civil money penalty recommended.

(b) The specific type of civil money penalty recommendation and applicable number of days recommended.

(2) The state medicaid agency shall notify the nursing facility, as provided in 42 C.F.R. §§488.402(f) and 488.434, of all of the following:

(a) The total civil money assessment.

(b) The nursing facility’s appeal rights.

(3) A nursing facility may only appeal the existence of a deficiency or the number of days considered to be in violation. The amount of the civil money penalty shall not be subject to appeal.

(4) Appeals shall be through the state medicaid agency. To the extent possible, the state medicaid agency shall coordinate the enforcement appeal hearings with any state licensure appeals processes afforded by the state survey agency.

(5) Within 30 calendar days of the notice of appeal rights, a nursing facility may elect to waive the right to appeal. The waiver shall be in writing and be received by the state medicaid agency appeals section within 30 days of the notice of appeal rights. Waiver of the right to appeal shall reduce the total civil money penalty amount by 35%.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11016 Civil money penalty collection {#sec-r-330.11016 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11016}

Rule 11016. (1) A civil money penalty shall be collected through voluntary transmittal.

(2) A civil money penalty shall be paid by check made payable to the "State of Michigan."

A penalty shall be paid within 30 calendar days of receipt of the initial notice of penalty or within 15 days of the issuance of appeal results. A repayment schedule shall not be allowed.

(3) If voluntary transmittal of the full penalty amount does not occur, the civil money penalty shall be recovered by gross adjustment against the next available medicaid warrant.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 330.11017 Civil money penalty not allowable medicaid cost {#sec-r-330.11017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.11017}

Rule 11017. A civil money penalty is not an allowable medicaid cost.

History

History: 1998-2000 AACS.

Legal Affairs and Legislative Services Administration Legal Affairs and Legislative Services Administration

R 333.1001 to R 333.1004 Nonopioid Directive

Mich. Admin. Code R 333.1001 Recording directive form in medical record; electronic records {#sec-r-333.1001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.1001}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

POLICY AND INNOVATION DIVISION

NONOPIOID DIRECTIVE

(By authority conferred on the department of health and human services by sections 2226, 2233, and 9145 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, and 333.9145)

Rule 1. (1) A health professional presented with a nonopioid directive must, without undue delay, record the directive in the individual’s medical record.

(2) A nonopioid directive must be recorded in a manner, whether paper or electronic, that makes the directive available to other health professionals who may review the record.

(3) A nonopioid directive may be incorporated into an existing patient form or other documentation used by the health professional or health facility or agency.

History

History: 2019 AACS.

Mich. Admin. Code R 333.1002 Revoking a nonopioid directive form {#sec-r-333.1002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.1002}

Rule 2. (1) A nonopioid directive form filed by an individual may be revoked at any time and in any manner by which he or she is able to communicate his or her intent to revoke the form.

(2) A nonopioid directive form filed by a patient advocate or guardian may be revoked at any time by issuing the revocation in writing and providing notice of the revocation to the individual’s health professional or his or her delegatee.

History

History: 2019 AACS.

Mich. Admin. Code R 333.1003 Confidentiality {#sec-r-333.1003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.1003}

Rule 3. A health professional who records, discloses, distributes, or otherwise interacts with a nonopioid directive form is required to abide by all relevant state and federal laws, rules, and regulations applicable to confidentiality of other similar health data.

History

History: 2019 AACS.

Mich. Admin. Code R 333.1004 Exemptions; hospital and emergency setting; substance abuse disorder; hospice patient {#sec-r-333.1004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.1004}

Rule 4. A nonopioid directive does not preclude administration or prescription of opioids when any of the following are met:

(a)The opioid is administered or prescribed to treat the individual for a substance use disorder.

(b)The criteria set forth by MCL 333.9145(3) are met.

History

History: 2019 AACS.

Children's Services Agency Children's Services Agency

R 400.10 to R 400.18 Interstate Compact on the Placement of Children

Mich. Admin. Code R 400.10 Definitions {#sec-r-400.10 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10}

DEPARTMENT OF HUMAN SERVICES

JUVENILE JUSTICE PROGRAMS

INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN

(By authority conferred on the department of human services by Article VII of 1984 PA 114, MCL 3.711.)

Rule 1. (a) "Child" means a person who, by reason of minority, is legally subject to parental, guardianship, or similar control.

(b) “Department” means the Michigan department of human services.

(c) “Foster Care”, for purposes of these rules only and defined by Regulation Three of the Interstate Compact on the Placement of Children, means placement of a child which includes 24-hour a day care provided by the child’s parent or parents by reason of a courtordered placement or 24-hour substitute care for children placed away from their parents or guardians and for whom the state agency has placement and care responsibility. This includes, but is not limited to the following:

(i) Placements in foster family homes.

(ii) Foster homes of relatives.

(iii) Group homes.

(iv) Emergency shelters.

(v) Residential facilities.

(vi) Child care institutions.

(vii) Pre-adoptive homes.

A child is in foster care regardless of any of the following:

(i) The foster care facility is licensed and payments are made by the state or local agency for the care of the child.

(ii) Whether adoption subsidy payments are being made prior to the finalization of an adoption.

(iii) Whether there is federal matching of any payments that are made.

(d) “Interstate Compact on the Placement of Children” or “ICPC” means the compact between states and parties pursuant to statute that ensures protection and services to children who are placed across state lines.

(e) “Parent” means a biological, adoptive parent, or legal guardian as determined by applicable state law and is responsible for the care, custody, and control of a child or upon whom there is legal duty for such care.

(f) "Placement" means the arrangement for the care of a child in a family free or boarding home or in a child-caring agency or institution, but does not include any institution caring for the mentally ill, mentally defective, or epileptic, or any institution primarily educational in character, and any hospital or other medical facility.

(g) "Receiving state" means the state to which a child is sent, brought, or caused to be sent or brought, whether by public authorities or private persons or agencies, and whether for placement with state or local public authorities or for placement with private agencies or persons.

(h) "Sending agency" means a party state, or officer or employee thereof; a subdivision of a party state, or officer or employee thereof; a court of a party state; a person, corporation, association, charitable agency, or other entity that sends, brings, or causes to be sent or brought any child to another party state.

(i) “State compact administrator” means an officer in the department who is appointed by the executive head of each jurisdiction and who acts as general coordinator of activities under this compact in the officer's jurisdiction to carry out more effectively the terms and provisions of this compact.

History

History: 2015 AACS.

Mich. Admin. Code R 400.11 Implementation of processes; policy {#sec-r-400.11 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.11}

Rule 2. Procedures for the implementation of these rules as required by the ICPC shall be published in this state’s ICPC policies and made available to the public.

History

History: 2015 AACS.

Mich. Admin. Code R 400.11a Scope and Purpose {#sec-r-400.11a omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.11a}

Rule 3. (1) The purpose of these rules is to provide, at the request of a sending agency, a home study and placement decision by a receiving state for the proposed placement of a child with a proposed caregiver who falls into either of the following categories of placement:

(a) For public adoption.

(b) Foster care and/or with parents or relatives.

(2) The ICPC regulations are promulgated by the Association of Administrators of the Interstate Compact on the Placement of Children by authority of the ICPC Compact.

Editor's Note: An obvious error in R 400.11a was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2015 MR 8. The memorandum requesting the correction was published in Michigan Register, 2015 MR 9.

History

History: 2015 AACS.

Mich. Admin. Code R 400.12 Applicability; authority of court; delegation {#sec-r-400.12 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12}

Rule 4. (1) Placement decisions apply to cases involving children who are under the jurisdiction of a court for abuse or neglect as a result of action taken by a child welfare agency.

(2) The court may determine supervision, custody, and placement of the child or may delegate authority to the child welfare agency if the child is being considered for placement in another state.

Editor's Note: An obvious error in R 400.12 was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2015 MR 8. The memorandum requesting the correction was published in Michigan Register, 2015 MR 9.

History

History: 2015 AACS.

Mich. Admin. Code R 400.13 ICPC placement protection status {#sec-r-400.13 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.13}

Rule 5. ICPC placement protection continues under either of the following conditions:

(a) The child has not yet been placed and there is consideration of a placement resource.

(b) When requesting a new home study on the current approved placement resource. This may include an upgrade from unlicensed relative to a licensed foster home or to adoption home placement category.

History

History: 2015 AACS.

Mich. Admin. Code R 400.14 Child placed without ICPC approval; violation; receiving state options {#sec-r-400.14 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.14}

Rule 6. (1) When a child has been placed in a receiving state prior to ICPC approval, the case is considered a violation of ICPC and the placement is made with the sending agency bearing full liability and responsibility for the safety of the child.

(2) The receiving state may request immediate removal of the child until the receiving state has made a decision under the ICPC.

(3) The receiving state may proceed, but is not required to proceed, with the home study/ICPC decision process as long as the child is placed in violation of the ICPC.

(4) The receiving state may choose to open the case for ICPC courtesy supervision.

History

History: 2015 AACS.

Mich. Admin. Code R 400.15 Placements not subject to ICPC protection {#sec-r-400.15 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.15}

Rule 7. (1) ICPC protection does not apply under the following conditions:

(a) When the court places the child with a parent from whom the child was not removed, and the court does the following:

(i) Has no evidence that the parent is unfit.

(ii) Does not seek any evidence from the receiving state that the parent is either fit or unfit.

(iii) Relinquishes jurisdiction over the child immediately upon placement with the parent.

The receiving state shall have no responsibility for supervision or monitoring for the court having made the placement.

(b) When a sending court/agency seeks an independent (not ICPC-related) courtesy check for placement with a parent from whom the child was not removed.

(2) The responsibility for credentials and quality of the courtesy check rests directly with the sending court/agency and the person or party in the receiving state who agrees to conduct the courtesy check without invoking the protection of the ICPC home study process.

(ii) The requirement in subrule (2) of this rule does not prohibit a sending state from requesting an ICPC.

History

History: 2015 AACS.

Mich. Admin. Code R 400.16 Returning child to sending agency; denial of placement {#sec-r-400.16 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.16}

Rule 8. (1) If the child is already residing in the receiving state with the proposed caregiver at the time the ICPC denies the placement, the receiving state compact administrator may request the sending agency to arrange for the return of the child as soon as possible or propose an alternative placement in the receiving state.

(2) Alternative placement resource shall be approved by the receiving state before placement is made.

(3) Return of the child shall occur within 5 business days from the date of the notice for removal unless otherwise agreed upon between the sending agency and receiving state ICPC offices.

History

History: 2015 AACS.

Mich. Admin. Code R 400.17 Request to return child to sending agency; previously approved or alternative placement {#sec-r-400.17 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.17}

Rule 9. (1) Following approval and placement of the child, if the receiving state compact administrator determines that the placement no longer meets the individual needs of the child, including the child’s safety, permanency, health, well-being, and mental, emotional, and physical development, the receiving state compact administrator may request the sending agency arrange for the return of the child as soon as possible or propose an alternative placement in the receiving state.

(2) Alternative placement resource shall be approved by the receiving state before placement is made.

(3) Return of the child shall occur within five (5) business days from the date of notice for removal unless otherwise agreed upon between the sending agency and receiving state ICPC offices.

History

History: 2015 AACS.

Mich. Admin. Code R 400.18 Withdrawing request for request for removal {#sec-r-400.18 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.18}

Rule 10. The receiving state request for removal may be withdrawn if the sending agency arranges services to resolve the reason for the requested removal and the receiving and sending state compact administrators mutually agree to the plan.

History

History: 2015 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 400.24 to R 400.26 State Vendor Participation in Medical Costs

DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

STATE VENDOR PARTICIPATION IN MEDICAL COSTS

(By authority conferred on the department of social services by section 6 of Act No. 280 of the Public Acts of 1939, as amended, being S400.6 of the Michigan Compiled Laws)

Rule 24. All claims incurred and paid by the county social welfare board involving vendor medical service for which state reimbursement is sought must be submitted to the county bureau of social aid on a monthly basis but not later than the end of the fifth month following the month in which the latest continuous service in the same class is rendered.

Provided, that the state department may pay a bill submitted beyond the fifth month if in its judgment there are extenuating circumstances and if federal financial participation can be obtained.

History

History: 1979 AC.

Mich. Admin. Code R 400.25 Determination of percentage of state participation {#sec-r-400.25 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.25}

Rule 25. The commission will redetermine from time to time the percentage of the costs of hospitalization to be paid by the state department under section 66a of the social welfare act, and such determination shall be applicable to invoices approved by the supervisor of the bureau of social aid in the month or months following such determination, regardless of the date the expense for hospitalization was incurred.

History

History: 1979 AC.

Mich. Admin. Code R 400.26 Enforcement of patient's right to hospitalization {#sec-r-400.26 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.26}

Rule 26. (1) "Promptly" as used in section 66b of the social welfare act and this rule shall, in nonemergency cases, be defined as "within 30 calendar days." Failure of a county department to make a decision promptly on an application for hospitalization by a person who is receiving old age assistance, aid to dependent children (except a person so receiving as an eligible child), aid to the blind, or aid to the permanently and totally disabled, as required by section 66b of the social welfare act, shall be considered to be a determination that hospitalization is not necessary, and the supervisor of the bureau of social aid shall then, with the consent of the applicant, petition for a hearing as provided in sections 66d and 9 of the social welfare act.

(2) The county social welfare board shall comply with a decision made by the director of the state department under R 400.7 concerning hospitalization within 5 working days following receipt of the notice of the decision.

(3) If the county social welfare board does not comply with the decision of the director of the state department as required by subrule (2), the bureau of social aid of the county department of social welfare shall arrange for or approve the necessary hospitalization and shall authorize payment by the state department for it.

(4) The county portion of the costs of hospitalization, when incurred under subrules (2) or (3), shall be recovered by the state department by withholding the amount from any funds due the county social welfare board by the state department.

History

History: 1979 AC.

Economic Stability Administration Economic Stability Administration

R 400.31 to R 400.38 Inter-County Disputes

Mich. Admin. Code R 400.31 Appeal; petition {#sec-r-400.31 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.31}

DEPARTMENT OF FAMILY INDEPENDENCE AGENCY

FAMILY SERVICES ADMINISTRATION

INTER COUNTY DISPUTES

(By authority conferred on the department of social services by section 9 of Act No. 380 of the Public Acts of 1965, as amended, sections 2 and 5 of Act No. 116 of the Public Acts of 1973, as amended, section 3 of Act No. 381 of the Public Acts of 1974, as amended, and sections 5, 10, and 13 of Act No. 218 of the Public Acts of 1979, as amended, being SS16.109,

PART 2. INTER-COUNTY DISPUTES

Rule 31. To appeal a dispute with another county or counties concerning the settlement of an applicant or recipient with respect to any form of public assistance, a county shall file a written petition with the director of administrative hearings. The petition shall clearly explain the nature of the dispute and provide a factual background of the dispute.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.32 Answer {#sec-r-400.32 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.32}

Rule 32. Upon notice from the family independence agency (FIA), the defending county or counties shall file an answer to the original petition that clearly explains the county of counties position in the dispute.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.33 Dispute Assignment {#sec-r-400.33 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.33}

Rule 33. The director of FIA administrative hearings shall assign the dispute to a senior level administrative law judge to hear the dispute pursuant to the provisions of Act No. 306 of the Public Acts of 1969, as amended, being SS24.201 et seq. of the Michigan Compiled Laws.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.34 Prehearing Conference {#sec-r-400.34 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.34}

Rule 34. (1) The assigned administrative law judge shall conduct a prehearing conference either in person or by telephone.

(2) At the prehearing conference the administrative law judge shall do all of the following:

(a) Ascertain the nature of the dispute.

(b) Determine the necessary parties to the dispute and the necessary witnesses.

(d) Set the date and time of hearing.

(e) Issue subpeonas.

(f) Resolve any other preliminary matters that the law judge deems necessary and appropriate.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.35 Hearing date; hearing place; notice {#sec-r-400.35 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.35}

Rule 35. The assigned administrative law judge shall set a date and place for the hearing and shall give every party to the dispute fair written notice of the date, place, and time of the hearing. The hearing shall be held in the offices of the FIA administrative hearings division, unless a client involved in the dispute requests that the hearing be held in a location more convenient to the client.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.36 Representation; evidence {#sec-r-400.36 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.36}

Rule 36. (1) A party to a dispute may be represented by another person.

(2) A party to a dispute may present witnesses and evidence if the presiding administrative law judge determines that the witnesses or evidence has a direct bearing on the dispute and if the witnesses or evidence is presented in compliance with sections 71 to 87 of Act No. 306 of the Public Acts of 1969, as amended, being SS24.271 to 24.287 of the Michigan Compiled Laws.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.37 Findings of fact; proposal for decision {#sec-r-400.37 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.37}

Rule 37. The presiding administrative law judge shall hear and weigh all evidence and shall prepare written findings of the facts and a proposal for decision. The findings of fact and the proposal for decision shall be mailed to the counties involved in the dispute for their review and an opportunity to file exceptions.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Mich. Admin. Code R 400.38 Director decision {#sec-r-400.38 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.38}

Rule 38. The director of the family independence agency shall review the proposal for decision and any exceptions and shall issue a decision. The decision shall be final and binding on the parties.

History

History: 1944 AC; 1954 AC; 1979 AC; 1997 AACS.

Children's Services Agency Children's Services Agency

R 400.201 to R 400.206 Placement on Central Registry After Criminal Conviction

Mich. Admin. Code R 400.201 Definitions {#sec-r-400.201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.201}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF CHILDREN’S SERVICES AGENCY

PLACEMENT ON CENTRAL REGISTRY AFTER CRIMINAL CONVICTION

(By authority conferred on the department of health and human services by section 7j of the child protection law, 1975 PA 238, MCL 722.627j)

Rule 1. (1) As used in these rules:

(a) “Act” means the child protection law, 1978 PA 238. MCL 722.621 to 722.638.

(b) “Conviction” means a formal declaration that an individual is guilty of a criminal offense, by the verdict of a jury or the decision of a judge in a court of law.

(d) “Department” means the department of health and human services.

(e) “Expunction” means removal of a record or report.

(f) “Individual” means the person convicted of a specific crime and whose conviction warrants placement on the central registry.

(g) “SCAO” means the state court administrator’s office, which is the office under this state’s judicial branch that provides guidance and management to trial courts statewide.

(2) Terms defined in the act have the same meanings when used in these rules.

History

History: 2022 AACS.

Mich. Admin. Code R 400.202 Department process after receipt of central registry placement from the court {#sec-r-400.202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.202}

Rule 2. (1) The department shall create a central point of contact for the receipt of all requests from the courts for placement of an individual on the central registry.

(2) After receipt of the request and conviction order from the court, the department shall review the request for a determination of placement on the central registry.

(3) If the department’s review results in placement, the placement must occur within 30 business days after receipt of the order.

(4) The central registry placement date must be the date of the conviction order.

(5) The department shall coordinate with SCAO in the creation of forms for an individual’s placement on the central registry.

History

History: 2022 AACS.

Mich. Admin. Code R 400.203 Multiple placements on the central registry {#sec-r-400.203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.203}

Rule 3. If it is determined that an individual named in the criminal conviction order for placement is currently on the central registry for a confirmed central registry case for the same offense investigated by the department, both placements must remain on the central registry.

History

History: 2022 AACS.

Mich. Admin. Code R 400.204 Department’s notification to an individual of placement on the central registry {#sec-r-400.204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.204}

Rule 4. Once an individual is placed on the central registry because of the individual's conviction, the department shall mail notification of the placement on the central registry to an individual by registered or certified mail, return receipt requested, and restricted delivery to the addressee. The department shall include language in the notification of an individual’s right to a hearing before the convicting court and, if applicable, the department, for expunction of the placement.

History

History: 2022 AACS.

Mich. Admin. Code R 400.205 Expunction request {#sec-r-400.205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.205}

Rule 5. (1) An individual requesting an expunction from the central registry because of a criminal conviction shall file a motion in the court of conviction to request an expunction by that court. The court may deny the request or issue a request to the department for expungement. An individual may only request expunction based on either of the following:

(a) Demonstrating that the individual was not convicted of an offense listed under section 7j(3) of the act, MCL 722.627j.

(b) Demonstrating that the individual's conviction of the offense that caused the individual to be placed on the central registry has been expunged.

(2) If an individual is placed on the central registry by the department’s substantiation for the same offense as placement for the criminal conviction, the individual requesting expunction must request expunction through both the department and the court of conviction.

History

History: 2022 AACS.

Mich. Admin. Code R 400.206 Expunction finding by court {#sec-r-400.206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.206}

Rule 6. (1) After receipt of a request from the court for an individual to be removed from the central registry, the department shall review the court’s request and determine whether removal is warranted.

(2) The court’s request for removal from the central registry is based on the criminal conviction only. If an individual has a placement for the same offense because of the department’s investigation and substantiation of a central registry placement, the individual shall file an administrative request for review and hearing with the department for removal of the department’s placement.

(3) After an individual is removed from the central registry, notification of the removal must be sent to the individual and the court of conviction, by first class mail.

(4) The department shall coordinate with the SCAO in the creation of forms for an individual’s removal from the central registry.

History

History: 2022 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 400.501 to R 400.515 Medical Assistance for the Aged

Mich. Admin. Code R 400.501 Living with the spouse {#sec-r-400.501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.501}

DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

MEDICAL ASSISTANCE FOR THE AGED

(By authority conferred on the department of social services by section 6 of Act No. 280 of the Public Acts of 1939, as amended, being S400.6 of the Michigan Compiled Laws)

Rule 501. As found in Act No. 2 of the Public Acts of 1960, First Extra Session, hereinafter referred to in these rules for medical assistance for the aged as "the act," the phrase "living with the spouse" applies to all married clients, except in case of legal separation, estranged separation, or deportation.

History

History: 1979 AC.

Mich. Admin. Code R 400.502 Rescinded {#sec-r-400.502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.502}

History

History: 1979 AC.

Mich. Admin. Code R 400.503 Disclosure of information {#sec-r-400.503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.503}

Rule 503. Records of recipients and former recipients are confidential and no information concerning them or their existence may be given out, except when necessary for purposes related to the administration of public assistance, including recovery of assistance granted.

When necessary to give information, R 400.6(2), (3), and (4) of part 1 of the rules of the commission will be followed.

History

History: 1979 AC.

Mich. Admin. Code R 400.504 Enforcement of patient's rights to services under this act {#sec-r-400.504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.504}

Rule 504. If the state department finds that the county social welfare board has refused to provide the services for which a patient has been certified as eligible by the county bureau of social aid, the state department will provide the services and deduct the cost thereof, including reasonable costs of administration, from moneys owing or to be owing the county by the state department.

History

History: 1979 AC.

Mich. Admin. Code R 400.505 Reduction of services {#sec-r-400.505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.505}

Rule 505. When, for financial reasons, the commission must reduce services, it may (a) discontinue some or all services for a month or months as determined by the commission after 30 days' notice has been given to the county social welfare board or (b) it may establish a time limitation on some or all services available to new or reinstated clients.

History

History: 1979 AC.

Mich. Admin. Code R 400.506 Hearings {#sec-r-400.506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.506}

Rule 506. The patient shall be informed in writing of his right to appeal any decision made concerning his application or his medical assistance and of his right to a hearing. Hearings will follow the procedures prescribed by the rules for public assistance hearings, R 400.7 of part 1 of the rules of the commission.

History

History: 1979 AC.

Mich. Admin. Code R 400.507 Rescinded {#sec-r-400.507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.507}

History

History: 1979 AC.

Mich. Admin. Code R 400.508 Intercounty disputes {#sec-r-400.508 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.508}

Rule 508. Disputes between 2 or more counties relating to interpretations of the act and claims thereunder may be settled by the social welfare commission in the same manner as prescribed in part 2 of the rules of the commission for appeals of settlement disputes.

History

History: 1979 AC.

Mich. Admin. Code R 400.509 Coverage in respect to services {#sec-r-400.509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.509}

Rule 509. The state department shall, in consultation with the state commissioner of insurance, determine what hospital and physicians' services are "furnished" under the 2 contracts in the act and in effect on September 1, 1960, and on file with the insurance commissioner. Such determination shall be implemented in written instructions to the county social welfare departments and bureaus of social aid as shall be deemed necessary from time to time.

History

History: 1979 AC.

Mich. Admin. Code R 400.510 Rescinded {#sec-r-400.510 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.510}

History

History: 1979 AC.

Mich. Admin. Code R 400.511 Reconsideration of eligibility for assistance {#sec-r-400.511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.511}

Rule 511. Eligibility for assistance granted under this act shall be reconsidered from time to time as circumstances may require, and such reinvestigation, including redetermination of medical need, shall be made at least once in each 12 months.

History

History: 1979 AC.

Mich. Admin. Code R 400.512 Definition of acute illness {#sec-r-400.512 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.512}

Rule 512. "Hospitalization for an acute illness" is defined as in-patient care in an approved hospital for: (a) an illness, injury, or defect which has arisen within 60 days immediately prior to date of entry into the hospital, or (b) admission to the hospital for an exacerbation of an illness, injury, or defect which has existed more than 60 days prior to admission, or (c) surgery.

History

History: 1979 AC.

Mich. Admin. Code R 400.513 Nursing care; 90-day limit {#sec-r-400.513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.513}

Rule 513. To qualify for nursing care in a licensed nursing home a person must have received hospitalization for an acute illness and enter the nursing home for care required for the illness for which the person was hospitalized within 30 calendar days following discharge from the hospital, provided that not more than 90 days of nursing care may be approved for any MAA recipient in a 12-month period, beginning with the first day of admission to the nursing home.

History

History: 1979 AC.

Mich. Admin. Code R 400.514 Death of patient after application {#sec-r-400.514 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.514}

Rule 514. In the case of a patient who dies after application, services may be provided under medical assistance for the aged if eligibility can be determined and certification issued within 30 calendar days following death.

History

History: 1979 AC.

Mich. Admin. Code R 400.515 Assistance to Michigan residents {#sec-r-400.515 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.515}

Rule 515. The state department may pay up to 100% of the cost of medical assistance for the aged services provided to: (a) Patients who have Michigan residence but are without domicile in any Michigan county; (b) Patients who are Michigan residents but are temporarily absent from the state.

History

History: 1979 AC.

Children's Services Agency Children's Services Agency

R 400.2001 to R 400.2049 Child Care Fund

Mich. Admin. Code R 400.2001 Definitions {#sec-r-400.2001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2001}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CHILDREN’S SERVICES AGENCY

CHILD CARE FUND

(By authority conferred on the department of health and human services by sections 6 and 117a of the social welfare act, 1939 PA 280, MCL 400.6 and 400.117a)

PART 1. GENERAL PROVISIONS

Rule 1. As used in these rules:

(a) “Child” means an individual who meets all of the following:

(i) Is not emancipated under 1968 PA 293, MCL 722.1 to 722.6.

(ii) Lives with a parent or caretaker.

(iii) Is either of the following:

(A) Less than 18 years of age.

(B) 18 years of age and a full-time high school student.

(iv) Is under the jurisdiction of the court pursuant to sections 2a and 5 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2a and 712A.5.

(b) “Community-based services” means programs or services that are used as alternatives to residential or detention care or expedite the return home of a youth to the community.

Community-based services include respite care and shelter care for less than 30 days pursuant to sections 117a to 117h of the social welfare act, 1939 PA 280, MCL 400.117a to 400.117h.

(c) "County department" means the county office of the department of health and human services created in each county by section 45 of the social welfare act, 1939 PA 280, MCL 400.45, or the tribal entity found within that county.

(d) "County department of health and human services subaccount" means the account authorized by the county board of commissioners or tribal entity responsible for the expenditure of child care funds by the county department.

(e) "Court" means the local or tribal court with jurisdiction over juvenile matters.

(f) “Department" means the department of health and human services.

(g) "Direct service" means service provided to a specific client rather than to a general target group.

(h) “Judicial costs” means costs related to or connected with the administration of justice that include, but are not limited to, the following:

(i) Filing fees.

(ii) Charges for service of summons and complaint.

(iii) Attorney fees.

(iv) Court reporter charges.

(i) "Published policies and business processes” means those policies and business processes contained in "The Child Care Fund Handbook” and department policy.

(j) "State ward charge-back" means the amount of money the department bills a county for the cost of care for state wards.

History

History: 1987 AACS; 2020 AACS; 2025 AACS.

Mich. Admin. Code R 400.2002 Exemption from rule {#sec-r-400.2002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2002}

Rule 2. (1) Upon written request of the court or county department, the department shall grant an exemption from an administrative rule only if there is clear and convincing evidence that the alternative to the rule complies with the intent of the administrative rule from which exemption is sought.

(2) The decision of the department, including the qualification under which the exemption is granted, shall be entered upon the records of the department and a signed copy shall be sent to the court or county department. This exemption may remain in effect for as long as the court or county department continues to comply with the intent of the rule or may be time limited.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2003 Court staff providing direct services; minimum qualification {#sec-r-400.2003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2003}

Rule 3. The court shall document that staff providing direct services to children, or supervising staff who provide direct services to children, for which service costs are reimbursed from the state child care fund meet the minimum qualifications established in the juvenile court standards and administrative guidelines for the care of children established by Supreme Court Administrative Order No. 1985-5, 422 Mich cxi (1985), as modified by Administrative Order No. 1988-3, 430 Mich xcix (1988) and by order of May 19, 2009, effective September 1, 2009, 483 Mich civ (2009), or by department policy.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2004 County department staff providing direct services; standards {#sec-r-400.2004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2004}

Rule 4. The county department shall document that staff providing direct services to children, or supervising staff who provide direct services to children, for which service costs are reimbursed from the state child care fund meet the standards set forth in R 400.4116, R 400.4117, R 400.4118, R 400.4119, R 400.4120, R 400.4121, R 400.12205, R 400.12206, and R 400.12207.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2005 Rescinded {#sec-r-400.2005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2005}

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2005a County requirements {#sec-r-400.2005a omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2005a}

Rule 5a. (1) In addition to the county requirements under section 117a(13) of the social welfare act, 1939 PA 280, MCL 400.117a, the county shall provide data for each of those requirements to receive state reimbursement.

(2) The data and method of providing the data will be cited in the department’s published policies and business processes.

History

History: 2025 AACS.

Mich. Admin. Code R 400.2006 Purchase of contractual services; requirements {#sec-r-400.2006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2006}

Rule 6. Contractual services purchased through basic grant or in-home care money must conform to the requirements published in the Child Care Fund Handbook.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2007 Case records {#sec-r-400.2007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2007}

Rule 7. (1) The court and county department shall document eligibility for each child claimed for state child care fund reimbursement by the program and accounting records.

(2) Documentation of eligibility must be retained as directed by the Child Care Fund Handbook.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2008 County child care fund expenditure reimbursement; eligibility {#sec-r-400.2008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2008}

Rule 8. (1) To be eligible for state child care reimbursement, a county or tribal entity shall annually submit a plan and budget, on forms provided by the department that conform to the requirements established in published policies and business processes. Each annual plan and budget shall be certified by the presiding judge of the court, director of the county department, and chairperson of the county board of commissioners or county or tribal executive.

(2) To be eligible for state child care fund reimbursement, expenditures made from the court subaccount for out-of-home care must be pursuant to sections 2, 5, 8, and 25 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2, 712A.5, 712A.18, and 712A.25.

(3) All of the following provisions apply to expenditures made from the county department subaccount for out-of-home care for these expenditures to be eligible for state child care fund reimbursement:

(a) The care is ordered by the court and the child is supervised by the county department.

(b) The care is voluntary, and all the following provisions apply:

(i) The child is under 18 years of age.

(ii) A written, signed agreement has been received from the child's parent, legal guardian, or other custodian.

(iii) The agreement specifies the amount of financial support required from the parent.

(iv) Financial need is not the sole reason for the request for out-of-home care.

(c) A county department supervising children funded through the child care fund shall document that it is approved as a child placing agency under 1973 PA 116, MCL 722.111 to 722.128.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2009 Community-based services {#sec-r-400.2009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2009}

Rule 9. (1) The community-based services option of the child care fund may be used for youth under the jurisdiction of the court, or at risk of being under the jurisdiction of the court, to provide for early intervention to treat problems of delinquency and neglect.

(2) Community-based services are provided as an alternative to, or to prevent, removal from home and placement in detention or other out-of-home care, including diversionary programming. Community-based services are reimbursable in the following situations and if all the following provisions have been met:

(a) The approval of an implementation plan that articulates how the local program and practice satisfies the quality assurance standards as determined by the department.

(b) The diversionary programming is consistent with sections 2 to 6 and 9 of the juvenile diversion act, 1988 PA 13, MCL 722.822 to 722.826 and 722.829, and sections 2f and 18 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2f and 712A.18, or equivalent tribal law and practices and as approved within the annual plan and budget.

(c) The child care fund can be used for programs and practices if a complaint, referral, or petition is generated by the local prosecutor, law enforcement, parent or guardian, or authorized school personnel for a youth at risk of juvenile court involvement through residential placement and re-entry, excluding general prevention services for all youth at risk of juvenile justice systems involvement. Community-based services include programming consistent with sections 821 to 831 of the juvenile diversion act, 1988 PA 13, MCL 722.821 to 722.831, and sections 2f and 18 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2f and 712A.18, or equivalent tribal law and practices and as approved within the annual plan and budget.

(d) A complaint, referral, or petition is received and the court has considered the results of a validated risk and needs assessment to determine the scope of community-based services programming to comply with legislative requirements under section 117a of the social welfare act, 1939 PA 280, MCL 400.117a, and section 18 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.18.

(e) The expenditure of child care fund money for community-based services is not for judicial costs.

(f) The programming provided must be consistent with best, promising, and culturally appropriate practices.

(g) The family is eligible for public assistance programs, community-based services payments must not be used to pay for basic family needs.

(3) The county department may provide for community-based services from its subaccount for substantiated category 1 and 2 protective services cases if expenditures are not for judicial costs. The case plan must identify all parties and services and 1 of the following must apply to the service or services:

(a) The service or services are ordered as an alternative to out-of-home care.

(b) The service or services prevent the need to petition the juvenile court for removal or prevent placement in voluntary foster care.

(d) The court documents that court staff or the designee responsible for case plan development and monitoring, or both, meet the qualifications established in the juvenile court standards and administrative guidelines for the care of children established by Administrative Order No. 1985-5, 422 Mich cxi (1985), as modified by Administrative Order No. 1988-3, 430 Mich xcix (1988) and by order of May 19, 2009, effective September 1, 2009, 483 Mich civ (2009).

(e) Community-based programs use case service payments in support of communitybased services, which can be shown by the county's or court’s relationship between those payments and the days of out-of-home care in the county.

(4) Case service payments are not made to cover basic family needs otherwise available through public assistance programs.

History

History: 1987 AACS; 2020 AACS; 2025 AACS.

Mich. Admin. Code R 400.2010 Basic grant programs; reimbursement eligibility {#sec-r-400.2010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2010}

Rule 10. To be eligible for state reimbursement, basic grant programs must be provided to youth who are within or are likely to come within the jurisdiction of the court as defined by sections 2a and 2b of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2a and 712A.2b. In addition, basic grant programs must comply with all the following provisions to be eligible for reimbursement:

(a) The programs are described in the annual county plan and budget and conform to the department’s published policies and business processes as provided in the Child Care Fund Handbook.

(b) The court shall document that court staff or designee responsible for individual case plan development and monitoring, or both, meet the qualifications established by Supreme Court Administrative Order No. 1985-5, 422 Mich cxi (1985), as modified by Administrative Order No. 1988-3, 430 Mich xcix (1988) and by order of May 19, 2009, effective September 1, 2009, 483 Mich civ (2009).

(c) The county department shall document that county department staff responsible for individual case management and monitoring meet the requirements for staff supervising children in foster care as specified in R 400.12205, R 400.12206, and R 400.12207.

(d) The county department or court shall document that contractual providers who develop or monitor case plans meet the requirements for staff supervising children in foster care as established in rule I of the juvenile court standards and administrative guidelines for the care of children established by Supreme Court Administrative Order No. 1985-5, 422 Mich cxi (1985), as modified by Administrative Order No. 1988-3, 430 Mich xcix (1988) and by order of May 19, 2009, effective September 1, 2009, 483 Mich civ (2009).

(e) The county department and court shall maintain individual case record documentation as specified by the department in published policies and business processes as provided in the Child Care Fund Handbook and shall make the individual case record documentation available to the department for review and monitoring.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2011 Rescission {#sec-r-400.2011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2011}

Rule 11. R 400.21, R 400.22, and R 400.23 of the Michigan Administrative Code, appearing on pages 2984, 2985, and 2986 of the 1979 Michigan Administrative Code, are rescinded.

PART 2. ELIGIBLE EXPENDITURE CLASSIFICATIONS

History

History: 1987 AACS.

Mich. Admin. Code R 400.2021 Definitions {#sec-r-400.2021 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2021}

Rule 21. As used in this part:

(a) "Case Services payments,” formerly known as nonscheduled payments, means payments to individuals or organizations for items specified and defined in the department’s published policies and business processes that are not included in the stateestablished per diem rate.

(b) "County-operated facility" means a facility licensed or approved as a child caring institution or a court-operated facility, or both, to provide group care, shelter care, or detention administered and staffed by county employees.

(c) "Intensive rate" means payment in excess of the state-established rate for specialized abuse/neglect foster care that must receive special approval as specified in the department’s published policies and business processes.

(d) "State rates” means rates established and published by the department for all the following:

(i) Payment for foster family care and independent living costs.

(ii) Payment for a private child care institution.

(iii) Payment for a private child placing agency.

(e) "Subsidy payment bed hold” means payment to assure the availability of bed space for placement referrals.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2022 County child care fund expenditures; eligibility for reimbursement {#sec-r-400.2022 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2022}

Rule 22. (1) Unless otherwise indicated, county child care fund expenditures within the limits of the approved annual child care fund budget a r e eligible for 50% reimbursement for residential services of detention and long-term residential placements.

Payments must be for a direct service, case-specific, identifiable to an individual child, and not be for a judicial cost or an administrative cost. However, certain administrative costs, as that term is defined by the department in published policies and business processes, are reimbursable.

(2) The county child care fund expenditures must be a 75% reimbursement of the annual expenditures from the child care fund for community-based services, including community-based supervision, services, respite care, and shelter care for less than 30 days and related practices, except expenditures that exceed the amount of budget approved.

Payments must be for a direct service, case specific, identifiable to an individual child, and not be for judicial cost or an administrative cost. However, certain administrative costs, as that term is defined by the department in published policies and business processes, are reimbursable.

(3) State child care fund reimbursement is allowed unless otherwise accessible and available by other public assistance programs necessary to achieve the goals and outcomes for community-based programming or out-of-home care. Reimbursement must not be made for costs associated with an otherwise eligible child or family, or both, if the reason for the unavailability of public assistance is due to intentional program violations and disqualification of public assistance.

History

History: 1987 AACS; 2020 AACS; 2025 AACS.

Mich. Admin. Code R 400.2023 Reimbursable family foster care expenditures and costs {#sec-r-400.2023 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2023}

Rule 23. (1) The following child-specific direct supervision or purchased placing agency family foster care expenditures are reimbursable within state-established rates or approved intensive rates:

(a) Care provided in the following locations:

(i) Foster family homes.

(ii) Foster family group homes.

(iii) Legal guardian homes.

(iv) Homes of related persons.

(b) Initial clothing, clothing maintenance, and supplemental clothing allowances within state rates as specified in thedepartment’s published policies and business processes.

(c) Items necessary for a child's educational experience that are not available without additional cost through the public-school system.

(d) Medical, dental, psychological, and psychiatric service and materials, subject to the limitations in R 400.2022.

(e) Unusual transportation costs incurred by the foster parents or payments to a public carrier for transportation for treatment and service as part of a case plan.

(f) Transportation costs incurred by a foster child's parents if the case plan documents that assistance is needed to assure contact between the parent and child. The maximum reimbursable rates must conform to the requirements published in the department’s policies and business processes.

(g) Other costs for behavioral incentive that are designed to encourage and support desirable behavior, and that are documented in a service plan.

(h) A once-a-year allowance for a gift at holiday time for each child in foster care.

(2) All the following are reimbursable non-child-specific family foster care costs:

(a) Payment to foster parents for the cost of foster parent training. Reimbursable costs include all the following:

(i) Cost of transportation.

(ii) Child care.

(iii) Tuition.

(iv) Training supplies.

(b) Subsidy payments to foster parents if supported by a contract.

(d) Respite payments to foster parents of an approved group or shelter home program if supported by a contract.

(e) Recreation payments to foster parents of an approved group or shelter home program as defined and restricted by the department’s policies and business processes.

(f) Supply payments to foster parents of an approved group or shelter home program for personal items for children in the program.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2024 Reimbursable costs of institutional care {#sec-r-400.2024 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2024}

Rule 24. All the following are reimbursable costs of institutional care:

(a) The operating costs of a county-operated facility approved to provide detention, group care, or shelter care, as defined by the office in published policies and business processes, which is limited to the governing policy provided by the office in published policies and business processes. These costs are restricted to the following expenditures for services and goods necessary to provide direct services to the youth placed in the facility:

(i) The cost for direct care, administrative, and support staff who devote 100% of their time to the youth placed in the facility.

(ii) The cost of supportive services on a prorated basis if supported by documentation.

(iii) Prorated space costs if the entire facility is not utilized as a child care institution.

(iv) A once-a-year allowance for a gift at holiday time for each ward in institutional care.

(b) The cost of care in an out-of-state institution that has filed documentation, with the state or the court, of having a valid license to provide care and the details of the rates and service provided.

(c) The cost of care provided in another county's child care facility if the facility has established and published the same per diem rate for all county and state placements.

(d) Subsidy payments to a facility operated by another county to assure the availability of bed spaces if approved in the annual plan and budget.

(e) The cost of care in a certified medical or psychiatric hospital.

(f) The cost of care, at the state-established rate, in a facility licensed as a private child care institution.

(g) The cost of care, exclusive of the education costs, at a boarding school licensed under section 1335 of the revised school code, 1976 PA 451, MCL380.1335.

(h) The cost of case service payments for services or materials not included in stateestablished rates.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2025 Out-of-country placements; cost not reimbursable {#sec-r-400.2025 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2025}

Rule 25. The cost of out-of-country placements is not reimbursable.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2026 Reimbursement for in-home care service costs {#sec-r-400.2026 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2026}

Rule 26. The cost of in-home care service as approved in the county annual plan and budget is reimbursable.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2027 Reimbursement for costs for independent living {#sec-r-400.2027 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2027}

Rule 27. The cost, at the state rate, for independent living is reimbursable.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2028 State expenses {#sec-r-400.2028 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2028}

Rule 28. The following county child care fund expenditures are 100% reimbursable from the state child care fund:

(a) Reimbursement to a private child caring agency for the cost of foster care, exclusive of administrative costs, for a child released to the agency under section 29 of chapter X of the probate code of 1939, 1939 PA 288, MCL 710.29.

(b) Basic grant costs as approved in the county annual plan and budget as set forth in R 400.2010.

PART 3. ACCOUNTING

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2031 Standards and requirements {#sec-r-400.2031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2031}

Rule 31. In addition to the accounting standards and requirements specified in section 117c of the social welfare act, 1939 PA 280, MCL 400.117c, and section 1 of the uniform budgeting and accounting act, 1968 PA 2, MCL 141.421, the following provisions apply:

(a) All expenditures and disbursements from the court subaccount for which state reimbursement is claimed must be recorded in the county child care fund in the expenditure accounts specified in the publication entitled "Accounting Procedures Manual for Local Units of Government in Michigan” issued by the department of treasury.

(b) All expenditures and disbursements from the county department subaccount for which state reimbursement is claimed must be recorded in the county child care fund in the expenditure accounts specified in the department accounting manual.

(c) All revenues and receipts to the court subaccount related to child care costs for which state reimbursement is claimed shall be recorded in the child care fund and be classified in the revenue accounts as specified in the publication entitled "Accounting Procedures Manual for Local Units of Government in Michigan” issued by the department of treasury.

(d) All revenues and receipts to the county department subaccount related to child care costs for which state reimbursement is claimed must be recorded in the child care fund and be classified in revenue accounts as specified in the department accounting manual.

(e) County child care fund expenditures submitted for state reimbursement must be recorded separately from expenditures that are not eligible for state reimbursement.

(f) A record of the cost for each child must be maintained for direct supervision or purchased placing agency family care, another county's institution, private institution, medical and psychiatric hospital, boarding schools, in-home care, and independent living.

(g) Money received for a child's care up to the cost of care must be reported on the monthly financial report forms provided by the department.

(h) Money received for a child's care more than the cost of care must be placed in a trust for the child.

(i) The accounting records of the probate court subaccount of the child care fund must be retained in compliance with the publication entitled "Record Retention General Schedule #15 Circuit Courts" issued by the state supreme court administration office.

(j) The accounting records of the county department subaccount of the child care fund must be retained in compliance with the department's child care fund policy and made available for state audit.

(k) The county shall document that the expenditure of child care fund money reported for state reimbursement for goods or services from a third party complies with county policy with respect to contract and bidding requirements.

(l) The county shall document that all supplies and equipment for which state reimbursement is received are identified as county property and controlled in compliance with the inventory and control policies of the county.

PART 4. REPORTING

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2041 Definition {#sec-r-400.2041 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2041}

Rule 41. As used in this part, "offset" means the process the department uses to determine the dollar amount to bill a county for state ward charge-back or the remittance of state aid for the reimbursement of department child care fund expenditures.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2042 Reporting county child care fund expenditures {#sec-r-400.2042 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2042}

Rule 42. County child care fund expenditures submitted to the department for reimbursement shall be reported monthly to the department on the forms provided by the department.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2043 Reporting county basic grant expenditures {#sec-r-400.2043 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2043}

Rule 43. County basic grant expenditures submitted to the department for reimbursement shall be reported monthly on forms provided by the department.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2044 Department approval of county annual plan and budget {#sec-r-400.2044 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2044}

Rule 44. The department shall approve, within 30 calendar days after receipt, a properly completed annual plan and budget that complies with the requirements of section 117c of the social welfare act, 1939 PA 280, MCL 400.117c.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2045 Rescinded {#sec-r-400.2045 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2045}

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2046 Offset of uncontested county child care fund reimbursement and state ward charge-back liabilities {#sec-r-400.2046 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2046}

Rule 46. The department shall offset county child care fund reimbursements and uncontested state ward charge-back liabilities monthly.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2047 Department reports to counties {#sec-r-400.2047 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2047}

Rule 47. The department shall provide counties with monthly child care fund expenditure/reimbursement reports and monthly child care fund-state ward chargeback/offset reports.

History

History: 1987 AACS.

Mich. Admin. Code R 400.2048 Department responsibilities to counties {#sec-r-400.2048 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2048}

Rule 48. (1) The office department shall be responsible for providing all necessary information to counties to meet the requirements of these rules and child care fund policy.

(2) The department shall provide county-level assistance for county plan and budget development, program eligibility monitoring, and compliance.

History

History: 1987 AACS; 2020 AACS.

Mich. Admin. Code R 400.2049 Monitoring county population projections {#sec-r-400.2049 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.2049}

Rule 49. The department shall monitor county population projections produced by the department of technology, management and budget. The department shall provide to those counties that are projected to exceed or decline below the 75,000 population mark a 15month period within which to develop a basic grant program or to change to the county juvenile officer grant payment system as provided in section 3 of 1919 (Ex Sess) PA 22, MCL 400.253.

History

History: 1987 AACS; 2020 AACS.

Economic Stability Administration Economic Stability Administration

R 400.3001 to R 400.3015 Food Assistance Program

Mich. Admin. Code R 400.3001 Definitions {#sec-r-400.3001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3001}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

ECONOMIC STABILITY ADMINISTRATION

FOOD ASSISTANCE PROGRAM

(By authority conferred on the department of health and human services by section 6 of the social welfare act, 1939 PA 280, MCL 400.6)

Rule 1. As used in these rules:

(a) "Administrative recoupment" means a process by which a group's benefits are reduced to make payments on an overissuance.

(b) "Application filing date" means the date that the department receives a signed application document that includes the minimum required information.

(d) “Department” mean the Michigan department of human services.

(e) "Nonprofit" means tax-exempt under section 501(c)(3) of the internal revenue code of 1986, 26 U.S.C. §501(c)(3).

(f) "Group living arrangement" has the meaning specified in the food stamp act and nutrition act of 2008, 7 U.S.C. §2012 (i)(7).

(g) "Overissuance" means an issuance of more benefits than the group is eligible to receive.

(h) "Per diem" means a daily rate.

(i) "Recoupment" means a department action to identify and recover a benefit overissuance.

(j) "Repayment" means an action by a group to pay back benefits received.

(k) "Substance abuse treatment center (SATC)" means a facility that provides special living arrangements and a complete program for the treatment of addiction to drugs or alcohol, or both.

(l) “Supplemental nutrition assistance program student status" has the meaning specified in the food and nutrition act of 2008, 7 U.S.C. §2015(e)(1) and (2) and 7 C.F.R. 273.5.

(m) "Treasury" means the Michigan department of treasury.

(n) "Verification" means documentation or other evidence to establish the accuracy of a client's verbal or written statements.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3002 Rescinded {#sec-r-400.3002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3002}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3003 Rescinded {#sec-r-400.3003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3003}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3004 Rescinded {#sec-r-400.3004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3004}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3005 Applications {#sec-r-400.3005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3005}

Rule 5. The application process shall be completed as specified in the food and nutrition act of 2008, 7 U.S.C. §2020 and 7 C.F.R. §273.2, except as follows:

(a) An application may be submitted by fax, mail, hand delivered or applied for online on a form prescribed by the department.

(b) An application may be denied within 30 calendar days from the application filing date if the applicant was interviewed and allowed not less than 10 calendar days to provide requested verifications.

(c) If an application is denied within 30 calendar days from the application filing date, and the applicant subsequently completes the application requirements within the original 30 calendar days, then benefits shall be provided back to the original date of application if the group is eligible.

(d) An applicant who fails to contact the department after missing the application interview shall not have a second interview automatically scheduled.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3006 Temporary absence from home {#sec-r-400.3006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3006}

Rule 6. (1) A person is temporarily absent from the home if all of the following provisions apply:

(a) The person's location is known.

(b) There is a definite plan for the person's return.

(d) The absence has lasted or is expected to last 30 calendar days or less.

(2) The 30-calendar-day provision in subrule (1)(d) of this rule does not apply if the absence is due to hospitalization.

(3) A person who is temporarily absent as specified in subrules (1) and (2) of this rule is considered to be living in the home and continues to receive assistance.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3007 Rescinded {#sec-r-400.3007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3007}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3008 Rescinded {#sec-r-400.3008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3008}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3009 Child support; required offer of service {#sec-r-400.3009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3009}

Rule 9. The department shall offer services to establish paternity and obtain child support to the client if the food assistance program group includes a child or children, but the food assistance program group does not include 1 or both parents of the child or children. The department shall provide comprehensive information about paternity and child support services to ensure the client can make an informed decision about whether to pursue or not to pursue those services.

History

History: 1997 AACS; 2014 AACS; 2024 AACS.

Mich. Admin. Code R 400.3010 Rescinded {#sec-r-400.3010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3010}

History

History: 1997 AACS; 2014 AACS; 2024 AACS.

Mich. Admin. Code R 400.3011 Benefit overissuance collection and repayment actions {#sec-r-400.3011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3011}

Rule 11. (1) The department shall seek recoupment of food assistance program (FAP) benefit overissuances from active or inactive FAP groups by cash repayment or benefit reduction through administrative recoupment processes.

(2) The department shall seek recoupment of benefit overissuances from any adult who was a group member when the overissuance occurred.

(3) If the overpaid FAP group did not include a qualified or disqualified adult at the time of the overissuance, then a collection action will not be initiated unless the overissuance was established through court action or by obtaining a signed repayment agreement.

(4) The department shall recoup overissuances to active FAP cases through benefit reduction, unless cash payments are ordered by a court.

(5) If an overissuance is not paid in full, then FAP benefits will be reduced by the percentage specified in the food and nutrition act of 2008,7 U.S.C. §2022(b).

(6) If a court orders cash repayment and the active FAP client does not make regular cash payments, then the department shall change the collection method to benefit reduction.

(7) Local department offices may pursue collection from estates through probate court claim action for a person who dies and has an overissuance balance.

(8) A payment received as restitution under the terms of probation will reduce the balance owed, but the completion of the probation period or the performance of a requirement of probation does not reduce the amount owed in excess of the actual dollar amount paid toward the overissuance.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3012 Rescinded {#sec-r-400.3012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3012}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3013 Rescinded {#sec-r-400.3013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3013}

History

History: 1997 AACS; 2012 AACS.

Mich. Admin. Code R 400.3014 Rescinded {#sec-r-400.3014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3014}

History

History: 1997 AACS.

Mich. Admin. Code R 400.3015 Rescinded {#sec-r-400.3015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3015}

History

History: 1997 AACS; 2014 AACS.

R 400.3101 to R 400.3131 Family Independence Program

Mich. Admin. Code R 400.3101 Definitions {#sec-r-400.3101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

ECONOMIC STABILITY ADMINISTRATION

FAMILY INDEPENDENCE PROGRAM

(By authority conferred on the department of health and human services by section 6 of the social welfare act, 1939 PA 280, MCL 400.6)

Rule 1. (1) As used in these rules:

(a) "Administrative recoupment" means a process by which a group's benefits are reduced to make payments on an over issuance.

(b) "Application" means an application for the family independence program.

(c) "Application filing date" means the date the department receives a signed application document that contains the minimum required information.

(d) "Authorized representative" means an individual who is not less than 18 years of age and who applies for assistance on behalf of a client or otherwise acts on a client's behalf, or both. The individual may be, but is not limited to being, a guardian, spouse, or relative outside the group.

(e)"Client error" means over issuances that are caused due to the action or inaction of a client or authorized representative. An over issuance resulting from a department action being deleted due to a client's hearing request is client error if the client withdraws the request, fails to appear for the hearing, or the department is upheld in the hearing decision.

(f) "Collection actions" means the department processes initiated to maximize the recovery of over issued benefits.

(g) "Department” means the department of health and human services.

(h) “Disqualification" means a department penalty action assessed for noncompliance with a family independence program requirement and results in the ineligibility of the noncompliant individual.

(i) “EBT” means electronic benefit transfer.

(j) "Eligible child" means a child who is part of a group that receives assistance under the family independence program.

(k) “FIP” means family independence program.

(l) "Immunizations" means all immunizations recommended by the department.

(m) "Institution" means an establishment that furnishes food, shelter, and some medical treatment or services to more than 3 individuals who are unrelated to the proprietor of the establishment.

(n) "Intentional program violation" means the intentional withholding or misrepresenting of information by a client or authorized representative for the purpose of obtaining benefits that the client or authorized representative would not otherwise be eligible for. Over issuances become intentional program violations if the client or client's authorized representative is found responsible for an intentional program violation by a court, as a result of an administrative hearing, or due to signing an agreement form.

(o) "Mandatory vendoring" means department payment of assistance amounts, without client request, directly to the client's landlord, mortgage holder, land contract holder, or the providers of the client's home heating and electricity services.

(p) "Minimum wage" means the lesser of the federal or state minimum wage.

(q) "Monthly payment amount" means the amount of assistance paid to the group after deductions for vendoring and any department recoupment.

(r) "Over issuance" means an issuance of more benefits than a client is eligible to receive.

(s) "Over issuance period” means the time period during which an over issuance occurs.

(t) "Pay period" means the half of the month from the first of the month to the fifteenth of the month or from the sixteenth of the month to the end of the month.

(u) “Payment standard” means the maximum monthly amount for the approved ongoing monthly certified group size.

(v) "Potential benefits" means any of the following benefits:

(i) Retirement, survivors, and disability insurance.

(ii) Worker's compensation benefits.

(iii) Veterans administration benefits.

(iv) Railroad retirement benefits.

(v) Unemployment compensation benefits.

(vi) Child support payments.

(vii) Pension payments.

(viii) Disability or retirement benefits.

(ix) Earned but unpaid wages.

(x) Strike pay.

(xi) Vacation pay.

(xii) Supplemental unemployment benefits.

(xiii) Supplemental security income.

(xiv) Other financial benefits for which potential eligibility exists and may reduce the family independence program benefit, other than state-funded, needs based programs.

(w) “RCA” means refugee cash assistance.

(x) "Recoupment" means a department action to identify and recover a benefit over issuance.

(y) "Redetermination" means a review of continuing eligibility for the family independence program.

(z) "Reinstatement" means restoring a closed assistance case to active status without a new application or redetermination form.

(aa) "Repayment" means an action by the client to pay back benefits received.

(bb) "Restricted payments" means the meeting of client shelter, heat, and utilities obligations through mandatory vendoring or third-party payments.

(cc) "Returned warrants" means uncashed warrants received by the local department office or treasury.

(dd) “SDA” means state disability assistance.

(ee) "Stop payment" means a department directive to treasury to not honor a warrant.

(ff) "Striker" means an individual who is involved in any of the following situations:

(i) An employee strike.

(ii) A concerted work stoppage, including a stoppage when a collective bargaining agreement expires.

(iii) A work slowdown.

(iv) Interruption of work activities or employment operations.

(gg) "Third-party payments" means department payment of the client’s entire assistance benefit, without client request, to an agency or individual outside the eligible group for management of the assistance on behalf of the group.

(hh) "Third-party resource" means an individual, entity, or program that is, or might be, liable to pay all or part of a group member's medical expenses.

(ii) "Treasury" means the department of treasury.

(jj) "Under issuance" means that a group has received less cash assistance than it is eligible to receive.

(kk) "Verification" means documentation or other evidence to establish the accuracy of the client's verbal or written statements.

(ll) "Voluntary vendoring" means a payment system where, at the group’s request, the department sends part of the group’s cash assistance directly to the provider of shelter, heat, or electricity.

(mm) “Warrant” means a written order to pay that instructs a federal, state, or county government treasurer to pay the warrant holder on demand or after a specific date.

(nn) "Warrant date" means the date shown on the warrant. For regular client and vendor warrants, the warrant date is the expected date of delivery. For replacement warrants, the warrant date is the date that the warrant is mailed by the department.

(2) Terms defined in the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, have the same meaning when used in these rules.

History

History: 1997 AACS; 2014 AACS; 2019 AACS; 2025 AACS.

Mich. Admin. Code R 400.3102 Rescinded {#sec-r-400.3102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3102}

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3103 Returned warrants {#sec-r-400.3103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3103}

Rule 3. (1) The department may rewrite returned warrants if a group was eligible for cash assistance during the period covered by the original warrant.

(2) A group is presumed ineligible under any of the following circumstances:

(a) The post office returned a client warrant to the treasury as undeliverable and the group has not contacted the department regarding the warrant.

(b) A warrant remains uncashed for more than 30 calendar days from the warrant date and the group has not contacted the department regarding the warrant.

(c) A group fails to contact the department by the disposition deadline for a warrant returned or delivered to the local department office.

(3) A representative of a group who picks up a group warrant shall present the group's signed statement of permission.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3104 Replacement policies for warrants and EBT thefts {#sec-r-400.3104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3104}

Rule 4. (1) A group is eligible for replacement of unendorsed warrants reported lost, stolen, not received, or destroyed if 1 or more of the following conditions are complied with:

(a) The group completes a stop payment or replacement request affidavit. For a stolen warrant, a group shall file a police report, unless replacement of the warrant is made after recovery of the warrant amount.

(b) A client or provider shall contact the post office to verify delivery of a warrant that was issued but not received. If delivery is verified, the warrant is considered lost. If delivery cannot be verified, the warrant is considered to be a warrant that is not received. For warrants considered not received, a client or provider shall complete a stop payment or replacement request affidavit.

(c) Under any of the following circumstances, a warrant must be replaced only after recovery of the original warrant amount:

(i) Replacement is requested more than 30 calendar days after the warrant date.

(ii) The client has previously requested a replacement after cashing the original warrant.

(iii) A police report was not filed on a stolen warrant.

(iv) The case is closed or closure is pending.

(v) The warrant to be replaced is a replacement warrant or a vendor warrant.

(2) If a warrant is cashed by a recipient of cash assistance, the department shall not take action on a request to stop payment on the cashed warrant and a replacement warrant must not be issued.

(3) A warrant that is lost or stolen after endorsement must be replaced only if the warrant is later returned or voided.

(4) If a replacement warrant is issued for a warrant that was cashed and a client claims that the warrant copy signature is not that individual’s signature, the client shall sign an affidavit that the signature is not the client's signature.

(5) If a replacement warrant is issued for a warrant that was cashed and the client fails to keep an appointment to view the warrant, refuses to sign the affidavit, or admits endorsing both the original and replacement warrants, the department shall recover the over issuance from the group.

(6) A group currently receiving ongoing FIP, RCA, or SDA may receive a replacement of its FIP, RCA, or SDA that was fraudulently removed from its EBT account. Both of the following conditions apply to a fraudulent removal from an EBT account:

(a) A group is only eligible to receive this payment 1 time in a 12-month period.

(b) Replacement funds can only be approved up to 4 times the payment standard or the amount that was fraudulently removed, whichever is less.

History

History: 1997 AACS; 2014 AACS; 2025 AACS.

Mich. Admin. Code R 400.3105 Supplemental benefits policy for cash assistance {#sec-r-400.3105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3105}

Rule 5. (1) The department shall issue supplemental benefits (a supplement) to correct an under issuance.

(2) A supplement is offset by over issuances for which collection actions have not yet begun. The amount of the over issuance is subtracted from the amount of the supplement, up to the amount of the supplement.

(3) A supplement shall be issued promptly upon receipt by the department of verification of a change in circumstances resulting in increased need or when the department becomes aware of an agency error that resulted in an under issuance.

(4) The department shall issue a supplement back to the month following the month verification shows the need began, but no earlier than the month that the group reported the change in circumstances.

(5) The department shall not issue a supplement for a period before the eligibility effective date for the program.

(6) The department shall give a group adequate notice that a supplement has been authorized or denied.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3106 Restricted payments to groups {#sec-r-400.3106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3106}

Rule 6. (1) A group shall have mandatory vendoring or third-party payments initiated when the department determines that the grantee's negligence resulted in mismanaged funds and has endangered the health or safety of a child.

(2) The department shall to initiate third-party payments or mandatory vendor payments based on the seriousness of the group's circumstances, the availability of a competent thirdparty payee, and the qualification of shelter providers.

(3) Mandatory vendoring shall be limited to the monthly combined shelter, heat, and utility expenses. The group shall receive a minimum of a $2.00 monthly payment after vendoring and other required deductions from the payment standard.

(4) A group that is in restricted payment status has the right to a department review of the need to continue mandatory vendoring or third-party payments at least once every 6 months.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3107 Applications {#sec-r-400.3107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3107}

Rule 7. (1) Any person may apply for assistance for himself or herself. With the group's permission, a person who is 18 years of age or older may be authorized to represent and apply on behalf of the group.

(2) A person may submit an application by fax on a form prescribed by the department.

The original, signed application must be received by the department before benefits are approved.

(3) A person shall complete a department application form when first applying for assistance benefits and when eligibility is redetermined.

(4) The department must accept an application and register it as soon as it is filed if it contains the minimum information established by the department and is signed by the client or the client's authorized representative.

(5) Upon receipt of an incomplete application, the department staff shall provide the client with an appropriate form identifying the information needed to render the application complete and shall specify a due date by which the information must be provided. The department must deny eligibility, or terminate an ongoing assistance case, if the application remains incomplete. An incomplete application is valid through the last day of the month after the month of denial or termination and may be updated during that period.

(6) As part of the application and redetermination process, the department may conduct an official, confidential interview with the client, another responsible applicant group member, or the authorized representative. An interview must be conducted in a department local office during normal weekday office hours or by telephone.

History

History: 1997 AACS; 2014 AACS; 2022 AACS.

Mich. Admin. Code R 400.3108 Verification of eligibility factors {#sec-r-400.3108 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3108}

Rule 8. (1) A group shall verify the factors that affect the initial and continued eligibility of the family independence assistance group, a program group, or individual group members, including information obtained by data exchanges.

(2) The department shall provide a group with written notice of the required verification items and the due date for their submittal to the department local office.

(3) Department staff may make home calls to verify information or conduct other department business. A group shall cooperate with department staff making home calls.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3109 Determination of eligibility and assistance amount {#sec-r-400.3109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3109}

Rule 9. The department shall determine the eligibility of each person in the program group and the amount of assistance for which the group qualifies.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3110 Assistance benefits; beginning dates {#sec-r-400.3110 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3110}

Rule 10. The department shall begin assistance benefits not earlier than the half-month pay period after the pay period that includes the application filing date, and not later than the pay period in which the application becomes 30 calendar days old, if the group is eligible for that pay period. If the application becomes 30 calendar days old and the group has not met the eligibility requirements, then the department shall begin assistance for the pay period in which all eligibility requirements are met.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3111 Client responsibility to cooperate with department; effect of failure to cooperate {#sec-r-400.3111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3111}

Rule 11. (1) A client shall cooperate with department staff in determining initial and ongoing eligibility and benefit levels. Cooperation includes all of the following:

(a) Answering completely and truthfully all questions on department forms and during interviews.

(b) Taking all actions within the group’s ability to verify factors concerning the group's eligibility.

(d) Accurately reporting, within 10 calendar days after the information is known to the client, information that might affect eligibility or benefit amounts.

(2) A client's failure to cooperate with the department in any matter of eligibility shall result in the denial of the assistance application, case closure, member disqualification, or benefit level reduction.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3112 Group composition {#sec-r-400.3112 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3112}

Rule 12. (1) If family independence assistance is requested for a child, then all of the following persons who live together shall, except as provided in subrule (7), be included in the program group applying for assistance and, if eligible, in the family independence assistance group:

(a) The child.

(b) The child's parents.

(d) The parents of the siblings.

(e) The child's stepparent.

(f) The child's stepsiblings who meet the definition of child.

(g) The child's child.

(2) If a minor parent applies for assistance for himself or herself and his or her child, and if the minor parent is living with his or her parent or parents or stepparent, then the minor parent is denied assistance in his or her own right and the minor parent and his or her child shall be treated as children in accordance with subrule (1) of this rule.

(3) If a minor parent applies for assistance and is living with a legal guardian or an adult relative, other than his or her parent or stepparent, and if the adult relative or legal guardian receives family independence assistance, then the minor parent and his or her child shall be included in the adult relative's or legal guardian's group and, if eligible, in the family independence assistance group as children in the care of the adult relative or legal guardian.

If the adult relative or legal guardian does not receive family independence assistance, then the minor parent may receive assistance in his orher own right, if eligible.

(4) If a caretaker is caring for and requesting assistance for 2 or more children who are not siblings or stepsiblings to each other, then all of the children under the care of the caretaker shall be included in a single program group and, if eligible, in a single family independence assistance group.

(5) In the absence of a parent or stepparent, a needy caretaker may request assistance and be included in the program group and, if eligible, in the family independence assistance group with the child. If the caretaker chooses to request assistance for himself or herself, then the caretaker's spouse and their dependent children, if living in the home, shall also be included in the request for assistance.

(6) The program group or family independence assistance group may consist of the following persons if there is no eligible child in the group:

(a) A pregnant woman and her husband, if living in the home.

(b) A parent, stepparent, or other caretaker of a child in the home who would be eligible except for the child's receipt of supplemental security income, and the spouse of the parent, stepparent, or other caretaker, if living in the home.

The parent, and the parent's spouse, if applicable, shall comply with the agency's case service plan.

(7) If an individual becomes a new group member as a result of marriage to a member of the group, the new group member’s income and assets may be disregarded for 18 months after the date of marriage, unless the program group’s income and assets, when combined with the new parent’s, the new stepparent’s or the new stepsibling’s income or assets, exceed twice the income and asset limits set by the department.

Editor's Note: An obvious error in R 400.3112 was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2019 MR 17. The memorandum requesting the correction was published in Michigan Register, 2019 MR 17.

History

History: 1997 AACS; 2019 AACS.

Mich. Admin. Code R 400.3113 Voluntary vendoring {#sec-r-400.3113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3113}

Rule 13. (1) A group may request voluntary vendoring at any time by completing a department vendor payment form.

(2) As part of the voluntary vendoring request, a group that has obligations for heat and electricity shall request vendor payments for both services, unless vendoring both would leave a monthly benefit amount of less than $2.00. Amounts vendored for heat and electricity shall be established by the department or utility company based on the assistance payment standard. A group may specify any monthly shelter amount that is not less than $2.00 to be vendored if vendoring would leave a monthly payment amount of not less than $2.00.

(3) The department shall cease voluntary vendor payments as soon as administratively feasible when requested in writing by the client.

(4) The department shall not authorize voluntary vendor payments for rent under any of the following circumstances:

(a) The local housing authority notifies the department that the dwelling fails to meet the housing code or the landlord has failed to comply with housing code policies and procedures. Ongoing vendoring shall be stopped within 5 workdays if administratively feasible.

(b) The landlord has not cooperated with the agency or a utility company in the installation of energy conservation measures that were determined necessary to reduce consumption.

Ongoing vendoring shall be stopped within 5 workdays if administratively feasible.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3114 Temporary absence from home {#sec-r-400.3114 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3114}

Rule 14. (1) A person is temporarily absent from the home if all of the following provisions apply:

(a) His or her location is known.

(b) There is a definite plan for his or her return.

(d) The absence has lasted or is expected to last 30 calendar days or less.

(2) The 30-calendar-day provision in subrule (1)(d) of this rule does not apply if the absence is due to hospitalization, training, or education.

(3) A person who meets the criteria for being temporarily absent specified in subrules (1) and (2) of this rule is considered to be living in the home and continues to receive assistance.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3115 Immunizations; exemptions; informing client of immunization requirement; department assistance; compliance; penalty {#sec-r-400.3115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3115}

Rule 15. (1) An eligible child who is under age 6 shall receive all immunizations.

(2) A child is exempt from the immunization requirement if any of the following conditions apply:

(a) The child is under 2 months of age.

(b) Immunizations are medically inappropriate for the child.

(3) At application, the department shall inform each group that has a nonexempt eligible child who is under age 6 of the immunization requirement and the penalty for failure to immunize.

(4) The department shall offer the group assistance to resolve problems that hinder compliance with the immunization requirement.

(5) A group is in compliance with the immunization requirement when immunizations have begun for all nonexempt children.

(6) If a nonexempt child has not been immunized and the group does not have an unresolved problem that hinders compliance with the immunization requirement, then an immunization penalty shall be imposed at redetermination.

(7) The department shall impose an immunization penalty by reducing the group’s payment standard by $25.00. The $25.00 penalty shall continue for each month in which 1 or more nonexempt eligible children under age 6 are not immunized and in which the group does not have unresolved problems that hinder compliance with the immunization requirement.

(8) If a group complies with the immunization requirement, then the group is considered to be in compliance for the whole month in which immunizations began.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3116 Identity verification requirement; acceptable verification sources {#sec-r-400.3116 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3116}

Rule 16. A grantee shall verify his or her identity in order to receive benefits.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3117 Striker penalties {#sec-r-400.3117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3117}

Rule 17. (1) A person who is on strike on the last day of a calendar month is excluded from the eligible group.

(2) A striker's spouse and a striker's children are also excluded from the eligible group if they live with the striker.

(3) At application, it is assumed that a striker will be on strike on the last day of the month unless it is verified that he or she will not be on strike.

(4) If a person is already receiving assistance and is on strike on the last day of the month, then the striker's spouse and children who live with him or her are ineligible for 2 pay periods or until the strike ends, whichever is longer.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3118 Changes in circumstances; reporting {#sec-r-400.3118 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3118}

Rule 18. (1) A group shall report a change in circumstances within 10 days of the change.

(2) The agency will act on a change in circumstances that continues for at least 1 month beyond the month in which the change was reported.

(3) Member additions and changes in income that result in a benefit increase shall affect the month after the change occurred, if reported within 10 days of the change. If reported late, the effective month of the increase is the month after the change is reported and verified.

(4) A change not specified in subrule (3) of this rule shall affect the first full benefit month that begins not later than 10 days after the change is reported. The agency may affect the first full benefit month that begins earlier than 10 days after the change is reported if administratively possible. The benefit month is the calendar month for which assistance is paid.

Assistance may be paid for 1/2 of the benefit month or for a full benefit month, depending upon the group's eligibility for payment.

(5) A change that results in case closure may affect the month the change occurred.

(6) A change in assets that exceeds the agency established asset standard results in group ineligibility for a minimum of 1 month or for as long as the assets exceed the standard, whichever is longer. The month in which assistance is closed is either the month after the month that the group obtained the asset or the second month after the month that the group obtained the asset if administratively feasible.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3119 Institutional status; eligibility for family independence program {#sec-r-400.3119 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3119}

Rule 19. (1) A person who is in an institution for more than 30 calendar days is not eligible for assistance.

(2) If a person is placed in an institution, it is presumed that he or she will remain there more than 30 calendar days, unless a shorter stay is verified by the person.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3120 Pursuit of potential benefits as condition of eligibility {#sec-r-400.3120 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3120}

Rule 20. (1) As a condition of eligibility, a client shall apply for potential benefits for which the group or a member of the group may be eligible.

(2) A client shall take action to make the entire benefit amount available to the group.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3121 Penalties for failure to pursue potential benefits; verification requirements {#sec-r-400.3121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3121}

Rule 21. (1) If a client fails to pursue a potential benefit, then the group is ineligible.

(2) If a client or other group member takes any action that restricts the amount of a benefit available to the group, then the group is ineligible.

(3) A client's statement that he or she has applied for a benefit or that he or she is not eligible shall be accepted as true, unless the statement is unclear, inconsistent, or in conflict with other information.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3122 Concurrent receipt of benefits prohibited {#sec-r-400.3122 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3122}

Rule 22. (1) Neither an adult nor a child may receive both supplemental security income benefits and family independence program benefits for the same period.

(2) A child may not receive foster care payments and family independence program benefits concurrently.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3123 Refusing offer of suitable employment; penalties; good cause explained {#sec-r-400.3123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3123}

Rule 23. (1) An applicant or recipient shall not refuse employment without good cause.

Any of the following actions constitute refusing employment:

(a) Refusing a bona fide offer of employment of at least minimum wage.

(b) Voluntary leaving a job.

(d) Otherwise reducing earnings.

(e) Being terminated from employment for misconduct or absenteeism.

(2) The department shall impose a penalty if an applicant or recipient refuses employment without good cause.

(3) If an applicant refuses employment within 30 calendar days before the date of application, then the penalty is applied as follows:

(a) The group is ineligible for family independence assistance for 30 calendar days from the date of refusal.

(b) Benefits shall not begin any earlier than the first pay period after the 30 calendar days have passed.

(4) A person refusing employment or quitting a job for any of the following reasons is determined to have good cause:

(a) The person suffers from a temporary debilitating illness or injury, or an immediate family member has a debilitating illness or injury and the person is needed in the home to care for the family member.

(b) Lack of child care as defined in Section 407(e)(2) of Public Law 104-193, 42 U.S.C. §607(e)(2).

(c) Commuting time is more than 2 hours per day or more than 3 hours per day when there are unique and compelling circumstances such as a salary at least twice the applicable minimum wage or it is the only available job placement within a 3-hour commute per day, not including the time necessary to transport a child to child care facilities.

(d) Transportation is not available to the participant at reasonable cost.

(e) Employment or participation involves illegal activities.

(f) The person is physically or mentally unfit to perform the job, as documented by medical evidence or by reliable information from other sources.

(g) The person is illegally discriminated against on the basis of age, race, disability, gender, color, national origin, or religious beliefs.

(h) Credible information or evidence establishes 1 or more unplanned or unexpected events or factors that reasonably could be expected to prevent or significantly interfere with the individual's compliance with employment and training requirements.

(i) The person voluntarily left employment to obtain comparable employment.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3124 Child support; good cause claim and determination; exceptions to cooperation requirement {#sec-r-400.3124 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3124}

Rule 24. (1) A client shall take all action required by 1939 PA 280, MCL 400.1 to establish paternity and obtain support.

(2) A client may claim good cause for not taking the action specified in sub rule (1) of this rule. Good cause includes any of the following reasons:

(a) The child entitled to support was conceived due to incest or forcible rape.

(b) Legal proceedings for the adoption of the child entitled to support are pending before a court.

(c) A client is currently receiving counseling from a public or licensed private social agency to decide if the child should be released for adoption and the counseling has not continued for more than 3 months.

(d) Physical or emotional harm may result if the client or child has been subject to or is in danger of any of the following:

(i) Serious physical harm to the child entitled to support.

(ii) Serious physical harm to the client.

(iii) Serious emotional harm to the child entitled to support that actually harms the child's ability to function in everyday life.

(iv) Serious emotional harm to the client that actually harms the client's capacity to adequately care for the child entitled to support.

(e) Sexual abuse of client or child.

(f) Sexual activity involving a dependent child.

(g) Being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities.

(h) Threats of, or attempts at, physical or sexual abuse of client or child.

(i) Mental abuse of client or child.

(j) Neglect or deprivation of medical care for child.

(2) A client's cooperation in establishing paternity and obtaining support is not required if good cause exists, but a support action may proceed if the department determines that the action would not endanger the child or client.

(3) Once a client is informed of the right to claim good cause and decides to make the claim, the client shall do all of the following:

(a) Specify the type of good cause.

(b) Specify the persons covered by the claim of good cause.

(4) The department shall make a good cause determination shall be made within 45 calendar days of the client's written claim, unless the client was granted an additional 25calendar-day extension to the original 20-calendar-day limit and more information is needed that cannot be obtained within the 45-calendar-day limit.

(5) A good cause determination shall make 1 of the following findings:

(a) Good cause does not exist and the client must cooperate.

(b) Good cause does exist and the client's cooperation in obtaining support is not required.

(c) Good cause does exist, but a support action can proceed without the client and without endangering the client or child.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3125 Imposition of support disqualification; removal of support disqualification {#sec-r-400.3125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3125}

Rule 25. (1) Failure to cooperate in obtaining support without good cause shall result in a disqualification, causing minimum 1 month ineligibility for the person who failed to cooperate.

(2) If the non-cooperative person is determined by the department to be disqualified for failure to cooperate in obtaining support, the entire case is closed. The case must remain closed for a minimum of 1 month and cannot be reopened until the non-cooperative person cooperates with the action(s) to establish paternity, obtain support or until the paternity/support action is no longer needed.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3126 Identification of third-party resource liability {#sec-r-400.3126 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3126}

Rule 26. (1) As a condition of eligibility, eligible group members shall cooperate in identifying all third-party resources, unless the group members have good cause not to identify third- party resources.

(2) A group member who does not have good cause for failing to identify third-party resources is disqualified from receiving program benefits.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3127 Failing to identify third-party resources; good cause reasons; determination {#sec-r-400.3127 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3127}

Rule 27. (1) The department shall advise a client of the right to claim good cause for failing to identify third-party resources and that the client has 20 calendar days after filing the claim to provide written evidence to support the claim. If a client has difficulty obtaining the evidence, then the initial 20-calendar-day period may be extended to 45 calendar days.

(2) The following reasons constitute good cause for failing to identify third-party resources:

(a) Establishing paternity might harm the child.

(b) Conception was due to incest or forcible rape.

(d) A regulated public or private agency is counseling the mother on whether to release the child for adoption. This reason is valid for 3 months of counseling.

(e) Serious physical or emotional harm to a group member might result.

(3) The department shall determine if good cause exists within 45 calendar days of a client's claim, unless an extension is granted to the client or is otherwise necessary to obtain evidence. The department shall not deny an application or delay benefits while a good cause claim is pending.

(4) The department shall make 1 of the following findings:

(a) Good cause does not exist and the client must cooperate to be eligible. The client may withdraw the application, request closure, or be disqualified.

(b) Good cause does exist and the third-party resource is not pursued.

(c) Good cause does exist, but the third-party resource can be pursued without endangering the client or dependent child.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3128 Disqualification; removing disqualification {#sec-r-400.3128 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3128}

Rule 28. (1) A responsible adult who fails to cooperate in identifying a third-party resource is disqualified indefinitely.

(2) A responsible adult is an adult who is an eligible group member when the resource is available to any of the following persons:

(a) Himself or herself.

(b) His or her unmarried child who is under age 18.

(d) A dependent child if his or her eligibility is based on specified relative status.

(3) A disqualified person cannot receive assistance on behalf of the group unless he or she is the only adult in the case and a suitable third-party payee cannot be found.

(4) A disqualification ends when any 1 of the following situations occurs:

(a) The disqualified person cooperates.

(b) Good cause for not cooperating is established.

(d) Eligibility ends for the person whose resources are the basis for the disqualification.

History

History: 1997 AACS.

Mich. Admin. Code R 400.3129 Benefit over issuance determination and recoupment {#sec-r-400.3129 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3129}

Rule 29. (1) An over issuance period starts with the first pay period that the benefit issuance exceeds the amount allowed. The over issuance period ends with the pay period immediately before the pay period when the benefit amount is corrected.

(2) The amount received by the group includes regular, supplemental, and duplicate warrants; vendor payments; and the amount of any benefit reduction used to repay previous over issuances.

(3) The department shall adjust family independence program over issuance amounts by subtracting all or part of any assigned current child support payments retained by the state during the over issuance period. If the group was ineligible for the family independence program during the over issuance period, then the full amount of support retained by the state is subtracted. If the group was eligible for part of the family independence program issued, then the portion of child support retained by the state in excess of the amount the group was eligible for will be subtracted.

(4) The budgeting method used to determine the original issuance amount shall be used to determine the over issuance amount if the correct budgeting method was used.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3130 Intentional program violation; disqualification and recoupment {#sec-r-400.3130 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3130}

Rule 30. (1) If an over issuance investigation finds that an intentional program violation occurred, then the accused individual shall be notified of the allegation, the potential penalty, and the right to meet with department representatives to discuss the allegation.

(2) The department shall conduct an administrative hearing to determine if an over issuance occurred due to an intentional program violation, unless either of the following provisions applies:

(a) The person waives his or her right to the hearing by signing a recoupment and disqualification agreement.

(b) The person was convicted of fraudulent receipt of benefits under section 60 of 1939 PA 280, MCL 400.60, or any other criminal fraud statute.

(3) If an person has agreed to and signed the recoupment and disqualification agreement, then no further administrative appeal is available.

(4) An individual may request a hearing to contest the computation of the benefit reduction amount, but not the over issuance amount.

(5) The department shall conduct an intentional program violation hearing with or without the person or authorized representative present if the hearing notice is not returned by the post office as undeliverable.

(6) Overpayments for which an intentional program violation is not established shall be recouped as department or client error.

(7) In an administrative disqualification hearing, an individual who is determined to have committed an intentional program violation, who pleads guilty to an intentional program violation, who waives his or her legal right to an administrative disqualification hearing regarding an allegation of intentional program violation, or who is convicted of criminal fraud based on the fraudulent receipt of benefits shall be disqualified by reducing the monthly benefit level by the amount deemed to meet the individual's monthly needs for the following periods:

(a) One year for a first offense.

(b) Two years for a second offense.

History

History: 1997 AACS; 2014 AACS.

Mich. Admin. Code R 400.3131 Benefit over issuance collection and repayment actions {#sec-r-400.3131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3131}

Rule 31. (1) The department shall seek recoupment of benefit over issuances from active or inactive family independence program groups through administrative recoupment processes. Repayment shall be in cash or through benefit reduction.

(2) The department shall seek recoupment of benefit over issuances from any adult who was a group member when the over issuance occurred.

(3) If the overpaid family independence program group did not include an eligible or disqualified adult at the time of the over issuance, then a collection action will not be initiated unless the debt was established through court action or by obtaining a signed repayment agreement.

(4) The department shall recoup over issuances to active family independence program groups through benefit reduction, unless cash payments are ordered by a court.

(5) If an over issuance is not paid in full during the notice period, then the family independence program warrants will be reduced by a percentage of the payment standard as follows:

(a) Agency and client error over issuances are recouped at a 5% reduction of the payment standard.

(b) Intentional program violation over issuances are recouped at a 10% reduction of the payment standard.

(6) A repayment amount is adjusted to maintain a minimum $2.00 cash benefit to the client.

(7) If a court orders cash repayment and the active family independence program client does not make regular cash payments, then the department shall change the collection method to benefit reduction.

(8) A local department office may pursue collection from an estate of a deceased who had an over issuance balance through probate court claim action.

(9) Any payments received as restitution under the terms of probation will reduce the balance owed, but the completion of the probation period or the performance of a requirement of probation does not reduce the amount owed in excess of the actual dollar amount paid toward the balance owed.

History

History: 1997 AACS; 2014 AACS.

R 400.3151 to R 400.3180 State Disability Assistance Program

Mich. Admin. Code R 400.3151 Definitions {#sec-r-400.3151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3151}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

ECONOMIC STABILITY ADMINISTRATION

STATE DISABILITY ASSISTANCE PROGRAM

(By authority conferred on the department of health and human services by section 6 of the social welfare act, 1939 PA 280, MCL 400.6)

Rule 1. (1) As used in these rules:

(a) “Administrative hearing” means the impartial review by an administrative law judge of a department decision that a client believes is illegal or unsatisfactory. Both the client and the department may present evidence in support of their respective positions.

(b) "Administrative recoupment” means a process by which a group’s benefits are reduced to make payments on an overissuance.

(c) "Application" means a signed and dated statement on a form prescribed by the department that an individual wishes to receive state disability assistance.

(d) "Application filing date" means the date an application with minimum required information is received by the department.

(e) "Authorized representative" means an individual who is not less than 18 years of age and applies for assistance on behalf of a client or otherwise acts on a client's behalf, or both. The individual may be, but is not limited to, a guardian, spouse, or relative outside the group.

(f) “Client” means an individual applying for, currently receiving program benefits, inquiring about benefits, or is part of the program group.

(g) "Client error" means the department has taken all actions required under normal processing procedures but the client has given incorrect or incomplete information or failed to meet other requirements which impact the amount of program benefits and the error has not been determined as intentional. An overissuance that results from department action being discontinued due to a client's administrative hearing request is client error if a client withdraws the request, fails to show for the administrative hearing, or the department's action is upheld at the hearing.

(h) “Department” means the department of health and human services.

(i) "Disqualification" means a department penalty action for an individual who is ineligible for program benefits because an eligibility factor has not been met or because the individual refuses or fails to cooperate in meeting an eligibility factor.

(j) "Domiciliary care" means a type of care given to residents in a special living arrangement whose principal need is supervision and who are generally able to perform the basic activities of daily living, such as eating, bathing, and dressing.

(k) “EBT” means electronic benefit transfer.

(l) "Group" means the state disability assistance group.

(m) “FIP” means family independence program.

(n) "Institution" means an establishment that furnishes food, shelter, and some treatment or services to more than 3 individuals who are unrelated to the proprietor.

(o) "Intentional program violation" means an action that occurs when a client or authorized representative intentionally withholds or misrepresents information for the purpose of obtaining benefits that the client or authorized individual would not otherwise be eligible. An overissuance becomes an intentional program violation if a client or client's authorized representative is found to be responsible for an intentional program violation by a court, or as a result of an administrative hearing or has signed a disqualification agreement.

(p) "Mandatory vendoring" means an agency payment of assistance amounts, without client request, directly to the client's landlord, mortgage holder, or land contract holder and to the providers of the client's home heating and electricity services.

(q) "Monthly payment amount" means the amount of assistance paid to a group after deductions for vendoring and any department recoupment.

(r) "Overissuance" means that a group receives more benefits than it is eligible to receive.

(s) "Overissuance period” means the time period during which the overissuance occurred (t) "Pay period" means the first to the fifteenth of the month or the sixteenth to the end of the month.

(u) “Payment standard” means the maximum monthly amount for the approved ongoing monthly certified group size.

(v) "Personal care" means assistance that is provided to an individual who needs help in performing personal daily activities, such as cooking, eating, grooming, shopping, and taking medication.

(w) "Potential benefits" means any of the following benefits:

(i) Retirement, survivors, and disability insurance.

(ii) Worker's compensation benefits.

(iii) Veterans administration benefits.

(iv) Railroad retirement benefits.

(v) Pension payments.

(vi) Disability or retirement benefits.

(vii) Earned but unpaid wages.

(viii) Strike pay.

(ix) Vacation pay.

(x) Supplemental security income.

(xi) Family independence program benefits.

(xii) Other than state-funded, needs-based programs, other financial benefits for which potential eligibility exists and which may reduce the state disability assistance program benefit.

(x) "Program group" means those individuals living together whose income and assets must be counted in determining eligibility for state disability assistance.

(y) "Provider" means an individual or agency that furnishes services to a client.

(z) “RCA” means refugee cash assistance.

(aa) "Recoupment" means the process by which the department recovers an overissuance of program benefits.

(bb) "Redetermination" means a review of continuing eligibility for state disability assistance.

(cc) "Repayment" means an action by a client to pay back benefits received.

(dd) "Restricted payments" means mandatory payment made to an individual other than the client in the form of vendor payments or third-party payments due to a third-party resource disqualification or money mismanagement.

(ee) "Returned warrants" means uncashed warrants received by the local department office or treasury.

(ff) “SDA” means state disability assistance.

(gg) "Special living arrangement" means any of the following:

(i) An adult foster care facility.

(ii) A county infirmary.

(iii) A substance abuse treatment center.

(iv) A home for the aged.

(v) A long-term care facility.

(vi) A hospital.

(hh) "State disability assistance group" means the members of a program group who receive state disability assistance.

(ii) "Stop payment" means a department directive to treasury to not honor a warrant.

(jj) "Third-party payments" mean an agency payment of a client’s entire assistance benefit, without client request, to an agency or individual outside the eligible group for management of the assistance on behalf of the group.

(kk) "Third-party resource" means an individual, entity, or program that is, or might be, liable to pay all or part of a group member's medical expenses.

(ll) "Treasury" means the department of treasury.

(mm) "Underissuance" means that a group receives less cash assistance than it is eligible to receive.

(nn) "Verification" means documentation or action taken that provides evidence establishing the accuracy of a client's verbal or written statements.

(oo) "Voluntary vendoring" means a payment system whereby, at the group’s request, the department sends part of the group’s cash assistance directly to the provider for payment of the group’s shelter, heat, or electricity.

(pp) “Warrant” means a written order to pay that instructs a federal, state, or county government treasurer to pay the warrant holder on demand or after a specific date.

(qq) "Warrant date" means the date shown on a warrant. For regular client and vendor warrants, the warrant date is the expected date of delivery. For replacement warrants, the warrant date is the date the warrant was mailed.

(2) Terms defined in the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, have the same meaning when used in these rules.

History

History: 1998-2000 AACS; 2015 AACS; 2025 AACS.

Mich. Admin. Code R 400.3152 Group composition {#sec-r-400.3152 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3152}

Rule 2. (1) If an individual requests state disability assistance, then the following persons are in the program group and, if eligible, in the state disability assistance group:

(a) The individual who requests assistance.

(b) The individual's spouse, if the spouse is living in the home with the individual.

(2) State disability assistance is limited to needy persons who are 18 years or older and to emancipated minors who meet all eligibility criteria.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3153 Temporary absence from home {#sec-r-400.3153 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3153}

Rule 3. (1) A person is temporarily absent from the home if all of the following provisions apply:

(a) The person's location is known.

(b) There is a definite plan for the person's return.

(d) The absence has lasted, or is expected to last, 30 calendar days or less.

(2) The 30-calendar-day provision in subrule (1)(d) of this rule does not apply if the absence is due to hospitalization, training, or education.

(3) A person who meets the criteria for being temporarily absent specified in subrules (1) and (2) of this rule is considered to be living in the home and continues to receive assistance.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3154 Institutional status; eligibility for state disability assistance {#sec-r-400.3154 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3154}

Rule 4. (1) A person who is in an institution for more than 30 calendar days is not eligible for state disability assistance.

(2) If a person is placed in an institution, it is presumed that he or she will remain there more than 30 calendar days unless a shorter stay is verified.

(3) Notwithstanding subrules (1) and (2) of this rule, a person in any of the following institutions may be eligible for state disability assistance if all other eligibility criteria are met:

(a) A home for the aged.

(b) A county infirmary.

(d) A substance abuse treatment center.

(e) A department of corrections contract facility for probationers.

(f) A technical institute and rehabilitation center operated by Michigan rehabilitation services.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3155 Applications for assistance {#sec-r-400.3155 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3155}

Rule 5. (1) Any person, regardless of age, may apply for assistance for himself or herself.

With the group's permission, a person who is 18 years of age or older may be authorized to represent and apply on behalf of the group.

(2) An applicant may submit an application in person, by mail, telephone, or electronically. The department must receive the original, signed application before benefits are approved.

(3) A person shall complete a department application form when first applying for assistance benefits and when eligibility is redetermined.

(4) If an application contains the minimum information established by the department, including the signature of the client or authorized representative, the department must accept and register the application as soon as it is filed.

(5) Upon receipt of an incomplete application, department staff shall give or send a client an appropriate form that identifies the information needed to render the application complete and shall specify a due date by which the information must be provided.

Eligibility must be denied, or an ongoing assistance case must be terminated, if an application remains incomplete. An incomplete application is valid through the last day of the month after the month of denial or termination and may be updated during that period.

(6) As part of the application and redetermination process, the department may conduct an official, confidential interview with a client, another responsible applicant group member, or an authorized representative. An interview must be conducted in a department local office during normal weekday office hours or by telephone.

History

History: 1998-2000 AACS; 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.3156 Verification of eligibility factors {#sec-r-400.3156 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3156}

Rule 6. (1) A group shall provide the department with verification of the factors that affect the initial and continued eligibility of the group or its individual members in the state disability assistance program, including information obtained by data exchanges.

(2) The department shall provide a client with a written notice of the factors that must be verified and the due date for submitting verification to the local office of the department.

(3) Department staff may visit a group's home to verify eligibility information or to conduct other department business. A group shall cooperate with department home visits.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3157 Determination of eligibility and assistance amount {#sec-r-400.3157 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3157}

Rule 7. The department shall determine the eligibility of each person in a program group and the amount of assistance for which the group qualifies.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3158 Beginning of assistance benefits {#sec-r-400.3158 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3158}

Rule 8. The department shall begin assistance benefits not earlier than the half-month pay period after the pay period that includes the application filing date and not later than the pay period in which the application becomes 30 calendar days old, if the group is eligible for that pay period. If the application becomes 30 calendar days old and the group has not met eligibility requirements, the department shall begin assistance benefits for the pay period in which all eligibility requirements are met.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3159 Client responsibility to cooperate with department; effect of failure to cooperate {#sec-r-400.3159 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3159}

Rule 9. (1) A client shall cooperate with department staff in determining initial and ongoing eligibility and benefit levels. Cooperation includes all of the following:

(a) Answering completely and truthfully all questions on department forms and during interviews.

(b) Taking all actions within the client’s ability to verify factors concerning the client's eligibility.

(d) Reporting accurate information that potentially affects eligibility or benefit amount within 10 calendar days after the information is known to the client.

(2) Failure to cooperate with the department in any matter of eligibility will result in denial of the assistance application or case closure, member disqualification, or benefit level reduction.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3160 Eligibility; citizenship and alien status {#sec-r-400.3160 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3160}

Rule 10. (1) To be eligible for assistance benefits, a person shall be either of the following:

(a) A citizen of the United States.

(b) An alien qualified to receive supplemental security income as provided under title IV, section 402 of Public Law 104-193, 8 U.S.C. §1612.

(2) An alien who is qualified as specified in subrule (1)(b) of this rule shall verify the qualification. An alien who is unable to provide verification or who refuses to cooperate with the department in obtaining verification is ineligible for assistance benefits.

(3) Subrule (1)(b) of this rule notwithstanding, a refugee or asylee who loses eligibility for the federal supplemental security income program by virtue of exceeding the maximum time limit for eligibility as delineated in Public Law 104-193 and who otherwise meets the eligibility criteria for the state disability assistance program shall be eligible to receive benefits under the state disability assistance program.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3161 Mandatory vendoring or third-party payments {#sec-r-400.3161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3161}

Rule 11. (1) If the department determines that a grantee's negligence has resulted in the mismanagement of funds and has endangered the health or safety of a group member, then, subject to subrule (2) of this rule, the department shall initiate mandatory vendoring or third-party payments.

(2) The department's decision to initiate third-party payments or mandatory vendoring shall be based on the seriousness of the client endangerment, the availability of a competent third-party payee, and the qualification of shelter providers.

(3) Mandatory vendoring shall be limited to the monthly combined shelter, heat, and utility expenses. A client shall receive a minimum $2.00 monthly payment amount after vendoring and other required deductions from the payment standard.

(4) A group in restricted payment status has the right to department review of the need to continue mandatory vendoring or third-party payments at least once every 6 months.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3162 Voluntary vendoring {#sec-r-400.3162 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3162}

Rule 12. (1) A group may request voluntary vendoring at any time by completing a department vendor payment form.

(2) As part of a voluntary vendoring request, a group that has heat and electricity obligations shall request vendor payments for both services unless vendoring both would leave a monthly payment amount of less than $2.00. The department or a utility company shall establish vendored amounts for heat and electricity based on the assistance payment standard.

(3) A group may specify any monthly shelter amount that is not less than $2.00 to be vendored if vendoring would leave a monthly payment amount of at least $2.00.

(4) The department shall cease voluntary vendor payments as soon as administratively feasible when requested in writing by a client.

(5) The department shall not authorize voluntary vendor payments for rent under any of the following circumstances:

(a) The local housing authority notifies the department that the dwelling fails to meet the housing code or that the landlord has failed to cooperate with housing code policies and procedures. In this situation, the department shall discontinue ongoing vendoring within 5 workdays if administratively feasible.

(b) The landlord has not cooperated with the department or a utility company in the installation of energy conservation measures that were determined necessary to reduce energy consumption. In this situation, the department shall discontinue ongoing vendoring within 5 workdays if administratively feasible.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3163 Special living arrangements {#sec-r-400.3163 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3163}

Rule 13. (1) A client who resides in an adult foster care facility, county infirmary, or home for the aged may be eligible for a client incidental allowance and for provider payment.

(2) A client who resides in a substance abuse treatment center, long-term care facility, or hospital may be eligible for a client incidental allowance, but is not eligible for provider payment.

(3) A special living arrangement facility must be licensed in order to receive payment.

(4) The department must determine a client's level of care to be either domiciliary care or personal care before provider payment may be authorized.

(5) Provider payment for a special living arrangement may begin up to 10 calendar days before the application filing date for an eligible client who was residing in a facility 10 days before the date of application.

(6) Subject to subrule (5) of this rule, per diem provider payment eligibility begins the day an eligible client enters a special living arrangement facility and ends the day the client becomes ineligible for assistance or the day before the date of discharge, whichever is earlier.

(7) If a client's failure to report timely, complete, and accurate information results in an overpayment for special living arrangement care, then the department shall recover the amount overpaid from the client.

(8) If a provider of special living arrangement care is overpaid as a result of incorrect provider billing or level of care authorization, then the department shall recover the amount overpaid from the provider.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3164 Changes in group's circumstances {#sec-r-400.3164 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3164}

Rule 14. (1) A group shall report a change in circumstance within 10 days of the change.

(2) The department shall act on changes that continue for at least 1 month beyond the month in which the change was reported.

(3) A group member addition or change in income that results in a benefit increase must affect the benefit level for the month after the month the change occurred, if the addition or change is timely reported. If a group member addition or change in income that results in a benefit increase is reported late, then the effective month of the increase is the month after the month the change is reported and verified.

(4) A change other than the changes specified in subrule (3) of this rule must affect the first full benefit month that begins not later than 10 days after the change is reported.

The department may affect the first full benefit month that begins earlier than 10 days after the change is reported, if administratively possible. A benefit month is the calendar month for which assistance is paid. Assistance may be paid for 1/2 of the benefit month or for a full benefit month, depending upon a group's eligibility for payment.

(5) A change that results in case closure may affect the month in which the change occurred.

(6) If a change in a group's assets results in exceeding the asset standard established by the department, then the group is ineligible for benefits for 1 month or for as long as the assets exceed the standard, whichever is longer. In this situation, the month in which assistance is closed is either the month following the month in which the group obtained the asset or, if administratively feasible, the second month following the month in which the group obtained the assets.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3165 Determination of eligibility and benefit levels; use of data base exchange {#sec-r-400.3165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3165}

Rule 15. The department shall use information available through data base matching to determine eligibility and benefit levels for clients.

History

History: 1998-2000 AACS; 2015 AACS.

Rule 16. A client shall verify his or her social security number or cooperate in obtaining a social security number to be eligible to receive benefits.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3167 Rescinded {#sec-r-400.3167 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3167}

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3168 Returned warrants {#sec-r-400.3168 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3168}

Rule 18. (1) A returned warrant may be rewritten by the department if a group was eligible for cash assistance during the period covered by the original warrant.

(2) A group is presumed to be ineligible for cash assistance under any of the following circumstances:

(a) The post office returned a client warrant to the treasury as undeliverable and there has been no contact from the group regarding the warrant.

(b) A warrant remains uncashed for more than 30 calendar days and there has been no contact from the client regarding the warrant.

(c) A client fails to contact the department by the disposition deadline for a warrant returned or delivered to the local department office.

(3) A representative of a group who picks up a client warrant shall present the group's signed statement authorizing the representative to pick up the warrant.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3169 Replacement policies for warrants and EBT thefts {#sec-r-400.3169 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3169}

Rule 19. (1) If a group reports an unendorsed warrant lost, stolen, not received, or destroyed, the group may have the warrant replaced if all the following criteria, as appropriate, are met:

(a) The group completes a stop payment or replacement request affidavit. For stolen warrants, a group shall file a police report, unless replacement of the warrant is made after recovery of the warrant amount.

(b) A client or provider shall contact the post office to verify delivery of a warrant that was issued but not received. If delivery is verified, the warrant is considered lost. If delivery cannot be verified, the warrant is considered not received. For warrants considered not received, a client or provider shall complete a stop payment or replacement request affidavit.

(c) Under any of the following circumstances, a warrant must be replaced only after recovery of the original warrant amount:

(i) Replacement is requested more than 30 calendar days after the warrant date.

(ii) The client has previously requested a replacement after cashing the original warrant.

(iii) A police report was not filed on a stolen warrant.

(iv) The case is closed, or closure is pending.

(v) The warrant to be replaced is a replacement warrant or a vendor warrant.

(2) If a warrant is cashed by a recipient of cash assistance, the department shall not take action on a request to stop payment on the cashed warrant and a replacement warrant must not be issued.

(3) A warrant that is lost or stolen after endorsement must be replaced only if the warrant is later returned or voided.

(4) If a replacement warrant is issued for a warrant that was cashed and the client claims that the warrant copy signature is not that individual’s signature, the client shall sign an affidavit that the signature is not the client's signature.

(5) If a replacement warrant is issued for a warrant that was cashed and the client fails to keep an appointment to view the warrant, refuses to sign the affidavit, or admits, endorsing both the original and replacement warrants, the department shall recover the overissuance from the group.

(a) A group is only eligible to receive this payment 1 time in a 12-month period.

(b) Replacement funds will only be approved up to 4 times the payment standard or the amount that was fraudulently removed, whichever is less.

History

History: 1998-2000 AACS; 2015 AACS; 2025 AACS.

Mich. Admin. Code R 400.3170 Supplemental benefits policy for cash assistance {#sec-r-400.3170 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3170}

Rule 20. (1) Supplemental benefits, also referred to as a supplement, are issued to correct an underissuance.

(2) A supplement is offset by overissuances for which collection actions have not yet begun. The department shall subtract the amount of the overissuance from the amount of the supplement, up to the amount of the supplement.

(3) The department shall issue a supplement promptly when verification of the need for a supplement is received by the department or when the department has knowledge of the need for a supplement.

(4) A supplement is issued back to the month following the month that verification, if required, shows the need began, but not earlier than the month following the month that the group reported the change which resulted in the need for a supplement.

(5) The department shall not issue a supplement for a period before the effective date for program eligibility.

(6) The department shall give a group adequate notice that a supplement has been authorized or denied.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3171 Identity verification requirement {#sec-r-400.3171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3171}

Rule 21. A grantee shall verify his or her identity in order to receive benefits.

Rule 22. (1) As a condition of eligibility, a client shall apply for potential benefits for which the group or a member of the group may be eligible.

(2) A client shall take action to make the entire potential benefit amount available to the group.

(3) A group that would otherwise be eligible for the family independence program (FIP) except for the group's failure to meet or comply with a FIP eligibility requirement is not eligible for the state disability assistance program.

History

History: 1998-2000 AACS; 2015 AACS. 400.3172 Pursuit of potential benefits as condition of eligibility.
History: 1998-2000 AACS.

Mich. Admin. Code R 400.3173 Penalties for failure to pursue potential benefits; verification requirements {#sec-r-400.3173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3173}

Rule 23. (1) If a group refuses to pursue a potential benefit, then the group is ineligible for state disability assistance.

(2) If a client or other group members act to restrict the amount of a potential benefit that is available to the group, then the group is ineligible for state disability assistance.

(3) The department shall accept a client's statement that he or she has applied for a benefit or that he or she is not eligible for a benefit, unless the statement is unclear, inconsistent, or in conflict with other information.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3174 Concurrent receipt of benefits prohibited {#sec-r-400.3174 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3174}

Rule 24. (1) A client may not receive state disability assistance benefits and refugee matching grant payments for the same period.

(2) A client may not receive state disability assistance benefits for the same period in which he or she received benefits from any of the following:

(a) The family independence program.

(b) Another state's cash assistance program that is either state-funded or funded under title IV-A of the social security act of 1962, 42 U.S.C. §601 et seq.

(d) The repatriate assistance program.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3175 Residence {#sec-r-400.3175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3175}

Rule 25. (1) For purposes of the state disability assistance program, a resident of this state is a person who is living in this state voluntarily with the intention of making his or her home in this state and not for a temporary purpose and who is not receiving assistance from another state.

(2) The continued absence of a recipient from this state, unless the absence is temporary or an intent to return is established, shall constitute abandonment by the recipient of residence in this state.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3176 Repayment agreements {#sec-r-400.3176 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3176}

Rule 26. (1) As a condition of eligibility, a client is required to sign an agreement to repay state disability assistance benefits issued during the period in which the client is pursuing a financial benefit for which he or she may be eligible.

(2) If a client refuses to sign a repay agreement when required, then the group is ineligible for benefits.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3177 Benefit overissuance determination and recoupment {#sec-r-400.3177 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3177}

Rule 27. (1) A benefit overissuance period starts with the first pay period that the benefit issuance exceeds the benefit amount allowed. The overissuance period ends with the pay period immediately before the pay period when the benefit amount is corrected.

(2) A benefit amount that a group receives includes all of the following:

(a) Regular, supplemental, and duplicate warrants.

(b) Vendor payments.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.3178 Intentional program violation; disqualification; recoupment {#sec-r-400.3178 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3178}

Rule 28. (1) If, in the course of an overissuance investigation, the department determines that an intentional program violation occurred, then the person accused of the violation shall be notified of all of the following:

(a) The allegation.

(b) A potential penalty.

(2) The department shall conduct an administrative hearing to determine if an overissuance occurred due to intentional program violation, unless either of the following provisions applies:

(a) The person accused of the violation waives his or her right to the hearing by signing a recoupment and disqualification agreement.

(b) The individual has been convicted of the fraudulent receipt of benefits under section 60 of 1939 PA 280, MCL 400.60, or any other criminal fraud statute.

(3) If a person accused of an intentional program violation has agreed to and signed a recoupment and disqualification agreement, then the person does not have recourse to further administrative appeal.

(4) A person accused of an intentional program violation may request a hearing to contest the computation of the benefit reduction amount, but not the overissuance amount.

(5) The department may conduct an intentional program violation hearing without the person accused of the violation or his or her authorized representative present if the hearing notice that was sent to the person is not returned by the post office as undeliverable.

(6) Any administrative hearing initiated by the department under this rule shall be conducted pursuant to notice served on the accused person not later than 6 years after the overissuance occurred.

(7) If the department does not establish that an overpayment was the result of an intentional program violation, then the department shall recoup the overpayment as department or client error.

(8) A person who is determined, in an administrative disqualification hearing, to have committed an intentional program violation, who pleads guilty to an intentional program violation, who waives his or her legal right to an administrative disqualification hearing regarding an allegation of intentional program violation, or who is convicted of criminal fraud based on the fraudulent receipt of benefits shall be disqualified by reducing the monthly benefit level by the amount deemed to meet the individual's monthly needs for the following periods:

(a) A period of 1 year for a first offense.

(b) A period of 2 years for a second offense.

(9) For current or former state disability assistance recipients, the department shall impose a disqualification penalty for an intentional program violation within 5 days of the receipt of a decision that an intentional program violation occurred.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3179 Benefit overissuance; collection and repayment actions {#sec-r-400.3179 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3179}

Rule 29. (1) The department shall employ administrative recoupment processes to recoup all benefit overissuances from active or inactive state disability assistance groups by cash repayment or benefit reduction.

(2) The department shall seek recoupment of benefit overissuances from any adult who was a group member when the overissuance occurred.

(3) The department shall recoup overissuances on active state disability assistance cases through benefit reduction, unless cash payments are ordered by a court.

(4) If an overissuance is not paid in full during the timely notice period, then the department shall reduce state disability assistance warrants by a percentage of the payment standard as follows:

(a) The department and client error overissuances are recouped at a 5% reduction of the payment standard.

(b) Intentional program violation overissuances are recouped at a 10% reduction of the payment standard.

(5) An overissuance repayment amount shall be adjusted to maintain a minimum $2.00 cash benefit to the client.

(6) If a court orders cash repayment of an overissuance and the active state disability assistance client does not make regular cash payments, then the department shall change the collection method to benefit reduction.

(7) A local department office may pursue, through probate court claim action, collection from the estate of a person who dies and has an overissuance balance.

(8) A payment received as restitution under the terms of a person's probation reduces the balance owed, but completing the probation period or performing a requirement of probation does not reduce the amount owed in excess of the actual dollar amount paid toward the balance owed.

History

History: 1998-2000 AACS; 2015 AACS.

Mich. Admin. Code R 400.3180 Recission {#sec-r-400.3180 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3180}

Rule 30. R 400.1121 of the Michigan Administrative Code, appearing on pages 850 and 851 of the 1993 Annual Supplement to the 1979 Michigan Administrative Code, is rescinded.

History

History: 1998-2000 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 400.3351 to R 400.3351 Medical Assistance Program

Mich. Admin. Code R 400.3351 Invoices or claim adjustments; identification of physician, dentist, or other practitioner {#sec-r-400.3351 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3351}

DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

MEDICAL ASSISTANCE PROGRAM

(By authority conferred on the director of the department of social services by sections 6 and 9 of Act No. 280 of the Public Acts of 1939, as amended, being SS400.6 and 400.9 of the Michigan Compiled Laws)

Rule 1. The department may, in the interest of utilization review and control, require identification of the attending, referring, or prescribing physician, dentist, or other practitioner on all invoices or claim adjustments submitted by medical or clinical laboratories, pharmacies, and hospitals enrolled in the medical assistance program. The attending, referring, or prescribing physician's, dentist's, or other practitioner's medical assistance program identification number or an alternative appropriate number which has been approved by the bureau of medical assistance shall be used to identify the attending, referring, or prescribing physician, dentist, or other practitioner.

History

History: 1979 AC.

R 400.3401 to R 400.3425 MSA Provider Hearings

Mich. Admin. Code R 400.3401 Rescinded {#sec-r-400.3401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3401}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

MEDICAL SERVICES ADMINISTATION

MSA PROVIDER HEARINGS

(By authority conferred on the executive director of the d e p a r t m e n t o f h e a l t h a n d h u m a n s e r v i c e s by sections 6 and 9 of 1939 P A 280, MCL 400.6 and 400.9, and Executive Reorganization Orders 2005-1 and 2011-4, MCL 445.2021 and 445.2030)

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3402 Definitions {#sec-r-400.3402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3402}

Rule 2. As used in these rules:

(a) “Adverse action” means any of the following:

(i) A suspension or termination of provider participation in the medical assistance program.

(ii) A denial of an applicant’s request for participation in the medical assistance program.

(iii) The reduction, suspension, or adjustments of provider payments.

(iv) Retroactive adjustments following the audit or review and determination of the daily reimbursement rates for institutional providers.

(b) “Applicant” means an individual, firm, corporation, association, agency, institution, or other legal entity that has applied to participate in the medical assistance program as a provider.

Editor's Note: An obvious error in R 400.3402 was corrected at the request of the promulgating agency, pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the error was published in Michigan Register, 2016 MR 10. The memorandum requesting the correction was published in Michigan Register, 2016 MR 12.

History

History: 1979 AC; 2016 AACS.

Mich. Admin. Code R 400.3403 Rescinded {#sec-r-400.3403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3403}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3404 Request for internal conference or appeal for administrative hearing {#sec-r-400.3404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3404}

Rule 4. (1) After notice of an adverse action, providers or applicants may request an internal conference or an appeal for administrative hearing.

(2) Providers and applicants must request an internal conference or an appeal for administrative hearing in writing which shall be received within 30 calendar days of the notice of adverse action unless otherwise specified in the notice of adverse action or if a different appeal period exists in state or federal regulations.

(3) If a provider or an applicant does not timely request an internal conference or appeal for administrative hearing after receiving notice of an adverse action, the notice of adverse action is final and the department may act on it.

History

History: 1979 AC; 2016 AACS.

Mich. Admin. Code R 400.3405 Internal Conference {#sec-r-400.3405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3405}

Rule 5. (1) Before a provider or an applicant requests an administrative hearing, a provider or an applicant may request an internal conference. Thepurpose of the internal conference is to determine whether the department action was taken according to policy.

(2) The provider or applicant may meet with a department staff member who acts as the appeals review officer from the appeals section or its successor section. The staff member is an impartial arbiter who facilitates the communication and the exchange of information between the provider or applicant and the department program staff.

(3) All requests for an internal conference must be submitted in writing to the department.

The appeals review officer may deny requests for internal conferences received after 30 days or after the date specified in the notice of adverse action.

(4) A request must state all of the following:

(a) Item or items being appealed.

(b) The dollar amount involved, if any.

(d) Failure to follow the requirements in this subrule may result in the denial of the internal conference by the appeals review officer.

(5) The appeals section must issue a decision within 30 days after the conclusion of the internal conference.

(6) Should the provider, applicant, and/or the department disagree with the internal conference decision, the provider, applicant, and/or the department has the right to an administrative hearing. Requests for an administrative hearing must be in writing and made within 30 days of the decision of the internal conference decision.

History

History: 1979 AC; 2016 AACS.

Mich. Admin. Code R 400.3406 Formal hearing {#sec-r-400.3406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3406}

Rule 6. (1) A provider or applicant is entitled to a formal hearing pursuant to chapter 4 of 1969 PA 306, MCL 24.271 to MCL 24.287, in any case in which there has been a final determination of an adverse action as defined in R 400.34012, except where that action is predicated upon the situation described in subrule (2) of this rule.

(2) A request for a formal hearing shall not be granted if the adverse action is the result of the revocation, suspension, or termination, by an authority other than the department, of the provider's license or certification to practice in the provider's profession or to operate a nursing home, hospital, or other such medical facility, and if the department is in receipt of a certified copy or formal notification of such revocation, suspension, or termination.

(3) A formal hearing shall be granted if the revocation, suspension, or termination of the provider's license, certification, or authorization is the result of a department action, unless the provider previously had an opportunity to have that action reviewed.

(4) Unless a written request for a formal hearing is received within 30 calendar days of notification of intent to terminate, the provider's participation shall automatically terminate as of the thirtieth calendar day after date of notification. Such termination shall then be a final and binding administrative determination.

(5) The request shall identify all of the following:

(a) Those aspects of the determination with which the provider or applicant is dissatisfied.

(b) An explanation of why the provider or applicant believes the determination on those matters is incorrect.

(6) The requestshall be submitted with any documentary evidence the provider or applicant considers necessary to support its position.

History

History: 1979 AC; 2016 AACS.

Mich. Admin. Code R 400.3407 Suspension and adjustment of program payments {#sec-r-400.3407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3407}

Rule 7. (1) Regardless of any request for a hearing, payments on pending and subsequently submitted bills may be immediately suspended, in whole or in part, if the bureau director determines that the practice set out in the final determination requires immediate action to protect the health, safety, or welfare of recipients or the general public.

This subrule does not prejudice the provider's right to a hearing as provided in R 400.3406.

Any hearing requested pursuant to this subrule shall be commenced forthwith if requested by the provider.

(2) The final determination notice shall constitute the basis for making retroactive adjustment of any program payments made to the provider during the period to which the determination applies, including the suspension of further payments to the provider, in order to recover, or to aid in the recovery of, an overpayment identified in the determination to have been made to the provider or applicant. If the provider or applicant requests a hearing, adjustments and recovery shall not be made, except as provided in subrule (1), until 10 days after the mailing of the hearing decision as provided in R 400.3424.

History

History: 1979 AC.

Mich. Admin. Code R 400.3408 Rescinded {#sec-r-400.3408 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3408}

History

History: 1979 AC; 2016 AACS.

Mich. Admin. Code R 400.3409 Rescinded {#sec-r-400.3409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3409}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3410 Rescinded {#sec-r-400.3410 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3410}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3410 Rescinded {#sec-r-400.3410 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3410}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3411 Rescinded {#sec-r-400.3411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3411}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3412 Rescinded {#sec-r-400.3412 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3412}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3413 Rescinded {#sec-r-400.3413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3413}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3414 Rescinded {#sec-r-400.3414 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3414}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3415 Rescinded {#sec-r-400.3415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3415}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3416 Rescinded {#sec-r-400.3416 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3416}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3417 Rescinded {#sec-r-400.3417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3417}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3418 Rescinded {#sec-r-400.3418 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3418}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3419 Rescinded {#sec-r-400.3419 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3419}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3420 Rescinded {#sec-r-400.3420 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3420}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3421 Rescinded {#sec-r-400.3421 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3421}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3422 Rescinded {#sec-r-400.3422 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3422}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3423 Rescinded {#sec-r-400.3423 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3423}

History

History: 1979 AC; 2015 AACS.

Mich. Admin. Code R 400.3424 Final decision of director or hearing authority {#sec-r-400.3424 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3424}

Rule 24. The director or hearing authority shall render a final decision in each case based upon the evidence in the record not later than 45 days after the administrative law judge makes his recommendation. The decision shall be made in writing. A copy of the decision shall be mailed to each party at the party's last known address. Copies of all decisions of the director or hearing authority shall be accessible to the public at the state office of the department. Copies may be obtained at actual cost.

History

History: 1979 AC.

Mich. Admin. Code R 400.3425 Nonapplicability of rules to alternate method of hospital reimbursement {#sec-r-400.3425 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.3425}

Rule 25. R 400.3401 to R 400.3423 do not apply to the alternate method of hospital reimbursement. That method shall follow the procedures in the approved state medical assistance plan.

History

History: 1979 AC.

Children's Services Agency Children's Services Agency

R 400.4101 to R 400.4666 Child Caring Institutions

Mich. Admin. Code R 400.4101 Definitions {#sec-r-400.4101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CHILDREN’S SERVICES AGENCY

DIVISION OF CHILD WELFARE LICENSING

CHILD CARING INSTITUTIONS

(By authority conferred on the director of the department of health and human services by sections 2, 5, 10, and 14 of 1973 PA 116, MCL 722.112, 722.115, 722.120, and 722.124, and Executive Reorganization Order No. 2015-1, MCL 400.227)

PART 1. GENERAL PROVISIONS

Rule 101. (1) As used in these rules:

(a) “Accredited college or university” means a college or university recognized by the United States Department of Education.

(b) “Act” means 1973 PA 116, MCL 722.111 to 722.128, known as the child caring organizations act.

(c) "Case record" means the individual file, including electronic records, kept by an institution concerning a youth who has been placed at the institution.

(d) “Chemical restraint” means a drug that meets all the following:

(i) Is administered to manage a youth’s behavior.

(ii) Has the temporary effect of restricting the youth’s freedom of movement.

(iii) Is not a standard treatment for the youth’s medical or psychiatric condition.

(e) "Chief administrator" means the person designated by the licensee as having the onsite day-to-day responsibility for the overall administration of a child caring institution and for assuring the care, safety, and protection of youth.

(f) “Child caring institution staff member” means an individual who is 18 years or older, and to whom any of the following apply:

(i) Is employed by a child caring institution for compensation, including adults who do not work directly with children.

(ii) Is a contract employee or self-employed individual working with a child caring institution.

(iii) Is an intern, volunteer, or other person who provides specific services under these rules.

(g) “Corporal punishment” means hitting, paddling, shaking, slapping, spanking, or any other use of physical force as a means of behavior management.

(h) "Department" means the Michigan department of health and human services.

(i) "Direct care worker" means a person who provides direct care and supervision of youth in an institution.

(j) “Emergency restraint or safety intervention” means use of personal restraint as an immediate response to an emergency safety situation.

(k) “Emergency restraint or safety situation” means the onset of an unanticipated or severely aggressive behavior that places the youth or others at serious threat of violence or injury if no immediate intervention occurs.

(l) “Human behavioral science” means a course of study producing a degree from an accredited college or university that is approved by the department for the specific positions when required by the act and these rules.

(m) “Juvenile justice youth” means a youth pending adjudication, or has been adjudicated, under section 2 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2a, or section 1 of chapter IX of The Code of Criminal Procedure, 1927 PA 175, MCL 769.1.

(n) "License" means a license issued by the department to a non-governmentally operated institution or a certificate of approval issued by the department to a governmentally operated institution indicating that the institution complies with these rules.

(o) “Licensee" means the agency, association, corporation, firm, organization, person, partnership, department, or agency of the state, county, city, or other political subdivision that has submitted an original application for licensure or approval or has been issued a license or certificate of approval to operate a child caring institution.

(p) "Licensing authority" means the administrative unit of the entity responsible for making licensing and approval recommendations for an institution.

(q) “Mechanical restraint” means a device, materials, or equipment attached or adjacent to the youth’s body that he or she cannot easily remove that restricts freedom of movement or normal access to one's body. Mechanical restraint does not include the use of a protective or adaptive device, or a device primarily intended to provide anatomical support.

(r) "Medication" means prescription and nonprescription medicines administered to treat a youth’s medical or psychiatric condition.

(s) "Michigan Children’s Institute Superintendent” or “MCI Superintendent” means the person appointed under 1935 PA 220, MCL 400.201 to 400.214, as the guardian of permanent state wards committed to it by the court.

(t) “Nonsecure institution” means an institution or facility, or portion thereof, that is used to house youth and that is not locked against egress.

(u) "Parent" means biological parent, including custodial and non-custodial parent, adoptive parent, or legal guardian.

(v) “Personal restraint” means the application of physical force, without the use of a device, that restricts the free movement of a youth’s body. Personal restraint does not include:

(i) The use of a protective or adaptive device.

(ii) Briefly holding a minor child without undue force in order to calm or comfort him or her.

(iii) Holding a minor child's hand, wrist, shoulder, or arm to safely escort him or her from 1 area to another.

(iv) The use of a protective or adaptive device or a device primarily intended to provide anatomical support.

(w) “Seclusion” means the involuntary placement of a youth in a room alone, where the youth is prevented from exiting by any means, including the physical presence of a staff person if that staff person's presence prevents the youth from exiting the room.

(x) “Seclusion room" means a room or area approved for the involuntary confinement or retention of a single youth. The door to the room may be equipped with a security locking device that operates by means of a key or is electrically operated and has a key override and emergency electrical backup in case of a power failure.

(y) "Secure institution" means any public or private licensed child caring institution where the movement and activities of residents is restricted and locked against egress from the building.

(z) “Sexual harassment” means verbal comments or gestures of a sexual nature to a youth by a staff member, contractor, or volunteer, including demeaning references to gender, sexually suggestive or derogatory comments about body or clothing, or obscene language or gestures.

(aa) “Shelter care facility” means an institution that primarily provides short-term assessment and planning.

(bb) "Social service supervisor" means a person who supervises a social service worker.

(cc) “Social service worker" means a person who works directly with youth, their families, and other relevant individuals and who is primarily responsible for the development, implementation, and review of treatment plans for the youth. This definition does not prevent a team approach to treatment plan development and implementation.

(dd) “Terms of license" means those designations noted on an institution's license for which the institution is authorized or approved.

(2) A term defined in the act has the same meaning when used in these rules unless otherwise indicated.

History

History: 1983 AACS; 2015 AACS; 2019 AACS; 2020 AACS; 2022 AACS.

Mich. Admin. Code R 400.4102 Inspection and approval of institution {#sec-r-400.4102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4102}

Rule 102. Residents may occupy an institution, including new construction, additions, and conversions, only after inspection and approval by the licensing authority.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4103 Space and equipment requirements {#sec-r-400.4103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4103}

Rule 103. An institution shall provide all of the following to assure delivery of licensed services:

Sufficient resident living space, as set forth in R 400.4510.

Office space.

Equipment to assure delivery of licensed services.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4104 Rules compliance {#sec-r-400.4104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4104}

Rule 104. (1) Before being licensed as an institution, an original applicant shall comply with 1973 PA 116, MCL 722.111 et seq.and the rules for the type of institution the applicant proposes to operate and for which compliance can be achieved prior to beginning operation and shall demonstrate intent to comply with those rules for which compliance can only be demonstrated after the institution has become fully operational.

(2) After being licensed, an institution shall, on an ongoing basis, comply with the act, child caring institution rules, and terms of the license.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4105 Rule variance {#sec-r-400.4105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4105}

Rule 105. (1) Upon written request of an applicant or licensee, the department may grant a variance from an administrative rule if there is clear and convincing evidence that the alternative to the rule complies with the intent of the administrative rule from which a variance is sought.

(2) The department shall enter its decision, including the qualification under which the variance is granted, in the records of the department and send a signed copy to the applicant or licensee. This variance may remain in effect for as long as the licensee continues to comply with the intent of the rule or may be time limited.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4106 Original licensure; application {#sec-r-400.4106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4106}

Rule 106. An applicant applying for an original license shall provide documentation of all of the following:

(a) Need for the type of program the institution proposes to provide.

(b) Sufficient financial resources to meet applicable licensing rules following the issuance of the initial license.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4107 Deemed status {#sec-r-400.4107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4107}

Rule 107. (1) The department may accept, for the purpose of determining compliance with part 1 of these rules, evidence that the child caring institution is accredited by the council on accreditation or other nationally recognized accrediting body whose standards closely match state licensing regulations.

(2) The institution may request deemed status when the accreditation site inspection is less than 12 months old. Both of the following apply:

(a) When accreditation is requested, an institution shall submit a copy of the most recent accreditation report to the department.

(b) An institution shall only be eligible for deemed status if the license is on a regular status.

(3) The acceptance of accreditation in subrule (1) of this rule does not prohibit the department from conducting on-site investigations or requiring environmental health and fire safety inspections at intervals determined by the department.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4108 Financing and audit {#sec-r-400.4108 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4108}

Rule 108. A licensee shall do all of the following:

(a) Obtain an annual audit of all financial accounts. Audits for nongovernmental institutions shall be conducted by an independent certified public accountant who is not administratively related to the agency.

(b) Annually develop and implement a plan to correct any deficiencies identified.

(c) Demonstrate sufficient financing to assure that proper care of residents is provided and that licensing rules are followed.

(d) Develop a budget that includes projected income and expenditures.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4109 Program statement {#sec-r-400.4109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4109}

Rule 109. (1) An institution shall have and follow a current written program statement which specifically addresses all of the following:

(a) The types of children to be admitted for care.

(b) The services provided to residents and parents directly by the institution and the services provided by outside resources.

(c) Policies and procedures pertaining to admission, care, safety, and supervision, methods for addressing residents’ needs, implementation of treatment plans, and discharge of residents.

(2) The program statement shall be made available to residents, parents, and referral sources.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4110 Employees qualified under prior rules {#sec-r-400.4110 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4110}

Rule 110. An employee in a position approved before the effective date of these rules is deemed to be qualified for that position at the institution. A person appointed to a position after the date of these rules shall meet the qualifications of these rules for that position.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4111 Job description {#sec-r-400.4111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4111}

Rule 111. An institution shall provide a job description for each staff position that identifies rules, required qualifications, and lines of authority.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4112 Criminal history check, subject to requirements; staff qualifications {#sec-r-400.4112 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4112}

Rule 112. (1) Child caring institutions subject to 42 USC 671 shall not permit a child caring institution staff member to begin working unless all the following has been completed using the forms, and in the manner, prescribed by the department:

(a) A criminal record check as referenced in R 400.4113(f), including a fingerprint-based check of national crime information databases, unless an alternative criminal history check has been approved by the federal government.

(b) A check of Michigan’s child abuse and neglect central registry or Canadian provincial agency as referenced in R 400.4113(i).

(2) A person who has unsupervised contact with children shall not have been convicted of either of the following:

(a) Child abuse or neglect.

(b) A felony involving harm or threatened harm to an individual within the 10 years immediately preceding the date of hire.

(3) A person who has unsupervised contact with children shall not be a person who is listed on the central registry as a perpetrator of child abuse or child neglect.

(4) A person with ongoing duties shall have both of the following:

(a) Ability to perform duties of the position assigned.

(b) Experience to perform the duties of the position assigned.

(5) An unsupervised volunteer who performs work, including adults who do not work directly with children, is subject to the requirements of subrule (1)(a) and (b) of this rule.

History

History: 1983 AACS; 2015 AACS; 2019 AACS.

Mich. Admin. Code R 400.4113 Employee records {#sec-r-400.4113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4113}

Rule 113. An institution shall maintain employee records for each employee and shall include documentation of all of the following information prior to employment or at the time specified in this rule:

(a) Name.

(b) A true copy of verification of education from an accredited college or university where minimum education requirements are specified by rule.

(d) Work history.

(e) Three dated references which are obtained prior to employment from persons unrelated to the employee and which are less than 12 months old.

(f) A record of any convictions other than minor traffic violations from either of the following entities:

(i) Directly from the Michigan state police or the equivalent state law enforcement agency, Canadian province, or other country where the person usually resides or has resided in the previous 5 years.

(ii) From an entity accessing either Michigan state police records or equivalent state, Canadian provincial, or other country law enforcement agency where the person usually resides or has resided in the previous 5 years.

(g) If the employee has criminal convictions, the institution shall complete a written evaluation of the convictions that addresses the nature of the conviction, the length of time since the conviction, and the relationship of the conviction to regulated activity for the purpose of determining suitability for employment in the institution.

(h) A statement from the employee regarding any convictions.

(i) Documentation from the Michigan department of human services, the equivalent state or Canadian provincial agency, or equivalent agency in the country where the person usually resides, that the person has not been determined to be a perpetrator of child abuse or child neglect. The documentation shall be completed not more than 30 days prior to the start of employment and every 12 months thereafter.

(j) A written evaluation of the employee's performance within 30 days of the completion of the probationary period or within 180 days, whichever is less, and a written evaluation of the employee’s performance annually thereafter.

(k) Verification of health where specified by institution policy.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4114 Tuberculosis screening for employees and volunteers {#sec-r-400.4114 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4114}

Rule 114. The licensee shall document, prior to employment, that each employee and volunteer who has contact with residents 4 or more hours per week for more than 2 consecutive weeks is free from communicable tuberculosis. Freedom from communicable tuberculosis shall be verified within the 1 year period before employment and shall be verified every 1 year after the last verification or prior to the expiration of the current verification.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4115 First aid; CPR {#sec-r-400.4115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4115}

Rule 115. A person certified within the preceding 36 months in first aid and within the preceding 24 months in age-appropriate cardiopulmonary resuscitation by the American Red Cross, the American Heart Association, or an equivalent organization or institution approved by the department shall be on duty at all times when 1 or more children are present.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4116 Chief administrator; responsibilities {#sec-r-400.4116 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4116}

Rule 116. (1) An agency shall assign the chief administrator responsibility for the on-site day-to-day operation of the institution and for ensuring compliance with these rules.

(2) An institution’s chief administrator shall be administratively responsible annually for all of the following functions:

(a) Not less than once annually, conduct a written assessment and verify the agency’s compliance with these rules.

(b) Develop and implement a written plan to correct, within 6 months, rule violations identified as a result of the assessment conducted pursuant to subdivision (a) of this subrule.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4117 Chief administrator; qualifications {#sec-r-400.4117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4117}

Rule 117. (1) A chief administrator, at the time of appointment, shall possess either of the following:

(a) A master's degree in a human behavioral science, education, business administration, or public administration from an accredited college or university and 2 years of experience in a child caring institution or child placing agency or equivalent organization from another state or Canadian province.

(b) A bachelor's degree with a major in education, a human behavioral science, business administration, or public administration from an accredited college or university and 4 years of post-bachelor's degree experience in a child caring institution or child placing agency or equivalent organization from another state or Canadian province.

(2) An organization shall notify the licensing authority of a change of chief administrator within 30 days of the change.

History

History: 1983 AACS; 2015 AACS.

Rule 118. A social service supervisor, at the time of appointment to the position, shall possess either of the following:

(a) A master's degree in a human behavioral science from an accredited college or university and 2 years of experience as a social service worker.

(b) A bachelor's degree in a human behavioral science or another major with 25% of the credits in a human behavioral science from an accredited college or university and 4 years of experience as a social service worker.

History

History: 1983 AACS; 2015 AACS.

Rule 119. A social service worker, at the time of appointment to the position, shall possess a bachelor's degree with a major in a human behavioral science from an accredited college or university or another major with 25% of credits in human behavioral sciences.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4120 Supervisor of direct care workers; qualifications {#sec-r-400.4120 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4120}

Rule 120. A supervisor of direct care workers shall have 1 of the following:

(a) A bachelor's degree from an accredited college or university and 2 years of work experience in a child caring institution.

(b) Two years of college from an accredited college or university and 3 years of work experience in a child caring institution.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4121 Direct care worker; qualifications {#sec-r-400.4121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4121}

Rule 121. A direct care worker shall have completed high school or obtained a general equivalency diploma (GED).

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4122 Resident and parent visitation {#sec-r-400.4122 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4122}

Rule 122. An institution shall provide for visits between each resident and the resident's parents, unless parental rights have been terminated or the resident's record contains documentation that visitation is detrimental to the resident.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4123 Education {#sec-r-400.4123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4123}

Rule 123. (1) An institution shall not admit a child for care unless an appropriate educational program can be provided.

(2) Provision shall be made for an appropriate education program in accordance with 1976 PA 451, MCL 380.1 to 380.1853. Each resident of school age shall be enrolled not later than 5 school days after admission and continuously thereafter.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4124 Communication {#sec-r-400.4124 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4124}

Rule 124. An institution shall have and follow a written policy regarding communication that ensures that a child is able to communicate with family and friends in a manner appropriate to the child’s functioning and consistent with the child’s treatment plan and security level.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4125 Personal possessions; money; clothing; storage space {#sec-r-400.4125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4125}

Rule 125. (1) A licensee shall have a written policy that designates all of the following:

(a) The method used to safeguard residents' personal possessions and money.

(b) The method used to accurately account for and return possessions and money to the resident or guardian upon discharge.

(2) The licensee shall provide accessible storage space for personal possessions.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4126 Sufficiency of staff {#sec-r-400.4126 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4126}

Rule 126 The licensee shall have a sufficient number of administrative, supervisory, social service, direct care, and other staff on duty to perform the prescribed functions required by these administrative rules and in the agency’s program statement and to provide for the continual needs, protection, and supervision of residents.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4127 Staff-to-resident ratio {#sec-r-400.4127 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4127}

Rule 127. (1) The licensee shall develop and adhere to a written staff-to-resident ratio formula for direct care workers.

(2) At a minimum, 1 direct care worker shall be responsible for not more than 10 residents at 1 time during residents' normal awake hours and not more than 20 residents at 1 time during the residents' normal sleeping hours.

(3) The ratio formula for direct care workers shall correspond with the institution's purpose and the needs of the residents and shall assure the continual safety, protection, and direct care and supervision of residents.

(4) When residents are asleep or otherwise outside of the direct supervision of staff, staff shall perform variable interval, eye-on checks of residents. The time between the variable interval checks shall not exceed fifteen minutes.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4128 Initial staff orientation and ongoing staff training {#sec-r-400.4128 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4128}

Rule 128. (1) The licensee shall provide an orientation program for new employees. Job shadowing shall not be the only form of orientation.

The orientation shall include the following:

(a) The institution's purpose, policies, and procedures, including discipline, crisis intervention techniques, and emergency and safety procedures.

(b) The role of the staff members as related to service delivery and protection of the children.

(2) The licensee shall provide a written plan of ongoing staff training related to individual job functions and the institution's program.

(3) The licensee shall document that each staff person whose function is covered by these rules has participated in a minimum of 50 clock hours of planned training within the first year of employment and a minimum of 25 clock hours of training annually thereafter related to the employee’s job function. At least 16 of the 50 hours provided in the first year shall be orientation provided prior to the assumption of duties.

(4) Training opportunities for direct care staff shall include, but are not limited to, all of the following:

(a) Developmental needs of children.

(b) Child management techniques.

(d) Appropriate discipline, crisis intervention, and child handling techniques.

(e) The direct care worker's and the social service worker's roles in the institution.

(f) Interpersonal communication.

(g) Proper and safe methods and techniques of restraint and seclusion if the agency has an approved seclusion room.

(h) First aid.

(5) An employee shall not participate in restraining a resident or placing a resident in seclusion prior to receiving training on those topics. The training model shall be approved, in writing, by the department.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4129 Institutions serving developmentally disabled youth; written procedures {#sec-r-400.4129 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4129}

Rule 129. An institution providing care to developmentally disabled residents shall require staff to follow written procedures for bathing, feeding, toilet training, and daily activities of residents.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4130 Privacy and confidentiality {#sec-r-400.4130 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4130}

Rule 130. (1) An institution shall assure resident and parent privacy and confidentiality and shall protect residents from exploitation.

(2) A resident's identity may be disclosed for public purposes or publicity only after both of the following criteria are met:

(a) The parent has consented.

(b) The resident has consented if the resident is capable of consent.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4131 Compliance with child protection law; development of plan required {#sec-r-400.4131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4131}

Rule 131. The licensee shall develop and implement a written plan to assure compliance with the child protection law, 1975 PA 238, MCL 722.621 to 722.638.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4132 Grievance procedures {#sec-r-400.4132 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4132}

Rule 132. (1) An agency shall have and follow a written grievance handling procedure for residents and their families. All of the following apply:

(a) The policy shall be provided to residents, their families, and referring sources prior to or at admission.

(b) The policy shall be explained in a language the resident and his or her family can understand.

(2) The procedure shall provide for all of the following:

(a) Safeguarding the legal rights of residents and their families.

(b) Addressing matters that relate to compliance with the act, rules promulgated under the act, and the agency's written policies and procedures regarding services covered by these rules.

(d) Specifying time frames for decisions.

(3) In a secure juvenile justice facility that uses room confinement as a behavioral sanction, the procedure shall provide for all of the following:

(a) Before the sanction begins, but not later than 24 hours after confinement for misconduct, an opportunity for the resident to be heard by a trained impartial fact finder designated by the chief administrator, has no personal knowledge of the incident, and has the authority to release the resident from confinement.

(b) Staff assistance in preparing and presenting his or her grievance or defense.

(4) An agency shall provide a grievant with a written copy of the grievance resolution.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4133 Institutional care for children under 6 years of age {#sec-r-400.4133 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4133}

Rule 133. A child under 6 years of age shall not remain in an institution for more than 30 days, unless this stay is documented to be in the best interest of the child.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4134 Religious/spiritual policy and practices {#sec-r-400.4134 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4134}

Rule 134. (1) The institution shall have and follow a policy on religious/spiritual participation that contains, at a minimum, both of the following:

(a) A resident shall not be prohibited from participating in religious activities and services in accordance with the resident's own faith and parental direction as long as the participation does not conflict with the safety and security of the facility.

(b) A resident shall not be compelled to attend religious services or religious education nor be disciplined for failing to attend.

(2) The institution shall provide the policy to parents and referral sources prior to or at admission.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4135 Resident work experience {#sec-r-400.4135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4135}

Rule 135. (1) An institution shall have and follow a written policy regarding work experiences for residents that specifies, at a minimum, all of the following:

(a) How and when residents are or are not compensated for working.

(b) Means of protection from exploitation.

(2) Work experiences for a resident shall be appropriate to the age, health, and abilities of the resident.

(3) Residents shall not be permitted to work for staff members’ personal gain and shall be protected from personal exploitation.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4136 Recreational activities, equipment, and supplies; swimming restriction {#sec-r-400.4136 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4136}

Rule 136. (1) An institution shall have and follow a written policy regarding recreational activities, equipment maintenance, appropriate supervision related to age of youth and developmental level of youth, and training of staff involved in recreational activities.

(2) Residents shall be provided a variety of indoor and outdoor recreational activities designed to meet the residents' needs.

(3) An institution shall provide appropriate recreation supplies and equipment.

(4) Swimming shall be permitted only where and when a qualified lifeguard is on duty and who is not counted in the staffing ratio.

(5) As used in this rule, high adventure activity means a program that requires specially trained staff or special safety precautions to reduce the possibility of an accident. If the institution provides high adventure activities, including swimming, the institution shall have and follow a program statement that covers all of the following:

(a) Activity leader training and certification and experience qualifications appropriate to the activity.

(b) Specific staff-to-resident ratio appropriate to the activity.

(d) Arrangement, maintenance, and inspection of the activity area.

(e) Equipment and the biannual inspection and maintenance of the equipment and the program by a nationally recognized inspection process.

(f) Safety precautions.

(g) High adventure activities shall be conducted by an adult who has training or experience in conducting the activity.

(6) If institution staff take youth away from the institution for 1 or more overnights, the institution shall keep a travel plan on file at the institution. The travel plan shall include an itinerary and pre-established check-in times.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4137 Sleeping rooms {#sec-r-400.4137 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4137}

Rule 137. (1) Residents may be required to remain in their assigned rooms for up to 30 minutes to accommodate staff shift changes.

(2) Residents of the opposite sex, if either is over 5 years of age, shall not sleep in the same sleeping room.

(3) In new and converted institutions, single occupant sleeping rooms shall not be less than 70 square feet, exclusive of closet space.

(4) In new and converted institutions, multi-occupant sleeping rooms shall not be less than 45 square feet per occupant, exclusive of closet space.

(5) In new or converted secure institutions, locked resident sleeping rooms shall be equipped with a 2-way monitoring device.

(6) In programs that accept children less than 2 years of age, the following safe sleep conditions shall be followed:

(a) Infants, birth to 12 months of age, shall rest alone in a crib that meets all of the following conditions:

(i) Has a firm, tight-fitting mattress with a waterproof, washable covering.

(ii) Does not have any loose, missing, or broken hardware or slats.

(iii) Has not more than 2 3/8 inches between slats.

(iv) Has no corner posts over 1/16 inches high.

(v) Has no cutout designs in the headboard or footboard.

(vi) Has a tightly fitted bottom sheet that covers the mattress with no additional padding placed between the sheet and mattress.

(vii) Blankets shall not be draped over cribs or bassinets.

(vii) Soft objects, bumper pads, stuffed toys, blankets, quilts or comforters, and other objects that could smother a child shall not be placed with or under a resting or sleeping infant.

An infant’s head shall remain uncovered during sleep.

(c) Infant car seats, infant seats, infant swings, highchairs, playpens, pack-n-play, waterbeds, adult beds, soft mattresses, sofas, beanbags, or other soft surfaces are not approved sleeping equipment for children 24 months of age or younger.

(d) Children 24 months or younger who fall asleep in a space that is not approved for sleeping shall be moved to approved sleeping equipment appropriate for their size.

(e) Children birth to 24 months of age shall sleep alone in a crib or toddler bed that is appropriate and sufficient for the child’s length, size, and movement.

An infant shall be placed on his or her back for resting and sleeping.

(g) An infant unable to roll from stomach to back, and from back to stomach, when found facedown, shall be placed on his or her back.

(h) An infant who can easily turn over from his or her back to his or her stomach shall initially be placed on his or her back, but allowed to adopt whatever position he or she prefers for sleep.

(i) For an infant who cannot rest or sleep on his or her back, the institution shall have written instructions, signed by a physician, detailing an alternative safe sleep position and/or other special sleeping arrangements for the infant.

(j) The institution shall maintain supervision and frequently monitor infant’s breathing, sleep position, and bedding for possible signs of distress. Baby monitors shall not be used exclusively to comply with this subdivision.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4138 Bedding and linen {#sec-r-400.4138 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4138}

Rule 138. (1) Each resident shall be provided with an individual bed with a clean pillow, mattress and sufficient clean blankets.

(2) Each resident shall be provided with clean sheets and a pillowcase at least weekly and more often if soiled.

(3) All bedding shall be in good repair and shall be cleaned and sanitized before being used by another person.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4139 Driver’s license {#sec-r-400.4139 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4139}

Rule 139. The institution shall document that the driver of any vehicle transporting residents at the request of or on behalf of the licensee shall be an adult and possess a valid operator or chauffeur license with endorsement appropriate to the vehicle driven and the circumstances of its use.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4140 Transportation {#sec-r-400.4140 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4140}

Rule 140. (1) The institution shall have and follow a policy on vehicle maintenance that ensures vehicles are properly maintained.

(2) All vehicles shall be insured as required by state law.

(3) Each resident transported shall occupy a manufacturer's designated seat. A resident shall not be transported in any portion of any vehicle not specifically designed by the manufacturer for passenger transportation.

(4) Infants and children shall use age appropriate child safety seats as required by state law.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4141 Safety belts {#sec-r-400.4141 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4141}

Rule 141. The driver and all passengers shall be properly restrained with safety belts while the vehicle is being operated.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4142 Health services; policies and procedures {#sec-r-400.4142 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4142}

Rule 142. (1) An institution shall establish and follow written health service policies and procedures addressing all of the following:

(a) Routine and emergency medical, and dental, and behavioral health care.

(b) Health screening procedures.

(d) Storage of medications.

(e) Dispensing medication.

(f) Definition and training of personnel authorized to dispense medications.

(g) Methods for dispensing medication when the resident will be off site.

(2) Resident medications shall be kept in the original pharmacy supplied container until dispensed, shall be kept with the equipment to administer it in a locked area, and refrigerated, if required.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4143 Medical treatment; supervision {#sec-r-400.4143 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4143}

Rule 143. Medical treatment shall be under the supervision of a licensed physician or other licensed health professional as permitted by law.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4144 Admission health screening; physical examinations {#sec-r-400.4144 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4144}

Rule 144. (1) An initial health screening shall be completed for each resident within 24 hours of admission to a facility.

(2) An institution shall have the following documentation of an admission physical examination for each resident, unless an earlier examination is medically indicated:

(a) For a resident under 3 years of age, a physical examination shall have been completed within 90 calendar days prior to admission or a new physical examination shall be completed within 30 calendar days after admission.

(b) For a resident 3 years of age or older, a physical examination shall have been completed within 1 year prior to admission or a new physical examination shall be completed within 30 calendar days after admission.

(3) Sufficient health history information shall be documented for each resident to assure proper medical care.

(4) Nothing in the rules adopted under the act shall authorize or require a medical or physical examination or treatment for any child whose parent objects on religious grounds.

If a parent objects to medical or physical examinations or treatments on religious grounds, the objection shall be made in writing to the institution and retained in the resident’s file.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4145 Periodic physical examinations {#sec-r-400.4145 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4145}

Rule 145. (1) An institution shall provide and document periodic physical examination for each resident as follows, unless greater frequency is medically indicated:

(a) At least once every 3 months for residents under 1 year of age.

(b) At least once every 14 months for residents 1 year of age or older.

(2) Nothing in the rules adopted under 1973 PA 116 shall authorize or require a medical or physical examination or treatment for any child whose parent objects on religious grounds. If a parent objects to medical or physical examinations or treatments on religious grounds, the objection shall be made in writing to the institution and retained in the resident’s file.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4146 Immunizations {#sec-r-400.4146 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4146}

Rule 146. (1) A resident shall have current immunizations as required by the department of community health.

(2) If documentation of immunizations is unavailable, immunizations shall begin within 30 calendar days of admission, unless a statement from a physician indicating that immunizations are contraindicated is included in the resident’s record.

(3) A written statement from a physician, referring agency, parent, or guardian indicating immunizations are current is sufficient documentation of immunizations.

(4) Nothing in the rules adopted under 1973 PA 116 shall authorize or require immunizations for any child whose parent objects on religious grounds. If a parent objects to immunizations on religious grounds, the objection shall be made in writing to the institution and retained in the resident’s file.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4147 Dental care {#sec-r-400.4147 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4147}

Rule 147. (1) A licensee shall provide for and document dental examinations and treatment for each resident 3 years of age and older.

(2) A dental examination within 12 months prior to admission shall be documented or there shall be an examination not later than 90 calendar days following admission.

(3) Reexamination shall be provided at least every 14 months unless greater frequency is indicated.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4148 Personal hygiene {#sec-r-400.4148 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4148}

Rule 148. An institution shall assure that each resident maintains or receives personal care, hygiene, and grooming appropriate to the resident's age, sex, race, cultural background, and health needs.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4149 Resident nutrition {#sec-r-400.4149 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4149}

Rule 149. (1) A licensee shall provide a minimum of 3 nutritious edible meals daily unless medically contraindicated and documented.

(2) Meals shall be of sufficient quantity to meet the nutritional allowances recommended by USDA guidelines: (www.healthierus.gov/dietaryguidelines)

(3) A resident who has been prescribed a special diet by a physician shall be provided such a diet.

(4) Menus, including snacks if provided, shall be written and posted prior to the serving of the meal. Any change or substitution shall be noted and considered as part of the original menu. Menus shall be retained for 1 year.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4150 Incident reporting {#sec-r-400.4150 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4150}

Rule 150. (1) Any incident resulting in serious injury of a resident or illness requiring inpatient hospitalization, shall be reported to the parent/ legal guardian, responsible referring agency, and the licensing authority as soon as possible, but not more than 24 hours after the incident.

(2) The death of a resident shall be reported immediately to the parent/legal guardian or next of kin, law enforcement, the licensing authority, and the referring agency.

(3) If an institution determines that a youth is absent without legal permission, then the institution shall immediately report the information to law enforcement, the parent/legal guardian or next of kin, the licensing authority, and the referring agency.

(4) When a resident’s behavior results in contact with law enforcement, the incident shall be reported to the parent/legal guardian, responsible referring agency, and the licensing authority as soon as possible, but not more than 24 hours after the incident.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4151 Emergency; continuity of operation procedures {#sec-r-400.4151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4151}

Rule 151. (1) An institution shall establish and follow written emergency procedures that have been approved by the department that maintain the continuity of operations for a minimum of 72 hours to assure the safety of residents for the following circumstances:

(a) Fire.

(b) Severe weather.

(d) Missing persons.

(f) Disasters.

(g) Utility failures.

(2) The procedures shall explain, in detail, all of the following:

(a) Staff roles and responsibilities.

(b) Evacuation procedures.

(c) Required notifications, including but not limited to, the licensing authority, the referring agency, and law enforcement.

(d) Methods for maintaining continuity of services.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4152 Initial documentation {#sec-r-400.4152 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4152}

Rule 152. At the time of admission, all of the following shall be in the resident's case record:

(a) Name, address, birth date, sex, gender, race, height, weight, hair color, eye color, identifying marks, religious preference, and school status.

(b) A photograph taken within the previous 12 months.

(c) A brief description of the resident's preparation for placement and general physical and emotional state at the time of admission.

(d) Name, address, and marital status of parents and name and address of legal guardian, if known.

(e) Date of admission and legal status.

(f) Documentation of legal right to provide care.

(g) Authorization to provide medical, dental, and surgical care and treatment as provided in section 14 a(1), (2), and (3) of 1973 PA 116, MCL 722.124a.

(h) A brief description of the circumstances leading to the need for care.

(i) Documentation that the grievance policy was provided as required in R 400.4132.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4153 Shelter care and detention institutions; preliminary service plans {#sec-r-400.4153 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4153}

Rule 153. Within 7 calendar days of admission, a plan shall be developed for each resident. The plan shall include all of the following:

(a) The reason for care.

(b) An assessment of the resident’s immediate and specific needs.

(d) Other resources to meet the resident’s needs.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4154 Shelter care and detention institutions; service plans {#sec-r-400.4154 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4154}

Rule 154. (1) Within 30 calendar days after admission and every 15 calendar days thereafter, an institution shall complete a written service plan. The service plan shall include all of the following:

(a) The reason for continued care.

(b) Evaluation of service needs.

(d) How service needs will be met.

(e) Unmet service needs and the reasons those needs are unmet.

(2) Copies of the plan shall be maintained at the institution.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4155 Institutions not detention institutions or shelter care institutions; initial treatment plan {#sec-r-400.4155 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4155}

Rule 155. (1) The social service worker shall complete, sign, and date an initial treatment plan for each resident within 30 calendar days of admission.

(2) The initial treatment plan developed by the social worker shall document input from the resident, the resident’s parents, direct care staff, and the referral source, unless documented as inappropriate.

(3) The initial treatment plan shall include all of the following:

(a) An assessment of the resident’s and family’s strengths and needs.

(b) Plans for parent and child visitation.

(d) Indicators of goal achievement.

(e) The person responsible for coordinating and implementing the resident and family treatment goals.

(f) Staff techniques for achieving the resident’s treatment goals, including a specific behavior management plan. The plan shall be designed to minimize seclusion and restraint and include a continuum of responses to problem behaviors.

(g) Projected length of stay and next placement.

(h) For youth who are permanent court wards or MCI wards, there must be documented co-ordination with the agency assigned to complete adoption or permanency planning for the youth.

(i) For youth 14 years of age and over, a plan to prepare the youth for functional independence.

(4) The social service worker shall sign and date the initial treatment plan.

(5) The social service supervisor shall approve, countersign, and date the initial treatment plan.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4156 Institutions not detention institutions or shelter care institutions; updated treatment plan {#sec-r-400.4156 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4156}

Rule 156. (1) The social service worker shall complete, sign, and date an updated treatment plan for each resident at least once every 90-calendar days following the initial treatment plan.

(2) The updated treatment plan developed by the social worker shall document input from the resident, the resident's parents, direct care staff, and the referral source, unless documented as inappropriate.

(3) The updated treatment plan shall include all of the following information:

(a) Dates, persons contacted, type of contact, and place of contact.

(b) Progress made toward achieving the goals established in the previous treatment plan.

(c) Changes in the treatment plan, including new problems and new goals to remedy the problems. Indicators of goal achievement and time frames for achievement shall be specified along with a specific behavior management plan designed to minimize seclusion and restraint and that includes a continuum of responses to problem behaviors.

(d) For youth who are permanent court wards or MCI wards, there must be documented co-ordination with the agency assigned to complete adoption or permanency planning for the youth.

(e) For youth 14 years of age and over, a plan to prepare the youth for functional independence.

(4) The social service worker shall sign and date the initial treatment plan.

(5) The social service supervisor shall approve, countersign, and date the updated treatment plan.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4157 Behavior management {#sec-r-400.4157 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4157}

Rule 157. (1) An institution shall establish and follow written policies and procedures that describe the institution’s behavior management system. The policies and procedures shall be reviewed annually and updated as needed. These shall be available to all residents, their families, and referring agencies.

(2) At a minimum, the behavior management system shall include all of the following:

(a) A structured system designed to reward the positive behavior of individual residents based upon the effort put forth.

(b) Positive intervention strategies to assist residents in developing improved problem solving, self-management, and social skills.

(d) Written rules of conduct that specify all of the following:

(i) Expected behavior.

(ii) Acts that are prohibited in the institution.

(iii) The range of interventions that may be imposed for violation of those rules.

(e) Scheduled training for institution personnel in the behavior management system.

(f) A provision for resident input into the proper application of the behavior management system.

(g) A provision for the distribution of behavior management policies and procedures to residents, parents, and referral agencies.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4158 Intervention standards and prohibitions {#sec-r-400.4158 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4158}

Rule 158. (1) A child caring institution shall establish and follow written policies and procedures that prohibit the following forms of intervention:

(a) Any type of physical punishment including, but not limited to:

(i) Use of chemical agents including, but not limited to, pepper spray, tear gas, and mace.

(ii) Hitting or striking, throwing, kicking, pulling, or pushing a youth on any part of their body.

(iii) Threats of restraint, seclusion, punishment, or otherwise suggesting physical or emotional harm to a youth.

(iv) Verbal abuse including the use of derogatory or discriminatory language including negative references to a youth’s background or appearance or mental state. Yelling, threats, ridicule, or humiliation are strictly prohibited.

(v) Peer-on-peer discipline.

(b) Denial of any essential program service as punishment. These include, but are not limited to, the following:

(i) Food or creating alternative menus.

(ii) Family time or any type of communications with family.

(iii) The opportunity for at least 8 hours of sleep in a 24-hour period.

(iv) Shelter, clothing, medical care, or essential personal needs, including culturally specific items.

(v) Any actions that inhibit a youth’s ability to achieve permanency.

(2) An agency will provide a list of these prohibited practices to all youth, their families, and referring agencies upon admission.

History

History: 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.4159 Youth restraint; pregnant youth; reduction, prevention; prohibited restraints; elimination of restraints {#sec-r-400.4159 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4159}

Rule 159. (1) A child caring institution, including private secure juvenile justice facilities, shall establish a process improvement and restraint reduction/elimination plan that:

(a) Includes documentation of each restraint.

(b) Requires staff training in approved crisis prevention and intervention techniques including:

(i) Prevention, de-escalation techniques, and non-violent responses to assaultive behavior.

(ii) Conflict management.

(iii) Minimizing trauma.

(iv) Staff emotional self-regulation techniques.

(d) Staff must complete refresher training annually or more frequently as needed.

(e) The agency must maintain documentation verifying staff training.

(f) The agency will review all restraints at least monthly.

(g) The agency shall establish a restraint reduction committee, including youth and family representation, for the purpose of analysis, process improvement, communication, and recognition of efforts to eliminate the use of restraints.

(2) The following restraints are strictly prohibited:

(a) Use of chemical restraints as defined in section 2b of the act, MCL 722.112b.

(b) Use of pressure point control and pain adherence techniques at the facility.

(d) Restraining youth to fixed objects, including beds or walls.

(e) Restraining youth in a prone position or any restraint that restricts the youth’s airway.

(f) Using restraints for punishment, discipline, retaliation, or humiliation.

(g) Peer-on-peer discipline or utilizing the assistance of another youth to implement a restraint.

(3) For a youth who is pregnant, including a youth who is in labor, delivery, or postpartum recovery, mechanical restraints are prohibited. In addition, the following restraints are prohibited for use on pregnant youth:

(a) Abdominal restraints.

(b) Leg and ankle restraints.

(d) Four or five-point restraints.

(4) Only the least restrictive intervention necessary to prevent immediate harm to the youth or others may be used and must follow an individualized set of graduated interventions that avoid the use of restraints.

(5) In the event a restraint occurs, it must be performed in a manner that is safe, appropriate, and proportionate to the severity of the youth’s behavior, chronological and developmental age, size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of trauma, and must be done in a manner consistent with the youth’s treatment plan.

(6) Restraint must not last longer than the minimal duration of time it takes for a youth to calm down and to restore safety.

(7) Staff must continuously monitor the youth’s breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being.

(8) When an emergency health situation occurs or the youth exhibits sign of physical distress during the restraint, staff must immediately obtain treatment for the youth.

(9) All restraints for child caring institutions, with the exception of those restraints allowed in R 400.4160 and R 400.4161, will be prohibited effective November 1, 2022.

History

History: 2015 AACS; 2020 AACS; 2022 AACS.

Mich. Admin. Code R 400.4160 Emergency restraint {#sec-r-400.4160 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4160}

Rule 160. The use of emergency restraint as a lifesaving response for a youth will be limited to:

(a) An emergency response to protect the youth or others from an unanticipated or severely aggressive behavior that places the youth or others at serious threat of violence or injury if no immediate intervention occurs.

(b) When all other interventions in the agency’s crisis prevention and intervention plan and the youth’s individual safety and calming plan have been utilized but fail to protect the youth or others from unanticipated or severely aggressive behavior that places the youth or others at serious threat of violence or injury if no immediate intervention occurs.

(d) Staff must continuously monitor the youth’s breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being.

(e) When an emergency health situation occurs or the youth exhibits sign of physical distress during the restraint, staff must immediately obtain treatment for the youth.

History

History: 1983 AACS; 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.4161 Secure juvenile justice facilities, mechanical restraint; policies and procedures; prohibitions {#sec-r-400.4161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4161}

Rule 161. (1) Secure juvenile justice facilities must develop and implement written policies and procedures regarding the use of mechanical restraint in actual practice in secure detention and residential treatment juvenile justice facilities.

(2) Staff are prohibited from doing the following:

(a) Handcuffing youth together during transportation or restraining youth to a vehicle.

(b) Leaving sleeping youth in restraints.

(3) The only mechanical restraints that staff may use within a facility are handcuffs, unless circumstances require, and written approval is given by the chief administrator, for the use of leg shackles, a leg bar, or belly chains or belly belts, or both.

(4) Within the facility or during transportation to or from the facility, staff may use handcuffs when an assessment has been made that the youth presents a current risk of escape or serious, recent assaultive behavior has been documented and there are no other means available to provide for the safety of other youth and staff. In the rare instances that staff need additional restraints as described in subrule (3) of this rule during transportation, staff must document specific reasons for the use of any mechanical restraint other than handcuffs and obtain written approval by the chief administrator.

(5) During secure facility emergencies, such as a lockdown or riot, staff may use handcuffs and belly chains to prevent serious injury or escape. Staff must remove handcuffs and other restraints promptly after the youth is placed in his or her room or is otherwise in a safe place.

(6) In the event a mechanical restraint occurs, it must be performed in a manner that is safe, appropriate, and proportionate to the severity of the youth’s behavior, chronological and developmental age, size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of trauma, and done in a manner consistent with the youth’s treatment plan.

(7) If a mechanical restraint is used, staff must use the permitted methods of mechanical restraint and appropriate techniques for use of restraints, and the agency shall provide guidance to staff in deciding what level of restraint to use if that becomes necessary.

(8) Restraint may not last longer than the minimal duration of time it takes for a youth to regain self-control and to restore safety.

(9) Staff must continuously monitor the youth’s breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being.

(10) When an emergency health situation occurs or the youth exhibits sign of physical distress during the restraint, staff must immediately obtain treatment for the youth.

(11) Written policies and notifications must be posted publicly in visiting areas and provided in writing, in their entirety, to referral agencies and legal guardians.

History

History: 1983 AACS; 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.4162 Seclusion within secure and nonsecure facilities; seclusion plan; prohibitions; reduction and elimination {#sec-r-400.4162 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4162}

Rule 162. (1) An agency must establish a process improvement and a seclusion reduction/elimination plan that addresses the following areas:

(a) Requires staff training in approved crisis prevention and intervention techniques including:

(i) Prevention, de-escalation techniques, and non-violent response to assaultive behavior.

(ii) Conflict management.

(iii) Minimizing and addressing trauma for youth and staff.

(b) Training must be conducted by certified trainers.

(d) Access to youth support team members.

(e) Review and update the youth’s individual behavioral and calming plan, as needed.

(2) Prior to using seclusion, staff must use less restrictive techniques to de-escalate the situation such as talking with youth, bringing in other staff or qualified mental health professionals to assist, or engaging family members or other youth to talk with the youth.

Prior to using seclusion or immediately after placing a youth in seclusion, staff will explain to the youth the reasons for the seclusion and the fact that he or she will be released upon regaining self-control.

(3) Seclusion must be performed in a manner that is safe, appropriate, and consistent with the youth’s chronological and developmental age, size, gender, physical condition, medical condition, psychiatric condition, and personal history, including history of trauma.

(4) Staff must only use seclusion as a temporary response to prevent life-threatening injury or serious bodily harm when other interventions are ineffective.

(5) Staff may not use seclusion for discipline, punishment, administrative convenience, retaliation, staffing shortages, or reasons other than a temporary response to behavior that threatens immediate harm to a youth or others.

(6) Staff may not place youth in seclusion for fixed periods of time. Staff must release the youth from seclusion as soon as the youth has regained self-control and is no longer engaging in behavior that threatens immediate harm to the youth or others.

(7) During the time that a youth is in seclusion, staff must perform variable interval, eye-on checks of youth. The time between the variable interval checks must not exceed 15 minutes unless the situation requires continuous observation for the child's safety, including, but not limited to, youth exhibiting suicidal ideations or performing self-harm.

(8) Youth in seclusion must have reasonable access to water, toilet facilities, and hygiene supplies.

(9) Staff will keep designated areas used for seclusion clean, appropriately ventilated, and at comfortable temperatures.

(10) Designated areas used for seclusion must be suicide-resistant and protrusion-free.

(11) All seclusion will be prohibited effective November 1, 2022.

History

History: 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.4163 Health status assessment; notification; debriefing; reporting {#sec-r-400.4163 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4163}

Rule 163. (1) The agency shall develop and implement written procedures for health status screening, notifications, debriefing, and reporting when a restraint, including an emergency restraint, or seclusion is used.

(2) Health status screening of the youth will occur immediately after seclusion or restraint by staff assigned to this screening, as defined in agency policy. If the youth has any physical complaints or if the screening staff has any concerns, depending on the severity of the complaint or concerns, the staff will arrange for the youth’s health needs to be met immediately by any of the following actions:

(a) Consultation with the on-call or onsite nursing staff.

(b) Referral for an off-site health assessment.

(3) Notification must be made to the following individuals in the event of a restraint or seclusion:

(a) If a restraint or seclusion does not involve injury or medical intervention, or an injury that does not give rise to a serious injury as defined by section 8 of the child protection law, 1975 PA 238, MCL 722.628, the following individuals shall be notified within 12 hours:

(i) The youth’s parent or parents or legal guardian or guardians, including the MCI Superintendent, if applicable.

(ii) The youth’s child and family caseworker.

(iii) The youth’s attorney or guardian ad litem.

(iv) The youth’s advocate, if applicable.

(v) Any other individual appropriate for notification.

(b) If a restraint or seclusion results in serious injury, the following individuals shall be notified as soon as possible but no later than 6 hours after the incident:

(i) The youth’s parent or parents or legal guardian or guardians, including the MCI Superintendent, if applicable.

(ii) The youth’s child and family caseworker.

(iii) The youth’s attorney or guardian ad litem.

(iv) The youth’s advocate, if applicable.

(v) Any other individual appropriate for notification.

(i) The date and time of the restraint or seclusion.

(ii) A brief summary of events that led to the restraint or seclusion.

(iii) The actions taken following the restraint or seclusion, including any medical services provided.

(iv) A plan for debriefing following the incident, including how the notified individual will be engaged in the debriefing process.

(4) The agency shall implement a debriefing protocol containing the following characteristics:

(a) Consistent with trauma-informed principles.

(b) Consistent with the agency’s crisis prevention and intervention processes.

(c) Inclusive of involved youth, caregivers, and staff directly involved in the incident, as well as supervisors, management, and agency leadership.

(d) Informs ongoing quality improvement in the treatment of the individual youth.

(e) Informs ongoing quality improvement in the agency’s programs, policies, and practices.

(5) An agency will provide an incident report on a form prescribed by the department for each incident involving the use of seclusion or restraint. The initial report shall be submitted to the department within 24 hours of the incident occurring. A final incident report shall be submitted no later than 72 hours after the incident has occurred.

(6) If mechanical restraint was used, the report must also include the following:

(a) Name of administrator or designee who approved equipment use.

(b) Time of the authorization.

(d) Time equipment was applied and removed, if different than the time of the overall incident.

(e) Name of the staff member who applied the equipment.

(f) Name or names of staff member or staff members continuously present with the youth throughout mechanical restraint use.

(7) The facility administrator shall review the use of restraint and seclusion on a quarterly basis to ensure that staff only use it as a temporary response to behavior that threatens immediate harm to the youth or others. Based upon the administrative review, a process improvement plan shall be implemented to address:

(a) Strategies to prevent use of restraints and seclusions for youth.

(b) Improvements to staff competency in non-physical crisis prevention and intervention techniques.

(8) The agency’s policies and procedures shall be provided and explained to all youth, their families, and referring agencies upon admission.

History

History: 1983 AACS; 2015 AACS; 2022 AACS.

Mich. Admin. Code R 400.4164 Secure facilities serving juvenile justice youth; reintegration {#sec-r-400.4164 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4164}

Rule 164. A secure facility that serves juvenile justice youth may have policies and procedures used to reintegrate youth who have been placed in seclusion back into the program. A facility shall not use reintegration in conjunction with seclusion that has been used as a sanction for misconduct, if that would extend a resident’s confinement for more hours than the original sanction or more than 72 total hours. The policy for reintegration shall include, at a minimum, all of the following:

(a) The room may only be used for the time needed to change the behavior compelling its use.

(b) When a resident has been in seclusion for more than 2 hours, the reintegration plan shall be developed at the supervisory level and shall include all of the following:

(i) A clear statement of the out-of-control behavior or risk to others that requires continued seclusion.

(ii) Target behavioral or therapeutic issues that must be resolved.

(iii) Specific reintegration requirements or behavioral or therapeutic intervention assignments and goals that must be completed while the resident is in the seclusion room, listed in writing, and shared with the resident.

(iv) If intermittent removal from the seclusion room is required for the resident to work on the specific behavioral/therapeutic intervention goals, the level of restriction from the program and goals for the period of time out of the room must be listed in writing and shared with the resident.

(v) The strategies staff are to use to aide the resident in resolving the issues requiring seclusion and reintegrating into the program.

(d) A reintegration plan shall not last longer than 72 hours.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4165 Secure facilities serving juvenile justice youth; lockdowns {#sec-r-400.4165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4165}

Rule 165. (1) A secure facility may only use lockdown in situations that threaten facility security, including but not limited to, riots, taking of hostages, or escape plans involving multiple residents.

(2) A secure facility serving juvenile justice youth that uses lockdowns in which all residents are confined to their rooms shall have a written policy that describes the procedures to be followed and includes all of the following:

(a) Who may order a lockdown.

(b) Who is to implement the lockdown when it has been ordered.

(d) Procedures to be followed after the incident is resolved.

(e) Notification of the licensing authority within 24 hours after the occurrence of a lockdown.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4166 Discharge plan {#sec-r-400.4166 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4166}

Rule 166. (1) When a resident is discharged from institutional care, all of the following information shall be documented in the case record within 14 days after discharge:

(a) The date of and reason for discharge, and the new location of the child.

(b) A brief summary or other documentation of the services provided while in residence, including medical and dental services.

(d) Any services that will be provided by the facility after discharge.

(e) A statement that the discharge plan recommendations, including medical and dental follow up that is needed, have been reviewed with the resident and with the parent and with the responsible case manager.

(f) The name and official title of the person to whom the resident was discharged.

(2) For an unplanned discharge, an institution shall provide a brief summary or other documentation of the circumstances surrounding the discharge.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4167 Case record maintenance {#sec-r-400.4167 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4167}

Rule 167. (1) The institution shall maintain a case record for each resident.

(2) Service plans shall be signed and dated by the social services worker and the social services supervisor.

(3) Narrative entries in the case record shall be signed and dated by the person making the entry.

(4) Records shall be maintained in a uniform and organized manner, shall be protected against destruction and damage, and shall be stored in a manner that safeguards confidentiality.

(5) Resident records shall be maintained for not less than 7 years after the resident is discharged.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4168 Rescinded {#sec-r-400.4168 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4168}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4169 Rescinded {#sec-r-400.4169 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4169}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4170 Rescinded {#sec-r-400.4170 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4170}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4172 Rescinded {#sec-r-400.4172 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4172}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4173 Rescinded {#sec-r-400.4173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4173}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4175 Rescinded {#sec-r-400.4175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4175}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4176 Rescinded {#sec-r-400.4176 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4176}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4177 Rescinded {#sec-r-400.4177 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4177}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4178 Rescinded {#sec-r-400.4178 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4178}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4181 Rescinded {#sec-r-400.4181 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4181}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4182 Rescinded {#sec-r-400.4182 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4182}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4183 Rescinded {#sec-r-400.4183 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4183}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4199 Rescission {#sec-r-400.4199 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4199}

Rule 199. R 400.141 to R 400.160 and R 400.174 to R 400.185 of the Michigan Administrative Code, appearing on pages 2996 to 3002, 3005, and 3006 of the 1979 Michigan Administrative Code, and pages 306 and 307 of the 1980 Annual Supplement to the Code, are rescinded.

PART 2. SHORT-TERM INSTITUTIONS

History

History: 1983 AACS.

Mich. Admin. Code R 400.4201 Rescinded {#sec-r-400.4201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4201}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4231 Rescinded {#sec-r-400.4231 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4231}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4232 Rescinded {#sec-r-400.4232 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4232}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4234 Rescinded {#sec-r-400.4234 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4234}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4237 Rescinded {#sec-r-400.4237 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4237}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4238 Rescinded {#sec-r-400.4238 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4238}

PART 3. RESIDENTIAL TREATMENT INSTITUTIONS

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4302 Rescinded {#sec-r-400.4302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4302}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4331 Rescinded {#sec-r-400.4331 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4331}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4332 Rescinded {#sec-r-400.4332 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4332}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4334 Rescinded {#sec-r-400.4334 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4334}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4335 Rescinded {#sec-r-400.4335 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4335}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4336 Rescinded {#sec-r-400.4336 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4336}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4337 Rescinded {#sec-r-400.4337 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4337}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4338 Rescinded {#sec-r-400.4338 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4338}

PART 4. ENVIRONMENTAL HEALTH AND SAFETY

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4401 Applicability {#sec-r-400.4401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4401}

Rule 401. The rules set forth in this part apply to all institution facilities unless specifically noted otherwise.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4407 Facility and premises maintenance {#sec-r-400.4407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4407}

Rule 407. (1) A facility and premises shall be maintained in a clean, comfortable, and safe condition. The facility shall be located on land that is properly drained.

(2) Hazardous areas shall be guarded or posted as appropriate to the age and capacity of the residents.

(3) The facility, including main and accessory structures, shall be maintained so as to prevent and eliminate rodent and insect harborage.

(4) Rooms, exterior walls, doors, skylights, and windows shall be weathertight and watertight and shall be kept in sound condition and in good repair.

(5) Floors, interior walls, and ceilings shall be sound and in good repair and shall be maintained in a clean condition.

(6) Plumbing fixtures and water and waste pipes shall be properly installed and maintained in good working condition.

(7) Water closet compartments, bathroom, and kitchen floors shall be constructed and maintained so as to be reasonably impervious to water and be composed of a slip resistant material.

(8) Equipment, including recreation devices, shall be inspected periodically for defects.

Proper maintenance shall be carried out to keep equipment in a safe operating condition.

(9) Water heaters shall have an operable thermostatic temperature control and a pressure relief valve.

(10) Stairways, porches, and elevated walkways shall have structurally sound and safe handrails.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4409 Ventilation {#sec-r-400.4409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4409}

Rule 409. (1) Except for a basement, each habitable room shall have direct outside ventilation by means of windows, louvers, air conditioning, or mechanical ventilation.

(2) During fly season, between May 1 and October 31, each door, window, and other opening to the outside which is used for ventilation purposes shall be supplied with standard screens of not less than 16 mesh. Each screen door shall have a self-closing device in working condition and shall swing outward.

(3) Where windows or louvers are used for ventilation, the total openable area for each resident-occupied room, other than a bathroom, shall not be less than 3 1/2% of the floor area of the room.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4411 Natural light {#sec-r-400.4411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4411}

Rule 411. (1) Every sleeping room occupied by residents shall have natural light from a source which is equal to not less than 8% of the floor area for that room. A skylight, louver, glass-blocked panel, or similar light-transmitting device shall not be counted for more than 50% of the required area in place of conventional windows and glass doors.

(2) Every habitable room shall have artificial light capable of providing not less than 20 footcandles of illumination at a height of 3 feet above the floor.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4414 Water supply {#sec-r-400.4414 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4414}

Rule 414. (1) The water supply for an institution shall comply with the requirements of the department of public health. Installation of new wells or repairs on existing wells shall be done by water drilling contractors registered under sections 12701 to 12721 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12701 to 333.12721 of the Michigan Compiled Laws.

(2) Each sink, lavatory, bath, shower, drinking fountain, and other water outlet shall be supplied with safe and potable water which is sufficient in quantity and pressure to meet the conditions of peak demand. Hot and cold or tempered water shall be provided in each sink, lavatory, bath, and shower. Hot water temperatures shall not exceed 120 degrees Fahrenheit at outlets accessible to residents.

(3) Plumbing shall be installed and maintained to prevent cross connections with the water supply.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4417 Toilet and bathing facilities {#sec-r-400.4417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4417}

Rule 417. Toilet and bathing facilities shall be provided as follows:

(a) Toilets that allow for individual privacy, unless inconsistent with a toilet training program or security program.

(b) Bathing and toilet fixtures that are specially equipped if used by the physically handicapped.

(c) At least 1 toilet, lavatory, and tub or shower, which are easily accessible from sleeping quarters, for each 8 residents.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4420 Food service facilities, equipment, and procedures {#sec-r-400.4420 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4420}

Rule 420. Facilities, equipment, and procedures used in the preparation, storage, and service of food shall comply with the applicable provisions of sections 12901 to 12922 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12901 to 333.12922 of the Michigan Compiled Laws. The facilities, equipment, and procedures required shall depend on the amount of food service and the type of food service operation.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4426 Garbage and refuse {#sec-r-400.4426 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4426}

Rule 426. (1) Garbage shall be stored in fly-tight, watertight containers with tight-fitting covers. A garbage can shall be provided with a waterproof liner or shall be thoroughly cleaned after each emptying., (2) Garbage and refuse shall be removed at intervals of at least once a week.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4428 Sewage disposal {#sec-r-400.4428 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4428}

Rule 428. Sewage and other water-carried wastes shall be disposed of through a municipal sewer system where such a system is available. Where a municipal sewer connection is not available, liquid waste shall be discharged into an approved private system. The private system shall not create a nuisance or pollute a stream, lake, or other body of water or contaminate a water supply or bathing place and shall comply with applicable local health department requirements.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4431 Heating equipment {#sec-r-400.4431 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4431}

Rule 431. (1) Heating equipment shall be capable of maintaining a temperature of not less than 68 degrees Fahrenheit at a point 4 feet above the floor. An accurate thermometer shall be provided.

(2) Hot water radiators or steam radiators and pipes or any other heating device capable of causing a burn shall be effectively shielded.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4435 Swimming beaches and pools {#sec-r-400.4435 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4435}

Rule 435. (1) The water and beach area of a natural swimming area of an institution shall be free from contamination by garbage, refuse, sewage pollution, and hazardous foreign or floating materials. A survey or evaluation of the quality of the water at the swimming area shall be made in accordance with sections 12541 to 12563 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12541 to 333.12563 of the Michigan Compiled Laws, and the rules promulgated thereunder.

(2) An institution's artificial swimming pool shall be constructed and maintained in accordance with sections 12521 to 12534 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12521 to 333.12534 of the Michigan Compiled Laws, and the rules promulgated thereunder.

PART 5. FIRE SAFETY FOR SMALL, LARGE, AND SECURE INSTITUTION

FACILITIES

History

History: 1983 AACS.

Mich. Admin. Code R 400.4501 Definitions {#sec-r-400.4501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4501}

Rule 501. As used in this part:

(a) "Ambulatory" means a resident who is physically and mentally capable of traversing a path to safety without the aid of another person. A path to safety includes the ascent and descent of any stairs or approved means of egress.

(b) "Approved" means acceptable to the department and fire inspecting authority and in accordance with these rules. The department makes the final approval based on recommendations from the fire inspecting authority.

(c) "Basement" means a story of a building or structure having ½ or more of its clear height below average grade for at least 50% of the perimeter of the story.

(d) "Combustible" means those materials which can ignite and burn.

(e) "Conversion" or "converted" means a change, after the effective date of these rules, in the use of a facility or portion thereof from some previous use to that of a licensed or approved institution, or an increase in capacity from a residential group home to a small facility or an increase in capacity from a small facility to a large facility or a change to a secure facility. A converted facility shall comply with the provisions of these rules for fire safety for converted facilities.

(f) "Electric lock" means an electric door lock system operated from a remote control unit.

The system is fail-safe in that all locks are automatically unlocked in the event of electrical failure. The system is approved by a nationally recognized independent testing laboratory.

(g) "Escape window" in new construction, remodeled, or converted facilitiesmeans an approved side-hinged window with a minimum net clear opening of 5.7 square feet with a net clear opening height of 24 inches and width of 20 inches. Grade floor openings shall have a minimum net clear opening of 5.7 square feet. The window shall be operable from the inside with a single motion and shall be equipped with non-locking-against-egress hardware. The window shall be operable without the use of special tools. The sill height shall not be greater than 36 inches from the floor, unless an approved substantial permanent ledge or similar device not less than 12 inches wide is provided under the window, in which case the sill height may be increased to 44 inches from the floor. In an existing facility, "escape window" means a window acceptable to the fire inspecting authority.

(h) "Existing facility" means a building, accessory buildings and surrounding grounds which is licensed or approved by the department as an institution at the time these rules take effect and which is not unoccupied for more than 90 days. Where an increase in capacity or change in use affects fire safety requirements, the facility shall comply with all applicable requirements prior to the increase or change in use.

(i) "Facility" means a building, and surrounding grounds including recreationalareas owned, leased, or primarily rented by a child care organization for use as a small, large, or secure facility to house and sleep residents. "Facility" includes new, remodeled, converted, and small, large, secure, and existing facilities. Any portion of a facility not used by residents and not used as a required means of egress and which is separated from the rest of the facility by an approved fire barrier, and buildings used by the residents strictly for up and awake activities do does not need to meet these rules for fire safety. However, the right of the fire inspecting authority to inspect a nonuse area for hazardous use, or any building on the grounds that is used by the residents strictly for up and awake activities, is retained and directives relative to fire safety of the nonuse such area or building may be issued to assure the fire safety of the those use areas.

(j) "Fire alarm device" means an approved device capable of sounding an alarm. A fire alarm shall be specifically designated as such and shall not be used for any purpose other than sounding an alarm of fire or other emergency or for fire drills. The device shall be loud enough to be heard throughout the facility under normal conditions. A device may be a bell, a horn, a whistle, or any other device acceptable to the fire inspecting authority.

(k) "Fire alarm system" means an approved electrical closed circuit, self-supervised local system for sounding an alarm. The system is comprised of a panel, pull stations, and audible electric signal devices.

(l) "Fire resistance rating" means the time in hours or fractions thereof that materials or their assemblies will resist fire exposure as determined by fire tests established and conducted by approved testing laboratories.

(m) "Hazardous area" means those parts of a facility housing a flame-producing heating plant, incinerators, water heater, and kitchens and areas where combustible materials, flammable liquids, or gases are used or stored.

(n) "Large facility" means a building used to house more than 15 residents.

(o) "Means of egress and exit" means an unobstructed way of departure from any point in a building to safe open air outside at grade.

(p) "Newly constructed," "new construction," or "new facility" means a new structure or new addition to a facility after the effective date of these rules.

(q) "Non-ambulatory" means a resident, including a resident confined to a wheelchair, who is physically or mentally incapable of traversing a path to safety without the aid of another person. A path to safety includes the ascent and descent of any stairs or other approved means of egress from the building.

(r) "Remodeled" means changes in a facility that modify existing conditions and includes renovation and changes in the fire alarms, sprinkler systems, and hood suppression systems. Remodeled and affected areas of a child caring institution shall conform to the provisions of these rules for fire safety for remodeled and converted facilities. Unaffected areas of a facility are not required to conform to the required provisions for remodeled and converted facilities.

(s) "Secure facility" means a building used as a detention facility or a secure child caring institution. The building or portions of the building are used to keep residents in custody.

Outside doors orindividual sleeping rooms usually have locks which are secure from the inside. The locks are used in the usual course of operation. A secure facility shall meet the requirements for a large facility, regardless of the number of residents. A facility with an approved seclusionroom is not a secure facility solely by virtue of having a seclusionroom.

(t) "Small facility" means a building which houses at least 7 or more than 15 residents and which is not a secure facility.

(u) "Street floor" means the lowest story of a facility which is not a basement.

(v) "Story" means that part of a building between a floor and the floor or roof next above.

(w) "Substantially remodeled" means changes in a facility that result in the exposure or addition of structural joists or studs.

(x) "Wire glass" means glass which is not less than 1/4 inch thick; which is reinforced with wire mesh, No. 24 gauge or heavier with spacing not greater than 1 square inch; and which is installed in steel frames or, when approved, installed in wood frames or stops of hardwood material not less than 3/4 inch actual dimension and not more than 1,296 square inches per frame with no single dimension more than 54 inches in length.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4502 Applicability {#sec-r-400.4502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4502}

Rule 502. The rules in this part apply to all newly constructed, remodeled, converted, and existing facilities of an institution as indicated.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4504 Adoption by reference {#sec-r-400.4504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4504}

Rule 504. The department adopts the following fire safety codes and standards. These codes and standards are available for inspection and distribution to the public at cost at the Department of Human Services, 201 N. Washington Square, PO Box 30650, Lansing, Michigan 48909. Copies of the codes and standards may also be obtained from the appropriate agency, organization, or association listed below.

(a) Standard E-84-07, "Standard Tests Method for Surface Burning Characteristics of Building Materials," 2014, American Society for Testing and Materials, 100 Bar Harbor Dr., West Conshohocken, PA 19428-2959, $69.00.

(b) Standard No. 13, "Standard for theInstallation of Sprinkler Systems," 2013, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $95.00.

(c) Standard No. 22, "Standard forWater Tanks for Private FireProtection," 2013, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 -9101, $46.50.

(d) Standard No. 70, "National Electric Code," 2014, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269(-9101,) $89.50.

(e) Standard No. 72 “National Fire Alarm Code”, 2013, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $80.10.

(f)Standard No. 80, “Standard for Fire Doors and Other Opening Protectives,” 2013, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269- 9101, $46.50.

(g) Standard No. 82, "Standard onIncinerator and Waste and Linen Handling Systems and Equipment, Rubbish Handling," 2014, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 (9101,) $42.00.

(h) Standard No. 90A, "Installation ofAir Conditioning and Ventilating Systems," 2015, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 (9101,) $45.00.

(i) Standard No. 96, "Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations” 2014, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 – (9101,) $42.00.

(j) Standard No. 220, "Standard on Types of Building Construction," 2015, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 - (9101,) $36.50.

(k) Standard No. 255, "StandardMethod of Test of Surface Burning Characteristics of Building Materials," 2006, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269 (9101,) $36.50.

(l) Standard 723, "Testfor Surface Burning Characteristics of Building Materials”2008, Underwriters Laboratories, Inc., 1414 Brook Dr., Downers Grove, Ill. 60513,$631.00.

(m) "Life Safety Code 101," 2015, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269, 93.00.

(n) Standard E-1590 13, “Standard Method for Fire Testing of Mattresses” American Society for Testing and Materials, 100 Bar Harbor Dr., West Conshohocken, PA 19428- 2959, $48.00.

(o) Standard No. 10, “Standard for Portable Fire Extinguishers”, 2013 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9109, $46.50.

(p) Standard No. 25, “Standard for the Inspection, Testing, and Maintenance of Water- Based Fire Protection Systems”, 2014, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $54.50.

(q) Standard No. 252, “Standard Methods of Fire Tests of Door Assemblies”, 2012, National Fire Protection Association, 1 Batterymarch Park, Quincy Massachusetts 02269- 9101, $36.50.

(r)Standard No. 257, “Standard on Fire Test for Window and Glass Block Assemblies”, 2012, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $36.50.

(s) Standard No. 261, “Standard Method of Test for Determining Resistance of Mock-Up Upholstered Furniture Material Assemblies to Ignition by Smoldering Cigarettes”, 2013 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269- 9109, $36.50.

(t) Standard No. 701 entitled “Standard Methods of Fire Tests for Flame Propagation of Textiles and Films,” 2010 National Fire ProtectionAssociation, 1 Batterymarch Park, Quincy, Massachusetts 02269-9109, $36.50.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4505 Plans and specifications {#sec-r-400.4505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4505}

Rule 505. (1) Plans and specifications shall be submitted to the bureau of fire services for review and approval prior to any remodeling in an institution, or the construction or conversion of a structure for use as an institution.

(2) The plans shall comply with all of the following provisions:

(a) Show layout, room arrangements, construction materials to be used, and the location, size, and type of fixed equipment.

(b) For additions, show those portions, including existing exits, types of construction, and room occupancies, which may be affected by the addition.

(d) Bear the seal of a registered architect or engineer when the cost of the project, including labor and materials, exceeds $15,000.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4506 Fire drills and telephone {#sec-r-400.4506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4506}

Rule 506. (1) There shall be quarterly emergency fire drills for each staff shift. Two of the drills shall include evacuations, unless approved by the department, in writing, as clinically contraindicated. Where a facility has a 24-hour staff shift, the emergency drills shall be conducted at different times of the day and night. Written records shall be maintained for each drill indicating the date and time of the drill and, where evacuation was a part of the drill, the approximate evacuation time.

(2) A telephone or other suitable means of communicating an alarm of fire to the fire department shall be provided. Pay stations are not a suitable means of communicating alarms. The telephone number of the fire department shall be posted conspicuously by all phones designated for outside service.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4508 Facility location {#sec-r-400.4508 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4508}

Rule 508. A new or converted facility shall not be established within 300 feet of an aboveground storage tank containing flammable liquids used in connection with a bulk plant, marine terminal, aircraft refueling or bottling plant of a liquified petroleum gas installation, or other similar hazard.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4510 Sleeping rooms {#sec-r-400.4510 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4510}

Rule 510. (1) In new construction, remodeled or converted facilities, single sleeping rooms shall not be less than 70 square feet in size, exclusive of closet space. Multi-resident sleeping rooms shall not be less than 50 square feet per resident, exclusive of closet space.

(2) In new construction, remodeled or converted facilities, locked resident sleeping rooms shall be equipped with 2-way monitoring devices.

(3) All facilities with sleeping rooms above the second floor shall comply with the requirements of a secure facility, with the exception of R 400.4522(c).

(4) A facility shall not use a basement as a sleeping room.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4512 Combustible materials, decorations, furnishings, and bedding {#sec-r-400.4512 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4512}

Rule 512. (1) A resident-occupied facility shall be kept free of all accumulation of combustible materials unnecessary for the immediate operation of the institution, unless materials are within an approved storage room.

(2) Easily ignited or rapidly burning combustible decorations are not permitted in a facility. Personal artwork and personal decorations made or owned by residents are permitted up to 20% of wall space in each room or use areas other than means of egress and hazardous areas if they have been treated with fire retardant materials approved by Underwriter’s Laboratory.

(3) Newly introduced upholstered furniture shall be tested in accordance and comply with the provisions of NFPA-261 unless located in an area having approved automatic sprinkler protection.

(4) Newly introduced mattresses shall be tested in accordance with ASTM E 1590 unless located in an area having approved automatic sprinkler protection.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4513 Rescinded {#sec-r-400.4513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4513}

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4515 Electrical installations {#sec-r-400.4515 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4515}

Rule 515. (1) In a newly constructed, converted, or remodeled facility, the electrical wiring and equipment shall be installed in accordance with the provisions of the national fire protection association standard No. 70, entitled "National Electrical Code," 2014. A final electrical certificate of approval for the electrical installation shall be obtained from a qualified local electrical inspecting authority or state electrical inspecting authority.

(2) In an existing facility, electrical wiring and equipment acceptable at the time these rules take effect shall continue to be approved until the facility or portion thereof is remodeled or converted. When an existing facility or portion thereof is remodeled or converted, only that portion remodeled or converted need comply with subrule (1) of this rule. Electrical services shall be maintained in a safe condition. When conditions indicate a need for inspection, the electrical services shall be inspected by a licensed electrical inspection service. A copy of the inspection report shall be maintained at the facility for review. Any areas cited in the report shall be corrected and a new electrical system inspection shall be obtained verifying that corrections have been made.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4517 Facility construction {#sec-r-400.4517 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4517}

Rule 517. (1) A new, substantially remodeled or converted large or secure facility shall be 1 of the following types of construction as specified in the national fire protection association standard No. 220, entitled "Standard on Types of Building Construction, 2015:”

(a) Type I 442 or 332 or type II 222.

(b) Type II 111, type III 211, type IV 2HH.

(2) New, converted, and substantially remodeled small facilities shall be at least frame construction and shall be fire-stopped at all wall and floor junctures and all wall and ceiling junctures with not less than 2-inch nominal lumber.

(3) Construction in existing licensed facilities that was approved before these rules take effect and which meets the construction requirements of the fire safety guidelines these rules supersede shall continue to be approved until the facility is substantially remodeled or converted. When an existing facility is substantially remodeled or added to, only the portion of the facility being substantially remodeled or added need comply with subrule (1) or (2) of this rule and R 400.4522, as appropriate.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4520 Interior finish {#sec-r-400.4520 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4520}

Rule 520. (1) The following alphabetical classification of finished materials for flame spread and smoke development, as determined by the tunnel test in accordance with the national fire protection association, standard No. 255, 2006; American society of testing materials E-84-07, 2014, or underwriters laboratories standard No. 723, 2008, shall be used to determine interior finishes:

Class Flame Spread Smoke Developed A 0 - 25 0 – 450 B 26 – 75 51 – 450 C 76 - 200 126 – 450 The same alphabetical classification is also used for combustibility of prefabricated acoustical tile units, only under federal test number SS-5-118a.

(2) Interior finish includes the plaster, wood, or other interior finish materials of walls; partitions, fixed or movable; ceiling; and other exposed interior surfaces of the facility, other than nominal wood trim.

(3) The classification of interior finish materials as to their flame spread and smoke development shall be that of the basic material used, without regard to subsequently applied paint or other coverings, except where such paint or other covering is of such a character or thickness where applied so as to affect the material classification. Finishes such as lacquer, polyurethane-based materials, or unapproved wall coverings shall not be used.

(4) In a new constructed, remodeled, or converted facility, an interior finish classification shall be that of the basic material used, without regard to subsequently applied paint or other covering in an attempt to meet the classification.

(5) Interior finish materials in facilities shall be as follows:

(a) In small and large open facilities without a sprinkler system, class A or B in exit ways and class A in seclusion rooms. In all other areas, at least class C.

(b) In open facilities with a sprinkler system, at least class C throughout, except in a seclusionroom.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4522 Fire protection {#sec-r-400.4522 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4522}

Rule 522. Fire protection shall be provided in all facilities as follows:

(a) In an existing licensed small facility, an attendant who is awake, fully dressed, and on duty 24 hours a day; complete sprinkler protection; or compliance with R 400.4523.

(b) In an existing licensed large facility, an attendant who is awake, fully dressed, and on duty 24 hours a day; complete sprinkler protection; or compliance with R 400.4524.

(d) In newly constructed facilities, conversions and additions shall be provided with automatic sprinkler protection in accordance with national fire protection pamphlet 13.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4523 Fire detection; small facilities {#sec-r-400.4523 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4523}

Rule 523. (1) An existing licensedsmall facility electing to provide fire protection by fire detection shall be protected throughout by approved fire detection provided by at least battery-operated ionization fire detection devices installed in every sleeping room and all areas, except kitchen and bathrooms. The fire detection devices shall comply with all of the following requirements:

(a) Be listed and labeled by an independent, nationally recognized testing laboratory.

(b) Be installed and maintained in accordance with the manufacturer's and test specifications.

(d) Be of a type that provides a signal when batteries are not providing sufficient power and when batteries are missing.

(2) Any battery-operated device required by subrule (1) of this rule which signals power is low or a battery is missing shall be immediately serviced and restored to full power.

There shall be not less than a 10% supply of extra batteries maintained at the facility at all times for the total number of battery-operated devices in the facility.

(3) In small facilities, licensed prior to November 30, 1983, previously approvedfire detection systems shall continue to be approved until the facility or portion thereof is remodeled or converted, then fire detection shall be at least as required by this rule for newly constructed, remodeled, or converted facilities in that portion of the facility remodeled or converted.

(4)Fire detection systems in existing licensed facilitiesshall be maintained in proper working order and shall be tested at least quarterly, with a written record maintained of the testing.

(5) All newly licensed small facilities shall be protected with a minimum 110 volt interconnected smoke detectors with battery backup.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4524 Fire detection; large facilities {#sec-r-400.4524 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4524}

Rule 524. (1) An existing licensedlarge facility electing to provide fire protection by fire detection shall be equipped with a 100% coverage fire detection system which is tested and listed by a nationally recognized, independent testing laboratory and which is installed in compliance with the national fire protection association standard No. 72, entitled “National Fire Alarm Code”, 2013and these rules except that the installing of wiring and equipment shall comply with national fire protection association standard No. 70, entitled "National Electric Code," 2014.

(2) In an existing licensedlarge facility, the main power supply source for an automatic fire detection system shall be from an electric utility company and shall be on a separate circuit with an identified and locked circuit breaker. A secondary power supply shall be provided which, in the event of the main power supply failure, will maintain the system in an operative condition for 24 hours and, in the event of a fire, will sound the alarm signaling units for a 5-minute period.

(3) In anexisting licensedlarge facility, where an automatic fire detection system is required, the detection devices shall comply with both of the following provisions:

(a) Be installed in all areas; that is, all rooms, lofts, closets, stairways, corridors, basements, attics, and like areas. Spacing of detection devices shall be as recommended by the manufacturer to provide complete coverage. Small bathrooms containing a single water closet and lavatory, small closets which are not more than 20 square feet, and similar spaces are exempted from this requirement.

(b) Be smoke detectors, except that heat detectors may be installed in attics, kitchens, bathrooms, attached garages, and heating plant rooms instead of smoke detectors. Heat detectors shall be the fixed temperature rate of rise type.

(4) In a new, remodeled, or converted large facility, an automatic fire detection system shall be an electrical, closed circuit, self-supervised system which gives a distinctive signal in a staff-occupied area when trouble occurs in the system, including loss of the main power supply and shall be in compliance with NFPA 72.

(5) In a new, remodeled, or converted large facility, complete final plans and specifications of the automatic fire detection or alarm system, where such a system is to be installed, shall be submitted to the department and approved prior to installation. The plan shall show facility floor plans and locations and types of detection devices, pull-stations, and sounding units. Newly required systems shall have a panel or annunciator located in an area regularly occupied by staff.

(6) In large facilities, licensed prior to November 30, 1983, fire detection systems shall continue to be approved until the facility is converted or a portion thereof is remodeled, then the portion of the facility remodeled or converted shall meet the appropriate requirements of this rule. Where the required new system cannot be added to the existing systems maintaining a single signaling alarm system, the total system shall be replaced and shall comply with this rule for remodeled and converted facilities.

(7) Automatic fire detection systems, fire alarm systems, and fire detection devices shall be maintained in proper working condition. When problems occur, they shall be immediately remedied. When the system is rendered inoperable, staff shall be awake and on duty until the system is again operable.

(8) Fire alarm systems shall be tested and maintained on an annual basis in accordance with NFPA 72. Smoke detector calibration shall be done as recommended. The licensee shall keep a record of fire alarm maintenance.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4527 Sprinkler systems {#sec-r-400.4527 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4527}

Rule 527. (1) A sprinkler system in a new or converted facility or an addition, shall comply with the2013 national fire protection association pamphlet No. 13, entitled "Standard for theInstallation of Sprinkler Systems." Where there is no adequate water from a community water system to supply a sprinkler system and where the area to be protected does not exceed 20,000 square feet, a special pressure tank supply for sprinklers, as specified in the 2013 edition of national fire protection association standard No. 22, entitled "Standard for Water Tanks for Private Fire Protection," shall be provided.

(2) All required sprinkler systems shall be inspected and tested and all other maintenance performed as specified in the 2014national fire protection association standard No. 25 entitled “Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems” at least once a year by a sprinkler contractor. The licensee shall maintain documentation of the last inspection and test.

(3) A sprinkler system in an existing facility approved before these rules take effect shall continue to be approved until the facility or portion thereof is remodeled, converted, or expanded. The system shall be maintained in accordance with the standards applicable at the time it was originally approved.

(4) When an existing facility is remodeled, converted, expanded or modified which results in the existing sprinkler system not providing adequate protection, fire protection shall be provided by extension of the current system where it is possible to extend the system and maintain its integrity or a new sprinkler system shall be installed in the affected area.

(5) The sprinkler piping for any isolated hazardous area which can be adequately protected by not more than 2 sprinklers may be connected directly to the domestic water system at a point where a minimum 1-inch supply is available. An approved automatic sprinkler controlvalve and check valve which is locked shall be installed between the sprinklers and the connection to the domestic water supply.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4532 Fire extinguishers {#sec-r-400.4532 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4532}

Rule 532. (1) All required fire extinguishers shall be subjected to a maintenance check at least once a year. Each fire extinguisher shall have a tag or label attached indicating the month and year maintenance was performed and identifying the person or company performing the service, as specified by NFPA Standard 10.

(2) All required extinguishers shall be recharged after use.

(3) A minimum of 1 approved fire extinguisher shall be provided on each floor and in or immediately adjacent to kitchens, rooms housingcombustion-type heating devices, and incinerators. Additional fire extinguishers may be required at the discretion of the fire safety inspector to assure that it is not necessary to travel more than 75 feet to a fire extinguisher.

(4) All fire extinguishers shall be locatednot less than 4 inches off the floor and the top of the extinguisher shall not be higher than 5 feet off the floor in a special cabinet or on a wall rack which is easily accessible at all times, unless programmatically contraindicated.

Where programmatically contraindicated, the required extinguishers may be kept behind locked doors if both of the following conditions are met:

(a) The locations are clearly labeled "Fire Extinguisher."

(b) All staff carry keys to the doors.

(5) In new, remodeled, or converted facilities, a fire extinguisher shall be at least type 2- A-10BC.

(6) In existing small facilities, previously approved fire extinguishers other than type 2- A-10BC will continue to be approved if they are maintained in the area for which approved.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4535 Fire alarm {#sec-r-400.4535 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4535}

Rule 535. (1) All new and converted large and secure facilities shall have a fire alarm with fire alarm pull-stations at each exit on each floor unless otherwise permitted by the following:

(a) Manual fire alarm boxes may be locked, provided that staff is present within the area when it is occupied and all staff have keys readily available to unlock the boxes.

(b) Manual fire alarm boxes may be permitted in a secure staff location, provided that both of the following criteria are met:

(i) The staff location is attended when the building is occupied.

(ii) The staff attendant has direct supervision of the sleeping area.

(2) Fire alarm systems shall be installed and in compliance with NFPA-72.

(3) All new and converted small facilities with resident sleeping on only 1 floor shall have at least a fire alarm device. All new and converted small facilities with sleeping on more than 1 floor shall have a fire alarm system with at least 1 pull-station on each level.

(4) Fire alarm systems and devices in existing facilities shall be maintained in proper working order and shall continue to be approved until the facility is remodeled or converted.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4538 Means of egress {#sec-r-400.4538 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4538}

Rule 538. (1) Means of egress shall be considered the entire way and method of passage to free and safe ground outside a facility. All required means of egress shall be maintained in anunobstructed, easily traveled condition at all times.

(2) In an existing facility, each resident-occupied room shall have access to not less than 2 independent, properly separated, approved means of egress or have a doorway leading directly to the outside at grade.

(3) In existing licensedmultistory secure and large facilities, at least 1 means of egress from each floor shall be direct to the outside or shall be through an enclosed stairway which is properly separated from exposure from floors below and which exits direct to the outside at grade or a previously approved escape window.

(4) In a small facility where ambulatory residents use a floor above the street level, 1 of the 2 required means of egress may be an approved escape window from each resident-occupied room which provides direct access to the ground and which has a sill height not more than 5 feet above the ground below or which provides access to an approved fire escape.

(5) In a newly constructed, remodeled, or converted facility, each resident-occupied story, including a resident-occupied basement, shall have not less than 2 independent approved means of egress separated by not less than 50% of the longest dimension of the story. All child-occupied rooms shall be situated between two approved exits unless the childoccupied room has an exit leading directly to the outside at grade. One adjacent intervening room shall be permitted between a sleeping room and an approved exit access corridor that leads to two approved exits in opposite or perpendicular directions.

(6) In a newly constructed, remodeled, or converted large or secure facility, additional means of egress, in addition to the minimum of 2 required from each story, are required if the maximum possible occupancy exceeds 100 residents per story. There shall be at least 1 additional means of egress for each 100 additional residents per story. Means of egress shall be of such number and so arranged that it is not necessary to travel more than 100 feet from the door of a resident-occupied room to reach the nearest approved protected exitway from that story.

(7) An elevator shall not be approved as a required means of egress.

(8) A means of egress shall not be used for the housing of residents or storage of any kind and shall not be obstructed or hidden from view by ornamentation, curtains, or other appurtenances.

(9) Each required means of egress from floors where non-ambulatory residents are permitted shall discharge at grade or shall be equipped with a ramp which terminates at grade level. Ramps shall not exceed 1 foot of rise in 12 feet of run and shall have sturdy handrails. Once at grade, there shall be a surface sufficient to permit occupants to move a safe distance from the facility.

(10) In a small facility housing 1 or more non-ambulatory or wheelchair residents, required exit-ways forming part of a required means of egress from portions of the facility housing such residents shall be not less than 48 inches wide in a new facility and not less than 44 inches wide in a converted facility, with doors a minimum of 36 inches wide.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4540 Stairways, halls, and corridors {#sec-r-400.4540 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4540}

Rule 540. (1) In existing and small facilities, all stairways and other vertical openings shall be enclosed with materials equal in fire resistance to the standard partition construction of the building, if such partition construction is at least standard lath and plaster. There shall be at least 1 3/4-inch solid core wood door with self-closing and latching hardware installed so that there is effective fire and smoke separation between floors or each sleeping room on the second floor shall be equipped with at least 1 1¾-inch solid core wood door with latching hardware.

(2) In all new and converted large and/or secure facilities, stairways and floor- to-floor openingsshall be enclosed with materials having at least the fire-resistance rating specified by the national fire protection association standard No. 220, “Standard on Types of Building Construction”, 2015, for the type of construction. All other vertical openings through floors shall be fire-stopped with like materials.

(3) Where a facility has 2 or fewer levels, where both levels exit at grade, and where elevations between levels do not exceed 4 feet, the building shall be considered to be 1 story and enclosures shall not be required between levels.

(4) In all new and converted facilities, stairs shall have treads and risers of uniform width and height, with treads not less than 11 inches deep, exclusive of nosing, and risers not more than7 inches in height.

(5) Stairs in new, remodeled, and converted facilities shall change direction by use of an intermediate landing and not by a variance in the width of treads. A sturdy and securely fastened handrail located between 34 and 38 inches, measured vertically, above the nose of the treads shall be provided.

(6) Stairs in existing facilities approved before these rules take effect shall continue to be approved until the portion of the building encompassing the stairs is remodeled.

(7) An outside stairway or fire escape used as part of an approved means of egress shall be protected against fire in the building by blank or closed walls directly under such stairway and for a distance of 6 feet in all directions. Windows may be allowed within this area if they are stationary wire glass windows.

(8) In newly constructed small facilities, halls, corridors, aisles, and stairs used as part of a means of egress shall be not less than 44 inches wide and not less than 36 inches wide in converted small facilities, except as required by R 400.4538(10).

(9) In newly constructed and converted large and secure facilities, halls, corridors, and aisles used as part of an exit way shall be not less than 5 feet wide and 90 inches high, and stairs shall be not less than 4 feet wide.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4543 Doors {#sec-r-400.4543 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4543}

Rule 543. (1) Doors to required means of egress shall comply with all of the following provisions:

(a) Be side-hinged and installed at floor level.

(b) Be not less than 36 inches wide in new and converted large and secure facilities and new small facilities, and not less than 30 inches wide in remodeled and converted small facilities, except as required by R 400.4538(10).

(d) In large and secure facilities, doors shall be hung to swing in the direction of egress, except doors to single-occupant rooms and bathrooms.

(e) Be equipped with at least knob-type, properly operating, approved, positive-latching, nonlocking-against-egress-type hardware which insures the opening of the door with a single motion, such as turning a knob or applying pressure of normal strength on a latch, except as where otherwise provided by subrule (2) of this rule and R 400.4545.

(2) In secure facilities, locking hardware is permitted if resident sleeping rooms are equipped with approved electric locks or if there are staff present and awake, fully dressed, on duty, and in possession of keys to release residents in an emergency.

(3) Doors entering stairs and other vertical openings and doors to fire rated enclosures shall not be held in an open position at any time by an underdoor wedge or hold-open device.

(4) Interior doors to any enclosure which is required to have not less than a 1-hour fire resistance rating shall be B-labeled fire doors in labeled frames and shall be equipped with positive-latching hardware and self-closing devices.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4545 Seclusion room {#sec-r-400.4545 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4545}

Rule 545. (1) A seclusionroom shall be approved in writing for use as such by the fire inspecting authority and the licensing authority.

(2) A seclusionroom shall be constructed to allow for both visual and auditory supervision of a resident in the room.

(3) A seclusion room shall have walls and ceiling made of noncombustible materials.

(4) A seclusionroom may have 1 approved locking-against-egress device on the door if a staff person is immediately present and awake and is in possession of a key for the door locking device when the room is being used.

(5) The egress door in a seclusion room shall open in the direction of egress.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4546 Partition construction {#sec-r-400.4546 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4546}

Rule 546. In new, remodeled, or converted large and secure facilities, rooms shall be separated from corridors used as means of egress with partition construction which extends to the floor or deck above and which affords at least a ¾-hour fire resistance rating. Doors shall be at least 1¾-inch solid wood core. Any glass in these partitions, including doors, shall be wired glass which is not more than 54 inches in any 1 lineal dimension and not more than a total of 1,296 square inches. Where glass breakage is a potential hazard, clear acrylic may be placed directly in contact with and between 2 layers of wired glass to give added strength. Glazing in compliance with national fire protection association pamphlet 257, 2007, and having the required fire resistant rating, may also be used in walls and in doors when tested in accordance with national fire protection association standard 252, 2012. This rule does not apply where the type of construction requires more restrictive separation.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4548 Large and secure facilities; lighting in means of egress {#sec-r-400.4548 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4548}

Rule 548. (1) In large and secure facilities, all halls, stairways, and means of egress shall be constantly lighted. Approved exit signs shall be installed over each required exit. Exit directional signs shall be provided where exit signs are not readily visible in means of egress. In new and converted large and secure facilities, emergency light packs and exit lights shall be provided along the means of egress. These devices shall include an electric charging unit that will maintain the batteries fully charged.

(2) In new and converted multistory large andor multistorysecure facilities, there shall be a system of emergency backup capable of maintaining required lighting for not less than 24 hours in the event of power failure.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4550 Elevators and dumbwaiters {#sec-r-400.4550 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4550}

Rule 550. Elevator and dumbwaiter shafts shall be completely enclosed by noncombustible materials with a fire-resistance rating of not less than 1 hour. An opening shall not be permitted through the side wall enclosure for ventilation or for any other purpose. Doors and frames servicing elevators and dumbwaiters shall be approved Blabeled fire door assemblies and labeled fire frame construction and shall be hung so as to be reasonably smoketight when the doors are closed. Glass side lights, transoms, and panels above the doors shall be wire glass and shall not exceed 100 square inches.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4552 Heating devices and flame-producing devices {#sec-r-400.4552 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4552}

Rule 552. (1) In large and secure facilities and all newly constructed and converted facilities, flame-producing-type heating devices and incinerators shall be in an enclosure providing at least 1-hour resistance to fire. Adequate combustion air shall be provided directly from the outside through a permanently open louver. Fire dampers are not required in ducts penetrating this enclosure.

(2) In existing small facilities, flame-producing-type heating devices and incinerators approved under the standards these rules replace shall continue to be approved with regard to enclosure or lack of enclosure until the portion of the facility containing the flameproducing device is remodeled or the facility is converted. This shall not preclude requirements relative to maintaining doors and other safety factors in proper working order.

(3) Electric heating shall be installed in accordance with the manufacturer's specifications and shall be approved by a nationally recognized, independent testing laboratory.

(4) Portable heaters and space heaters, including solid fuel heaters, are prohibited.

(5) A fireplace is permitted if it is masonry and has all of the following components:

(a) An approved glass door shielding the opening. The door shall be closed at all times except when a fire is being tended.

(b) A noncombustible hearth extending a minimum of 16 inches out from the front and 8 inches beyond each side of the fireplace opening.

(d) A masonry chimney constructed with approved flue liners.

(e) The chimney shall be visually inspected every other month while in use and cleaned as needed, but not less than once every 12 months.

(6) A heating plant room shall not be used for combustible storage or for a maintenance shop unless the room is provided with automatic sprinkler protection. Flammable liquids or gases shall not be stored in a heating plant room.

(7) A furnace and other flame-producing unit shall be installed according to manufacturer and test specifications and shall be vented by metal ducts to a chimney which is constructed of bricks, solid block masonry, or reinforced concrete, which has an approved flue lining, and is properly erected and maintained in a safe condition. A bracket chimney is not permitted. This rule does not prohibit the installation and use of any prefabricated chimney bearing the label of an approved, nationally recognized, independent testing laboratory if the chimney is installed and used in accordance with manufacturer and test specifications and is compatible with the heating unit or units connected to it. Only gas and oil-fired units may be connected to a prefabricated chimney.

(8) All furnaces shall be inspected on an annual basis by a licensed inspector. A copy of the inspection must be made available to the qualified fire inspector or the department’s licensing authority upon request.

(9) A carbon monoxide detector, bearing a safety certification mark of a recognized testing laboratory such as UL (Underwriters Laboratories) or ETL (Electro technical Laboratory), shall be placed on all levels approved for child care and in all furnace zones.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4554 Air-handling equipment {#sec-r-400.4554 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4554}

Rule 554. (1) In newly constructed or converted large or secure facilities, air-conditioning, warm air heating, air cooling, and ventilating systems shall comply with the national fire protection association standard No. 90A, entitled "Installation ofAir Conditioning and Ventilating Systems," 2002.

(2) In newly constructed or converted large or secure facilities, fans and air handling equipment used for re-circulating air in more than 1 room or single area shall have an approved automatic smoke detector located in the system at a suitable point in the return air duct ahead of the fresh air intake, the actuating of which shall open the electrical circuit supplying the fan motor and when an approved fire alarm system is installed, be connected to the fire alarm system in accordance with national fire protection association standard No. 72, 2013.

(3) In existing facilities, fans and air-handling equipment and systems approved in accordance with the standards these rules replace shall continue to be approved until the facility is converted. This shall not preclude requirements relative to maintaining the equipment, including thermostatic or other detection devices, and systems, in proper and safe working order.

(4) Fan rooms shall not be designed or used for any other use except housing other mechanical equipment.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4555 Smoke barriers {#sec-r-400.4555 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4555}

Rule 555. (1) Smoke barriers with a 1-hour fire resistance rating shall be provided on each floor used for sleeping rooms for more than 24 residents and shall be so located as to form an area of refuge on either side that is served with an approved means of egress. The barriers shall be located as close as possible to the middle of the floor to be protected and shall extend from outside wall to outside wall and from the floor through any inter-stud spaces to the roof or floor structure above.

(2) Doors in the smoke barrier shall be at least 20-minute fire-rated door or 1 ¾ inch solid core flush door hung in labeled frames with self-closing devices. Where double doors without mullions are used, synchronizing hardware and astragals shall be installed and maintained regularly. For new construction, additions and conversions these doors shall be arranged so that each door swings in a direction opposite from the other.

(3) Doors in smoke barrier partition may be held open only by electric hold-open devices designed so that interruption of the electric current or actuation of the fire alarm, sprinkler system, or the heat or smoke detector will cause the release of the doors. The doors shall also be capable of being opened and closed manually.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4557 Storage rooms {#sec-r-400.4557 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4557}

Rule 557. Storage rooms larger than 100 square feet used for the storage of combustible materials shall be separated from the remainder of the facility by construction with at least a 1-hour fire resistance rated construction.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4559 Combustible storage {#sec-r-400.4559 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4559}

Rule 559. (1) In a new, remodeled, or converted large facility, hazardous areas and rooms for storage of combustible materials, including all janitor rooms and closets, linen rooms, shipping and receiving rooms, kitchens, kitchen storage rooms, and maintenance shops shall be separated from the remainder of the building by construction having at least a 1hour fire resistance rating with a “B” rated door with an approved hydraulic closer.

(2) In an existing facility, combustible materials storage rooms and hazardous areas, including janitor rooms and closets, shipping and receiving rooms, kitchen storage rooms, and maintenance shops approved before these rules take effect, shall continue to be approved until the facility or portion thereof is remodeled or converted. All features of fire protection, including fire detection, automatic sprinkler protection, and required fire separations, shall be properly maintained.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4560 Cooking appliances {#sec-r-400.4560 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4560}

Rule 560. (1) Cooking appliances shall be suitably installed in accordance with approved safety practices.

(2) Where metal hoods or canopies are provided over domestic cooking appliances, they shall be equipped with filters which shall be maintained in an efficient and clean condition.

(3) In a newly constructed, remodeled, or converted large and secure facility, where metal hoods or canopies are provided over commercial kitchen cooking appliances, they shall be designed and equipped in compliance with the national fire protection association standard No. 96, entitled "Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations,” 2014, and shall comply with all of the following requirements:

(a) Filters shall be maintained in an efficient and clean condition.

(b) Only vapor proof electrical wiring and equipment shall be permitted in hoods or canopies.

When exhaust ducts are run through open spaces between a ceiling and a floor or roof or through any floors above, the ducts shall be enclosed in horizontal or vertical shafts protected from the remainder of the building by construction which affords a 2-hour fire resistance rating.

(d) Fire extinguishment equipment for the hood and exhaust duct of a cooking appliance in a kitchen shall be in compliance with the national fire protection association standard No. 96, entitled "Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations,”.

(4) In an existing facility, metal hoods and canopies approved before these rules take effect shall continue to be approved until the facility or portion thereof which incorporates the kitchen is remodeled or converted. When the kitchen is remodeled or the facility is converted, hoods, canopies, and kitchen hood suppression systems for cooking appliances shall comply with the requirements of this rule for new construction. Filters in any hood or canopy in an existing facility shall be maintained in an efficient and clean condition.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4562 Rubbish handling and incinerators {#sec-r-400.4562 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4562}

Rule 562. (1) In a newly constructed, remodeled, or converted large or secure facility, rubbish handling and incinerators shall be in accordance with the national fire protection association standard No. 82, entitled “Standard on Incinerators and Waste and Linen Handling Systems and Equipment”, 2014 Rubbish chutes and refuse bins or rooms shall comply with the provision of this pamphlet for industrial-type incinerators. Approved 2bushel or less gas incinerators may be placed in an approved furnace room and shall be equipped with approved automatic 100% shutoff controls, including a safety pilot. Feed doors shall be located in an enclosed room that is provided with automatic sprinkler protection or compartment separated from other parts of the building by walls, floor, and a ceiling having a fire-resistance rating of not less than 1 hour with openings to such rooms or compartments protected by approved B-labeled fire door assembly and fire door frames.

(2) In a newly constructed, remodeled, or converted large and/or secure facility, rubbish chutes shall extend not less than 4 feet above the roof and shall be covered by a metal skylight glazed with thin pane glass. A sprinkler head shall be installed at the top of rubbish chutes and within the chutes at alternate floor levels in buildings more than 2 stories in height. A rubbish chute shall empty into a separate room, closet, or bin constructed of materials having at least a 1-hour resistance to fire and protected with an automatic sprinkler system.

(3) In new construction, incinerator rooms shall have at least 1 wall on an outside wall not exposing a closed court.

(4) In an existing large or secure facility, rubbish handling and incinerators approved before these rules take effect shall continue to be approved until the facility is converted or the portion of the facility which includes the rubbish handling facilities or incinerators is remodeled.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4563 Laundries {#sec-r-400.4563 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4563}

Rule 563. (1) In a newly constructed, remodeled, or converted large or secure facility with a laundry, the laundry shall comply with all of the following requirements:

(a) Be located in a room constructed of materials that have a 1-hour fire resistance rating.

(b) Have steam lines installed with a 1-inch clearance from combustibles.

(c) Have dryer vents constructed of rigid metal vented directly to the exterior or through the roof. Lint traps shall be cleaned each time the dryer is used.

(d) Have 100% automatic and manual shutoff controls for gas appliances other than domestic laundry equipment, which need only have manual shutoff controls.

(e) Have adequate outside air for combustion where combustion-type equipment is used.

(2) In a newly constructed, remodeled, or converted facility, laundry chutes shall be in compliance with all of the following requirements:

(a) Be enclosed in shafts constructed of an assemblage of noncombustible materials having at least a 1-hour resistance to fire. If the shaft does not extend through the roof of the building, the top shall be covered with noncombustible material affording at least a 1hour resistance to fire. There shall be no openings into the shaft other than those necessary to the intended use of the laundry chute. Feed doors shall be located in an enclosed room that is provided with automatic sprinkler protection or compartment separated from other parts of the building by walls, a floor, and a ceiling having a fire-resistance rating of not less than 1 hour with openings to such rooms or compartments protected by B-labeled fire doors and in labeled frames with self-closing, positive latching hardware.

(b) Have a sprinkler head installed at the top of the chutes and within the laundry chutes at alternate floor levels in buildings over 2 stores in heights.

(c) Empty into a separate room, closet, or bin constructed of materials having at least a 1hour resistance to fire and protected by automatic sprinklers.

(d) Have an open vent at the top where the shaft extends through the roof of the building, a skylight which is glazed with ordinary glass and which is not less than 10% of the shaft area, or a window of ordinary glass which is not less than 10% of the shaft area and which is set into the side of the shaft with the sill of the window not less than 2 feet above the roof level and 10 feet from any property line or other exposure it faces.

(3) In an existing facility, laundry facilities and laundry chutes approved before these rules take effect shall continue to be approved until the facility is converted or the portion of the facility which includes the laundry facility or chute is remodeled.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4564 Motor vehicle housing {#sec-r-400.4564 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4564}

Rule 564. A motor vehicle or gasoline-powered equipment or devices which may cause or communicate fire and are not necessary for the personal care of residents shall not be stored within a facility, unless the area housing such equipment is separated from the rest of the facility by materials having at least a 1-hour fire resistance rating.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4566 Garages {#sec-r-400.4566 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4566}

Rule 566. (1) Garages located beneath, or attached to, a facility shall have walls, partitions, floors, and ceilings separating the garage space from the rest of the facility by construction with not less than a 1-hour fire resistance rating.

(2) In existing facilities, garages located beneath or attached to the facility approved before November 30, 1983 shall continue to be approved until the facility is converted or the portion of the facility containing the garage is remodeled.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4568 Assemblage area {#sec-r-400.4568 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4568}

Rule 568. A resident use assemblage area in a newly constructed, remodeled, or converted facility, such as a recreation room, dining hall, or chapel, with an occupancy of 51 or more persons, as computed by the public assemblage regulations, shall be maintained and arranged in accordance with national life safety code standard 101, 2015, governing places of public assemblage. These rules may be obtained from the department. Each door from an assemblage area occupied by residents shall enter a corridor between exits or there shall be direct egress to the outside from each room. In an existing facility, assemblage areas approved before these rules take effect shall continue to be approved until the areas are remodeled or converted.

PART 6. FIRE SAFETY FOR RESIDENTIAL GROUP HOME FACILITIES

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4601 Applicability {#sec-r-400.4601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4601}

Rule 601. The rules in this part apply to residential group homes.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4602 Definitions {#sec-r-400.4602 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4602}

Rule 602. As used in this part:

(a) "Approved" means acceptable to the department and fire inspecting authority and in accordance with these rules. The department shall make the final approval based on recommendations from the fire inspecting authority.

(b) "Basement" means a story of a building or structure having ½ or more of its clear height below average grade for at least 50% of the perimeter of the story.

(d) "Conversion" or "converted" means a change, after the effective date of these rules, in the use of a facility or portion thereof from some previous use to that of a licensed or approved institution, or an increase in capacity from a residential group home facility to a small facility or a large facility or a change in a secure facility. A converted facility shall comply with these rules for fire safety for converted facilities.

(e) "Existing facility" means a building, accessory buildings and surrounding grounds which are licensed or approved by the department as an open institution for 6 or fewer residents at the time these rules take effect and which is not unoccupied or unlicensed for more than 90 consecutive days thereafter. Where an increase in capacity or change in use affects fire safety requirements, the facility shall comply with all applicable requirements prior to the increase or change in use.

(f) "Facility" means a building and surrounding grounds and recreational areas owned, leased, or primarily rented by a child care organization for use as a residential group home facility to house and sleep residents. "Facility" includes new, remodeled, converted, and existing facilities. Any portion of a facility not used by residents and not used as a required means of egress and which is separated from the rest of the facility by an approved fire barrier, and buildings used by the residents strictly for up and awake activities do not need to meet these rules for fire safety. However, the right of the fire inspecting authority to inspect a nonuse area for hazardous use, or any building on the grounds that is used by the residents strictly for up and awake activities, is retained and directives relative to fire safety of such area or building may be issued to assure the fire safety of the those use areas.

(g) "Fire alarm device" means an approved device capable of sounding an alarm. A fire alarm shall be specifically designated as such and shall not be used for any purpose other than sounding an alarm of fire or other emergency or for fire drills. The device shall be loud enough to be heard throughout the facility under normal conditions. A device may be a bell, a horn, a whistle, or any other device acceptable to the fire inspecting authority.

(h) "Fire resistance rating" means the time in hours or fractions thereof that materials or their assemblies will resist fire exposure as determined by fire tests established and conducted by approved testing laboratories.

(i) "Means of egress or exit" means an unobstructed way of departure from any point in a building to safe open air outside at grade.

(j) "Newly constructed," "new construction," or "new facility" means a structure or addition to a facility after the effective date of these rules.

(k) "Non-ambulatory" means a resident, including a resident confined to a wheelchair, who is physically or mentally incapable of traversing a path to safety without the aid of another person. A path to safety includes the ascent and descent of any stairs or other approved means of egress from the building.

(l) "Remodeled" means changes in a facility that modify existing conditions and includes renovation. Remodeled and affected areas of an institution shall conform to these rules for fire safety for remodeled and converted facilities. Unaffected areas of a facility are not required to conform to the required provisions for remodeled and converted facilities.

(m) "Residential group home facility" means a building used to house not more than 6 residents and is not a secure facility.

(n) "Second story" means the story of a building above the highest story that has a means of egress that is not more than 4 feet to grade.

(o) "Street floor" means the lowest story of a facility that is not a basement.

(p) "Story" means that part of a building between a floor and the floor or roof next above.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4604 Adoption by reference {#sec-r-400.4604 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4604}

Rule 604. The department adopts the fire safety codes and standards in this rule. These codes and standards are available for inspection and distribution to the public at cost at the Department of Human Services, 201 N. Washington Square, P.O. Box 30650, Lansing, Michigan 48909. Copies of the codes and standards may also be obtained from the appropriate agency, organization, or associationlisted below. The costs indicated are those in effect at the time these rules are promulgated. The codes and standards adopted are as follows:

(a) Standard No. 10, “Standard for Portable Fire Extinguishers”. 2013 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9109, $46.50.

(b) Standard No. 13D, “Standard for the Installation of Sprinkler Systems in One-and Two-Family Dwellings and Manufactured Homes”, 2007 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9109, $33.50.

(c) Standard No. 25, “Standard for the Inspection, Testing and Maintenance of Water- Based Fire Protection systems”, 2014 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9109, $54.50.

(d) Standard No. 70, “National Electric Code,” 2014, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $89.50.

(e) Standard No. 72, “National Fire Alarm Code”, 2013 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $80.10.

(f) Standard No. 80, “Standard for Fire Doors and Other Opening Protectives”, 2013, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269- 9101, $46.50.

(g) Standard No. 261, “Standard Method of Test for Determining Resistance of Mock-Up Upholstered Furniture Material Assemblies to Ignition by Smoldering Cigarettes”, 2013 National Fire Protection Association, 1 Battterymarch Park, Quincy, Massachusetts 02269- 9101, $36.50.

(h) Standard No. 255, “Standard Method of Test of Surface Burning Characteristics of Building Materials”, 2006, National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $36.50.

(i) Standard No. 701, “Standard Methods of Fire Tests for Flame Propagation of Textiles and Films”, 2010 National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101, $36.50.

(j) Standard E-1590 2002, “Standard Method for Fire Testing of Mattresses” American Society for Testing and Materials, 100 Bar Harbor Dr., West Conshohocken, PA, 19428- 2959.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4605 Plan review {#sec-r-400.4605 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4605}

Rule 605. (1) Plans and specifications shall be submitted to the bureau of fire services for review and approval prior to any remodeling in a residential group home or the construction or conversion of a residential group home.

(2) The plans shall comply with all of the following provisions:

(a) Show layout, room arrangements, construction materials to be used, and the location size, and type of fixed equipment.

(b) For additions, show those portions, including existing exits, types of construction, and room occupancies, which may be affected by the addition.

(3) The plans shall be approved in writing by the bureau of fire services before construction begins.

(4) The plans for residential group homes for not more than 6 residents do not require the seal of a registered architect or engineer.

History

History: 2015 AACS.

Mich. Admin. Code R 400.4606 Evacuation training and telephone {#sec-r-400.4606 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4606}

Rule 606. (1) Staff shall be trained in evacuation of the facility in the event of emergency.

A record shall be maintained of the training.

(2) There shall be a telephone for communicating an alarm of fire to the fire department.

A pay phone is not acceptable as a phone for communicating an alarm of fire.

(3) The telephone number of the fire department shall be posted by all phones.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4608 Facility location {#sec-r-400.4608 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4608}

Rule 608. A residential group home facility shall not be established within 300 feet of an aboveground storage tank containing flammable liquids used in connection with a bulk plant, marine terminal, aircraft refueling, or bottling plant of a liquid petroleum gas installation or other similar hazard.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4612 Combustible materials, decorations, furnishings, and bedding {#sec-r-400.4612 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4612}

Rule 612. (1) A residential group home facility shall be kept free of all accumulation of combustible materials other than those necessary for the daily operation of the residential group home.

(2) Easily ignited or rapidly burning combustible decorations are not permitted in a facility. Personal artwork and personal decorations made or owned by residents are permitted up to 6 square feet of wall space in each room or area other than means of egress or hazardous areas.

(3) Newly introduced upholstered furniture shall be tested in accordance with and comply with NFPA-261 unless located in an area having automatic sprinkler protection.

(4) Newly introduced mattresses shall be tested in accordance with ASTM E 1590 unless located in an area having automatic sprinkler protection.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4613 Basement as sleeping room prohibited {#sec-r-400.4613 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4613}

Room 613. A basement shall not be used for sleeping.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4615 Electrical service {#sec-r-400.4615 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4615}

Rule 615. (1) The electrical service shall be maintained in a safe condition.

(2) Where the inspecting authority believes there is a need for an inspection of the electrical system because of its condition, the electrical service shall be inspected by a qualified electrical inspection service. A copy of the inspection report shall be maintained at the facility for review.

(3) Where an electrical system inspection indicates deficiencies in the electrical system, the deficiencies shall be corrected and a certificate of approval shall be maintained at the facility confirming that all deficiencies related to the electrical system have been corrected.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4617 Residential group home facility construction {#sec-r-400.4617 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4617}

Rule 617. A residential group home facility shall be at least of ordinary construction, light platform frame, and not over 2 stories high above the highest grade.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4618 Locked seclusionroom; prohibition {#sec-r-400.4618 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4618}

Rule 618. A locked seclusionroom is not permitted in a residential group home facility.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4620 Interior finish {#sec-r-400.4620 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4620}

Rule 620. (1) The following alphabetical classification of finished materials for flame spread and smoke development, as determined by the tunnel test in accordance with the national fire protection association, standard No. 255, 2006; American society of testing materials E-84-77A, 2014; or Underwriters Laboratories standard No. 723, 2008, shall be used to determine interior finishes:

Class Flame Spread Smoke Developed A 0 - 25 0 - 450 B 26 - 75 51 - 450 C 76 - 200 126 - 450 The same alphabetical classification is used for combustibility of prefabricated acoustical tile units, only under federal specifications test No. SS-5-118a.

(2) The classification of interior finish materials as to their flame spread and smoke development shall be that of the basic material used, without regard to subsequently applied paint or other coverings, except where such paint or other covering is of such a character or thickness where applied to affect the material classification. Finishes such as lacquer, polyurethane-based materials, or unapproved wall coverings shall not be used.

(3) In a newly constructed, remodeled, or converted residential group home, an interior finish classification shall be that of the basic material used, without regard to subsequently applied paint or other covering in an attempt to meet the classification.

(4) Interior finishes and materials shall be at least class C throughout.

R 400.4621Automatic sprinkler protection.

Rule 621. All newly constructed residential group homes shall be provided with automatic sprinkler protection in accordance with the requirements of NFPA-13D. Sprinkler systems shall be inspected, tested, and maintained in accordance with NFPA 25.

History

History: 1983 AACS; 2015 AACS.
History: 2015 AACS.

Mich. Admin. Code R 400.4623 Smoke detection equipment {#sec-r-400.4623 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4623}

Rule 623. (1) Newly constructed or licensed residential group homes shall be protected by interconnected smoke detectors in accordance with NFPA 72.

(2) Aresidential group home facility shall be protected by at least battery-operated smoke detection devices installed in all of the following areas:

(a) Between sleeping areas and the other areas of the facility.

(b) At the top of all interior stairways.

(c) In the immediate vicinity of combustion-type heating and incinerating devices, where such devices are not in an enclosure providing at least 1-hour resistance to fire. Where such devices are in enclosures which provide at least 1-hour resistance to fire, a fire detection device shall be immediately outside of the enclosure.

(d) At least 1 on every floor.

(3) Fire detection devices shall comply with all of the following requirements:

(a) Be listed or labeled by an independent, nationally recognized testing laboratory.

(b) Be installed and maintained in accordance with the manufacturer's and test specifications.

(d) Have the batteries replaced at least annually.

(e) Be of a type that provides a signal when batteries are not providing sufficient power and where batteries are missing.

(4) Any device required by this rule which signals that power is low or a battery is missing shall be immediately serviced and restored to full power.

(5) A written record shall be maintained in the facility of quarterly cleanings and testing of devices and of annual battery replacements.

(6) Fire detection systemsin an existing residential group home facility, approved before November 30, 1983 shall continue to be approved. Allfire detection systems in residential group homes shall be maintained in proper working order.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4632 Fire extinguishers {#sec-r-400.4632 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4632}

Rule 632. (1) All required fire extinguishers shall be subjected to a maintenance check at least once a year. Each fire extinguisher shall have a tag or label attached indicating the month and year maintenance was performed and identifying the person or company performing the service.

(2) All required extinguishers shall be recharged after use.

(3) A minimum of 1 approved fire extinguisher shall be provided on each floor.

(4) All fire extinguishers shall be at least 4 inches off the floor and the top of the extinguisher shall be less than 5 feet off the floor in a special cabinet or on a wall rack which is easily accessible at all times, unless programmatically contraindicated. Where programmatically contraindicated, the required extinguishers may be kept behind locked doors if all staff carry keys to the doors.

(5) In new, remodeled, or converted facilities, a fire extinguisher shall be at least a type 2-A-10BC.

(6) In existing facilities licensed prior to November 30, 1983, previously approved fire extinguishers other than a 2-A-10BC type will continue to be approved if they are maintained in the area for which they areapproved.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4635 Fire alarm systems {#sec-r-400.4635 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4635}

Rule 635. A residential group home facility shall be equipped with a fire alarm device.

The device shall be used only to sound an alarm of fire, for practice fire drills, and other emergencies requiring evacuation of the facility.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4638 Means of egress {#sec-r-400.4638 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4638}

Rule 638. (1) Means of egress shall be considered the entire way and method of passage to free and safe ground outside a facility. All required means of egress shall be maintained in unobstructed, easily traveled condition at all times.

(2) There shall be not less than 2 means of egress from the street floor story. At least 1 of the 2 means of egress shall be through a side-hinged door. The door shall be a minimum of 30 inches wide, except as provided in R 400.4639. The second means of egress may be a sliding glass door.

(3) A second story shall only be used by ambulatory residents and shall comply with 1 of the following requirements:

(a) Two open stairways separated by not less than 50% of the longest dimension of the story.

(b) One open interior stairway and 1 exterior stairway or fire escape separated by not less than 50% of the longest dimension of the story. An exterior stairway or fire escape does not require protection from fire in the building. An exterior stairway or fire escape shall be constructed of not less than 2-inch nominal lumber and be in good repair.

(c) One interior stairway and all floors separated by materials which afford at least a 3/4hour fire resistance rating. The doors separating floors shall be at least 1 3/4-inch solid wood core and shall be equipped with positivelatching hardware and approved self-closing devices. Each sleeping room on the second story shall have a window of not less than 5 square feet with no dimension less than 22 inches to allow for emergency rescue.

(4) A basement used by residents requires 1 means of egress which may be a stairway.

The stairway may be an open stairway, except as required by subrule (3)(c) of this rule.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4639 Special requirements for facilities caring for nonambulatory residents {#sec-r-400.4639 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4639}

Rule 639. A residential group home facility providing care to 1 or more nonambulatory residents shall comply with all of the following provisions:

(a) House such residents only on the street floor.

(b) Have required exitways which are not less than 48 inches wide in a new facility and not less than 44 inches wide in an existing or converted facility. Doors shall be a minimum of 36 inches wide.

(c) Have required exits discharge at grade level or have required exits equipped with ramps. Ramps shall not exceed 1 foot of rise in 12 feet of run and shall have sturdy handrails. Once at grade, there shall be a surface sufficient to permit occupants to move a safe distance from the facility.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4640 Stairs {#sec-r-400.4640 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4640}

Rule 640. (1) In new and converted facilities, stairs shall have treads of uniform width and risers of uniform heights. In converted facilities, treads shall be not less than 9 1/2 inches deep, exclusive of nosing, and risers shall be not more than 7 ¾ inches in height. In newly constructed facilities, treads shall be not less than 11 inches deep, exclusive of nosing, and risers shall be not more than 7 inches in height.

(2) Stairs in an existing facility approved before these rules take effect shall continue to be approved until the portion of the building encompassing the stairs is remodeled.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4643 Doors {#sec-r-400.4643 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4643}

Rule 643. (1) Doors to required means of egress shall be equipped with at least knob-type, properly operating, positive-latching, nonlocking-against-egress-type hardware which insures the opening of the door with a single motion, such as turning a knob or applying pressure of normal strength on a latch, except that an approved sliding door may be equipped with a non-key locking device.

(2) Required doors entering stairs and doors to fire rated enclosures shall not be held in an open position at any time by an underdoor wedge or hold-open device.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4652 Heating devices and flame-producing devices {#sec-r-400.4652 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4652}

Rule 652. (1) Flame-producing-type heating devices and incinerator devices on any story used by residents shall be in an enclosure that provides at least 1-hour resistance to fire.

Any interior door to the enclosure shall be of at least a B-labeled fire door in a labeled frame equipped with latching hardware and a self-closing device. Adequate combustion air shall be provided to the enclosure directly from the outside through a permanently opened louver or continuous ducts. Fire dampers are not required in ducts penetrating this enclosure.

(2) Where flame-producing-type heating devices or incinerator devices are located on a story not used by residents, there shall be a separation between the story or stories containing such devices and resident-used stories such that at least a 3/4-hour resistance to fire is provided. Any interior stairway to such a nonresident-used story shall have at least a 1¾ inch solid wood core door which is equipped with latching hardware and a self-closing device separating the non-resident-used story from resident-used stories.

(3) Electric heating shall be installed in accordance with the manufacturer's specifications and shall be of a type approved by a nationally recognized, independent testing laboratory.

(4) Portable heaters and space heaters, including solid fuel heaters, are prohibited.

(5) A fireplace is permitted if it is masonry and has all of the following components:

(a) An approved glass door shielding the opening. The door shall be closed at all times except when a fire is being tended.

(b) A noncombustible hearth extending a minimum of 16 inches out from the front and 8 inches beyond each side of the fireplace opening.

(d) A masonry chimney constructed with approved flue liners.

(e) The chimney shall be visually inspected every other month while in use and cleaned as needed, but at least once every 12 months.

(6) A heating plant room shall not be used for combustible storage or for a maintenance shop unless the room is provided with automatic sprinkler protection.

(7) A furnace and other flame-producing unit shall be installed according to manufacturer and test specifications and shall be vented by metal ducts to a chimney which is constructed of bricks, solid block masonry, or reinforced concrete which has an approved flue lining and is properly erected and maintained in safe condition. A bracket chimney is not permitted. This rule does not prohibit the installation and use of any prefabricated chimney bearing the label of an approved, nationally recognized, independent testing laboratory if it is installed in accordance with manufacturer and test specifications and is compatible with the heating unit or units connected to it. Only gas and oil-fired units may be connected to a prefabricated chimney.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4657 Storage rooms {#sec-r-400.4657 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4657}

Rule 657. Storage rooms larger than 100 square feet used for the storage of combustible materials shall be separated from the remainder of the facility by construction with at least a 1-hour fire resistance rating and interior door openings protected with minimum Blabeled fire door and frame assemblies that has approved self-closing, latching hardware.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 400.4660 Cooking appliances {#sec-r-400.4660 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4660}

Rule 660. (1) Cooking appliances shall be of the domestic type and shall be installed in accordance with approved safety practices.

(2) Where hoods or canopies are provided over the cooking appliances, they shall be equipped with filters which shall be maintained in an efficient and clean condition.

History

History: 1983 AACS.

Mich. Admin. Code R 400.4666 Garages {#sec-r-400.4666 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.4666}

Rule 666. (1) Garages located beneath a residential group home facility shall have walls, partitions, floors, and ceilings separating the garage from the rest of the facility by construction with not less than a 1-hour fire resistance rating with connecting door openings protected with B-labeled fire door and frame assemblies.

(2) Garages attached to a facility shall be separated from the rest of the facility by construction with not less than a 1-hour fire resistance rating with connecting door openings protected with B-labeled fire door and frame assemblies that has approved selfclosing, latching hardware.

History

History: 1983 AACS; 2015 AACS.

Economic Stability Administration Economic Stability Administration

R 400.7000 to R 400.7049 State Emergency Relief Program

Mich. Admin. Code R 400.7001 Definitions; A {#sec-r-400.7001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7001}

DEPARTMENT OF HUMAN SERVICES

FAMILY PROGRAM POLICY ADMINISTRATION

STATE EMERGENCY RELIEF PROGRAM

(By authority conferred on the department of human services by sections 6 and 14 of 1939 PA 280, MCL 400.6 and MCL 400.14.)

Rule 1. As used in these rules:

(a) "Adult" means either of the following:

(i) A person who is 21 years of age or older.

(ii) A person who is less than 21 years of age and who is not a dependent child.

(b) "Adult burial without services allowance" means the maximum amount that may be approved for the burial or cremation of an adult or of a child who is 1 month of age or older if family services are not provided.

(c) "Adult burial with services allowance" means the maximum amount that may be approved for the burial or cremation of an adult or of a child who is 1 month of age or older if family services are provided.

(d) "Affordable housing" means that the total housing obligation is equal to or less than 75% of the State Emergency Relief (SER) group's net countable income. The basic 75% may be increased by the following percentages if heat, electricity, or water/cooking gas is included in the rent:

(i) Heat included adds 15% to the basic 75%.

(ii) Electricity included ads 5% to the basic 75%.

(iii) Water or cooking gas, or both, included adds 5% to the basic 75%.

(e) "Applicant" means a person who has applied for the SER program or on whose behalf an authorized representative has made application for the SERprogram.

(f) "Application" means a statement, on a form or an online application prescribed by the department, that the client wishes to receive SERwhich is signed and dated by the applicant or by a person who acts on the applicant's behalf and which is received by the department.

(g) "Asset" means a real or personal, tangible or intangible resource that a client owns or possesses, in that the client has a legal interest, and that the client has the legal ability to use or dispose of.

(h) "Authorization” or “30-day eligibilityperiod" means the 30-day period immediately following the date of the application.

(i) "Authorized representative" or "a person who acts on the applicant’s behalf" means a person who applies or provides eligibility information on behalf of a client.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7002 Definitions; C, D {#sec-r-400.7002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7002}

Rule 2. As used in these rules:

(a) "Cash assets" means any of the following:

(i) Currency and coins.

(ii) Amounts on deposit in banks, savings and loan associations, credit unions, and other financial institutions.

(iii) Uncashed checks, drafts, and warrants.

(iv) Traveler's checks.

(v) Stocks, bonds, and other investments, including negotiable instruments.

(vi) Individual retirement accounts.

(vii) Keogh plans.

(viii) Revocable prearranged funeral contracts.

(ix) Nonrecurring lump-sum payments that do not represent an accumulation of monthly benefits.

(b) "Client" means an applicant for, or recipient of, SER and includes all members of the SER group.

(d) "Dependent child" means a person who is under the age of 21 and who is living with any of the following:

(i) A parent.

(ii) An adult relative.

(iii) An unrelated adult who functions as a parent.

(e) "Director" means the director of the department.

(f) "Divestment" means the disposition of an asset without receiving its market value with the intent of becoming or remaining eligible for, or increasing the amount of, emergency relief or with the intent of avoiding making reimbursement of emergency relief received.

(g) "Dwelling unit" means a shelter, such as a house, apartment, or mobile home.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7003 Definitions; E, F {#sec-r-400.7003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7003}

Rule 3. As used in these rules:

(a) "Earned income" means cash that is received by a person for activities he or she engages in as a self-employed person or as an employee, from renting property, or from providing room and board.

(b) "Electricity fiscal year cap" means the maximum amount that may be approved for electricity during a fiscal year.

(c) "Electricity required payment amount" means the amount that a SER group must have paid toward its household electric obligation during each month of the 6-month period before the month in which the SER group applies for energy assistance as a condition of eligibility for emergency relief for energy.

(d) "Emergency" means a situation in which immediate action is necessary to prevent serious harm or hardship.

(e) "Emergency relief" means relief that is paid under the SERprogram.

(f) "Equity" means the current market value of an asset minus any liens and indebtedness on the asset and minus the reasonable expenses that are necessary to liquidate the asset.

(g) "Federally funded home repairs allowance" means the maximum cumulative amount that may be approved during the lifetime of the client for energy-related home repairs that are wholly funded with federal funds.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7004 Definitions; H {#sec-r-400.7004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7004}

Rule 4. As used in these rules:

(a) "Heating fuel fiscal year cap" means the maximum amount that may be approved for heating fuel during a fiscal year.

(b) "Heating fuel required payment amount" means the amount that a SER group must have paid toward its heating fuel obligation during each month of the 6-month period before the month in which the SER group applies for energy assistance as a condition of eligibility for emergency relief for energy.

The term applies to all of the following groups:

(i) Groups in emergency shelters.

(ii) Groups sleeping in cars or on the streets.

(iii) Groups living temporarily with others due to a fire or natural disaster that occurred within 60 days before application.

(d) "Home ownership services allowance” means the maximum cumulative amount that may be approved during the lifetime of the client for any or all of the following services:

(i) Mortgage, land contract payments, or mobile home sales contracts, including principal and interest, legal fees, and escrows for taxes and insurance.

(ii) Property taxes and fees.

(iii) House insurance premiums that are required under the terms of a mortgage or land contract.

(iv) Mobile home lot rental.

(e) "Home repairs" means repairs that are necessary to make a home safe for occupancy or that are required by a rule, regulation, or ordinance of a governmental agency or mobile home park. The term includes repairs to any of the following with respect to a house or mobile home:

(i) The basic structure.

(ii) The plumbing system.

(iii) The water supply system.

(iv) The electrical system.

(v) The waste disposal system.

(vi) The heating system.

(f) "Homestead" means a structure that is occupied as a home and is owned, being purchased or held by a life estate. The term includes buildings on leased land, mobile homes, and adjoining land. A SER group may have only 1 exempt homestead at a time.

(g) "Household furniture allowance" means the maximum amount that may be approved per issuance for furniture.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7005 Definitions; I to P {#sec-r-400.7005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7005}

Rule 5. As used in these rules:

(a) "Income" means all earned or unearned monies that are received by a client.

(b) "Infant burial allowance" means the maximum amount that may be approved for the burial, cremation, or other disposition of a child who is less than 1 month of age, a fetus, or a limb.

(c) "Market value," with respect to an asset, means the price that the owner would receive if he or she disposed of the asset on short notice, possibly without the opportunity to realize the full potential on his or her investment in the asset.

(d) "Noncash assets" means assets that are not cash assets.

(e) "Potential resource" means an asset or income that may be available to a client if action is taken to make the asset or income available.

(f) "Protected cash asset limit" means the maximum total combined cash assets that the members of a relief group which is eligible with respect to cash assets may own.

(g) "Protected noncash asset limit" means the maximum total combined noncash assets that the members of a relief group which is eligible with respect to noncash assets may own.

History

History: 1993 AACS.

Mich. Admin. Code R 400.7006 Definitions; R {#sec-r-400.7006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7006}

Rule 6. As used in these rules:

(a) "Relocation fiscal year cap" means the maximum amount that may be approved for relocation during a fiscal year.

(b) "Required payment amount" means a payment by the client of his or her obligation for any of the following in an amount specified in these rules:

(i) Rent.

(ii) The purchase of a home.

(iii) Mandatory house insurance premiums required under the terms of a mortgage or land contract.

(iv) Heating fuel.

(v) Electricity.

(vi) Water or cooking fuel, or both.

(vii) Utility deposit.

(c) "Resource" means income or assets that are owned by, and are under the control of; a client and thatmay be used to achieve a level of subsistence.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7007 Definitions; S to W {#sec-r-400.7007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7007}

Rule 7. As used in these rules:

(a) "State-funded home repairs allowance" means the maximum cumulative amount that may be approved during the lifetime of the client for home repairs that are wholly or partially funded with state funds.

(b) "SER group" means all persons who live together in the same dwelling unit except for the following entities:

(i) Renters who live in the same dwelling unit and who pay a fair market rent to the SER group.

(ii) Landlords who live in the same dwelling unit if the SER group pays the landlord fair market rent to live in the home.

(iii) Any person who claims and verifies that he or she will not be adversely affected by the emergency situation for which the SER group is requesting SER and will not benefit if the SER group's application is approved.

(c) “State Emergency Relief Program” or “SER program” assists individuals and families who meet the established eligibility criteria with safe, decent, affordable housing and other essential needs when an emergency situation arises that may result in serious harm to individuals and families.

(d) "Total housing obligation" means the total monthly amount the SER group must pay for all of the following:

(i) Rent.

(ii) House payment.

(iii) Mobile home lot rent.

(iv) Property taxes.

(v) Required insurance premiums.

(e) "Unearned income" means any income, other than earned income, and includes all of the following:

(i) Money received in the form of public assistance.

(ii) Pensions.

(iii) Benefits.

(iv) Interest.

(v) Dividends.

(vi) Support.

(vii) Compensation.

(f) "Utility deposit cap" means the maximum amount that may be approved for a utility deposit.

(g) "Verification" means documentation or collateral proof that is used to confirm the validity of a relief group's reported circumstances.

(h) "Water or cooking gas, or both, fiscal year cap” means the maximum amount that may be approved for water or cooking gas, or both, during a fiscal year.

(i) "Water or cooking gas, or both, required payment amount" means the amount that a relief group must have paid toward its obligations for water or cooking gas, or both, during each month of the 6-month period before the month in which the SERgroup applies for water or cooking gas, or both, assistance as a condition of eligibility for emergency relief for water or cooking gas, or both.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7008 Application; completing required forms and providing relevant documentation to department; eligibility determination based on conditions and resources existing during emergency period; request for emergency relief after authorization period {#sec-r-400.7008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7008}

Rule 8. (1) Any person may apply for the SER program for himself or herself and the SER group of which he or she is a member or as an authorized representative of another person or persons. The right to apply shall not be limited or denied due to any of the following:

(a) Age.

(b) Race.

(d) Ethnic background.

(e) Sex.

(f) Political opinions.

(g) Religious beliefs.

(h) Physical or mental handicaps.

(i) Marital status.

(2) All members of the SER group shall be listed on the application form.

(3) An application is considered completed when all of the following provisions have been complied with:

(a) The application form prescribed by the department has been filled out.

(b) The application has been signed by the applicant or by the applicant's authorized representative.

(4) To assist the department in determining eligibility for emergency relief, a client shall complete forms that are required by the department or that provide information needed for the completion of such forms. When required by the department, a completed form shall include signatures of all adult members of the SER group.

(5) A client shall cooperate in the eligibility determination process by providing any available documentation requested by the department regarding to any of the following matters:

(a) Identity.

(b) The existence and nature of the emergency.

(d) Assets.

(e) Social security number.

(f) The cost of resolving the emergency.

(g) Liability for shelter, heat, non-heat electric and utility costs.

(h) The amount of shelter costs.

(i) Payment by the relief group of a required payment amount that is established by these rules as a condition of eligibility for relief.

(6) Eligibility shall be determined on the basis of conditions and resources as they exist during the emergency period. If emergency relief is requested after the end of the authorization period, a new application and determination of eligibility are required.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7009 Verification of information {#sec-r-400.7009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7009}

Rule 9. (1) All of the following items shall be verified:

(a) The existence of an emergency.

(b) The sources and amounts of income and the dates received.

(d) The cost of resolving the emergency.

(e) The ownership and market value of assets.

(f) Payment by the SER group of a required payment amount that is established by these rules as a condition of eligibility for relief.

(2) Failure on the part of the client to cooperate in obtaining proof of eligibility shall be reason to deny relief.

(3) If verification of the information specified in subrule (1) of this rule cannot be obtained after the client has made reasonable efforts to obtain it, the department may waive verification and base the determination of eligibility on the best available evidence.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7010 General requirements for relief {#sec-r-400.7010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7010}

Rule 10. Relief shall not be granted until all of the following requirements are satisfied:

(a) An application has been completed.

(b) A face-to-face interview has been conducted by an employee of the department with an adult member of the SER group, if required by the department.

(c) The application is signed. The department may require the application to be signed in the presence of a department worker and be witnessed by the worker.

(d) Information and verification that are required by the department have been obtained.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7011 Determination of eligibility within 10 business days required {#sec-r-400.7011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7011}

Rule 11. Eligibility for the SER program shall be determined within 10 business days from the date the application is completed.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7012 Divestment of resources by client {#sec-r-400.7012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7012}

Rule 12. A client who sells or otherwise disposes of an asset or other resource within 90 days before applying for the SER program without receiving the market value of the asset or resource shall be ineligible for the SER program if the reason for the sale or disposition is to become eligible for, or remain eligible for, the SER program, to increase the amount of emergency relief, or to avoid repayment of emergency relief that has been granted.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7013 Relief; issuance; form; standard rates; approval by department {#sec-r-400.7013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7013}

Rule 13. (1) The department may issue emergency relief for which a client has been determined eligible in the form of vendor payments to the provider.

(2) Prior authorization from the department for relief is required, except when the emergency need occurs before or after regular office hours of the department, in which case payment may be made if the client files an application within 5 business days of the emergency. Prior authorization is required for burial unless the department is closed for the entire period between death and burial or cremation, in which case payment may be made if an application is filed on the first business day following the occurrence.

(3) Payment may be made only for the services that are approved during the authorization period.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7014 Eligibility; exempt income; available earned and unearned income {#sec-r-400.7014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7014}

Rule 14. (1) Income that is exempt from consideration in determining eligibility for the SERprogram shall be income from the following sources:

(a) Income in kind.

(b) Food assistance program.

(d) Money given to the SER group by a person or organization as reimbursement for past, current, or future training-related expenses, medical care expenses, or expenses incurred as a volunteer.

(e) Reimbursement of medicare premiums.

(f) Michigan department of mental community health family support subsidy payments.

(g) Compensation that is awarded for a particular use.

(h) Child care payments and allowances that are made by the department.

(i) Disaster relief assistance.

(j) Benefits that are received from any of the following programs:

(i) Women, infants, and children program.

(ii) Title VII nutrition program for the elderly.

(iii) Energy assistance that is received from any of Michigan's low income energy assistance grant programs.

(iv) Child nutrition and school lunch programs and subsidies.

(k) Housing assistance that is paid under any state or federal law.

(l) Educational grants and scholarships.

(m) The earnings of a member of the SERgroup who is a dependent child when both of the following conditions are met:

(i) The accumulated earnings are held in a savings account of which the dependent child who earned the money is the sole tenant.

(ii) The accumulated earnings are not commingled with money obtained from any source except the earnings of the dependent child.

(2) Unearned income shall be counted in determining the amount of emergency relief that a SER group is eligible to receive. Such income includes all of the following:

(a) Assistance that is paid by the department pursuant to the family independence program or the state disability assistance program.

(b) Retirement, survivors, and disability insurance benefits that are paid by the social security administration.

(d) Alimony.

(e) Child support.

(f) Veterans administration benefits.

(g) Unemployment benefits, including unemployment compensation benefits, railroad unemployment benefits, and other governmental unemployment benefits.

(h) Payments from private sick and accident insurance plans.

(i) Workers' compensation benefits.

(j) Pensions and retirement benefits.

(k) Strike benefits.

(l) Income that is received by a client from the sale of property on a land contract or mortgage, including principal and interest.

(m) Military allotments.

(n) Investment income, such as dividends, interest, and royalties.

(o) Income from annuities, bonds, stocks, and trusts.

(3) Net unearned income shall be determined by deducting all of the following from the gross amount received:

(a) Mandatory taxes.

(b) Court-ordered child support paid, but not more than the amount ordered by the court.

(4) Net income from employment or self-employment shall be determined by deducting the expenses of employment from the gross amount received. Expenses of employment shall be limited to the following:

(a) Mandatory taxes.

(b) Deductions required by the employer as a condition of employment.

(d) Court-ordered child support paid, but not more than the amount ordered by the court.

(e) The cost of dependent care for either of the following:

(i) A dependent child who is less than 13-years-old.

(ii) A person who is 13-years-old or older and who needs care due to a mental or physical impairment.

(5) The amount deducted for dependent care under the provisions of subrule (4)(e) of this rule shall be the actual cost of care or $200.00, whichever is less, for each person who receives dependent care. The cost of dependent care for a person shall not be allowed as a deduction from the earnings of more than 1 member of the SER group. A deduction for the cost of dependent care shall not be allowed if the caregiver is any of the following persons:

(a) A member of the SER group.

(b) A legally responsible relative of the employed person or of the person who needs care.

(d) A person who is not a member of the SER group, if the care can reasonably and safely be provided by 1 of the following persons who lives in the home:

(i) A member of the SER group.

(ii) A responsible relative of the employed person or the person who needs care.

(iii) A dependent relative of the employed person.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7015 Basic monthly income need standards; determining amount of relief {#sec-r-400.7015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7015}

Rule 15. (1) A SER group shall be eligible with respect to income if the total combined monthly net income that is received or expected to be received by all members of the SER group in the 30-day period after the date of application for emergency relief is not more than the monthly basic income need standard for the number of members in the SERgroup.

(2) Income that is more than the basic monthly income need standard for the number of members in the SER group shall be deducted from the cost of resolving the emergency to determine the amount of emergency relief to be issued by the department, except that the department may require that the client execute a reimbursement agreement in the amount of the client's share of the cost of meeting the emergency or reduce or waive the client's share of the cost of meeting the emergency when the department determines that the client's share is not immediately available to meet the cost of the emergency and the service is necessary to remove a threat to life or health.

(3) The basic monthly income need standards shall be establishedby the department based on available actual appropriations. The standards shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7016 Eligibility; assets {#sec-r-400.7016 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7016}

Rule 16. (1) If the total combined cash assets that are not exempt from consideration of all members of the SER group are more than the protected cash asset limit, the amount in excess of the protected cash asset limit shall be deducted from the cost of resolving the emergency to determine the amount of emergency relief to be issued by the department.

(2) A SER group composed solely of recipients of any of the following shall have automatic eligibility on the basis of noncash assets:

(a) Family independence program.

(b) State disability assistance.

(d) Food assistance program.

(e) Supplemental security income paid by the social security administration.

(3) A SER group whose members' equity in noncash assets is more than the protected noncash asset limit for the number of members in the SER group is not eligible for the SER program.

(4) To be relevant to a determination of eligibility, the assets in question shall be legally available to, and under the control of, the client and shall be salable.

(5) In determining the equity in an asset, the department shall deduct all of the following from the market value of the asset:

(a) Any encumbrances against the asset.

(b) The costs incurred in selling the asset.

(6) All of the following assets are exempt from consideration in determining eligibility for emergency relief:

(a) One homestead.

(b) Household goods.

(d) One burial space per SER group member.

(e) Assets that are essential to employment or self-employment, including all of the following:

(i) Farm livestock and farm equipment.

(ii) Farmland.

(iii) Tools, equipment, and machinery.

(f) One motor vehicle that is used as the primary means of transportation.

(g) The accumulated earnings of a member of the relief group who is a dependent child when both of the following conditions are met:

(i) The accumulated earnings are held in a savings account of which the dependent child who earned the money is the sole tenant.

(ii) The accumulated earnings are not commingled with money obtained from any source except the earnings of the dependent child.

(h) Educational grants and scholarships.

(i) The total cash surrender value of life insurance policies.

(j) Irrevocable prepaid burial contracts.

(7) The protected cash asset limit shall not exceed the maximum limit set by the department. The protected cash asset limit shall be published in department policy and be made available to the public.

(8) The protected noncash asset limit shall not exceed the maximum limit set by the department. The protected noncash asset limit shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7017 Eligibility; reimbursement repayment of certain SER grants {#sec-r-400.7017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7017}

Rule 17. As a condition of eligibility for the SER program, the department may require an applicant to sign a repay agreement for any of the following:

(a) The relief that is granted to the extent of any lump-sum payment or potential resources expected to be received, except for those benefits that are unattachable by law.

(b) The relief that is granted pending the reissuance of a lost or stolen assistance warrant.

(c) The relief that is issued pursuant to undera waiver of any of the eligibility requirements established by these rules.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7018 Eligibility; evaluating need and resources of SER group members {#sec-r-400.7018 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7018}

Rule 18. The need and resources of each member of the SER group shall be evaluated in determining eligibility for relief to meet emergency relief needs. All assets and income of each member of the SER group shall be counted in determining the eligibility of the group and the amount of relief to be issued.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7019 Agreement by client to make potential resources available {#sec-r-400.7019 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7019}

Rule 19. A client shall agree to take all feasible reasonable action to make potential resources, as described in department policy, available before emergency relief is issued.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7020 Client actions contributing to emergency as basis for denial of relief; required payments {#sec-r-400.7020 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7020}

Rule 20. (1) Failure, without good cause, on the part of any member of the SER group to meet required payments for any of the following shall be a basis for the denial of an application for the SER program if the department determines that the failure to meet required payments contributed to the emergency situation for which relief is requested:

(a) Rent.

(b) Purchase of a home.

(d) Heating fuel.

(e) Electricity.

(f) Water or cooking gas, or both.

(g) Utility deposits.

(2) The required payments for rent or the purchase of a home are the total amount of the SER group’s monthly obligations for these needs during each of the 6 months before the month during which the SER group applies for emergency relief.

(3) The required payments for mandatory house insurance premiums required by the terms of a mortgage or land contract are the total amount of the SER group's obligations for mandatory house insurance premiums that fell due, or were overdue, during the 6 months before the month during which the SER group applies for emergency relief.

(4) The required payments for electricity, heat, and heat and electric deposits are met if, during each month of the 6-month period before the month in which the SER group applies for electricity, heat, or heat and electric deposit assistance, the group paid the combined electricity and heat required payment amounts for the number of persons in the group.

(5) The required payments for a non-energy utility deposit, water, cooking gas, or water and cooking gas are met if, during each month of the 6-month period before the month in which the SER group applies for a non-energy utility deposit, water, cooking gas, or water and cooking gas assistance, the group paid the water or cooking gas, or both, required payment amount for the number of persons in the group.

(6) Good cause shall exist for a failure to meet required payments if the SER group’s net countable income from all sources during each month that the group failed to pay shelter, energy, or utility obligations was not reduced under the provisions of R 400.7021 and was less than the amounts specified by group size and establishedby the department and published in department policy.

(7) Electricity required payment amounts shall be establishedby the department and published in department policy.

(8) Heating fuel required payment amounts shall beestablishedby the department and published in department policy.

(9) Water or cooking gas, or both, required payment amounts shall be established by the department and published in department policy.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7021 Action to obtain other governmental program resources required {#sec-r-400.7021 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7021}

Rule 21. A SER group shall not be eligible for relief under the SERprogram if a member of the SER group has been denied assistance under any of the following programs for failure to comply, when able, with a procedural requirement of those programs:

(a) The family independence program administered by the department.

(b) The state disability assistance program administered by the department.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7022 Expanded services for individual SER groups {#sec-r-400.7022 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7022}

Rule 22. The director, or a person who is designated by the director, may, within limits established by the department, make exceptions in individual cases to these rules to accomplish any of the following purposes:

(a) To expand services to meet a particular SER group's emergency.

(b) To increase the standard rates established by the department for the covered services needed to meet a particular SER group's emergency.

(c) To approve payment for a service that did not have the required prior approval when, in the judgment of the director or the director's designee, the service provided under the exception is necessary to remove a threat to life or health.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7023 Exemption from rules in individual cases {#sec-r-400.7023 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7023}

Rule 23. The director, or a person who is designated by the director, may, within limits established by the department, grant an exemption from these rules in an individual case if there is evidence that the rule prevents the resolution of a threat to life or health or a condition of hardship.

History

History: 1993 AACS.

Mich. Admin. Code R 400.7024 Eligibility; presence of client {#sec-r-400.7024 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7024}

Rule 24. To be eligible for benefits of the SER program, a client shall be in this state at the time of application or at the time the application is approved.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7025 Rescinded {#sec-r-400.7025 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7025}

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7026 Relocation services {#sec-r-400.7026 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7026}

Rule 26. (1) Relocation services may be approved for any of the following reasons:

(a) To establish a dwelling unit for a homeless SER group.

(b) To reestablish a dwelling unit for a client who is living temporarily with other persons following a fire or natural disaster that occurred not more than 60 days before the date the client files an application for emergency relief.

(c) A dwelling unit that meets acceptable standards of health and safety is needed to accomplish either of the following purposes:

(i) To prevent the removal of children from parental care.

(ii) To enable children to be returned to parental care.

(d) To prevent eviction of a SER group when a member of the group has received a summons to appear in court as a defendant in an eviction action or a judgment of eviction has been issued by the court.

(e) To relocate a SER group that has received a final notice to vacate condemned housing from a local public agency authorized to issue such an order.

(2) Payment for relocation services under this rule may be made for any of the following needs:

(a) First month’s rent.

(b) Rent arrears.

(3) Payment for relocation services shall not be made unless the income of the SER group is sufficient to meet the total housing obligation of the dwelling unit, thereby assuring that the same emergency will not recur in the immediate future.

(4) Payment for relocation services shall not be more than the relocation services payment maximum for the number of members in the SER group.

(5) The relocation fiscal year cap shall be established by the department, published in department policy, and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7027 Home ownership services {#sec-r-400.7027 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7027}

Rule 27. (1) The department may issue payment for home ownership services, which include any of the following services that are necessary to maintain a homestead:

(a) Mortgage, land contract payments, or mobile home sales contracts, including principal and interest, legal fees, and escrow accounts for taxes and insurance.

(b) Property taxes and fees.

(d) Mobile home lot rental.

(2) Home ownership services may be approved only to prevent foreclosure or the initiation of a foreclosure or eviction action or loss of a homestead due to unpaid taxes.

Emergency relief shall not be approved for home ownership services if there is no plan to ensure that the home will continue to provide safe and affordable shelter for the SER group.

(3) Payment for home ownership services shall not be made unless the income of the SER group is sufficient to meet the total housing obligation of the dwelling unit, thereby assuring that the same emergency will not recur in the immediate future.

(4) Payment for home ownership services shall not be approved if the payment would cause the home ownership services allowance to be exceeded.

(5) The home ownership services allowance shall be determined by the department and shall be published in department policy and be made available to the public. The allowance is for the lifetime of the client.

(6) Payment for home ownership services shall not be approved unless all of the following provisions are satisfied:

(a) A member of the SER group is the owner or purchaser of the home.

(b) The home is the SER group's permanent, usual place of residence.

(c) The home is in livable condition or can be brought to livable condition within the remaining home repairs allowances.

(d) The home is not currently listed for sale.

(7) Payment for property taxes under home ownership services shall not be approved if the total tax arrearage for all years is more than the ownership services maximum $2,000.00.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7028 Rescinded {#sec-r-400.7028 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7028}

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7029 Payment for home repairs {#sec-r-400.7029 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7029}

Rule 29. (1) Payment for home repairs may be made only if all the following conditions are met:

(a) The home is owned, being purchased, or held under a life estate by a member of the SER group and is the group’s permanent, usual place of residence.

(b) The SER group is living in the home, unless the members are absent due to the condition of the home or the health of a member.

(d) The home is not in jeopardy of loss due to unpaid property taxes or foreclosure of a mortgage or land contract.

(e) The repairs are necessary to remove a direct threat to the health or safety of the SER group members.

(2) Repairs shall restore the home to a livable condition.

(3) The most cost-effective repair or replacement of the defect is authorized.

(4) The client may be required to obtain or assist in obtaining an estimate of the costs of repairs.

(5) The client may be required to use a licensed contractor.

(6) If the department authorizes furnace replacement, the client may be required to purchase an energy-efficient unit.

(7) Emergency relief shall not be approved for home repairs if there is no plan to ensure that the home will continue to provide shelter for the SER group in the future.

(8) Payment for home repairs shall not be made unless the income of the SER group is sufficient to meet the total housing obligation of the dwelling unit, thereby assuring that the homestead will provide shelter for the SER group in the foreseeable future.

(9) Payment for home repairs shall not be approved if the payment would cause the federally funded home repairs allowance or the state-funded home repairs allowance to be exceeded.

(10) The federally funded home repairs allowanceshall be determined by the department based upon available federal funding. The allowance shall be published in department policy and be made available to the public.

(11) The state-funded home repairs allowance shall be established by the department based on available actual appropriations. The allowance shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7030 Payment for water or cooking gas services; payment for utility deposits {#sec-r-400.7030 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7030}

Rule 30. (1) Payment may be made to prevent the shutoff of water service or cooking gas service, or both, or to restore the service, including reconnect or hookup fees and other charges necessary to provide service.

(2) Payment for water or cooking gas services, or both, shall not be made unless such payment will assure continuation of water or cooking gas services, or both, or restoration of such services, for a minimum of 30 calendar days.

(3) A payment for water or cooking gas services, or both, shall not be approved if the payment would cause the water or cooking gas, or both, fiscal year cap to be exceeded.

(4) Payment of a utility deposit may be made to commence utility service or to prevent discontinuance of utility service. Payment for a utility deposit shall not be more than the lesser of the following:

(a) The amount charged by the utility company.

(b) The utility deposit cap.

(5) The water or cooking gas, or both, fiscal year cap shall be established by the department based on available actual appropriations. The allowance shall be published in department policy and be made available to the public.

(6) The utility deposit capshall be established by the department based on available actual appropriations. The issuance shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7031 Payment for electricity {#sec-r-400.7031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7031}

Rule 31. (1) Payment may be made to prevent the shutoff of electricity or to restore the service.

(2) Payment for electricity shall not be made unless the payment will assure the continuation of electricity service, or the restoration of such service, for a minimum of 30 calendar days.

(3) A payment for electricity shall not be approved if the payment would cause the electricity fiscal year cap to be exceeded.

(4) The electricity fiscal year cap shall be established by the department based on available actual appropriations. The cap shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7032 Payment for heating fuel {#sec-r-400.7032 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7032}

Rule 32. (1) Payment may be made to prevent the shutoff of heating fuel or to restore the service.

(2) Payment for heating fuel shall not be made unless the payment will assure the continuation of heating fuel service, or the restoration of such service, for a minimum of 30 calendar days.

(3) A payment for heating fuel shall not be approved if the payment would cause the heating fuel fiscal year cap to be exceeded.

(4) The heating fuel fiscal year cap if natural gas or wood is the heat source shall be established by the department based on available actual appropriations. The cap shall be published in department policy and be made available to the public.

(5) The heating fuel fiscal year cap if fuel oil, liquefied propane gas, or coal is the heat source shall be established by the department based on available actual appropriations. The cap shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7033 Payment for inpatient or outpatient hospitalization of migrant families {#sec-r-400.7033 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7033}

Rule 33. (1) Inpatient hospitalization or outpatient services for migrant families may be provided for a period of up to 30 consecutive days in any 12-month period if all of the following provisions are satisfied:

(a) Members of the migrant family have not received migrant hospitalization services from the SER program in the 12-month period preceding the date of hospital admission.

(b) The person applying for inpatient hospitalization or outpatient services is ineligible for medicaid, and medicaid ineligibility did not result from any of the following:

(i) Excess income.

(ii) The applicant’s failure to meet a procedural requirement of medicaid.

(iii) The applicant's entrance into this state for reasons other than employment.

(c) No member of the household quit or refused employment or training without good cause within the 30 days prior to application.

(2) A migrant family is a family that meets all of the following requirements:

(a) Works primarily in agriculture or a related seasonal industry.

(b) Moves from place to place to find work.

(d) Has a child who is less than 21-years-old and who is living with, or has lived with, a specified relative during the last 6 months.

(e) The household members are nonresidents of this state.

(3) Exclusions, payment rates, and conditions of coverage for inpatient hospitalization shall be based on medicaid payment rates and covered services. Elective hospitalization is not a covered service.

(4) Exclusions, payment rates, and conditions of coverage for outpatient services shall be based on medicaid payment rates and covered services subject to the following provisions:

(a) Services which are a follow-up to inpatient services and which are performed within 30 days of the hospital admission will be covered.

(b) Services which are normally performed as inpatient services, but which the attending physician and the client have decided to have performed on an outpatient basis will be covered.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7034 Payment for burial or cremation of deceased person {#sec-r-400.7034 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7034}

Rule 34. (1) Payment may be made for burial or cremation of a deceased person when sufficient resources from the deceased person's estate and expected contributions from responsible relatives are not available.

(2) Payment may be made for any of the goods and services that are customarily provided for the burial or cremation of a deceased person, including all of the following:

(a) Goods and services that are provided by a funeral director.

(b) An outside receptacle that is required by the cemetery and that consists of a metal or concrete rough box.

(d) Opening and closing the grave.

(e) The use of cemetery equipment.

(f) Transportation.

(g) Clothing.

(h) Clergyman's honorarium.

(i) Cremation.

(3) Payment may be approved for burial or cremation in any of the following locations:

(a) The county where the deceased had lived.

(b) The county where the deceased died.

(d) A location stipulated in a prearranged burial agreement.

(4) Friends or relatives may supplement the SER payment in any amount up to that shall be determined by the department and shall be published in department policy and be made available to the public for additional services. Responsible relatives may designate a maximum amount designated by the department of a required copayment for this purpose.

(5) An application for emergency relief shall be denied if the total amount contributed for additional services is more than the maximum amount determined by the department and published in department policy to be made available to the public.

(6) The amount of an expected lump-sum death benefit from the social security administration shall be deducted from the state payment if the surviving spouse resided with the deceased person at the time of death.

(7) The department shall determine the availability of benefits from veterans' programs, life insurance, fraternal or social organizations, and prearranged funeral agreements. Such benefits may reduce the amount paid by the department by an amount equal to the benefits.

(8) Payment for the burial or cremation of an adult or of a child who is 1 month of age or older shall not be more than the adult burial with services allowance if family services are provided.

(9) Payment for the burial or cremation of an adult or of a child who is 1 month of age or older shall not be more than the adult burial without services allowance if family services are not provided.

(10) The payment for the burial, cremation, or other disposition of a child who is less than 1 month of age, a fetus, or a limb shall not be more than the infant burial allowance.

(11) The adult burial with services allowance shall be established by the department based on available actual appropriations. The allowance shall be published in department policy and be made available to the public.

(12) The adult burial without services allowance shall be established by the department based on available actual appropriations. The allowance shall be published in department policy and be made available to the public.

(13) The infant burial allowance shall be established by the department based on available actual appropriations. The allowance shall be published in department policy and be made available to the public.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 400.7049 Rescission {#sec-r-400.7049 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7049}

Rule 49. R 400.3501 to R 400.3540 of the Michigan Administrative Code, appearing on pages 3132 to 3143 of the 1979 Michigan Administrative Code, are rescinded.

History

History: 1993 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 400.7171 to R 400.7173 Prohibition of Discrimination in the Medical Assistance Program and General Assistance Program

Mich. Admin. Code R 400.7171 Definitions {#sec-r-400.7171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7171}

DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

PROHIBITION OF DISCRIMINATION IN THE MEDICAL ASSISTANCE

PROGRAM AND THE GENERAL ASSISTANCE MEDICAL PROGRAM

(By authority conferred on the director of the department of social services by sections 6, 10, and 14 of Act No. 280 of the Public Acts of 1939, as amended, and section 453 of Act No. 380 of the Public Acts of 1965, as amended, being SS400.6, 400.10, 400.14, and 16.553 of the Michigan Compiled Laws)

Rule 1. As used in these rules:

(a) "Department" means the department of social services, its officials, or agents.

(b) "General assistance medical program" means the department's program to provide for medical assistance established by sections 14 and 55 of Act No. 280 of the Public Acts of 1939, as amended, being SS400.14 and 400.55 of the Michigan Compiled Laws.

(c) "Medical assistance program" means the department's program to provide for medical assistance established by section 105 of Act No. 280 of the Public Acts of 1939, as amended, being S400.105 of the Michigan Compiled Laws, and title 19 of the federal social security act, 42 U.S.C. S1396 et seq.

(d) "Provider" means an individual, firm, corporation, association, agency, institution, or other legal entity which has been approved to provide medical assistance to a recipient pursuant to the medical assistance program or the general assistance medical program.

(e) "Recipient" means an individual eligible to receive medical assistance through the department.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7172 Discrimination in general assistance medical and medical assistance programs prohibited {#sec-r-400.7172 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7172}

Rule 2. (1) Services provided to recipients by providers pursuant to and within the limits of the medical assistance program and the general assistance medical program shall be of the same scope, quality, and delivery as those provided to the general public.

(2) A provider shall not discriminate in the rendering of medical services to a recipient on the basis of age, race, creed, color, sex, physical or mental handicap, national origin, marital status, or sexual preference.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7173 Compliance {#sec-r-400.7173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7173}

Rule 3. (1) The department shall investigate all complaints or alleged violations of R 400.7172.

(2) The department shall notify a complainant in writing of the disposition of a complaint.

(3) Failure to comply with R 400.7172 may constitute grounds for suspension or termination of a provider's participation in the medical assistance program and the general assistance medical program.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7701 Definitions {#sec-r-400.7701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7701}

DEPARTMENT OF COMMUNITY HEALTH

MEDICAL SERVICES ADMINISTRATION

STERILIZATION AND HYSTERECTOMY CONSENT PROCEDURES

(By authority conferred on the department of social services by sections 6, 10, and 14 of Act No. 280 of the Public Acts of 1939, as amended, and section 453 of Act No. 380 of the Public Acts of 1965, as amended, being SS400.6, 400.10, 400.14, and 16.553 of the Michigan Compiled Laws)

Rule 1. As used in these rules:

(a) "Acknowledgement of receipt of hysterectomy information form" means the form approved by the department for use in the medical assistance program to obtain the recipient's acknowledgement that she has received the required hysterectomy information.

(b) "Claim" means any written request for reimbursement for a service, a supply, or an item of equipment rendered to a recipient.

(d) "General assistance medical program" means the department's program to provide for medical assistance established by section 55 of Act No. 280 of the Public Acts of 1939, as amended, being S400.55 of the Michigan Compiled Laws.

(e) "Hysterectomy" means a medical procedure or operation for the purpose of removing the uterus.

(f) "Medical assistance program" means the department's program to provide for medical assistance established by section 105 of Act No. 280 of the Public Acts of 1939, as amended, being S400.105 of the Michigan Compiled Laws, and title 19 of the federal social security act, 42 U.S.C. S1396 et seq.

(g) "Provider" means an individual, firm, corporation, association, agency, institution, or other legal entity which has been approved to provide medical assistance to a recipient pursuant to the medical assistance program or the general assistance medical program.

(h) "Recipient" means an individual eligible to receive medical assistance through the department.

(i) "Sterilization" means any medical procedure, treatment, or operation that is performed for the purpose of rendering an individual permanently incapable of reproducing.

(j) "Sterilization consent form" means the form approved and required by the United States department of health and human services and used by the department in the medical assistance program and the general assistance medical program to obtain the recipient's informed consent to sterilization.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7702 Recipients excluded from sterilization {#sec-r-400.7702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7702}

Rule 2. A provider shall not be reimbursed for a sterilization procedure that is performed on a recipient in any of the following situations:

(a) Where the recipient has been declared mentally incompetent by a federal, state, or local court.

(b) Where the recipient is institutionalized in a corrective, penal, mental, or rehabilitative facility.

History

History: 1980 AACS.

Rule 3. (1) A provider shall obtain an informed consent to the sterilization procedure from the recipient and shall complete a sterilization consent form.

(2) The sterilization consent form shall be signed by the recipient to be sterilized, the person who obtained the recipient's consent, and the interpreter, if appropriate, not less than 30, nor more than 180, days before the sterilization procedure, except if a premature delivery or emergency abdominal surgery becomes necessary during the required minimum 30-day waiting period before the sterilization procedure. In a case of premature delivery, the recipient shall sign the sterilization consent form not less than 72 hours before the sterilization procedure and not less than 30 days before the expected delivery date. In a case of emergency abdominal surgery, the recipient shall sign the sterilization consent form not less than 72 hours before the sterilization procedure.

(3) At the time that the recipient signs the sterilization consent form, the recipient shall not be less than 21 years old and shall not be in labor, seeking to obtain or obtaining an abortion, or under the influence of alcohol or other substance that affects the recipient's state of awareness.

(4) The provider who obtains the recipient's consent shall comply with all of the following:

(a) Permit the recipient to have a witness of his or her own choice present.

(b) Give the recipient a copy of the sterilization consent form.

(c) Advise the recipient that the sterilization will not be performed in less than 30 days, except as set forth in subrule (2) of this rule.

(d) Offer to answer any questions the recipient may have concerning sterilization.

(e) Advise the recipient that he or she is free to withhold or withdraw consent to the sterilization at any time before the sterilization without affecting the right to future care or treatment and without the loss or withdrawal of any federal or state program benefits to which the recipient might be otherwise entitled.

(f) Describe to the recipient available alternative methods of family planning and birth control.

(g) Advise the recipient that the sterilization procedure is considered to be irreversible.

(h) Give a thorough explanation of the specific sterilization procedure to be performed.

(i) Give a full description of the discomforts and risks that may accompany or follow the performing of the procedure, including an explanation of the type and possible effects of any anesthetic to be used.

(j) Give a full description of the benefits or advantages that may be expected as a result of the sterilization.

(5) If the recipient is deaf, blind, or otherwise handicapped, suitable arrangements shall be made by the provider who obtains the recipient's consent to ensure that the information required by these rules is effectively communicated to the recipient before the recipient signs the sterilization consent form.

(6) If the recipient does not understand the language used on the sterilization consent form or the language used by the person who obtains the recipient's consent, the provider shall ensure that an interpreter is provided before the recipient signs the sterilization consent form.

(7) In addition to the requirements of subrule (4) of this rule and shortly before the sterilization procedure, the provider who performs the sterilization shall explain orally to the recipient the requirements for informed consent set forth in subdivisions (d) to (j) of subrule (4) of this rule.

(8) The provider who performs the sterilization shall sign the sterilization consent form after the sterilization procedure. This signature shall constitute certification that the requirements set forth in these rules have been met.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7704 Hysterectomy requirements {#sec-r-400.7704 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7704}

Rule 4. (1) A provider shall not perform a hysterectomy on a recipient solely for family planning purposes.

(2) A provider shall not perform a hysterectomy on a recipient for family planning purposes if the medical indications present do not, by themselves, mandate a hysterectomy.

(3) The provider who performs the hysterectomy shall sign the acknowledgement of receipt of hysterectomy information form, thereby certifying compliance with this rule.

(4) A provider shall obtain the recipient's or the recipient's representative's signature on the acknowledgement or receipt of hysterectomy information form.

(5) The recipient shall be informed in writing, by means of the acknowledgement of receipt of hysterectomy information form, and orally, by the provider, that a hysterectomy will render her permanently incapable of reproducing.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7705 Billing requirements {#sec-r-400.7705 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7705}

Rule 5. (1) The provider who performs the sterilization or hysterectomy procedure shall include any charge for compliance with these rules in the total charge for the sterilization or hysterectomy.

(2) Each provider, that is, the surgeon, anesthesiologist, or hospital, shall obtain a copy of the fully completed sterilization consent form from the provider who obtained the consent and shall submit it with any claim related to the sterilization procedure.

(3) Each provider, that is, the surgeon, anesthesiologist, or hospital, shall obtain a copy of the fully completed acknowledgement of receipt of hysterectomy information form from the provider who obtained the consent and shall submit it with any claim related to the hysterectomy procedure.

History

History: 1980 AACS.

Mich. Admin. Code R 400.7706 Compliance {#sec-r-400.7706 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.7706}

Rule 6. A provider who fails to submit a claim pursuant to the provisions of these rules shall forfeit the provider's right to payment and shall not seek reimbursement from the recipient.

History

History: 1980 AACS.

Children's Services Agency Children's Services Agency

R 400.9101 to R 400.9506 Foster Family Homes and Foster Family Group Homes

Mich. Admin. Code R 400.9101 Definitions {#sec-r-400.9101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CHILDREN’S SERVICES AGENCY

FOSTER FAMILY HOMES

AND FOSTER FAMILY GROUP HOMES

(By authority conferred on the director of the department of health and human services by sections 2, 5, 10, and 14 of 1973 PA 116, MCL 722.112, 722.115, 722.120, 722.124, and Executive Reorganization Order No. 2015-1, MCL 400.227)

PART 1. GENERAL PROVISIONS

Rule 101. (1) As used in these rules:

(a) "Act" means 1973 PA 116, MCL 722.111 to 722.128.

(b) "Agency" means the child placing agency that certifies the foster home for licensure by the department.

(c) “Corporal punishment” means hitting, paddling, shaking, slapping, spanking, or any other use of physical force as a means of discipline, punishment, or behavior management.

(d) "Department" means the Michigan department of health and human services.

(e)"Foster care" means a child's placement outside the child's parental home by and under the supervision of a child placing agency, the court, or the department. Foster care does not include the delegation of a parent's or guardian's powers regarding care, custody, or property of a child or ward under a properly executed power of attorney under the safe families for children act, 2018 PA 434, MCL 722.1551 to 722.1567.

(f) "Foster child" means a person who meets both of the following criteria:

(i) Resides in an out-of-home placement based on a court order or is temporarily placed by a parent or guardian for a limited time in a foster home as defined by the act or has been released by a parent to the department or a child placing agency pursuant to section 22 of the probate code of 1939, 1939 PA 288, MCL 710.22.

(ii) Is either of the following:

(A) Placed with or committed to the department for care and supervision by a court order under section 2 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2.

(B) Is 18 years of age or older, was in foster care prior to turning 18, and agrees to remain in care following termination of court jurisdiction.

(g) “Foster parent" means the person or persons, including tribal members, to whom a foster home license is issued.

(h) “Gender” or “gender identity” means a person’s internal identification or self-image as a man, boy, woman, girl, or another gender identity.

(i) “Gender expression” means how a person publicly expresses or presents their gender, which may include behavior and outward appearance such as dress, hair, make-up, body language, and voice. Components of gender expression may or may not align with gender identity.

(j) "Infant" means a child between birth and the date of the child’s first birthday.

(k) “Sexual orientation” means a person's identity in relation to the gender or genders to which they are attracted.

(l) “Social services worker” means a person who performs social service functions prescribed by these rules.

(m) “SOGIE” means an individual’s sexual, orientation, gender, identity, and expression.

(2) A term defined in the act has the same meaning when used in these rules.

History

History: 1998-2000 AACS; 2007 AACS; 2011 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9102 Rule variance {#sec-r-400.9102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9102}

Rule 102. (1) The department may grant a variance from an administrative rule if all the following provisions are satisfied:

(a) The agency and the foster parent have reviewed and agreed with the request.

(b) The agency requests the variance, in writing, from the department.

(c) The proposed variance from the rule ensures that the health, care, safety, protection, and supervision of a foster child are maintained.

(2) The decision of the department, including the conditions for which the variance is granted, must be entered upon the records of the department and a signed copy sent to the agency and the foster parent. The variance may be time-limited or may remain in effect as long as the foster parent continues to ensure that the health, care, safety, protection, and supervision of foster children are maintained.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9199 Rescinded {#sec-r-400.9199 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9199}

PART 2. APPLICATION AND LICENSING

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.9201 Foster home applicant /licensee qualifications; central registry check {#sec-r-400.9201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9201}

Rule 201. (1) A foster home applicant or licensee must meet all the following qualifications:

(a) Be 18 years of age or older.

(b) Be willing and can demonstrate the ability to meet the following requirements for children who are served by the agency:

(i) How to provide care.

(ii) Understanding the care needed and the ability to meet those care needs.

(iii) Has adequate time to provide care and supervision.

(iv) Work with a foster child’s current and future family.

(v) Willingness to accept a child’s spirituality, or religious beliefs or practices, even if they are different from the foster parent.

(vi) Willingness to accept and support a child’s SOGIE.

(d) Have the physical, mental, and emotional health to ensure appropriate care of children.

(e) Be of responsible character and be suitable and able to meet the needs of children and provide for their care, supervision, and protection.

(f) Be residing in the United States legally.

(2) In addition to the qualifications in subrule (1), an applicant may also live on a reservation or may be a confirmed member of a federally recognized Indian tribe.

(3) If an applicant is identified on the state central registry as a perpetrator of child abuse or neglect in this state, any other state, a Canadian province, or as part of a tribe, the applicant may not be licensed.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9202 Member of household qualifications; central registry {#sec-r-400.9202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9202}

Rule 202. If an adult member of the household is identified on the central registry as a perpetrator of child abuse or neglect in this state, any other state, a Canadian province, or as part of a tribe, the applicant may not be licensed.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9203 Orientation {#sec-r-400.9203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9203}

Rule 203. Before completing and submitting an application for an original license or transferring a license to another certifying agency, each applicant/licensee for a foster home license must attend orientation pursuant to R 400.12307.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9204 Application submission {#sec-r-400.9204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9204}

Rule 204. (1) A foster home applicant must complete, acknowledge, and submit an application.

(2) In a multiple-caregiver household, all applicants must acknowledge the application.

(3) An agency may consider an application withdrawn after 60 days if the applicant fails to cooperate, after attempts to actively engage the family, with the completion of the licensing process, provided there are no known non-compliances that would result in disciplinary action.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9205 Criminal history; central registry; “good moral character;” convictions {#sec-r-400.9205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9205}

Rule 205. (1) A foster home applicant or licensee must provide the agency with the name of, and a signed release for a criminal history and child protective services check to obtain any of the following information from each adult member of the household, including children who turn 18 years of age while living in the home:

(a) Conviction of a crime other than a minor traffic violation.

(b) Involvement in substantiated abuse or neglect of a child or adult.

(2) If an applicant, licensee, or adult member of the household identifies as a member of a federally recognized Indian tribe or identifies that they have lived on a reservation, the certifying child placing agency must contact the specific tribal jurisdiction, including tribal social services or the tribal court, to determine whether that jurisdiction has relevant background information to provide to the department regarding the licensing approval. The department may proceed with the licensing application process using all other factors for licensing approval of the home if there is no tribal response.

(3) A foster home applicant or licensee must undergo a fingerprint-based, criminal history check.

(4) Any adult member of the household must undergo a state-based criminal history background check and, if applicable, contact with the appropriate jurisdiction as referenced in subrule (2) of this rule.

(5) A license may not be issued or maintained by an applicant or licensee unless the department has made a determination under section 2 of 1974 PA 381, MCL 338.42, regarding the applicant or licensee’s “good moral character” and convictions.

(6) A foster parent must provide the agency with the name of any adult who moves into a licensed foster home within 3 working days, or upon the agency’s request. A release must be signed by the adult to obtain the information required in subrule (1) of this rule.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9206 Foster home evaluation {#sec-r-400.9206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9206}

Rule 206. A foster home applicant/licensee must do all the following:

(a) Allow the agency access to the foster home and any other buildings located on the premises for licensing and foster child supervision purposes.

(b) Provide accurate and truthful information on an ongoing basis regarding the following:

(i) The applicant or licensee’s family and marital status and history, including the current and previous level of family functioning and relationships, and any current and previous incidents of domestic violence, elder abuse, or child abuse, either as a perpetrator or victim.

(ii) The circumstances surrounding any criminal convictions or arrests for each member of the household, including minor children.

(iii) Current or past physical, mental, and emotional health of each member of the household, including substance use,abuse, or treatment.

(iv) Parenting skills and strategies for building healthy relationships with children.

(v) Methods of discipline of children.

(vi) Adjustment and special needs of the applicant’s own children, including children not living in the home.

(vii) Previous licenses or experience in providing child foster care, child day care, or adult foster care.

(viii) Existence of a social support system including alternate care providers.

(ix) Willingness to accept a child’s spirituality, or religious beliefs or practices, even if they are different from the foster parent.

(x) Willingness to accept and support a child’s SOGIE.

(xi) Safety and maintenance of the applicant’s house and property, including, but not limited to, sufficient beds and sleeping space, pets, firearms and other weapons, and water hazards.

(xii) The age, number, SOGIE, race, ethnic background, and special characteristics of children preferred by the applicants, including those characteristics that an applicant or licensee would not accept.

(i) Three current references related or non-related to the applicant/licensee.

(ii) Verification of completed pre-licensure training for each person listed on the license as outlined in R 400.12312(2) and (3).

(iii) A medical statement that includes all treatments, prescriptions, and medications for each member of the household that indicates the member has no known condition which would affect the care of a foster child. The statement must be signed by a physician, physician assistant, or nurse practitioner within the 12-month period preceding the date of the initial evaluation. Any subsequent household member added to the household must provide the medical statement within 90 days.

(iv) Information regarding any past or current mental health treatment by any member of the household.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9207 Rescinded {#sec-r-400.9207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9207}

PART 3. THE FOSTER HOME

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9301 Maintenance {#sec-r-400.9301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9301}

Rule 301. (1) A foster parent shall ensure the home, grounds, and all structure on the grounds of the property are maintained in a clean, safe, and sanitary condition, and in a reasonable state of repair within community standards.

(2) A foster parent shall ensure that all animals are safe to be around members of the household and children who may be placed in the home. Animals must be vaccinated in accordance with the state, tribal, and local laws where the foster home is located.

(3) Children must be supervised during any water activity as appropriate for their age and functioning level.

(4) Swimming pools on the premises must meet all the following:

(a) State, tribal, and local safety requirements.

(b) Availability of rescue equipment at all times.

(d) A swimming pool that cannot be emptied after each use must have a barrier on all sides and access through the barrier must be equipped with a safety device. For more information, access “Safety Barrier Guidelines for Residential Pools” on the U.S.

Consumer Product Safety Commission website.

(5) Spas or hot tubs must have safety covers that are locked when not in use.

(6) There must be an alarm on any exterior door that leads directly to a pond or other body of water, and water rescue equipment must be available at all times.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9302 Heat, light, and ventilation {#sec-r-400.9302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9302}

Rule 302. (1) A foster parent shall ensure that the foster home heat, light, and ventilation is adequate.

(2) A foster parent shall ensure that the foster home windows and doors are screened if used for ventilation. This subrule does not apply to those homes where windows or doors, or both, are not used for ventilation.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9303 Flame and heat-producing equipment; maintenance {#sec-r-400.9303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9303}

Rule 303. (1) A foster parent shall ensure that all the following items are maintained in safe condition:

(a) Furnace.

(b) Water heater.

(d) Pipes.

(e) Radiators.

(f) Wood-burning stoves.

(g) Other flame-producing or heat-producing equipment.

(2) Portable heating devices may not be used in bedrooms.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9304 Smoke detectors; carbon monoxide detectors {#sec-r-400.9304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9304}

Rule 304. (1) A foster parent shall ensure that at least 1 single-station smoke detector that is approved by a nationally recognized testing laboratory is installed and maintained as follows:

(a) On each floor of the home, including the basement.

(b) Between the sleeping area and the rest of the home. In a home that has more than 1 sleeping area, a foster parent shall ensure that a smoke detector is installed and maintained to protect each separate sleeping area.

(2) A foster parent shall ensure that at least 1 carbon monoxide detector that is approved by a nationally recognized testing laboratory is installed and maintained in an area of the home as recommended by the manufacturer.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.9305 Bathrooms; water supply; sewage disposal {#sec-r-400.9305 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9305}

Rule 305. A foster parent shall ensure the foster home has or complies with all the following:

(a) A minimum of 1 flush toilet, 1 sink that has running water, and 1 bathtub or shower that has running water, all of which must be in working order.

(b) The temperature of water available from outlets accessible to a foster child may not exceed 120 degrees Fahrenheit.

(c) The foster home has bathroom facilities that are readily accessible to the foster child who regularly requires the use of a wheelchair, walker, or any other durable medical equipment.

(d) The foster home water supply is from a source that is approved for a private home by the health authority.

(e) All sewage is disposed of through a public system or, in the absence of a public system, in a manner that is approved for a private home by the health authority.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9306 Bedrooms {#sec-r-400.9306 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9306}

Rule 306. (1) A foster parent shall ensure that bedrooms comply with all the following provisions:

(a) Provide an adequate opportunity for both rest and privacy and access to adult supervision as appropriate for the age and functioning level of each child. The use of video cameras in a bedroom of any foster child over the age of 2 is strictly prohibited.

(b) Have sufficient space for all the following:

(i) Occupants.

(ii) Beds with adequate head clearance for each child.

(iii) Space to store clothing and personal belongings.

(iv) A clear path to the bed, belongings, and the door.

(c) Have floor-to-ceiling permanently affixed walls, and painted or sealed surfaces, privacy barriers, and hazard-free flooring.

(d) Have a latchable door that leads directly to a means of egress. As used in this rule, latchable means that the door can be closed and will remain closed until someone opens it.

Latchable does not mean lockable.

(e) Have at least 1 outside window that complies with all the following:

(i) Is accessible to the room’s occupant or occupants.

(ii) Can be readily opened from the inside of the room.

(iii) Is of sufficient size and design to allow for the evacuation of the room’s occupant or occupants.

(f) If a family member occupies or uses a level of a home that is above the second floor, then the building must have 2 exits to ground level, at least 1 of which must provide a direct means of egress to the outside at ground level.

(g) The bedroom must be free from of all the following:

(i) Furnace.

(ii) Water heater.

(iii) Portable heating devices.

(2) A room that is primarily used for purposes other than sleeping may not be used as a bedroom, and includes the following:

(a) A hall.

(b) A closet.

(d) A garage.

(e) A shed.

(f) A detached building.

(g) A room or space, including an attic, that is accessible only by a ladder, folding stairway, or through a trapdoor.

(h) A common area of the home.

(3) A foster parent shall ensure that bedding and sleeping equipment comply with all following:

(a) The standards set forth in the U.S. Consumer Product Safety Commission, Safety Standards for Full Size Baby Cribs and Non-Full Size Baby Cribs; Final Rule, 16 CFR parts 1219, 1220, and 1500, (http://www.cpsc.gov) for the age of the child using the equipment.

(b) Pillows, linens, and mattresses must be clean, safe, age appropriate, and in good repair.

(c) Infants, birth to 12 months of age, must rest or sleep alone only in a crib, bassinet, or Pack ‘n Play, based on the age, size, and needs of the infant.

(d) A foster parent must follow the department’s safe sleep practices located at www.michigan.gov/dhhs.

(e) Objects may not be placed or draped over a crib, bassinet, or Pack ‘n Play, and an infant’s head may not be covered during sleep.

(f) The foster parent must have the appropriate sleeping equipment available in the home prior to licensure or a change in terms for all children who will be covered under the terms of the license.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9307 Rescinded {#sec-r-400.9307 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9307}

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9308 Telephone {#sec-r-400.9308 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9308}

Rule 308. (1) A foster parent shall ensure that a working telephone is available in the foster home or in close walking proximity to the foster home.

(2) A foster parent shall ensure that emergency telephone numbers, including Poison Control, are posted in a prominent place in the home.

(3) The foster parent must provide the telephone number to the certifying agency and inform the agency within 24 hours if the number changes.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9309 Wheelchair access; other durable medical equipment {#sec-r-400.9309 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9309}

Rule 309. A foster parent shall ensure that a foster home that provides care to a foster child who regularly requires the use of a wheelchair, a walker, or any other durable medical equipment, is accessible.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9310 Smoking {#sec-r-400.9310 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9310}

Rule 310. (1) An individual may not smoke any substance inside the foster home while foster children are placed in the home.

(2) An individual may not smoke any substance inside a vehicle while transporting foster children.

PART 4. FOSTER CARE

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9401 Child capacity; living arrangement {#sec-r-400.9401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9401}

Rule 401. (1) Both of the following apply to the capacity of a foster home:

(a) Not more than 8 children under 17 years of age, including children of the foster parents, may live in or receive foster care in a foster home at any given time.

(b) If a foster home is concurrently licensed for childcare, the total number of children under 17 years of age, including children of the foster parents, who live in or receive care in the foster home, may not exceed 12. The foster home must comply with all applicable licensing rules for both foster homes and childcare homes.

(2) All children in the home must be treated equitably, meaning each child has similar sleeping arrangements as other household members.

(3) Foster parent or parents must designate sleeping arrangements that are appropriate for each child’s age, SOGIE, medical and mental health needs, behavior, and history of abuse.

(4) A child who is non-ambulatory and cannot readily be carried by 1 member of the household must sleep in a bedroom that has a means of exiting at ground level.

(5) A child may not share a bedroom with a non-parent adult unless 1 of the following conditions exists:

(a) The child and adult are siblings.

(b) The child and adult are foster siblings who were sharing the bedroom prior to 1 of them turning 18 years of age.

(6) Each child must sleep alone or may share a bed with a sibling in a bed based on the functioning level, size, and other special needs of the child.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9402 Child placement {#sec-r-400.9402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9402}

Rule 402. A foster parent shall receive a foster child for care only within the approved placement specifications and the terms of the foster home license. Placement of a foster child must only be received from the agency that certified the home or from another agency with the prior approval of the agency that certified the home.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9403 Foster parent duties {#sec-r-400.9403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9403}

Rule 403. A foster parent shall carry out each of the following functions:

(a) Cooperate with and assist the agency in the agency's implementation of the service plan for children and their families.

(b) Fully disclose to the agency information concerning a foster child's progress, strengths, and needs.

(c) Provide written notification to the agency of the need for a foster child to be moved from the foster home not less than 14 calendar days before the move, except when a delay would jeopardize the foster child's care or safety or the safety of members of the foster family.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9404 Behavior management {#sec-r-400.9404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9404}

Rule 404. (1) A foster parent must follow the behavioral support plan developed for each foster child by the child's social services worker.

(2) A foster parent may use reasonable methods of physical intervention to prevent a foster child from harming himself or herself or other persons.

(3) A foster parent may not physically discipline or use corporal punishment for any reason with a foster child and will intervene with a child in ways that are traumaresponsive, positive, and consistent, and are based on each foster child’s needs, stage of development, and behavior. Children must always be treated with dignity, sensitivity, compassion, and respect.

(4) All the following are prohibited:

(a) Corporal punishment, any type of restraint, or any kind of punishment inflicted on the body.

(b) Confinement in an area such as a closet or locked room.

(d) Mental or emotional cruelty.

(e) Verbal abuse, including the use of derogatory or discriminatory language, including negative references to the child’s SOGIE, yelling at youth, threats, ridicule, or humiliation.

(f) Prohibiting visits or communication with a foster child’s family.

(g) Denial of necessary educational, medical, counseling, or social work services.

History

History: 1998-2000 AACS; 2011 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9405 Religion and spirituality {#sec-r-400.9405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9405}

Rule 405. (1) An agency’s religion policy must, at a minimum, ensure that the foster child has the opportunity to receive religious instruction and may participate or choose not to participate in religious or spiritual instruction, engage or choose not to engage in religious or spiritual practices, or attend or choose not to attend religious or spiritual services.

(2) A foster child may not be required to attend religious or spiritual services or follow specific religious or spiritual doctrine.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9406 Communication {#sec-r-400.9406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9406}

Rule 406. A foster parent must comply with the agency's communication policy and ensure that a child is able to communicate with family and friends in a manner consistent with the child’s expressed wishes, appropriate to the child’s functioning, and in accordance with the child’s treatment plan.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9407 Education {#sec-r-400.9407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9407}

Rule 407. (1) Within 5 school days of placement, an agency must provide for the enrollment of each child of school age, as defined by state law, into a school program.

(2) A foster parent must cooperate with the agency to implement the education or training plan for a foster child to ensure that a school age child attends school or a training program and will participate with the school or the training program in education planning.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9408 Personal possessions {#sec-r-400.9408 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9408}

Rule 408. A foster parent shall comply with all the following:

(a) Ensure that a child has his or her personal possessions during placement with the foster family and has them returned when leaving the foster family.

(b) Safely store a child’s personal possessions.

(c) All gifts and clothing that are purchased for the child during placement with the foster family remain the property of the foster child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9409 Allowance and money {#sec-r-400.9409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9409}

Rule 409. (1) A foster parent must apply both of the following regarding a child’s allowance and money:

(a) General guidelines that provide a monetary range based on a child’s age.

(b) Allowance for specific youth will be determined by the social services worker and the foster parent based on the child’s age and treatment needs.

(2) Any money earned or received directly by the child remains the property of the child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9410 Clothing {#sec-r-400.9410 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9410}

Rule 410. (1) A foster parent must ensure that a foster child has the minimum required clothing specified by the agency’s policy and leaves the foster home with not less than the minimum required clothing.

(2) All clothing the child has when he or she arrives at the foster home and all clothing purchased for the child while in the foster home remains the property of the foster child, unless returned to the biological parent or parents.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9411 Emergencies {#sec-r-400.9411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9411}

Rule 411. (1) A foster parent must have a written emergency evacuation plan displayed in a prominent place in the home.

(2) A foster parent must familiarize each member of the household, including the foster child according to the child's ability to understand and persons who provide care and supervision, with the emergency and evacuation procedures.

(3) A foster parent must maintain first aid supplies in the home.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9412 Medical and dental care {#sec-r-400.9412 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9412}

Rule 412. (1) A foster parent shall follow the health plan for a foster child as prescribed by a physician, health authority, or the agency.

(2) A foster parent shall follow agency approved protocols for medical care of a foster child who is injured or ill.

(3) A foster parent shall ensure that all medications, both prescription and nonprescription, are properly stored and are accessible as appropriate for the age and functioning level of the child.

(4) A foster parent shall ensure that prescription medication is given or applied as directed by a licensed physician.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9413 Supervision {#sec-r-400.9413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9413}

Rule 413. (1) A foster parent shall always ensure an appropriate level of care and supervision for the foster child, consistent with a child’s age, level of functioning, and treatment plan.

(2) A foster parent shall identify at least1 adult who would care for the foster child for an extended overnight period. The identified adult must have both a central registry and a criminal history background check.

(3) A foster parent must notify the agency of any extended, overnight period when a foster child will be out of the home for a period exceeding 3 days.

(4) A foster parent must notify any foster child’s care provider of the agency’s policies relating to care and supervision and the care provider must follow the policies.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9414 Unusual incident notification {#sec-r-400.9414 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9414}

Rule 414. (1) A foster parent must immediately notify the agency regarding any of the following:

(a) The death of a foster child.

(b) The removal or attempted removal of a foster child from a foster home by any person not authorized by the agency.

(d) Any illness or serious injury that results in inpatient hospitalization of a foster child.

(2) A foster parent must notify the agency within 24 hours after the foster parent knows of any of the following:

(a) Any injury of a foster child that requires medical treatment by a licensed or registered health care person.

(b) A foster child's involvement with law enforcement authorities.

(d) Incidences of child-on-child abuse.

(e) Involvement with law enforcement by anyone in the home pursuant to a criminal investigation.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9415 Hazardous materials {#sec-r-400.9415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9415}

Rule 415. (1) Federal standards for a foster family or group home include specific safety requirements for weapons, pools, hot tubs, and spas, as these pose a particular preventable danger to children.

(2) Dangerous equipment and objects, weapons, chemicals, medications, poisonous materials, cleaning supplies, and other hazardous materials that may present a risk to children placed in the foster home must be stored securely and out of the reach of children, as appropriate for the age and functioning level of the children.

(3) Unless carried in the licensed home and on the licensed property as permitted by law, firearms and ammunition must be stored as follows:

(a) Firearms must be all the following:

(i) Locked in compliance with 1 of the following:

(A) By a cable-lock.

(B) By a trigger-lock.

(D) A solid metal gun case.

(E) A solid wood gun case.

(ii) Unloaded.

(iii) Separate from ammunition; however, as long as the firearm is stored in compliance with paragraph (i)(C) to (E) of this subdivision, the ammunition may be stored together with the firearm in the same locked safe or case.

(iv) Inaccessible to children.

(b) Ammunition must be stored in a locked location and inaccessible to children.

(c) All applicable laws regarding the possession, use, transportation, and storage of firearms and ammunition, including for hunting, still apply.

(d) Licensees with a CPL may possess a firearm pursuant to the law in a vehicle on the licensed property, provided it is done so in such a manner to prevent foster children from having access to it, such as being on the licensee’s person or stored in a locked container.

(e) Licensees may engage in hunting, range shooting, and target practice with a foster child in accordance with the reasonable and prudent parenting standard as defined in section 1 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.1.

History

History: 1998-2000 AACS; 2014 AACS; 2019 AACS; 2023 AACS.

Mich. Admin. Code R 400.9416 Foster parent training {#sec-r-400.9416 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9416}

Rule 416. (1) Each licensed foster parent must attend training as required by the agency’s foster parent training plan, totaling to at least 6 hours per year.

(2) At least 1 adult member of the household must have training in and maintain a current certification in first aid and cardiopulmonary resuscitation from the American Heart Association or the American Red Cross, or other institution approved by the department.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9417 Food and nutrition {#sec-r-400.9417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9417}

Rule 417. (1) A foster parent shall provide a foster child with meals that are nutritious, well-balanced, and of sufficient quantity.

(2) A foster parent must allow the foster child to eat with other members of the family and serve a foster child the same meals as other members of the household, unless a special diet has been prescribed by a licensed physician or unless otherwise dictated by differing nutritional requirements related to the child's age, medical condition, or religious beliefs.

(3) A foster parent shall ensure that refrigeration is used for perishable foods.

(4) If milk is being provided to foster children, a foster parent only serves pasteurized milk products to foster children.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9418 Foster child tasks {#sec-r-400.9418 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9418}

Rule 418. A foster child's tasks must be within the child's ability, be reasonable, and be similar to routine tasks expected of other members of the household of similar age and ability.

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.9419 Recreation {#sec-r-400.9419 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9419}

Rule 419. A foster parent must provide opportunities for, and encourage a foster child to participate in, a variety of indoor and outdoor recreational activities that are appropriate for the child's age and ability.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9420 Transportation {#sec-r-400.9420 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9420}

Rule 420. (1) All transportation must be done in a safe, responsible manner.

(2) A foster parent shall ensure that the transportation of the foster child, foster parents, and members of the household is conducted as required by state laws regarding transportation in a motor vehicle.

PART 5. REPORTING AND RECORDKEEPING

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9501 Reporting suspected child abuse or neglect {#sec-r-400.9501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9501}

Rule 501. (1) A foster parent who has reasonable cause to suspect abuse or neglect of a child must make a report immediately to the child protective services central intake unit of the department of health and human services.

(2) If the suspected abuse or neglect occurred in the foster home or to a foster child placed in the foster home, then a foster parent must make a report immediately to both of the following entities:

(a) The child protective services central intake unit of the department.

(b) The agency.

(3) The foster parent shall provide a written report as required by section 3 of the child protection law, 1975 PA 238, MCL 722.623.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9502 Reporting foster home changes {#sec-r-400.9502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9502}

Rule 502. A foster parent shall report to the agency any significant changes in the foster home by the next business day from the time a foster parent knows of a change, including any of the following:

(a) Serious illness, injury, or death of a foster parent.

(b) Changes in household composition.

(d) Court-supervised parole or probation of a foster parent or member of the household.

(e) Admission to, or release from, a correctional facility, a hospital, or an institution for the treatment of an emotional, mental, or substance abuse problem of a foster parent or member of the household.

(f) Assessment, treatment, or therapy on an outpatient basis for an emotional, mental, or substance abuse disorder of a foster parent or member of the household.

(g) Any revocation or modification of a driver's license.

(h) Any major changes or renovations to the structure of the foster home.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9503 License application filing; agency notification {#sec-r-400.9503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9503}

Rule 503. (1) A foster parent shall notify the agency within 5 calendar days after filing an application for an adult foster care family home license, a family child care home certificate of registration, or a group child care home license.

(2) If the foster home is licensed concurrently as an adult foster care family home or a child care group home or registered as a family child care home, the foster parent must notify the agency if there is a change in the terms of the adult foster care or child care license or registration.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.9504 Change of residence; agency notification {#sec-r-400.9504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9504}

Rule 504. A foster parent shall inform the agency of any change of residence and submit an application for licensure at the new address not less than 4 weeks before a move.

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.9505 Confidentiality {#sec-r-400.9505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9505}

Rule 505. (1) A foster parent shall keep information and records obtained by the foster parent regarding a foster child and a foster child's parents and relatives confidential under section 10(3) of the act, MCL 722.120.

(2) The requirements in subrule (1) of this rule may not prohibit a foster parent from communicating with any person representing the foster parent in an administrative or judicial proceeding involving the foster parent in licensing, Central Registry expunction, or any civil matter.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.9506 Record management {#sec-r-400.9506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.9506}

Rule 506. (1) A foster parent shall store and maintain all records received on behalf of the child.

(2) When a foster child moves from the foster home, all records regarding that child must be returned to the agency.

(3) Upon closure of the foster home license, all records provided by the child placing agency must be returned to the agency.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

R 400.10101 to R 400.10639 Juvenile Court Operated Facilities

Mich. Admin. Code R 400.10101 Definitions {#sec-r-400.10101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF CHILD WELFARE LICENSING

CHILDREN’S SERVICES AGENCY

JUVENILE COURT OPERATED FACILITIES

(By authority conferred on the department of health and human services by sections 1 and 14 of the social welfare act, 1939 PA 280, MCL 400.1 and 400.14, and section 2 of 1973 PA 116, MCL 722.112.)

PART 1. GENERAL PROVISIONS

Rule 101. (1) As used in these rules:

(a) “Act” means 1973 PA 116, MCL 722.111 to 722.128, and known as the child care organization licensing act.

(b) "Behavior management" means techniques employed to control behavior in accordance with written policy and procedures related to program expectations, child safety, facility safety, and security.

(c) "Chief administrator" means the person designated as having the day-to-day responsibility for the overall administration of a facility and for assuring the care, safety, and protection of residents.

(d) "Counseling" means planned opportunities for residents to express their feelings verbally with the goal of resolving individual problems. Counseling may be in a one-toone relationship or in a small or large group.

(e) "Department" means the Michigan department of health and human services.

(f) "Detention" means the temporary residential care of a juvenile who requires custody in a physically restricting facility pending court action or other placement.

(g)"Direct care worker" means a person who has assigned child care responsibilities and provides direct care and supervision of children in a facility.

(h) "Discipline" means action taken for the sake of training or correction and may include punishment.

(i) "Employee" means a staff person who is under contract of hire on a full-time or a parttime basis at a juvenile facility.

(j) "Human services degree or field" means a major in a curriculum that is designed to give students an understanding of human behavior and to teach them appropriate intervention/problem-solving skills on behalf of selected populations.

(k) "Inspection" means the on-site review of a juvenile facility by the department to determine compliance with these administrative rules for a juvenile facility.

(l) "Juvenile facility," hereinafter referred to as "facility" means a program operated by a juvenile court and providing residential care as provided in the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.

(m) "Medication" means prescription and nonprescription medicines.

(n) "Parent" means a biological parent, adoptive parent, or guardian.

(o) "Physical examination" means a thorough evaluation of a patient's current physical condition and a medical history conducted by, or under the supervision of, a licensed medical professional.

(p) "Policy" means a definitive, stated course or method of action that guides and determines present and future decisions and activities. A policy is a written statement of principles that guides the facility in the attainment of objectives. To comply with a rule that requires a policy, there must be evidence that a line of action or principle has been adopted and is being followed by the facility.

(q) "Protection" means the continual responsibility of the facility to take reasonable action to insure the health, safety, and well-being of a resident while under the supervision of the facility or an agent or employee of the facility and includes protection from physical harm, humiliation, intimidation, and social, moral, financial, and personal exploitation while on the premises.

(r) "Rated capacity" means the actual number of beds that are available and approved by the department for use. This does not include hospital beds, segregation beds, or other spaces used only on a temporary basis.

(s) "Resident" means a child who is admitted to and resides in a facility.

(t) "Resident confinement room" means a locked or unlocked room or area that is approved by the licensing authority for the seclusion or retention of a resident.

(u) "Residential treatment facility" means a facility that has established a goal-oriented intervention program to provide post-dispositional residential care.

(v) "Resident record" means the individual file kept by a facility concerning a child who has been placed at the facility.

(w) "Resident restraint" means the use of material, mechanical, medical, or physical techniques for restricting a resident's behavior or movement.

(x) "Secure facility" means a facility, or portion thereof, other than a resident confinement room, that is used to retain residents in custody. Outside doors usually have locks that prevent egress from the building.

(y) "Shelter care facility" means a facility that provides care for residents pending court action or other placement planning.

(z) "Social service supervisor" means a person who supervises a social service worker.

(aa) "Social worker" means a person who works directly with residents, their families, and other relevant individuals and who is primarily responsible for the development, implementation, and review of service plans for the resident. This definition shall not be interpreted to prevent a team approach to service plan development and implementation.

(bb) "Training" means any of the following:

(i) Formal classroom instruction.

(ii) Recognized courses provided through other means.

(iii) On-the-job training under the direction of an instructor.

(iv) Meetings or conferences that include agendas and instruction by instructors.

(v) Other instructional programs that include a trainer-trainee relationship.

(cc) "Volunteer" means a person who donates his or her time in activities at a juvenile facility.

(2) A term defined in the act has the same meaning when used in these rules.

History

History: 1992 AACS; 2020 AACS.

Mich. Admin. Code R 400.10103 Program statement {#sec-r-400.10103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10103}

Rule 103. (1) A facility shall have a current written program statement which specifically addresses all of the following:

(a) Purpose and function, including the types of children to be admitted for care.

(b) The services provided to residents and parents directly by the facility and the services to be provided by outside resources.

(2) A program statement shall be available to residents, parents, and referral sources.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10105 Financing plan {#sec-r-400.10105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10105}

Rule 105. A facility shall annually develop a plan of financing to carry out the facility's programs. The plan shall include projected income and expenditures.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10106 Rule variance {#sec-r-400.10106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10106}

Rule 106. (1) Upon written request from a juvenile facility, the department may grant a variance from an administrative rule if the facility demonstrates, through clear and convincing facts, that the alternative proposed will provide equivalent protection to the health, welfare, safety, and needed services of children.

(2) The decision of the department, including the conditions upon which the variance is granted, shall be entered upon the records of the department and a signed copy shall be sent to the facility. This variance may remain in effect for as long as the facility continues to comply with the intent of the rule or may be time-limited.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10107 Employment policies and procedures; establishment {#sec-r-400.10107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10107}

Rule 107. A facility shall establish and follow written employment policies and procedures that shall assure that staff are emotionally stable and of suitable health, ability, experience, and education to perform the duties assigned.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10109 Job description {#sec-r-400.10109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10109}

Rule 109. There shall be a job description for each staff position which prescribes duties, required qualifications, and lines of authority.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10111 Employees; qualifications {#sec-r-400.10111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10111}

Rule 111. An employee who is in a position and who was approved pursuant to the provisions of R 400.71 et seq. is deemed to be qualified for that position at that facility or in an identical position at any other facility governed by these rules. A person who is appointed to a position after these rules become effective shall meet the qualifications of these rules for that position.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10113 Employee records {#sec-r-400.10113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10113}

Rule 113. Employee records shall be maintained for each employee and shall include all of the following information:

(a) Name.

(b) Verification of education where minimum education requirements are specified by rule.

(d) Three references which are obtained before employment from persons unrelated to the employee.

(e) A record of any convictions other than minor traffic violations.

(f) A written evaluation of the employee's performance within the first 6 months of each position designated by these rules and annually thereafter.

(g) Verification of freedom from communicable disease at the time of employment.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10115 Tuberculosis screening for employees and volunteers {#sec-r-400.10115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10115}

Rule 115. A facility shall document that each employee and each volunteer who has contact with residents 4 or more hours per week for more than 2 consecutive weeks is free from communicable tuberculosis. Freedom from communicable tuberculosis shall be verified within the 3-year period before employment and shall be verified every 3 years after the last verification.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10117 Chief administrator; qualifications {#sec-r-400.10117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10117}

Rule 117. A chief administrator, at the time of appointment, shall possess either of the following:

(a) A master's degree in any of the following areas and 1 year of supervisory experience in a facility, a child caring institution, a child placing agency, or a criminal justice agency:

(i) Social work.

(ii) Sociology.

(iii) Psychology.

(iv) Guidance and counseling.

(v) Criminal justice.

(vi) Other human services field.

(vii) Education.

(viii) Business administration.

(ix) Public administration.

(b) A bachelor's degree with a major in any of the following areas and 2 years of supervisory experience in a facility, a child caring institution, a child placing agency, or a criminal justice agency:

(i) Social work.

(ii) Sociology.

(iii) Psychology.

(iv) Criminal justice.

(v) Guidance and counseling.

(vi) Other human services field.

(vii) Education.

(viii) Business administration.

(ix) Public administration.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10119 Supervisor of direct care workers; qualifications {#sec-r-400.10119 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10119}

Rule 119. A supervisor of direct care workers shall possess either of the following:

(a) A bachelor's degree in human services with 1 year of work experience in a facility, child caring institution, or a criminal justice agency.

(b) Two years of college in a human services field, with 2 years of work experience in a facility, a child caring institution, a child placing agency, or a criminal justice agency.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10121 Direct care worker; qualifications {#sec-r-400.10121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10121}

Rule 121. (1) A direct care worker shall have completed 30 semester hours of college or equivalent quarter hours.

(2) In place of meeting the requirement specified in subrule (1) of this rule, a direct care worker shall have a minimum of a high school diploma or its equivalent and 2 years of work experience in a facility or child caring institution.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10123 Staff sufficiency {#sec-r-400.10123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10123}

Rule 123. (1) A facility shall have a staffing pattern of administrative, supervisory, direct care, and other staff sufficient to perform the prescribed functions required by these administrative rules and to provide for the needs, protection, and supervision of the residents.

(2) A facility shall maintain a staffing ratio of at least 1 direct care worker or supervisory staff for 8 residents at all times when the residents are present and awake. During normal sleeping hours, there shall be a staffing ratio of at least 1 direct care worker or supervisory staff for 20 residents. These staff shall be awake, on duty, available within the facility, and have immediate access to the residents.

(3) A facility shall have a designated employee in charge on the premises at all times.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10125 Initial staff orientation and ongoing staff training {#sec-r-400.10125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10125}

Rule 125. (1) A facility shall provide an orientation program for all direct care workers.

(2) A facility shall document that each direct care worker participated in 40 hours of planned orientation preceding independent assignment to direct care functions. The orientation shall include the following:

(a) The facility's purpose, policies, and procedures, including those related to discipline, crisis intervention, emergency, and safety.

(b) The role of the staff members in service delivery and the protection of the residents.

(3) In addition to the orientation training, a facility shall document that each direct care worker received 24 clock hours of planned training annually.

(4) A facility shall establish and follow a written plan of ongoing staff training related to the facility's function, which shall include all of the following areas:

(a) Developmental needs of children.

(b) Child management techniques.

(d) Appropriate discipline, crisis intervention, deescalation techniques, and child handling techniques.

(e) The direct care worker's and the social service worker's roles in the facility.

(f) Interpersonal communication.

(g) Proper and safe methods and techniques of restraint.

(h) First aid and cardiopulmonary resuscitation training.

(i) Suicide prevention.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10127 Compliance with child protection law; development of plan required {#sec-r-400.10127 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10127}

Rule 127. A facility shall develop and implement a written plan to assure compliance with the provisions of Act No. 238 of the Public Acts of 1975, as amended, being S722.621 et seq. of the Michigan Compiled Laws, and known as the child protection law.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10129 Privacy and confidentiality {#sec-r-400.10129 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10129}

Rule 129. A facility shall provide for resident and parent privacy and confidentiality and shall protect residents from exploitation.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10131 Resident correspondence {#sec-r-400.10131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10131}

Rule 131. (1) A facility shall establish and follow written policy and procedure granting residents the right to correspond with persons or organizations, subject only to the limitation necessary to maintain facility order and security.

(2) The written policy and procedure shall permit residents to send sealed letters to any of the following entities:

(a) Courts.

(b) Counsel.

(d) Administrators of grievance systems.

(e) Members of the releasing authority.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10133 Resident visitation {#sec-r-400.10133 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10133}

Rule 133. (1) A facility shall establish and follow written visitation policy and procedures.

The policy shall provide for visits at least weekly between each resident and the resident's parents, except where parental rights have been terminated or the resident's record contains documentation that visitation is detrimental to the resident.

(2) The policy shall specify that visitors must register upon entry and shall indicate the circumstances under which visitors are searched.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10135 Religion policy {#sec-r-400.10135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10135}

Rule 135. A facility shall establish and follow written policy and procedures that permit residents to participate in religious services and religious counseling on a voluntary basis, subject only to limitations necessary to maintain order and security.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10137 Grievance procedure {#sec-r-400.10137 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10137}

Rule 137. (1) A facility shall have and follow a written grievance procedure.

(2) The grievance procedure shall be explained and made available to residents and their parents.

(3) The grievance procedure shall allow for the progression of a grievance to at least 1 level beyond the supervisor of the direct care worker.

(4) In place of meeting the requirement specified in subrule (3) of this rule, a grievance shall progressively extend to at least the level of the chief administrator.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10139 Resident records; admission information {#sec-r-400.10139 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10139}

Rule 139. Upon admission to a juvenile facility, the facility shall obtain all of the following information for each child:

(a) Date and time of admission.

(b) Name.

(d) Name, title, and signature of delivering person.

(e) Specific charge or charges.

(f) Sex.

(g) Date of birth; age.

(h) Race or nationality.

(i) Last school attended and current educational status.

(j) Religion.

(k) Medical consent authorization or the instructions for obtaining immediate medical consent authorization.

(l) Name, relationship, address, and phone number of a parent or parents, a guardian or guardians, or a person or persons with whom the child resided at the time of admission.

(m) Health status, including notation of any of the following:

(i) Bruises.

(ii) Open wounds or sores that require treatment.

(iii) Evidence of disease, body vermin, or tattoos.

(n) Name of the person who records the health status information required by subdivision (m) of this rule.

(o) An inventory of property.

(p) Name, address, and phone number of emergency contacts.

(q) Name and title of the person who prepares the admission information.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10141 Resident records; maintenance {#sec-r-400.10141 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10141}

Rule 141. (1) Written information shall be maintained for each resident, shall be kept in a secure place, and shall include, at a minimum, the following information:

(a) Admission forms.

(b) Documented legal authority to accept resident.

(d) A record of cash and valuables held.

(e) Notations of temporary absences from the facility, if any.

(f) Probation officer or caseworker assigned.

(g) Progress reports on program involvement.

(h) Program rules and disciplinary policy signed by resident.

(i) Grievance and disciplinary record, if any.

(j) Final release information.

(2) Responsible staff members shall make all entries into the records of youth assigned to them and shall date and sign each entry.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10143 Daily population list {#sec-r-400.10143 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10143}

Rule 143. A facility shall maintain a daily up-to-date single master population list that identifies all residents who are housed in the facility.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10145 Admission; policy and procedure {#sec-r-400.10145 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10145}

Rule 145. (1) A facility shall establish and follow written policy and procedure which governs the reception and orientation of newly admitted residents.

(2) Each child brought into the intake process shall be informed of the steps in the process at the initiation of intake.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10147 Personal possessions {#sec-r-400.10147 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10147}

Rule 147. A facility shall establish and follow written policy and procedure requiring that a written, itemized list is made of all personal property in the possession of a newly admitted resident. A copy of this list, which notes all property that will be held until release, shall be signed by the resident and signed again when the resident is released. The resident's signature at the time of his or her release certifies that the resident has received all of his or her personal property.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10149 Programs and services {#sec-r-400.10149 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10149}

Rule 149. (1) Programs and services shall be initiated for all residents as soon as they are admitted to living units.

(2) A facility shall provide or make available the following minimum programs and services to residents:

(a) An education program.

(b) Provisions for visiting with parents and guardians.

(d) Continuous supervision of living units.

(e) Medical services.

(f) Food services.

(g) Recreation and exercise.

(h) Reading materials.

(3) A resident shall be provided with activities and services outside of his or her room not less than 14 hours each day, except when the resident is confined for purposes of discipline or behavior management as stipulated in R 400.10171.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10151 Education {#sec-r-400.10151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10151}

Rule 151. (1) A facility shall assure that an appropriate education program is provided to residents in accordance with the provisions of Act No. 451 of the Public Acts of 1976, as amended, being S380.1 et seq. of the Michigan Compiled Laws, and known as the school code of 1976, not later than 5 calendar days after admission and continuously thereafter for each resident of school age or otherwise available for special education.

(2) A facility shall provide, or arrange for the provision of, an educational program through either of the following means:

(a) Employ staff and operate a private school in accordance with the provisions of Act No. 302 of the Public Acts of 1921, as amended, being S388.551 et seq. of the Michigan Compiled Laws.

(b) Contract or arrange with a local or intermediate school district to operate an on-site school program or provide education elsewhere.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10153 Resident work experience {#sec-r-400.10153 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10153}

Rule 153. Work experiences for a resident shall be appropriate for the age, health, and abilities of the resident.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10155 Recreational activities {#sec-r-400.10155 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10155}

Rule 155. (1) Written policy and procedure shall provide a recreation and leisure time plan that includes at least 1 hour per day of large muscle activity and 1 hour of leisure time activities.

(2) Residents shall have access to recreational opportunities and equipment, including, when the weather permits, outdoor exercise.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10157 Health services; policies and procedures {#sec-r-400.10157 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10157}

Rule 157. (1) A facility shall establish and follow written health service policies and procedures that address all of the following:

(a) Routine and emergency medical and dental care.

(b) Health screening procedures.

(d) Storage of medications.

(e) Dispensing medication.

(f) Personnel authorized to dispense medications.

(2) Prescription medication shall be kept in the original pharmacy-labeled container, stored in a locked area, and refrigerated if required.

(3) Medical treatment, including the prescribing of medications, shall be under the supervision of a licensed physician.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10159 Reporting hospitalization or death of resident {#sec-r-400.10159 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10159}

Rule 159. (1) Any serious injury or illness that requires the hospitalization of a resident shall be reported to the parent and responsible referring agency as soon as possible, but not more than 24 hours after hospitalization.

(2) The death of a resident shall be reported immediately to all of the following entities:

(a) The parents or next of kin.

(b) The department.

(d) Law enforcement officials.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10161 Clothing {#sec-r-400.10161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10161}

Rule 161. Each resident shall have sufficient, clean, properly fitting, seasonally appropriate clothing.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10163 Personal hygiene {#sec-r-400.10163 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10163}

Rule 163. A facility shall arrange for each resident to maintain or receive personal care, hygiene, and grooming appropriate for the resident's age, sex, race, cultural background, and health needs.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10165 Resident nutrition {#sec-r-400.10165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10165}

Rule 165. (1) A facility shall provide a minimum of 3 nutritious meals daily, unless medically contraindicated and documented.

(2) Special diets shall be prescribed only by a physician. A resident who has been prescribed a special diet by a physician shall be provided such diet.

(3) Menus shall be written before a meal is served. Any change or substitution to the menu shall be noted and considered as part of the original menu.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10167 Emergency procedures; firearms {#sec-r-400.10167 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10167}

Rule 167. (1) A facility shall have written procedures to be followed in emergency situations, including all of the following situations:

(a) Fire.

(b) Tornado.

(d) A missing person.

(e) The taking of a hostage.

(f) A bomb threat.

(g) A riot.

(h) A power outage.

(2) The written procedures shall designate all of the following:

(a) Who is to implement the emergency procedures.

(b) Which personnel are to be involved.

(3) Written plans shall be developed that govern space arrangements and procedures to be followed in the event of a group arrest that exceeds the rated capacity of the facility.

(4) Firearms are not permitted in the resident living area of the facility. A provision for the temporary, safe, locked storage of such equipment is required.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10169 Discipline {#sec-r-400.10169 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10169}

Rule 169. (1) A facility shall have and follow written policy and procedure which stipulates that residents shall not be subjected to any of the following:

(a) Corporal or cruel punishment.

(b) Humiliation.

(d) Punitive interference with daily physiological functions.

(2) A facility shall have and follow written discipline policy and procedure that specify acts which are prohibited within the facility and penalties that may be imposed for minor misbehavior and major violations.

(a) The policy and procedures shall be posted in a conspicuous place.

(b) A copy shall be given and explained to each resident and staff member.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10171 Resident confinement room; approved usage {#sec-r-400.10171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10171}

Rule 171. A facility approved to use a resident confinement room may place a resident in this room for the following reasons:

(a) For sleep during normal sleeping hours.

(b) For medical reasons.

(d) For confinement during an emergency situation to maintain the safety and security of other residents, staff, and the facility.

(e) For behavior management/confinement when a resident is in danger of harming self or others.

(f) For confinement, when the facility's normal security precautions are inadequate to prevent a resident's escape.

(g) For disciplinary reasons in accordance with the provisions of R 400.10169.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10173 Resident confinement room; construction {#sec-r-400.10173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10173}

Rule 173. (1) A room used for resident confinement shall be approved in writing for use as such by the fire inspection authority and the licensing authority.

(2) A resident confinement room shall be constructed and equipped so as to minimize suicide and fire risk.

(3) A resident confinement room established and approved after the effective date of these rules shall:

(a) Be constructed to allow for both visual and auditory supervision of a resident in the room.

(b) Be equipped with a 2-way audio monitoring device. The device shall be maintained in an operative condition.

(d) Have breakable outside windows covered by security screening.

(e) Have walls and ceilings made of noncombustible materials.

Polyurethane materials shall be prohibited.

(f) Provide adequate lighting.

(g) The area of the resident confinement room shall not be less than 48 square feet.

(4) A resident confinement room may have 1 approved locking-against-egress device on the door if a staff person is available and awake and is in possession of a key for the door locking device when the room is occupied.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10175 Resident confinement room; procedures for use {#sec-r-400.10175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10175}

Rule 175. (1) A facility that uses a resident confinement room shall establish and follow written policies and procedures specifying its use.

(2) The policy shall include the approved reasons for use as specified in R 400.10171.

(3) Not more than 1 resident shall be placed in a resident confinement room at one time when it is used for behavior management or discipline purposes.

(4) When a resident is confined in a resident confinement room, except during normal sleeping hours, for sleeping purposes only, staff shall maintain a record of confinement.

The record shall contain all of the following information:

(a) The name of the resident.

(b) Time of confinement.

(d) A description of the specific behavior that necessitated the confinement.

(5) For each instance in which a resident remains in a resident confinement room for more than 2 hours, except during normal sleeping hours, a record shall be maintained and shall contain documented supervisory approval and the reasons for continued use.

(6) During a resident's confinement, visual observations of the resident shall be made by staff at least every 15 minutes. Each contact shall be logged at the time of the observation.

(7) A review by the chief administrator or a designee who is not involved in the room confinement shall be conducted and logged every 12 hours for each room confinement that is 12 hours or longer in duration.

The review shall determine both of the following:

(a) Whether each room confinement was appropriate and consistent with the facility's policies and procedures.

(b) The action that is necessary to insure the appropriate use of resident confinements.

(8) When a resident is confined in a resident confinement room for sleeping purposes only during normal sleeping hours, a visual observation of the resident shall be made by staff at least every 30 minutes.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10176 Resident confinement room; disciplinary usage {#sec-r-400.10176 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10176}

Rule 176. (1) A resident confinement room may be used for disciplinary reasons, but only as specified in written policy and procedure.

(2) Before confinement to a resident confinement room or as soon as possible thereafter, a resident shall have the disciplinary reason for the restriction explained to him or her and have an opportunity to explain his or her behavior that led to the restriction.

(3) Confinement to a resident confinement room for up to 72 hours may be used when a resident has been charged with a major rule violation that endangers the safety of residents or others or endangers the security of the facility.

(4) Confinement to a resident confinement room for more than 72 hours may be used only with the written approval of the chief administrator.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10177 Resident restraint; pregnant youth {#sec-r-400.10177 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10177}

Rule 177. (1) The facility shall establish and follow written policy and procedures specifying the use of resident restraint.

(2) The written policy must limit the uses of resident restraint to the following:

(a) As a precaution against escape during transfer.

(b) For medical reasons by direction of the medical officer.

(3) The written resident restraint policy must prescribe the maintenance of written records of the routine and emergency distribution and use of restraint equipment.

(4) Restraint equipment and physical restraint techniques must not be used for punishment.

(5) Resident restraint must only be applied for the minimum time necessary to accomplish the purpose for its use as specifically permitted in subrule (2) of this rule and must only be applied with the approval of the facility administrator or administrative designee. Approval must be obtained within 20 minutes after the restraint has been initiated.

(6) Subrules (7) and (8) of this rule apply to those secure juvenile detention and correction facilities, for which the primary purpose is to serve juveniles that have been accused of or adjudicated delinquent for having committed an offense.

(7) Mechanical restraints must not be used on pregnant youth, including youth who are in labor, delivery, and post-partum recovery, unless credible, reasonable grounds exist to believe the youth presents an immediate and serious threat of hurting self, staff, or others.

(8) The following restraints are prohibited for use on pregnant youth unless reasonable grounds exist to believe the youth presents an immediate and credible risk of escape that cannot be reasonably minimized through any other method:

(a) Abdominal restraints.

(b) Leg and ankle restraints.

(d) Four-point restraints.

(9) A staff member shall be present continuously while material or mechanical restraint equipment is being used on a resident.

(10) Each use of material or mechanical restraint equipment must be documented in a written record and must include all of the following information:

(a) The name of the resident.

(b) The name of the administrator or designee who authorized the use of the equipment, and the time of the authorization.

(d) The name of the staff member who was responsible for the application.

(e) A description of the specific behavior that necessitated its use.

(f) The name of the staff person who was continuously with the resident.

(g) The date and the time of removal of the equipment and the name of the person removing the equipment.

History

History: 1992 AACS 2020 AACS.

Mich. Admin. Code R 400.10179 Inspection and approval of facility {#sec-r-400.10179 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10179}

Rule 179. A facility, including new construction, additions, and conversions, shall be occupied by residents only after inspection and approval by the department.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10181 Facility construction; plans and specifications {#sec-r-400.10181 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10181}

Rule 181. (1) Plans and specifications shall be submitted to the licensing authority for review and approval before any remodeling in a facility or the construction or conversion of a structure for use as a facility.

(2) The plans shall comply with all of the following provisions:

(a) Show layout, room arrangements, construction materials to be used, and the location, size, and type of fixed equipment.

(b) For additions, show those portions, including existing exits, types of construction, and room occupancies, which may be affected by the addition.

(c) Be approved, in writing, by the department, fire inspection authority, and, where applicable, the health inspection authority before construction begins.

(3) The plans for open institutions for not more than 6 residents need not be developed by an architect.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10183 Sleeping rooms and resident confinement rooms; minimum requirements {#sec-r-400.10183 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10183}

Rule 183. (1) All resident sleeping rooms and resident confinement rooms shall have a bed above floor level.

(2) If not a part of the sleeping room, all of the following shall be made available to residents:

(a) A toilet that is available for use 24 hours a day.

(b) A washbasin and drinking water.

(d) Storage space.

(3) The room shall be constructed to allow for the visual supervision of the resident in the room.

(4) In new and converted facilities, a single sleeping room shall not be less than 70 square feet, exclusive of closet space.

(5) In new and converted facilities, a multiresident sleeping room shall not be less than 45 square feet per resident, exclusive of closet space.

(6) Residents of the opposite sex who are older than 5 years of age shall not sleep in the same room.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10185 Facility proximity to adult corrections facility {#sec-r-400.10185 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10185}

Rule 185. If the facility is on the grounds of or is attached to an adult corrections facility, it shall be in a separate, self-contained unit.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10187 Housing population; rated capacity {#sec-r-400.10187 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10187}

Rule 187. The population in housing or living units shall not exceed the rated capacity.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10189 Bedding and linen {#sec-r-400.10189 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10189}

Rule 189. (1) Each resident shall be provided with an individual bed with a clean mattress and sufficient clean blankets. Polyurethane mattresses are prohibited.

(2) Each resident shall be provided with clean bedding at least weekly and more often if soiled.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10199 Rescission {#sec-r-400.10199 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10199}

Rule 199. R 400.71 to R 400.74 of the Michigan Administrative Code, appearing on pages 2991 and 2992 of the 1979 Michigan Administrative Code, are rescinded.

PART 2. DETENTION AND SHELTER CARE FACILITIES

History

History: 1992 AACS.

Mich. Admin. Code R 400.10201 Applicability {#sec-r-400.10201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10201}

Rule 201. This part and part 1 apply to all detention and shelter facilities unless specifically noted otherwise.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10205 Residential care after 48 hours {#sec-r-400.10205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10205}

Rule 205. A detention or shelter care facility shall continue to provide care for a resident for more than 48 hours only after it has been established that the facility is an appropriate placement for the resident in accordance with applicable statute or court rules.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10207 Admission physical examination; screening for communicable disease {#sec-r-400.10207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10207}

Rule 207. (1) A detention or shelter care facility shall arrange for an admission physical examination for each resident not later than 7 calendar days after admission.

(2) A facility shall have and follow written procedures approved by a licensed physician for screening all residents for communicable diseases upon their admission.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10208 Preliminary resident plan {#sec-r-400.10208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10208}

Rule 208. A brief written plan shall be developed within 7 calendar days of admission for each resident in a detention or shelter care facility.

The plan shall include both of the following:

(a) An assessment of the resident's immediate and specific needs.

(b) The specific services to be provided by the facility and other resources.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10209 Resident report {#sec-r-400.10209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10209}

Rule 209. (1) A written resident report shall be completed 30 days after admission and every 15 days thereafter for each resident in a detention or shelter care facility. The report shall include all of the following:

(a) The reasons for continued care.

(b) Plans for other placement.

(2) Copies of the report shall be maintained at the facility.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10211 Resident release report {#sec-r-400.10211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10211}

Rule 211. When a resident is released from a detention or shelter care facility, all of the following shall be documented:

(a) The reason for release.

(b) The new location of the resident, if known.

(d) The name and title of the person to whom the resident was released.

(e) The name and title of the person who prepared the release report.

PART 3. RESIDENTIAL TREATMENT FACILITIES

History

History: 1992 AACS.

Mich. Admin. Code R 400.10301 Applicability {#sec-r-400.10301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10301}

Rule 301. This part and part 1 apply to all juvenile court-operated residential treatment facilities unless specifically noted otherwise.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10303 Admission of child {#sec-r-400.10303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10303}

Rule 303. A child shall be admitted to a facility only after establishing that the facility is an appropriate placement to meet the child's needs.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10305 Admission physical examination {#sec-r-400.10305 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10305}

Rule 305. A facility shall document that each resident received a physical examination within 3 months before admission to a facility or a new physical examination shall be completed within 30 days after admission, unless a greater frequency is medically indicated.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10307 Immunizations {#sec-r-400.10307 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10307}

Rule 307. (1) A resident in a facility shall have current immunizations as required by the department of public health.

(2) If documentation of immunization is unavailable, immunizations shall begin within 30 days of admission, unless a statement from a physician which indicates that immunizations are contraindicated is included in the resident's record.

(3) A statement from a physician, referring agency, parent, or guardian which indicates that immunizations are current is sufficient documentation of immunizations.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10309 Dental care {#sec-r-400.10309 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10309}

Rule 309. A facility shall document the provision of a dental examination and treatment for each resident who is 3 years of age and older. A dental examination within 12 months before admission shall be documented or there shall be an examination not later than 3 months after admission. Reexamination shall be provided at least annually.

History

History: 1992 AACS.

Rule 311. A social service supervisor, at the time of appointment to the position, shall possess either of the following:

(a) A master's degree in a human service field and 1 year of professional experience in a juvenile facility, child caring institution, child placing agency, or criminal justice agency.

(b) A bachelor's degree with a major in a human service field and 2 years of professional experience in a juvenile facility, child caring institution, child placing agency, or criminal justice agency.

History

History: 1992 AACS.

Rule 313. A social worker, at the time of appointment to the position, shall possess a bachelor's degree with a major in a human service field.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10315 Initial service plan {#sec-r-400.10315 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10315}

Rule 315. (1) An initial service plan shall be completed and recorded by the social worker for each facility resident within 30 days of admission.

(2) The initial service plan shall be developed with the resident, the resident's parents, and the referral source, unless documented as inappropriate.

(3) The initial service plan shall include all of the following information:

(a) Problems that require placement.

(b) A social history for the resident and family which includes past and current family functioning.

(d) Identified resident's needs and strengths based on the social history.

(e) Identified family needs and strengths based on the social history.

(f) A long-range permanent plan for the resident.

(g) Objectives which must be met to achieve the long-range permanent plan.

(h) Specific steps and time frames for addressing the problems, achieving the objectives, and meeting the needs of the resident.

(i) Plans for, and the purpose of, visits between the resident and the resident's family.

(j) Documented approval of the plan by the social service supervisor.

(4) A resident's parents shall be involved in the development of the service plan and shall be informed of their role and responsibility while the resident is in care.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10317 Updated service plan {#sec-r-400.10317 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10317}

Rule 317. (1) An updated service plan shall be completed and recorded by the social worker for each facility resident at least once every 3 months after completing the initial service plan.

(2) The updated service plan shall be developed with the resident, the resident's parents, and the referral source, unless documented as inappropriate.

(3) The updated service plan shall include all of the following information:

(a) Progress made toward achieving the objectives established in the previous service plan.

(b) Any changes in the service plan, including new problems and new objectives to remedy the problems. Steps and time frames for achievement shall be indicated.

(c) A release plan. The plan shall be developed and recorded in the updated services plan before the release date and shall include a projected release date, projected next placement, and action steps necessary to accomplish the plan.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10319 Resident release; documentation {#sec-r-400.10319 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10319}

Rule 319. When a resident is released from a facility, all of the following information shall be documented in the resident's record within 14 days after release:

(a) The reason for release and the new location of the child.

(b) An assessment of the resident's needs which remain to be met.

(d) The name and title of the person to whom the resident was released.

PART 4. ENVIRONMENTAL HEALTH AND SAFETY

History

History: 1992 AACS.

Mich. Admin. Code R 400.10401 Applicability {#sec-r-400.10401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10401}

Rule 401. This part applies to all facilities unless specifically noted otherwise.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10403 Facility and premises maintenance {#sec-r-400.10403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10403}

Rule 403. (1) A facility and premises shall be maintained in a clean, comfortable, and safe condition. The facility shall be located on land that is properly drained.

(2) Hazardous areas shall be guarded or posted as appropriate for the age and developmental capacity of the residents.

(3) The facility, including main and accessory structures, shall be maintained so as to prevent and eliminate rodent and insect harborage.

(4) Rooms, exterior walls, doors, skylights, and windows shall be weathertight and watertight and shall be kept in sound condition and good repair.

(5) Floors, interior walls, and ceilings shall be sound and in good repair and shall be maintained in a clean condition.

(6) Plumbing fixtures and water and waste pipes shall be properly installed and maintained in good working condition.

(7) Water closet compartment, bathroom, and kitchen floors shall be constructed and maintained so as to be reasonably impervious to water and be composed of a slip-resistant material.

(8) Equipment, including recreation devices, shall be inspected periodically for defects.

Proper maintenance shall be carried out to keep equipment in a safe operating condition.

(9) Water heaters shall have an operable thermostatic temperature control and a pressure relief valve.

(10) Stairways, porches, and elevated walkways shall have structurally sound and safe handrails.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10405 Ventilation {#sec-r-400.10405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10405}

Rule 405. (1) Except for a basement, each habitable room shall have direct outside ventilation by means of windows, louvers, air conditioning, or mechanical ventilation.

(2) Each door, window, and other opening to the outside which is used for ventilation purposes shall be supplied with screens. Each screen door shall have a self-closing device in working condition and shall swing outward.

(3) Where windows or louvers are used for ventilation, the total openable area for each resident-occupied room, other than a bathroom, shall not be less than 3 1/2% of the floor area of the room.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10407 Lighting {#sec-r-400.10407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10407}

Rule 407. (1) Every sleeping room that is occupied by residents shall have natural light from a source which is equal to not less than 8% of the floor area for that room. A skylight, louver, glass-blocked panel, or similar light-transmitting device shall not be counted for more than 50% of the required area in place of conventional windows and glass doors.

(2) Every habitable room shall have artificial light that is capable of providing not less than 20 footcandles of illumination at a height of 3 feet above the floor.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10409 Water supply {#sec-r-400.10409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10409}

Rule 409. (1) The water supply for a facility shall comply with the requirements of the department of public health. The installation of new wells or repairs on existing wells shall be done by a water drilling contractor who is registered under sections 12701 to 12721 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12701 to 333.12721 of the Michigan Compiled Laws.

Hot and cold or tempered water shall be provided in each sink, lavatory, bath, and shower.

Hot water temperatures shall not be more than 120 degrees Fahrenheit at outlets accessible to residents.

(3) Plumbing shall be installed and maintained to prevent cross-connections with the water supply.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10411 Toilet and bathing facilities {#sec-r-400.10411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10411}

Rule 411. The following toilet and bathing facilities shall be provided:

(a) Toilets that allow for individual privacy, unless such toilets are inconsistent with a toilet training program or security program.

(b) Bathing and toilet fixtures that are specially equipped if used by the physically handicapped.

(c) For each 8 residents, at least 1 toilet, lavatory, and tub or shower that are easily accessible from sleeping quarters.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10413 Food service facilities, equipment, and procedures {#sec-r-400.10413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10413}

Rule 413. Facilities, equipment, and procedures used in the preparation, storage, and service of food shall comply with the applicable provisions of sections 12901 to 12922 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12901 to 333.12922 of the Michigan Compiled Laws. The facilities, equipment, and procedures required shall be based on the amount of food service and the type of food service operation.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10415 Garbage and refuse {#sec-r-400.10415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10415}

Rule 415. (1) Garbage shall be stored in fly-tight, watertight containers with tight-fitting covers. A garbage can shall be provided with a waterproof liner or shall be thoroughly cleaned after each emptying.

(2) Garbage and refuse shall be removed at intervals of at least once a week.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10417 Sewage disposal {#sec-r-400.10417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10417}

Rule 417. Sewage and other water-carried wastes shall be disposed of through a municipal sewer system where such a system is available. Where a municipal sewer connection is not available, liquid waste shall be discharged into an approved private system. The private system shall not create a nuisance or pollute a stream, lake, or other body of water or contaminate a water supply or bathing place and shall comply with applicable local health department requirements.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10419 Heating equipment {#sec-r-400.10419 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10419}

Rule 419. (1) Heating equipment shall be capable of maintaining a temperature of not less than 68 degrees Fahrenheit at a point 4 feet above the floor. An accurate thermometer shall be provided.

(2) Hot water radiators, steam radiators and pipes, or any other heating device that is capable of causing a burn shall be effectively shielded.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10421 Swimming beaches and pools {#sec-r-400.10421 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10421}

Rule 421. (1) The water and beach area of a natural swimming area of a facility shall be free from contamination by garbage, refuse, sewage pollution, and hazardous foreign or floating materials. A survey or evaluation of the quality of the water at the swimming area shall be made in accordance with the provisions of sections 12541 to 12563 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12541 to 333.12563 of the Michigan Compiled Laws, and the rules promulgated thereunder.

(2) A facility's artificial swimming pool shall be constructed and maintained in accordance with the provisions of sections 12521 to 12534 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.12521 to 333.12534 of the Michigan Compiled Laws, and the rules promulgated thereunder.

PART 5. FIRE SAFETY FOR SMALL, LARGE, AND SECURE FACILITIES

History

History: 1992 AACS.

Mich. Admin. Code R 400.10501 Definitions {#sec-r-400.10501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10501}

Rule 501. As used in this part:

(a) "Ambulatory," with respect to a resident, means being physically and mentally capable of traversing a path to safety without the aid of another person. A path to safety includes the ascent and descent of any stairs or approved means of egress.

(b) "Approved" means acceptable to the department and the fire inspecting authority and in accordance with these rules. The department makes the final approval based on recommendations from the fire inspecting authority.

(c) "Basement" means the habitable portion of a building which is below grade, but which is so located that the vertical distance from the grade to the floor is not more than the vertical distance from the grade to the ceiling. Where the ceiling of such portion of a building is located 5 feet or more above grade for more than 25% of the perimeter measurement of the building or part of the building affected, the building shall be classed as a first story.

(d) "Combustible" means those materials which can ignite and burn.

(e) "Conversion" or "converted" means any of the following:

(i) A change, after the effective date of these rules, in the use of a facility or portion thereof from some previous use to that of a licensed or approved institution.

(ii) An increase in capacity from a residential group home to a small facility.

(iii) An increase in capacity from a small facility to a large facility.

(iv) A change to a secure facility.

(v) After the effective date of these rules, a change from caring for ambulatory residents only to caring for 1 or more nonambulatory or wheelchair-confined residents. A converted facility shall comply with the provisions of these rules for fire safety for converted facilities.

(f) "Electric lock" means an electric door lock system that is operated from a remote control unit. The system shall be fail-safe and all locks shall automatically unlock in the event of electrical failure. The system shall be approved by a nationally recognized independent testing laboratory.

(g) "Escape window," in a newly converted or remodeled facility, means an approved side-hinged window which has a minimum opening of 5 square feet and which does not have an open dimension of less than 22 inches. The window shall be openable from the inside with a single motion and shall be equipped with nonlocking-against-egress hardware. The window shall be openable without the use of special tools. The sill height shall not be more than 36 inches from the floor, unless an approved substantial permanent ledge or similar device which is not less than 12 inches wide is provided under the window, in which case the sill height may be increased to 44 inches from the floor. In an existing facility, "escape window" means a window that is acceptable to the fire inspecting authority.

(h) "Existing facility" means a building which is licensed or approved by the department as an institution at the time these rules take effect and which is not unoccupied or unlicensed for more than 90 consecutive days thereafter. Where an increase in capacity or change in use affects fire safety requirements, the facility shall comply with all applicable requirements before the increase or change in use.

(i) "Facility" means a building that is owned, leased, or primarily rented by a juvenile court for use as a small, large, or secure facility to house and sleep residents. "Facility" includes new, remodeled, converted, and small, large, secure, and existing facilities. Any portion of a facility which is not used by residents, which is not used as a required means of egress, and which is protected from the rest of the facility by an approved fire barrier does not need to meet these rules for fire safety. However, the right of the fire inspecting authority to inspect a nonuse area for hazardous use is retained and directives relative to fire safety of the nonuse area may be issued to assure the fire safety of the use areas.

"Facility" does not include an open occupancy building for less than 7 residents.

(j) "Fire alarm device" means an approved device that is capable of sounding an alarm. A fire alarm shall be specifically designated as such and shall not be used for any purpose other than sounding an alarm of fire or other emergency or for fire drills. The device shall be loud enough to be heard throughout the facility under normal conditions. A device may be a bell, a horn, a whistle, or any other device that is acceptable to the fire inspecting authority.

(l) "Fire-resistance rating" means the time in hours or fractions thereof that materials or their assemblies will resist fire exposure as determined by fire tests established and conducted by approved testing laboratories.

(m) "Hazardous area" means those parts of a facility that house a flame-producing heating plant, an incinerator, a water heater, or a kitchen and areas where combustible materials, flammable liquids, gases, or dangerous chemicals are used or stored. Domestic laundry equipment is excluded from this definition.

(n) "Large facility" means a building that is used to house more than 15 residents.

(o) "Means of egress and exit" means an unobstructed way of departure from any point in a building to safe open air outside at grade.

(p) "Newly constructed," "new construction," or "new facility" means a structure or addition to a facility after the effective date of these rules.

(q) "Nonambulatory," with respect to a resident, including a resident confined to a wheelchair, means being physically or mentally incapable of traversing a path to safety without the aid of another person. A path to safety includes the ascent and descent of any stairs or other approved means of egress from the building.

(r) "Remodeled" means changes in a facility which modify existing conditions and includes renovation. Remodeled and affected areas of a child caring institution shall conform to the provisions of these rules for fire safety for remodeled and converted facilities. Unaffected areas of a facility are not required to conform to the required provisions for remodeled and converted facilities.

(s) "Residential group home" means an open institution that is used to house less than 7 residents.

(t) "Secure facility" means a building that is used as a detention facility. The building or portions of the building are used to keep residents in custody. Outside doors and individual sleeping rooms usually have locks which are secure from the inside. The locks are used in the usual course of operation. A secure facility shall meet the requirements for a large facility, regardless of the number of residents. A facility with an approved resident confinement room is not a secure facility solely by virtue of having a resident confinement room.

(u) "Small facility" means a building which houses not less than 7 residents and not more than 15 residents and which is not a secure facility.

(v) "Story" means that part of a building between a floor and the floor or roof next above.

(w) "Street floor" means the lowest story of a facility that is not a basement.

(x) "Substantially remodeled" means changes in a facility that result in the exposure or addition of structural joists or studs.

(y) "Wire glass" means glass which is not less than 1/4 of an inch thick; which is reinforced with wire mesh, no. 24 gauge or heavier, with spacing of not more than 1 square inch; and which is installed in steel frames or, when approved, installed in wood frames or stops of hardwood material which is not less than 3/4 of an inch actual dimension and not more than 1,296 square inches per frame, with no single dimension more than 54 inches in length.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10503 Applicability {#sec-r-400.10503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10503}

Rule 503. The rules set forth in this part apply to all newly constructed, remodeled, converted, and existing facilities as indicated.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10505 Adoption by reference {#sec-r-400.10505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10505}

Rule 505. The department adopts the fire safety codes and standards set forth in this rule.

These codes and standards are available for inspection and distribution to the public at cost at the Department of Social Services, 235 S. Grand Avenue, P.O. Box 30037, Lansing, Michigan 48909.

Copies of the codes and standards may also be obtained from the appropriate agency, organization, or association listed in this rule. The costs indicated are those in effect at the time these rules were promulgated. The codes and standards adopted are as follows:

(a) Standard E-84-77A, "Tests for Surface Burning Characteristics of Building Materials," 1978, American Society for Testing and Materials, 1916 Race Street, Philadelphia, Pennsylvania 19103 - $1.75.

(b) Pamphlet no. 13, "Installation of Sprinkler Systems," 1980, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $6.00.

(c) Pamphlet no. 13A, "Care and Maintenance of Sprinkler Systems," 1981, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $1.00.

(d) Pamphlet no. 22, "Water Tanks for Private Protection," 1978, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.75.

(e) Pamphlet no. 70, "National Electrical Code," 1978, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $6.75.

(f) Pamphlet no. 72A, "Local Protective Signaling Systems," 1979, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $5.00.

(g) Pamphlet no. 72E, "Automatic Fire Detectors," 1978, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $5.00.

(h) Pamphlet no. 82, "Incinerator, Rubbish Handling," 1977, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.50.

(i) Pamphlet no. 90A, "Air Conditioning and Ventilating Systems," 1978, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $5.00.

(j) Pamphlet no. 96, "Standard for the Installation of Equipment for the Removal of Smoke and Grease Laden Vapors from Commercial Cooking Equipment," 1980, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.50.

(k) Pamphlet no. 220, "Standard on Types of Building Construction," 1979, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - 50 cents.

(l) Pamphlet no. 255, "Method of Test of Surface Burning Characteristics of Building Materials," 1979, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.50.

(m) Standard 723, "Test Method for Fire Hazard Classification of Building Materials," 1977, Underwriters Laboratories, Inc., 333 Pfingsten Road, Northbrook, Illinois 60062 - $3.50.

(n) "Life Safety Code 101," 1967, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.00.

(o) "Life Safety Code 101," 1973, National Fire Protection Association, Batterymarch Park, Quincy, Massachusetts 02269 - $4.00.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10507 Fire drills and telephone {#sec-r-400.10507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10507}

Rule 507. (1) There shall be quarterly emergency fire drills for each staff shift. Two of the drills shall include evacuations, unless approved by the department, in writing, as clinically contraindicated. Where a facility has a 24-hour staff shift, the emergency drills shall be conducted at different times of the day and night. Written records shall be maintained for each drill and shall indicate the date and time of the drill and, where evacuation was a part of the drill, the approximate evacuation time.

(2) A telephone or other suitable means of communicating an alarm of fire to the fire department shall be provided. Pay stations are not suitable means of communicating alarms. The telephone number of the fire department shall be posted conspicuously by all phones designated for outside service.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10509 Facility location {#sec-r-400.10509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10509}

Rule 509. A new or converted facility shall not be established within 300 feet of an aboveground storage tank that contains flammable liquids that are used in connection with any of the following:

(a) A bulk storage plant.

(b) A marine terminal.

(d) A bottling plant of a liquefied petroleum gas installation.

(e) Other similar hazard.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10511 Facilities with sleeping rooms above second floor {#sec-r-400.10511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10511}

Rule 511. All facilities with sleeping rooms above the second floor shall comply with the requirements of a secure facility, except for the requirements of R 400.10523(c).

History

History: 1992 AACS.

Mich. Admin. Code R 400.10513 Combustible materials and decorations {#sec-r-400.10513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10513}

Rule 513. (1) A resident-occupied facility shall be kept free of all accumulations of combustible materials that are unnecessary for the immediate operation of the institution.

(2) Easily ignited or rapidly burning combustible decorations are not permitted in a facility. Personal artwork and personal decorations made or owned by residents are permitted up to 6 square feet of wall space in each room or use areas other than means of egress and hazardous areas.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10515 Basement as sleeping room prohibited {#sec-r-400.10515 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10515}

Rule 515. A basement shall not be used as a sleeping room.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10517 Electrical installations {#sec-r-400.10517 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10517}

Rule 517. (1) In a newly constructed, converted, or remodeled facility, the electrical wiring and equipment shall be installed in accordance with the provisions of the national fire protection association pamphlet no. 70, entitled "National Electrical Code," 1978. A final electrical certificate of approval for the electrical installation shall be obtained from a qualified local electrical inspecting authority or state electrical inspecting authority.

(2) In an existing facility, electrical wiring and equipment that is acceptable at the time these rules take effect shall continue to be approved until the facility or a portion thereof is remodeled or converted. When an existing facility or a portion thereof is remodeled or converted, only that portion remodeled or converted need comply with the provisions of subrule (1) of this rule. Electrical services shall be maintained in a safe condition. When conditions indicate a need for inspection, the electrical services shall be inspected by a qualified electrical inspection service. A copy of the inspection report shall be maintained at the facility for review. Any areas cited in the report shall be corrected and a new electrical system inspection shall be obtained to verify that corrections have been made.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10519 Facility construction {#sec-r-400.10519 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10519}

Rule 519. (1) A new, substantially remodeled, or converted large or secure facility shall be 1 of the following types of construction as specified in the national fire protection association pamphlet no. 220, entitled "Standard on Types of Building Construction, 1979":

(a) Type I 443 or 332 or type II 222.

(b) Type II 111, type III 211, type IV 2HH, or type V 111 up to 2 stories. A basement and second story for these types of construction require complete sprinkler protection.

(c) Type II 000, type III 200, or type V 000 up to 2 stories, with all stories completely covered by sprinkler protection.

(2) New, converted, and substantially remodeled small facilities shall be at least frame construction and shall be fire-stopped with not less than 2-inch nominal lumber at all wall and floor junctures and all wall and ceiling junctures.

(3) Existing construction which was approved before these rules take effect and which meets the construction requirements of the fire safety guidelines these rules supersede shall continue to be approved until the facility is substantially remodeled or converted. When an existing facility is substantially remodeled or added to, only the portion of the facility being substantially remodeled or added need be in compliance with the provisions of subrule (1) or (2) of this rule, as appropriate.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10521 Interior finish {#sec-r-400.10521 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10521}

Rule 521. (1) The following alphabetical classification of finished materials for flame spread and smoke development, as determined by the tunnel test in accordance with the national fire protection association pamphlet no. 255, 1979; American society of testing materials standard E-84-77A, 1978; or underwriters laboratories standard no. 723, 1977, shall be used to classify interior finishes: Class Flame Spread Smoke Developed A 0-25 0- 450 B 26-75 0-450 C 76-200 0-450 The same alphabetical classification is also used to classify combustibility of prefabricated acoustical tile units, as determined by federal specifications test no. SS-S-118a.

(2) Interior finish includes all of the following:

(a) The plaster, wood, or other interior finish materials of walls.

(b) Partitions, fixed or movable.

(d) Other exposed interior surfaces of the facility, other than nominal wood trim.

(4) Paints or coatings that contain plastics, polyurethane, or epoxies may be used on noncombustible surfaces without proof of classification if they are not applied more than 8 mils in thickness.

(5) In a newly constructed, remodeled, or converted facility, an interior finish classification shall be that of the basic material used, without regard to subsequently applied paint or other covering in an attempt to meet the classification.

(6) In an existing facility, where an interior finish at the time these rules take effect does not comply with the provisions of subrule (5) of this rule and where an interior finish is applied to or furred out not more than 1 inch from a continuous noncombustible backing, an interior finish may have the surface protected with an approved fire retardant coating so as to meet the interior finish requirements.

(7) Interior finish materials in facilities shall have the following classifications:

(a) In small and large open facilities without a sprinkler system, class A or B in exitways and class A in behavior management rooms. In all other areas, at least class C.

(b) In open facilities with a sprinkler system, at least class C throughout, except in a behavior management room.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10523 Fire protection {#sec-r-400.10523 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10523}

Rule 523. Fire protection shall be provided in all facilities as follows:

(a) In a small facility any of the following:

(i) An attendant shall be on duty 24 hours a day and shall be awake and fully dressed.

(ii) Complete sprinkler protection shall be provided.

(iii) The provisions of R 400.10525 shall be met.

(b) In a large facility, any of the following:

(i) An attendant shall be on duty 24 hours a day and shall be awake and fully dressed.

(ii) Complete sprinkler protection shall be provided.

(iii) The provisions of R 400.10527 shall be met.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10525 Fire detection; small facilities {#sec-r-400.10525 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10525}

Rule 525. (1) A newly constructed, remodeled, or converted small facility that elects to provide fire protection through fire detection shall be protected by approved fire detection equipment that consists, at a minimum, of battery-operated ionization fire detection devices installed in every sleeping room and all areas, except kitchen and bathrooms. The fire detection devices shall comply with all of the following requirements: (a) Be listed and labeled by an independent, nationally recognized testing laboratory.

(b) Be installed and maintained in accordance with the manufacturer's and test specifications.

(d) Be of a type that provides a signal when batteries are not providing sufficient power and when batteries are missing.

(2) Any battery-operated device required by the provisions of subrule (1) of this rule which signals that power is low or that a battery is missing shall be immediately serviced and restored to full power. There shall be not less than a 10% supply of extra batteries maintained at the facility at all times for the total number of battery-operated devices in the facility.

(3) In existing small facilities, fire detection systems that are approved before these rules take effect shall continue to be approved until the facility or a portion thereof is remodeled or converted. When the facility or a portion thereof is remodeled or converted, fire detection shall be, at a minimum, as required by this rule for the newly constructed, remodeled, or converted facilities in that portion of the facility that is remodeled or converted. Existing fire detection systems shall be maintained in proper working order and shall be tested at least quarterly, with a written record maintained of the testing.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10527 Fire detection; large facilities {#sec-r-400.10527 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10527}

Rule 527. (1) A newly constructed, remodeled, or converted large facility that elects to provide fire protection through fire detection shall be equipped with a 100% coverage fire detection system which is tested and listed by a nationally recognized, independent testing laboratory and which is installed in compliance with the national fire protection association pamphlet no. 72A, entitled "Local Protective Signaling Systems," 1979, national fire protection association pamphlet no. 72E, entitled "Automatic Fire Detectors," 1978, and these rules, except that the installation of wiring and equipment shall comply with national fire protection association pamphlet no. 70, entitled "National Electrical Code," 1978.

(2) In a new, remodeled, or converted large facility, the main power supply source for an automatic fire detection system shall be from an electric utility company and shall be on a separate circuit which is fused ahead of the building main service switch. A secondary power supply shall be provided which, in the event of the main power supply failure, will maintain the system in an operative condition for 24 hours and, in the event of a fire, will sound the alarm signaling units at least a 5-minute period.

(3) In a new, remodeled, or converted large facility, where an automatic fire detection system is required, the detection devices shall comply with both of the following provisions:

(a) Be installed in all rooms, lofts, closets, stairways, corridors, basements, attics, and any other areas. Spacing of detection devices shall be as recommended by the manufacturer to provide complete coverage. Small bathrooms that contain a single water closet and lavatory, small closets that are not more than 20 square feet, and similar spaces are exempted from the provisions of this subdivision.

(5) In a new, remodeled, or converted large facility, complete final plans and specifications of the automatic fire detection system, where such a system is to be installed, shall be submitted to the department and approved before installation. The plan shall show facility floor plans and locations and types of detection devices, pull stations, and sounding units.

(6) In existing large facilities, fire detection systems that are approved before these rules take effect shall continue to be approved until the facility is converted or a portion thereof is remodeled. When the facility is converted or a portion thereof is remodeled, the portion of the facility remodeled or converted shall meet the appropriate requirements of this rule.

Where the required new system cannot be added to the existing systems maintaining a single signaling alarm system, the total system shall be replaced and shall comply with this rule for remodeled and converted facilities.

(7) Automatic fire detection systems, fire alarm systems, and fire detection systems shall be maintained in proper working condition. When problems occur, they shall be immediately remedied. When the system is rendered inoperable, staff shall be awake and on duty until the system is again operable.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10529 Sprinkler systems {#sec-r-400.10529 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10529}

Rule 529. (1) A sprinkler system in a new or converted facility shall comply with the provisions of the national fire protection association pamphlet no. 13, 1980, entitled "Installation of Sprinkler Systems." Where there is no adequate water from a community water system to supply a sprinkler system and where the area to be protected is not more than 20,000 square feet, a special pressure tank supply for sprinklers, as specified in the national fire protection association pamphlet no. 22, 1981, entitled "Standard for Water Tanks for Private Fire Protection," shall be provided. The special pressure tanks shall contain 2,000 gallons of water in a 3,000-gallon tank for partial systems and for complete building systems shall have 3,000 gallons of water in a 4,500-gallon tank.

The tank shall be enclosed in at least a 1-hour-fire-resistance rated structure or room.

(2) All required sprinkler systems shall be inspected and tested and all other maintenance performed as specified in the national fire protection association pamphlet no. 13A, 1981, entitled "Care and Maintenance of Sprinkler Systems," at least once a year by a sprinkler contractor. The licensee shall maintain documentation of the last inspection and test.

(3) A sprinkler system in an existing facility that is approved before these rules take effect shall continue to be approved until the facility or a portion thereof is remodeled, converted, or expanded. The system shall be maintained in accordance with the standards applicable at the time it was originally approved.

(4) When an existing facility is remodeled, converted, or expanded and the remodeling, conversion, or expansion results in an existing sprinkler system that does not provide adequate protection, fire protection shall be provided by extension of the current system where it is possible to extend the system and maintain its integrity or a new sprinkler system shall be installed in the affected area.

(5) The sprinkler piping for any isolated hazardous area that can be adequately protected by not more than 2 sprinklers may be connected directly to the domestic water system at a point where a minimum 1-inch supply is available. An approved OS and Y valve and check valve shall be installed between the sprinklers and the connection to the domestic water supply.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10531 Fire extinguishers {#sec-r-400.10531 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10531}

Rule 531. (1) All required fire extinguishers shall be subjected to a maintenance check at least once a year. Each fire extinguisher shall have a tag or label attached that indicates the month and year maintenance was performed and identifies the person or company that performs the service.

(2) All required extinguishers shall be recharged after use.

(3) A minimum of 1 approved fire extinguisher shall be provided on each floor and in or immediately adjacent to kitchens, combustion-type heating devices, and incinerators.

Additional fire extinguishers may be required at the discretion of the fire safety inspector to assure that it is not necessary to travel more than 75 feet to a fire extinguisher.

(4) All fire extinguishers shall be not less than 4 inches off the floor and the top of the extinguisher shall not be higher than 5 feet off the floor in a special cabinet or on a wall rack which is easily accessible at all times, unless programmatically contraindicated.

Where programmatically contraindicated, the required extinguishers may be kept behind locked doors if both of the following conditions are met:

(a) The locations are clearly labeled "Fire Extinguisher."

(b) All staff carry keys to the doors.

(5) In new, remodeled, or converted facilities, a fire extinguisher shall be at least type 2- A-10BC.

(6) In existing small facilities, previously approved fire extinguishers other than type 2- A-10BC will continue to be approved if they are located in the area for which approved.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10533 Fire alarm {#sec-r-400.10533 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10533}

Rule 533. (1) All new and converted large and secure facilities shall have a fire alarm with fire alarm pull stations at each exit on each floor.

(2) All new and converted small facilities that have resident sleeping on only 1 floor shall have at least a fire alarm device. All new and converted small facilities that have resident sleeping on more than 1 floor shall have a fire alarm system with at least 1 pull station on each level.

(3) Fire alarm systems and devices in existing facilities shall be maintained in proper working order and shall continue to be approved until the facility is remodeled or converted.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10535 Means of egress {#sec-r-400.10535 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10535}

Rule 535. (1) Means of egress shall be considered the entire way and method of passage to free and safe ground outside a facility. All required means of egress shall be maintained in an unobstructed, well-defined, easily traveled condition at all times.

(2) In an existing facility, each resident-occupied room or area shall have access to not less than 2 independent, properly separated, approved means of egress or have a doorway leading directly to the outside at grade.

(3) In multistory secure and large facilities, at least 1 means of egress from each floor shall be direct to the outside or shall be through an enclosed stairway which is properly separated from floors below and which exits directly to the outside at grade or through a previously approved escape window.

(4) In a small facility where ambulatory residents use a floor above the street level, 1 of the 2 required means of egress may be an approved escape window from each residentoccupied room which provides direct access to the ground and which has a sill height that is not more than 5 feet above the ground below or which provides access to an approved fire escape.

Where possible, resident sleeping rooms shall be located between approved means of egress.

When this is not possible, each exit shall be arranged so that a corridor or aisle does not have a pocket or dead end of more than 20 feet and so that not more than 4 residents have sleeping rooms with exit access on such corridor or aisle. There shall not be a hazardous area on such a dead-end corridor or aisle.

(6) In a newly constructed, remodeled, or converted large or secure facility, additional means of egress, in addition to the minimum of 2 required from each story, are required if the maximum possible occupancy is more than 100 residents per story. There shall be at least 1 additional means of egress for each 100 additional residents per story. Means of egress shall be of such number and so arranged that it is not necessary to travel more than 100 feet from the door of a resident-occupied room to reach the nearest approved protected exitway from that story.

(7) An elevator shall not be approved as a required means of egress.

(8) A means of egress shall not be used to house residents or for storage of any kind and shall not be obstructed or hidden from view by ornamentation, curtains, or other appurtenances.

(9) Each required means of egress from floors where nonambulatory residents are permitted shall discharge at grade or shall be equipped with a ramp which terminates at grade level. Ramps shall not exceed 1 foot of rise in 12 feet of run and shall have sturdy handrails. Once at grade, nonambulatory residents shall have a surface that is sufficient to permit them to move a safe distance from the facility.

(10) In a small facility that houses 1 or more nonambulatory residents, required aisles that form part of a required means of egress from portions of the facility housing such residents shall be not less than 48 inches wide in a new facility and not less than 44 inches wide in a converted facility and shall have doors that are a minimum of 36 inches wide.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10537 Stairways, halls, corridors, and aisles {#sec-r-400.10537 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10537}

Rule 537. (1) In existing and small facilities, all stairways and other vertical openings shall be enclosed with materials equal in fire resistance to the standard partition construction of the building, if such partition construction is at least standard lath and plaster. There shall be at least a 1 3/4-inch solid-core wood door that has self-closing and latching hardware which is installed so that there is effective fire and smoke separation between floors or, alternatively, each sleeping room on the second floor shall be equipped with at least a 1 3/4-inch solid-core wood door with latching hardware.

(2) In all new and converted large and secure facilities, stairways shall be enclosed with materials that have at least the fire-resistance rating specified by the national fire protection association pamphlet no. 220, 1979, for the type of construction. All other vertical openings through floors shall be fire-stopped with like materials.

(3) If a facility has less than 3 levels, if each level exits at grade, and if elevations between levels are not more than 4 feet, the building shall be considered to be 1 story and enclosures shall not be required between levels.

(4) In all new and converted facilities, stairs shall have treads and risers of uniform width and height, with treads that are not less than 9 1/2 inches deep, exclusive of nosing, and risers that are not more than 7 3/4 inches in height.

(5) Stairs in new, remodeled, and converted facilities shall change direction by use of an intermediate landing and not by a variance in the width of the treads. A sturdy and securely fastened handrail that is located between 30 and 34 inches, measured vertically, above the nose of the treads shall be provided.

(6) Stairs in existing facilities that are approved before these rules take effect shall continue to be approved until the portion of the building that encompasses the stairs is remodeled.

(7) An outside stairway or fire escape that is used as part of an approved means of egress shall be protected against fire in the building by blank or closed walls directly under such stairway and for a distance of 6 feet in all directions. Windows are permitted within this area if they consist of wire glass set in unopenable frames.

(8) In newly constructed small facilities, halls, corridors, aisles, and stairs that are used as part of a means of egress shall be not less than 44 inches wide and shall be not less than 36 inches wide in converted small facilities, except as required by R 400.10535(10).

(9) In newly constructed and converted large and secure facilities, halls, corridors, and aisles that are used as part of a means of egress shall be not less than 5 feet wide and 90 inches high and stairs that are used as part of an exit shall be not less than 4 feet wide.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10539 Doors {#sec-r-400.10539 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10539}

Rule 539. (1) Doors to required means of egress shall comply with all of the following provisions:

(a) Be side-hinged and installed at floor level.

(d) In large and secure facilities, doors shall be hung to swing in the direction of egress, except for doors to single-occupant rooms and bathrooms.

(e) Be equipped with at least knob-type, properly operating, approved, positive-latching, nonlocking-against-egress-type hardware which insures the opening of the door with a single motion, such as turning a knob or applying normal pressure on a latch, except as otherwise provided by subrule (2) of this rule and R 400.10173.

(2) In secure facilities, locking hardware is permitted if resident sleeping rooms are equipped with approved electric locks with mechanical overrides or if staff are present and awake, fully dressed, on duty, and in possession of keys to release residents in an emergency.

(3) Doors that enter stairs and other vertical openings and doors to fire-rated enclosures shall not be held in an open position at any time by an under-door wedge or hold-open device.

(4) Interior doors to any enclosure that is required to have not less than a 1-hour-fireresistance rating shall be B-labeled fire doors in labeled frames and shall be equipped with positive-latching hardware and self-closing devices.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10541 Partition construction; large and secure facilities {#sec-r-400.10541 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10541}

Rule 541. In new, remodeled, or converted large and secure facilities, rooms shall be separated from corridors used as means of egress with partition construction which extends to the floor or deck above and which affords not less than a 3/4-hour-fire-resistance rating.

Doors shall be at least 1 3/4-inch solid-core wood. Any glass in these partitions, including doors, shall be wire glass that is not more than 54 inches in any 1 lineal dimension and not more than a total of 1,296 square inches. If glass breakage is a potential hazard, clear acrylic may be placed directly in contact with and between 2 layers of wire glass to give added strength.

This rule does not apply where the type of construction requires more restrictive separation.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10543 Hall, stairways, and means of egress lighting; emergency lighting; large and secure facilities {#sec-r-400.10543 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10543}

Rule 543. (1) In large and secure facilities, all halls, stairways, and means of egress shall be constantly lighted. Approved exit signs shall be installed over each required exit. Exit directional signs shall be provided where exit signs are not readily visible in means of egress. In new and converted large and secure facilities, the circuits for this lighting shall be installed ahead of the main power disconnect.

(2) In new and converted multistory large and secure facilities, there shall be a system of emergency backup lighting that is capable of maintaining required lighting for not less than 24 hours in the event of power failure.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10545 Elevators and dumbwaiters {#sec-r-400.10545 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10545}

Rule 545. Elevator and dumbwaiter shafts shall be completely enclosed by noncombustible materials with a fire-resistance rating of not less than 1 hour. An opening shall not be permitted through the side wall enclosure for ventilation or for any other purpose. Doors and frames that service elevators and dumbwaiters shall be approved Blabeled fire door assemblies and labeled fire frame construction and shall be hung so as to be reasonably smoketight when the doors are closed. Glass side lights, transoms, and panels above the doors shall be wire glass and shall not be more than 100 square inches.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10547 Heating devices and flame-producing devices {#sec-r-400.10547 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10547}

Rule 547. (1) In large and secure facilities and all newly constructed and converted facilities, flame-producing-type heating devices and incinerators shall be in an enclosure that provides at least 1 hour of resistance to fire. Adequate combustion air shall be provided directly from the outside through a permanently open louver. Fire dampers are not required in ducts that penetrate this enclosure.

(2) In existing small facilities, flame-producing-type heating devices and incinerators approved pursuant to R 400.71 et seq. shall continue to be approved with regard to enclosure or lack of enclosure until the portion of the facility that contains the flameproducing device is remodeled or the facility is converted. This subrule does not abrogate requirements relative to maintaining doors and other safety devices in proper working order.

(3) Electric heating shall be installed in accordance with the manufacturer's specifications and shall be approved by a nationally recognized, independent testing laboratory.

(4) Portable heaters and space heaters, including solid fuel heaters, are prohibited.

(5) A fireplace is permitted if it is masonry and has all of the following components:

(a) An approved glass door shielding the opening. The door shall be closed at all times except when a fire is being tended.

(b) A noncombustible hearth that extends a minimum of 16 inches out from the front, and 8 inches beyond each side, of the fireplace opening.

(c) A noncombustible face that extends not less than 12 inches above, and 8 inches on each side of, the fireplace opening.

(d) A masonry chimney that is constructed with approved flue liners.

(6) A heating plant room shall not be used to store combustibles or as a maintenance shop unless sprinklered.

(7) A furnace and other flame-producing units shall be installed according to manufacturer and test specifications and shall be vented by metal ducts to a chimney which is constructed of bricks, solid block masonry, or reinforced concrete, which has an approved flue lining, and which is properly erected and maintained in a safe condition. A bracket chimney is not permitted. This rule does not prohibit the installation and use of any prefabricated chimney that bears the label of an approved, nationally recognized, independent testing laboratory if the chimney is installed and used in accordance with manufacturer and test specifications and is compatible with the heating unit or units connected to it. Only gas- and oil-fired units may be connected to a prefabricated chimney.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10549 Air-handling equipment {#sec-r-400.10549 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10549}

Rule 549. (1) In newly constructed or converted large or secure facilities, air conditioning, warm-air heating, air cooling, and ventilating systems shall comply with the provisions of the national fire protection association pamphlet no. 90A, entitled "Air Conditioning and Ventilating Systems," 1978.

(2) In newly constructed or converted large or secure facilities, fans and air-handling equipment used for recirculating air in more than 1 room or single area shall have a thermostatic device with a setting of not more than 125 degrees Fahrenheit or an approved automatic smoke detector located in the system at a suitable point in the return air duct ahead of the fresh air intake, the actuating of which shall open the electrical circuit that supplies the fan motor. Fan rooms shall be designed and used only to house other mechanical equipment.

(3) In existing facilities, fans and air-handling equipment and systems that are approved pursuant to R 400.71 et seq. shall continue to be approved until the facility is converted.

This subrule does not abrogate requirements relative to maintaining the equipment and systems in proper and safe working order.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10551 Smoke barriers {#sec-r-400.10551 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10551}

Rule 551. (1) Smoke barriers with a 1-hour-fire-resistance rating shall be provided on each floor that is used for sleeping rooms for more than 24 residents and shall be located so as to form an area of refuge on either side that is served with an approved means of egress. The barriers shall be located as close as possible to the middle of the floor to be protected and shall extend from outside wall to outside wall and from the floor through any interstitial spaces to the roof or floor structure above.

(2) Doors in the smoke barrier shall be at least C-labeled fire doors that are hung in labeled frames with self-closing devices. Where double doors without mullions are used, synchronizing hardware and astragals shall be installed.

(3) Doors in smoke barrier partitions may be held open only by electric hold-open devices which are designed so that interruption of the electric current or actuation of the fire alarm, sprinkler system, or the heat or smoke detector will cause the release of the doors. The doors shall also be capable of being manually opened and closed.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10553 Storage rooms {#sec-r-400.10553 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10553}

Rule 553. Storage rooms which are larger than 100 square feet and which are used for the storage of combustible materials shall be separated from the remainder of the facility by construction which has at least a 1-hour-fire-resistance rating.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10555 Combustible storage {#sec-r-400.10555 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10555}

Rule 555. (1) In a new, remodeled, or converted large facility, hazardous areas and rooms for storing combustible materials, including all janitor rooms and closets, except as provided by subrule (2) of this rule; linen rooms, except as provided by subrule (2) of this rule; shipping and receiving rooms; kitchen storage rooms; and maintenance shops shall be separated from the remainder of the building by construction which has at least a 1hour-fire-resistance rating and shall be protected by automatic sprinklers.

(2) In a new, remodeled, or converted large facility, janitor rooms, closets, and linen rooms that are less than 21 square feet do not require automatic sprinklers if such rooms are not located on a corridor or in an area used as part of a required means of egress or if these rooms and closets are on an egress corridor and the door to such is a B-labeled fire door and labeled frame.

(3) In an existing facility, combustible materials storage rooms and hazardous areas, including janitor rooms and closets, shipping and receiving rooms, kitchen storage rooms, and maintenance shops, that are approved before these rules take effect shall continue to be approved until the facility or portion thereof is remodeled or converted.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10557 Cooking appliances {#sec-r-400.10557 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10557}

Rule 557. (1) Cooking appliances shall be suitably installed in accordance with approved safety practices.

(2) If metal hoods or canopies are provided over domestic cooking appliances, they shall be equipped with filters. Filters shall be maintained in an efficient and clean condition.

(3) In a newly constructed, remodeled, or converted large and secure facility, if metal hoods or canopies are provided over commercial kitchen cooking appliances, they shall be designed and equipped in compliance with the provisions of the national fire protection association pamphlet no. 96, entitled "Standard for the Installation of Equipment for the Removal of Smoke and Grease Laden Vapors from Commercial Cooking Equipment," 1980, and shall comply with all of the following requirements:

(a) Filters shall be maintained in an efficient and clean condition.

(b) Only vaporproof electrical wiring and equipment shall be permitted in hoods or canopies.

When exhaust ducts are run through concealed spaces between a ceiling and a floor or roof or through any floors above, the ducts shall be enclosed in horizontal or vertical shafts which are protected from the remainder of the building by construction that affords a 2hour-fire-resistance rating. Hoods and unenclosed ducts shall be a minimum of 18 inches from any combustible surfaces.

(d) Fire extinguishing equipment for the hood and exhaust duct of a cooking appliance in a kitchen shall be in compliance with the provisions of the national fire protection association pamphlet no. 96, entitled "Standard for the Installation of Equipment for the Removal of Smoke and Grease Laden Vapors from Commercial Cooking Equipment," 1980.

(4) In an existing facility, metal hoods and canopies that are approved before these rules take effect shall continue to be approved until the facility or a portion thereof which incorporates the kitchen is remodeled or converted. When the kitchen is remodeled or the facility is converted, hoods or canopies for cooking appliances shall be in compliance with the requirements of this rule for new construction. Filters in any hood or canopy in an existing facility shall be maintained in an efficient and clean condition.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10559 Rubbish handling and incinerators {#sec-r-400.10559 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10559}

Rule 559. (1) In a newly constructed, remodeled, or converted large or secure facility, rubbish handling and incinerators shall be in compliance with the provisions of the national fire protection association pamphlet no. 82, entitled "Incinerators, Rubbish Handling,"

Rubbish chutes and refuse bins or rooms shall be in compliance with the provision of this pamphlet for industrial-type incinerators. Approved 2-bushel or less gas incinerators may be placed in an approved furnace room and shall be equipped with approved automatic 100% shutoff controls, including a safety pilot. Feed doors shall be located in an enclosed sprinklered room or compartment that is separated from other parts of the building by walls, a floor, and a ceiling that have a fire-resistance rating of not less than 1 hour. Openings to such rooms or compartments shall be protected by approved B-labeled fire door assemblies and fire door frames.

(2) In a newly constructed, remodeled, or converted large or secure facility, rubbish chutes shall extend to not less than 4 feet above the roof and shall be covered by a metal skylight that is glazed with thin pane glass. A sprinkler head shall be installed at the top of rubbish chutes and within the chutes at alternate floor levels in buildings that are more than 2 stories in height. A rubbish chute shall empty into a separate room, closet, or bin which is constructed of materials that have at least a 1-hour resistance to fire and which is protected with an automatic sprinkler system.

(3) In new construction, incinerator rooms shall have at least 1 wall on an outside wall not exposing a closed court.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10561 Laundries {#sec-r-400.10561 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10561}

Rule 561. (1) In a newly constructed, remodeled, or converted large or secure facility with a laundry, the laundry shall be in compliance with all of the following requirements:

(a) Be located in a room that is constructed of materials which have a 1-hour-fireresistance rating. The laundry shall be protected by an approved automatic sprinkler system. When a laundry is located in a nonresident-occupied level, a sprinkler system is not required if domestic laundry equipment is used.

(b) Have steam lines installed that have at least a 1-inch clearance from combustibles.

(d) Have 100% automatic and manual shutoff controls for gas appliances other than domestic laundry equipment, which need only have manual shutoff controls.

(e) Have adequate outside air for combustion where combustion-type equipment is used.

(2) In a newly constructed, remodeled, or converted facility, laundry chutes shall be in compliance with all of the following requirements:

(a) Be enclosed in shafts that are constructed of an assemblage of noncombustible materials which have at least a 1-hour resistance to fire.

If the shaft does not extend through the roof of the building, the top shall be covered with noncombustible material that affords at least a 1-hour resistance to fire. There shall be no openings into the shaft other than those necessary for the intended use of the laundry chute.

Feed doors shall be located in an enclosed sprinklered room or compartment that is separated from other parts of the building by walls, a floor, and a ceiling which have a fireresistance rating of not less than 1 hour.

Openings to such rooms or compartments shall be protected by B-labeled fire doors in labeled frames.

(b) Have a sprinkler head installed at the top of the chutes and within the laundry chutes at alternate floor levels in buildings over 2 stories in height.

(c) Empty into a separate room, closet, or bin which is constructed of materials that have at least a 1-hour resistance to fire and which is protected by automatic sprinklers.

(d) Have any of the following:

(i) An open vent at the top where the shaft extends through the roof of the building.

(ii) A skylight which is glazed with ordinary glass and which is not less than 10% of the shaft area.

(iii) A window of ordinary glass which is not less than 10% of the shaft area.

(iv) A window of ordinary glass which is not less than 10% of the shaft area and which is set into the side of the shaft with the sill of the window not less than 2 feet above the roof level and 10 feet from any property line or other exposure it faces.

(3) In an existing facility, laundry facilities and laundry chutes that are approved before these rules take effect shall continue to be approved until the facility is converted or the portion of the facility which includes the laundry facility or chute is remodeled.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10563 Motor vehicle housing {#sec-r-400.10563 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10563}

Rule 563. A motor vehicle or gasoline-powered equipment or devices which may cause or communicate fire and which are not necessary for the personal care of residents shall not be stored within a facility, unless the area that houses such equipment is separated from the rest of the facility by materials that have at least a 1-hour-fire-resistance rating.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10565 Garages {#sec-r-400.10565 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10565}

Rule 565. (1) Garages that are located beneath a facility shall have walls, partitions, floors, and ceilings separating the garage space from the rest of the facility by construction that has not less than a 1-hour-fire-resistance rating.

(2) In newly constructed, remodeled, or converted facilities, a garage that is located beneath the facility shall be sprinklered.

(3) Garages that are attached to a facility shall be completely separated from the rest of the facility by construction that has not less than a 1-hour-fire-resistance rating.

(4) In all new, remodeled, or converted facilities, the sills of all door openings between the garage and breezeway or the garage and the facility shall be raised not less than 4 inches above the garage.

(5) In existing facilities, garages which are located beneath or attached to the facility and which are approved before these rules take effect shall continue to be approved until the facility is converted or the portion of the facility that contains the garage is remodeled.

PART 6. FIRE SAFETY FOR RESIDENTIAL GROUP HOME FACILITIES

History

History: 1992 AACS.

Mich. Admin. Code R 400.10601 Definitions {#sec-r-400.10601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10601}

Rule 601. As used in this part:

(a) "Approved" means acceptable to the department and fire inspecting authority and in accordance with these rules. The department makes the final approval based on recommendations from the fire inspecting authority and recognized national standards.

(b) "Basement" means that habitable portion of a building which is below grade but which is located so that the vertical distance from the grade to the floor is more than the vertical distance from the grade to the ceiling. However, where the ceiling of such portion of a building is located 5 feet or more above grade for more than 25% of the perimeter measurement of the building or part of the building affected, the building shall be classed as a first story.

(d) "Conversion" or "converted" means any of the following:

(i) A change, after the effective date of these rules, in the use of a facility or a portion thereof from some previous use to that of a licensed or approved facility.

(ii) An increase in capacity from a residential group home facility to a small facility or a large facility.

(iii) A change to a secure facility.

(iv) After the effective date of these rules, a change from caring for ambulatory residents only to caring for 1 or more nonambulatory residents.

A converted facility shall be in compliance with the provisions of these rules for fire safety for converted facilities.

(e) "Existing facility" means a building which is licensed or approved by the department as an open facility for less than 7 residents at the time these rules take effect and which is not unoccupied or unlicensed for more than 90 consecutive days thereafter. Where an increase in capacity or change in use affects fire safety requirements, the facility shall comply with all applicable requirements before the increase or change in use.

(f) "Facility" means a building that is owned, leased, or primarily rented by a juvenile court for use as a residential group home facility to house and sleep residents. "Facility" includes new, remodeled, converted, and existing facilities.

(g) "Fire alarm device" means an approved device that is capable of sounding an alarm.

A fire alarm shall be specifically designated as such and shall not be used for any purpose other than sounding an alarm of fire or other emergency or for fire drills. The device shall be loud enough to be heard throughout the facility under normal conditions. A device may be a bell, a horn, a whistle, or any other device that is acceptable to the fire inspecting authority.

(h) "Fire-resistance rating" means the time in hours or fractions thereof that materials or their assemblies will resist fire exposure as determined by fire tests established and conducted by approved testing laboratories.

(i) "Means of egress or exit" means an unobstructed way of departure from any point in a building to safe open air outside at grade.

(j) "Newly constructed," "new construction," or "new facility" means a structure or addition to a facility after the effective date of these rules.

(k) "Nonambulatory" with respect to a resident, including a resident confined to a wheelchair, means being physically or mentally incapable of traversing a path to safety without the aid of another person. A path to safety includes the descent and ascent of any stairs or other approved means of egress from the building.

(l) "Remodeled" means changes in a facility that modify existing conditions and includes renovation. Remodeled and affected areas of an institution shall conform to the provisions of these rules for fire safety for remodeled and converted facilities. Unaffected areas of a facility are not required to conform to the required provisions for remodeled and converted facilities.

(m) "Residential group home facility" means a building which is used to house less than 7 residents and which is not a secure facility.

(n) "Second story" means the story of a building above the highest story which has a means of egress that is not more than 4 feet to grade.

(o) "Street floor" means the lowest story of a facility that is not a basement.

(p) "Story" means that part of a building between a floor and the floor or roof next above.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10603 Applicability {#sec-r-400.10603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10603}

Rule 603. The rules set forth in this part apply to residential group home facilities.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10604 Evacuation training; telephone {#sec-r-400.10604 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10604}

Rule 604. (1) Residential group home facility staff shall be trained in the evacuation of the facility in the event of an emergency. A record shall be maintained of the training.

(2) There shall be a telephone for communicating an alarm of fire to the fire department.

A pay phone is not acceptable as a phone for communicating an alarm of fire.

(3) The telephone number of the fire department shall be posted by all phones.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10605 Facility location {#sec-r-400.10605 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10605}

Rule 605. A residential group home facility shall not be established within 300 feet of an aboveground storage tank which contains flammable liquids that are used in connection with any of the following:

(a) A bulk plant.

(b) A marine terminal.

(d) Bottling plant of a liquid petroleum gas installation.

(e) Other similar hazard.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10607 Combustible materials and decorations {#sec-r-400.10607 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10607}

Rule 607. (1) A residential group home facility shall be kept free of all accumulation of combustible materials other than those necessary for the daily operation of the residential group home.

(2) Easily ignited or rapidly burning combustible decorations are not permitted in a facility. Personal artwork and personal decorations made or owned by residents are permitted up to 6 square feet of wall space in each room or area other than means of egress or hazardous areas.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10609 Basement as sleeping room prohibited {#sec-r-400.10609 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10609}

Rule 609. A residential group home facility basement shall not be used for sleeping.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10611 Electrical service {#sec-r-400.10611 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10611}

Rule 611. (1) The electrical service in a residential group home facility shall be maintained in a safe condition.

(2) If the inspecting authority believes there is a need for an inspection of the electrical system because of its condition, the electrical service shall be inspected by a qualified electrical inspection service. A copy of the inspection report shall be maintained at the facility for review.

(3) If an electrical system inspection indicates deficiencies in the electrical system, the deficiencies shall be corrected and a certificate of approval shall be maintained at the facility which confirms that all deficiencies related to the electrical system have been corrected.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10613 Construction {#sec-r-400.10613 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10613}

Rule 613. A residential group home facility shall be at least of ordinary construction, light platform frame, and not over 2 stories high above the highest grade.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10614 Locked resident confinement room prohibition {#sec-r-400.10614 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10614}

Rule 614. A locked resident confinement room is not permitted in a residential group home facility.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10615 Interior finish {#sec-r-400.10615 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10615}

Rule 615. (1) The following alphabetical classification of finished materials for flame spread and smoke development, as determined by the tunnel test in accordance with the provisions of the national fire protection association pamphlet no. 255, 1979; American society of testing materials standard E-84-77A, 1978; or underwriters laboratories standard no. 723, 1977, shall be used to classify interior finishes in residential group home facilities:

Class Flame Spread Smoke Developed A 0-25 0-450 B 26-75 51-450 C 76-200 126-450 The same alphabetical classification is used to classify combustibility of prefabricated acoustical tile units, as determined by federal specifications test no. SS-S-118a.

(2) The classification of interior finish materials as to their flame spread and smoke development shall be that of the basic material used, without regard to subsequently applied paint or other coverings, except where such paint or other covering is of such a character or thickness where applied so as to affect the material classification. Finishes such as lacquer, polyurethane-based materials, or unapproved wall coverings shall not be used.

(4) In an existing residential facility, if an interior finish at the time these rules take effect does not comply with the provisions of subrule (3) of this rule and if an interior finish is applied to or furred out not more than 1 inch from a continuous noncombustible backing, an interior finish may have the surface protected with an approved fire-retardant coating so as to meet the interior finish requirements.

(5) Interior finishes and materials shall be at least class C throughout.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10617 Smoke detection equipment {#sec-r-400.10617 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10617}

Rule 617. (1) A residential group home facility shall be protected by at least batteryoperated smoke detection devices that are installed in all of the following areas:

(a) Between sleeping areas and the other areas of the facility.

(b) At the top of all interior stairways.

(c) In the immediate vicinity of combustion-type heating and incinerating devices, if such devices are not in an enclosure that provides at least 1 hour of resistance to fire. If such heating and incinerating devices are in enclosures that provide at least 1 hour of resistance to fire, a fire detection device shall be installed immediately outside of the enclosure.

(d) At least 1 on every floor.

(2) Fire detection devices shall be in compliance with all of the following requirements:

(a) Be listed or labeled by an independent, nationally recognized testing laboratory.

(b) Be installed and maintained in accordance with the manufacturer's and test specifications.

(d) Have the batteries replaced at least annually.

(e) Be of a type that provides a signal if batteries are not providing sufficient power and if batteries are missing.

(3) Any device that is required by this rule which signals that power is low or that a battery is missing shall be immediately serviced and restored to full power.

(4) A written record shall be maintained in the facility of the quarterly cleaning and testing of devices and of the annual battery replacements.

(5) In an existing residential group home facility, fire detection systems that are approved before these rules take effect shall continue to be approved. In an existing residential group home facility and in any other residential group home facility with a fire detection system, the fire detection system shall be maintained in proper working order.

(6) Detectors shall be ceiling-mounted when possible.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10619 Fire extinguishers {#sec-r-400.10619 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10619}

Rule 619. (1) All required fire extinguishers in residential group home facilities shall be subjected to a maintenance check at least once a year.

Each fire extinguisher shall have a tag or label attached that indicates the month and year maintenance was performed and that identifies the person or company that performs the service.

(2) All required extinguishers shall be recharged after use.

(3) A minimum of 1 approved fire extinguisher shall be provided on each floor.

(4) All fire extinguishers shall be not less than 4 inches off the floor and the top of the extinguisher shall be not more than 5 feet off the floor in a special cabinet or on a wall rack which is easily accessible at all times, unless programmatically contraindicated. Where programmatically contraindicated, the required extinguishers may be kept behind locked doors if all staff carry keys to the doors.

(5) In new, remodeled, or converted facilities, a fire extinguisher shall be at least a type 2-A-10BC.

(6) In existing facilities, previously approved fire extinguishers other than type 2-A-10BC will continue to be approved if they are located in the area for which approved.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10621 Fire alarm systems {#sec-r-400.10621 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10621}

Rule 621. A residential group home facility shall be equipped with a fire alarm device.

The device shall be used only to sound an alarm of fire, for practice drills, and for other emergencies that require evacuation of the facility.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10623 Means of egress {#sec-r-400.10623 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10623}

Rule 623. (1) Means of egress in a residential group home facility shall be considered the entire way and method of passage to free and safe ground outside a facility. All required means of egress shall be maintained in an unobstructed, well-defined, easily traveled condition at all times.

(2) There shall be not less than 2 means of egress from the street floor story. At least 1 of the 2 means of egress shall be through a side-hinged door. The door shall be a minimum of 30 inches wide, except as provided in R 400.10625. The second means of egress may be a sliding glass door.

(3) A second story shall only be used by ambulatory residents and shall be in compliance with 1 of the following requirements:

(a) Have 2 open stairways that are separated by not less than 50% of the longest dimension of the story.

(b) Have 1 open interior stairway and 1 exterior stairway or fire escape that are separated by not less than 50% of the longest dimension of the story. An exterior stairway or fire escape does not require protection from fire in the building. An exterior stairway or fire escape shall be constructed of not less than 2-inch nominal lumber and be in good repair.

(c) Have 1 interior stairway and all floors separated by materials which afford at least a 3/4-hour-fire-resistance rating. The doors separating floors shall be at least 1 3/4-inch solidcore wood and shall be equipped with latching hardware and self-closing devices. Each sleeping room on the second story shall have a window which is not less than 5 square feet and which does not have a dimension that is less than 22 inches to allow for emergency rescue.

(4) A basement that is used by residents shall have at least 1 means of egress, which may be a stairway. The stairway may be an open stairway, except as required by the provisions of subrule (3)(c) of this rule.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10625 Special requirements for nonambulatory residents {#sec-r-400.10625 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10625}

Rule 625. A residential group home facility that provides care to 1 or more nonambulatory residents shall comply with all of the following provisions:

(a) House such residents only on the street floor.

(b) Have required exitways that are not less than 48 inches wide in a new facility and not less than 44 inches wide in an existing or converted facility. Doors shall be a minimum of 36 inches wide.

(c) Have required exits discharge at grade level or have required exits equipped with ramps. Ramps shall not have more than 1 foot of rise in 12 feet of run and shall have sturdy handrails. Once at grade, nonambulatory residents shall have a surface that is sufficient to permit them to move a safe distance from the facility.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10629 Stairs {#sec-r-400.10629 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10629}

Rule 629. (1) In new and converted residential group home facilities, stairs shall have treads of uniform width and risers of uniform heights.

Treads shall be not less than 9 1/2 inches deep, exclusive of nosing, and risers shall be not more than 7 3/4 inches in height.

(2) Stairs in an existing facility that is approved before these rules take effect shall continue to be approved until the portion of the building that encompasses the stairs is remodeled.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10631 Doors {#sec-r-400.10631 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10631}

Rule 631. (1) Doors to required means of egress in residential group home facilities shall be equipped with at least knob-type, properly operating, positive-latching, nonlockingagainst-egress-type hardware which insures the opening of the door with a single motion, such as turning a knob or applying normal pressure on a latch, except that an approved sliding door may be equipped with a non-key locking device.

(2) Required doors that enter stairways and doors to fire-rated enclosures shall not be held in an open position at any time by an under-door wedge or hold-open device.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10633 Heating devices and flame-producing devices {#sec-r-400.10633 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10633}

Rule 633. (1) Flame-producing-type heating devices and incinerator devices on any story of a residential group home facility that is used by residents shall be in an enclosure that provides at least 1 hour of resistance to fire. Any interior door to the enclosure shall be at least a B-labeled fire door in a labeled frame that is equipped with latching hardware and a self-closing device. Adequate combustion air shall be provided to the enclosure directly from the outside through a permanently opened louver or continuous ducts. Fire dampers are not required in ducts that penetrate this enclosure.

(2) If flame-producing-type heating devices or incinerator devices are located on a story that is not used by residents, there shall be a separation between the story or stories that contain such devices and resident-used stories such that at least a 3/4-hour resistance to fire is provided. Any interior stairway to such a nonresident-used story shall have at least a 1 3/4-inch solid-core wood door which is equipped with latching hardware and a self-closing device which separates the nonresident-used story from resident-used stories.

(3) Electric heating shall be installed in accordance with the manufacturer's specifications and shall be of a type approved by a nationally recognized, independent testing laboratory.

(4) Portable heaters and space heaters, including solid fuel heaters, are prohibited.

(5) A fireplace is permitted if it is masonry and has all of the following components:

(a) An approved glass door shielding the opening. The door shall be closed at all times, except when a fire is being tended.

(b) A noncombustible hearth that extends a minimum of 16 inches out from the front, and 8 inches beyond each side, of the fireplace opening.

(c) A noncombustible face that extends not less than 12 inches above, and 8 inches on each side of, the fireplace opening.

(d) A masonry chimney that is constructed with approved flue liners.

(6) A heating plant room shall not be used for combustible storage or for a maintenance shop unless sprinklered.

(7) A furnace and other flame-producing unit shall be installed according to manufacturer and test specifications and shall be vented by metal ducts to a chimney which is constructed of bricks, solid block masonry, or reinforced concrete, which has an approved flue lining, and which is properly erected and maintained in a safe condition. A bracket chimney is not permitted. This rule does not prohibit the installation and use of any prefabricated chimney that bears the label of an approved, nationally recognized, independent testing laboratory if it is installed in accordance with manufacturer and test specifications and is compatible with the heating unit or units connected to it. Only gas- and oil-fired units may be connected to a prefabricated chimney.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10635 Storage rooms {#sec-r-400.10635 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10635}

Rule 635. Residential group home facility storage rooms which are more than 100 square feet and which are used for the storage of combustible materials shall be separated from the remainder of the facility by construction that has at least a 1-hour-fire-resistance rating.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10637 Cooking appliances {#sec-r-400.10637 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10637}

Rule 637. (1) Cooking appliances that are used in residential group home facilities shall be of the domestic type and shall be installed in accordance with approved safety practices.

(2) If hoods or canopies are provided over the cooking appliances, they shall be equipped with filters. Filters shall be maintained in an efficient and clean condition.

History

History: 1992 AACS.

Mich. Admin. Code R 400.10639 Garages {#sec-r-400.10639 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.10639}

Rule 639. (1) A garage that is located beneath a residential group home facility shall have walls, partitions, floors, and ceilings that separate the garage from the rest of the facility by construction that has at least a 1-hour-fire-resistance rating.

(2) A garage that is attached to a facility shall be separated from the rest of the facility by construction that has at least a 1-hour-fire-resistance rating.

History

History: 1992 AACS.

R 400.12101 to R 400.12808 Child Placing Agencies

Mich. Admin. Code R 400.12101 Definitions {#sec-r-400.12101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CHILDREN’S SERVICES AGENCY

CHILD PLACING AGENCIES

(By authority conferred on the director of the department of health and humans services by sections 2, 5, 10, and 14 of 1973 PA 116, and Reorganization Nos. 1996- 1, 1996-2, 2003-1, 2004-4, and Executive Order 2015-004; MCL 722.112, 7 2 2 . 1 1 5 , 722.120, and 722.124, and Executive Reorganization Order No. 2015-1, MCL 400.227.330.3101, 333.5111, 445.2001, 445.2011, and 400.226)

PART 1. GENERAL PROVISIONS

Rule 101. (1) As used in these rules:

(a) “Act” means 1973 PA 116, MCL 722.111 to 722.128.

(b) “Agency” means child-placing agency as defined in section 1 of the act, MCL 722.111.

(c) "Case record" means the individual file, including electronic records, kept by an agency concerning a child who has been placed by the agency.

(d) “Chief administrator” means the person designated by the licensee as having the day-to-day responsibility for the overall administration of a child placing agency and for assuring the care, safety, and protection of children and families served.

(e) “Concurrent planning” means simultaneously planning for reunification and alternative permanence.

(f) “Contractor” means a person contracted to perform services or to provide supplies to a child placing agency.

(g) “Corporal punishment” means hitting, paddling, shaking, slapping, spanking, or any other use of physical force as a means of behavior management.

(h) “Department” means the Michigan department of health and human services.

(i) “Deemed status” means a status conferred on an organization based on a professional standard’s review by a national accrediting organization that recognizes that the organization’s programs meet certain effectiveness criteria.

(j) “Emergency placement” means a placement that is made in response to a sudden unexpected occurrence that demands immediate action.

(k) “Foster care” means a child's placement outside the child's parental home by and under the supervision of a child placing agency, the court, or the department. Foster care does not include the delegation of a parent's or guardian's powers regarding care, custody, or property of a child or ward under a properly executed power of attorney under the safe families for children act, 2018 PA 434, MCL 722.1551 to 722.1567.

(l) “Foster child” means a person who meets all the following criteria:

(ii) Is either of the following:

(A) Placed with or committed to the department for care and supervision by a court order under section 2 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2.

(B) Is 18 years of age or older, was in foster care prior to turning 18, and agrees to remain in care following termination of court jurisdiction.

(m) “Foster parent" means the person or persons, including tribal members, to whom a foster home license is issued.

(n) “Gender” or “gender identity” means a person’s internal identification or selfimage as a man, boy, woman, girl, or another gender identity.

(o) “Gender expression” means how a person publicly expresses or presents their gender, which may include behavior and outward appearance such as dress, hair, makeup, body language, and voice. Components of gender expression may or may not align with gender identity.

(p) “Human behavioral science” means a course of study producing a degree from an accredited college or university that is approved by the department for the specific positions when required by the act and these rules.

(q) “Independent living” means the placement, by an agency, of a youth who is not less than 16 years of age in his or her own unlicensed residence, the residence of an adult who does not have supervisory responsibility for the youth, or in a residence under the control of the agency. The authorized agency or governmental unit retains supervisory responsibility for the youth.

(r) “Infant” means a child between birth and the date of the child’s first birthday.

(s) “Licensing authority” means the administrative unit of the department responsible for making licensing and approval recommendations for a child placing agency.

(t) “Parent” means a legal parent and includes a custodial parent, noncustodial parent, or adoptive parent.

(u) “Placement” means moving a child to an out-of-home living arrangement for purposes of foster care, adoption, or independent living; or from out-of-home placement to another out-of-home placement.

(v) “Sexual orientation” means a person's identity in relation to the gender or genders to which they are attracted.

(w) “Social service aide” means an individual who is employed, contracted, or a volunteer who has specified case-support duties as defined by department or agency policy.

(x) “Social service supervisor” means a person who supervises a social service worker. A social service supervisor may also function as a social service worker in the temporary absence of the social service worker if the provisions of R 400.12205 are met.

(y) “Social service worker” means a person who performs social service functions prescribed by these rules.

(z) “SOGIE” means an individual’s sexual orientation, gender identity, and expression.

(aa) “Staff” means an individual who is 18 years of age or older and who is employed by a child placing agency for compensation.

(bb) “Tribe” means a federally recognized tribe.

(cc) “Volunteer” means a person who is not an employee and does not receive compensation but donates his or her work and acts at the direction of and within the scope of duties determined by the child placing agency.

(2) A term defined in the act has the same meaning when used in these rules.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2015 AACS; 2023 AACS.

Mich. Admin. Code R 400.12102 Rule variance {#sec-r-400.12102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12102}

Rule 102. (1) Upon the written request of an applicant or agency, the department may grant a variance from an administrative rule if the alternative proposed ensures that the health, care, safety, protection, supervision, and needed services of children are maintained, and that the alternative aligns with the intent of the administrative rule.

(2) The department shall enter its decision, including the qualifications under which the variance is granted, in the records of the department and a signed copy must be sent to the applicant or agency. The variance may be time-limited or may remain in effect for as long as the agency continues to comply with the intent of the rule.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12103 Staff exception {#sec-r-400.12103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12103}

Rule 103. An agency who has a person in a position that is regulated by these rules and who was approved before the effective date of these rules is considered qualified for the position.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12104 Deemed status {#sec-r-400.12104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12104}

Rule 104. (1) The department may accept, for the purpose of determining rule compliance, evidence that the child placing agency is accredited by the council on accreditation or other nationally recognized accrediting body whose standards closely match state licensing regulations.

(2) All of the following apply to deemed status:

(a) The organization may request deemed status when the accreditation site inspection is less than 12 months old.

(b) When deemed status is requested, an organization shall submit a copy of the most recent accreditation report to the department.

(3) The acceptance of accreditation in subrule (1) of this rule does not prohibit the department from conducting on-site inspections or investigations of any rule at intervals determined by the department.

History

History: 1979 AC; 1998-2000 AACS, 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12105 Public review {#sec-r-400.12105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12105}

Rule 105. An agency shall make all written policies, procedures, and program statements, required by these administrative rules, available for review by the public.

PART 2. AGENCY SERVICES

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12201 Department authorization {#sec-r-400.12201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12201}

Rule 201. An agency shall comply with the provisions of part 2 of these rules to be authorized by the department to provide regulated services.

History

History: 1998-2000 AACS.

Mich. Admin. Code R 400.12202 Policy and procedures {#sec-r-400.12202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12202}

Rule 202. An agency shall have and follow written policies and procedures for all the areas of foster care services as provided in R 400.12203 to R 400.12214.

History

History: 1998-2000 AACS; 2007 AACS; 2023 AACS.

Mich. Admin. Code R 400.12203 Financial stability {#sec-r-400.12203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12203}

Rule 203. (1) An agency shall demonstrate sufficient financing, on an ongoing basis, to ensure the agency is carrying out its programs and meeting the requirements for licensing. A plan of financing must include all the following:

(a) A listing of all income sources and the anticipated amount of income for the current fiscal year.

(b) An annual budget for the current fiscal year.

(d) A copy of the nonprofit tax return from the previous fiscal year.

(e) An audit of all financial accounts conducted annually by an independent certified public accountant not administratively related to the agency. A copy of the audit shall be available to the department upon request.

(2) Subdivisions (d) and (e) of subrule (1) do not apply to a governmentally operated agency.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12204 Facilities {#sec-r-400.12204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12204}

Rule 204. (1) An agency shall provide and maintain sufficient office space, equipment, and supplies to ensure the delivery of services.

(2) An agency shall have physical office space with a Michigan street address.

(3) An organization may maintain satellite offices when the following conditions are met:

(a) The agency has notified the department in writing prior to opening the satellite office and has received approval to open the satellite office.

(b) There is a completed written plan to ensure appropriate supervision is provided on a regular basis.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12205 Required staff {#sec-r-400.12205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12205}

Rule 205. (1) An agency shall employ or contract for all the following staff positions:

(a) Chief administrator.

(b) Social service supervisor.

(2) An agency shall appoint a chief administrator who possesses at least 1 of the following:

(a) A master’s degree in a human behavioral science, or in another major where 25% of the course credits earned toward the degree are in human behavioral sciences, business administration, or public administration from an accredited college or university and 2 years of experience in an agency or child caring institution, at least 1 of which is in a management capacity.

(b) A bachelor’s degree in a human behavioral science, or in another major where 25% of the course credits earned toward the degree are in human behavioral sciences, business administration, or public administration from an accredited college or university and 4 years of post- bachelor’s degree experience in an agency or child caring institution, at least 2 of which are in a management capacity.

(3) An agency shall report any change of chief administrator by the next business day to the department.

(4) An agency shall appoint a social service supervisor who possesses the qualifications in either of the following:

(a) A master’s degree from an accredited college or university in a human behavioral science or in another major where 25% of the course credits earned toward the degree are in human behavioral sciences and 3 years of experience as a social service worker in an agency, or a child caring institution, or in an agency in a child welfare function.

(b) A bachelor’s degree from an accredited college or university in a human behavioral science, or in another major where 25% of the course credits earned toward the degree are in human behavioral sciences, and 4 years of experience as a social service worker, 2 years of which are in an agency or in a child caring institution, or in an agency in a child welfare function.

(5) An agency shall appoint a social service worker who possesses at least a bachelor’s degree from an accredited college or university with a major in a human behavioral science, or in another major where 25% of the course credits earned toward the degree are in human behavioral sciences.

(6) A person who is employed by the agency or who has a contract with the agency and who fulfills more than 1 function specified by subrule (1) of this rule must meet the requirements for each position.

(7) If a social service worker also has social service supervisor responsibilities, as permitted under subrule (6) of this rule, then the worker may not supervise his or her own tasks as a social service worker.

(8) An agency shall employ or contract for a sufficient number of competent staff to carry out the provisions covered by these rules. The workload for each staff member may not be more than any of the following:

(a) Five social service workers per supervisor.

(b) Fifteen children assigned to a social services worker for purposes of providing direct services in foster care, independent living, adoption, or post adoption services or a combination thereof.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12206 Staff qualifications; volunteer, contractors on central registry {#sec-r-400.12206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12206}

Rule 206. (1) An agency shall require a staff member who has ongoing contact with children or parents to be a person who has the ability, experience, education, and training to perform the duties assigned.

(2) A staff member must be of responsible character and suitable and able to meet the needs of children and families served by the agency.

(3) An agency’s policy on staff qualifications must state all the following:

(a) A person who has unsupervised contact with children may not have been convicted of either of the following:

(i) Child abuse or neglect.

(ii) A felony involving harm or threatened harm to an individual within the 10 years immediately preceding the date of hire.

(b) A person who is listed on the central registry as a perpetrator of child abuse or child neglect is ineligible for employment if the responsibilities of the position includes unsupervised contact with children.

(4) A volunteer or contractor who is listed on the central registry as a perpetrator of child abuse or child neglect may not have unsupervised contact with children.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12207 Staff responsibilities {#sec-r-400.12207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12207}

Rule 207. (1) An agency shall designate the chief administrator as responsible for the day-to-day operation of the agency and for ensuring compliance with the applicable provisions of these rules.

(2) An agency chief administrator is administratively responsible for all the following functions:

(a) The licensee or chief administrator has the administrative capability to operate a child placing agency and provide the level of care and program stipulated in the application.

(b) A chief administrator must demonstrate the administrative capability to oversee the on-site, day-to-day operation of the institution and for ensuring compliance with these rules.

(c) Not less than once annually, conduct a written assessment and verify the agency’s compliance with the applicable provisions of these rules.

(d) Assess all disrupted and unplanned removals of children from foster homes, independent living, and adoptive homes to identify systemic trends and patterns of those disrupted and unplanned removals.

(e) Within 6 months, develop and implement a written plan to correct noncompliance identified in subdivision (c) of this subrule and address causes of disrupted and unplanned removals identified in subdivision (d) of this subrule.

(f) Provide space to individuals served to be interviewed privately by police, regulatory staff, children’s protective services, or other entities investigating activities of the agency related to safety of children and compliance with statute and promulgated rules.

(3) An agency shall require that social service workers be directly responsible for all the following activities:

(a) Placing and supervising children in out-of-home care. Social service workers shall work directly with the children, their families, and other relevant individuals and be primarily responsible for the development, implementation, and review of service plans for the children and their families.

(b) Facilitating services and parenting time for children for purposes of reunification.

(d) Conducting evaluations of private family homes for purposes of adoption.

(e) Supervising and assessing children for adoptive placement.

(4) An agency shall require social service aides to be directly responsible to a social service worker or social service supervisor. A social service aide may provide clearly defined support functions, but may not have responsibility for any of the following:

(a) Case planning.

(b) Selecting placements.

(d) Conducting foster care and licensing case contacts for purposes of foster care or adoption case planning, or licensing certification contacts.

(e) Conducting adoptive family evaluations.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12208 Job descriptions {#sec-r-400.12208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12208}

Rule 208. (1) An agency shall have a current written job description for each staff and position.

(2) Each job description must contain all the following information:

(a) Prescribed duties and functions.

(b) Specific education, knowledge, experience, and skills necessary to provide services to children and families served by the agency.

(3) An agency shall give copies of job descriptions to staff at the time of employment in a specified position and when the job description is revised.

(4) Practice must conform to the job description.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12209 Orientation and training {#sec-r-400.12209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12209}

Rule 209. (1) An agency shall ensure and document all the following:

(a) That each social service worker and each social service supervisor receives not less than 16 hours of orientation after initial appointment and before assumption of assigned duties.

(b) That each social service worker and each social service supervisor receives not less than 15 hours of training relating to his or her current position within the first year of being assigned to the position.

(c) That each social service worker and each social service supervisor receives not less than 15 hours of planned training relating to his or her current position annually after the time periods specified in subrule (1) of this rule.

(2) The orientation and training specified in subrule (1) of this rule for each social service worker must include all the following topics:

(a) Characteristics and needs of children and families served by the agency, including trauma-informed parenting, human trafficking, systemic racism, and SOGIE training.

(b) Requirements of applicable statutes relating to the services the agency provides that are subject to these rules.

(c) Agency expectations for the social service worker to facilitate and supervise the care of children and to work with families that are served by the agency.

(d) Agency expectations for the social service worker’s role and responsibility with foster parents and other persons who provide care or services to children and families served by the agency.

(e) Agency expectations for developing, maintaining, and reviewing initial and updated service plans for children and families served by the agency.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12210 Grievance handling {#sec-r-400.12210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12210}

Rule 210. An agency shall have a written grievance handling procedure as mandated by section 8a of the foster care and adoption services act, 1994 PA 203, MCL 722.958a, and known as the “foster parent’s bill of rights law.”

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12211 Privacy safeguard {#sec-r-400.12211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12211}

Rule 211. (1) An agency shall safeguard the privacy of a child and his or her family.

(2) An agency shall not use a child's identity for publicity purposes unless consent is provided by the appropriate legal parent, the department, or the court.

(3) Video cameras in a bedroom of any foster child over the age of 2 is strictly prohibited.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12212 Personnel records {#sec-r-400.12212 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12212}

Rule 212. (1) An agency shall maintain a personnel record for each staff member.

(2) The personnel record must contain all the following information before employment may occur:

(a) Name.

(b) Verification of education.

(d) Three references obtained from persons who are unrelated to the staff person.

(e) A record of any convictions other than minor traffic violations from either of the following:

(i) The Michigan state police, tribal police, or the equivalent state or Canadian provincial law enforcement agency where the person usually resides.

(ii) An entity accessing either Michigan state police records or equivalent state or Canadian provincial law enforcement agency where the person usually resides.

(f) If the employee has criminal convictions, the chief administrator or his or her designee shall complete a written evaluation of the convictions that addresses the nature of the conviction, the length of time since the conviction, and the relationship of the conviction to regulated activity.

(g) A written statement from the employee regarding any convictions.

(h) Documentation from the department that the person has not been named in a central registry case as the perpetrator of child abuse or neglect in Michigan or in any state where the person lived in the 5 years preceding hire.

(3) The personnel record must contain both of the following:

(a) A written evaluation of a staff member’s performance within a probationary period or not later than 6 months after the staff member assumes his or her current responsibilities. After the initial evaluation, a written evaluation must be conducted every 12 months.

(b) A copy of the job description for the staff member’s current position.

(4) An agency shall maintain an orientation and training record for staff members.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12213 Record Management {#sec-r-400.12213 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12213}

Rule 213. An agency shall do all the following with respect to maintenance of required records:

(a) Protect each record against destruction and damage.

(b) Keep each record in a uniform fashion.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12214 Compliance with the child protection law {#sec-r-400.12214 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12214}

Rule 214. An agency shall comply with the child protection law, 1975 PA 238, MCL 722.621 to 722.638.

PART 3. FOSTER HOME CERTIFICATION

History

History: 2007 AACS; 2023 AACS.

Mich. Admin. Code R 400.12301 Department authorization {#sec-r-400.12301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12301}

Rule 301. (1) The department shall authorize an agency to certify foster homes for licensure.

(2) An approved governmental unit must comply with the provisions of this part to be authorized to certify foster homes for licensure.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12302 Program statement {#sec-r-400.12302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12302}

Rule 302. An agency shall have and follow a current written program statement that includes all the following information:

(a) Types of foster care provided.

(b) Age and characteristics of children served.

(d) Types of services provided to children, parents, relatives, and foster families.

(e) Geographical area covered.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12303 Policy and procedures {#sec-r-400.12303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12303}

Rule 303. (1) An agency shall have and follow written policies and procedures for assessing and certifying foster homes for licensure. An agency may not have a policy related to certifying homes that violates section 102 of the Elliott-Larsen civil rights act, 1976 PA 453, MCL 37.2102.

(2) Policies and procedures must address R 400.12304 to R 400.12328 and be on forms provided, and in a manner prescribed, by the department.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12304 Recruitment and retention {#sec-r-400.12304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12304}

Rule 304. (1) An agency shall have an ongoing foster home recruitment program to ensure an adequate number of suitable and qualified homes based on the needs of children referred to the agency.

(2) An agency shall develop, implement, and maintain a program of foster home retention that includes foster parent involvement.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12305 Certification training {#sec-r-400.12305 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12305}

Rule 305. (1) All social service workers who perform foster home certification functions must complete certification and special evaluation trainings provided by the department within 6 months of assignment to the certification function. Workers must pass the written exam.

(2) Supervisors of social service workers who perform foster home certification functions must complete certification and special evaluation training prior to supervising the certification of foster homes and must pass the written exam.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12306 Application request {#sec-r-400.12306 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12306}

Rule 306. (1) An agency shall provide an orientation for prospective applicants for a foster home license before a foster home application is provided.

(2) An agency shall document that a person who has met the requirements of subrule (1) of this rule has received an application and information regarding all the following:

(a) A copy of the act.

(b) Administrative rules for foster homes.

(d) Good moral character rules.

(e) The child protection law.

(f) The children’s ombudsman act.

(g) The agency’s program statement.

(h) The agency’s foster care services policies.

(i) The agency’s foster parent training requirements.

(3) An agency shall provide the licensee an application for renewal of the license and document the action not less than 60 calendar days before the expiration date of the license. A renewal application must be provided to a licensee, regardless of any pending recommendation for disciplinary action of the license.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12307 Orientation {#sec-r-400.12307 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12307}

Rule 307. An agency foster parent orientation must consist of an overview of all the following areas:

(a) Purposes of foster care.

(b) Characteristics and needs of the children and families served by the agency.

(d) Impact of fostering on the foster family.

(e) Role of the foster family.

(f) Licensing process.

(g) Grievance procedure.

(h) Importance of a child’s parents and relatives (i) Parenting time and sibling visits.

(j) Agency foster care policies and procedures.

(k) Agency foster parent training requirements.

(l) Supportive services and resources.

(m) Trauma responsive care.

(n) Collaboration in transportation planning.

(o) Provisions of the children’s ombudsman act.

(p) Provisions of the child protection law.

(q) Foster care review board appeal procedures.

(r) Foster parent bill of rights law.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12308 Application submission {#sec-r-400.12308 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12308}

Rule 308. (1) An agency shall act on a completed and signed application.

(2) An agency shall require all caregivers in a multiple-caregiver household to sign the application.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12309 Criminal history; central registry; “good moral character”; convictions {#sec-r-400.12309 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12309}

Rule 309. (1) The agency shall obtain from a foster home applicant or licensee the name of, and a signed release for, a criminal history and child protective services check to obtain any of the following information from each adult member of the household, including children who turn 18 years of age while living in the home:

(a) Conviction of a crime other than a minor traffic violation.

(b) Involvement in a confirmed abuse or neglect of a child or adult.

(2) If an applicant, licensee, or adult member of the household is a member of a federally recognized Indian tribe or identifies that they have lived on a reservation, the certifying child placing agency must contact the specific tribal jurisdiction, including tribal social services or the tribal court, to determine whether that jurisdiction has relevant background information to provide to the certifying child placing agency regarding the licensing assessment. In the event the tribe does not respond to the inquiry, the department may proceed with the licensing assessment.

(3) The agency shall require a foster home applicant or licensee to undergo a fingerprint-based, criminal history check.

(4) The agency shall require any adult member of the household to undergo a statebased, criminal history background check and, if applicable, contact with the appropriate tribal jurisdiction as referenced in subrule (2) of this rule. Upon the agency receiving information that an additional adult is residing in the home, the agency shall immediately obtain a release from the additional adult for the information required in subrule (1) of the rule.

(5) A license will not be issued or maintained by an applicant or licensee unless the department has made a determination under section 2 of 1974 PA 381, MCL 338.42, regarding the applicant, licensee, or adult member of the household’s “good moral character” and convictions.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12310 Initial evaluation {#sec-r-400.12310 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12310}

Rule 310. (1) An agency social service worker shall complete a written initial foster home evaluation, on a form provided by the department, before certifying the home for licensure.

(2) The report must include the dates and places of contacts and persons interviewed or observed.

(3) The agency shall assess all the following:

(a) The applicant or licensee’s family and marital status and history, including current and past level of family functioning and relationships, and any incidents of domestic violence, elder abuse, or child abuse, as a perpetrator.

(b) The circumstances surrounding any criminal convictions or arrests for each member of the household, including minor children.

(c) Physical, mental, and emotional health of each member of the household, including any history of substance use disorder or treatment.

(d) Current mental health or substance use, or both.

(e) Parenting skills and strategies for building healthy relationships with children.

(f) Methods of discipline of children.

(g) Adjustment and special needs of the applicant’s own children, including children not living in the home.

(h) Previous licenses or experience in providing child foster care, child day care, or adult foster care.

(i) Existence of a social support system including alternate care providers.

(j) Willingness to accept a child’s spirituality, or religious beliefs or practices, even if they differ from the foster parent.

(k) Willingness to accept and support a child’s SOGIE.

(l) Safety and maintenance of the applicant’s house and property, including but not limited to, the following:

(i) Sufficient beds and sleeping space.

(ii) Pets.

(iii) Weapons.

(iv) Fire or water hazards.

(m) The age, number, gender, race, ethnic background, and characteristics of children preferred by the applicants, including those characteristics that an applicant or licensee would not accept.

(4) The agency will collect all the following:

(a) Three current references, related or non-related, from the applicant or licensee.

(b) A medical statement that includes all treatments, prescriptions, and medications for each adult member of the household that indicates that the member has no known condition which would affect the care of a foster child. The statement must be signed by a physician, physician's assistant, or nurse practitioner within the 12-month period preceding the date of the initial evaluation. Any subsequent household member added to the household must provide the medical statement within 90 days.

(c) Information regarding any past or current, or both, mental health or substance use disorder treatment by any member of the household.

(d) The inspection results in compliance with R 400.9305.

(5) An agency shall document placement specifications consistent with the information contained in the evaluation. The placement specifications must include the following:

(a) The age, number, SOGIE, race, ethnic background, and characteristics of children preferred by the applicants.

(b) Characteristics of children best served by the family, (c) Children who may not be placed in the home. The child’s racial, ethnic, and cultural identity, heritage, and background may only be considered if an assessment of the individual child indicates that such consideration is in the best interests of the child.

(6) An agency shall inform the applicant of the department’s policies and procedures regarding concurrent planning.

(7) An agency shall provide the applicant with a copy of the final initial evaluation.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12311 Foster parent/agency agreement {#sec-r-400.12311 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12311}

Rule 311. (1) An agency shall have a written foster parent/agency agreement signed by the foster parent and the agency before initially certifying a foster home for licensure.

(2) The foster parent/agency agreement must contain all the following provisions:

(a) The responsibilities of the agency.

(b) The services to be provided to foster children and the foster family.

(d) That the foster family has been informed of, and agrees to follow, agency policies and procedures.

(e) A description of the role and the expectation to cooperate with the lawyer guardian ad litem and the state and tribal court, including the role of other appointed state and tribal attorneys.

(f) The agency schedule of foster care payments to foster parents.

(3) An agency shall document review of the foster parent/agency agreement with the foster family at least annually and, when needed, develop a new agreement.

(4) An agency shall give a foster family a copy of the signed current foster parent/agency agreement.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12312 Foster parent training {#sec-r-400.12312 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12312}

Rule 312. (1) An agency shall develop a foster parent training plan with the participation of foster parents.

(2) The foster parent training plan must provide for all the following:

(a) Not less than 12 hours of training to be completed by each person named on the license before a recommendation is made for licensure, taking into account the individual training needs of the foster parents. Not more than 3 hours of orientation may be included as part of the initial 12 hours of training.

(b) Not less than 6 hours of training annually for each licensee after the time periods specified in subdivision (a) of this subrule.

(3) The training specified in subrule (2)(a) of this rule must address all the following areas:

(a) Characteristics and needs of children who may be placed into the home.

(b) Safe sleep practices for infants.

(d) Calming and soothing supports for children, including sensory modulation and de-escalation techniques.

(e) Importance of the foster child’s parents and relatives.

(f) Concurrent planning.

(g) Role of the agency.

(h) Emergency procedures, first aid, and fire safety.

(i) Preparation of the foster child for permanence and independence.

(j) The role of the court and lawyer guardian ad litem in permanency planning.

(k) Reasonable and prudent parent standards.

(l) Firearm storage and safety.

(m) The unique needs of foster children based on individual identities related to culture, race and ethnicity, religion, and spirituality, and SOGIE.

(n) Human trafficking.

(o) Trauma-informed parenting, including the effects of discipline in the household.

(4) At least 1 adult member of the household must have training in and maintain a current certification in first aid and cardiopulmonary resuscitation from the American Heart Association or the American Red Cross, or other institution approved by the department.

(5) An agency shall document all training received by each foster parent.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12313 Behavior support policy {#sec-r-400.12313 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12313}

Rule 313. (1) An agency’s behavior support policy must identify appropriate and specific methods of behavior support for foster children.

(2) An agency shall ensure that methods of behavior support for a foster child are positive, consistent, and compassionate based on each foster child’s needs, stage of development, and behavior, and promote self-regulation, self-esteem, and independence.

(3) All the following are prohibited:

(a) Corporal punishment, any type of restraint, including physical, chemical, mechanical, or noxious substances; or any kind of punishment inflicted on the body.

(b) Confinement or seclusion in an area such as a closet or a room.

(d) Mental or emotional cruelty.

(e) Verbal abuse, threats, including the use of derogatory or discriminatory language, negative references to the child’s or the child’s family SOGIE, yelling at youth, ridicule, or humiliation.

(f) Prohibiting visits or communication with a foster child’s family.

(g) Denial of necessary educational, medical, mental health, or social work services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12314 Religion and spirituality policy {#sec-r-400.12314 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12314}

Rule 314. (1) An agency’s religion policy must ensure that the foster child may participate or choose not to participate in religious or spiritual instruction, engage or choose not to engage in religious or spiritual practices, or attend or choose not to attend religious or spiritual services.

(2) A foster child may not be required to attend religious or spiritual services or follow specific religious or spiritual doctrine.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12315 Communication {#sec-r-400.12315 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12315}

Rule 315. An agency must ensure that a child is able to communicate with family and friends in a manner consistent with the child’s expressed wishes, appropriate to the child’s functioning, and in accordance with the child’s treatment plan.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12316 Personal possessions {#sec-r-400.12316 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12316}

Rule 316. An agency’s personal possessions policy must address all the following:

(a) Ensure that a child has a right to have his or her personal possessions during placement with a foster family and when leaving the foster family.

(b) Safe storage of a child’s personal possessions.

(c) All gifts and clothing that are given to or purchased for the child during placement with the foster family remain the property of the foster child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12317 Allowance and money {#sec-r-400.12317 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12317}

Rule 317. (1) The agency must specify the following:

(a) General guidelines that provide a monetary range based on a child’s age.

(b) Allowance for specific youth will be determined by the social services worker, the child’s parent, and the foster parent based on the child’s age and treatment needs.

(2) Any money earned or received directly by the child remains the property of the child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12318 Clothing policy {#sec-r-400.12318 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12318}

Rule 318. The agency’s clothing policy for foster parents must specify both of the following:

(a) A foster parent must ensure that a foster child has the minimum required clothing specified by the agency’s policy and leaves the foster home with not less than the minimum required clothing.

(b) All clothing the child has when he or she arrives at the foster home and all clothing purchased for the child while in the foster home remains the property of the foster child, unless returned to the child’s parent or parents.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12319 Transfer of enrollment or license {#sec-r-400.12319 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12319}

Rule 319. (1) Prior to requesting the transfer of an enrollment or license, the receiving agency must provide the applicant/licensee with the following:

(a) Orientation of the receiving agency.

(b) Application.

(2) The current certifying agency must provide the receiving agency with the following:

(a) The most recent application for a license.

(b) The initial evaluation and current reevaluation and any other relevant licensing home study reports.

(d) All completed special evaluation reports and any associated corrective action plans.

(e) All record clearance documents for all members of the household, including any administrative review team assessments.

(f) Other information that might assist the agency considering the transfer with making an informed decision.

(3) The agency considering the transfer must review all information in subrule (2) of this rule. Prior to acceptance of the transfer, the receiving agency must make at least 1 home visit.

(4) If the agency considering the transfer declines to accept a transfer of the license or enrollment, the agency must inform the applicant or licensee in writing and provide a copy to the certifying agency.

(5) Written approval must come from the receiving agency’s chief administrator or his or her designee prior to the transfer of the license during a special evaluation. When a license is transferred during a special evaluation, the receiving agency must complete the special evaluation.

(6) Written approval must come from the receiving agency’s chief administrator or his or her designee prior to the transfer of the license during a provisional status.

(7) If there is an existing corrective action plan, the receiving agency is responsible for ensuring compliance.

(8) Transfer of a license during a pending disciplinary action must be approved by the department prior to the transfer.

(9) The receiving child placing agency must submit transfer documents to the department within 7 calendar days after the decision has been made to accept the transfer.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12320 Supervision {#sec-r-400.12320 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12320}

Rule 320. (1) An agency shall ensure an appropriate level of care and supervision for the foster child at all times consistent with a child’s age, level of functioning, and treatment plan.

(2) A foster parent shall identify at least 1 adult who would care for the foster child for an extended overnight period. The identified adult must have both a central registry and a criminal history background check.

(3) A foster parent shall notify the agency of any extended, overnight period when the period will exceed 3 days.

(4) A foster parent shall notify any foster child’s care provider of the agency’s policies relating to care and supervision and the care provider must follow the policies.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12321 Hazardous materials policy {#sec-r-400.12321 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12321}

Rule 321. (1) Federal standards for a foster family or group home include specific safety requirements for weapons, pools, hot tubs, and spas, as these pose a particular preventable danger to children.

(3) Unless carried in the licensed home and on the licensed property as permitted by law, firearms and ammunition must be stored as follows:

(a) Firearms must be all the following:

(i) Locked in compliance with 1 of the following:

(A) By a cable-lock.

(B) By a trigger-lock.

(D) A solid metal gun case.

(E) A solid wood gun case.

(ii) Unloaded.

(iv) Inaccessible to children.

(b) Ammunition must be stored in a locked location and inaccessible to children.

(c) All applicable laws regarding the possession, use, transportation, and storage of firearms and ammunition, including for hunting, still apply.

(d) Licensees with a CPL may possess a firearm pursuant to the law in a vehicle on the licensed property, provided it is done so in a manner that prevents foster children from having access to it, such as being on the licensee’s person or stored in a locked container.

(e) Licensees may engage in hunting, range shooting, and target practice with a foster child in accordance with the reasonable and prudent parent standard as defined in section 1 of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.1.

History

History: 2014 AACS; 2019 AACS; 2023 AACS.

Mich. Admin. Code R 400.12322 Unusual incident policy {#sec-r-400.12322 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12322}

Rule 322. (1) An agency’s unusual incident policy must include immediate notification to the agency by the foster parent of any of the following incidents:

(a) The death of a foster child.

(b) The removal or attempted removal of a foster child from a foster home by any person not authorized by the agency.

(d) Any illness that results in treatment at a hospital emergency room or inpatient hospitalization of a foster child.

(2) An agency’s unusual incident policy must include notification to the agency by the foster parent of any of the following incidents within 24 hours of knowledge of the incident:

(a) A foster child’s involvement with law enforcement authorities.

(b) Pregnancy of a foster child.

(d) Involvement with law enforcement by anyone in the home pursuant to a criminal investigation.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12323 Emergency policy {#sec-r-400.12323 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12323}

Rule 323. (1) An agency’s emergency policy must include procedures for each of the following situations:

(a) Fire.

(b) Tornado.

(d) Epidemic.

(2) An agency shall approve the written evacuation plan for a foster home that provides care for a person who requires assistance to evacuate the home.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12324 Reevaluation {#sec-r-400.12324 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12324}

Rule 324. (1) An agency shall conduct an annual on-site visit and complete a written reevaluation of a foster home.

(2) The annual reevaluation must include a determination and assessment of all the following:

(a) All changes to the factual information contained in the initial evaluation and subsequent renewal evaluations.

(b) Family functioning and interrelationships as determined by observation of, and interviews with, each member of the household and each social service worker who has had children placed in the home during the last licensing period.

(d) Compliance with the licensing rules for foster homes.

(e) Compliance with the agency’s written policies and procedures.

(3) An agency shall record the dates and places of contacts and persons interviewed or observed as part of a reevaluation.

(4) An agency shall document placement specifications consistent with the information contained in the reevaluation. The placement specifications must include all the following:

(a) The age, number, SOGIE, race, ethnic background, and characteristics of children preferred by the applicants.

(b) Characteristics of children best served by the home.

(c) Children who may not be placed in the home. The child’s racial, ethnic, and cultural identity, heritage, and background may only be considered if an assessment of the individual child indicates that such consideration is in the best interests of the child.

(5) An agency shall inform the foster parent of and discuss the agency’s policy and procedures regarding concurrent planning.

(6) An agency shall complete a licensing record clearance request form on each adult non-licensee member of the household, including foster youth who turn 18 years of age, prior to each renewal and assess the results of the record check.

(7) An agency shall provide the foster parent with a copy of the reevaluation upon request.

(8) An agency shall complete a reevaluation and make a licensing recommendation to the department at least 15 calendar days before the expiration date of the foster home license.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12325 License recommendation {#sec-r-400.12325 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12325}

Rule 325. (1) An agency shall recommend to the department the appropriate licensing action consistent with facts contained in the foster home evaluation and any special evaluations.

(2) An agency shall document foster home license changes in the foster home record and communicate the changes immediately to the department in the manner prescribed by the department.

(3) Except for an original license, an agency shall recommend to the department the issuance of a regular license or the continuation of an active license only when all rules are in compliance, or both of the following conditions exist:

(a) All non-compliances relating to the recommendation are correctable.

(b) A written corrective action plan has been developed. The plan must comply with all of the following requirements:

(i) Upon determining a rule noncompliance that is correctable by the foster parent, the agency must develop a written corrective action plan with the foster parent on the form prescribed by the department.

(ii) Be completed within 6 months of being signed.

(iii) Be signed and dated by the foster parent and the agency.

(4) Except for an original license, an agency shall recommend to the department the issuance of a provisional license only when all of the following conditions exist:

(a) The foster parent has signed an acceptable corrective action plan.

(b) The foster parent has been informed, in writing, of the facts and the basis for the provisional license.

(5) An agency shall recommend to the department the denial of license issuance, the revocation of a license, or the refusal to renew a license when all the following conditions exist:

(a) The applicant or the foster parent falsifies the application, or the applicant or the foster parent willfully and substantially violates the act or 1 or more of the licensing rules for foster homes.

(b) The agency has provided the applicant or the foster parent with all the following:

(i) A copy of the special evaluation report outlining the facts and the basis for the recommended action.

(ii) Written notice that the agency’s recommendation for disciplinary action has been referred to the department for a final decision.

(iii) Written notice to the applicant or foster parent of their right to appeal the department’s decision for licensing action.

(6) An agency shall provide the department with all documentation that details the basis for the agency’s recommendation or any requested documentation for a department licensing action.

(7) An agency shall participate in, and present facts at, a foster home licensing administrative hearing to support an agency recommendation or a department licensing action.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12326 Borrowed home {#sec-r-400.12326 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12326}

Rule 326. (1) Before placing a child in a foster home certified by another agency, the borrowing agency shall have a record containing all the following:

(a) Approval from the certifying agency authorizing the placement of a child in the home.

(b) Verification that the foster parent is willing to accept the foster child.

(d) A copy of all special evaluations completed during the last 2 years.

(e) Verification of all children currently placed in the home.

(f) Documentation that the foster parent has received orientation to the policies of the borrowing agency.

(g) A copy of the foster parent /agency agreement signed by the foster parent and the borrowing agency.

(h) The requirements in subdivisions (a) to (g) of this subrule do not apply to foster homes licensed by a tribe. A completed “Verification of Tribal Foster Home Safety Requirements” form is required when borrowing a foster home licensed by a tribe.

(2) Only in an after-hours emergency placement will a verbal agreement be acceptable. During an after-hours emergency placement, the certifying agency must provide a verbal summary of the information in subrule (1)(a) to (h) of this rule to the borrowing agency. Written borrowed home protocol must be completed and documented within 3 calendar days of an after-hours emergency placement.

(3) The borrowing agency is responsible for requesting the items identified in subrule (1)(c), (d), and (e) of this rule annually for the duration of the child’s placement.

The certifying agency must provide the items in subrule (1)(c), (d), and (e) of this rule annually for the duration of the child’s placement.

(4) The certifying agency is responsible for certification functions, including special evaluations, and must share all information regarding changes in the home with all agencies that have children in placement in the home.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12327 Special evaluation {#sec-r-400.12327 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12327}

Rule 327. (1) Upon receipt of any information that relates to possible noncompliance with any foster home rule, the agency must do all the following:

(a) Submit a special investigation record to the department’s licensing authority within 5 working days in the manner prescribed by the department.

(b) Initiate a special evaluation of the foster home as soon as is indicated, based on the information received, but not later than 7 calendar days after receipt of the information.

(c) Conduct an evaluation, in cooperation with child protective services, when applicable, including all necessary collateral contacts.

(d) Notify all social service workers who have children placed in the home that a special evaluation has been initiated.

(2) An agency shall inform foster parents of all the following before they are questioned or interviewed regarding a special evaluation:

(a) That a special evaluation has been initiated.

(b) A clear description of the allegations.

(c) That the foster parents may involve a person of their choice in any interviews with them involving the special evaluation if the involvement does not impede the timely completion of the evaluation.

(3) An agency shall complete a special evaluation within 45 calendar days after receipt of the information. If additional time is required, then the agency shall inform the foster parent, in writing, of the basis for the extension and the expected length of the extension. The total time for the completion of the investigation may not exceed 90 calendar days without written approval from the chief administrator or his or her designee.

(4) Before completion of the written report required by subrule (6) of this rule, an agency shall provide the foster parent with a verbal summary of the preliminary findings at the conclusion of the evaluation.

(5) Within 15 days of the conclusion of the evaluation, an agency shall complete a written report that includes all the following information:

(a) The date the information was received.

(b) The allegations.

(c) Dates and places of contacts, names of persons interviewed, and names of the interviewers. If children are interviewed, their last names may not be included in the report.

(d) Findings of fact based upon the evaluation.

(e) Conclusions regarding licensing rules compliance or noncompliance based on the findings of fact.

(f) Any change in the agency’s decision regarding the number, SOGIE, age, race, religion, spirituality, ethnic background, and specific characteristics of children who may be placed that is based upon the documentation contained in the summary and conclusions of the report.

(g) Recommendations regarding licensing action and any required corrective action.

(6) An agency shall do all the following:

(a) Provide the foster parent with a copy of the report required by subrule (5) of this rule within 10 calendar days of its completion.

(b) Inform the foster parent, in writing, that the foster parent has a right to have his or her written response included as an attachment to the report required by subrule (5) of this rule.

(7) If any violations are cited and there is a signed corrective action plan, all social service workers who have children placed in the home must be notified there is a corrective action plan and what is required of the foster parent in that plan.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12328 Foster home record {#sec-r-400.12328 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12328}

Rule 328. (1) An agency shall maintain a foster home record in the manner prescribed by the department for each foster care home. An agency shall maintain a foster home record in the manner in which is prescribed by the department for each foster care home.

(2) The record must contain all the following information:

(a) All documents pertaining to certification of the home.

(b) Any special evaluation reports.

(d) A placement list of all children placed in the foster home, including all the following information about each child:

(i) Name, age, sex, and race of the child.

(ii) Date of placement.

(iii) Date of, and reasons for, a child’s removal from the foster home.

(e) Any written response from a foster parent, as provided by R 400.12327(6)(b).

(3) An agency shall make copies of a record available to the applicant or licensee upon request, except for the following items:

(a) Pending evaluation reports and documents.

(b) Records of privileged communication.

(c) Criminal records, police reports, child protective services information, and social security numbers from any source.

(4) An agency shall maintain records for not less than 7 years after closure.

PART 4. FOSTER CARE SERVICES

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12401 Department authorization {#sec-r-400.12401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12401}

Rule 401. The department shall authorize an agency to receive children for placement in licensed foster homes.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12402 Program statement {#sec-r-400.12402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12402}

Rule 402. An agency shall have and follow a current written program statement that includes all the following information:

(a) Types of foster care provided.

(b) The racial, ethnic, and cultural identity, heritage, spirituality, and background of the children served.

(d) Geographical area covered.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12403 Policy and procedures {#sec-r-400.12403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12403}

Rule 403. (1) An agency shall provide a copy of the policies and procedures to the foster parents of a home where the agency places a child.

(2) An agency may not be more restrictive than the department policies or the administrative rules governing licensing and services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12404 Placement {#sec-r-400.12404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12404}

Rule 404. (1) An agency shall only place a child with an adult who is a relative of the child, a legal custodian, or in a licensed foster home, except as permitted in R 400.12503(2)(b) and R 400.12709.

(2) Initial consideration must be given to placement with a relative or placing siblings together, or both.

(3) An agency’s placement of a child in a foster home must be consistent with the placement specifications for the home.

(4) An agency shall consider all the following factors in selecting an appropriate placement for a child:

(a) Proximity to the child’s parents, family, or community.

(b) The physical, emotional, and educational needs of the child.

(d) Expressed preferences of the child, and the child’s parent or parents.

(e) The child and child’s family’s religious or spiritual, or both, preference.

(f)The foster parents’ ability and willingness to accept and support the child’s SOGIE.

(g) The child’s racial, ethnic, cultural identity, heritage, and spiritual background.

(h) The continuity of relationships, including relationships with parents, siblings, relatives, foster parents, previous foster parents, and other persons significant to the child.

(i) The availability of placement resources for the purpose of making a timely placement.

(5) Before the placement of a child, the agency shall document preparation of all relevant parties, including the child or infant, which must include an explanation of all the following:

(a) The circumstances necessitating placement.

(b) The child’s individual needs.

(6) An agency must document, in the child’s record, within 7 calendar days after placement, the information specified in R 400.12417(1) and all the following information:

(a) All the following child characteristics:

(i) Gender identity.

(ii) Race.

(iii) Height and weight.

(iv) Eye color and hair color.

(v) Identifying marks.

(vi) Religious or spiritual preference.

(vii) School status, including grade, last school attended, and educational program.

(b) Name, known addresses and marital status of the child’s parents or legal guardian, if any.

(d) Known names, addresses, and dates of any previous out-of-home placements.

(e) The date that the agency received the child for placement.

(f) The child’s legal status and the agency’s legal right to provide care.

(g) Documentation of the child’s placement preparation.

(h) A photograph of the child at the time of placement.

(i) Documentation that tribal ancestry was assessed.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12405 Change of placement {#sec-r-400.12405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12405}

Rule 405. (1) An agency shall make every reasonable effort to maintain a stable placement for each child placed in foster care. The efforts must be documented in the child’s record.

(2) An agency shall first consider returning the child to a parent.

(3) The agency shall document all the following in the child’s record before a change of placement occurs:

(a) Reason for the change in placement.

(b) If the child is not returned to the parent, then the reason why return is not possible.

(c) If the child is not reunited with siblings or placed with a relative, then the reason why those placements are not possible.

(d) Consideration of the factors identified in R 400.12404(4).

(e) Replacement preparation of all relevant parties, including the child or infant, which includes an explanation as to why the change is necessary.

(f) Notification to the parents, referral source, lawyer guardian ad litem, and courts when applicable, of the change in placement.

(g) Information about the child was shared with the new placement, consistent with the requirements of R 400.12417.

(h) The child’s new location and address.

(i) That the current foster parent was notified in writing of the following information:

(i) Not less than 14 calendar days in advance, of the change, except when prior notification would jeopardize the child’s care or safety. If prior notice is not provided, then the agency shall notify the foster parent, at the time of the change, why prior notice was not given.

(ii) Of the current foster parent’s rights concerning the change in placement.

(j) Supervisory approval before the change.

(4) If an emergency change in placement is necessary, then all the documentation required in subrules (2) and (3) of this rule must be in the child’s record within 14 calendar days after the change in placement.

(5) If an agency is no longer providing services to the child in a foster home, then both the following must be documented before a change in placement:

(a) A summary of the services provided during care up to the time of the change in placement and the needs that remain to be met.

(b) Provision for any continuing services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12406 Rescinded {#sec-r-400.12406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12406}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12407 Rescinded {#sec-r-400.12407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12407}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12408 Rescinded {#sec-r-400.12408 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12408}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12409 Education {#sec-r-400.12409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12409}

Rule 409. An agency must ensure that, within 5 school days of placement, an agency shall provide for the enrollment of each child of school age, as defined by state law, into a school program.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12410 Rescinded {#sec-r-400.12410 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12410}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12411 Clothing {#sec-r-400.12411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12411}

Rule 411. An agency must ensure that a foster child has the minimum required clothing specified by the department’s policy and leaves the foster home with not less than the minimum required clothing.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12412 Rescinded {#sec-r-400.12412 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12412}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12413 Medical and dental care policy {#sec-r-400.12413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12413}

Rule 413. (1) An agency’s medical and dental care policy must include all the following:

(a) The provision of routine medical care.

(b) The provision of emergency medical, surgical, and dental care.

(i) A comprehensive medical examination, including a behavioral/mental health and trauma screening, within 30 calendar days from the date the child entered into an out-of-home placement, regardless of the date of the last physical examination.

(ii) A physical examination every 14 months.

(d) Current immunizations for each child as required by section 5111 of the public health code, 1978 PA 368, MCL 333.5111. All the following apply:

(i) A statement from a parent or licensed medical authority, which indicates that immunizations are current or contraindicated, is sufficient documentation of immunizations.

(ii) A copy of a waiver addressed to the department that is signed by the parent stating immunizations are not being administered due to religious, medical, or other reasons is sufficient documentation of immunizations, unless the child is a temporary court ward, a motion is heard, and order is entered by the circuit court for the child’s case. A waiver must be accompanied by a certification by the local health department that the parent or parents received education on the risks of not receiving the vaccines being waived and the benefits of vaccination to the individual and the community as required by section 5111 of the public health code, 1978 PA 368, MCL 333.5111, and R 325.176(12).

(iii) If documentation of immunization or a copy of the waiver is unavailable, then immunizations must begin within 30 calendar days of placement.

(e) A dental examination must be completed within 3 months before entry into foster care or an initial dental examination must be completed not more than 90 calendar days after entry into a foster care out-of-home placement. A child entering foster care under 1 year of age must have an initial dental exam within 3 months of his or her first birthday.

(f) A dental re-examination must be obtained at least every 9 months unless a greater frequency is indicated.

(2) An agency shall maintain a file documentation from the medical or dental provider of all medical and dental care received by a foster child.

History

History: 1998-2000 AACS; 2014 AACS; 2015 AACS; 2023 AACS.

Mich. Admin. Code R 400.12414 Rescinded {#sec-r-400.12414 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12414}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12415 Unusual incident reporting policy {#sec-r-400.12415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12415}

Rule 415. An agency must adhere to the following incident reporting protocols:

(a) Immediately notify the child’s parents; the department licensing authority; the lawyer guardian ad litem and court, as applicable; the department; and the foster child’s parents, if any of the following occurs:

(i) The death of a foster child.

(ii) The foster child is absent without legal permission.

(iii) Attempted removal or removal of the foster child from the foster home by any person who is not authorized by the agency.

(iv) Any medical and mental illness or condition that results in treatment at a hospital emergency room or inpatient hospitalization of a foster child.

(b) Notification of the child’s parents, the responsible agency, and guardian ad litem as applicable within 24 hours of knowledge of the following:

(i) Any injury of a foster child that requires medical treatment.

(ii) A foster child’s involvement with law enforcement authorities.

(iii) Pregnancy of a foster child.

(iv) Incidences of a foster child being abused, including child-on-child abuse.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12416 Rescinded {#sec-r-400.12416 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12416}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12417 Foster parent information {#sec-r-400.12417 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12417}

Rule 417. (1) An agency shall provide a foster parent with all the following information before the placement or replacement of a child:

(a) Child’s name.

(b) Child’s date of birth.

(d) Any known history of abuse or neglect of the child.

(e) All known emotional and psychological factors relating to the care of the child.

(f) All known behaviors of the child.

(g) Circumstances necessitating placement or replacement of the child.

(h) Any other known information to enable the foster parent to provide a stable, safe, and healthy environment for the foster child and the foster family, including information about siblings who do not reside in the foster home as provided in federal law.

(i) Name of assigned social service worker.

(j) Authorization to provide routine and emergency medical care.

(2) For an emergency placement, if any of the information specified in subrule (1)(a) to (h) of this rule is not available at the time of placement, then the agency shall provide information to the foster parent within 7 calendar days of the placement.

(3) After the child is placed, and on an ongoing basis, the agency shall notify the foster parent of any known information regarding the child, or the child’s siblings who do not reside in the foster home as provided in federal law, or both, that will enable the foster parent to provide a stable, safe, and healthy environment for the foster child and the foster family.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12418 Development of service plans {#sec-r-400.12418 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12418}

Rule 418. (1) An agency shall develop service plans with the child, the child’s parents or legal guardian, the referring agency, and other parties involved in providing needed services, or medical care, unless the agency documents why any of the entities have not been involved.

(2) An agency shall complete written service plans for each child and parent or parents, as follows:

(a) Within 30 calendar days from removal from the home.

(b) Within 120 calendar days after the initial removal and at least once every 90 calendar days thereafter.

(3) When case responsibility changes from 1 child placing agency to another child placing agency, a modified service plan must be completed within 30 calendar days of the change in agency responsibility if no other plan is done within 30 days. The plan must address why the agency responsibility changed and whether there are any modifications to existing service plans.

(4) An agency shall place service plans in the case record.

(5) An agency shall involve the child’s parent or parents and the foster parents in the development of service plans to enable the parent or parents and foster parents to understand the plan for the child and the parents’ and the foster parent’s role in assisting the agency in carrying out the plan. An agency shall give a copy to and review the parentagency treatment plan with the parent or parents and foster parents. The agency must inform the parent or parents and foster parent that the information in the parent-agency treatment plan and any other information about the child and the child’s family is confidential.

(6) Service plans must be signed by the social services worker and the social services supervisor.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12419 Initial service plans {#sec-r-400.12419 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12419}

Rule 419. (1) The initial service plan, as required in R 400.12418(2)(a), must include all the following information:

(a) Dates, types, and places of agency contacts and persons contacted.

(b) Circumstances necessitating placement.

(d) A social history pertinent to the circumstances necessitating placement that assesses the child and persons in the child’s family to determine the services best suited to meet the child’s needs.

(e) A plan that has as its goal reunification of the child with his or her family or another goal of permanent placement. The plan shall include all the following information:

(i) The permanency goal for the child.

(ii) The conditions necessary to achieve the permanency goal identified in paragraph (i) of this subdivision.

(iii) Action steps and time frames to achieve the necessary conditions identified in paragraph (ii) of this subdivision.

(iv) The persons responsible for implementing the action steps identified in paragraph (iii) of this subdivision.

(v) Projected length of placement in foster care.

(f) Specific goals, as appropriate, to meet the child’s needs in the following areas:

(i) Education.

(ii) Health.

(iii) Vocational training.

(iv) Psychological, psychiatric, and mental health services.

(g) Plans for contact between the child, siblings, the child’s family, and any other person.

(h) The child behavior support plan to be used by the foster parent.

(2) If parental rights have not been terminated, the service plan must include all the following:

(a) An assessment of the parents’ needs as they relate to the care of the child.

(b) The parents’ role while the child is in placement, including parenting time.

(d) The time frames for meeting the stated requirements.

(e) Documentation of how the parents were informed of their rights and responsibilities in the care of their child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12420 Updated service plans {#sec-r-400.12420 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12420}

Rule 420. An updated service plan, as required in R 400.12418(2)(b), must include all the following information:

(a) Dates, types, and places of agency contacts and persons contacted.

(b) Confirmation that the child’s current foster home continues to appropriately meet the placement needs of the child.

(c) A summary of information pertinent to the updated services plan received since the last service plan from the child, the child’s parents or legal guardian, foster parents, referring agency, and others, unless the agency documents why any of these entities cannot be involved.

(d) Assessment of progress in achieving the permanency goal for the child.

(e) A plan that includes any changes made since the previous plan and that has the content specified in R 400.12419.

(f) Plans for visits between the child, siblings, the child’s family, and any other person.

(g) A child behavior support plan that includes any changes made since the previous plan and is to be used by the foster parents.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12421 Visitation and family time; in person contact {#sec-r-400.12421 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12421}

Rule 421. (1) An agency shall develop a plan of visitation and family time for each child in foster care consistent with the child’s service plans, as required by R 400.12419 and R 400.12420 to ensure the safety and well-being of the child.

(2) An agency social service worker shall visit the foster child, and the foster parent, if applicable, in the child’s placement at least once every month.

(3) An agency shall facilitate in-person contact between parents and children except where parental rights have been terminated or when there is a court determination that visits are detrimental to the child.

(4) An agency shall facilitate in-person contact between siblings who are not placed together except when there is a court determination that contact is detrimental to either child.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12422 Foster care case record {#sec-r-400.12422 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12422}

Rule 422. (1) An agency shall maintain a case record for each child in its foster care program.

(2) An agency shall protect each record against destruction and damage and store and maintain each child’s record in a manner to ensure confidentiality and to prevent unauthorized access.

(3) The record must contain all the following information:

(a) Initial service plan.

(b) Any required updated service plans.

(d) Placement documentation as required by R 400.12404.

(e) Change of placement documentation as required by R 400.12405.

(f) Plan of visitation and parenting time as required by R 400.12421.

(g) A photograph taken at least annually.

(4) An agency shall maintain the records under the retention schedule for not less than 7 years after the agency’s termination of services to the child.

(5) If an agency ceases operating as a child placing agency, the records must be returned to the child’s referring agency.

PART 5. INDEPENDENT LIVING SERVICES

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12501 Department authorization {#sec-r-400.12501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12501}

Rule 501. The department shall authorize an agency to supervise independent living placements.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12502 Program statement {#sec-r-400.12502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12502}

Rule 502. (1) An agency shall have and follow a current written program statement that includes all the following information:

(a) Types of living arrangements approved.

(b) Eligibility requirements for a youth, including age and level of physical, emotional, and intellectual functioning and youth not appropriate for the program.

(d) Means of financial support for the youth.

(e) Supervision.

(f) Educational and vocational or work requirements.

(g) Medical, mental health, and dental care.

(h) Basis for termination.

(2) An agency shall give a copy of the program statement to a youth before placement in independent living.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12503 Policy and procedures {#sec-r-400.12503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12503}

Rule 503. (1) An agency shall have and follow written policies and procedures for the independent living services provided.

(2) The policies and procedures must cover at least all the following areas:

(a) Eligibility requirements for youth to participate in the program.

(b) Types of living arrangements provided or approved.

(d) Service plans.

(e) Supervision provided by the agency.

(f) Amount of financial support and how it is disbursed. An agency may not withhold financial support intended for the youth while the youth is actively involved in the program.

(g) Education, vocational training, and employment.

(h) Human trafficking awareness and prevention for youth.

(i) Medical, dental, and mental health care.

(j) Independent living record.

(k) Termination.

(3) An agency shall provide a youth in independent living with a copy of the agency’s policies and procedures required by this rule.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12504 Eligibility requirements {#sec-r-400.12504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12504}

Rule 504. (1) An agency shall document the rationale for selection of independent living as the most appropriate placement for the youth.

(2) All the following must be in the case record before a youth is placed in independent living:

(a) How the youth meets the eligibility requirements for the specific program the youth is being placed into.

(b) The basis for concluding that a youth exhibits self-care potential.

(c) That the youth’s social service worker has personally observed and determined that the living situation is safe, and that the youth has a bed and has access to cooking and bathing facilities.

(d) The availability of specific and relevant resources that provide for suitable social, physical, educational, vocational, and emotional needs of a youth.

(e) An evaluation of a youth's need for supervision and a plan for providing the level of supervision determined necessary.

(f) Proof that financial support to meet the youth’s housing, clothing, food, and miscellaneous expenses is available.

(3) An independent living home, staffed and operated by the child placing agency, must be clean, safe, and appropriate to the needs of the youth it serves.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12505 Supervision {#sec-r-400.12505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12505}

Rule 505. (1) An agency shall provide supervision for a youth in independent living consistent with the youth's need for supervision, as required by R 400.12504(2)(e).

(2) An agency shall provide the following minimum supervision:

(a) Face-to-face contact between the social service worker and the youth in independent living at least once each month at a youth's place of residence.

(b) At monthly intervals, ensure that the youth is complying with the terms of the agreement required by R 400.12510, continues to reside in a safe and acceptable environment, and is managing expenditures.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12506 Education; vocational training; employment {#sec-r-400.12506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12506}

Rule 506. An agency shall ensure that it works with a youth involved in independent living in the following areas as outlined in the youth’s service plan:

(a) Employment.

(b) Job training.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12507 Medical, dental, and mental health care {#sec-r-400.12507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12507}

Rule 507. (1) An agency shall ensure that a youth in independent living receives any needed medical, dental, and mental health care as required in R 400.12413. Medical, dental, and mental health care provided must be documented in the youth’s record.

(2) For a youth who become 18 years of age while in the program or who enters independent living after the age of 18, the agency shall provide information on how to access needed medical, dental, and mental health services and actively, and on an ongoing basis, encourage participation in needed medical, dental, and mental health services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12508 Rescinded {#sec-r-400.12508 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12508}

History

History: 1998-2000 AACS; 2014 AACS.

Mich. Admin. Code R 400.12509 Independent living record {#sec-r-400.12509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12509}

Rule 509. (1) An agency shall maintain a case record for each youth placed in independent living.

(2) An agency shall protect each record against destruction and damage and store and maintain each child’s record in a manner to ensure confidentiality and to prevent unauthorized access.

(3) The case record must contain all the following information and documentation, which must be recorded within 30 calendar days after placement in independent living and updated at least once every 90 calendar days:

(a) All the following personal information pertaining to the youth:

(i) Name.

(ii) Social security number.

(iii) Address and telephone number.

(iv) Date of birth.

(v) Gender.

(vi) Race.

(vii) Height.

(viii) Weight.

(ix) Hair color.

(x) Eye color.

(xi) Identifying marks.

(xii) A photograph updated on an annual basis.

(b) Documentation of the agency's legal right to place a youth.

(d) The names, dates of birth, and addresses of the youth's siblings, if applicable.

(e) The names and addresses of any offspring.

(f) The names and addresses of any other significant persons.

(g) Current documentation of financial support sufficient to meet the youth's housing, clothing, food, and miscellaneous expenses.

(h) The date, location, documented purpose, and a summary of the findings of each contact between the youth and the social service worker.

(i) Current adjustment.

(j) The youth's relationship with family members and agency efforts to resolve family conflicts.

(k) Medical and dental records.

(l) Birth certificate.

(m) Placement documentation as required by R 400.12404.

(n) Change of placement documentation as required by R 400.12405.

(o) Service plans as required in R 400.12419 and R 400.12420. If the youth has biological children, the service plan must address the living arrangement for the child or children, visitation/parenting time with the youth’s biological children or a clear explanation why this is not possible or appropriate.

(4) An agency shall maintain the record for not less than 7 years after the agency’s termination of services to the youth.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12510 Independent living agreement {#sec-r-400.12510 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12510}

Rule 510. (1) There must be a mutual agreement between the youth and the agency specifying all the following:

(a) The responsibilities of the agency and the youth.

(b) A plan for education or work.

(d) The location where the youth is living.

(2) The agreement must be signed and dated by the youth and the social service worker. The agreement must be reviewed with the youth at least once every 90 calendar days and a copy provided to the youth.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12511 Termination {#sec-r-400.12511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12511}

Rule 511. (1) When an agency terminates its independent living services for a youth, the agency shall document all the following information in the case record within 30 calendar days of termination of its services:

(a) The reason for the termination.

(b) The youth's new location.

(d) Provision for any follow-up services.

(2) An agency shall ensure and document that each youth who ends independent living is provided with all the following:

(a) Basic information about health, housing, counseling and mental health services, and emergency resources.

(b) A birth certificate.

(d) The youth's funds and personal property.

PART 6. ADOPTION EVALUATION SERVICES

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12601 Department authorization {#sec-r-400.12601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12601}

Rule 601. The department shall authorize an agency to evaluate applicants for adoption.

History

History: 1998-2000 AACS; 2023 AACS.

Mich. Admin. Code R 400.12602 Program statement {#sec-r-400.12602 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12602}

Rule 602. (1) An agency shall have and follow a current written program statement.

(2) The statement must include all the following information:

(a) Services and functions provided directly or indirectly.

(b) Geographical area covered.

(d) A clear delineation of fees, charges, or other consideration or thing of value for adoption services that includes specific charges for expenses and services, within and outside the agency, and differentiates between the charges that are refundable and the charges that are not refundable.

(e) Training requirements.

(3) An agency shall document that the statement was provided to all persons making inquiry about the agency’s services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12603 Policy and procedures {#sec-r-400.12603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12603}

Rule 603. (1) An agency shall have and follow written policies and procedures for the adoption services provided.

(2) The policies and procedures must cover at least all the following areas:

(a) Orientation.

(b) Training requirements.

(d) Agency recommendation.

(e) Grievance policy as required by R 400.12210.

(3) An agency shall document that the policies and procedures were provided to all persons making inquiry about the agency’s services.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12604 Orientation {#sec-r-400.12604 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12604}

Rule 604. (1) An agency shall provide an orientation for prospective applicants for adoption before an adoptive application is provided.

(2) The orientation must include a review of all the following:

(a) Program statement, policies, and procedures.

(b) Needs and characteristics of children legally eligible for adoption.

(d) Fees and charges.

(e) Legal process.

(f) Training requirements.

(g) Post adoption service availability.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12605 Adoptive family evaluation {#sec-r-400.12605 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12605}

Rule 605. (1) An agency social service worker shall complete a written adoptive evaluation within 90 days of the family signing an adoption application and prior to approving a family for adoption.

(2) The report must include the dates and places of contacts and persons interviewed or observed.

(3) The report must assess all the following:

(a) A minimum of 1 visit at the residence of the applicants for adoption to conduct observations of, and interviews with, each member of the household to determine all the following:

(i) Marital and family status and history, including current and previous level of family functioning and relationships and any incidents of domestic violence.

(ii) Educational history and any special skills and interests.

(iii) Employment history, current financial status, including property and income, money management skills, and outstanding financial obligations.

(iv) Physical, mental, and emotional health of each member of the household.

(v) Any history of substance use disorder of each member of the household.

(vi) Parenting skills and attitudes toward children.

(vii) Methods of calming children and responding to challenging behaviors.

(viii) Adjustment and special needs of the applicant’s own children, including children not living in the home.

(ix) Strengths and weaknesses of each member of the household.

(x) Experiences with own parents and any history of out-of-home care.

(xi) Reasons for adopting.

(xii) Previous licenses or experience in providing child foster care, child day care, or adult foster care.

(xiii) Willingness to accept and support an adoptive child with the child’s individual characteristics, needs, and background.

(xiv) Willingness to parent cross-racially or cross-culturally and to create an atmosphere that fosters the racial identity and culture of an adopted child.

(xv) Willingness and ability to understand an adopted child’s attachment to the birth family and other significant relationships.

(xvi) An understanding of and willingness to participate in concurrent planning.

(xvii) Willingness and ability to give an adopted child guidance, love, and affection and accept the child as a member of the household.

(xviii) Existence of social support system and alternate care providers.

(b) Previous adoption evaluations or placements.

(c) Previous criminal convictions and confirmed child abuse or neglect or concerns brought to the agency or department’s attention for any member of the household.

(d) Three current references from persons not related to the applicants. There must be an evaluation of any negative references.

(e) A medical statement for each member of the household that indicates that the member has no known condition which would affect the care of an adoptive child. The statement must be signed by a physician within the 12-month period before the adoptive evaluation.

(f) Safety and maintenance of the applicant’s house and property, including, but not limited to, the following:

(i) Sufficient beds and sleeping space.

(ii) Pets.

(iii) Weapons.

(iv) Fire and water hazards.

(g) Assessment of the neighborhood, schools, community, and available resources for the purpose of adoption.

(h) The plan for guardianship of the child or children in the event of the parent or parents’ death or permanent disability preventing continuation of parental responsibility.

(i) The family’s plan to discuss adoption with any child adopted.

(j) Training needs of the family.

(k) The age, number, gender, race, ethnic background, and characteristics of children preferred by the applicants.

History

History: 1998-2000 AACS; 2007 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12606 Training requirements {#sec-r-400.12606 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12606}

Rule 606. An agency shall document that an applicant for adoption has, at a minimum, training in all the following areas:

(a) Separation.

(b) Attachment and bonding.

(d) Behavioral, developmental, and emotional needs of adoptive children.

(e) Impact of adoption on the family.

(f) Post adoption service availability.

(g) Trauma.

(h) SOGIE.

(i) Human trafficking.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12607 Agency recommendation {#sec-r-400.12607 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12607}

Rule 607. (1) An agency shall recommend the appropriate action consistent with the facts contained in the adoptive evaluation. An agency shall make a written recommendation based on the findings of the adoptive family evaluation.

(2) The recommendation must include all the following:

(a) Be in writing.

(b) Contain approval or denial of the applicants for adoption by a social service supervisor.

(c) If approved, the number, SOGIE, age, race, ethnic background, religion or spirituality, and characteristics of adoptive children who may be placed in the adoptive applicants’ home. A child's racial, ethnic, and cultural identity, heritage, and background may only be considered if an assessment of the individual child indicates that such consideration is in the best interests of the child.

(3) If an agency concludes that an individual is not approved, then the basis for the decision must be specified in the recommendation.

(4) An agency shall provide the applicants for adoption with a signed and dated copy of the evaluation and recommendation upon its completion.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12608 Adoptive family evaluation record {#sec-r-400.12608 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12608}

Rule 608. (1) An agency shall retain a case record for each applicant for adoption.

(2) The record must contain all the following:

(a) Orientation documentation as required by R 400.12604.

(b) Adoptive evaluation as required by R 400.12605.

(d) Documentation agency policies were provided to applicants.

(e) All documents pertaining to adoption evaluation required by R 400.12605.

(f) Agency recommendation as required by R 400.12606.

(3) An agency shall retain each adoptive family evaluation record for not less than 3 years after the agency’s termination of services to the applicant.

(4) If a branch or associate office of a child-placing agency ceases to operate, then the branch’s or office’s adoption records must be forwarded to the central office of the branch or associate office.

(5) If a child-placing agency ceases operation, the agency’s adoptive family evaluation records must be shredded or returned to the applicant if services to the applicant were terminated 3 or more years before the closure. Records must be forwarded to the department’s central office adoptions for all other records.

PART 7. ADOPTION PLACEMENT SERVICES

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12701 Department authorization {#sec-r-400.12701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12701}

Rule 701. The department shall authorize an agency to accept and place children for purposes of adoption.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12702 Program statement {#sec-r-400.12702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12702}

Rule 702. (1) An agency shall have and follow a current written program statement.

(2) The statement must include all the following information:

(a) Types of adoptions provided by the agency, including whether the agency accepts children released under the section 20 of chapter XII of the probate code of 1939, 1939 PA 288, MCL 712.20.

(b) Procedures for selecting adoptive parents for a child, including the role of the child's parent or guardian in the selection process.

(c) The extent to which the agency permits or encourages exchange of identifying information or contact between biological and adoptive parents.

(d) A clear delineation of fees, charges, or other consideration or thing of value for adoption services. The delineation must include specific charges for expenses and services, within and outside the agency, and differentiate between the charges that are refundable and the charges that are not refundable.

(e) Services and functions provided directly or indirectly, including all the following:

(i) Counseling services and any other available services to a person who is releasing a child for adoption.

(ii) Counseling services and any other available services to a child being released for adoption based on the needs of the child.

(iii) Therapeutic services or post-finalization services provided to adoptive parents or to the adoptee.

(f) Geographical area covered.

(3) An agency shall document that the statement has been provided to all persons making inquiry to release a child for adoption and to prospective adoptive parents.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12703 Policy and procedures {#sec-r-400.12703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12703}

Rule 703. An agency shall have and follow written policies and procedures for the adoption services provided under R 400.12704 to R 400.12713.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12703 Policy and procedures {#sec-r-400.12703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12703}

Rule 703. An agency shall have and follow written policies and procedures for the adoption services provided under R 400.12704 to R 400.12713.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12705 Release {#sec-r-400.12705 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12705}

Rule 705. (1) An agency social service worker shall document that information has been provided for birth parents before the birth parents release their rights to a child unless the child is relinquished under chapter XII of the probate code of 1939, 1939 PA 288, MCL 712.1 to 712.20.

(2) The information must include a review of all the following:

(a) Program statement, policies, and procedures.

(b) Legal process for adoption.

(d) Meaning and consequences of a release.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12706 Recruitment {#sec-r-400.12706 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12706}

Rule 706. (1) An agency shall have an ongoing recruitment program to ensure an adequate number of suitable adoptive parents for the timely placement of all children serviced by the agency who are available for adoption.

(2) An agency shall recruit adoptive parents for children served by the agency considering all the following criteria:

(a) Ages and developmental needs of children.

(b) Racial, ethnic, cultural identity, spirituality, and SOGIE of children.

(d) Special needs of children.

(3) There must be a child-specific recruitment plan for any child the agency is responsible for who is available for adoption and who does not have an identified family.

The child-specific plan must be based on the child evaluation, as required by R 400.12708, reviewed every 90 days, and updated annually, as needed.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12707 Rescinded {#sec-r-400.12707 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12707}

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12708 Child evaluation {#sec-r-400.12708 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12708}

Rule 708. (1) A social service worker shall complete a written assessment of each child available for adoption. The assessment must include all available information about the child and meet all requirements of section 27 of chapter X of the probate code of 1939, 1939 PA 288, MCL 710.27.

(2) An agency must have on file a written adoptive family evaluation and agency recommendation as required under R 400.12605 and R 400.12607 before approving the adoptive parents for each adoptive placement and before referring a child to, or placing a child in, the home for purposes of adoption.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12709 Placement selection {#sec-r-400.12709 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12709}

Rule 709. (1) An agency shall document how all the following factors were assessed in selecting appropriate adoptive parents:

(a) The physical, emotional, medical, and educational needs of the child.

(b) The child’s needs for continued contact with their parents, siblings, relatives, foster parents, and other persons significant to the child.

(c) The racial, ethnic, and cultural identity, heritage, spirituality, SOGIE, and background. The child’s racial, ethnic, and cultural identity, heritage, spirituality, SOGIE, and background may only be considered if an assessment of the individual child indicates that such consideration is in the best interests of the child.

(2) An agency shall place a child with agency-approved adoptive parents consistent with the needs of the child identified in subrule (1) of this rule, the child evaluation required by R 400.12708, orientation as required by R 400.12604, and the agency’s adoptive parent recommendation as required by R 400.12607.

(3) An agency shall require a social service supervisor or chief administrator if the placement is recommended by a social service supervisor, to approve or deny the recommendation for placement by the social service worker. The approval must be documented in the record.

(4) An agency may approve overnight pre-placement visits to a family being considered for adoption of a child. Pre-placement overnight visits may only occur under the following conditions:

(a) If the placement selected is a licensed foster home, the certifying agency gives approval prior to any visits starting.

(b) There is an approved child evaluation.

(d) The child evaluation has been shared with the prospective adoptive family prior to any pre-placement visits occurring.

(e) Planning for pre-placement visits is focused on the best interests of the child.

(f) There is a written plan for transitioning the child from the foster home to the adoptive home.

(g) Unless there are exceptional circumstances, that the transition period will not exceed 3 calendar months. A transitional period of more than 3 calendar months must be approved in writing by the MCI superintendent or the court with jurisdiction over the child.

(5) A public or private agency may place a child in an unlicensed home for the purposes of adoption if all the following conditions have been met:

(a) The adoptive parents have received orientation in accordance with the requirements of R 400.12604.

(b) The evaluation of the prospective adoptive parents has been completed in accordance with the requirements of R 400.12605 and the placement is consistent with the recommendation completed in accordance with R 400.12607.

(c) Supervisory approval of the placement has been documented in accordance with the requirements of subrule (3) of this rule.

(d) The adoptive petition has been filed with the court or consent to adopt has been granted by the authorized agency representative.

(6) The provisions of this rule do not prohibit a temporary placement made under section 23d of chapter X of the probate code of 1939, 1939 PA 288, MCL 710.23d.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12710 Adoptive parent information {#sec-r-400.12710 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12710}

Rule 710. (1) An agency must provide adoptive parents with all the following information before the placement of a child:

(a) Child’s name.

(b) Date, time, and place of birth including hospital, city, state, and country.

(d) Child’s racial, ethnic, SOGIE, and religious or spiritual background.

(e) Description of the child’s family of origin, including age and gender of family members, relationship to the child, and medical, social, and educational history of each member of the family.

(f) Circumstances necessitating placement of the child.

(g) Child’s preparation for placement and attitude toward the adoption.

(h) Placement history.

(i) Any other known information to enable the adoptive parent to provide a stable, safe, and healthy environment for the child.

(2) An agency shall provide adoptive parents with any additional information that becomes available to the agency after the placement of the adoptive child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12711 Placement {#sec-r-400.12711 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12711}

Rule 711. An agency shall document how the following factors were assessed in selecting appropriate adoptive parents for a child:

(a) The physical, emotional, medical, and educational needs of the child.

(b) The child’s needs for continued contact with the birth parent, siblings, relatives, foster parents, and other persons significant to the child.

(c) The racial, ethnic, cultural, spiritual, identity, heritage, and background. The child’s racial, ethnic, and cultural, spiritual, identity, heritage, and background may only be considered if an assessment of the individual child indicates that such consideration is in the best interests of the child.

(d) The child’s SOGIE, if an assessment of the individual child indicates that such consideration is in the best interests of the child.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12712 Supervision {#sec-r-400.12712 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12712}

Rule 712. (1) An agency shall provide post-placement supervisory visits for the adoptive family at the adoptive parent’s home as needed to ensure the safety and wellbeing of the child, but not less than once every month, after the placement of a child and until the final order of adoption, or as required by the sending state where the adoption originated.

(2) An agency shall assess and record the child’s and adoptive family’s adjustment and, where needed, include plans to assist the child or adoptive family.

(3) An agency shall keep the adoptive parents informed of the results of the agency’s continuing assessment of the placement at the conclusion of each visit.

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12713 Adoption placement record {#sec-r-400.12713 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12713}

Rule 713. (1) An agency shall permanently retain a case record for each adoptive child after adoptive placement except as identified in subrule (5) of this rule.

(2) The record must contain, at a minimum, all the following:

(a) Orientation documentation as required by R 400.12604.

(b) Evaluation documentation as required by R 400.12708.

(d) Supervision documentation as required by R 400.12712.

(3) If a branch or associate office of a child-placing agency ceases to operate, then the agency shall forward the branch’s or office’s adoption records to the central office of the branch or associate office.

(4) If a child-placing agency ceases to operate, then the agency shall forward its records to the department.

(5) The department must permanently retain all adoption records for children adopted in Michigan under section 27b of the probate code of 1939, 1939 PA 288, MCL 710.27b. The adoption agency must forward any adoption records for children adopted in Michigan to the department 1 year after finalization of the adoption. The adoption agency may not retain the original copies or any other copies of the adoption records.

PART 8 INTER-COUNTRY ADOPTION

History

History: 1998-2000 AACS; 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12801 Department authorization {#sec-r-400.12801 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12801}

Rule 801. (1) The department shall authorize an agency to evaluate applicants for inter-country adoption.

(2) The department shall authorize an agency to assist with the adoption or placement of a child coming to the United States for the purpose of being adopted.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12802 Program statement {#sec-r-400.12802 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12802}

Rule 802. (1) An agency shall have and follow a current written program statement that includes all the following information:

(a) Placement programs, by country.

(b) Eligibility requirements for adoptive parents established by the agency and the specific countries.

(d) Procedures for completing adoptive evaluations.

(e) A clear delineation of fees, charges, or other consideration or thing of value for adoption services. Differences in fees for different countries must be clearly stated.

(f) If the agency has written contracts or agreements with individuals in the foreign country or entity, the responsibilities of the agency and the responsibilities of the contractor must be clearly identified.

(2) The regulations issued by the United States federal government regarding the procedures for United States citizens adopting from a particular country or entity and the regulations issued by that country or entity for adoptions by foreigners must be kept on file at the agency.

(3) If an agreement exists between a foreign government or entity and an agency, an English language translation of verified written agreements with the foreign government must be on file at the agency and available for review. The agreement must conform to the laws and regulations of the United States, this state, and the foreign country.

(4) An agency shall provide the statement to all persons making inquiry about the agency’s services at the time of inquiry.

(5) Where a child requires readoption in the state of residence where they will be living, the agency shall coordinate with the family’s home study agency to ensure all legal requirements of the family’s home state are followed.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12803 Policies and procedures {#sec-r-400.12803 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12803}

Rule 803. The agency shall have and follow written policies and procedures for inter-country adoption services, including the requirements in R 400.12604, R 400.12605, and R 400.12808.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12804 Adoptive family evaluation {#sec-r-400.12804 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12804}

Rule 804. (1) If an agency assists a family with an evaluation prepared specifically for the adoption of a child coming to the United States for the purpose of being adopted, then the agency shall complete adoptive evaluations as required in R 400.12605.

(2) Adoptive family evaluations accepted from other states or agencies in this state must be completed by an agency or social worker licensed to complete adoption home studies in the state where the evaluation was completed.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12805 Fees {#sec-r-400.12805 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12805}

Rule 805. An agency shall have a specific fee policy that covers the following:

(a) That all fees are to be covered in a written agreement with applicants.

(b) What specific services are covered by the fees.

(d) Fees associated with modifying the agreement.

(e) Specific fees for each country.

(f) Fees associated with changing countries.

(g) What fees can be transferred during the agreement.

(h) What fees are refundable and at what points in time.

(i) How fees are to be paid to individuals in other countries.

(j) Which fees are to be paid to individuals in other countries.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12806 Placement {#sec-r-400.12806 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12806}

Rule 806. (1) An agency shall require a social service supervisor or chief administrator, if the placement is recommended by a social service supervisor, to approve or deny the recommendation for placement. The decision must be documented in the record.

(2) An adoptive family evaluation completed by a different agency or licensed social worker, where legal, must be endorsed by the agency arranging the placement.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12807 Supervision {#sec-r-400.12807 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12807}

Rule 807. (1) An agency shall provide post-placement supervision for the adoptive family at the adoptive parent’s home as needed, but not less than once every month after the placement of a child and until the final order of adoption, or as required by the country where the adoption originated.

(2) An agency shall assess and record the child’s and adoptive family’s adjustment and, where needed, include plans to assist the child or adoptive family.

(3) An agency shall keep the adoptive parents informed of the results of the agency’s continuing assessment of the placement at the conclusion of each visit.

History

History: 2014 AACS; 2023 AACS.

Mich. Admin. Code R 400.12808 Inter-country adoption record {#sec-r-400.12808 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.12808}

Rule 808. (1) An agency shall permanently retain a case record for each adoptive child after adoptive placement.

(2) The child record must contain all the following:

(a) Orientation documentation as required by R 400.12604.

(b) Evaluation documentation as required by R 400.12708.

(d) Supervision documentation as required by R 400.12711.

(3) An agency shall retain a case record for each applicant family for adoption.

(4) The applicant family record must contain all the following:

(a) Orientation documentation as required by R 400.12604.

(b) Adoptive family evaluation as required by R 400.12605.

(d) Documentation of agency policies that were provided to applicants.

(e) All documents pertaining to adoption evaluation required by R 400.12605.

(f) Agency recommendation as required by R 400.12606.

(5) An agency shall retain each applicant family record for not less than 3 years after the agency’s termination of services to the applicant family.

(6) If a branch or associate office of a child-placing agency ceases to operate, then the agency shall forward the branch’s or office’s adoption records to the central office of the branch or associate office.

(7) If a child-placing agency ceases to operate, the agency shall forward its child records to the department.

(8) If a child-placing agency ceases operation, the agency’s adoptive applicant family records must be shredded or returned to the applicant family if services to the applicant family were terminated 3 or more years before the closure. Records must be forwarded to the central adoption division for all other records.

History

History: 2014 AACS; 2023 AACS.

Behavioral and Physical Health and Aging Services Administration Behavioral and Physical Health and Aging Services Administration

R 400.20101 to R 400.20615 State and Local Programs on Aging

Mich. Admin. Code R 400.20101 Definitions; A to G {#sec-r-400.20101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20101}

DEPARTMENT OF COMMUNITY HEALTH

OFFICE OF SERVICES TO THE AGING

STATE AND LOCAL PROGRAMS ON AGING

(By authority conferred on the office of services to the aging by section 11 of Act No. 180 of the Public Acts of 1981, being S400.591 of the Michigan Compiled Laws)

PART 1. GENERAL PROVISIONS

Rule 101. As used in these rules:

(a) "Act" means Act No. 180 of the Public Acts of 1981, being S400.581 et seq. of the Michigan Compiled Laws.

(b) "Area agency" or "area agency on aging" means the single local agency or organization within each planning and service area which plans for and administers the delivery of a comprehensive and coordinated system of supportive and nutrition services to older persons and which is designated pursuant to section 4(1) of the act.

(c) "Area plan" means the document which is developed by an area agency, is approved by the commission, and which describes the comprehensive and coordinated system for providing supportive and nutrition services to older persons in the planning and service area.

(d) "Commission" means the commission on services to the aging established by section 3(1) of the act.

(e) "Comprehensive and coordinated system" means a program of interrelated supportive and nutrition services designed to meet the needs of older persons in a planning and service area.

(f) "Contract" means a written agreement directly with the office or under the provisions of an area plan which establishes the rights and responsibilities of respective parties for the quality and quantity of goods or a service being provided.

(g) "Contractor" means the party or parties specified in a contract to receive remuneration in return for goods or services rendered.

(h) "Director" means the director of the office of services to the aging as established by section 5 of the act.

(i) "Grant" means an award of funds by the office to an area agency for administrative and contract purposes under provisions of an approved area plan or to another entity in accordance with criteria established by the commission.

(j) "Grantee" means the entity to which a grant is awarded and which is accountable to the office for the use of funds provided.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20102 Definitions; M to S {#sec-r-400.20102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20102}

Rule 102. As used in these rules:

(a) "Means test" means the measure of income, financial resources, or real property as a basis for establishing eligibility or service limits to an older person.

(b) "Nonprofit" means a nonprofit corporation registered and in good standing with the corporations and securities bureau, Michigan department of commerce, pursuant to Act No. 327 of the Public Acts of 1931, as amended, being S450.62 et seq. of the Michigan Compiled Laws.

(d) "Office" or "state agency" means the office of services to the aging created by section 5 of the act.

(e) "Older person" means a state resident who is 60 years of age or older, and the spouse of the older persons, regardless of age.

(f) "Program cost" means all cost incurred by a grantee in managing, administering, and delivering services to older persons.

(g) "Program income" means that income accruing through payments or contributions received in connection with the provision of a service to older persons.

(h) "PSA" or "planning and service area" means a geographic area of the state designated by the commission for purposes of area plan development and area agency designation.

(i) "Service provider" means an entity under contract to a grantee, that provides services to older persons, under provisions of an approved area plan.

(j) "Service recipient" means an older person who receives services directly from a service provider.

(k) "State plan" means the document required by section 6 of the act and the OAA.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20103 Services system {#sec-r-400.20103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20103}

Rule 103. The system or organization through which financial resources shall flow in providing services and programs to the aging under provision of the act and the OAA consists of the following:

(a) The office, which is administered by the director to perform those functions and responsibilities specified by sections 5 and 6 of the act.

(b) The commission, which is responsible for those functions and responsibilities specified by sections 3 and 4 of the act.

(c) A system of grantees to plan and allocate resources for services and programs to older persons. Grantees may be area agencies established in accordance with section 9 of the act or other entities designated in accordance with criteria approved by the commission.

(d) A system of entities authorized to provide supportive and nutrition services directly to older persons. Such services shall be provided through contractual agreements in accordance with either of the following provisions:

(i) By grantees contracting with service providers under the provision of an area plan or other criteria approved by the commission and the state agency.

(ii) By direct contract with the state agency subject to approval by the commission.

(e) A service recipient as the beneficiary of programs and services to the aging.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20104 Grantees; reporting responsibilities and requirements {#sec-r-400.20104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20104}

Rule 104. (1) A grantee shall do all of the following:

(a) Submit to the office program and financial reports necessary to comply with state and federal requirements, as instructed in procedures issued by the director or as made part of the grant award instrument.

(b) Submit reports on time and in a manner prescribed by the director as part of the procedures issued pursuant to subdivision (a) of this subrule.

(c) Be responsible for obtaining and reporting necessary information from those entities with whom contracts have been made.

(2) A grantee shall obtain reports from contractors in a manner consistent with procedures issued pursuant to subrule (1) of this rule.

(3) A grantee shall be legally constituted as required under provisions of the act, the OAA, or requirements issued by the state agency.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20105 Grantees; contracting practices {#sec-r-400.20105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20105}

Rule 105. (1) A grantee shall not consummate a contract using funds made available, in whole or in part, through the office until an area plan or other document detailing the proposed use for financial assistance has been approved by the commission for a specified time period and notice of authorization to encumber grant funds has been issued by the director.

(2) A grantee shall contract for only those services enumerated in the area plan or other document detailing the proposed use of funds which has been approved by the commission as provided in subrule (1) of this rule.

(3) A grantee shall select contractors through a request for proposal process which gives full opportunity for free and open competition among bidders. Timely written notice shall be given to those potential contractors not selected through the process, and shall state the reasons for the grantee's decision and notice of the right to appeal.

(4) A grantee shall ensure that an assessment of each grantee's contractors is conducted in accordance with procedures and criteria issued pursuant to R 400.20301.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20106 Grantees; written operating procedures required {#sec-r-400.20106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20106}

Rule 106. (1) A grantee receiving funding or delegated authority received under provisions of the act shall have written procedures to govern the conduct of its operations and functions. Procedures shall describe the administrative and policy structure of the entity. Procedures shall describe the methods used in dealing with contractors or other agencies and incorporate those applicable procedures issued by the director.

(2) A grantee's written procedures shall be officially adopted by action of the entity's governing body. Before adoption, a grantee shall provide an opportunity for comment on the proposed operating procedures by local governments, contractors, and affected agencies. Notice of opportunity for comment shall be published in a newspaper or newspapers of general circulation or by direct mail to affected parties within the grantee's geographic jurisdiction or within the PSA. A prior notice of 14 days shall be provided for public comment before the procedures are adopted by the grantee.

(3) A grantee shall provide copies of the written procedures to each of its contractors and to the office without cost. Other parties may be charged a fee not to exceed the actual per copy cost of reproduction.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20107 Grantees; procedures for appeals and appeals hearings required {#sec-r-400.20107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20107}

Rule 107. (1) A grantee shall establish an appeals mechanism which provides the opportunity for contractors or service providers to appeal any of the following:

(a) A service provider's contract that has been suspended, terminated, or not renewed, except for cause of termination or non-renewal.

(b) A contractor's or potential contractor's application, or proposal to provide services, that was denied as provided in R 400.20105.

(2) A grantee, through action of its governing body, shall establish and issue an appeals procedure for items covered by subrule (1)(a) and (b) of this rule which includes all of the following:

(a) Written notice to the contractor or service provider of grantee action to suspend, terminate, not renew, or deny a contract, including a notice of right to appeal.

(b) Notice that information or criteria on which the grantee's action was based is available for review by affected parties.

(c) Notice that the affected party may appear in person or by a designated representative to appeal the grantee's action.

(d) Provision for, as the initial step of any appeal, a meeting with the governing body within 30 days to review items in dispute and seek clarification or resolution to the issue in dispute. A record of the meeting, including relevant facts, shall be maintained, and a determination shall be rendered in writing by the governing body. Issues unresolved shall be appealed to arbitration.

(e) A specification that appeals proceedings shall be conducted within an aggregate timeframe of 60 days, within which all of the following shall occur:

(i) A notice of right to appeal shall be sent to the contractor within 7 days of the grantee's action.

(ii) An appeal shall be requested by the aggrieved party, in writing, within 10 days of notice as provided by paragraph (i) of this subdivision.

(iii) A hearing shall be scheduled and completed.

(iv) A decision shall be rendered and reported, in writing, to the affected parties.

(f) Notice shall be given that decisions of the governing body may be appealed to arbitration in accordance with the provisions of the American arbitration association or a similar recognized professional arbitration organization. The arbiter shall determine the distribution of costs between the parties involved in the appeal.

(g) Notice shall be provided that a grantee's hearing decision may be appealed to the state agency and that the state agency shall review and act on such appeal as provided by R 400.20309(1).

(h) A description of those circumstances under which a request for appeal hearing may be refused; such circumstances shall be limited to failure to comply with the appeal procedures required by this subrule or, to lack of standing by the appellant.

(3) A grantee, through action of its governing body, shall issue administrative appeals procedures for items covered by subrule (1)(c) of this rule which shall include all of the following:

(a) Written notice to all contractors and service providers of the administrative appeals process.

(b) Written notice that contractors or service providers may appeal administrative complaints to the grantee's governing body.

(d) Written notice of decision shall include a statement that appellants may appeal the decision to the state agency within 10 days of the written notice provided by subdivision (c) of this subrule.

(e) The grantee, prior to final adoption of its procedures as required by subrules (2) and (3) of this rule, shall first submit the procedure to the state agency for review for content and form as required by R 400.20309.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20108 Contractors; responsibilities and requirements {#sec-r-400.20108 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20108}

Rule 108. (1) A contractor shall do all of the following in providing services for older persons:

(a) Meet state and local licensing requirements which are necessary for providing a specific service.

(b) Ensure that funds are used for only those services specified in the contract instrument.

(d) Provide systematic reports to the grantee as required by procedures issued by the office or made a part of the contract instrument.

(2) A contractor shall provide a recommended schedule for contributions by service recipients when required in procedures issued by the office.

(3) A contractor shall conform to service requirements issued by the state agency in accordance with R 400.20305. Such service requirements shall be made part of a contract instrument by reference.

(4) A contractor shall be any 1 of the following legally constituted entities:

(a) A nonprofit corporation.

(b) A for-profit corporation, established pursuant to Act No. 284 of the Public Acts of 1972, as amended, being S450.1101 et seq. of the Michigan Compiled Laws.

(5) Evidence of legal status is required as a condition to the receipt of funds provided under the act or the OAA.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20109 Director; duties and responsibilities {#sec-r-400.20109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20109}

Rule 109. The duties of the director include all of the following:

(a) Organize and align the state agency, including its personnel and financial resources, to perform those duties and responsibilities established by the act.

(b) Consummate grant, contract, or cooperative agreements between the state agency and the federal government, area agencies, other state or local agencies and organizations so as to direct and channel resources which provide services to older persons.

(c) Serve as the official liaison between the commission and the state agency and ensure that those state agency functions which require commission action or approval are coordinated in a timely and informed manner.

(d) Ensure that the commission, grantees, and contractors are routinely notified of policy changes or program modifications for those programs administered by the state agency.

(e) Establish special committees, advisory groups, or task forces as may be needed to achieve the orderly development and implementation of the state agency's programs.

PART 2. COMMISSION ON SERVICES TO THE AGING

History

History: 1983 AACS.

Mich. Admin. Code R 400.20201 Functions and responsibilities {#sec-r-400.20201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20201}

Rule 201. (1) The commission shall be responsible for those functions and responsibilities specified in sections 3 and 4 of the act.

(2) The commission shall approve the award of financial assistance to each grantee or contractor which is administered by the office.

(3) The commission shall issue, within 45 days from the beginning of each fiscal year, a listing which provides an index of its operating policies and procedures. The index shall indicate the status of those policies and procedures currently in effect, those modified or rescinded during the previous fiscal year, and those where change is contemplated during the current year.

(4) The commission shall appoint a state advisory council pursuant to section 4(1)(j) of the act. The composition of the advisory council shall conform to requirements of the OAA and its implementing regulations.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20202 Grants and contracts; commission action {#sec-r-400.20202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20202}

Rule 202. (1) The commission shall issue procedures governing its process of review and actions for approval or disapproval of grants or contracts to be awarded and administered by the office. Procedures of the commission shall be issued through the director and shall include all of the following criteria:

(a) Practices for scheduling dates of commission action.

(b) Practices for conveying a notice of decision, through the director, to grantees and contractors.

(c) Provisions to inform a grantee, a contractor, or an applicant for PSA or AAA designation whether the action is subject to appeal.

(d) A stipulation that the grant or contract is to be administered by the office under the supervision of the director.

(2) The commission shall only approve proposed grants or contracts for action which meet the requirements specified in R 400.20302 and R 400.20303.

(3) The commission shall require the office, through the director, to submit an analysis and recommendation of disposition before a grant or contract is acted upon.

(4) The commission shall issue procedures in conjunction with the director governing all of the following:

(a) Suspension, probation, or termination of a grantee for failure to comply with these rules or other state or federal requirements or for noncompliance with the grant agreement.

(b) Suspension or termination of a contractor for failure to comply with a contract agreement.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20203 State and area plans; commission action {#sec-r-400.20203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20203}

Rule 203. (1) The commission shall not act to approve the state plan or amendments thereto required by section 6 of the act until both of the following occur:

(a) One or more public hearings have been conducted to obtain testimony on the proposed state plan, goals, and action measures.

(b) The proposed plan has been transmitted by the director assuring that technical and procedural requirements of state or federal law, rules, or regulation have been complied with.

(2) The commission shall approve area plans or amendments thereof as a prerequisite to grants to area agencies as provided by section 4 of the act. Before action is taken by the commission, it shall ensure all of the following:

(a) That hearings have been conducted in the PSA to obtain public review and comment on the proposed goals and plan of implementation, assuring that adequate time was provided to evaluate public comment for the purpose of possible modification of the proposed plan.

(b) That the area agency's governing body and advisory council have endorsed and adopted the proposed plan as submitted.

(c) That analysis and recommended disposition of the proposed plan has been provided by the office, through the director, concerning technical and procedural requirements for area plans and R 400.20305 requirements.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20204 Public hearings {#sec-r-400.20204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20204}

Rule 204. (1) The commission, in cooperation with the office, shall conduct public hearings for all of the following:

(a) The state plan.

(b) The designation of PSAs.

(d) The determination of needs, issues, and concerns of older persons.

(2) Advance hearing notice of 14 days or more shall be given through publication of the hearing notice in a newspaper of general circulation for the territory for which the hearing has applicability. The notice shall include the date, time, location, and purpose of the public hearing.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20205 Designation of planning and service areas {#sec-r-400.20205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20205}

Rule 205. (1) The commission shall review and take action on the designation of planning and service areas. Requests for designation of PSAs shall be initiated in writing by either of the following:

(a) A unit of general purpose government which has a population of 100,000 or more, a regional area consisting of several cooperating general purpose governments, or an Indian reservation.

(b) The commission.

(2) The commission shall approve criteria for designation of PSAs based on recommendations of the office. Criteria are to include all of the following:

(a) Conformance with requirements of the OAA.

(b) The relationship to other service regions established by the state through executive or legislative action.

(c) Consultation with the governor's office and state agencies concerning the relationship to other service regions and the proposed PSA.

(d) Review and comment by local governments and human resource agencies within the proposed PSA.

(3) The commission shall conduct 1 or more public hearings on the proposed PSA designation as provided in R 400.20204 before taking action to designate planning and service areas.

(4) At least 1 public hearing shall be held in that locality of the state where a proposed PSA designation will alter or modify the existing PSA geographic configurations.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20206 Designation of area agencies on aging {#sec-r-400.20206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20206}

Rule 206. (1) The commission shall designate only 1 area agency on aging for each PSA.

(2) The commission shall ensure that the provisions of section 9(1) of the act and the OAA are met before taking designation action.

(3) The commission shall review requests for area agency designation on the basis of procedures issued in conjunction with the director. At a minimum, the procedures shall contain all of the following:

(a) Instructions for applicants who wish to file a request for designation.

(b) Specific requirements to be met by the applicant to be considered as an eligible applicant.

(4) The commission shall not designate any area agency on aging until all of the following requirements have been complied with:

(a) A technical review of the request and supporting documentation has been conducted by the office to determine conformance with the act or the OAA and its implementing regulations.

(b) The director has submitted his or her recommendations concerning the request.

(c) Evidence of support has been provided by resolution from a majority of the affected general purpose governments in the PSA.

(d) A public hearing has been conducted as provided in R 400.20204.

(e) That applicants requesting area agency designation possess the legal and organizational capacity to carry out the functions specified in this rule and R 400.20401 to R 400.20405.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20207 Appeal of commission decision {#sec-r-400.20207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20207}

Rule 207. (1) An appeal may be made of any of the following commission actions:

(a) Denial of a planning and service area designation.

(b) Withdrawal of an area agency designation.

(d) Termination or suspension of a grantee.

(2) Appeal of commission actions shall be conducted in accordance with the provisions of R 400.20601 to R 400.20615.

PART 3. OFFICE ON SERVICES TO THE AGING

History

History: 1983 AACS.

Mich. Admin. Code R 400.20301 Functions and responsibilities; issuance of procedures on administration and management {#sec-r-400.20301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20301}

Rule 301. (1) The office shall perform those functions and responsibilities as provided in sections 5, 6, 7, and 10 of the act and those conferred by the OAA.

(2) The office, through the director, shall issue written procedures regarding its administrative and management responsibilities in accordance with the following provisions:

(a) Sections 24 to 26 of Act No. 306 of the Public Acts of 1969, as amended, being SS24.224 to 24.226 of the Michigan Compiled Laws.

(b) Applicable federal program requirements and regulations for those federal programs administered by the office pursuant to the OAA.

(3) The office shall issue procedures to provide for all of the following:

(a) Systematic administration and management to grantees and contractors, including procedures for application, action, payment, reporting, closeout, and audit of such grants or contracts.

(b) The general conduct of business with area agencies, other grantees and contractors on an ongoing basis. Such procedures shall include program and fiscal information to interpret, instruct, or otherwise provide guidance.

(c) Methods by which state and federal program and financial requirements are to be fulfilled by grantees, contractors, and the office.

(d) The office's notice to the commission of any modification or amendment to the commission's previously approved grants, contracts, and state or area plans.

(e) Developing and maintaining a state comprehensive plan on services to the aging, including its substantive content, period of applicability, public review through hearing, and methods for amendment.

(f) Grantee assessment of those entities with which they have entered into contract to provide services, including criteria for such assessment.

(g) The processing of administrative complaints registered by grantees or contractors which are based on established policies or procedures.

(4) The director, before the adoption and issuance of office procedures, shall ensure that grantees, contractors, and other interested parties have been given an opportunity for expressing views on proposed procedures in accordance with subrule (2) of this rule.

(5) Within 45 days from the beginning of each fiscal year, the office shall issue a listing which provides an index of its operating procedures and policies. The index shall indicate the status of those procedures and policies in current effect, those rescinded or modified during the previous fiscal year, and those where change is contemplated during the current fiscal year.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20302 Distribution formulae for formula-type grants; criteria for discretionary-type grants; development; publication; use {#sec-r-400.20302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20302}

Rule 302. (1) The office shall develop distribution formulae and criteria for use in the allocation of state and federal grant funds to be consistent with the act and OAA.

(2) The distribution formulae shall be made an attachment to the state plan and shall be subject to commission action pursuant to R 400.20203 and R 400.20204.

(3) The office shall issue criteria for the allocation of funds which are to be determined on the basis of discretion rather than non-discretion formula, to include both of the following:

(a) A notice of grant availability, where funds are to be awarded on a discretionary basis.

(b) The requirements for making a request for such discretionary funds.

(4) The commission, as provided in R 400.20202, shall use the distribution formulae or criteria for discretionary grants, whichever is applicable, in taking action on funding decisions.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20303 Award of financial assistance through grants and contracts; criteria and procedures {#sec-r-400.20303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20303}

Rule 303. (1) The office shall issue, through the director, criteria and procedures for both of the following:

(a) The selection of grantees and contractors to be recommended for financial award through commission action.

(b) The effectuation of a grant or contract, awarded by commission action, through a written grant or contract instrument.

(2) The office, through the director, shall issue information and procedures on seeking financial assistance through the office, including all of the following:

(a) The instructions required to officially request, make application for, or submit a proposal for, funding through a grant or contract.

(b) Requirements to qualify as an eligible applicant.

(d) Criteria for revising or amending the proposal prior to commission action.

(e) Criteria for revising or amending the grant or contract instrument after action by the commission.

(3) The office shall use a uniform grant or contract agreement instrument when making the award of financial assistance as provided in subrule (2) of this rule. Specific requirements of state or federal law, rules, or regulations shall be referenced and made addenda of the grant or contract instrument.

(4) The office, through the director, shall ensure that written procedures are issued for each state and federal program for which financial assistance is available as a grant or a contract.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20304 State plan; development; content {#sec-r-400.20304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20304}

Rule 304. (1) The office shall be responsible for the development, maintenance, and implementation of a state plan in accordance with the following:

(a) Provisions of section 6 of the act.

(b) Provisions of section 307 of the OAA and its implementing regulations.

(2) The state plan shall include, but not be limited to, all of the following:

(a) The duration or time frame the plan is to be in effect.

(b) The content to comply with applicable OAA requirements or its implementing regulations.

(d) Action steps that will be established to effectuate the plan.

(e) The funding formula, as provided in R 400.20303, shall be made an attachment to the plan.

(3) The state plan shall be subject to public hearing as provided in R 400.20204.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20305 Area plans; development of uniform standards and criteria for development, approval, and effectuation {#sec-r-400.20305 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20305}

Rule 305. (1) The office shall develop, and the director shall issue, standards and criteria for area plans, including all of the following:

(a) The format and content for the development and preparation of area plans by area agencies.

(b) The time frame for submittal of area plans to achieve office review and commission action.

(d) The use of standardized service definitions to describe the function and unit of measure for each category of service to older persons which may be provided or funded under provisions of an area plan.

(e) Procedures for revising or amending an area plan and submitting the plan for commission action.

(f) Distribution of grant monies through the area plan.

(2) The office shall establish criteria and issue instruction to area agencies for ensuring that local governments, agencies, service providers, and older persons have an opportunity for involvement in the development, coordination, and implementation of an area plan.

(3) The office shall establish a procedure or coordination mechanism to ensure there is a coordination and correlation of data used for the development of area plans with that used for the state plan.

(4) The office shall establish and issue procedures for granting a waiver to area agencies that demonstrate they can provide a nutrition or supportive service more effectively than a contractor.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20306 Assessments of grantees and state agency contractors for performance and compliance {#sec-r-400.20306 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20306}

Rule 306. (1) At least annually, the office shall conduct an on-site assessment of grantees and state agency contractors for the following purposes:

(a) To determine the extent of compliance in meeting state and federal requirements.

(b) To assess the performance of the grantee or its contractor in attaining objectives made part of the grant or contract agreement.

(2) The office shall issue procedures for all of the following, through the director, for grantees and contractors:

(a) Assuring that a grantee or state agency's contractor is given advance notice, in writing, of a scheduled assessment, including all of the following:

(i) The date scheduled for on-site assessment.

(ii) The scope of the on-site assessment.

(iii) Criteria to be used in conducting the on-site assessment.

(b) Assuring that a written report will be submitted within 60 days to the grantee or the state agency's contractor describing the office's findings as a result of the on-site assessment.

(c) Assuring that the grantee or the state agency's contractor may respond to the office within 21 days of receipt of the office's findings concerning any exceptions noted in the assessment report.

(3) Each written assessment report issued by the office shall be used as a basis for the following:

(a) Corrective action to be taken by the grantee or the state agency's contractor.

(b) Suspension, probation, or termination action by the office toward the grantee or its contractor.

(4) Each assessment report shall make notation of changes, improvements, or corrections which have been made by the grantee or contractor since the latest annual assessment.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20307 Determination of need for services to the aging {#sec-r-400.20307 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20307}

Rule 307. (1) The office shall systematically determine the need for services to the aging on an ongoing basis focusing on statewide, institutional, and community-based settings.

Needs shall be based on demographic, social, and economic indicators.

(2) The office shall use data, findings, and conclusions resulting from the determination of need for all of the following:

(a) Preparation and development of the state plan as provided by R 400.20304.

(b) Establishing standards and criteria for area plans as provided by R 400.20305.

(d) Preparing the annual report to the governor and legislature under provisions of section 6(n) of the act.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20308 Recommendations to the commission; basis for action {#sec-r-400.20308 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20308}

Rule 308. The director shall submit to the commission a report containing the recommendation of the office for each grant, contract, or area plan transmitted for commission action. The report shall contain information to guide the commission's action, including all of the following information:

(a) The extent to which the proposed grant or contract or area plan conforms to applicable provisions of the act or the OAA.

(b) The extent to which the request conforms to the provisions of R 400.20302.

(d) The extent to which the grant or contract will provide services, in quantifiable terms, for older persons.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20309 Hearings and appeals {#sec-r-400.20309 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20309}

Rule 309. (1) The director of the state agency shall establish procedures for receiving and processing appeals requests for both of the following:

(a) Appeal of those commission actions which are subject to appeal as provided by R 400.20207.

(b) Appeal by a grantee's contractor as provided by R 400.20107(2)(g).

(2) Notification of each commission action which is subject to appeal shall be issued by the director of the state agency to the affected party as stipulated in R 400.20207.

(3) The state agency shall conform to the requirements of R 400.20601 to R 400.20615 when undertaking an appeals transaction for those commission or state agency actions described in R 400.20207.

(4) The director of the state agency, in consultation with the commission, shall issue criteria for the development of grantee appeals procedures, including review and concurrence by the state agency as provided by R 400.20107.

(5) The commission chairperson shall appoint an appeal panel to hear those appeals received pursuant to subrule (1)(b) of this rule. The panel shall serve as the hearing body and prepare a written record of facts concerning the case and provide a recommended decision.

PART 4. AREA AGENCIES ON AGING

History

History: 1983 AACS.

Mich. Admin. Code R 400.20401 Area agencies; designation; legal basis {#sec-r-400.20401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20401}

Rule 401. (1) Area agencies shall be designated by the commission in accordance with R 400.20206.

(2) Area agencies shall be established with a statutory basis as 1 of the following:

(a) A general purpose government or agency thereof.

(b) An agency designated by resolution of a combination of units of general purpose government.

(d) An Indian tribal organization.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20402 Area agencies; responsibilities and functions {#sec-r-400.20402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20402}

Rule 402. (1) Area agencies shall be responsible for those functions contained in section 9(2) of the act and section 306 of the OAA.

(2) Area agencies shall develop a comprehensive and coordinated area plan for the delivery of nutrition and supportive services to older persons for their respective PSA.

(3) Area agencies shall not be engaged in the direct provision of nutrition and supportive services. An area agency may obtain a waiver from the state agency to provide services if it can substantially demonstrate that it can provide the service more effectively and efficiently than a contractor in accordance with provisions of R 400.20305.

(4) Area agencies shall administer program, financial, and technical assistance to service providers with whom they contract in accordance with procedures issued by the office pursuant to R 400.20301 to R 400.20309 and R 400.20104 to R 400.20107.

(5) Area agencies may enter into cooperative agreements with public and private agencies in the PSA to achieve coordination and cooperation in the planning and delivery of services to older persons.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20403 Area plans; preparation, approval, expenditures, and amendment {#sec-r-400.20403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20403}

Rule 403. (1) Area agencies shall develop an area plan in accordance with R 400.20305 and shall submit the plan for commission action in accordance with R 400.20203.

(2) Area agencies shall receive grants from the office only under the provisions of an area plan developed and approved in accordance with subrule (1) of this rule.

(3) Area agencies shall expend monies only for those functions and services contained in their approved area plans and the grant award instruments issued by the office and in accordance with R 400.20105.

(4) Area agencies may request an amendment to their approved area plan in accordance with R 400.20305 after written notice has been given to contractors providing services under the plan and after public hearings have been conducted on the proposed amendment by the area agency.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20404 Service provision; use of service providers; contracts {#sec-r-400.20404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20404}

Rule 404. (1) Area agencies shall contract with service providers to deliver supportive and nutrition services under the provisions of an area plan, unless otherwise authorized pursuant to R 400.20402.

(2) Area agencies shall not execute a contract until an area plan has been approved by the commission pursuant to R 400.20203 and authorization to encumber grant funds has been issued by the director pursuant to R 400.20303.

(3) Area agencies shall issue instructions for the reporting of program and fiscal information. Reference to such instructions shall be made a part of each contract instrument. Such instruments shall be consistent with those issued by the director in accordance with R 400.20202 and R 400.20303.

(4) Area agencies shall include information contained in reports required by subrule (3) of this rule as part of the reports required by the office pursuant to R 400.20104.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20405 Financial allocations; requirements {#sec-r-400.20405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20405}

Rule 405. (1) Area agencies shall use their allocations under an approved area plan and approved grant instrument for those services which are consistent with service definitions issued pursuant to R 400.20305 and priority service needs identified by the area plan.

(2) Area agencies shall make supportive service allotments received under provisions of the OAA to ensure that an adequate proportion of the allotment is used to fund each of the following service categories:

(a) Services associated with access to other services.

(b) In-home services.

(3) Area agencies may request a waiver of subrule (2) of this rule at the time of area plan submittal required by R 400.20403.

(4) The office shall issue criteria for determining the basis of granting a waiver under subrule (3) of this rule. The criteria shall be made a part of the procedures specified in R 400.20303.

(5) Area agencies, as part of the area plan, shall describe the rationale for allocating funds made available through grants within the PSA. The rationale shall describe how funds will be distributed to meet priority nutrition and supportive service needs identified in the area plan.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20406 Area agencies; written procedures required {#sec-r-400.20406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20406}

Rule 406. (1) Area agencies will be required to have written procedures in accordance with R 400.20106.

(2) Area agencies shall adopt written procedures as provided by R 400.20106 to govern the conduct for both of the following:

(a) The agency's governing body or board of directors.

(b) The agency's advisory council.

(d) Assessment of contractors as provided by R 400.20105.

(3) Area agencies shall have written procedures for the conduct of public hearings to be held for any of the following:

(a) The area plan.

(b) Advocacy hearings on service needs determination or issues of older persons.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20407 Service need evaluation; cooperative effort {#sec-r-400.20407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20407}

Rule 407. Area agencies shall cooperatively participate with service providers and the office in the determination of need for services required by R 400.20307.

PART 5. FINANCIAL REQUIREMENTS

History

History: 1983 AACS.

Mich. Admin. Code R 400.20501 Notice of financial award {#sec-r-400.20501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20501}

Rule 501. (1) The office, within 30 days after commission action to approve a grant or contract, shall issue a grant or contract instrument as a 2-party agreement for obligating funds.

(2) The grant or contract instrument shall constitute the official document which specifies the terms of the agreement. The grant or contract agreement shall include all of the following:

(a) Total financial amount, including both of the following:

(i) Funds provided through the office.

(ii) Funds, or services in lieu of funds, provided by the grantee or contractor.

(b) Conditions of the grant or contract, including all of the following:

(i) Beginning and ending dates for which the agreement is to be in effect.

(ii) Documentation of services to be provided or objectives to be achieved by the grant or contract.

(iii) Special conditions, if any, which may be specified as a part of commission approval action.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20502 Modification of approved grants or contracts {#sec-r-400.20502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20502}

Rule 502. (1) A grantee or contractor of the state agency shall submit a request and gain approval of the commission for any change which modifies the grant or contract agreement in any of the following ways:

(a) Changes the program scope, planned objectives, or the character of service delivery made part of the instrument.

(b) Provides financial assistance to any person not authorized by the grant or contract instrument.

(c) Transfers to a third party the conduct of functions or responsibilities which are central to executing the purposes of the grant or contract.

(d) Alters the approved budget of the grant or contract, except as may occur through the limits of administrative discretion as provided in the agreement.

(2) Grantees or contractors of the state agency shall be notified by the director of commission action on requests initiated under the provisions of subrule (1) of this rule.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20503 Grantee responsibilities when contracting for services under grant {#sec-r-400.20503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20503}

Rule 503. A grantee shall do all of the following when contracting for services under provisions of a grant:

(a) Contract for services within 45 days after the effective date of the grant instrument executed with the office in accordance with R 400.20501.

(b) Not alter the contract amount during the final 60 days of any fiscal year unless approved by the director.

(c) Retain a copy of each contract in the grantee's office for review and audit for a period of 3 years after contract completion.

(d) Obtain prior written approval from the state agency when proposing to contract with profit-making organizations.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20504 Audits {#sec-r-400.20504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20504}

Rule 504. A financial audit of grantee records shall be made not less than biennially.

Audits are to be conducted in accordance with standards established by the American institute of certified public accountants and requirements issued by the director of the state agency. Audit requirements shall include, but not be limited to, all of the following:

(a) Audits shall be made on an agency-wide basis to test the integrity of financial transactions and compliance with grant or contract terms.

(b) The office shall ensure that timely and appropriate resolution of negative audit findings and recommendations for reconciliation occur promptly.

(c) Grantees may audit contractors that have provided services if the audit conforms to minimum audit standards approved by the director.

(d) The expense of an independent audit which does not meet the standards cited in this rule shall not be authorized.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20505 Audit disallowances {#sec-r-400.20505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20505}

Rule 505. A grantee shall be responsible for any costs disallowed as a result of any of its contractors. Resolution of audit disallowances shall be achieved between the grantee and the contractor of record.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20506 Determining reasonable, allowable, and allocable costs; written procedures {#sec-r-400.20506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20506}

Rule 506. In accordance with R 400.20301, procedures shall be issued by the office director to all grantees and state agency contractors for determining the reasonableness, allowability, and allocability of costs.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20507 Means test to deny or limit services; failure to contribute to costs {#sec-r-400.20507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20507}

Rule 507. (1) A grantee or contractor shall not use a means test to deny or limit a service to older persons unless specifically required by state law or federal regulation.

(2) A grantee or contractor shall not deny or limit a service to an older person who fails to contribute to the cost of the service unless authorized by specific state law or federal regulation.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20508 Program income {#sec-r-400.20508 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20508}

Rule 508. (1) A grantee and contractor shall maintain a record of all income derived through the provision of a nutrition or supportive service. The office shall issue procedures for recording program income in accordance with R 400.20301.

(2) Program income shall be used to increase or expand the level of service from which the income is derived.

(3) A grantee and contractor shall ensure that acceptable accounting procedures are established for recording the receipt and expenditure of program income.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20509 Fees for services {#sec-r-400.20509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20509}

Rule 509. (1) A grantee or contractor shall do both of the following:

(a) Assess a service fee to persons who are not older persons unless they are volunteers in providing a nutrition service.

(b) Record fees for services as program income.

(2) A grantee or contractor shall not claim for credit or payment as a part of the grant or contract for those services rendered to noneligible persons.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20510 Payments to grantees or contractors {#sec-r-400.20510 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20510}

Rule 510. (1) The office shall only make payments for those authorized costs made in conformance with a fully executed grant or contract instrument.

(2) A grantee or contractor shall not receive payment for costs incurred until authorized under subrule (1) of this rule.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20511 Withholding of payment; basis {#sec-r-400.20511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20511}

Rule 511. Payments may be withheld by the office under any of the following circumstances:

(a) Failure to submit reports as provided by R 400.20104.

(b) Costs of audits fail to comply with R 400.20504.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20512 Purchase of equipment or property; permission required {#sec-r-400.20512 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20512}

Rule 512. A grantee or contractor shall not use funds made available through the office for the purpose of purchasing equipment or property, unless specifically authorized by the act or the OAA and approved by the commission as part of the proposed grant or contract action conducted in accordance with R 400.20202.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20513 Suspension of a grantee; termination of a grant; closeout of a grant; issuance of procedures {#sec-r-400.20513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20513}

Rule 513. (1) Procedures shall be issued by the office, pursuant to R 400.20301, for each of the following:

(a) Suspension of a grantee.

(b) Termination of a grant.

(d) Probation of a grantee.

(2) Procedures issued in accordance with subrule (1) of this rule shall include all of the following:

(a) A specific reason for the action and instructions for corrective actions to be taken.

(b) Specific conditions for payment or financial settlement under the conditions of suspension or termination.

(d) Specific rights of appeal available to the grantee.

(e) A specification of how services to older persons are to be continued under the conditions of suspension or termination.

(3) The office shall not pay for additional obligations incurred by the grantee during a period of suspension, unless expressly authorized by commission action.

(4) The office shall not pay a grantee for any financial obligations incurred after the effective grant termination date.

(5) The office may institute an emergency suspension if, considering its responsibility to protect the public's interest, a delayed suspension date would be unreasonable. Emergency suspensions shall be reviewed by the commission for action at its next regular meeting following the date of suspension. The office, through the director, shall issue criteria for determining an emergency condition in accordance with R 400.20301.

PART 6. APPEALS AND APPEALS HEARINGS

History

History: 1983 AACS.

Mich. Admin. Code R 400.20601 Notice of right to appeal; right to appeals hearing {#sec-r-400.20601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20601}

Rule 601. (1) The state agency director shall provide written notice to each affected party of those commission actions which are subject to appeal. The following actions are subject to appeal:

(a) Commission action which denies an applicant's designation as a planning and service area.

(b) Commission action which withdraws an area agency's designation.

(d) Commission action which terminates or suspends a grantee or which places a grantee on probation.

(e) Terminating or altering a contract of a state agency contractor, except as provided by terms of the contract.

(2) The director of the state agency shall notify those parties specified in subrule (1) of this rule of all commission or state agency actions and those which may be appealed. Notice shall be provided in writing and contain all of the following:

(a) A concise statement of the action and whether it may be appealed.

(b) The basis for the action which makes it subject to appeal.

(d) A statement to notify the affected party of right to appeal and the timeframe within which an appeal request must be initiated.

(3) Each party notified of the right to appeal and hearing shall be notified that this rule to R 400.20602 to R 400.20615 shall govern the method of proceeding.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20602 Request for hearing; timeliness {#sec-r-400.20602 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20602}

Rule 602. (1) A written notice of appeal and request for an appeals hearing shall be made to the director. Requests made by public or private agencies shall certify that the request is officially endorsed by the agency's governing body.

(2) Freedom to make an appeal request shall not be limited or interfered with in any way.

If needed, the office shall assist the party in filing and processing the request.

(3) Parties shall have 30 days from the mailing of notice provided by R 400.20601 to submit an appeal by certified mail and request an appeals hearing.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20603 Denial or dismissal of request for hearing {#sec-r-400.20603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20603}

Rule 603. (1) The director shall deny or dismiss the request for an appeals hearing under any of the following circumstances:

(a) A request was not submitted within the 30 days provided.

(b) A request is withdrawn by an aggrieved party through written notice before issuance of the final decision.

(d) The office has no jurisdiction over the matter.

(e) An issue is not appealable.

(2) Abandonment occurs if an aggrieved party, without good cause as determined by the hearing officer, fails to appear or be represented at the scheduled hearing.

(3) Written notice shall be given by the director to an aggrieved party stating the reasons for denial or dismissal as provided in subrule (2) of this rule.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20604 Hearings; place and notice {#sec-r-400.20604 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20604}

Rule 604. (1) A hearing shall be conducted at a reasonable time, date, and place which will normally be in state facilities at Lansing.

(2) A notice of hearing shall be mailed to the aggrieved party or its representative of record not less than 10 days before the hearing date and shall include all of the following:

(a) Time, date, and place of hearing.

(b) A citation of the provision of the regulation, rule, or law involved.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20605 Hearings officer {#sec-r-400.20605 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20605}

Rule 605. A hearing for each appeal of a state agency or commission action shall be conducted by a hearings officer. A hearings officer assigned to preside shall not have been involved in the initial determination of the action in question. As a general rule, a hearings officer will be an administrative law judge from within a principal department of state government.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20606 Powers of hearings officer {#sec-r-400.20606 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20606}

Rule 606. A presiding hearings officer may do all of the following:

(a) Administer oaths or affirmations.

(b) Sign and issue subpoenas in the name of the agency, requiring the attendance and giving of testimony by witnesses or the production of books, papers, and other documentary evidence to the extent permitted by law.

(d) Regulate the course of the hearing, set the time and place for continued hearings, and fix the time for filing briefs and other documents.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20607 Hearing considerations {#sec-r-400.20607 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20607}

Rule 607. A hearing shall include consideration of all of the following:

(a) The manner by which the issue under appeal was guided by federal regulation, state law, the act, or rule.

(b) The timeliness by which the office or commission acted on the issue being appealed.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20608 Rights of parties {#sec-r-400.20608 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20608}

Rule 608. A party to a hearing or its authorized representative shall have the opportunity to do all of the following:

(a) Examine the contents of its file and all documents and records to be used by the office at the hearing at a reasonable time before the date of the hearing and during the hearing.

(b) Represent the case directly or by an authorized representative. The office and commission have the right to be represented by legal counsel and other representatives.

(d) Establish all pertinent facts and circumstances.

(e) Advance any relevant arguments without undue interference.

(f) Question any testimony or evidence, including cross-examining adverse witnesses.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20609 Evidence; oath {#sec-r-400.20609 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20609}

Rule 609. (1) A witness or party testifying shall be put under oath or affirmation.

(2) Insofar as practical, the hearings officer shall follow the rules of evidence as applied in a nonjury civil case in circuit court. If necessary, evidence not admissible thereunder may be admitted, unless precluded by statute, if it is the type commonly relied upon by reasonably prudent persons in the conduct of their affairs. Effect shall be given to rules of privilege recognized by law. Incompetent, irrelevant, immaterial, or unduly repetitious evidence may be excluded. Objections to offers of evidence may be made and shall be noted in the record.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20610 Adjournments; continuances {#sec-r-400.20610 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20610}

Rule 610. An adjournment or continuance may be granted by a hearings officer for good cause. Good cause includes the absence of material witnesses and necessary evidence.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20611 Hearings officer's opinion {#sec-r-400.20611 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20611}

Rule 611. A hearings officer's opinion shall be prepared in writing subsequent to the hearing and shall contain his or her findings of fact, conclusions of law, and a recommendation to the director as to the proper decision, based exclusively on the evidence and other materials introduced at the hearing.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20612 Decisions {#sec-r-400.20612 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20612}

Rule 612. (1) A decision, to be issued by the director, shall be based exclusively on the hearings officer's opinion, evidence, and other material introduced at the hearing.

(2) The record shall consist of an official report containing the substance of what transpired at the hearing, together with all exhibits and motions filed in the proceeding, and the recommendation of the hearings officer. The record shall be available to the grievant at a place accessible to the grievant or his or her representative of record.

(3) Prompt, definitive, and final administrative action shall be taken within 90 days of the request for a hearing, unless otherwise provided by governing state or federal laws and rules.

(4) All parties and their representatives shall be promptly notified, in writing, by registered mail, of the decision, including the director's or commission's decision and order, including the hearings officer's opinion.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20613 Retroactivity {#sec-r-400.20613 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20613}

Rule 613. When a hearing decision is favorable to the aggrieved party the office shall make corrective retroactive actions in accordance with the requirements of state or federal regulation, rule, or law.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20614 Rehearing following decision {#sec-r-400.20614 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20614}

Rule 614. A hearing decision adverse to the aggrieved party is not subject to a rehearing upon the same issue, unless newly discovered, relevant evidence is to be presented.

History

History: 1983 AACS.

Mich. Admin. Code R 400.20615 Appeal of decisions {#sec-r-400.20615 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.20615}

Rule 615. Decisions made pursuant to R 400.20612 may be appealed as follows:

(a) To the U.S. commissioner on aging for those applicable matters related to the OAA and applicable federal regulations.

(b) To the circuit court of Ingham county.

History

History: 1983 AACS.

Mich. Admin. Code R 550.501 Definitions {#sec-r-550.501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 550.501}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF FINANCIAL MANAGEMENT AND ADMINISTRATIVE SERVICES

SHARING HEALTH CARE INFORMATION

(By authority conferred on the director of community health by section 9 of 2006 PA 593, MCL 550.289)

Rule 1. As used in these rules:

(a) "Director" means the director of community health.

(b) "Complainant" means any entity who files a complaint about an alleged violation of this act.

History

History: 2010 AACS.

Mich. Admin. Code R 550.502 Applicability {#sec-r-550.502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 550.502}

Rule 2. These rules govern the administrative procedures for the handling of a complaint filed by any entity and provide additional procedures for a request for a hearing.

History

History: 2010 AACS.

Mich. Admin. Code R 550.503 Complaints {#sec-r-550.503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 550.503}

Rule 3. (1) A complaint shall be in writing and signed by the complainant.

(2) A complaint shall be limited to matters involving an alleged violation of this act.

History

History: 2010 AACS.

Mich. Admin. Code R 550.504 Receipt and disposition of complaints {#sec-r-550.504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 550.504}

Rule 4. (1) A complaint shall be filed with the director or his or her designated representative.

(2) A complainant must file the complaint within 30 days of the date of the action giving rise to the complaint.

(3) The director or designated representative shall give the complainant a file number, establish a file, and send acknowledgement to the complainant.

(4) A complaint shall be investigated according to a priority established by the director or his or her designated representative. A memorandum of the investigation shall be prepared and placed in the complaint file.

(5) The memorandum written following investigation of a complaint with copy to the involved complainant shall detail all of the following:

(a) Brief description of the complaint.

(b) Investigatory findings.

(d) Need for follow-up, if indicated.

(6) The director shall send a letter to the complainant following investigation of the complaint informing the complainant generally of any action taken.

History

History: 2010 AACS.

Mich. Admin. Code R 550.505 Hearings on complaints {#sec-r-550.505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 550.505}

Rule 5. (1) A complainant may request a hearing on his or her complaint if he or she is dissatisfied with the investigation or results.

(2) A complainant shall submit a request for a hearing in writing to the director or his or her designated representative within 30 days after receipt of the letter specified in R 500.504(5).

(3) A complainant shall have access to the complaint file and its content prior to the hearing by appointment at a mutually convenient time in the department's offices.

History

History: 2010 AACS.

Children's Services Agency Children's Services Agency

R 722.751 to R 722.756 Children's Trust Fund Grant Program

Mich. Admin. Code R 722.751 Definitions {#sec-r-722.751 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.751}

DEPARTMENT OF MANAGEMENT AND BUDGET

STATE CHILD ABUSE AND NEGLECT PREVENTION BOARD

CHILDREN'S TRUST FUND GRANT PROGRAM

(By authority conferred on the state child abuse and neglect prevention board by section 11 of Act No. 250 of the Public Acts of 1982, being S722.611 of the Michigan Compiled Laws)

Rule 1. (1) As used in these rules:

(a) "Act" means Act No. 250 of the Public Acts of 1982, being S722.601 et seq. of the Michigan Compiled Laws.

(b) "Children's trust fund board" means the state child abuse and neglect prevention board as defined in section 2(e) of the act.

(c) "Council" means a local council which has applied to the children's trust fund board for, and has received, designation status based on the children's trust fund board's review of the council's compliance with section 10 of the act.

(d) "Demonstration project" is a direct service administered or controlled by a council for a limited period of time to demonstrate some aspect of prevention or to initiate and provide a needed direct service.

(e) "Direct service" means help or benefit provided to children or their families on a person-to-person basis.

(f) "Facilitation of interagency projects" means the coordination and encouragement of a project in which the direct service component is not done under the control or direction of the council or its employees.

(g) "Prevention services" refers to a continuum of primary, secondary, and tertiary efforts aimed at the prevention of child abuse. In this continuum, primary prevention refers to programs which are believed to be universally beneficial in curbing child abuse aimed at the general population; secondary prevention refers to programs or services aimed at high risk populations which may be more prone to abuse or neglect of children; tertiary prevention refers to programs or services aimed at limiting the amount of damage, morbidity, or further abuse once child abuse or neglect has occurred in a given family or population.

(2) A term defined in the act has the same meaning when used in these rules.

History

History: 1986 AACS.

Mich. Admin. Code R 722.752 Council responsibilities {#sec-r-722.752 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.752}

Rule 2. A council shall do all of the following:

(a) Facilitate collaborative community prevention programs and services in a specific geographical area. The prevention program shall utilize trained volunteers and existing community resources where practicable.

(b) Provide the children's trust fund board with review and comments on grant applicants from its geographic area.

(c) Participate, when invited by the children's trust fund board, in monitoring funded projects in relationship to the process component of the evaluation.

(d) Run or facilitate a collaborative community effort in the provision of local public education and professional training programs.

(e) Foster fund-raising to the children's trust fund and councils.

(f) Provide input to the children's trust fund board on the establishment of priorities for prevention services development.

(g) Provide assistance to prevention projects in its area in developing match and ongoing funding.

History

History: 1986 AACS.

Mich. Admin. Code R 722.753 Children's trust fund board responsibilities {#sec-r-722.753 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.753}

Rule 3. The children's trust fund board shall do all of the following:

(a) Inform the councils of the children's trust fund board's involvement in their local communities, including an invitation to participate in any site visits.

(b) Forward copies of grants awarded in their areas to the councils.

(d) Provide technical assistance to councils or their designees.

(e) Fund councils to help underwrite costs associated with being a local council.

History

History: 1986 AACS.

Mich. Admin. Code R 722.754 Council funding {#sec-r-722.754 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.754}

Rule 4. (1) The children's trust fund board shall annually establish the proportion and amount of the children's trust fund which shall be available for allocation to councils and shall establish the formula by which these funds will be distributed.

(2) All councils shall receive a yearly allotment of funds, contingent on the submittal of acceptable annual prevention plans. The allotment may vary in amount from council to council.

(3) The match for formula funding to local councils may be matched 100% with in-kind services as listed in R 722.752.

History

History: 1986 AACS.

Mich. Admin. Code R 722.755 Grants for prevention services {#sec-r-722.755 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.755}

Rule 5. (1) The children's trust fund board shall biennially develop a state plan which establishes a rationale and priorities for the allocation of grants for prevention services.

(2) The children's trust fund board shall establish a procedure for accepting and reviewing applications which includes the review and comment of local projects by the councils.

(3) In making funding determinations, the children's trust fund board shall take into consideration the recommendations of the councils, together with such factors as geographic distribution, prevention service priorities, and other factors the children's trust fund board deems appropriate. These conditions shall be published in an annual request for proposals.

(4) Councils may submit applications for demonstration projects or the facilitation of interagency projects within the stated priorities. Such applications shall be reviewed on a competitive basis through the project grant award process. It is not mandatory that such grants be awarded. If a grant is awarded, the plans for transfer to another agency shall be a condition of any demonstration grant award.

(5) In determining the length of funding from the children's trust fund beyond 1 year, the children's trust fund board shall take into consideration such factors as performance, length of time required to complete an evaluation, efforts of the project sponsor and council to obtain other funding, and other factors the children's trust fund board deems appropriate and publishes prior to issuing grants.

(6) The children's trust fund board may designate grants for any of the following purposes:

(a) As seed money to pay for the establishment, but not ongoing operation, of a prevention service.

(b) As a subsidy for the basic underwriting of service costs.

(c) For declining funding, moving from 100% the first year to 0% over a period of time specified in advance by the children's trust fund board.

(7) Any applicant rejected for funding may contact the executive director of the children's trust fund, who shall give the children's trust fund board's reasoning for not awarding a grant. In addition, the applicant may submit to the director specific reasons, in writing, why it should be funded. The director shall then present this statement to the chairperson of the children's trust fund board. The chairperson shall present the written statement to a specially appointed review committee. The review committee shall consist of the chairperson of the children's trust fund board, 1 children's trust fund board member who did not serve on the committee that reviewed the original application, the chairperson of the committee that did review the initial application, and the executive director. The chairperson shall present the findings to the children's trust fund board as a whole for its final decision on action to be taken. The applicant shall then be notified, in writing, of the children's trust fund board's final decision.

History

History: 1986 AACS.

Mich. Admin. Code R 722.756 Board meetings; purpose; open meetings {#sec-r-722.756 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 722.756}

Rule 6. (1) The purpose of a children's trust fund board meeting is to conduct the business of the children's trust fund, allowing and encouraging public input.

(2) The business which the children's trust fund board performs shall be conducted at a public meeting of the children's trust fund board held in compliance with Act No. 267 of the Public Acts of 1976, as amended, being S15.261 et seq. of the Michigan Compiled Laws. Public notice of the time, date, and place of the meeting shall be given in the manner required by Act No. 267 of the Public Acts of 1976, as amended.

History

History: 1986 AACS.

Public Health Administration Public Health Administration

R 18.351 to R 18.367 Crime Victim Services – General Rules

Mich. Admin. Code R 18.351 Definitions {#sec-r-18.351 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.351}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF COMMUNITY SERVICES-CRIME VICTIM'S SERVICES

COMMISSION

GENERAL RULES

(By authority conferred on the crime victims compensation board by section 3 of 1976 PA 223, MCL 18.353.)

Rule 1. (1) As used in these rules:

(a) "Accomplice" means any person who knowingly aids or assists another person in the commission of a crime, either before, during, or after the crime.

(b) "Act" means 1976 PA 223, MCL 18.351 to 18.368.

(c) "Civil infraction" has the meaning prescribed by section 6a of 1949 PA 300, MCL 257.6 (d) "Closed session" means a meeting or part of a meeting of the commission that is closed to the public in order to protect certain rights of confidentiality.

(e) "Crime" means an act or omission forbidden by law that is not designated as a civil infraction and that is punishable, upon conviction, by imprisonment, a fine that is not a civil fine, or other penal discipline.

(f) "Criminally responsible" means legally accountable or legally answerable for a crime.

(g) "Household" means persons who dwell together as a family under 1 roof and who are related by blood, marriage, or judicial decree.

(h) "Intimate personal privacy" means matters dealing with the mental or physical health of a person or the details or a crime involving sexual assault in any degree.

(i) "Legally incapacitated person" means a person, other than a minor, for whom a guardian has been appointed by a court.

(j) "Meeting" means the convening of the commission at which a majority of the board are present for the purpose of deliberating toward or rendering a decision on a public policy.

(k) "Minor" means a person who is less than 18 years of age.

(l) "Other services necessary" means recognized medical treatment, convalescent aids, supplies, and other equipment needed by the victim because of physical incapacity sustained as a direct result of the crime.

(m) "Peace officer" means an employee of this state, or any political subdivision of this state thereof, who is employed as a police officer, sheriff, firefighter, conservation officer, or similar officer exercising powers of a police officer.

(n) "Resident" means a person who is living in this state when the crime occurs.

Resident does not include a person who resides in another state or foreign country and who is temporarily in this state for business, recreation, or personal matters.

(o) "Unreimbursed and unreimbursable expenses" means expenses for which the claimant has no means of payment other than the claimant's assets or through an award of the commission.

(p) "Writing" means any of the following:

(i) Handwriting.

(ii) Typewriting.

(iii) Printing.

(iv) Photostating.

(v) Photographing.

(vi) Photocopying.

(vii) Any other means of recording, including the recording of letters, words, pictures, sounds, symbols, or any combination thereof.

(viii) Maps.

(ix) Papers.

(x) Magnetic or punched cards.

(xi) Discs.

(xii) Drums.

(xiii) Any other means of recording or retaining meaningful contents.

(2) Terms defined in the act have the same meanings when used in these rules.

History

History: 1983 AACS; 2013 AACS; 2015 AACS; 2018 AACS.

Mich. Admin. Code R 18.352 Attorney fees {#sec-r-18.352 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.352}

Rule 2. (1) Attorney fees shall only be paid when the board makes an award to the claimant for medical expenses that the claimant has paid or for loss of earnings or loss of support, or both, payable to the claimant. The attorney shall not receive from the claimant or any other source an attorney fee attributable, in whole or part, to that portion of an award paid to medical providers.

(2) When a board member decides a claim in favor of a claimant and the claimant does not appeal to the full board, the attorney fee awarded by the board member shall not exceed 15% of the amount awarded to the claimant and is payable from the award.

(3) When the full board decides a claim totally or partially in favor of a claimant and judicial review is not sought within 30 days of the board decision, the attorney fee awarded by the board shall not exceed 15% of the amount awarded to the claimant and is payable from the award.

(4) In cases involving judicial review, where the claimant prevailed in whole or in part, the board, upon conclusion of any further review of the claim, shall determine and allow attorney fees pursuant to a fee request which is duly submitted or which has been agreed upon with the attorney of record. For purposes of this subrule only, the attorney fee shall not exceed 25% of the amount awarded to the claimant.

(5) An attorney shall not charge, demand, receive, or collect any fee for services rendered in connection with any claim or appeal or in conjunction with review before the board or judicial review, except as allowed under this rule. However, an attorney may agree to accept a lesser attorney fee than is allowed by this rule and may agree to waive or not accept any attorney fee.

(6) In the event of subrogation under section 14 of the act, if private counsel is involved, the chair or board may agree to reimburse attorney fees up to 15% of the amount paid to the board by the victim or claimant.However, for good cause shown, the board may elect to waive the limitation on attorney fees imposed by subrule (1) of this rule.

(7) If the board or a member of the board determines that the claimant will not suffer serious financial hardship, then attorney fees shall not be awarded.

History

History: 1983 AACS.

Mich. Admin. Code R 18.353 Application for compensation {#sec-r-18.353 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.353}

Rule 3. An application for compensation shall be made on a form provided by the board. A copy of these rules shall be provided to any applicant upon request.

Rule 4. (1) A claim is subject to the time limits for filing that are set forth in section 5 of the act; however, if a claim is filed after the time limits in section 5 of the act, the commission may presume that good cause to file a claim late exists unless contrary evidence exists.

(2) Children of a victim born after the victim’s death are surviving children and are eligible for an award.

(3) A child support order demonstrates eligibility for a support award when the parent ordered to pay support was a victim of a crime who died as a direct result of the crime.

History

History: 1983 AACS. 18.354 Claim filing time.
History: 1983 AACS; 2013 AACS; 2018 AACS.

Mich. Admin. Code R 18.355 Claimant cooperation with law enforcement agency and board required; claimant to bear burden of proof of authenticity and eligibility of claim {#sec-r-18.355 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.355}

Rule 5. (1) To receive an award, a claimant shall cooperate with the law enforcement agency investigating the crime giving rise to the claim and with the investigators, agents, and representatives of the commission. If a claimant refuses to cooperate, the commission may deny the claim or reduce the size of any award.

(2) The final burden of proof of the authenticity and eligibility of a claim, or any part of a claim, rests with the claimant. When an award cannot be made because the law enforcement agency, medical providers, or employer cannot verify the claim, the claimant shall be given written notice of the particular deficiencies of verification. The information requested by the commission as necessary to verify the claim shall be supplied by the claimant. If the claimant does not comply within a reasonable period of time, the claim shall be denied in whole or in part as appropriate.

(3) Health Care providers cannot bill a sexual assault victim for any portion of a Sexual Assault Forensic Examination (SAFE).

(4) A Peace Officer is one who sustains a personal physical injury, which means bodily harm as a result of an assault in the course of employment.

History

History: 1983 AACS; 2013 AACS.

Mich. Admin. Code R 18.356 Nonreimbursable loss, damage, theft, and detriment {#sec-r-18.356 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.356}

Rule 6. (1) Loss of, damage to, or theft of, personal property is not eligible for reimbursement.

(2) Noneconomic detriment in the form of pain, suffering, inconvenience, physical impairment, or other nonpecuniary damage is not eligible for reimbursement.

History

History: 1983 AACS.

Mich. Admin. Code R 18.357 Claims resulting from operation of motor vehicle prohibited; exception {#sec-r-18.357 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.357}

Rule 7. A claim resulting from the operation of a motor vehicle shall not be awarded, except when the claimed injuries are the result of a crime and not a civil infraction under state law. In appropriate circumstances, the board will refer the claimant to the department of state assigned claims plan.

History

History: 1983 AACS.

Mich. Admin. Code R 18.358 Payment limitations {#sec-r-18.358 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.358}

Rule 8. (1) When an award is ordered for funeral expenses, including burial expenses, the commission shall pay a burial benefit of not more than $2,000 for each victim for the date of injury on or before December 15, 2010 and not more than the amount set forth in section 11 of the act for each victim for the date of injury on or after December 16, 2010.

(2) Expenses for flowers, gravestones, catering services, or other personal and family accommodations not directly related to the funeral service and disposition of the body will not be considered.

(3) When the commission awards funeral expenses, which in the absence of commission payment, would be receivable from other public funds, the amount awarded shall not exceed the amount normally paid by the other sources.

(4) The commission shall not award more than the amount set forth in section 11 of the act for grief counseling for homicide victim’s spouse, children, parents, siblings, grandparents, and grandchildren.

(5) The commission shall not award more than the amount set forth in section 11 of the act for crime scene clean-up services as allowed under the act.

History

History: 1983 AACS; 2013 AACS.

Mich. Admin. Code R 18.359 Travel costs {#sec-r-18.359 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.359}

Rule 9. (1) The costs of transporting the victim's body will be included in the burial benefit under R 18.358. Travel costs for family members will not be considered.

(2) Personal injury victims may be reimbursed for travel costs to and from a particular health care facility where a specific treatment or care unavailable locally is rendered. The board will consider all pertinent medical information in making its decision.

History

History: 1983 AACS.

Mich. Admin. Code R 18.360 Lost earnings award; permanent disability {#sec-r-18.360 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.360}

Rule 10. When a protracted award is ordered for lost earnings and subsequent medical reports indicate permanent disability, the board shall require the claimant to file with the social security administration for disability benefits. All claimants receiving compensation for lost earnings shall be required to make the application within 1 year from the date of the crime which gave rise to the claim.

History

History: 1983 AACS.

Mich. Admin. Code R 18.361 Serious financial hardship determination {#sec-r-18.361 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.361}

Rule 11. (1) In determining serious financial hardship under section 11 (7) of the act, the commission shall consider all of the financial resources of the claimant.

(2) In all cases, the commission shall render a decision which will, as nearly as practicable, permit the claimant or family to maintain a reasonable standard of living.

Where out-of-pocket expenses or loss of earnings or support significantly lower this standard of living, the commission may consider this serious financial hardship.

History

History: 1983 AACS; 2013 AACS.

Mich. Admin. Code R 18.362 Award; manner of payment; verification of treatment; claim file {#sec-r-18.362 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.362}

Rule 12. (1) An award shall be paid in a lump sum, except for direct payments to medical care and other providers of services and for periodic payments to compensate for out-of-pocket expenses or loss of earnings or support where protracted disability has occurred.

(2) Upon submittal of additional out-of-pocket expenses or lost earnings, the board shall verify that treatment for the injuries has been rendered to the victim within the preceding 12-month period. If such verification cannot be made, the board may deny further awards for compensation.

(3) The board shall retain a complete claim file for a period of 4 years following the final disposition of the claims.

History

History: 1983 AACS.

Mich. Admin. Code R 18.363 Board meetings {#sec-r-18.363 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.363}

Rule 13. (1) All meetings of the board shall be open to the public, except as otherwise provided by Act No. 267 of the Public Acts of 1976, as amended, being S15.261 et seq. of the Michigan Compiled Laws.

(2) All writings prepared or used by, or in the possession of, the board shall be available for public inspection, except as otherwise provided by law or these rules.

(3) The first 15 minutes of the new business portion of each board meeting open to the public shall be reserved for public comment. A member of the public wishing to address the board shall be allotted a 3-minute time period. This time period may, in the discretion of the board chair, be increased. When it appears to the chair that there are more than 5 members of the public who wish to address the board, the chair has discretion either to increase the original 15-minute period of public comment or set aside additional time for public comment as the last item of business during the open portion of the meeting.

History

History: 1983 AACS.

Mich. Admin. Code R 18.364 Closed session of board; request; documents exempt from disclosure {#sec-r-18.364 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.364}

Rule 14. (1) A claimant who wishes to have matters of intimate personal privacy considered in a closed session of the board shall request a closed session, in writing, not less than 10 days prior to the scheduled date of the meeting of the board where the claim shall be considered. The 10-day requirement may be waived at the discretion of the board for good cause.

(2) All documents referred to by the board during the course of a closed session shall be considered part of the minutes of the closed session and are exempt from disclosure as provided by Act No. 442 of the Public Acts of 1976, as amended, being S15.231 et seq. of the Michigan Compiled Laws.

(3) When the board, in the course of its deliberations, is required to utilize or refer to documents which are exempt from disclosure by law or these rules, the chair shall announce in the preceding open portion of the meeting that the consideration of material which is exempt from discussion or disclosure by law or by these rules is required. The board shall then take a roll call vote on the question of closing the session. Upon the recording of a 2/3 vote of the board to close the session, the board shall go into closed session to discuss and consider the material.

History

History: 1983 AACS.

Mich. Admin. Code R 18.365 Appeals; application for full board review of claim or evidentiary hearing {#sec-r-18.365 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.365}

Rule 15. (1) When a board member to whom a claim is assigned is unable to decide a claim in favor of the claimant or denies the claim in whole or in part, the claimant shall be advised in writing, of the right to full board review of the claim or an evidentiary hearing before the full board at the option of the claimant.

(2) Within 30 days after receipt of the report of the decision of the board member, a claimant, a claimant's attorney, or a board member may make an application, in writing, to the board at its Lansing office for consideration of the decision by the full board or an evidentiary hearing, if desired. The secretary of the board shall notify the claimant, the claimant's attorney, or the board member requesting the appeal of the date, time, and place when the appeal will be considered.

Additional information which the claimant desires the board to consider shall be submitted to the board in Lansing not less than 10 days prior to such hearing.

History

History: 1983 AACS; 2015 AACS.

Mich. Admin. Code R 18.366 Conduct of hearing {#sec-r-18.366 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.366}

Rule 16. (1) Where full board review, but not an evidentiary hearing, is requested, the board shall review the record and any additional information in support of the appeal.

(2) If an evidentiary hearing is requested, one shall be held and the board shall do the following:

(a) Hold a hearing.

(b) Administer oaths or affirmations.

(d) Issue subpoenas requiring the attendance and testimony of witnesses and the production of books, papers, documents and other evidence.

(e) Review the record and any additional material in support of the claim.

(3) The board, in its discretion, for good cause shown, may consider additional information submitted at the hearing.

History

History: 1983 AACS.

Mich. Admin. Code R 18.367 Report and final decision of the board; judicial review {#sec-r-18.367 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 18.367}

Rule 17. (1) After reviewing the claimant's file and record evidence, a proposed final decision containing written findings of fact setting forth the basis for decision shall be prepared by the chair. If the proposed final decision of the board varies from the report of the board member, the proposed final decision shall set forth reasons for such variance.

(2) The proposed decision, with any amendments thereto, shall become the final decision of the board, for purposes of judicial review, on the date the chair of the board signs and dates such decision, if at least 1 other board member has also signed the final decision.

(3) The board shall immediately file its final decision with the secretary of the board. The secretary shall, within 15 days after such filing, notify the claimant of the final decision of the board and furnish a copy of the decision. Such notification shall advise the claimant of the statutory 30-day period after receipt of the board's final decision for filing a petition in the court of appeals for leave to appeal and review the board's decision.

History

History: 1983 AACS.

R 325.1 to R 325.4 Transportation and Disposition of Dead Bodies

Mich. Admin. Code R 325.1 Preparation and transportation of bodies dead from certain causes; permission for public funeral {#sec-r-325.1 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.1}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF DISEASE CONTROL, PREVENTION AND EPIDEMIOLOGY

TRANSPORTATION AND DISPOSITION OF DEAD BODIES

(By authority conferred on the department of health and human services by section 2226 of 1978 PA 368, MCL 333.2226, section 2233 of 1978 PA 368, MCL 333.2233; by section 2678 of 1978 PA 368, MCL 333.2678; and by Executive Reorganization Orders No. 2015-1 and No. 2015-4.)

Rule 1. (1) The bodies of those who have died of diphtheria, meningococcic infections, plague, poliomyelitis, scarlet fever, or smallpox shall not be transported or accepted for transportation unless they have been prepared for shipment by being thoroughly embalmed and disinfected by arterial and cavity injection with an accepted embalming fluid. This preparation must be effected by an embalmer licensed with the state of Michigan.

(2) When bodies are transported under this rule, notice must be sent by the shipping embalmer to the health officer of the jurisdiction where the body is to be received, advising the date and time of arrival.

(3) Public funerals may be conducted, provided that prior permission is obtained from the local health officer. When permission is granted, persons in isolated areas may be released for the purpose of accompanying the body to a funeral home, church, or cemetery, provided that they do all of the following:

(a) Use a separate car or means of conveyance.

(b) Remain in a separate room or separate from the public and avoid proximity to others in attendance.

History

History: 2016 AACS.

Mich. Admin. Code R 325.2 Transportation of certain bodies in sound shipping cases; preparation for shipment; burial-transit or disinterment permit {#sec-r-325.2 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.2}

Rule 2. Bodies dead from a cause not named in R 325.1 that will reach their destination within 48 hours from the time of death, or are addressed to the demonstrator of anatomy of a medical college or for other demonstration purposes, may be received for transportation when encased in a sound shipping case. If the body is not so addressed or cannot reach its destination within 48 hours it must be prepared for shipment as described in R 325.1. When dead bodies are shipped by common carrier, a burial-transit or disinterment permit shall be securely fastened upon the outside box, and a duplicate of the permit shall be supplied by the funeral director to the person escorting the body, or, if there is no escort, a duplicate of the permit shall be mailed to the receiving funeral director.

History

History: 2016 AACS.

Mich. Admin. Code R 325.3 Burial-transit permit {#sec-r-325.3 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3}

Rule 3. The Michigan department of health and human services may authorize a registrars, mortuary science, and funeral director licensees to have full authority to make out and sign a new burial-transit permit where a dead human body is transferred beyond the destination point as given on the burial-transit permit which accompanies the body. The same applies to cases where bodies are placed in a cemetery vault and transferred at some later date. The original burial-transit permit which accompanies the body must be given to the registrar, mortuary science, or funeral director licensee before a new burial-transit permit is made by the person authorizing the transfer. The person issuing the new permit must indicate the point of destination on the original burial-transit permit. When a mortuary science or funeral director licensee issues a new burial-transit permit, the original burial-transit permit must be filed within 72 hours with the registrar in whose jurisdiction the transfer was made.

History

History: 2016 AACS.

Mich. Admin. Code R 325.4 Removal of body from incorporated or unincorporated area; death or stillbirth certificate; burial-transit permit; duty of county clerk {#sec-r-325.4 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.4}

Rule 4. (1) When a mortuary science or funeral director licensee is called upon to remove a body from an incorporated or unincorporated area, the mortuary science or funeral director licensee may remove the body for the purpose of caring for it but must file a completed death or stillbirth certificate and secure a burial-transit permit within 72 hours from the local registrar of the incorporated or unincorporated area in which the death occurred.

(2) If a death occurs in an unincorporated area, when a Sunday or a holiday or both, or when an immediate internment, cremation, or shipment makes it impossible to obtain a burial-transit permit by mail, a mortuary science or funeral director licensee may issue a burial-transit permit to him or herself, provided that the envelope in which the completed death or stillbirth certificate is mailed to the county clerk in whose jurisdiction the death occurred is postmarked within the 72 hours after the death occurred.

(3) If for any other reason a burial-transit permit has not been received by mail in time for the interment, cremation, or shipment, the mortuary science or funeral director licensee may issue a burial-transit permit to him or herself, provided that the envelope in which the completed death or stillbirth certificate was mailed to the county clerk in whose jurisdiction the death occurred is postmarked within the 72 hours after the death occurred.

(4) When a county clerk receives a death or stillbirth certificate from his or her primary registration district by mail, he or she shall enter on the certificate, as the date of filing, the date on which the certificate or certificates were received and shall also enter beneath the date of filing the postdate appearing on the envelope in which the certificate or certificates arrived.

History

History: 2016 AACS.

R 325.61 to R 325.68 Heavy Metal and Pesticide Analysis Reporting

Mich. Admin. Code R 325.61 Definitions {#sec-r-325.61 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.61}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF EPIDEMIOLOGY

DIVISION OF ENVIRONMENTAL AND OCCUPATIONAL

EPIDEMIOLOGY

HEAVY METAL AND PESTICIDE ANALYSIS REPORTING

(By authority conferred on the director of the department of community health by sections 5111 and 2226(d) of 1978 PA 368, section 8 of 1978 PA 312, and Executive Reorganization Order Nos. 1996-1 and 1997-4, MCL 333.5111, 333.2226(d), 325.78, 330.3101, and 333.26324)

Rule 1. (1) As used in these rules:

(a) "Heavy metal analysis report form" means the form used to report the required reportable information for blood and urine that has been analyzed for arsenic, cadmium, or mercury.

(b) "Pesticide poisoning report form" means the form used to report the required reportable information for blood that has been analyzed for acetylcholinesterase or pseudocholinesterase.

(c) "Pesticide" means any substance or mixture of substances including inert ingredients and adjuvants used to prevent, destroy, mitigate, or repel any pest.

Pesticides include, but are not limited to, insecticides, herbicides, fungicides, rodenticides, repellents, fumigants, wood treatment products, and disinfectants.

(d) "Department" means the Michigan department of community health.

(e) "Physician/provider" means a person who is licensed under Article 15 of the public health code MCL 333.16101 to 333.18838 who provides health care services and who is authorized to request the analysis of blood and urine specimens.

History

History: 2005 AACS.

Mich. Admin. Code R 325.62 Reportable information {#sec-r-325.62 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.62}

Rule 2. (1) Reportable information is specifically related to blood and urine samples submitted to clinical laboratories for analysis.

(2) Upon initiating a request for analysis of arsenic, cadmium, mercury, acetylcholinesterase, or pseudocholinesterase, the physician/provider ordering the analysis shall complete the client information (section I) and the physician/provider information (section II) of a heavy metal analysis report form or pesticide poisoning report form designated by the department.Or, the physician/provider shall complete a similar form that ensures the inclusion of the same required data and provide all of the following information:

(a) All of the following information with respect to the individual tested:

(i) Name.

(ii) Sex, if available.

(iii) Race, if available.

(iv) Ethnic group, if available.

(v) Birthdate or age.

(vi) Address.

(vii) Telephone number.

(viii) If the individual is a minor, then the name of a parent or guardian.

(ix) If the individual is an adult, then the name and address of his or her employer, if available.

(b) The date the sample was collected.

(3) The heavy metal analysis report form or pesticide poisoning analysis report form, or a document with the same data, shall be submitted with the sample for analysis to a clinical laboratory that performs the analysis.

(4) Upon receipt of the blood or urine sample for analysis, the clinical laboratory shall complete the laboratory information (section III) and provide all of the information required and/or submitted by the physician/provider along with all of the following:

(a) The name, address, and phone number of the laboratory.

(b) The date of analysis.

For arsenic, blood levels shall be reported in micrograms per milliliter (μg/ml) and urine levels in micrograms per liter (μg/L).For cadmium, blood levels shall be reported as micrograms per liter (μg/L) of whole blood and urine tests shall be reported as micrograms per gram of creatinine (μg/gram creatinine) or micrograms per liter (μg/L).Mercury shall be reported as nanograms per milliliter of blood (ng/ml) and micrograms per liter (μg/L) of urine. Acetylcholinesterase shall be reported as units per gram of hemoglobin (U/g hemoglobin), and the laboratory normal range shall be included. Pseudocholinesterase levels shall be reported as units per liter (U/L) of plasma, and the laboratory normal range shall be included. Alternate units will be accepted for reporting purposes, as approved by the department.

History

History: 2005 AACS.

Mich. Admin. Code R 325.63 Reporting responsibilities {#sec-r-325.63 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.63}

Rule 3. (1) All clinical laboratories doing business in this state that analyze blood or urine samples for arsenic, cadmium, mercury, acetylcholinesterase, or pseudocholinesterase shall report all results to the department of community health, bureau of epidemiology, division of occupational and environmental epidemiology, 3423 N. Martin Luther King Jr. Blvd., Lansing, MI 48909. Reports shall be made within 5 working days after test completion.

(2) Nothing in this rule shall be construed to relieve a laboratory from reporting results of a blood or urine analysis for arsenic, cadmium, mercury, acetylcholinesterase, or pseudocholinesterase to the physician or other health care provider who ordered the test or to any other entity as required by state, federal, or local statutes or regulations or in accordance with accepted standard of practice, except that reporting in compliance with this rule satisfies the reporting requirements of 1978 PA 368, MCL 333.1101.

History

History: 2005 AACS.

Mich. Admin. Code R 325.64 Electronic communications {#sec-r-325.64 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.64}

Rule 4. (1) A clinical laboratory may submit the data required in R 325.62 electronically to the department.

(2) For electronic reporting, upon mutual agreement between the reporting laboratory and the department, the reporting shall utilize the data format specifications provided by the department.

History

History: 2005 AACS.

Mich. Admin. Code R 325.65 Investigation and quality assurance {#sec-r-325.65 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.65}

Rule 5. (1) The department, upon receiving a report under R 325.63 may investigate to determine the accuracy of the report, patient's source of exposure, and adverse health effects resulting from the exposure.

(2) Requests for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized.

(3) The copies of the medical records shall not be recopied by the department and shall be kept in a locked file cabinet when not in use.

(4) Reports may be released to other state, local, or federal agencies for those agencies to administer and enforce provisions of laws or rules to protect individuals from exposure to hazardous levels of arsenic, mercury, cadmium, or pesticides.

Confidential information may be released to another governmental agency only after execution of a signed interagency agreement assuring that the other agency will abide by the confidentiality requirements of R 325.66.

(5) Nothing in this rule shall be construed to relieve or preempt any other entities from investigating hazards associated with these substances under state, federal, or local statutes or regulations.

History

History: 2005 AACS.

Mich. Admin. Code R 325.66 Confidentiality of reports {#sec-r-325.66 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.66}

Rule 6. (1) Reports submitted to the department under R 325.63 are not public records and are exempt from disclosure pursuant to the freedom of information act, 1976 PA 442, MCL 15.243, section 13(1)(d).

(2) The department shall maintain the confidentiality of all reports of all tests submitted to the department and shall not release reports or any information that may be used to directly link the information to a particular individual, unless the department has received written consent from the individual, or from the individual's parent or legal guardian, requesting the release of information.

(3) Medical and epidemiological information that is released to a legislative body shall not contain information that identifies a specific individual. Aggregate epidemiological information concerning the public health that is released to the public for informational purposes only shall not contain information that identifies a specific individual.

History

History: 2005 AACS.

Mich. Admin. Code R 325.67 Heavy metal analysis report form {#sec-r-325.67 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.67}

Rule 7. The heavy metal analysis report form reads as follows:

MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

HEAVY METAL ANALYSIS REPORT

DATA/INFORMATION REQUIRED BY ADMINISTRATIVE RULE R 325.62

I. CLIENT INFORMATION

Last name First name M.I.

Sex (M/F) Race (White/Black/Asian/Pacific Islander/American Indian/Alaskan/mixed)

Ethnicity (Hispanic Y/N) Birth date or age Phone number Street address City State/Zip Code/County Name of parent or guardian if individual is a minor Employer name (if adult)

Employer street address City State/Zip Code II. PHYSICIAN/PROVIDER INFORMATION ( )

Provider last name First name Phone number Provider street address City State/Zip Code III. LABORATORY INFORMATION ( )

Name of testing laboratory Phone number Laboratory street address City State/Zip Code Date sample taken Date sample analyzed Results Sample Arsenic Cadmium Mercury Blood μg/ml μg/L ng/ml Urine μg/L μg/gram creatinine μg/L OR μg/L MDCH - Bureau of Epidemiology, Division of Occupational and Environmental Epidemiology 3423 N. M.L. King, Jr. Blvd., Lansing, MI 48909 o Fax Number (517) 335-9775 o Phone number (517) 335-8350

History

History: 2005 AACS.

Mich. Admin. Code R 325.68 Pesticide poisoning analysis report form {#sec-r-325.68 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.68}

Rule 8. The pesticide poisoning report form reads as follows:

MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

PESTICIDE POISONING REPORT

DATA/INFORMATION REQUIRED BY ADMINISTRATIVE RULE R 325.62

I. CLIENT INFORMATION

Last name First name M.I.

Sex (M/F) Race (White/Black/Asian/Pacific Islander/American Indian/Alaskan/mixed)

( )

Ethnicity (Hispanic Y/N) Birth date Phone number Street address City State/Zip Code/County Name and address of parent or guardian if individual is a minor Employer Employer street address City State/Zip Code/County II. PHYSICIAN/PROVIDER INFORMATION ( )

Provider last name First name Phone number Name of medical facility of requesting physician/provider Facility street address City State/Zip Code III. LABORATORY INFORMATION ( )

Name of testing laboratory Phone number Laboratory street address City State/Zip Code Date sample taken Date sample analyzed Results Test Laboratory normal range Acetylcholinesterase U/g hemoglobin - U/g hemoglobin Pseudocholinesterase U/L - U/L MDCH - Bureau of Epidemiology, Division of Occupational and Environmental Epidemiology 3423 N. M.L. King, Jr. Blvd., Lansing, MI 48909 o Fax Number (517) 335-9775 o Phone number (517) 335-8350

History

History: 2005 AACS.

R 325.71 to R 325.75 Reporting Of Non-Suicidal, Non-Medicinal Chemical Poisonings

Mich. Admin. Code R 325.71 Definitions {#sec-r-325.71 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.71}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF EPIDEMIOLOGY

DIVISION OF ENVIRONMENTAL HEALTH

REPORTING OF NON-SUICIDAL, NON-MEDICINAL CHEMICAL

POISONINGS

(By authority conferred on the community public health agency by sections 5111 and 2226 of PA 368 of 1978, as amended, section 8 of PA 312 of 1978, and Executive Reorganization Order No.1996-1,MCL 333.5111, MCL 333.2226, MCL 325.78, MCL 333.2233, MCL 333.2221, and MCL 330.3101.)

Rule 1. (1) As used in these rules:

(a) "Chemical" means any substance or mixture of substances composed of chemical elements or obtained by a chemical process.

(b) "Chemical poison" means a substance which, when ingested, inhaled or absorbed, injected into, or developed within the body, causes damage to structure or disturbance of function in the body. "Chemical poison" includes asphyxiant gases.

(c) "Chemical poisoning report form" means the form used to report the required reportable information for individuals with a chemical poisoning.

(d) "Department" means the Michigan department of community health.

(e) "Health facility" means any facility or agency licensed under article 17 of the public health code, MCL 333.20101 to 333.22260 that provides health care services.

"Health facility" includes a hospital, clinical laboratory, surgical outpatient facility, health maintenance organization, nursing home, home for the aged, county medical care facility, ambulance operation, and hospice.

(f) "Local health department" means a public health department established under the provisions of article 24 of the public health code, MCL 333.2401 to 333.2498, to protect the public health and prevent disease within a specific geographic area.

(g) "Non-medicinal" means substances that are not classified as drugs, medicines, or biologicals.

(h) "Non-suicidal" means not associated with an intention to commit self-harm, including suicide.

(i)"Health professional" means a person licensed under article 15 of the public health code, MCL 333.16101 to 333.18838, in medicine, osteopathic medicine, as a physician's assistant, or nurse practitioner.

(j) "Poisoning" means a morbid condition, including death, produced by a poison.

(k) "Protected health information" means any individually identified health information, whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and, relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.

(l) "Public health investigation" means the collection of medical, epidemiologic, exposure, and other information to determine the magnitude and cause of illness or injury, which is used to determine appropriate actions to prevent or mitigate additional illness or injury.

History

History: 2007 AACS; 2009 AACS.

Mich. Admin. Code R 325.72 Reportable information {#sec-r-325.72 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.72}

Rule 2. (1) Reportable information is specifically related to patients with known or suspected non-suicidal, non-medicinal chemical poisonings.

(2) Clinical laboratory evidence of overexposure to a chemical poison, defined as a laboratory test result outside of that laboratory's reference range, shall be considered evidence of known or suspected chemical poisoning.

(3) The health professional or health facility shall submit its report a format that ensures the inclusion of the information listed under subdivisions (a) to (e) of this subrule as applicable.

(a) All of the following information, with respect to the patient, shall be provided:

(i) Last and first name and middle initial.

(ii) Sex.

(iii) Race, if available.

(iv) Ethnic group, if available.

(v) Birth date or age.

(vi) Residential address.

(vii) Telephone number.

(viii) If the individual is a minor, the name of a parent or guardian.

(ix) If the individual is an adult, the name and address of his or her employer, if available.

(b) If the reporting entity is a health care provider or health facility other than a clinical laboratory, the following diagnostic information shall be provided, in addition to information specified in R 325.72 (3)(a):

(i) The date of diagnosis.

(ii) The diagnosis, including diagnostic code, if available.

(iii) Brief narrative of the poisoning event, including date, location, and type of chemical poison involved, and any other information considered by the health professional/health facility to be related to health of the public.

(iv) Brief narrative of the patient signs and symptoms, clinical findings, results of diagnostic tests, and clinical outcome.

(c) If the reporting entity is a clinical laboratory, the following information shall be provided in addition to information specified in R 325.72 (3)(a):

(i) Name of the clinical test performed.

(ii) Test result including units of measurement.

(iii) Laboratory reference range including units of measurement.

(iv) Date laboratory test was ordered.

(d) Name, address, telephone, and other contact information shall be provided for the reporting health professional. If the reporting entity is a health facility, contact information for the diagnosing/treating/ordering physician shall be provided.

(e) Name, address, telephone and other contact information for the health facility shall be provided if the reporting entity is the facility.

History

History: 2007 AACS; 2009 AACS.

Mich. Admin. Code R 325.73 Reporting responsibilities {#sec-r-325.73 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.73}

Rule 3. (1) When requested by the department or local health department, health professionals and health facilities shall provide reports. The department or local health department shall notify health professionals and health facilities when reports of 1 or more types of chemical poisonings shall be submitted. Both of the following apply:

(i) Reports shall be made within 5 working days following request by the department or local health department.

(ii) Reports shall be provided to the agency (department and/or local health department) that makes the request.

(2) Reports may be provided by health professionals and health facilities, without departmental or local health department request, when the reporting entity believes that public health investigation is needed to protect the public.

(3) Nothing in this rule shall be construed to relieve a health professional or health facility from reporting to any other entity as required by state, federal, or local statutes or regulations or in accordance with accepted standard of practice, except that reporting in compliance with this rule satisfies the reporting requirements of 1978 PA 368, MCL 333.1101.

History

History: 2007 AACS.

Mich. Admin. Code R 325.74 Investigation and quality assurance {#sec-r-325.74 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.74}

Rule 4. (1) The department or local health department, upon receiving a report under R 325.73, may investigate to determine the accuracy of the report, a patient's source of exposure, and adverse health effects resulting from the exposure.

(2) The department and local public health departments shall collaborate in the development of procedures for processing poisoning reports and conducting follow-up investigations to ensure efficient, non-duplicative, and effective public health response.

(3) Requests for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized.

(4) Copies of protected health information from reported poisoning cases shall be kept in locked file cabinets when not in use. Information stored electronically shall be maintained on a secure server accessible only by department or local health department program staff through password protected user accounts.

(5) Reports may be released to other state, local, or federal agencies for those agencies to administer and enforce provisions of laws or rules to protect individuals from exposure to chemical poisons. Protected health information may be released to other governmental agencies and bona fide agents of the state that comply with the confidentiality requirements of R 325.75.

(6) Confidential information obtained during the public health investigation may be exchanged between the department and the local health department with jurisdiction where the chemical poisoning occurred.

(7) Nothing in this rule shall be construed to relieve or preempt any other entities from investigating hazards associated with chemical poisons under state, federal, or local statutes or regulations.

History

History: 2007 AACS; 2009 AACS.

Mich. Admin. Code R 325.75 Confidentiality of reports {#sec-r-325.75 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.75}

Rule 5. (1) Reports submitted to the department or local health department under R 325.73 are not public records and are exempt from disclosure pursuant to the freedom of information act, section 13 of 1976 PA 442, MCL 15.231.

(2) The department and local health departments shall maintain the confidentiality of all reports and shall not release reports, including protected health information or any information that may be used to directly link the information to a particular individual, except as allowed in R 325.74(5), unless the department or local health department has received written consent from the individual, or from the individual's parent or legal guardian, requesting the release of information.

(3) Medical and epidemiological information that is released to a legislative body shall not contain information that identifies a specific individual. Aggregate epidemiological information concerning the public health, which is released to the public for informational purposes only, shall not contain information that allows individuals to be identified.

History

History: 2007 AACS; 2009 AACS.

R 325.76 to R 325.79 Reporting of Poisonings Due to Use of Prescription and Illicit

Mich. Admin. Code R 325.76 Definitions {#sec-r-325.76 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.76}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EPIDEMIOLOGY AND POPULATION HEALTH DIVISION

OF ENVIRONMENTAL HEALTH

REPORTING OF POISONINGS DUE TO THE USE OF PRESCRIPTION OR

ILLICIT DRUGS

(By authority conferred on the department of health and human services by section 8 of the critical health problems reporting act, 1978 PA 312, MCL 325.78, sections 2221, 2226, 2233, and 5111 of the public health code, 1978 PA 368, MCL 333.2221, 333.2226, 333.2233, and 333.5111, and Executive Reorganization Order No. 2015-1, MCL 400.227)

Rule 6. As used in these rules:

(a) “Department" means the department of health and human services.

(b) “Drug” means any of the following as provided in section 17703 of the public health code, 1978 PA 368, MCL 333.17703:

(i) A substance recognized or for which the standards or specifications are prescribed in the official compendium.

(ii) A substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in human beings or other animals.

(iii) A substance, other than food, intended to affect the structure or a function of the body of human beings or other animals.

(iv) A substance intended for use as a component of a substance specified in subdivision (i), (ii), or (iii), but not including a device or its components, parts, or accessories.

(c) "Health facility" means any facility or agency licensed under article 17 of the public health code, 1978 PA 368, MCL 333.20101 to 333.22260, that provides health care services. "Health facility" includes a hospital, clinical laboratory, surgical outpatient facility, health maintenance organization, nursing home, home for the aged, rural health county medical care facility, and ambulance operation. “Health facility” does not include any facility or agency that is prohibited by law under 42 CFR part 2 from releasing records on substance abuse disorders.

(d) "Health professional" means a person licensed under article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838, in medicine, osteopathic medicine, as a physician's assistant, or nurse practitioner.

(e) “Illicit drugs” means any Schedule 1 drug, new and emerging psychoactive substances, or Schedule 2-5 drugs that are not obtained directly from, or pursuant to, a valid prescription or order of a practitioner while acting in the course of the practitioner's professional practice.

(f) "Local health department" means a public health department established under the provisions of part 24 of the public health code, 1978 PA 368, MCL 333.2401 to 333.2498, to protect the public health and prevent disease within a specific geographic area.

(g) "Poison" means a substance which, when ingested, inhaled or absorbed, injected into, or developed within the body, causes damage to structure or disturbance of function in the body.

(h) "Poisoning" means any morbid condition, including death, that is related to, characterized by, affected by, induced by, or a product of a poison as defined in subrule (g)."

(i) "Public health investigation" means the collection of medical, epidemiologic, exposure, and other information to determine the magnitude and cause of illness or injury, which is used to determine appropriate actions to prevent or mitigate additional illness or injury.

(j) “Substance use disorder services” means substance use disorder prevention, treatment, and rehabilitation services established under the provisions of article 6 of the public health code, 1978 PA 368, MCL 333.6230 to 333.6251, to reduce the consequences of substance use disorders in individuals and communities.

History

History: 2019 AACS.

Mich. Admin. Code R 325.77 Reporting requirement; timeframe; reports provided without request; electronic reporting {#sec-r-325.77 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.77}

Rule 7. (1) Health professionals and health facilities shall provide reports when requested by the department or local health department for routine public health surveillance and/or investigation of specific events. The department or local health department shall notify health professionals and health facilities when reports of prescription or illicit drug poisonings shall be submitted. Both of the following apply:

(a) Reports shall be made within 5 working days following request by the department or local health department.

(b) Reports shall be provided to the department or local health department that makes the request.

(4) The department shall develop procedures and systems to enable electronic laboratory and case reporting by health care providers and facilities to reduce reporting burden and ensure efficiency and security of information sharing.

History

History: 2019 AACS.

Mich. Admin. Code R 325.78 Patient information; diagnostic and clinical information to be reported {#sec-r-325.78 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.78}

Rule 8. (1) Reportable information is information specifically related to patients with known or suspected poisonings due to use of prescription or illicit drugs, including fatal and nonfatal overdoses.

(2) International Classification of Disease Codes (ICD) for medicinal and illicit drug poisonings and toxicological laboratory evidence shall be considered evidence of poisoning.

(3) The health professional or health facility shall submit its report in a format that ensures the inclusion of the information listed under subdivisions (a) to (e) of this subrule as applicable.

(a) All of the following information with respect to the patient shall be provided:

(i) Last and first name and middle initial.

(ii) Sex.

(iii) Race, if available.

(iv) Ethnic group, if available.

(v) Birth date or age.

(vi) Residential address.

(vii) Telephone number.

(viii) If the individual is a minor, the name of a parent or guardian.

(i) The date of diagnosis.

(ii) The diagnosis, including ICD diagnostic code, if available.

(iii) Brief narrative of the poisoning event, including date, location, and type of medicine or drug involved, and any other information considered by the health professional or health facility to be related to health of the public.

(iv) Brief narrative of the patient’s signs and symptoms, clinical findings, results of diagnostic tests, and clinical outcome.

(c) If the reporting entity is a clinical laboratory, the following information shall be provided in addition to information specified in subdivision (a) of this subrule.

(i) Unique specimen ID or accession number, or both.

(ii) Name of the clinical test performed.

(iii) Test result, including units of measurement and LOINC and SNOMED codes.

(iv) Laboratory reference range including units of measurement.

(v) Date the laboratory test was ordered.

(e) Name, address, telephone and other contact information for the health facility shall be provided if the reporting entity is the facility.

History

History: 2019 AACS.

Mich. Admin. Code R 325.79 Investigation and collaboration; storage of information; confidentiality {#sec-r-325.79 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.79}

Rule 9. (1) The department or local public health department, upon receiving a report under subrule (2) of this rule, may investigate to determine the accuracy of the report, a patient's source of drug, and adverse health effects resulting from the poisoning due to drugs.

(2) The department and local public health departments shall collaborate in the development of procedures for processing reports of poisonings and conducting follow-up investigations to ensure efficient, non-duplicative, and effective public health response.

(3) Requests by the department or local public health departments for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized.

(4) Information from reported cases shall be kept in a secure manner when not in use. Information stored electronically shall be maintained in a secure manner, accessible only by department or local health department program staff through password protected user accounts.

(5) Except as provided in subrule (6) of this rule, the department and local health departments shall maintain the confidentiality of all reports and other information received under these rules and shall not release reports or information that may be used to directly link the information to a particular individual.

(6) The department and local health departments may release reports or information, otherwise protected under subrule (5) of this rule, under any of the following conditions:

(a) If the department has received written consent from the individual, or from the individual’s parent or legal guardian, requesting the release of information.

(b) As necessary for the department to carry out its duties under the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(c) If necessary for the purpose of public health activities designed to prevent poisonings due to use of prescription or illicit drugs.

(d) If necessary for the purpose of research designed to develop or contribute to generalizable knowledge, with documented approval by the department’s institutional review board.

(e) If the director of the department determines that release of information is crucial to protect the public health against an imminent threat or danger.

(7) Nothing in this rule shall be construed to relieve or preempt any other entities from investigating hazards associated with drug poisonings under state, federal, or local statutes or regulations.

(8) Reports submitted to the department or local health department under Rule 7 are not public records and are exempt from disclosure pursuant to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

(9) Reports and information submitted to the legislature by the department as necessary to carry out its duties shall not contain any identifiable information.

Aggregate information concerning public health that is released to the public shall not contain information that allows individuals to be identified.

History

History: 2019 AACS.

R 325.125 to R 325.138 Statewide Trauma System

Mich. Admin. Code R 325.125 Definitions; A to D {#sec-r-325.125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.125}

MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EMS, TRAUMA AND PREPAREDNESS

EMS AND TRAUMA SERVICES SECTION

STATEWIDE TRAUMA SYSTEM

(By authority conferred on the department of health and human services by sections 20910, 20917a, and 2233 of 1978 PA 368, MCL 333.20910, 333.20917a, and 333.2233; and Executive Reorganization Order No 2015-1, MCL 400.227.)

PART 1. GENERAL PROVISIONS

Rule 1. As used in these parts:

(a) "ACS-COT" means the American College of Surgeons-Committee on Trauma.

(b) "Adult trauma patient" means an injured or potentially injured individual that is, or reasonably appears to be, 15 years of age or older.

(c) "ATLS course" means an advanced trauma life support course with an emphasis on the first hour of initial assessment and primary management of an injured patient, starting at the point in time of injury continuing through initial assessment, lifesaving intervention, reevaluation, stabilization, and transfer when appropriate.

(d) "Administrative hearing" means a hearing conducted pursuant to the administrative procedures act, 1969 PA 306, MCL 24.201 to 24.328.

(e) "Code" means MCL 333.1101 to MCL 333.25211 and known as the Michigan public health code.

(f) "Department" means the Michigan department of health and human services, or its duly appointed successor.

(g) "Disciplinary action" means an action taken by the department against a health care facility or regional trauma network for failure to comply with the code, rules, or protocols approved by the department.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.126 Definitions; E to O {#sec-r-325.126 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.126}

Rule 2. As used in this part:

(a) "Health care facility" means a health care facility licensed under MCL 333.20801 and 333.21501 that operates a service for treating emergency patients, 24 hours a day, 7 days a week.

(b) "Hold itself out" means the agency, health care facility, or trauma facility advertises, announces, or charges specifically for providing trauma care as defined in the code.

(c) "Inter-facility trauma transfer" means identifying the group of trauma patients that require additional trauma resources with the goal of providing optimal care to these patients by the timely transfer of that patient to an appropriate level of care to optimize outcome.

(d) "Medical control" means the supervision and coordination of emergency medical services through a medical control authority, as prescribed, adopted, and enforced through department-approved protocols, within an emergency medical services system.

(e) "Medical Control Authority or “MCA” means an organization designated by the department to provide medical control as defined in the code.

(f) "Medical control authority board" means a board appointed by the participating organizations to carry out the responsibilities and functions of the medical control authority.

(g) "Medical control authority region" means the geographic area comprised of a county, group of counties, or parts of an individual county, as designated by the department.

(h) "Non-designated health care facility” means a health care facility that has chosen not to be a part of Michigan's trauma care system, or a health care facility that the department has not designated as a trauma facility.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.127 Definitions; P to T {#sec-r-325.127 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.127}

Rule 3. As used in this part:

(a) "Pediatric trauma facility" means a facility that has obtained a level of verification as a pediatric trauma facility, as provided by the ACS-COT, as well as those requirements to be designated as a trauma facility in Michigan, as set forth in R 325.127 to R 325.138.

(b) "Pediatric trauma patient" means an injured or potentially injured individual that is, or reasonably appears to be, under 15 years of age.

(c) "Physician" means a doctor of medicine (MD) or a doctor of osteopathy (DO) who possesses a valid current license to practice medicine in the state of Michigan.

(d) "Protocol" means a patient care standard, standing orders, policy, or procedure for providing emergency medical services that is established by a medical control authority and approved by the department under MCL 333.20919.

(e) "Professional standards review organization" means a committee established by a life support agency or a medical control authority for the purpose of improving the quality of medical care, as provided in MCL 331.531.

(f) "Quality improvement program" means actions taken by a life support agency, medical control authority, trauma facility, or jointly between a life support agency, medical control authority, or trauma facility with a goal of continuous improvement of medical care in accordance with the code. Actions shall take place under a professional standards review organization, as provided in MCL 331.531 to 331.533.

(g) "Regional Professional Standards Review Organization or RPSRO" means a committee established by the regional trauma network for the purpose of improving the quality of trauma care within a recognized trauma region as provided in MCL 331.531 to 331.533.

(h) "Regional trauma advisory council or “RTAC" means a committee established by a regional trauma network and comprised of MCA personnel, emergency medical services (EMS) personnel, life support agency representatives, health care facility representatives, physicians, nurses, and consumers. The functions of the RTAC are to provide leadership and direction in matters related to trauma systems development in their region, and monitor the performance of the trauma agencies and health care facilities within the region, including, but not limited to, the review of trauma deaths and preventable complications.

(i) "Regional trauma network" means an organized group comprised of the local MCAs within a region, which integrates into existing regional emergency preparedness, and is responsible for appointing a regional trauma advisory council and creating a regional trauma plan.

(j) "Regional trauma plan" means a written plan prepared by a RTAC, and submitted by the regional trauma network and approved by the department, that is based on minimum criteria established by the department.

(k) "Statewide Trauma Care Advisory Subcommittee or “STAC," as used in these rules, means the statewide trauma care advisory subcommittee as defined in MCL 333.20917a, 333.20908, and 333.20910, that acts as the department's subject matter experts with regard to the clinical and operational components of trauma care.

(l) "Statewide trauma care system" means a comprehensive and integrated arrangement of emergency services personnel, facilities, equipment, services, communications, medical control authorities, and organizations necessary to provide trauma care to all patients within a particular geographic region.

(m) "Statewide trauma registry" means a system for collecting data which the department manages and analyzes the data and disseminates results.

(n) "Trauma" means bodily injury caused by the application of external forces.

(o) "Trauma bypass" means to forego delivery of a patient to the nearest health care facility for another health care facility whose resources are more appropriate to the patient's injury pursuant to direction given to a pre-hospital emergency medical service by online medical direction or predetermined triage criteria as established by department-approved protocols. However, trauma care still must be provided to patients as necessary pursuant to 42 USC §1395dd or other applicable laws.

(p) "Trauma diversion” means the re-routing of a trauma patient from a trauma care facility that has 1 or more of its essential resources currently functioning at maximum capacity, or is otherwise unavailable, to an alternate trauma care facility in order to serve the best interests of the trauma patient.

(q) “Trauma facility" means a health care facility designated by the department as having met the criteria set forth in the code as being either a level I regional trauma research facility, level II regional trauma facility, level III community trauma facility, or level IV trauma support facility.

(r) "Trauma response" means a patient who has been injured or potentially injured as a result of the application of external forces and requires the utilization of the trauma care system.

(s) "Trauma team" means a team of multidisciplinary health care providers established and defined by a health care facility or emergency care facility that provides trauma care.

(t) "Triage" means classifying patients according to the severity of their medical conditions.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.128 Terms {#sec-r-325.128 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.128}

Rule 4. Terms defined in the code have the same meanings when used in these rules.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.129 Powers and duties of department {#sec-r-325.129 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.129}

Rule 5. (1) The department, with the advice of the emergency medical services coordination committee and statewide trauma care advisory subcommittee, shall do all of the following:

(a) Implement an "all-inclusive" trauma system throughout the state. This type of system allows for the care of all injured or potentially injured patients in an integrated system of health care in the pre-hospital and health care facility environments by personnel that are well trained and equipped to care for injured patients of any severity. The system allows for a health care facility to participate in the system to the extent or level that it is willing to commit the resources necessary for the appropriate management of the trauma patients and prohibits the department from limiting the number of health care facilities that seek to qualify for any given level of trauma designation under this system. It also ensures that all trauma patients are served by a system of coordinated care, based on the degree of injury and care required.

(b) Perform all of the following:

(i) Establish a statewide trauma quality improvement process using a statewide database.

(ii) Monitor the statewide trauma system.

(iii) Ensure the coordination and performance of the regional trauma networks.

(iv) Set minimum standards for system performance and trauma patient care.

(c) Develop a statewide process to establish regional trauma networks comprised of local medical control authorities in a manner that integrates into existing regional emergency preparedness, EMS, or medical control systems.

(d) Implement and maintain a statewide trauma systems plan.

(e) Develop a statewide process for the verification of trauma resources based on criteria as defined in the “American College of Surgeons-Resources for Optimal Care of the Injured Patient; 2014,” including any subsequent amendments and editions of this publication. This document is available online at the ACS website or from ACS, P.O.

Box 92425, Chicago, IL 60675.

(f) Develop a statewide process for the designation of trauma facilities.

(g) Develop an appeals process for facilities contesting their designation.

(h) Establish state trauma recommendations and approve regional trauma triage protocols which are established and adopted by the local medical control authority.

(i) Maintain the established regional trauma networks to provide system oversight of the trauma care provided in each region of the state. Regional trauma networks shall be comprised of collaborating local medical control authorities (MCAs) in a region. The collaborating MCAs in a region shall apply to the department for approval and recognition as a regional trauma network. The department, with the statewide trauma care advisory subcommittee and emergency medical services coordination committee, shall review the regional trauma network application for approval every 3 years. The establishment of the regional trauma networks shall not limit the transfer or transport of trauma patients between regional trauma networks.

(j) Require field triage protocols which are established and adopted by local medical control and regional trauma networks, and shall be developed based on triage criteria prescribed by the department upon the recommendation of the STAC and emergency medical services coordination committee, and following the procedures established by the department under MCL 333.20919(3).

(k) Verify the trauma care resources of designated trauma facilities or health care facilities seeking designation in this state for a 3-year period.

(l) Establish a mechanism for periodic redesignation of all health care trauma care facilities.

(m) Develop a comprehensive statewide data collection system.

(n) Formulate recommendations for the development of performance improvement plans by the regional trauma networks, consistent with those in R 325.135.

(o) Develop a process for trauma system performance improvement, which will include responsibility for monitoring compliance with standards, maintaining confidentiality, and providing periodic review of trauma facility standards. The standards as specified in R 325.129(2)(l)(e) and R 325.135 are incorporated by reference in these rules.

(p) Develop a process for the evaluation of trauma system effectiveness based on standards that are incorporated by reference in these rules, as specified in subdivision (b) of this subrule and R 325.135.

(q) Coordinate and integrate appropriate injury prevention initiatives and programs.

(r) Support the state trauma system and provide resources to carry out its responsibilities and functions.

(s) Support the training and education needs and resources of trauma care personnel throughout the state.

(2) The department may deny, suspend, or revoke designation of a trauma facility upon a finding including, but not limited to, any of the following:

(a) Failure to comply with the administrative rules and/or health care facility rules and regulations.

(b) Willful preparation or filing of false reports or records.

(d) Failure to meet designation criteria established in these rules.

(e) Unauthorized disclosure of medical or other confidential information.

(f) Alteration or inappropriate destruction of medical records.

(g) The facility no longer has the resources required to comply with the current level of designation conferred.

(h) The facility no longer cares for trauma patients.

(i) A department-approved trauma care verification body has determined that the facility no longer meets its trauma facility verification criteria.

(j) Identified deficiencies are not remediated in the allowable timeframe.

(3) The department shall provide notice of intent to deny, suspend, or revoke trauma facility designation and shall provide for an appeals process in accordance with the code and the sections 71 to 87 of the administrative procedures act of 1969, MCL 24.271 to 24.287.

(4) In developing a statewide trauma system, the department shall consider all of the following factors:

(a) Efficient implementation and operation.

(b) Decrease in morbidity and mortality.

(d) Incorporation of national standards.

(e) Availability of funds for implementation.

R 325.130. Trauma facility verification; designation and redesignation.

Rule 6. (1) A health care facility, which intends to provide trauma care, shall obtain designation as a trauma facility. A health care facility shall not self-designate itself as a trauma facility.

(2) A health care facility shall not use the word "trauma" to describe its facility, or in its advertising, unless it obtains and maintains a designation as a "trauma facility" from the department.

(3) The department shall redesignate the trauma capabilities of each health care facility on the basis of verification and designation requirements in effect at the time of redesignation.

(4) To obtain a designation as a "trauma facility," the institution shall apply to the department. An applicant health care facility has a right to an administrative hearing if denied a specific trauma facility level designation.

(5) The department shall designate the existing trauma resources of all participating health care facilities in the state, based upon the following categories:

(a) A level I regional trauma research center shall comply with the standards that are incorporated by reference and verification criteria developed by ACS-COT for Level I trauma facilities pursuant to R 325.129(l)(e), and all of the following:

(i) Comply with data submission requirements in R 325.133 and R 325.134.

(ii) Participate in coordinating and implementing regional injury prevention plans.

(iii) Provide staff assistance to the department in the designation and verification process of community trauma facilities and trauma support facilities.

(iv) Participate in the regional performance improvement process.

(b) A level II regional trauma center shall comply with the standards that are incorporated by reference and verification criteria established by the ACSCOT or level II trauma facilities, pursuant to R 325.129(l)(e), and all of the following:

(i) Comply with data submission requirements in R 325.133 and R 325.134.

(ii) Participate in coordinating and implementing regional injury prevention plans.

(iii) Provide staff assistance to the department in the designation and verification process of community trauma facilities and trauma support facilities.

(iv) Participate in the regional performance improvement process.

(c) For a level III, community trauma facility, verification criteria shall be established by the department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee. The standards are incorporated by reference in these rules, based upon verification criteria established by ACS-COT for level III facilities, pursuant to R 325.129(l)(e), and all of the following:

(i) Comply with data submission requirements in R 325.133 and R 325.134.

(ii) Participate in coordinating and implementing regional injury prevention plans.

(iii) Participate in the regional performance improvement process.

(d) For a Level IV trauma support facility, verification shall be completed using an "in-state" process, and criteria shall be established by the department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee. The verification standards incorporated by reference in these rules, are based upon criteria recommended by ACS-COT for level IV facilities, pursuant to R 325.129(l)(e) and Michigan level IV verification criteria and all of the following:

(i) Comply with data submission requirements in R 325.133 and R 325.134.

(ii) Participate in coordinating and implementing regional injury prevention plans.

(iii) Participate in the regional performance improvement process.

(e) The Michigan level III and IV verification criteria document is available from the department or online at the Michigan trauma system website.

(6) The resources of health care facilities applying for level I regional trauma research facility or level II regional trauma facility designation status shall be verified by the ACS-COT and shall do all of the following:

(a) Comply with data submission requirements in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(c) Provide staff assistance to the department in the designation and verification process of community trauma facilities and trauma support facilities.

(d) Participate in the regional performance improvement process.

(7) Health care facilities seeking designation as a level III, community trauma facility shall be verified using either an in-state process established by the department, with the advice of the state trauma advisory subcommittee, or by the ACS-COT and shall do all of the following:

(a) Comply with data submission requirements in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(8) Health care facilities seeking designation as a level IV, trauma support facility shall be verified using an in-state process established by the department, with the advice of the state trauma advisory subcommittee, and shall do all of the following:

(a) Comply with data submission requirements in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(9) Health care facilities wishing to be redesignated as a level I regional trauma research facility must independently obtain ACS-COT verification at that level, and shall comply with the standards that are incorporated by reference pursuant to R 325.129(l)(e), and all of the following:

(a) Comply with data submission requirements in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(c) Provide staff assistance to the department in the designation and verification process of community trauma facilities and trauma support facilities.

(d) Participate in the regional performance improvement process.

(10) Health care facilities wishing to be redesignated as a Level II regional trauma facility must independently obtain ACS-COT verification at that level, and shall comply with the standards that are incorporated by reference pursuant to R 325.129(l)(e), and all of the following:

(a) Comply with data submission requirements as set forth in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(c) Provide staff assistance to the department in the designation and verification process of community trauma facilities and trauma support facilities.

(d) Participate in the regional performance improvement process.

(11) Health care facilities wishing to be re-designated as a level III community trauma facility must obtain verification at that level using either in-state resources, or the ACS-COT, and shall comply with the standards that are incorporated by reference pursuant to R 325.129(l)(e), and all of the following:

(a) Comply with data submission requirements in R 325.133 and R 325.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(12) Health care facilities wishing to be redesignated as a level IV trauma support facility must obtain verification at that level using an in-state process. Level IV verification criteria shall be established by the department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee. The verification standards incorporated by reference in these rules are based upon criteria recommended by ACS-COT for level IV facilities, pursuant to R 325.129(l)(e), R 325.130, and Michigan level IV verification criteria, including all of the following:

(a) Comply with data submission requirements in R 325.133 and R 324.134.

(b) Participate in coordinating and implementing regional injury prevention plans.

(13) The department may, with the advice and recommendations of the state trauma advisory committee and emergency medical services coordination committee, modify the criteria or establish additional levels of trauma care resources as appropriate to maintain an effective state trauma system, and protect the public welfare, except that the department shall not establish any criteria for the purpose of limiting the number of health care facilities that qualify for a particular trauma level under these rules.

History

History: 2007 AACS; 2017 AACS.
History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.131 Triage and transport {#sec-r-325.131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.131}

Rule 7. (1) The department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee, shall develop recommendations, based on standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e), R 325.136, R 325.137, and R 325.138 for protocols which are established and adopted by local medical control, for the triage, transport, and inter-facility transfer of adult and pediatric trauma patients to appropriate trauma care facilities.

(2) The standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e), R 325.136, R 325.137, and R 325.138 for the triage, transport, and the inter-facility transfer of trauma patients, provide recommended minimum standards of care for protocols which are established and adopted by local medical control that must be utilized during transport of trauma patients. On an annual basis, or as needed, the department shall review and update these recommended minimum standards with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee.

(3) The department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee, shall create regional trauma networks that shall have the responsibility for developing triage and transport procedures within that geographical area. Both of the following apply:

(a) Each regional trauma network shall be created within the emergency preparedness region currently established within the state.

(b) Each trauma region may create its own triage and transport criteria and protocols, destination criteria and protocols, and inter-facility transfer criteria and protocols, which are established and adopted by local medical control, so long as they meet or exceed the standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e), R 325.129(1)(k), R 325.136, R 325.137, and R 325.138, and that they are reviewed by the quality assurance task force and approved by the department. This may include coordination of triage and transport criteria and protocols, which are established and adopted by local medical control, across geographic regions if in the best interest of providing optimal trauma care to patients.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.132 Trauma regions {#sec-r-325.132 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.132}

Rule 8. (1) The department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee, shall support the establishment and operational activities of the trauma regions through the commitment of resources.

(2) Each region shall establish a regional trauma network as prescribed and defined by R 325.125 to R 325.135.

(3) All MCAs within a region must participate in the regional trauma network, and life support agencies that care for trauma patients shall be offered membership on the regional trauma advisory council. Regional trauma advisory councils shall be operated in a manner that maximizes inclusion of their constituents. All of the following must apply:

(a) At least quarterly, a regional trauma network shall submit evidence of ongoing activity, such as meeting notices and minutes, to the department. Annually, the regional trauma advisory council shall file a report with the department which describes progress toward system development, demonstrates on-going activity, and includes evidence that members of the regional trauma advisory council are currently involved in trauma care.

(b) The regional trauma network shall develop a system regional trauma plan. The plan is subject to review of the STAC and emergency medical services coordination committee and approval by the department.

(i) All counties within the regional trauma advisory council have been included unless a specific county, or portion thereof, has been aligned within an adjacent network, and all health care entities and MCAs, life support agencies have been given an opportunity to participate in the planning process.

(ii) All of the following components have been addressed:

(A) Injury prevention.

(B) Communications.

(D) Trauma education.

(E) Infrastructure.

(F) Continuum of care.

(4) Each regional trauma network shall appoint a RPSRO as defined in R 325.127(g).

(5) Each regional trauma advisory council shall develop performance improvement plans that are based on standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e), R 325.129(1)(k), and R 325.135, and shall be reviewed annually by the state trauma advisory subcommittee and emergency medical services coordination committee for recommendations to the department.

(6) Recommendations, which are developed and proposed for implementation by a regional trauma advisory council, shall meet or exceed those that have been established by the department with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee, as based on standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e) and R 325.129(1)(k).

(7) The department shall recognize the regional trauma network once it approves a completed regional trauma plan. The regional trauma network approval process shall consist of the following phases:

(a) The first phase is the application phase, which begins with the submission to the department of a completed regional plan for the regional trauma network.

(b) The second phase is the review phase, which begins with the receipt of the regional plan, and ends with a department recommendation to approve the regional trauma network.

(c) The third phase is the final phase, with the department making a final decision regarding the regional trauma network plan. This phase also includes an appeal procedure for the denial of an approval of application in accordance with the department's administrative hearings requirements.

(8) If the application phase results in a recommendation to the department for approval by the statewide trauma advisory subcommittee and the emergency medical services coordination committee, and the department approves, then the department shall notify the regional trauma network applicant of the recommended action within 90 days from receipt by the department.

(9) Upon approval, a regional trauma advisory council shall implement the plan to include the following:

(a) Education of all entities about the plan components.

(b) On-going review of resources, process, and outcome data.

(10) The regional trauma network approval is in effect for 3 years.

R 325.133. Data collection.

Rule 9. (1) The department, with the advice and recommendations of the state trauma advisory subcommittee and emergency medical services coordination committee, shall develop and maintain a statewide trauma data registry. The department shall do all of the following:

(a) Adopt the national trauma data standard elements and definitions as a minimum set of elements for data collection, with the addition of elements as recommended by the STAC. The following standards are incorporated by reference in these rules, as identified in the National Trauma Data Standard: Data Dictionary, 2016 Admissions, including subsequent amendments and editions. A link to the document is available online at the Michigan trauma systems website. A copy may be obtained at no cost by writing to the Bureau of EMS, Trauma and Preparedness.

(b) Implement a plan for data including the following:

(i) Notify partners of data dictionary changes and new iterations annually.

(ii) Define the data validation process for designated trauma facility data submissions to the statewide trauma registry.

(iii) Participate in state data collaboration activities.

(iv) Establish and maintain processes for the following:

(A) Data related to trauma incidents shall be submitted to the statewide trauma registry according to the data submission timelines.

(B) Monitor national standards, regional issues, facility, and RPSROs to determine the need for additional data metrics needed for system function.

(C) For those trauma incidents that met the inclusion criteria identified for data submission, the following data elements shall be submitted to the department:

(1) All national trauma data standard data elements.

(2) All data elements recommended by the STAC.

(v) Develop annual reports using regional and state data defined by the STAC which assesses the state trauma system and regional trauma networks.

(vi) Evaluate and import additional data from existing databases as needed.

(vii) Support and evaluate probabilistic and deterministic data linkages.

(2) The department shall support the data collection and analysis process.

(3) Both of the following apply to health care facility participation in data submission:

(a) All designated facilities shall participate in data submission.

(b) Participation as appropriate in the RPSRO, as provided in 1967 PA 270, MCL 331.531 to 331.533.

History

History: 2007 AACS; 2017 AACS.
History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.134 Statewide trauma registry {#sec-r-325.134 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.134}

Rule 10. (1) The purpose of the trauma registry is to collect and analyze trauma system data to evaluate the delivery of adult and pediatric trauma care, develop injury prevention strategies for all ages, and provide resources for research and education.

(2) The department shall coordinate data collected by the trauma care facilities and emergency medical service providers. The department shall develop and publish a data submission manual that specifies all of the following:

(a) Data elements and definitions. The standards that are incorporated by reference pursuant to R 325.133(1)(a), and all of the following:

(i) Definitions of what constitutes a reportable trauma case.

(ii) Method of submitting data to the department.

(iii) Timetables for data submission.

(iv) Data submission format.

(v) Protections for individual record confidentiality.

(b) Notification of trauma care facilities of the required registry data sets and update the facilities and providers, as necessary, when the registry data set changes.

(3) All health care facilities shall submit to the department trauma data determined by the department to be required for the department's operation of the state trauma registry. The department shall prescribe and provide both of the following:

(a) Standard reporting mechanisms to be used by all health care facilities.

(b) The form and content of records to be kept and the information to be reported to the department.

(4) The department and regional trauma advisory councils shall use the trauma registry data to identify and evaluate regional trauma care and to prepare reports and analyses as requested by regional trauma advisory councils, the state trauma advisory subcommittee, or the emergency medical services coordination committee.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.135 Regional performance improvement {#sec-r-325.135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.135}

Rule 11. (1) Each trauma care region shall be required to develop and implement a regional trauma performance improvement program. This program shall include the standards that are incorporated by reference pursuant to R 325.129(1)(e), R 325.129(1)(k), and R 325.130(6)(d), and shall include the development of an annual process for reporting to the department a review of all region-wide policies, procedures, and protocols.

(2) Each regional trauma network is responsible for monitoring, assessing, and evaluating its regional trauma system to improve trauma care, reduce death and disability, surveillance of injury, and implementation of injury prevention activities.

(3) Each regional trauma network shall appoint a RPSRO.

(4) Deviations from protocols, which are established and adopted by local medical control and approved by the department for trauma patients, shall be addressed through a documented trauma performance improvement process established by a professional standards review organization.

(5) Each regional trauma advisory council shall observe the confidentiality provisions of the health insurance portability and accountability act under 45 CFR Part 164, data confidentiality provisions under the code, or as established by the regional professional standards review organization.

(6) The performance improvement process shall include the following standards that are incorporated by reference in these rules, pursuant to R 325.129(l)(e), R 325.129(1)(k), and R 325.130(6)(d) and include all of the following system components to be evaluated for both pediatrics and adults:

(a) Components of the regional trauma plan.

(b) Triage criteria and effectiveness.

(d) Data driven provision of care defined by available data metrics supported by the region, the statewide trauma advisory subcommittee, and the department.

(7) Each trauma care region shall be responsible for the ongoing evaluation of its trauma care system. Accordingly, each region shall be responsible for the ongoing receipt of information from the regional trauma system constituents on the implementation of various components of that region’s trauma system, and shall include the standards that are incorporated by reference pursuant to R 325.129(1)(e), R 325. 129(A)(12), and R 325.130(6)(d), and include all of the following system components to be evaluated:

(a) Components of the regional trauma plan.

(b) Triage criteria and effectiveness.

(d) Data analytics as defined by the department with the advice of the statewide trauma advisory subcommittee.

(8) Based upon information received by the region in the evaluation process, the region shall annually prepare a report containing results of the evaluation and a performance improvement plan. The report shall be made available to all regional trauma system constituents. The region shall ensure that all trauma facilities participate in this annual evaluation process, and encourage all other hospitals that treat trauma patients to participate in the annual evaluation process. The region shall not release specific information related to an individual patient or practitioner. Aggregate system performance information and evaluation will be available for review.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.136 Destination protocols {#sec-r-325.136 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.136}

Rule 12. Local MCAs shall develop and submit trauma destination protocols to the EMS and trauma section for review by the quality assurance task force, pursuant to MCL 333.20916. Upon review and approval by the department, the MCA must formally adopt and implement the protocol. The following factors will be used in evaluating those destination protocols:

(a) Trauma patients shall not be transported to a facility not participating in the state trauma system unless there is no other reasonable alternative available.

(b) Trauma patients shall be transported to the closest appropriate trauma facility as identified in regional and local medical control protocols.

(c) If a level I or level II trauma facility is not within a reasonable distance from the scene, the trauma patient shall be transported to the closest appropriate trauma facility.

(d) Each region shall make appropriate determinations for destination based on what is best for the patient.

(e) In areas of the state close to state borders, the most appropriate facility may be out of the state. If possible, transport trauma patients within state borders. Local protocols shall address this issue.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.137 Trauma patient inter-facility transfer protocols {#sec-r-325.137 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.137}

Rule 13. (1) All designated trauma centers shall maintain inter-facility transfer protocols for trauma patients that are consistent with regional and local medical control protocol and that are compliant with the emergency medical treatment and labor act, 42 USC 1395dd.

(2) All level III and level IV designated hospitals will develop and implement formal policies based on published guidelines for the transfer of trauma patients who need care at level I or level II trauma facilities.

(3) Trauma patients will be transported to a hospital that is designated as a trauma facility.

History

History: 2007 AACS; 2017 AACS.

Mich. Admin. Code R 325.138 Criteria for transfer protocols; criteria {#sec-r-325.138 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.138}

Rule 14. Designated trauma centers shall contact the department for current trauma patient transfer guidelines.

History

History: 2007 AACS; 2017 AACS.

R 325.161 to R 325.169 Michigan Care Improvement Registry

Mich. Admin. Code R 325.161 Definitions {#sec-r-325.161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.161}

DEPARTMENT OF COMMUNITY HEALTH

COMMUNITY PUBLIC HEALTH AGENCY

MICHIGAN CARE IMPROVEMENT REGISTRY

(By authority conferred on the department of community health by section 9227 of 1978 PA 368, and Executive Reorganization Order No. 1996-1, MCL 333.9227 and 30.3101)

Rule 1. As used in these rules:

(a) "Act" means 1978 PA 368, MCL 333.1001 to 333.35211.

(b) “Body mass index” or “BMI” means a calculation from a person’s height and weight used as a screening tool for identifying overweight and obese individuals who may be at risk for weight related health problems. It is commonly expressed in percentiles to control for differences in children’s body sizes due to gender and age.

(d) “Health care provider” has the same meaning as defined in section 9206(5) of the act.

(e) "MCIR" means the Michigan care improvement registry which is a registry of health information, including but not limited to;, children's immunizations,; immunization history; height, weight, and other reportable information; and, identification information on children, adolescents, and adults.

(f) "User" means any of the following entities:

(i) A health care provider.

(ii) Michigan schools.

(iii) Michigan day-care providers.

(iv) Healthcare organizations.

(v) Department personnel.

(vi) A person or organization otherwise authorized by the department.

History

History: 1997 AACS; 2009 AACS; 2012 AACS.

Mich. Admin. Code R 325.162 Users; access authorization; revocation of access privilege {#sec-r-325.162 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.162}

Rule 2. The department shall maintain a registry of all users. Users may apply to the department to be authorized for MCIR access. The department may grant access and issue an authorization code only upon receipt and acceptance of a written agreement between the user and the department that stipulates the terms and conditions of obtaining information, including the data elements that may be obtained and how the user will maintain the confidentiality of the information. The department may revoke a user's access privileges if the user violates the agreement.

History

History: 1997 AACS; 2009 AACS; 2012 AACS.

Mich. Admin. Code R 325.163 Reportable information {#sec-r-325.163 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.163}

Rule 3. (1) A person who administers an immunization, as defined in section 5101(e) of the act after the effective date of these rules to a child who was born after December 31, 1993, shall report the immunization to the department in a manner consistent with the rules and under either of the following circumstances, unless the immunization need not be reported under section 9206(2) and (3):

(a) The individual was born after December 31, 1993.

(b) The individual is less than 20 years of age.

(2) A person who administers an immunization may report any immunization administered to an individual if the individual was born before January 1, 1994.

(3) Only a health care provider who is authorized to administer an immunizing agent under section 9204 of the act shall report an immunization.

(4) A health care provider shall submit all of the information required by the department.

(5) A health care provider who receives written notification from a person requesting that his or her (or his or her child's) immunization data not be reported to the registry shall forward the request to the department in a form provided by the department.

The department shall not add any immunization information to that individual's or child's record after receipt of the request. This subrule does not apply to drugs, medications, chemicals, vaccines, or biological products being used in response to a public health emergency.

(6) A health care provider who is required to report an immunization shall submit the report within 72 hours of administering an immunization. The report shall be on a form provided by the department, except for a report that is submitted by electronic transmission or on electronic media.

(7) A health care provider who submits an immunization report by electronic transmission or on electronic media shall submit the report in the format provided by the department.

(8) If a public health emergency, and at the discretion of the director of the department in consultation with the chief medical executive, health care providers and other persons as defined by the director shall report to the department information regarding administration or dispensing of certain drugs, medications, chemicals, vaccines, or biological products used in response to the public health emergency. The department shall add functionality to the MCIR so that such information can be reported using the MCIR.

History

History: 1997 AACS; 2009 AACS; 2012 AACS.

Mich. Admin. Code R 325.163a Reportable information regarding height and weight {#sec-r-325.163a omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.163a}

Rule 3a (1) A health care provider that provides health care services to a child ages birth to 18 may report to MCIR the child’s height and weight measured during a patient encounter after obtaining the consent of the child’s parent(s) and/or guardian(s). The health care provider must provide the child’s parent(s) and/or guardian(s) with a written consent that explains that the reporting of the child’s height and weight information is optional, and that the parent(s) and/or guardian(s) may opt-out of the reporting.

(2) A health care provider who receives written notification from an adult requesting that his or her (or his or her child's) data not be reported to the registry shall forward the request to the department. The department shall not add any information about the child’s height and weight to that individual's or child's record after receipt of the request.

(3) For each report of height and weight, the department shall calculate and include in MCIR the BMI for the child. The department may make this information accessible to health care providers that provide health care services to a child ages birth to 18.

(4) To promote clinical quality and provider and patient education, the department shall identify evidence-based resource materials and reference information concerning BMI to be made available to health care providers. Provider oriented resource materials shall be consistent with clinical guidelines established by professional medical associations and quality improvement guidelines recognized by the department. Patient and family oriented resource materials shall be consistent with public education materials published by either federal public health agencies or the department. These materials are to be intended for informational purposes only and shall include a disclaimer that the department does not provide clinical guidance or assume responsibility for health care provided to a patient.

(5) The department may convene an expert advisory panel to review and advise the department on resource materials and reference information described in subsection (4) of this rule.

History

History: 2012 AACS.

Mich. Admin. Code R 325.164 Quality assurance {#sec-r-325.164 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.164}

Rule 4. (1) For the purpose of assuring the quality of submitted data, a provider shall allow the department to inspect the parts of a patient's medical records as necessary to verify the accuracy of submitted data.

(2) A health care provider who meets the standards of quality and completeness of submitted data set by the department is subject to inspection not more than once every 3 years for the purpose of assessing the quality and completeness of reporting from the provider, unless summary data for the provider indicate a significant deviation from expectation.

(3) A health care provider shall, at the request of the department, supply missing information, if known, or clarify information submitted to the department.

(4) Upon mutual agreement between a health care provider and the department, the provider may elect to submit copies of medical records instead of submitting to an inspection. The department shall use a copy of a submitted medical record or part of a record only to verify corresponding reported data, shall not recopy the record, and shall keep the record in a locked file cabinet when the record is not being used. The department shall promptly destroy a copy of a medical record submitted under this rule after verifying corresponding reported data or, if the reported data appear to be inaccurate, after clarifying or correcting the reported data.

History

History: 1997 AACS.

Mich. Admin. Code R 325.165 Amendment, replacement, and removal of records {#sec-r-325.165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.165}

Rule 5. (1) To protect the integrity and accuracy of the MCIR, information contained in the MCIR may only be amended, replaced, or removed as prescribed by these rules.

(2) A provider who submits health information or the department may amend the information in the MCIR by providing the minimum information needed to identify the record, a valid authorization code, and the replacement information on a form or in an electronic format prescribed by the department.

(3) A provider or the department may amend or update information in the MCIR by providing the minimum information needed to identify the record, a valid authorization code, and replacement or additional information on a form or in an electronic format prescribed by the department.

(4) A subject of a record, the subject's parents, a provider who did not submit the information to be amended, or a legal representative of either the subject or the subject's parents may apply to amend information contained in the MCIR. An application shall be in writing on a form prescribed by the department and shall be accompanied by documentary evidence specified by the department to support the amendment. The department shall review the application and supporting evidence and either make the amendments or deny the request. An applicant shall be informed in writing of the denial and of the reason for the denial.

(5) The department shall delete or replace birth registration information transmitted to the MCIR when original birth registration information is deleted or replaced by the department.

(6) The department shall make immunization information inaccessible or reinstate immunization information from the MCIR upon receipt of a written request to make inaccessible or reinstate immunization information. The request shall be on a form prescribed or authorized by the department, be signed by the subject of the record, the subject's parents, or legal representative of the subject or the subject's parents and be witnessed as required in R 325.166(3).

(7) If a parent or legal guardian requests that the department terminate its notices regarding required immunization for the parent's child, then the department shall terminate the notices. A request shall be in writing and may be submitted to the department or to a provider.

(8) The department shall maintain a record of all changes to information in the MCIR, except for changes where the original birth information supplied by the department is deleted or replaced by the department. At a minimum, the record shall indicate the date of the change, the item changed, and the user who made the change.

History

History: 1997 AACS; 2009 AACS.

Mich. Admin. Code R 325.166 Confidentiality of reports {#sec-r-325.166 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.166}

Rule 6. (1) The department shall maintain the confidentiality of all health information submitted to the department and shall not release the reports, immunization assessments, BMI screening data, or any information that, because of name, identifying number, mark, or description, can be readily associated with a particular individual, except in accordance with subrules (2), (3), (4), (5), and (6) of this rule. The department shall not release any information that would indicate whether or not the name of a particular person is listed in the registry, except in accordance with subrules (2), (3), (4), (5), and (6) of this rule.

(2) An immunization, height and weight, or any other report submitted to the MCIR concerning a particular individual, and any other information maintained in the MCIR that, because of name, identifying number, mark, or description, can be readily associated with a particular individual, shall be released by the department only as follows:

(a) To the particular individual upon compliance with both of the following provisions:

(i) Receipt of a written request which is signed by the particular individual and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Presentation by the particular individual of suitable identification as required by subrule (4) of this rule.

(b) If the particular individual is a minor, to a parent of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the parent and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the parent of suitable identification as required by subrule (4) of this rule.

(c) If the particular individual has a court-appointed guardian or if the particular individual is deceased, to the court-appointed guardian or to the executor or administrator of the particular individual's estate upon compliance with all the following provisions:

(i) Receipt of a written request which is signed by the particular individual's executor, administrator, or court-appointed guardian, and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Receipt of a certified copy of the order or decree that appoints the guardian, executor, or administrator.

(iii) Presentation by the guardian, executor, or administrator of suitable identification as required by subrule (4) of this rule.

(d) To an attorney or other person designated by the particular individual upon compliance with both of the following provisions:

(ii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(e) To an attorney or other person designated by the court appointed guardian of the particular individual or designated by the executor or administrator of the estate of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the court appointed guardian, executor, or administrator, which is witnessed or notarized as required by subrule (3) of this rule, and which requests release of the information to the attorney or other person.

(ii) Receipt of a certified copy of the order or decree that appoints the guardian, executor, or administrator.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(f) If the particular individual is a minor, to an attorney or other person designated by the parent of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the parent, is witnessed or notarized as required by subrule (3) of this rule, and which requests release of the information to the attorney or other person.

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(3) Every written request for the release of information submitted under subrule (2) of this rule shall be signed by the person making the written request. The signature shall either be witnessed by an employee or authorized agent of the department who has been designated to witness requests and to whom the person making the request presents suitable identification as required by subrule (4) of this rule or shall be notarized by a notary public or magistrate.

(4) A person who is required by subrules (2) or (3) of this rule to present suitable identification shall present an identification document, such as a driver's license, or other document that contains both a picture of the person and the signature or mark of the person.

(5) Information in the MCIR may be provided to any registered user of the MCIR upon presentation of a written, oral, or electronic request containing the minimum information necessary to identify the record requested and the user's authorization code.

(6) As specified in R 325.167, the director of the department may release information from the MCIR to an authorized representative of a study or research project reviewed by the scientific advisory panel and approved by the director. The department shall not release any part of a patient's medical record obtained under R 325.164.

History

History: 1997 AACS; 2009 AACS; 2012 AACS.

Mich. Admin. Code R 325.167 Scientific advisory panel; release of information for research {#sec-r-325.167 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.167}

Rule 7. (1) A research proposal that requires the release of information which identifies individuals in the MCIR shall be reviewed by the department's scientific advisory panel as established under R 325.9055.

(2) The panel shall advise the director in writing concerning the merits of the study.

(3) A release of information for research that identifies individuals in the MCIR is subject to the terms and conditions set by the department. A person who conducts a study or research project shall not publish the name of any individual who is or was in the MCIR and shall not release any identifying number, mark, or description that can be readily associated with an individual who is or was the subject of an immunization report submitted to the department.

History

History: 1997 AACS.

Mich. Admin. Code R 325.168 Exchange of records {#sec-r-325.168 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.168}

Rule 8. By written agreement, the department may transmit transcripts or copies of public health records or reports to state or national secure public health data systems or individuals responsible for the health care of a person if the records or reports relate to residents of other states or countries. The agreement shall require that the transcripts or records be used only for public health purposes and that the identity of a person who is subject to the report is confidential and shall only be released as specified in the agreement.

History

History: 1997 AACS; 2009 AACS.

Mich. Admin. Code R 325.169 Acceptance of immunization record as official record {#sec-r-325.169 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.169}

Rule 9. An immunization record obtained from the MCIR shall be accepted as the official immunization record of the person for the purposes of satisfying the requirements of sections 9208 and 9211 of the act.

History

History: 1997 AACS.

Mich. Admin. Code R 325.171 Definitions {#sec-r-325.171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.171}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF EPIDEMIOLOGY

COMMUNICABLE AND RELATED DISEASES

(By authority conferred on the department of community health by sections 2221, 2226(d), 2231(1), 2233, 5111, 5125 and 9227 of 1978 PA 368 and Executive Reorganization Order Nos.1996-1 and 1997-4, MCL 333.2221, 333.2226(d), 333.2231(1), 333.2233, 333.5111, 333.5125, 333.9227, 330.3101, 333.26324, 333.5114, and MCL 16.109)

Rule 1. (1) As used in these rules:

(a) "Appropriate local health department" means the local health department that has jurisdiction where an individual who has a disease or condition that is required to be reported resides or the local health department of the county in which the service facility is located.

(b) "Code" means 1978 PA 368, MCL 333.1101 to 333.25211.

(c) "Communicable" means capable of being transmitted from individual to individual, from animal to individual, or from an inanimate reservoir to an individual.

(d) "Department" means the Michigan department of community health.

(e) "Director" means the state director of community health or his or her designee.

(f) "Epidemic" means any increase in the number of cases, above the number of expected cases, of any disease, infection, or other condition in a specific time period, area, or demographic segment of the population.

(g) "Local health officer" means the health officer, or his or her designee, in the appropriate local health department.

(h) "Medical and epidemiological information" means any of the following:

(i) Medical histories.

(ii) Results of examinations.

(iii) Findings on laboratory tests.

(iv) Diagnoses.

(v) Treatments employed.

(vi) Outcomes.

(vii) Description and source of suspected causative agents.

(viii) Any other information that is pertinent to an investigation which is requested by the local health department or the department in the course of that investigation.

(i) "Novel influenza" means any strains or subtypes of influenza viruses not included in the current year influenza vaccine formulation.

(k) "Venereal disease" means any of the following:

(i) Syphilis.

(ii) Gonorrhea.

(iii) Chancroid.

(iv) Lymphogranuloma venereum.

(v) Granuloma inguinale.

(2) Unless the context requires otherwise or as further clarified in these rules, terms defined in the code have the same meanings when used in these rules.

History

History: 1993 AACS; 1999 AACS; 2009 AACS; 2014 AACS.

Mich. Admin. Code R 325.172 Disease reporting {#sec-r-325.172 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.172}

Rule 2. (1) The department, as required in MCL 333.5111 (1), annually reviews, maintains, and publishes a list of reportable diseases, infections, and disabilities on the department’s website.

(2) Physicians and laboratories shall report the unusual occurrence, outbreak, or epidemic of any condition, including healthcare-associated infections, to the local health department and to the department as required in R 325.173.

History

History: 1993 AACS; 1999 AACS; 2005 AACS; 2009 AACS; 2014 AACS.

Mich. Admin. Code R 325.173 Reporting and surveillance requirements {#sec-r-325.173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.173}

Rule 3. (1) A physician shall report each case of a serious communicable disease that is listed and maintained by the department as required in, MCL 333.5111(1), except for human immunodeficiency virus infection and acquired immunodeficiency syndrome, within 24 hours of diagnosis or discovery, to the appropriate health department. Reporting requirements for human immunodeficiency virus infection and acquired immunodeficiency syndrome are set out in MCL 333.5114 and subrules (12) to (14) of this rule.

(2) A physician shall report the unusual occurrence of any disease, infection, or condition that threatens the health of the public, within 24 hours of diagnosis or discovery, to the appropriate local health department.

(3) A physician shall report noncommunicable diseases that are listed and maintained by the department as required in MCL 333.5111(1) within 3 days of diagnosis or discovery, to the appropriate local health department.

(4) A physician may report any disease, infection, or condition that is not included in subrule (1), (2), or (3) of this rule to the appropriate local health department according to the physician's medical judgment.

(5) A laboratory shall report, within 24 hours of discovery, both of the following to the appropriate local health department:

(a) Laboratory evidence of any serious infection that is listed and maintained by the department as required in MCL333.5111(1), except for human immunodeficiency virus which is governed by MCL 333.5114.

(b) Laboratory evidence of any other disease, infection, or condition that is judged by the laboratory director to indicate that the health of the public is threatened. A laboratory in this state that receives or processes specimens to be tested for the listed agents shall report a result confirming presence of a listed agent, even if the testing is not done on-site, for example, the specimen is shipped to an out-of-state reference laboratory for testing.

(6) When a physician or laboratory director suspects the presence of a designated condition, but does not have sufficient information to confirm its presence, the physician or laboratory shall report the designated condition as suspect to the appropriate local health department. Upon confirmation of the designated condition, a physician or laboratory director shall report the condition as confirmed to the appropriate local health department.

(7) A health facility infection control committee shall develop policies and procedures to ensure the appropriate reporting of designated conditions by physicians who treat individuals at that facility and by laboratories at that facility.

(8) All of the following individuals may report to the appropriate local health department any designated condition or any other disease, infection, or condition which comes to their professional attention and which poses a threat to the health of the public:

(a) An administrator, epidemiologist, or infection control professional from a health care facility or other institution.

(b) A dentist.

(d) A pharmacist.

(e) A physician's assistant.

(f) A veterinarian.

(g) Any other health care professional.

(9) A primary or secondary school, child day care center, or camp shall report, within 24 hours of suspecting, both of the following to the appropriate local health department:

(a) The occurrence among those in attendance of any of the serious communicable diseases listed and maintained by the department as required in MCL 333.5111(1), except for human immunodeficiency virus and acquired immunodeficiency syndrome which are governed by MCL 333.5131.

(b) The unusual occurrence, outbreak, or epidemic of any disease, infection, or condition among those in attendance.

(10) A report shall be directed to the appropriate local health department. A report may be written, oral, or transmitted by electronic media. A report shall be transmitted in a manner prescribed or approved by the appropriate local health department.

(11) Except as provided in subrules (13) and (14) of this rule, a required report by a physician shall contain all of the following information:

(a) The patient's full name.

(b) The patient's residential address, including street, city, village or township, county, and zip code.

(d) The patient's date of birth, age, sex, race, and ethnic origin.

(e) The name of the disease, infection, or condition reported.

(f) The estimated date of the onset of the disease, infection, or condition, where applicable.

(g) The identity of the reporting person.

(h) Pertinent laboratory results.

(i) Any other information considered by the physician to be related to the health of the public.

(12) Acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection, tuberculosis, and venereal disease shall be reported by completing forms provided by the department.

(13) In addition to reporting requirements under section 5114 of the code for acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection, a physician shall report, if available, the ethnicity and country of birth, if known, of the test subject.

(14) Nothing in these rules is intended to limit use or disclosure of information needed by the department or local health department to carry out its responsibilities under the code as authorized by, but not limited to, MCL 333.5131.

(15) Viral influenza need only be reported by the number of cases identified during a specified time period or when influenza is suspected to have caused or contributed to mortality in a person aged less than 18 years, or if the infected individual traveled outside of North America within the 2 weeks prior to symptom onset.

(16) A required report by a laboratory shall contain all of the following information, except for human immunodeficiency virus and acquired immunodeficiency syndrome, which are governed by MCL 333.5114:

(a) The patient's full name.

(b) The patient's residential address, including street, city, village or township, county, and zip code.

(d) The patient's date of birth or age.

(e) The patient's sex.

(f) The specific laboratory test, date performed, and the results.

(g) The name and address of the reporting laboratory.

(h) The name, address, and telephone number of the ordering person.

(17) To the extent that the information is readily available, a report of an unusual occurrence, outbreak, or epidemic of a disease, infection, or other condition shall include all of the following information:

(a) The nature of the confirmed or suspected disease, infection, or condition.

(b) The approximate number of cases.

(d) The location of the outbreak.

(18) Within 24 hours of receiving a report, a local health department shall communicate the report of an individual who has a serious communicable disease listed and maintained by the department as required in MCL 333.5111(1) or a serious infection listed and maintained by the department as required in MCL 333.5111(1) to the department and any other Michigan jurisdiction if the individual resides in that other jurisdiction.

(19) Within 3 days of receiving a report, a local health department shall communicate the report of an individual who has a noncommunicable disease listed and maintained by the department as required in MCL 333.5111(1) to the department and another Michigan jurisdiction if the individual resides in that other jurisdiction.

(20) Within 24 hours of receiving a report that concerns an individual who resides outside of this state, a local health department shall forward the report to the department.

(21) Reports of designated conditions acquired by residents of a local health department's jurisdiction shall be recorded by the local health officer and shall be forwarded to the department in a format specified by the department.

History

History: 1993 AACS; 2005 AACS; 2009 AACS; 2014 AACS.

Mich. Admin. Code R 325.174 Investigation of diseases, infections, epidemics, and situations with potential for causing diseases {#sec-r-325.174 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.174}

Rule 4. (1) The department or the local health department that has jurisdiction where an individual who has a reported condition resides or where an illness or infection is being or may be spread shall initiate an investigation as necessary.

(2) An investigator who presents official identification of the local health department or the department shall promptly be provided with medical, epidemiologic, and other information pertaining to any of the following:

(a) Individuals who have designated conditions or other conditions of public health significance.

(b) Individuals, whether ill or well, who are part of a group in which an unusual occurrence, outbreak, or epidemic has occurred.

(c) Individuals who are not known to have a designated condition but whose medical or epidemiological information is needed for investigation into the cause of the occurrence of the condition.

(d) Individuals who were potentially exposed to a designated condition.

(e) Individuals who may be a carrier or health threat to others under MCL 333.5201.

(f) Any other information that may be relevant to an investigation under this rule.

(3) Requests for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized. Information released in response to a request made by type of disease, infection, or condition or diagnostic code category may include information about individuals who are not the primary focus of the request if it is not reasonably possible to delete it from the requested information.

(4) A representative of the local health department or the department may obtain human, animal, environmental, or other types of specimens or cause such specimens to be obtained by appropriate means, including venipuncture, in the course of an investigation of a reported disease, infection, or condition.

(5) The local health department shall transmit the results of its investigation of a report of an unusual occurrence of illness, outbreak, or epidemic to the department by an immediate informal report that shall be followed by progress reports and a final report.

The reports shall be in a format that is acceptable to the department.

History

History: 1993 AACS; 2014 AACS.

Mich. Admin. Code R 325.175 Procedures for physicians, local health officers, and schools for control of diseases and infections {#sec-r-325.175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.175}

Rule 5. (1) A physician or other person who attends to a case of communicable disease shall arrange for appropriate barrier precautions, treatment, or isolation if needed to prevent the spread of infection to other household members, patients, or the community. A physician or other person who seeks information on appropriate precautionary measures may request the local health officer or the department to provide the necessary information. Appropriate isolation or other barrier precautions may be instituted for a case or a suspected case of disease, infection, or other condition by the local health officer or the department as necessary to protect the public health.

(2) When a school official reasonably suspects that a student has a communicable disease except for AIDS, HIV infection, and noncommunicable diseases, the official may exclude the student for a period sufficient to obtain a determination by a physician or local health officer as to the presence of a communicable disease.

(3) The local health officer may initiate the exclusion from school or group programs of a student or individual who has a communicable disease. A student or individual may be returned to school or a group program when a physician or local health officer indicates that the excluded individual does not represent a risk to other individuals.

(4) When a local health officer confirms or reasonably suspects that a student or individual attending school or a group program has a communicable disease, the health officer may, as a disease control measure, exclude from attendance any individuals lacking documentation of immunity or otherwise considered susceptible to the disease until such time as the health officer deems there to be no likely further risk of disease spread.

History

History: 1993 AACS; 2014 AACS.

Mich. Admin. Code R 325.176 Immunizations required of children attending group programs or entering school {#sec-r-325.176 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.176}

Rule 6. (1) As used in this rule:

(a) "Certificate of immunization" means a medical, health department, school, or personal record which indicates the dates when each dose of a vaccine was given to an individual and which is certified by a health professional or local health department.

(b) "Exemption" means a temporary or permanent waiver of 1 or more of the specific immunization requirements for medical, religious, or other reasons.

(c) "Medical exemption" means a written statement from a physician that a vaccination is medically contraindicated for a particular child for a specified period of time.

(d) "Religious or other exemption" means a written statement which is signed by the parent, guardian, or person in loco parentis of a child, which certifies that immunization is in conflict with religious or other convictions of the signer, and which includes the name and date of birth of the child.

(e) "Vaccine" means an agent for immunization against an infection or disease caused by an infectious agent.

(2) A child who is 2 months through 3 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:

(a) One dose of any appropriate diphtheria vaccine.

(b) One dose of any appropriate tetanus vaccine.

(d) One dose of any appropriate poliovirus vaccine.

(e) One dose of any appropriate Haemophilus influenzae type B vaccine.

(f) One dose of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(g) One dose of any appropriate pneumococcal conjugate vaccine.

(3) A child who is 4 months through 5 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:

(a) Two doses of any appropriate diphtheria vaccine.

(b) Two doses of any appropriate tetanus vaccine.

(d) Two doses of any appropriate poliovirus vaccine.

(e) Two doses of any appropriate Haemophilus influenzae type B vaccine.

(f) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(g) Two doses of any appropriate pneumococcal conjugate vaccine.

(4) A child who is 6 months through 15 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:

(a) Three doses of any appropriate diphtheria vaccine.

(b) Three doses of any appropriate tetanus vaccine.

(d) Two doses of any appropriate poliovirus vaccine.

(e) Two doses of any appropriate Haemophilus influenzae type B vaccine.

(f) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(g) Pneumococcal conjugate vaccine as shown by either of the following:

(i) Three doses of any appropriate pneumococcal conjugate vaccine.

(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.

(5) A child who is 16 months through 18 months of age and who is registered in a program of group residence, care, or camping shall have received at least all of the following vaccines:

(a) Three doses of any appropriate diphtheria vaccine.

(b) Three doses of any appropriate tetanus vaccine.

(d) Two doses of any appropriate poliovirus vaccine.

(e) Haemophilus Influenzae type B vaccine age as shown by either of the following:

(i) Receipt of 1 dose of any appropriate haemophilus influenzae type B vaccine at or after 15 months of age.

(ii) Receipt of a complete series of any appropriate haemophilus influenzae type B vaccine.

(f) One dose of any appropriate live measles vaccine at or after 12 months of age. A laboratory finding of measles immunity satisfies this requirement.

(g) One dose of any appropriate live mumps vaccine at or after 12 months of age. A laboratory finding of mumps immunity satisfies this requirement.

(h) One dose of any appropriate live rubella vaccine at or after 12 months of age. A laboratory finding of rubella immunity satisfies this requirement.

(i) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(j ) Pneumococcal conjugate vaccine as shown by either of the following:

(i) Four doses of any appropriate pneumococcal conjugate vaccine.

(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.

(6) A child who is 19 months through 4 years of age and who is registered in a program of group residence, care, or camping shall have received at least all of the following vaccines:

(a) Four doses of any appropriate diphtheria vaccine.

(b) Four doses of any appropriate tetanus vaccine.

(d) Three doses of any appropriate poliovirus vaccine.

(e) Haemophilus influenzae type B vaccine as shown by either of the following:

(i) Receipt of 1 dose of any appropriate Haemophilus influenzae type B vaccine at or after 15 months of age.

(ii) Receipt of a complete series of any appropriate Haemophilus influenzae type B vaccine.

(f) One dose of any appropriate live measles vaccine at or after 12 months of age. A laboratory finding of measles immunity satisfies this requirement.

(g) One dose of any appropriate live mumps vaccine at or after 12 months of age. A laboratory finding of mumps immunity satisfies this requirement.

(h) One dose of any appropriate live rubella vaccine at or after 12 months of age. A laboratory finding of rubella immunity satisfies this requirement.

(i) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(j) Have evidence of varicella immunity as shown by any of the following:

(i) One dose of any appropriate varicella vaccine at or after 12 months of age.

(ii) Laboratory evidence of varicella immunity.

(iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.

(k) Pneumococcal conjugate vaccine as shown by either of the following:

(i) Four doses of any appropriate pneumococcal conjugate vaccine.

(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.

(iii) Receipt of 1 dose of any appropriate pneumococcal conjugate vaccine at or after 24 months of age.

(7) A child who is 5 years of age and who is registered in a program of group residence, care, or camping shall have received at least all of the following vaccines:

(a) Four doses of any appropriate diphtheria vaccine.

(b) Four doses of any appropriate tetanus vaccine.

(d) Three doses of any appropriate poliovirus vaccine.

(e) One dose of any appropriate live measles vaccine at or after 12 months of age. A laboratory finding of measles immunity satisfies this requirement.

(f) One dose of any appropriate live mumps vaccine at or after 12 months of age. A laboratory finding of mumps immunity satisfies this requirement.

(g) One dose of any appropriate live rubella vaccine at or after 12 months of age. A laboratory finding of rubella immunity satisfies this requirement.

(h) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(i) Have evidence of varicella immunity as shown by any of the following:

(i) One dose of any appropriate varicella vaccine at or after 12 months of age.

(ii) Laboratory evidence of varicella immunity.

(iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.

(8) A child who is 4 years through 6 years of age and who is entering school shall be in compliance with all of the following immunization requirements:

(a) Have received 4 doses of any appropriate diphtheria vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.

(b) Have received 4 doses of any appropriate tetanus vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.

(c) Have received 4 doses of any appropriate pertussis vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.

(d) Have received 4 doses of any appropriate polio vaccine. If dose 3 was administered on or after the fourth birthday only 3 doses are required.

(e) Have evidence of measles immunity as shown by either of the following:

(i) Two doses of any appropriate live measles vaccine received after the first birthday, not less than 28 days apart.

(ii) Laboratory evidence of measles immunity.

(f) Have evidence of mumps immunity as shown by either of the following:

(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not less than 28 days apart.

(ii) Laboratory evidence of mumps immunity.

(g) Have evidence of rubella immunity as shown by either of the following:

(i) Two doses of any appropriate live rubella vaccine received after the first birthday, at least 28 days apart.

(ii) Laboratory evidence of rubella immunity.

(h) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.

(i) Have evidence of varicella immunity as shown by any of the following:

(i) Two doses of any appropriate live varicella vaccine at or after 12 months of age.

(ii) Laboratory evidence of varicella immunity.

(iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.

(9) A child who is 7 through 18 years of age and who is entering school or enrolled in grade 7, shall be in compliance with all of the following immunization requirements:

(a) Have received 4 doses of any appropriate diphtheria vaccine - 3 doses if the first dose was received on or after the first birthday.

(b) Have received 4 doses of any appropriate tetanus vaccine - 3 doses if the first dose was received on or after the first birthday.

(d) Have received 4 doses of any appropriate poliovirus vaccine. If dose 3 was administered on or after the fourth birthday only 3 doses are required.

(e) Have evidence of measles immunity as shown by either of the following:

(i) Two doses of any appropriate live measles vaccine received after the first birthday, not less than 28 days apart.

(ii) Laboratory evidence of measles immunity.

(f) Have evidence of mumps immunity as shown by either of the following:

(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not less than 28 days apart.

(ii) Laboratory evidence of mumps immunity.

(g) Have evidence of rubella immunity as shown by either of the following:

(i) Two doses of any appropriate live rubella vaccine received after the first birthday, not less than 28 days apart.

(ii) Laboratory evidence of rubella immunity.

(h) Receipt of a complete series of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis b immunity or disease satisfies this requirement.

(i) Have evidence of varicella immunity as shown by any of the following:

(i) Two doses of any appropriate live varicella vaccine at or after 12 months of age.

(ii) Laboratory evidence of varicella immunity.

(iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.

(j) Have received 1 dose of meningococcal conjugate vaccine for grades 7 and higher with children 11 years of age and older.

(10) To satisfy the requirements in subrules (2) to (9) of this rule, each vaccine shall have been administered in accordance with the manufacturer's instructions. A 4-day grace leniency is allowed on the minimum ages and intervals for each vaccine.

(11) If the requirements for immunization cannot be completed due to medical reasons within 4 months of admittance, a child may remain enrolled in a school or group program for a reasonable length of time that is consistent with good medical practice. A statement requesting the enrollment of the child beyond the exclusion date shall be signed by a physician or local health officer and shall certify that the child is in the process of complying with all immunization requirements. This medical exemption shall be filed with the child's school or group program immunization records until it can be replaced with proof that the vaccines for which an exemption was granted have been received. Upon completion of the required immunizations, a parent shall present the school or group program with a certificate of immunization.

(12) When presented with a medical exemption, religious or other exemption, the administrator of a child's school or operator of a child's group program shall recognize the exemption status of the child. Each nonmedical exemption filed at the child’s school or group program of a child entering a program after December 31, 2014 shall be certified by the local health department that the individual received education on the risks of not receiving the vaccines being waived and the benefits of vaccination to the individual and the community. All waivers shall be submitted using the waiver form prescribed by the department.

(13) A standard record of the immunizations required by this rule and exemptions shall be maintained by every school for every pupil on forms supplied by the department. When a pupil transfers to another school or school district, the record of immunization, or a true copy of the record, shall be sent to the new school by the original school.

(14) All of the following information shall be provided to fulfill the requirements of section 9209(1) of the code:

(a) A listing, by child, of the number of doses of each vaccine received.

(b) The date of each immunization for each vaccine received in the series.

(15) Not less than 95% of entering students in a school, -- less the entering students who have medical, religious, or other exemptions, -- shall have received vaccinations as outlined in subrules (8) and (9) of this rule.

(16) A principal of a school or operator of a group program shall make immunization records available for inspection by authorized representatives of the department or the appropriate local health department. The local health officer shall also make public clinic immunization records available to local schools or group programs for the purpose of verifying pupil immunizations.

(17) A requirement for immunization with a specific vaccine may be suspended temporarily at the request of the department director for reasons of inadequate vaccine supply.

History

History: 1993 AACS; 1994 AACS; 1995 AACS; 1999 AACS; 2006 AACS; 2009 AACS; 2014 AACS.

Mich. Admin. Code R 325.177 Provision of care by local health departments for venereal disease; maintenance of test records after provision of pregnancy care {#sec-r-325.177 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.177}

Rule 7. (1) As used in this rule, "venereal disease case" means an individual who is diagnosed or treated for venereal disease on the basis of symptoms, signs, or laboratory tests.

(2) A local health department shall provide for the diagnosis, treatment, and case intervention of venereal disease cases within its jurisdiction. Through direct service or referrals, the local health department shall ensure that professional care and case follow-up are provided without regard to race, age, sex, national origin, or income. All of the following services shall be provided for the diagnosis, treatment, and case intervention of venereal disease cases:

(a) Relevant medical history and physical examination.

(b) Diagnostic tests.

(d) Follow-up examination and testing.

(e) Patient education.

(f) Identification and notification of sexual contacts.

(g) The examination and treatment of sexual contacts and other designated high-risk individuals exposed to venereal disease cases.

(h) The maintenance of records for not less than 5 years after the last reactive test in syphilis cases and for not less than 1 calendar year, not including the present year, for other venereal diseases.

(3) Records of test results that are obtained under section 5123 of the code shall be maintained for not less than 3 calendar years after the termination of pregnancy.

History

History: 1993 AACS.

Mich. Admin. Code R 325.178 Rescinded {#sec-r-325.178 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.178}

R325.179 Submission of tuberculosis laboratory specimens and test results.

Rule 9. (1) For the purpose of this rule, "preliminary result" includes, but is not limited to, results from nucleic acid amplification tests, nucleic acid or other genetic probe tests, chromatographic or other such tests that may be performed prior to final culture identification of a clinical specimen.

(2) A laboratory that initially receives any clinical specimen which yields Mycobacterium tuberculosis complex, or yields a preliminary result indicative of Mycobacterium tuberculosis complex, is responsible for ensuring that the following are submitted:

(a) All preliminary results and any interpretation of those results to the appropriate local health department.

(b) The first Mycobacterium tuberculosis complex isolate, or subculture thereof, from the patient being tested for tuberculosis, to the department.

(c) Any Mycobacterium tuberculosis complex isolate, or subculture thereof, from a follow-up specimen, collected 90 days or more after the collection of the first Mycobacterium tuberculosis complex positive specimen.

R 325.179a. Submission of other designated conditions specimens.

Rule 9a. A laboratory shall submit to the department the first isolate or subculture thereof, or specimen where appropriate, from the patient being tested, any of the following:

(a) Specimens suspected to contain and suspect isolates of any of the following:

(i) Bacillus anthracis.

(ii) Brucella species.

(iii) Burkholderia pseudomallei.

(iv) Burkholderia mallei.

(v) Clostridridium botulinum.

(vi) Coxiella burnetii.

(vii) Francisella tularensis.

(viii) Orthopox viruses, including smallpox and monkey pox.

(ix) Yersinia pestis.

(b) Specimens that contain and isolates any of the following:

(i) Corynebacterium diphtheriae.

(ii) Escherichia coli 0157:H7 and all other shiga toxin positive serotypes.

(iii) Haemophilus influenza, only if isolate collected from a normally sterile site or if patient is less than 15 years of age.

(iv) Legionella species.

(v) Listeria monocytogenes.

(vi) Neisseria meningtidis, only if isolate collected from a normally sterile site.

(vii) Novel influenza.

(viii) Salmonella species including Typhi.

(ix) Severe Acute Respiratory Syndrome (SARS) coronavirus.

(x) Shigella species.

(xi) Staphylococcus aureus, only vancomycin intermediate and resistant.

(xii) Vibrio cholera.

(xiii) Vibrio paphemolyticus.

(xiv) Vibrio vulnificus.

R 325.179b. Submission of HIV laboratory specimens.

Rule 9b. (1) A laboratory that receives any clinical specimen which yields results indicative of infection with human immunodeficiency virus (HIV) is responsible for ensuring that specimens are submitted to the department or to a laboratory designated by the department. These specimens include any of the following:

(a) Remnant specimens from all positive western blot (WB) or immunofluorescent antibody (IFA) confirmed tests.

(b) Remnant specimens from viral detection or quantitation tests upon request by the department within 3 months from specimen collection date, if available.

(c) Remnant specimens from multiple reactive rapid enzyme immunoassay (EIA) tests that together constitute an HIV diagnosis.

History

History: 1993 AACS; 1999 AACS; 2015 AACS.
History: 1993 AACS; 2009 AACS.
History: 2009 AACS; 2015 AACS.
History: 2009 AACS.

Mich. Admin. Code R 325.180 Procedures for control of rabies; disposition of rabid animals {#sec-r-325.180 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.180}

Rule 10. (1) For the purposes of this rule, animals that are subject to rabies testing are any nonhuman mammals, except for rabbits or hares and rodents other than woodchucks.

(2) As used in this rule, "owner" means a person who has a right of property ownership of an animal, who keeps or harbors an animal, who has custody of an animal, or who permits an animal to remain on or about any premises occupied by the person.

(3) Any laboratory in this state that conducts examinations of animals for rabies shall report all of the following data to the department within 7 days after examination:

(a) Species of animal.

(b) Name and address of the owner of the animal.

(d) Name and address of the individuals who have been exposed to the animal or the name and address of the owner of the pet that has been exposed to the animal.

(e) Date and results of the examination.

(4) A physician who performs a postmortem on the body of an individual who died of rabies or who was suspected of dying of rabies shall immediately submit nonpreserved portions of the hippocampus major and spinal cord to the department for rabies examination. A history of the case shall accompany the specimens.

(5) An animal that has bitten an individual or otherwise potentially exposed an individual to rabies shall be handled pursuant to the provisions of the publication entitled "Compendium of Animal Rabies Control, 2011" issued by the national association of state public health veterinarians (NASPHV). The provisions of the publication entitled "Compendium of Animal Rabies Control, 2011 2008" or most recent version, are adopted by reference in these rules. Copies of this publication may be obtained from the State Public Health Veterinarian, Communicable Disease Division, Bureau of Disease Control, Prevention & Epidemiology, Michigan Department of Community Health, 201 Townsend Street, 5th Floor, Lansing, Michigan 48909 at no cost as of the time of adoption of these rules.

(6) Any person who has knowledge of an animal bite where rabies is suspected shall, within 24 hours of the biting incident, report the bite to the appropriate local health department and to the local health department where the bite occurred. The report shall include all of the following information:

(a) Animal species inflicting the bite.

(b) Animal owner's name, address, and telephone number.

(d) Date and location of the biting incident.

(e) Name, address, and telephone number of the individual bitten.

(f) Site of the bite on the body.

(g) Name of the reporter of the bite.

(7) Upon request by the department or local health department, any person who has information regarding the identity, whereabouts, or vaccination status of an animal that that has bitten an individual or otherwise potentially exposed an individual to rabies, or information about the owner of the animal, shall provide information about the animal or the animal's owner to the department or local health department.

History

History: 1993 AACS; 1999 AACS; 2009 AACS; 2015 AACS.

Mich. Admin. Code R 325.181 Confidentiality of reports, records, and data pertaining to testing, diagnosis, care, treatment, reporting, and research {#sec-r-325.181 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.181}

Rule 11. (1) This rule applies to the communicable, serious communicable, chronic and noncommunicable diseases, infections, and disabilities listed and maintained by the department as required in MCL 333.5111 (1), except for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS).

(2) Medical and epidemiological information that identifies an individual and that is gathered in connection with an investigation is confidential and is not open to public inspection without the individual's consent or the consent of the individual's guardian, unless public inspection is necessary to protect the public health as determined by a local health officer or the director.

(3) Medical and epidemiological information that is released to a legislative body shall not contain information that identifies a specific individual.

History

History: 1993 AACS; 2015 AACS.

Mich. Admin. Code R 325.182 Newborn eye prophylaxis {#sec-r-325.182 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.182}

Rule 182. The following prophylaxes against ophthalmia neonatorum are approved:

(a) Erythromycin (0.5%) ophthalmic ointment in single-use tubes or ampules.

(b) A substance for which written approval has been given by the director of the Michigan department of community health.

History

History: 2010 AACS.

Mich. Admin. Code R 325.199 Rescissions {#sec-r-325.199 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.199}

Rule 99. (1) R 325.763 to R 325.773, R 325.775, R 325.781 to 325.784, R 325.786, R 325.801 to R 325.818, R 325.820 to R 325.898, and R 325.901 of the Michigan Administrative Code, appearing on pages 1763 to 1775 of the 1979 Michigan Administrative Code, are rescinded.

(2) R 325.3401 to R 325.3409 of the Michigan Administrative Code, appearing on pages 284 to 286 of the 1981 Annual Supplement to the 1979 Michigan Administrative Code, are rescinded.

(3) R 325.3501 to R 325.3513 of the Michigan Administrative Code, appearing on pages 2012 to 2015 of the 1979 Michigan Administrative Code and page 286 of the 1981 Annual Supplement to the Code, are rescinded.

(4) R 325.9001 to R 325.9011 of the Michigan Administrative Code, appearing on pages 290 to 292 of the 1981 Annual Supplement to the 1979 Michigan Administrative Code and pages 195 to 197 of the 1984 Annual Supplement to the Code, are rescinded.

History

History: 1993 AACS.

R 325.301 to R 325.306 Reporting of Traumatic Injuries

Mich. Admin. Code R 325.301 Definitions {#sec-r-325.301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.301}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF EPIDEMIOLOGY

DIVISION OF ENVIRONMENTAL HEALTH

REPORTING OF TRAUMATIC INJURIES

(By authority conferred on the community public health agency by sections 5111 and 2226[d] of 1978 PA 368, MCL 333.5111 and MCL 333.2226[d],section 8 of 1978 PA 312, MCL 325.78, MCL 333.2233, MCL 333.2221 and Executive Reorganization Order No. 1996-1, MCL 330.3101.)

Rule 1. (1) As used in these rules:

(a) "Department" means the Michigan department of community health.

(b) "External cause-of-injury codes" means the standard codes adopted by reference in R 325.302(1).

(c) "Health facility" means any facility or agency licensed in Michigan under Article 17 of the public health code, MCL 333.20101 to 333.22260 that provides health care services. It includes an ambulance, aircraft transport, non-transport prehospital life support, or medical first response operation; clinical laboratory; county medical care facility; freestanding surgical outpatient facility; health maintenance organization; nursing home; home for the aged; hospital; nursing home; hospice; and hospice residence.

(d) "Health professional" means a person licensed under article 15 of the public health code, MCL 333.16101 to 333.18838, in medicine, osteopathic medicine, as a physician's assistant, or nurse practitioner.

(e) "Local health department" means a public health department established under article 24 of the public health code, MCL 333.2401 to 333.2498, to protect the public health and prevent disease within a specific geographic area.

(f) "Nature-of-injury codes" means the standard codes adopted by reference in R 325.302(1).

(g) "Patient" means any injured person who receives medical attention, care, or treatment for that injury.

(h) "Protected health information" means any individually identified health information, whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and, relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.

(i) "Public health investigation" means the collection of medical, epidemiologic, exposure, and other information to determine the magnitude and causes of specific illnesses or injuries, which is used to determine appropriate actions to prevent or mitigate additional illness or injury.

(j) "Traumatic injury" means bodily damage resulting from exposure to physical agents such as mechanical energy, thermal energy, ionizing radiation, or resulting from the deprivation of basic environmental requirements such as oxygen or heat.

Mechanical energy injuries include acceleration and deceleration injuries, blunt trauma, and penetrating wound injuries.

History

History: 2010 AACS.

Mich. Admin. Code R 325.302 Adoption by reference {#sec-r-325.302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.302}

Rule 2. (1) The department adopts by reference the following standards which are available for inspection at the department of community health; division of environmental health, 201 Townsend, Lansing, Michigan 48909. The standard codes as published by the World Health Organization at http://www.who.int, classify injuries based on the type injury, as specified in either of the following:

(a) International Classification of Diseases Ninth Revision Clinical Modification; 1975 for $45.50.

(b) International Classification of Diseases and Related Health Problems, Tenth Revision; 1992 for $390.00.

(2) Copies of the standards adopted in subrule (1) of this rule can be obtained from the department of community health at the cost noted in subrule (1) of these rules, plus $20.00 for shipping and handling.

History

History: 2010 AACS.

Mich. Admin. Code R 325.303 Reportable information {#sec-r-325.303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.303}

Rule 3. (1) Reportable information is specifically related to patients with traumatic injuries.

(2) The health professional or health facility shall submit its report in a format that ensures the inclusion of the information listed under subdivisions (a) to (c) of this subrule.

(a) All of the following information, with respect to the patient, shall be provided:

(i) Last and first name and middle initial.

(ii) Sex.

(iii) Race, if available.

(iv) Ethnic group, if available.

(v) Birth date or age.

(vi) Street address, city, and state of residence.

(vii) Telephone number.

(viii) If the individual is a minor, the name of a parent or guardian.

(ix) Work-relatedness of the injury.

(x) Name and address of his or her employer, if injury is work-related.

(xi) The date of injury.

(xii) The date of diagnosis of the injury.

(xiii) Nature (type) of injury or injuries, and corresponding nature-of-injury codes, if available.

(xiv) Cause and intentionality of injury, and corresponding external cause-ofinjury codes, if available.

(xv) Brief narrative of the injury event and any other information considered by the health professional or health facility to be relevant to public health response to the event.

(b) Name, address, and telephone number of the health professional that diagnosed or treated the patient for their injury.

History

History: 2010 AACS.

Mich. Admin. Code R 325.304 Reporting responsibilities {#sec-r-325.304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.304}

Rule 4. (1) Traumatic injuries are not required to be reported unless requested by the department or local health department.

(2) The department or local health department will notify health professionals and health facilities in writing when reporting of 1 or more types of traumatic injuries is requested. The following apply to injury reports requested by the department or local health department:

(i) Reports shall be submitted within the time frame requested by the department or local health department, but no later than 10 days following the request.

(ii) Except as provided in subrule (3) of this rule, reports shall be provided only to the department or local health department that makes the request.

(2) Reports may be provided by health professionals or health facilities in the absence of a department or local health department request, when the reporting entity believes that public health investigation is needed to protect the public.

History

History: 2010 AACS.

Mich. Admin. Code R 325.305 Investigation and quality assurance {#sec-r-325.305 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.305}

Rule 5. (1) The department or local health department, upon receiving a report under R 325.304, may investigate to determine the accuracy of the report and collect additional information from health professionals and health facilities pertaining to, but not limited to, risk factors, medical condition, and circumstances of injury.

(2) The department and local public health departments shall collaborate in the development of procedures for processing injury reports and conducting follow-up investigations to ensure efficient, non-duplicative, and effective public health response.

(3) Requests for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized by the department in accordance with this rule.

(4) A health facility shall keep copies of protected health information from reported injury cases in secure storage when not in use. Information stored electronically shall be maintained on a secure server accessible only by appropriate department or local health department program staff through password protected user accounts.

(5) Reports may be released to other state, local, or federal agencies for those agencies to administer and enforce provisions of laws or rules to protect individuals from conditions associated with the injury. Protected health information may be released to other governmental agencies and bona fide agents of the state that comply with the confidentiality requirements of R 325.306.

(7) Nothing in this rule shall be construed to relieve or preempt any other entities from investigating injury hazards under state, federal, or local statutes or regulations.

History

History: 2010 AACS.

Mich. Admin. Code R 325.306 Confidentiality of reports {#sec-r-325.306 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.306}

Rule 6. (1) Reports submitted to the department or local health department under R 325.304 are not public records and are exempt from disclosure pursuant to the freedom of information act, section 13 of 1976 PA 442, MCL 15.231.

(2) The department and local health departments shall maintain the confidentiality of all reports and shall not release reports, including protected health information or any information that may be used to directly link the information to a particular individual, except as allowed in R 325.305(5), unless the department or local health department has received written consent from the individual, or from the individual's parent or legal guardian, authorizing the release of information.

(3) Medical and epidemiological information that is released to a legislative body shall not contain information that identifies a specific individual. Aggregate epidemiological information concerning the public health, which is released to the public for informational purposes only, shall not contain information that allows individuals to be identified.

History

History: 2010 AACS.

R 325.3201 to R 325.3221 Completion, Filing, and Registration of Vital Records Documents

Mich. Admin. Code R 325.3201 Definitions {#sec-r-325.3201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3201}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH ADMINISTRATION

OFFICE OF THE STATE REGISTRAR

COMPLETION, FILING, AND REGISTRATION OF VITAL RECORDS

DOCUMENTS

(By authority conferred on the department of health and human services by sections 2226, 2233, 2235, and 2896 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, 333.2235, and 333.2896.)

Rule 1. (1) As used in these rules:

(a) "Code" means Act No. 368 of the Public Acts of 1978, as amended, being S333.1101 et seq. of the Michigan Compiled Laws.

(b) "Date of application" means the date the application to establish a delayed registration of birth or a delayed registration of death is received in the office of the state registrar.

(c) "Date of filing" means the date the local registrar places on the document at the time the record is accepted for filing.

(d) "Live birth" means the complete expulsion or extraction from a pregnant woman of a product of human conception which, after such expulsion or extraction, shows any evidence of life, whether or not the umbilical cord has been cut or the placenta is attached.

(e) "Registered record" means a record accepted by the state registrar for incorporation into the permanent official records of the system of vital statistics.

(f) "Registrant" means the individual to whom the record pertains.

(2) The terms defined in part 28 of the code have the same meanings when used in these rules.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3202 Instructions for completing and filing vital records {#sec-r-325.3202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3202}

Rule 2. The state registrar shall prepare and distribute instructions on the proper completion and filing of vital records.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3203 Information designated as confidential or collected for statistical, health, or medical purposes {#sec-r-325.3203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3203}

Rule 3. (1) The state registrar shall identify on vital records forms all items which are confidential or collected only for statistical, health, or medical purposes.

(2) Information identified on vital records forms to be confidential or collected for a statistical, health, or medical purpose shall not be retained at the office of a local registrar beyond the time required by these rules to properly file and forward the vital record to the state registrar.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3204 Forms {#sec-r-325.3204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3204}

Rule 4. (1) All vital records forms prepared and distributed by the state registrar for reporting vital events and vital statistics shall be surrendered to the state registrar upon demand.

(2) Only forms furnished or approved by the state registrar shall be used to report vital events and vital statistics or to make copies thereof.

(3) The forms prescribed and distributed by the state registrar shall be used only for official purposes.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3205 Storage and distribution of blank forms {#sec-r-325.3205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3205}

Rule 5. (1) An individual responsible for the preparation and filing of vital records shall do all the following:

(a) Store blank vital records forms in such a manner as to safeguard the forms against theft or misuse.

(b) Distribute forms only to other persons when authorized to do so by a local registrar or the state registrar.

The report must contain all the following:

(i) The date the records were discovered missing.

(ii) The type of record.

(iii) Information that may lead to the recovery of the forms.

(2) A local registrar receiving a report of missing or stolen forms shall forward the report to the state registrar.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3206 Vital records preparation; acceptability for filing {#sec-r-325.3206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3206}

Rule 6. (1) All births, deaths, marriages, divorces, and other events designated by the state registrar must be entered in the state electronic registration system, using established procedures, or as otherwise directed by the state registrar.

(2) In the event that a state electronic registration system is not available or otherwise directed by the state registrar, paper forms must be typed or printed legibly using black ink or toner, and all required signatures must be in black, archival quality ink.

(3) All signatures must be original signatures, except for the signatures of the local registrar, state registrar, or a judge of a circuit or probate court, or as otherwise determined permissible by the state registrar.

(4) The full name of each individual recorded on vital records must be recorded in English alphabetic characters, with the exception of surname suffixes, which may be recorded in Roman or Arabic numerals, and limited to the following:

(a) Upper and lower-case letters.

(b) Letters a to z.

(d) Periods.

(e) Apostrophes.

(f) Hyphens.

(g) Spaces.

(4) All references to time on vital records must refer to the time in effect at the place and on the date the event occurred.

(5) Unless otherwise directed by the state registrar, a certificate is unacceptable for filing under any of the following circumstances:

(a) It is not completed in conformance with instructions issued by the state registrar.

(b) It contains alterations or erasures, except on portions required only for statistical, health, or medical use.

(d) It is marked "copy" or "duplicate."

(e) It is a carbon copy.

(f) It is prepared on an improper or obsolete form.

(g) It contains obvious improper, inconsistent, or incomplete information.

(h) It has been folded, bent, stained, or otherwise damaged.

(i) It is illegible.

(j) It contains cause of death information not properly recorded in conformance with instructions issued by the state registrar.

(k) It is not certified by a person authorized by law or by rule to certify to the facts of the event.

(l) It records an event that occurred more than 1 year before the date the record is received by the local registrar.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3207 Replacement of vital records not acceptable for filing {#sec-r-325.3207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3207}

Rule 7. (1) When a vital record is not acceptable for filing, the individual responsible for filing the original vital record shall prepare another record acceptable for filing and submit it to the local registrar within 5 days after receipt of notice that the record is not acceptable for filing, except for records not accepted pursuant to R 325.3206(5)(l).

(2) If, after receipt of notice that a vital record is not acceptable for filing, the individual responsible for filing the original vital record cannot meet the required filing date, the individual shall submit a written notification to the local registrar stating the reason for the lateness and expected date of submission.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3208 Recording false information {#sec-r-325.3208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3208}

Rule 8. (1) An individual responsible for filing a vital record that contains suspected false information shall file the vital record and report the suspicion to the local registrar.

(2) A local registrar receiving a report of suspected false information or a vital record suspected of containing false information, shall report it to the state registrar.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3209 Late filing of certificates of birth and certificates of death {#sec-r-325.3209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3209}

Rule 9. When an individual is found dead and the date of death as determined by the county medical examiner is at least 1 year before the date the body was found, the death must be registered on the form in use at the time the body is found and the state registrar shall mark the certificate of death "delayed."

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3210 Filing of certificates of death with incomplete information {#sec-r-325.3210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3210}

Rule 10. (1) If all the information necessary to complete a certificate of death is not available within the time prescribed for filing of the certificate, the funeral director shall file the certificate completed with all information that is available. In all cases, the medical certification must be signed by the individual responsible for the certification. If the cause of death is not known or not yet determined, the cause of death must be shown as "pending."

(2) A local registrar shall accept a certificate of death showing the cause of death as "pending" only if signed by a county medical examiner or a deputy county medical examiner licensed to practice medicine in any state.

(3) A supplemental report providing the information missing from the original certificate must be filed by the individual responsible for obtaining the missing information with the state registrar as soon as possible, but in all cases within 60 days after the date the death occurred.

(4) If the supplemental report is filed before the certificate is registered, the missing information must be added to the certificate. Otherwise, the certificate must be replaced.

(5) Supplemental reports filed more than 60 days after the date of death must be considered an application to amend the record.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3211 Original records; minor changes or alterations {#sec-r-325.3211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3211}

Rule 11. (1) The individual responsible for filing a vital record may make a minor change or alteration to the original paper record only through use of a lift-off process.

Changes or alterations made by erasure, correcting tape, or image overlay are not acceptable, except on portions designated for statistical, health, or medical use only.

(2) Death certificates may be changed by the mortuary science or funeral director licensee responsible for the disposition of the deceased or the physician who certified the cause of death within 30 days after the file date in the electronic death registration system. Changes made to the medical section of the record by the mortuary science or funeral director licensee must be substantiated by documentary evidence provided by the certifying physician.

(3) Data entry errors by the data provider in the birth registration system may be corrected during the 6 months after the date of birth. Statistical data can be changed by the data provider until the annual statistical file is closed.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3212 Errors in filing and registration {#sec-r-325.3212 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3212}

Rule 12. The state registrar or a local registrar may make changes to the record where the change corrects an error made by a registrar in the filing or registration of the record. All changes must be done using procedures approved by the state registrar.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3213 Local registrar to number, date, and affix signature {#sec-r-325.3213 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3213}

Rule 13. A local registrar shall number, provide a date of filing for, and sign or electronically certify each vital record accepted for filing in accordance with instructions issued by the state registrar.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3214 Packaging and shipping vital records {#sec-r-325.3214 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3214}

Rule 14. (1) A local registrar shall package and ship vital records in conformance with instructions issued by the state registrar.

(2) Records shall be shipped to the state registrar by the fourth of the month following the month the record was filed.

(3) The state registrar may require the immediate shipment of an individual record.

History

History: 1981 AACS.

Mich. Admin. Code R 325.3215 Hospitals or institutions; preparation of certificates of death {#sec-r-325.3215 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3215}

Rule 15. When death occurs in a hospital or other institution and the death does not fall within the jurisdiction of the county medical examiner, the individual in charge of the institution, or that individual’s designated representative, may initiate the preparation of the certificate of death through either of the following:

(a) Enter the required information into the electronic death registry system in conformance with instructions issued by the state registrar.

(b) Complete the medical certificate of death as follows:

(i) Place the full name and sex of the deceased and the date and place of death on the medical certificate of death.

(ii) Obtain the cause of death from the attending physician, other information required of the physician, and the attending physician's signature.

(iii) Present the completed medical certificate of death to the funeral director or an individual acting as such.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3216 County medical examiner; preparation of certificates of death {#sec-r-325.3216 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3216}

Rule 16. If a death falls within the jurisdiction of a county medical examiner, the county medical examiner may initiate the preparation of the certificate of death as specified in these rules.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3217 Proper presentation of certificates of death for physician signature {#sec-r-325.3217 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3217}

Rule 17. (1) A physician responsible for completing the medical certification on a certificate of death shall provide the certification when a certificate of death is presented to that individual with at least all the following information:

(a) The name of the deceased.

(b) The sex of the deceased.

(2) A record completed in the manner described in subrule (1) of this rule is considered properly presented for the purpose of obtaining the medical certification.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3218 Foundling registration {#sec-r-325.3218 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3218}

Rule 18. (1) When an individual assumes custody of a child of unknown parentage, the facts as prescribed by section 2825 of the code, MCL 333.2825, must be reported on the birth certificate form in use at the time the infant is found.

(2) All items on the form must be completed in conformance with instructions issued by the state registrar. The completed certificate must be forwarded to the local registrar in the area where the infant was found.

(3) Before registration, the data provider shall mark the record to identify the record as that of a foundling child. The reference mark must not disclose the fact that the record is for a foundling child.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3219 Registration of presumptive death {#sec-r-325.3219 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3219}

Rule 19. (1) A certificate of death prepared on the basis of an order of the court that finds that an individual is presumed to have died in this state as a result of a disaster or accident must be prepared in the manner in use at the time the order is presented.

(2) All items on the certificate of death must be prepared as fully as possible. If unknown, the items must be completed as unknown, except that all information on the disposition of the body must be left blank.

(3) A copy of the court order and the certificate of death must be submitted to the state registrar.

(4) Before registration, the state registrar must mark the certificate "presumptive" and record on the certificate the name of the court that issued the order, case number, and date of the order.

(5) Following registration, the state registrar shall forward a copy of the certificate to the local registrar for the area where death was presumed to have occurred.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3220 Delayed registration of birth; application; establishment; evidence; review of application and evidence; dismissal or denial of application; preparation and filing of registration; rescission of registration {#sec-r-325.3220 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3220}

Rule 20. (1) A living individual born in this state who has received an official notice from the state registrar that the individual’s birth is not recorded in the office of the state registrar, or that individual’s parent, guardian, or legal representative, may apply for the establishment of a delayed registration of birth subject to these rules. In the absence, inability, or refusal of a parent or guardian of any non-emancipated minor, any next of kin 18 years of age or older who is at least 10 years older than the registrant acting for the registrant and having personal knowledge of the facts of the live birth, may apply for the establishment of a delayed registration of birth subject to these rules.

(2) An application must be made on a form prescribed by the state registrar setting forth the facts prescribed in subrule (3) of this rule and sworn to before a notary by the individual whose birth is to be registered if the registrant is 18 years of age or older or an emancipated minor, and is competent to sign and swear to the accuracy of the facts stated on the application. Otherwise, the application must be sworn to by any of the following:

(a) One of the parents.

(b) The legal guardian.

(d) In the absence, inability, or refusal of a parent or guardian, any next of kin 18 years of age or older who is at least 10 years or older than the registrant acting for the registrant and having personal knowledge of the facts of the live birth.

(3) The minimum facts to be established for a delayed registration of birth are as follows:

(a) The full name of the registrant at the time of birth.

(b) The date of birth and place of birth of the registrant.

(d) The full name and birthplace of the registrant's father, except that if the mother was not married to the father at the time of birth or within 300 days preceding the birth, the name of the father must not be entered on the delayed registration of birth, unless there is filed with the department a properly executed affidavit of parentage, a true or certified copy of an acknowledgment of paternity filed in a court, or a true or certified copy of a court determination of paternity.

(4) The application must be accompanied by the fee prescribed by law and documentary evidence as prescribed by these rules.

(5) The official notice of the state registrar that the birth cannot be located in the files of the state registrar must accompany the application, except that this notice is not necessary for applications received within 1 year after the date the statement was issued.

(6) Each of the facts prescribed by subrule (3) of this rule must be supported by any of the following:

(a) For individuals over the age of 10, 3 pieces of acceptable documentary evidence that establish to the satisfaction of the state registrar the facts and date of the live birth. Documents must have been established at least 10 years before the date of application.

(b) For individuals 10 and under, 2 pieces of acceptable documentary evidence that establish to the satisfaction of the state registrar the facts of birth. Documents must be dated at least 1 year before the date of application or within the first year of life.

(c) At least 1 piece of documentary evidence that establishes to the satisfaction of the state registrar the names of the mother and father.

(7) Documents submitted in support of a request to establish a delayed birth certificate that contain signs of erasure, alterations, or changes to the pertinent information must not be accepted.

(8) The state registrar shall review each application and the evidence submitted in support of the application. When the documentary evidence is insufficient to support the application, the state registrar may require the submission of additional documentary evidence. The state registrar shall dismiss an application when additional evidence requested or the required fee is not received within 1 year after the request for the additional evidence or the fee. When an application is dismissed, the state registrar shall send a written notice of dismissal to the applicant. The application fee submitted must be retained. The state registrar shall deny an application when the applicant is not eligible to apply or when the applicant cannot provide satisfactory documentary evidence in support of the application. When an application is denied, a written notice of denial must be forwarded to the applicant indicating the reason for the denial. The application fee submitted must be retained, except when the applicant is not eligible to apply.

(9) If, after review of the application and the evidence, the state registrar is satisfied that the evidence supports the request, the state registrar shall prepare a delayed registration of birth on a form prescribed by the state registrar and place the record in the active files of the system of vital statistics. A delayed registration of birth must show on its face a summary statement of the evidence submitted in support of the delayed registration of birth and be marked "delayed." A copy of the delayed registration of birth must be forwarded to the local registrar for the area where the birth occurred.

(10) If the state registrar becomes aware that a delayed registration of birth prepared by the department is invalid or that the evidence received in support of the delayed birth certificate is false or invalid, the delayed registration of birth must be rescinded. The state registrar shall notify the local registrar of the rescission of the record and instruct the local registrar to remove the record from the files.

(11) A delayed registration of birth cannot be registered for a deceased individual.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 325.3221 Delayed registration of death; application; establishment; evidence; review of application and evidence; dismissal or denial of application; preparation and filing of registration; rescission of registration {#sec-r-325.3221 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3221}

Rule 21. (1) A next of kin of a deceased individual, the individual responsible for the medical certification of death, or the individual responsible for disposing of the deceased's body who has received an official notice from the state registrar that the death is not recorded in the office of a local registrar, or the state registrar may establish a delayed registration of death if the date of application is more than 1 year after the date the individual was pronounced dead.

(2) An application must be made on a form prescribed by the state registrar, set forth the minimum facts prescribed in subrule (3) of this rule, and be sworn to by the applicant before an official authorized to administer oaths.

(3) The minimum facts to be established are as follows:

(a) The full name of the deceased at the time of death.

(b) The sex of the deceased.

(d) The manner and cause of death as determined by a physician licensed to practice medicine in this state and the name and address of the physician.

(e) The date, place, and method of disposition of the body as recorded by an individual authorized by law to dispose of a dead body and that individual’s name and address.

(4) The application must be accompanied by the fee prescribed by law and documentary evidence prescribed by these rules.

(5) Documents submitted in support of a request to establish a delayed registration of death that contain signs of erasure, alterations, or changes to the pertinent information must not be accepted.

(6) The facts prescribed in subrule (3) of this rule must be supported by either of the following:

(a) A copy of pertinent medical records for the deceased or an affidavit by a physician licensed to practice medicine in this state that sets forth all the following:

(i) The full name of the deceased.

(ii) The date and place of death.

(iii) The manner of death.

(iv) The cause of death.

(v) The physician's address.

(b) An affidavit by an individual authorized by law to dispose of a dead body that sets forth all the following:

(i) The full name of the deceased.

(ii) The date, place, and method of disposal of the body.

(iii) The address of the individual disposing of the body.

(iv) Other personal facts identified on the application form that may be known to the affiant or copies of documents that support the facts.

(c) In all cases the affiant shall swear that the facts provided are based on pertinent records concerning the deceased that are in the possession of the affiant.

(7) The state registrar must review each application and the evidence submitted in support of the application. When the documentary evidence is insufficient to support the requested change, the state registrar may require the submission of additional documentary evidence. The state registrar shall dismiss an application when additional evidence requested or the required fee is not received within 1 year after the request for the additional evidence or fee. When an application is dismissed, the state registrar shall send a written notice of dismissal to the applicant. The application fee submitted must be retained. The state registrar shall deny an application when the applicant is not eligible to apply or when the applicant cannot provide satisfactory documentary evidence in support of the application. When an application is denied, a written notice of denial must be forwarded to the applicant indicating the reason for the denial. The application fee submitted must be retained, except when the applicant is not eligible to apply.

(8) If, after review of the application and the evidence, the state registrar is satisfied that the evidence supports the request, the state registrar shall prepare a delayed registration of death on a form prescribed by the state registrar and place the record in the active files of the system of vital statistics. A delayed registration of death must be marked "delayed." A copy of the delayed registration of death must be forwarded to the local registrar for the area where the death occurred.

(9) If the state registrar becomes aware that a delayed registration of death record prepared by the state registrar is invalid or that the evidence received in support of the delayed registration of death is false or invalid, the delayed registration of death must be rescinded. The state registrar must notify the local registrar of the rescission of the record and instruct the local registrar to remove the record from the files.

History

History: 1981 AACS; 2025 MR 9, Eff. April 30, 2025.

R 325.3231 to R 325.3236 Vital Records Documents; Public Inspection and Copying

Mich. Admin. Code R 325.3231 Definitions {#sec-r-325.3231 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3231}

DEPARTMENT OF COMMUNITY HEALTH

OFFICE OF THE STATE REGISTRAR

VITAL RECORDS INSPECTION AND DISCLOSURE

(By authority conferred on the department of public health by section 2888 and 2896 of Act No. 368 of the Public Acts of 1978, as amended, being SS333.2888 and 333.2896 of the Michigan Compiled Laws)

Rule 1. (1) As used in these rules:

(a) "Code" means Act No. 368 of the Public Acts of 1978, as amended, being S333.1101 et seq. of the Michigan Compiled Laws.

(b) "Heir" means any living relative of a deceased individual.

(i) Reference to the type of event.

(ii) The name of the registrant.

(iii) A reference to locate the record. Except that an index shall not contain the residence or mailing address of the registrant or informant.

(d) "Registrant" means the individual to whom the record pertains.

(2) The terms defined in part 28 of the code have the same meanings when used in these rules.

History

History: 1983 AACS.

Mich. Admin. Code R 325.3232 Indexes; availability for inspection {#sec-r-325.3232 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3232}

Rule 2. Indexes of marriage, divorce, or death records in the possession of a local registrar shall be made available for inspection by the public at times and places specified by each local registrar. Each local registrar shall, by public notice, specify the times and places indexes shall be available for inspection.

History

History: 1983 AACS.

Mich. Admin. Code R 325.3233 Lists of vital events {#sec-r-325.3233 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3233}

Rule 3. (1) Upon request, the state registrar or a local registrar may prepare a listing of marriages, divorces, or deaths containing any information of the record, except for the mailing or residence address of the registrant or informant and information identified as being collected for statistical or health purposes.

(2) The local registrar or state registrar may charge a fee in accordance with section 2891 of the code for preparing the list and providing a copy of the list or for providing a copy of a marriage, divorce, or death index prepared in accordance with subrule (1) of this rule.

History

History: 1983 AACS.

Mich. Admin. Code R 325.3234 Vital record documents; public inspection and copying {#sec-r-325.3234 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3234}

Rule 4. (1) An original vital record document registered at the office of the state registrar shall not be open to public inspection.

(2) Vital record documents on file at the office of a local registrar shall not be open to public inspection, except when a local registrar determines that a person eligible to receive a copy of a selected individual record has a legitimate research interest in inspecting the record.

(3) A local registrar may allow any person who is eligible to receive a copy of a record and who has a legitimate research interest in inspecting the record to inspect vital records books of marriages and deaths when the individual record of interest cannot be located in the place specified in the index or when there is a possibility that the document may not have been properly recorded or indexed.

(4) A local registrar may restrict access to records or indexes which are determined to be in such a state of deterioration that public use of the index or document may result in damage to the record or index.

(5) Except as provided in subrule (2) or (3) of this rule or by law, a local registrar shall not allow persons to inspect or copy information from vital record documents on file in the office of the local registrar.

(6) A local registrar or the state registrar shall release a copy or certified copy of a vital record or information contained in a vital record only to a person who is eligible to receive a copy or certified copy of a vital record or information contained in a vital record as specified in sections 2882, 2883, and 2884 of the code.

(7) A local registrar shall not permit the inspection or copying of information collected for statistical or health purposes from original vital records documents in his or her possession before transmission to the state registrar, except upon written permission from the state registrar.

History

History: 1983 AACS.

Mich. Admin. Code R 325.3235 Vital records; security; procedures {#sec-r-325.3235 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3235}

Rule 5. (1) A vital record registered at the office of the state registrar or on file with a local registrar shall be maintained in a locked or secured area when not under the supervision of office personnel.

(2) A local registrar shall establish written minimum security procedures governing access to vital records. A copy of the procedures shall be forwarded to the state registrar for approval.

History

History: 1983 AACS.

Mich. Admin. Code R 325.3236 Misuse of documents or attempts to obtain vital records by ineligible individuals; notification of state registrar by local registrar {#sec-r-325.3236 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3236}

Rule 6. A local registrar shall notify the state registrar in writing of any suspected misuse of vital records or any attempt to obtain a vital record by an individual who is not eligible to receive a copy or certified copy of the requested document.

History

History: 1983 AACS.

R 325.3271 to R 325.3276 Hearing Screening of Preschool and School-age Children

Mich. Admin. Code R 325.3271 Definitions {#sec-r-325.3271 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3271}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH PROGRAMS ADMINISTRATION

BUREAU OF CHILDREN AND FAMILY PROGRAMS

HEARING SCREENING OF PRESCHOOL AND SCHOOL-AGE CHILDREN

(By authority conferred on the department of public health by sections 2226(d), 2233, and 9321 of 1978 PA 368 and section 9 of 1965 PA 380, MCL §333.2226(d), 333.2233, 333.9321, and 16.109 and Executive Reorganization Order No. 1996-1, MCL 330.3101)

Rule 1. (1) As used in these rules:

(a) "Clinic" means a place where hearing screening is done, such as a school, a nursery, or a local health department facility.

(b) "Code" means 1978 PA 368, MCL 333.1101 et seq.

(c) "Screening" means the overall procedure which employs a number of tests designed to determine if an individual is at risk of hearing loss.

(d) "Test" means an individual specific procedure used to determine if an individual is at risk of hearing loss.

(2) Words or phrases used in the code have the same meanings when used in these rules.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.3272 Hearing screening {#sec-r-325.3272 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3272}

Rule 2. (1) Hearing screening for children who are 3 years old or older shall include audiometric tests.

(2) The procedures used in hearing screening shall be approved by the department.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.3273 Hearing screening and tests; administration by properly trained and qualified individuals {#sec-r-325.3273 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3273}

Rule 3. Public health hearing screening tests shall be given by individuals trained and qualified to properly administer the screening tests. Their training and qualifications shall be approved by the department.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.3274 Frequency of screening {#sec-r-325.3274 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3274}

Rule 4. (1) Hearing screening of preschool children shall be done at least once during the ages of 3 to 5 years.

(2) Hearing screening of school-age children shall be done at least in grades K, 2, and 4, or screening shall be done at least biennially starting at age 5 and continuing at least to age 10 years.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.3275 Follow-up notices {#sec-r-325.3275 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3275}

Rule 5. The statement required by section 9305 of the code shall be a written statement that an ear examination by a physician is required. The statement shall be given or sent to the parent or guardian of the child.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.3276 Reporting results of hearing screening {#sec-r-325.3276 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.3276}

Rule 6. A local health department shall report to the department the status of hearing screening within its jurisdiction. The report shall be made on a form provided by the department.

History

History: 1981 AACS; 2004 AACS.

R 325.8051 to R 325.8057 Disinterment - Reinterment

Mich. Admin. Code R 325.8051 Discovery of remains; notification of police required; exception {#sec-r-325.8051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8051}

DEPARTMENT OF COMMUNITY HEALTH

OFFICE OF THE STATE REGISTRAR

DISINTERMENT--REINTERMENT

(By authority conferred on the department of public health by section 2853 of Act No. 368 of the Public Acts of 1978, as amended, being S333.2853 of the Michigan Compiled Laws)

Rule 1. A person who inadvertently discovers a burial or parts of a human skeleton shall immediately notify the police authority of the jurisdiction where the remains are found. If preliminary inspection by the police authority indicates that the remains are those of a prehistoric or historic native American, the state archaeologist of the Michigan history division, department of state, shall be immediately notified of the finding. This rule does not apply to archaeological excavations conducted by representatives of established scientific institutions or societies.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8052 Disinterment permit; application; fee {#sec-r-325.8052 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8052}

Rule 2. (1) A request for a disinterment permit shall be made to the local health officer in whose district the cemetery is located, and the request shall be made on an affidavit which is signed by a licensed funeral director and by a person or persons as follows:

(a) The surviving spouse.

(b) If no surviving spouse, then by all surviving children.

(d) If no surviving parents, then by all surviving brothers and sisters.

(2) The request shall be accompanied by a fee established by the local health department pursuant to section 2444 of Act No. 368 of the Public Acts of 1978, as amended, being S333.2444 of the Michigan Compiled Laws.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8053 Affidavit content {#sec-r-325.8053 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8053}

Rule 3. An affidavit shall contain all of the following information:

(a) The name and address of the licensed funeral director to whom the permit is to be issued.

(b) The name and address of the person petitioning for the permit.

(d) The name of the deceased.

(e) The present location of the grave, including the lot number, the section number, or other location, such as a location in a mausoleum.

(f) Reinterment location.

(g) Relationship of petitioner to deceased.

(h) Reason for disinterment.

(i) Approval of all persons who may have a claim for the deceased as specified in R 325.8052.

(j) Written consent of the lot or burial space owner or owners, if other than petitioner.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8054 Local health officer; duties {#sec-r-325.8054 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8054}

Rule 4. The local health officer or his or her designated representative shall do all of the following:

(a) Review the affidavit for disinterment-reinterment.

(b) Issue the disinterment-reinterment permit if the consent required by R 325.8052(1) has been obtained, or deny the disinterment-reinterment permit if the consent required by R 325.8052(1) has not been obtained.

(c) Provide instructions or guidance to the funeral director on the handling of the disintered body which is necessary to protect the health of the public and those handling the disintered body.

(d) Retain the affidavit for a period of not less than 5 years.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8055 Disinterment of cremated remains; opening casket; permit not required {#sec-r-325.8055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8055}

Rule 5. (1) A permit is not required to disinter cremated remains. A request to disinter cremated remains may be made to the cemetery by the next surviving kin, as designated in R 325.8052, on an affidavit described in R 325.8053. The affidavit shall be maintained as part of the permanent records of the cemetery from which the cremated remains are removed.

(2) A permit is not required to open a casket to remove an article or to place an article in a casket.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8056 Cemetery retention of permit {#sec-r-325.8056 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8056}

Rule 6. A duplicate copy of the permit shall be maintained as part of the permanent records of the cemetery from which the deceased was removed.

History

History: 1982 AACS.

Mich. Admin. Code R 325.8057 Transportation of disintered body {#sec-r-325.8057 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.8057}

Rule 7. A disintered body shall not be accepted for transportation by common or contract carrier unless it has been enclosed in a container which insures against leakage, offensive odors, and other menaces to the public health and safety. A disintered body may be transported by private vehicle, under the supervision of a licensed funeral director, if enclosed in any suitable container which insures against leakage, offensive odors, and other menaces to the public health and safety. The licensed funeral director in charge of disinterment shall be responsible for the proper conduct of the disinterment and removal.

History

History: 1982 AACS.

R 325.9031 to R 325.9031 Definition of Infectious Agent

Mich. Admin. Code R 325.9031 Definition; "infectious agent." {#sec-r-325.9031 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9031}

DEPARTMENT OF COMMUNITY HEALTH

BUREAU OF EPIDEMIOLOGY

DEFINITION OF "INFECTIOUS AGENT"

(By authority conferred on the department of public health by sections 2226, 2233, and 2843b of Act No. 368 of the Public Acts of 1978, as amended, being SS333.2226, 333.2233, and 333.2843b of the Michigan Compiled Laws)

Rule 1. For purposes of section 2843b of Act No. 368 of the Public Acts of 1978, as amended, being S333.2843b of the Michigan Compiled Laws, "infectious agent" means any of the following diseases or organisms:

(a) Acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection.

(b) Anthrax.

(d) Cholera.

(e) Creutzfeldt-Jakob disease.

(f) Diphtheria.

(g) [si=?]Campylobacter species[ri=?].

(h) [si=?]Cryptosporidium species[ri=?].

(i) [si=?]Entamoeba histolytica[ri=?](amebic dysentery).

(j) [si=?]Giardia lamblia[ri=?].

(k) [si=?]Salmonella species,[ri=?] including typhoid fever.

(l) [si=?]Shigella species[ri=?].

(m) [si=?]Yersinia enterocolitica[ri=?].

(n) Hepatitis, viral, any type.

(o) [si=?]Group A streptococcus[ri=?].

(p) Plague.

(q) Poliomyelitis, acute infectious.

(r) Rat-bite fever, spirillum or [si=?]streptobacillary[ri=?].

(s) Relapsing fever.

(t) Rickettsial fevers, including Rocky Mountain spotted fever and typhus.

(u) Syphilis, primary and secondary.

(v) [si=?]Mycobacterium tuberculosis[ri=?].

(w) Tularemia ([si=?]Pasteurella tularesis[ri=?]).

(x) Viral hemorrhagic fevers, including Lassa fever, Ebola disease, and Marburg virus disease.

(y) Meningococcus ([si=?]Neisseria meningitidis[ri=?]).

(z) Leprosy (Hansen's disease; [si=?]Mycobacterium leprae[ri=?]).

(aa) Leptospirosis.

(bb) Trypanosomiasis, such as Chagas' disease and African sleeping sickness.

(cc) Rabies.

History

History: 1987 AACS.

R 325.9050 to R 325.9057 Cancer Reporting

Mich. Admin. Code R 325.9050 Registry {#sec-r-325.9050 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9050}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

OFFICE OF THE STATE REGISTRAR

CANCER REPORTING

(By authority conferred on the department of health and human services by section 2619 of 1978 PA 368, MCL 333.2619)

Rule 9050. (1) The department shall establish a registry to record cases of cancer and other specified tumorous and precancerous diseases that occur in the state. The registry shall include information concerning these cases as the department considers necessary and appropriate to conduct epidemiologic surveys of cancer and cancer-related diseases in the state.

(2) Each diagnosed case of cancer and other specified tumorous and precancerous diseases shall be reported to the department pursuant to subrule (4) of this rule, or reported to a cancer reporting registry if the cancer reporting registry meets standards established pursuant to subrule (4) of this rule by a reporting entity as defined in R 325.9051 to ensure the accuracy and completeness of the reported information. A reporting entity required to report a diagnosis pursuant to subrule (4) of this rule may elect to report the diagnosis to the state through an existing cancer registry only if the registry meets minimum reporting standards established by the department.

(3) The department shall maintain comprehensive records of all reports submitted pursuant to this rule. These reports shall be subject to the same requirements of confidentiality as provided in section 2631 of the public health code, 1978 PA 368, MCL 333.2619 for data or records concerning medical research projects.

(4) The director shall provide for all of the following:

(a) A list of tumorous and precancerous disease other than cancer to be reported pursuant to subrule (2) of this rule.

(b) The quality and manner in which the cases and other information described in subrule (1) of this rule are reported to the department.

(c) The terms and conditions under which records disclosing the name and medical condition of a specific individual and kept pursuant to this rule are released by the department.

(5) This rule does not require an individual to submit to medical or department examination or supervision.

(6) The department may contract for the collection and analysis of, and research related to, the epidemiologic data required by this rule.

(7) Within 2 years after the effective date of these rules, the department shall begin evaluating the reports collected pursuant to subrule (2) of this rule. The department shall publish and make available to the public reports summarizing the information collected.

(8) Reporting pursuant to subrule (2) of this rule shall begin the next calendar year after the effective date of this rule.

History

History: 2004 AACS; 2016 AACS.

Mich. Admin. Code R 325.9051 Definitions {#sec-r-325.9051 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9051}

Rule 9051. As used in these rules:

(a) "Primary brain-related tumor" means a primary tumor, whether malignant or benign, of the brain, meninges, spinal cord, cauda equina, a cranial nerve or nerves, or any part of the central nervous system or of the pituitary gland, pineal gland, or craniopharyngeal gland.

(b)"Cancer" means all diagnoses with a behavior code of 2 (carcinoma in situ) or 3 (malignant primary site) which is listed in publication found in department policy and made available to the public including carcinomas of skin of the vagina, prepuce, clitoris, vulva, labia, penis, and scrotum but excluding basal, epithelial, papillary, and squamous cell carcinomas of the skin.

(d) “Reporting entity or reporting entities” means an individual, facility, or other entity described in these rules as required to report patient information with a diagnosed cancer or other reportable condition to the state cancer registry. A reporting entity includes the following:

(i) Physician as defined in sections 17001 and 17501 of the public health code, 1978 PA 368, MCL 333.17001 and 333.17501.

(ii) Dentist as defined in in section 16601 of the public health code, 1978 PA 368, MCL 333.16601.

(iii) Hospital as defined in section 20106 of the public health code, 368 PA 1978 of the public health code, MCL 333.20106.

(iv) Clinic defined as an outpatient facility that provides advice, counseling, diagnosis, treatment, surgery, care, or services relating to the preservation or maintenance of health.

(v) Clinical laboratory as defined in section 20104 of the public health code, 1978 PA 368, MCL 333.20104.

History

History: 1985 AACS; 2004 AACS; 2016 AACS.

Mich. Admin. Code R 325.9052 Reportable diagnoses {#sec-r-325.9052 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9052}

Rule 9052. (1) Cancer diagnoses, diagnoses of benign brain-related tumors, and any tumorous and precancerous diseases otherwise required to be reported by state or federal law shall be reported to the department in a manner consistent with these rules and procedures issued by the department.

(2) Diagnoses shall be reported by all reporting entities.

(3) A reporting entity may elect to report cases through a hospital or regional cancer registry that meets the rules set by the department.

(4) Reports shall be submitted within 180 days of a diagnosis on a form prescribed or approved by the department, except for reports forwarded on electronic media.

(5) Reports submitted on electronic media shall meet data quality, format, and timeliness standards prescribed by the department.

History

History: 1985 AACS; 2004 AACS; 2016 AACS.

Mich. Admin. Code R 325.9053 Quality assurance {#sec-r-325.9053 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9053}

Rule 3. (1) For the purpose of assuring the quality of submitted data, each reporting entity shall allow the department to inspect such parts of a patient's medical records as are necessary to verify the accuracy of submitted data.

(2) A reporting entity which meets the standards of quality and completeness set by the department shall be subject to inspection not more than once every 2 years for the purpose of assessing the quality and completeness of reporting from the entity.

(3) A reporting entity shall, upon request of the department, supply missing information, if known, or clarify information submitted to the department.

(4) Upon mutual agreement between a reporting entity and the department, the reporting entity may elect to submit copies of medical records instead of inspection. Each copy of a medical record or part thereof submitted to the department pursuant to this rule shall be used only for verification of corresponding reported data, shall not be recopied by the department, and shall be kept in a locked file cabinet when not being used. Such copies shall be destroyed promptly following verification of the corresponding reported data or, if the reported data appears to be inaccurate, following clarification or correction of the reported data.

(5) Both of the following provisions shall be complied with to preserve the confidentiality of each patient's medical records:

(a) Each reporting entity shall provide to the department, for inspection only, all of the following records and reports:

(i) Reports of tissue analyses which have been performed for the purpose of determining the presence or absence of malignant disease.

(ii) Reports of radiological examinations performed for the purpose of determining the presence or absence of malignant disease.

(iii) Reports of diagnoses of malignant disease and notations of the reasons for such diagnoses, including both the primary clinician's reports and consultation reports.

(iv) Those parts of medical records which contain the specific information required to be reported.

(b) A reporting entity shall not be required by this rule to allow inspection of any part of any patient's medical record other than those parts listed in subrule (3) of this rule. A reporting entity may allow the inspection of medical records from which parts, other than those specified, have been deleted, masked, crossed out, or otherwise rendered illegible.

History

History: 1985 AACS.

Mich. Admin. Code R 325.9054 Confidentiality of reports {#sec-r-325.9054 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9054}

Rule 4. (1) The department shall maintain the confidentiality of all reports of cancer submitted to the department and shall not release such reports, or any information which, because of name, identifying number, mark, or description, can be readily associated with a particular individual, except in accordance with subrules (2), (3), (4), and (5) of this rule. The department shall not release any information that would indicate whether or not the name of a particular person is listed in the cancer registry, except in accordance with subrules (2), (3), (4), and (5) of this rule.

(2) A report of cancer submitted to the department concerning a particular individual, and any other information maintained in the cancer reporting system which, because of name, identifying number, mark, or description, can be readily associated with a particular individual, shall be released as follows:

(a) To the particular individual upon compliance with both of the following provisions:

(i) Receipt of a written request which is signed by the particular individual and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Presentation by the particular individual of suitable identification as required by subrule (4) of this rule.

(b) If the particular individual is a minor, to a parent of the particular individual upon compliance with all of the following provisions:

(i) Receipt of a written request which is signed by the parent and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the parent of suitable identification as required by subrule (4) of this rule.

(i) Receipt of a written request which is signed by the court-appointed guardian, executor, or administrator and which is witnessed or notarized as required by subrule (3) of this rule.

(ii) Receipt of a certified copy of the order or decree which appoints the guardian, executor, or administrator.

(iii) Presentation by the guardian, executor, or administrator of suitable identification as required by subrule (4) of this rule.

(d) To an attorney or other person designated by the particular individual upon compliance with both of the following provisions:

(ii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(e) To an attorney or other person designated by the court-appointed guardian of the particular individual or designated by the executor or administrator of the estate of the particular individual upon compliance with all of the following provisions:

(ii) Receipt of a certified copy of the order or decree which appoints the guardian, executor, or administrator.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(f) If the particular individual is a minor, to an attorney or other person designated by the parent of the particular individual upon compliance with all of the following provisions:

(ii) Receipt of a certified copy of the birth certificate of the particular individual.

(iii) Presentation by the attorney or other person of suitable identification as required by subrule (4) of this rule.

(3) Every written request for the release of information submitted pursuant to subrule (2) of this rule shall be signed by the person making the written request. Such signature shall comply with either of the following provisions:

(b) Be notarized by a notary public or magistrate.

(5) The director of the department may, pursuant to R 325.9055, release information from the cancer reporting system to an authorized representative of a study or research project reviewed by the scientific advisory panel and approved by the director. The department shall not release any part of a patient's medical record obtained pursuant to R 325.9053.

History

History: 1985 AACS.

Mich. Admin. Code R 325.9055 Scientific advisory panel; release of information for research {#sec-r-325.9055 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9055}

Rule 5. (1) The director of the department shall appoint a scientific advisory panel of not less than 3 scientists to review research proposals whereby a release of information maintained by the department which identifies an individual reported to have a diagnosis of cancer is required.

(2) All research proposals which require the release of information that identifies individuals with reported diagnoses of cancer shall be reviewed by the scientific advisory panel.

(3) The panel shall, in writing, advise the director concerning the merits of the study.

(4) The release of information for research which identifies individuals with reported diagnoses of cancer shall be subject to the terms and conditions set by the department. Such study or research project shall not publish the name of any individual who is or was the subject of a report of cancer submitted to the department, and such study or research project shall not release any identifying number, mark, or description which can be readily associated with an individual who is or was the subject of a report of cancer submitted to the department.

(5) A reporting entity shall, upon notification that the director has approved a research project, provide to the department or a researcher named by the director the name of the primary physician responsible for the medical care of persons selected for the research study as indicated in the reporting entity's records.

History

History: 1985 AACS.

Mich. Admin. Code R 325.9056 Exchange of records {#sec-r-325.9056 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9056}

Rule 6. The department, by agreement, may transmit transcripts or copies of reports of cancer diagnoses to state or national cancer registries when the reports relate to residents of other states or countries. The agreement shall require that the transcripts or records be used for statistical purposes only as specified in the agreement and that the identity of a person subject to the report shall not be released.

History

History: 1985 AACS.

Mich. Admin. Code R 325.9057 Rescinded {#sec-r-325.9057 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.9057}

History

History: 1985 AACS; 2016 AACS.

R 325.13001 to R 325.13009 Local Health Personnel

Mich. Admin. Code R 325.13001 Definitions {#sec-r-325.13001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13001}

DEPARTMENT OF COMMUNITY HEALTH

OFFICE OF PUBLIC HEALTH ADMINISTRATOR

LOCAL HEALTH PERSONNEL

(By authority conferred on the director of public health by section 2495 of 1978 PA 368, MCL 333.2495.

Rule 1. As used in these rules:

(a) "Code" means 1978 PA 368, MCL 333.1101.

(b) "Health officer" means the administrative officer of a city, county, district, or associated health department who is appointed by the local governing entity or, in the case of a district health department, by the district board of health and who is responsible for the planning, implementation, and evaluation of a public health program designed to prevent disease and disability and to promote health. A health officer shall be a medical health officer or administrative health officer. If the health officer is not a physician, a medical director shall also be employed who is responsible to the health officer for medical decisions.

(d) "Medical director" means a physician who qualifies as a medical health officer but who is employed by a local governing entity or, in the case of a district health department, by the district board of health to provide direction in the formulation of medical public health policy and program operation. A medical director shall be responsible for developing and carrying out medical policies, procedures, and standing orders and for advising the administrative health officer on matters related to medical specialty judgments.

(e) "Public health administrator" means a person who is responsible for developing and implementing good administrative practices and policies for a local health department and its programs.

(f) "Public health physician advisor" means a physician who is responsible for providing public health medical consultation and advice to persons serving under provisional or acting appointments as medical health officers, administrative health officers, or medical directors.

History

History: 1980 AACS; 2011 AACS.

Mich. Admin. Code R 325.13002 Medical health officer; qualifications {#sec-r-325.13002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13002}

Rule 2. A medical health officer shall be a physician licensed in Michigan as an M.D. or D.O. who complies with 1 of the following requirements:

(a) Is board certified in preventive medicine or public health.

(b) Has an M.P.H. or M.S.P.H. degree and not less than 2 years of full-time public health practice.

(c) Has an unexpired provisional appointment issued by the department under the authority of MCL 325.2495, provided the appointment was issued before the effective date of these rules.

History

History: 1980 AACS; 2011 AACS.

Mich. Admin. Code R 325.13003 Administrative health officer; qualifications {#sec-r-325.13003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13003}

Rule 3. An administrative health officer shall comply with 1 of the following requirements:

(a) Have an M.P.H. or M.S.P.H. degree and 3 years of full-time public health administrative experience.

(b) Have a related graduate degree and 5 years of full-time public health administrative experience.

(c) Have a bachelor's degree and 8 years of full-time public health experience, 5 years of which shall have been in the administration of a broad range of public health programs.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13004 Medical director; qualifications {#sec-r-325.13004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13004}

Rule 4. A medical director shall have the same qualifications as a medical health officer.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13004a Medical director; requirements {#sec-r-325.13004a omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13004a}

Rule 4a. A medical director shall comply with all of the following requirements:

(a) Except as provided in subdivision (c) of this rule, a medical director shall devote his or her full time to the needs of a local health department.

(b) For purposes of this rule, "full time" means 32 hours or more per week.

(c) If a local health department serves a population of not more than 250,000 and cannot obtain full time medical direction, the time may be reduced to not less than 16 hours per week. This exception does not apply if the medical director is covering 3 or more local health departments, even if the combined population served is not more than 250,000. Medical directors covering 3 or more local health departments must be full time, regardless of the total combined population.

History

History: 2011 AACS.

Mich. Admin. Code R 325.13005 Public health administrator; qualifications {#sec-r-325.13005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13005}

Rule 5. A public health administrator shall comply with either of the following requirements:

(a) Have an M.P.H. or M.S.P.H. degree, or equivalent graduate degree, and 3 years of full-time administrative experience.

(b) Have a bachelor's degree and 5 years of full-time public health administrative experience.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13006 Public health physician advisor; qualifications {#sec-r-325.13006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13006}

Rule 6. A public health physician advisor shall be a physician licensed in Michigan as an M.D. or D.O. who complies with either of the following requirements:

(a) Is board certified in preventative medicine or public health.

(b) Has an M.P.H. or M.S.P.H. degree and 3 years of public health experience.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13007 Provisional appointments; medical health officers; administrative health officers; medical directors {#sec-r-325.13007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13007}

Rule 7. (1) A provisional appointment of a medical health officer, medical director, or administrative health officer may be made for a period of not more than 3 years, if an arrangement satisfactory to the state health director is made for the fulfillment of the appropriate qualifications specified in these rules, and if during such time a qualified public health physician advisor is appointed.

(2) A provisional medical health officer or medical director shall be a physician licensed in Michigan as an M.D. or D.O., but with less than the necessary qualifications for permanent appointment as specified in these rules.

(3) A provisional administrative health officer shall have an M.P.H., M.S.P.H., or equivalent graduate degree, or a bachelor's degree in a health-related field and not less than 3 years of public health experience.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13008 Acting health officers; medical directors; appointments {#sec-r-325.13008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13008}

Rule 8. (1) If a health officer position is vacant, the local governing entity or in the case of a district health department the district board of health shall appoint an acting health officer. If a medical director position is vacant, the health officer shall appoint an acting medical director. Such appointments shall be for 6 months, subject to the approval of the state health director, and may be renewed upon his approval.

Approval shall be based on the performance of the individual and the efforts being made to hire a qualified, permanent, full-time person.

(2) If the person appointed to the position of acting health officer or acting medical director does not meet the appropriate qualifications specified in these rules, an arrangement shall be made for consultation and advice. This may be provided without charge by the state department of public health or, subject to approval of the state health director, through local arrangement by a person meeting the appropriate qualifications.

History

History: 1980 AACS.

Mich. Admin. Code R 325.13009 Rescission {#sec-r-325.13009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13009}

Rule 9. R 327.47 of the Michigan Administrative Code, appearing on pages 7918 and 7919 of the 1979 Annual Supplement to the Code, is rescinded.

History

History: 1980 AACS.

R 325.13091 to R 325.13096 Vision Screening and of Preschool and School-age Children

Mich. Admin. Code R 325.13091 Definitions {#sec-r-325.13091 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13091}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH PROGRAMS ADMINISTRATION

BUREAU OF CHILDREN AND FAMILY PROGRAMS

VISION SCREENING OF PRESCHOOL AND SCHOOL-AGE CHILDREN

(By authority conferred on the department of public health by sections 2226(d), 2233, and 9321 of 1978 PA 368 and section 9 of 1965 PA 380, MCL 333.2226(d),333.2233, 333.9321, and 16.109 and Executive Reorganization Order No.

1996-1, MCL 330.3101)

Rule 1. (1) As used in these rules:

(a) "Clinic" means a place where vision screening is done, such as a school, a nursery, or a local health department facility.

(b) "Code" means 1978 PA 368, MCL 333.1101 et seq.

(c) "Screening" means the overall procedure which employs a number of tests designed to determine if an individual should be referred for a professional eye examination.

(d) "Test" means an individual specific procedure used to determine if an individual should be referred for a professional eye examination.

(2) The terms defined in the code have the same meaning when used in these rules.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.13092 Vision tests {#sec-r-325.13092 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13092}

Rule 2. (1) Vision tests of preschool children who have not yet registered for the first time in school shall include tests for monocular and binocular visual acuity and for eye muscle function.

(2) Vision tests for school-age children shall include tests for monocular visual acuity and for eye muscle function.

(3) The procedures used in vision screening and testing shall be approved by the department.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.13093 Vision technician training {#sec-r-325.13093 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13093}

Rule 3. Public health vision screening and vision tests shall be given by individuals trained to properly administer the screening and tests. The method of their training shall be approved by the department.

History

History: 1981 AACS.

Mich. Admin. Code R 325.13094 Frequency of screening {#sec-r-325.13094 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13094}

Rule 4. (1) Vision screening of preschool children shall be done at least once during the ages 3 to 5 years.

(2) Vision screening of school-age children shall, at a minimum, be done in grades 1, 3, 5, 7, 9, or grades 1, 3, 5, 7 and in conjunction with driver training. For school children who are not in graded programs, screening shall be done biennially starting at age 6.

History

History: 1981 AACS; 2004 AACS.

Mich. Admin. Code R 325.13095 Follow-up notices {#sec-r-325.13095 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13095}

Rule 5. The statement required by section 9305 of the code shall be a written statement that an eye examination by an ophthalmologist or optometrist is required. The statement shall be given or sent to the parent or guardian of the child.

History

History: 1981 AACS.

Mich. Admin. Code R 325.13096 Vision screening or test results {#sec-r-325.13096 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.13096}

Rule 6. Copies of the results of the vision screening or testing shall be forwarded to the department on a monthly basis within 30 days after the screening or testing is administered.

History

History: 1981 AACS.

R 325.22101 to R 325.22217 Emergency Medical Services – Life Support Agencies and Medical Control

Mich. Admin. Code R 325.22101 Definitions; A to D {#sec-r-325.22101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EMS TRAUMA AND PREPAREDNESS

EMERGENCY MEDICAL SERVICES - LIFE SUPPORT AGENCIES AND

MEDICAL CONTROL

(By authority conferred on the director of the department of health and human services by sections 2233, 20910, and 20975 of the public health code, 1978 PA 368, MCL 333.2233, 333.20910, and 333.20975, and Executive Reorganization Order No.

2015-1, MCL 400.227)

PART 1. GENERAL PROVISIONS

Rule 101. As used in these rules:

(a) "Accountable" means ensuring compliance on the part of each life support agency or emergency medical services personnel in carrying out emergency medical services based upon protocols established by the medical control authority and approved by the department.

(b) “Air ambulance service” means providing at least advanced life support services utilizing an air ambulance or ambulances that operate in conjunction with a base hospital or hospitals. Air ambulance service may also include any of the following:

(i) Searches.

(ii) Emergency transportation of any of the following:

(A) Drugs.

(B) Organs.

(D) Equipment.

(E) Personnel.

(c) “Back-up air ambulance” means an air ambulance that is used to provide air ambulance services if the primary air ambulance is not available to provide air ambulance services.

(d) "Board certified in emergency medicine" means current certification by the American Board of Emergency Medicine, the American Board of Osteopathic Emergency Medicine, or other organization approved by the department that meets the standards of these organizations.

(e) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(f) "Designated event” means a temporary event, such as an air show, of no more than 7 days in duration that requires full-time, on-site availability of an air ambulance.

(g) Direct communication" means a communication methodology that ensures medical control authority supervision of a life support agency when performing emergency medical services through any of the following methods:

(i) Direct interpersonal communications at the scene of the emergency.

(ii) Direct verbal communication by means of an approved two-way telecommunications system operating within the medcom requirements.

(iii) Protocols adopted by the medical control authority and approved by the department.

(iv) Other means approved by the department that are not in conflict with the medcom requirements.

(h) "Disciplinary action" means an action taken by the department against a medical control authority, a life support agency, or individual, or an action taken by a medical control authority against a life support agency or individual for failure to comply with the code, rules, or protocols approved by the department.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22102 Definitions; E to M {#sec-r-325.22102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22102}

Rule 102. As used in these rules:

(a) "Emergency medical services intercept" means an ambulance operation is transporting an emergency patient from the scene of an emergency, and requests patient care intervention from another transporting ambulance operation.

(b) "Emergency medical services telecommunications" means the reception and transmission of voice or data, or both, information in the emergency medical services system consistent with the medcom requirements prescribed by the department.

(c) “Field study status” means that process required under sections 20910 and 20956 of the code, MCL 333.20910 and 333.20956.

(d) "Fixed wing aircraft" means a non-rotary aircraft transport vehicle that is primarily used or available to provide patient transportation between health facilities and is capable of providing patient care according to orders issued by the patient's physician.

(e) "Ground ambulance" means a vehicle that complies with design and structural specifications, as that term is defined in these rules, and is licensed as an ambulance to provide transportation and basic life support, limited advanced life support, or advanced life support.

(f) "Hold itself out" means the agency advertises, announces, or charges specifically for providing emergency medical services, as that term is defined in the code.

(g) "License" means written authorization issued by the department to a life support agency and its life support vehicles to provide emergency medical services, as that term is defined in the code.

(h) "License expiration date" means the date of expiration indicated on the license issued by the department.

(i) "Licensure action" means probation, suspension, limitation, or removal by the department of a license for a life support agency or a life support vehicle for violations of the code or these rules.

(j) “Life support agency” means an ambulance operation, non-transport pre-hospital life support operation, air transport operation, or medical first response service.

(k) "Life support vehicle" means an ambulance, a non-transport, prehospital life support vehicle, or a medical first response vehicle, as that term is defined in the code.

(l) "Medcom requirements" means medical communication requirements for an emergency medical services communication system.

(m) "Medical control" means supervising and coordinating emergency medical services through a medical control authority, as prescribed, adopted, and enforced through department-approved protocols, within an emergency medical services system.

(n) "Medical control authority" means an organization designated by the department to provide medical control.

(o) "Medical control authority area" means the geographic area composed of a county, group of counties, or parts of an individual county, as designated by the department.

(p) "Medical control authority board" means a board appointed by the participating organizations to carry out the responsibilities and functions of the medical control authority.

(q) “Mutual aid” means a written agreement between 2 or more licensed life support agencies for the provision of emergency medical services when an agency is unable to respond to a request for emergency services, or an agreement according to the direction of a medical control authority in accordance with department approved protocols.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22103 Definitions; P to S {#sec-r-325.22103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22103}

Rule 103. As used in these rules:

(a) "Physician" means a doctor of medicine or doctor of osteopathy who possesses a valid license to practice medicine in this state.

(b) "Primary dispatch service area" means a service area.

(c) “Professional standards review organization” means a committee established by a life support agency or a medical control authority for the purpose of improving the quality of medical care.

(d) “Protocol” means a patient care standard, standing orders, policy, or procedure for providing emergency medical services that is established by a medical control authority and approved by the department under section 20919 of the code, MCL 333.20919.

(e) "Quality improvement program" means actions taken by a life support agency, medical control authority, or jointly between a life support agency and medical control authority with a goal of continuous improvement of emergency medical services in accordance with section 20919 of the code, MCL 333.20919.

(f) “Regional trauma network” means an organized group comprised of the local medical control authorities within a region, which integrates into existing regional emergency preparedness, and is responsible for appointing a regional trauma advisory council and creating a regional trauma plan.

(g) "Rotary aircraft" means a helicopter that is licensed under the code as an ambulance.

(h) "Service area" means the geographic area in which a life support agency is licensed to provide emergency medical services for responding to an emergency.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22104 Terms in code {#sec-r-325.22104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22104}

Rule 104. Terms defined in the code have the same meanings when used in these rules.

PART 2. LIFE SUPPORT AGENCIES-GENERAL

History

History: 2004 AACS.

Mich. Admin. Code R 325.22111 Life support agencies; general provisions {#sec-r-325.22111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22111}

Rule 111. (1) A life support agency shall not operate unless it is licensed by the department and operates under the direction of a medical control authority in accordance with department-approved protocols. A life support agency shall not operate at a level that exceeds its license or violates approved medical control authority protocols, unless otherwise allowed by part 209 of the code, MCL 333.20901 to 333.20979.

(2) A life support agency license shall do both the following:

(a) Communicate approved protocols to appropriate emergency medical services personnel.

(b) Provide emergency medical services in accordance with protocols established by the medical control authority and approved by the department.

(3) A life support agency application shall not be approved by the department unless signed by the medical director of each medical control authority responsible for the service area of the life support agency in accordance with R 325.22205(2). The medical director’s signature serves as confirmation that the medical control authority intends to provide medical control to the life support agency.

(4) A life support agency, except an aircraft transport operation, shall provide at least 1 life support vehicle for response to requests for emergency assistance on a 24hour-a-day, 7-day-a-week basis in accordance with its licensure level and medical control authority protocols.

(5) All life support agencies shall have a mutual aid agreement with another life support agency to ensure a response within the bounds of its service area.

(6) If no other life support agency is licensed in the medical control authority that meets this criteria, a mutual aid agreement may be entered into with a life support agency in an adjacent medical control authority. This does not preclude a life support agency from entering into additional mutual aid agreements with other life support agencies that are at a level of licensure that is less than their level of licensure.

(7) A life support agency shall notify the jurisdictional medical control authority of any of the following:

(a) Any investigations, disciplinary actions, or exclusions against the life support agency with the potential to impact service delivery.

(b) Action taken by an agency against emergency medical services personnel based on a violation of section 20958 of the code, MCL 333.20958.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22112 Patient destination; transporting agencies {#sec-r-325.22112 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22112}

Rule 112. (1) An ambulance operation, both ground and rotary, shall transport an emergency patient only to an organized emergency department located in and operated by 1 of the following:

(a) A hospital licensed under part 215 of the code, MCL 333.21501 to 333.21571.

(b) A freestanding surgical outpatient facility licensed under part 208 of the code, MCL 333.20801 to 333.20821, that operates a service for treating emergency patients 24hours-a-day, 7-days-a-week, and complies with medical control authority protocols.

(c) An off-campus emergency department of a hospital licensed under part 215 of the code, MCL 333.21501 to 333.21571, if the off-campus emergency department is available for treating emergency patients 24-hours-a-day, 7-days-a-week, complies with medical control authority protocols, and has obtained provider-based status under 42 CFR 413.65.

(2) An ambulance operation may transport to an alternate destination requested by the medical control authority and approved by the department under field study status.

History

History: 2004 AACS; 2014 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22113 Patient transfers; ground, rotary, aircraft transport {#sec-r-325.22113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22113}

Rule 113. (1) A person shall not transport a patient by stretcher, cot, litter, or isolette unless it is done in a licensed ambulance or aircraft transport vehicle. The life support agency transporting the patient shall require that any applicable departmentapproved protocols of the medical control authority are followed in accordance with section 20921(4) and (5) of the code, MCL 333.20921.

(2) An out-of-state service that is coming to this state to transfer a patient from a Michigan facility to a facility in another state or country shall be licensed or certified within its own jurisdiction.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22114 Professional standards review organization: data collection {#sec-r-325.22114 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22114}

Rule 114. Each life support agency shall establish a professional standards review organization for improving the quality of emergency medical services. As part of the professional standards review organization, each life support agency shall collect data to assess the need for and quality of emergency medical services. The data must be submitted to the medical control authority as determined by department-approved medical control authority protocol as required in R 325.22207.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22115 Use of descriptive words, phrases, symbols, advertising {#sec-r-325.22115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22115}

Rule 115. A person shall not use words, phrases, signs, symbols, or insignia that advertise or convey to the public that it provides emergency medical services or that it provides emergency medical services at a particular level unless it is licensed to do so.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22116 Inability to provide service {#sec-r-325.22116 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22116}

Rule 116. (1) If a life support agency cannot operate or staff at least 1 vehicle for response to an emergency within its service area in accordance with the code, these rules, or applicable protocols, then the life support agency shall do all the following:

(a) Immediately notify the department and medical control authority within its service area if it cannot provide at least 1 life support vehicle available for response to requests for emergency assistance on a 24-hour-a-day, 7-day-a-week basis in accordance with medical control authority protocols. This rule excludes air ambulance services and aircraft transport operations when the weather does not meet weather minimums outlined by a national accrediting body for air ambulance services.

(b) Immediately notify the department of a change that would alter the information contained on its application.

(c) Notify the dispatch center that regularly receives requests for its services, and other public safety agencies if appropriate, that it is not available to respond. The notification must advise the dispatch center of the period in which the agency will be out of service and the name of the agency that will be covering its service area.

(d) Notify life support agencies providing mutual aid.

(2) The life support agency shall comply with R 325.22202(4).

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22117 Maintenance of medical records {#sec-r-325.22117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22117}

Rule 117. In accordance with section 20175(1) of the code, MCL 333.20175, a life support agency shall maintain an accurate record of each case where care is rendered in a format approved by the medical control authority. Medical records must be maintained for a minimum of 7 years. However, records of minors must be maintained until they reach 25 years of age.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22118 Removal of vehicle from service; licensure; interagency vehicle transfer, lease, loan, from another life support agency {#sec-r-325.22118 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22118}

Rule 118. (1) A life support agency shall notify the department if it permanently removes a vehicle from service. If a vehicle is permanently removed from service, then the agency shall contact the department, in writing, within 30 days after removal. The notification must include the make, model, year, and vehicle identification number on an application prescribed by the department. The agency shall remove all oscillating, rotating, or flashing lights, and words, phrases, signs, symbols, or insignia that advertise or convey to the public that it provides emergency medical services before transfer or sale of the vehicle.

(2) A life support vehicle license is nontransferable. A life support agency may temporarily use a state licensed life support vehicle of another licensed life support agency through a loan. Vehicle loans may occur if mechanical problems prevent an agency from deploying its existing vehicles. The life support agency acquiring the vehicle shall do all the following:

(a) Notify the department of the loan within 3 business days on an application prescribed by the department.

(b) Replace an existing licensed vehicle with the loaned vehicle at the agency. The loaned vehicle must not increase the total number of vehicles the agency is licensed to use.

(d) Extend the loan 1 time for 60 additional calendar days if the agency notifies the department on an application prescribed by the department.

(3) A life support agency that obtains a vehicle through a gift, lease, transfer, or purchase from another life support agency shall comply with both of the following:

(a) Submit an application for the vehicle in accordance with R 325.22190.

(b) Comply with R 325.22181.

(4) A life support agency that gives, leases, transfers, or sells a vehicle to another life support agency shall comply with subrule (1) of this rule.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22119 Operational routine vehicle and equipment inspection {#sec-r-325.22119 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22119}

Rule 119. A life support agency shall have a written policy in place to ensure vehicles and equipment are operational and provide documentation of not less than a weekly inspection program for all vehicles, communications equipment, and mechanical and electronic medical equipment.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22120 Life support agencies licensed in other states or dominion of Canada {#sec-r-325.22120 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22120}

Rule 120. (1) A life support agency licensed in another state or the dominion of Canada that responds to emergencies in this state shall be licensed by the department unless specific intergovernmental agreements exist between the department, the dominion of Canada, or the other state.

(2) A life support agency licensed in another state or in the dominion of Canada that responds to emergencies is accountable to the medical control authority in whose geographical boundaries initial patient contact is made.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22121 Inquiry into ability to pay {#sec-r-325.22121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22121}

Rule 121. Life support agencies shall not inquire about ability to pay or source of payment before providing life support consistent with its license and approved medical control authority protocols to each emergency patient.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22122 Misleading information concerning emergency response {#sec-r-325.22122 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22122}

Rule 122. A life support agency shall not knowingly provide a person with false or misleading information concerning the time at which an emergency is initiated or the location from which the response is being initiated. The department or medical control authority may investigate any allegation of wrongdoing submitted under this rule. If a violation of this rule occurs, the department or medical control authority may take any corrective action authorized under the code and these rules.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22123 Spontaneous use of vehicle under exceptional circumstances; written report {#sec-r-325.22123 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22123}

Rule 123. (1) If an ambulance operation is unable to respond to an emergency patient within a reasonable time, a vehicle may be used under exceptional circumstances, as defined by department policy, to provide, without charge or fee and as a humane service, transportation for the emergency patient.

(2) Emergency medical personnel who transport, or who make the decision to transport, an emergency patient under subrule (1) of this rule shall file a written report with the medical control authority describing the incident within 7 days.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22124 Enforcement {#sec-r-325.22124 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22124}

Rule 124. (1) The department may take any action authorized by sections 20162, 20165, and 20168 of the code, MCL 333.20162, 333.20165, and 333.20168, or other provisions of the code in response to a violation of the code or these rules. Enforcement actions include any of the following:

(a) Denial, suspension, limitation, or revocation of a life support agency license.

(b) The issuance of a nonrenewable conditional license effective for not more than 1 year.

(c) The issuance of an administrative order to correct deficiencies and prescribing the actions the department determines necessary to obtain compliance with the code or to protect the public health, safety, and welfare.

(d) Imposition of an administrative fine.

(e) The issuance of an emergency order limiting, suspending, or revoking license.

(2) A life support agency that is granted a 1-year nonrenewable conditional license by the department shall comply with, at a minimum, all the following:

(a) Provide at least 1 vehicle for response to requests for emergency assistance on a 24-hour-a-day, 7-day-a-week basis in accordance with its licensure level.

(b) Submit a statement of the reasons for the life support agency's inability to comply with the code for licensure.

(c) Develop a plan of action to meet all licensure requirements. The plan must be submitted to the medical control authority and the department.

(d) Submit a monthly report to the medical control authority that outlines the progress made on the plan.

(e) Report all out-of-service time to each involved medical control authority.

(3) A life support agency that is granted a 1-year nonrenewable conditional license shall comply with all licensure fee requirements in the code.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22125 Life support agency; licensure at higher level of care; requirements {#sec-r-325.22125 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22125}

Rule 125. (1) A life support agency seeking licensure at a higher level qualifies for that license only if the life support agency meets the following requirements:

(a) Under the code, a life support agency that is licensed to provide medical first response life support may apply for licensure at the basic, limited advanced, or advanced life support level. A life support agency that is licensed to provide basic life support may apply for licensure at the limited advanced or advanced life support level. In the same manner, a life support agency that is licensed to provide limited advanced life support may apply for licensure at the advanced life support level.

(b) Each life support agency that meets the requirements of subdivision (a) of this subrule shall apply for a higher level of licensure on applications provided by the department and meet the requirements of the code and these rules. The application must include the required fee and identification of level of life support of the operation.

(2) A life support agency that obtains licensure at a higher level shall provide that level of care 24-hours-a-day, 7-days-a-week.

(3) If a life support agency applies to the department for licensure at a higher level than that of its current level, the department shall conduct an inspection of the agency and its vehicles. Verification of compliance with this subrule must be included with the application for licensure for each ground ambulance or non-transport, prehospital life support vehicle by both of the following methods:

(a) Provide, as part of the application, the name and address of the medical control authority or authorities under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority under which it operates. The signature on the application of the emergency medical services medical director, from each medical control authority, must verify that the medical control authority agrees to provide medical control to the life support agency.

(b) Attest, by signing the application, to all the following:

(i) The radio communication system for each ambulance or non-transport, prehospital life support vehicle complies with the medcom requirements.

(ii) Each vehicle meets minimum equipment requirements.

(iii) Minimum staff requirements are being met to operate at least 1 vehicle on a 24 hour-a-day, 7 day-a-week basis.

(iv) Each ground ambulance licensed by the department has a manufacturer certificate of compliance.

(4) Verification of compliance with this subrule must be available to the department upon request.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22126 Life support agency; medical control; disciplinary action {#sec-r-325.22126 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22126}

Rule 126. (1) A medical control authority may exercise disciplinary action against a life support agency or its emergency medical services personnel that may result in the life support agency, or its personnel not being allowed to provide prehospital emergency care.

The basis for these actions must be for noncompliance with protocols established by the medical control authority and approved by the department. Disciplinary action may include the suspension, limitation, or removal of medical control for the life support agency of a medical control authority providing medical control, from an individual providing emergency medical services care, or any other action authorized by the code.

(2) If a suspension or removal of medical control for a life support agency or individual occurs, the life support agency or individual shall not operate or practice in that medical control authority region until medical control is restored by the medical control authority.

(3) If a suspension or removal of medical control for a life support agency or individual occurs, the life support agency or individual may appeal the decision to the medical control authority. After appeals to the medical control authority have been exhausted, the life support agency or individual may appeal the medical control authority's decision to the statewide emergency medical services coordination committee.

An appeal to the emergency medical services coordination committee must be filed with the department in writing not more than 30 calendar days following notification to the agency or individual of the final determination of the medical control authority.

(4) The emergency medical services coordination committee shall review the appeal of a life support agency or individual and make a recommendation to the department. The department shall consider the emergency medical services coordination committee recommendation and conduct its own review of the appeal. If the department determines that licensure action is required, the department shall provide a hearing in accordance with the code and chapter 4 of the administrative procedures act of 1969, 1969 PA 369, MCL 24.271 to 24.288.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22127 Life support agency; life support vehicle; inspection; contractor requirements {#sec-r-325.22127 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22127}

Rule 127. (1) The department shall, at least annually, inspect or provide for the inspection of each life support agency. The department shall conduct random inspections of life support vehicles during the agency licensure period.

(2) A life support agency that receives accreditation from the Commission on Accreditation of Ambulance Services or another department-approved national accrediting organization as having equivalent expertise and competency in the accreditation of life support agencies, may not be subject to an agency inspection by the department if the life support agency meets both of the following requirements:

(a) Submits verification of accreditation described in this rule.

(b) Maintains accreditation as described in this rule.

(3) Accreditation of a life support agency does not prevent the department from conducting a life support agency inspection.

(4) Pursuant to section 20910(2)(b) of the code, MCL 333.20910, if emergency medical services activities apply to contracts with agencies or individuals for purposes of providing life support agency and life support vehicle inspections, the department shall notify each life support agency and medical control authority of the existence of the contracts, including the roles and responsibilities of those agencies or individuals having been awarded contracts.

PART 3. LIFE SUPPORT AGENCIES

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22131 Life support agency; initial application {#sec-r-325.22131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22131}

Rule 131. A life support agency and its life support vehicles shall be licensed by the department in accordance with sections 20920, 20926, 20931, and 20941 of the code, MCL 333.20920, 333.20926, 333.20931, and 333.20941. The application for initial licensure must include all the following:

(a) Be on an application provided by the department and include the required fees and identification of level of life support of the agency.

(b) Specify each life support vehicle to be operated, the level of life support being provided by that life support vehicle, and include a certificate of insurance covering each life support vehicle as identified in this rule.

(c) Provide the name and address of each medical control authority under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority under which it operates. A signature on the application by the emergency medical services medical director, from each medical control authority, is proof that the medical control authority agrees to provide medical control to the life support agency.

(d) Provide an attestation, as evidenced by signing the application, of all the following:

(i) Radio communications for each life support vehicle comply with medcom requirements.

(ii) Each vehicle meets minimum equipment requirements.

(iii) Minimum staff requirements must be met to operate at least 1 vehicle on a 24 hour-a-day, 7 day-a-week basis, consistent with section 20921(3) and (4), 20927(3), 20932(2), or 20941(6) of the code, MCL 333.20921, 333.20927, 333.20932, and 333.20941, as appropriate.

(iv) A manufacturer certificate of compliance for each ground ambulance licensed by the department.

(e) Include evidence that the operation possesses not less than $1,000,000.00 insurance coverage or is under a self-insurance program authorized under 1951 PA 35, MCL 124.1 to 124.13 for property damage and personal injury, except for rotary winged aircraft. An application for rotary winged aircraft must include evidence that the operation possesses not less than $5,000,000.00 insurance coverage or is under a selfinsurance program authorized under 1951 PA 35, MCL 124.1 to 124.13, for property damage and personal injury, except under section 20934(6) of the code, MCL 333.20934.

(f) Include full disclosure of the operation ownership, including all the following:

(i) Copies of documents relating to the official type of legal organization of the operation, stating whether it is an individual proprietorship, partnership, corporation, or subsidiary of another corporation or unit of government. These documents must be maintained by the operation and made available to the department upon request.

(ii) Copies of registration of the operation with the secretary of state or other designated official in each state that the agency is chartered, incorporated, or authorized to do business. These documents must be maintained by the operation and made available to the department upon request.

(iii) Disclose all legally responsible individuals, owners, or officers of the life support agency when submitting an application, including any trade names under which the organization operates. These must include, but are not limited to, the name or names by which the life support agency is known to the public.

(iv) Disclose all parent organizations and any person, as that term is defined in section 20908 of the code, MCL 333.20908, that have not less than a 10% interest in the life support agency.

(g) Identify 1 individual who will serve as the agency licensure administrator for the life support agency. The agency licensure administrator is the point of contact for licensing and inspection activities.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22132 Life support agency; operating requirements {#sec-r-325.22132 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22132}

Rule 132. In addition to requirements prescribed in the code and these rules, life support agency shall do all the following:

(a) Establish and maintain a written procedure that explains the steps that will be followed when a complaint is received by the agency. This procedure shall be maintained by the agency and made available to the department upon request.

(b) Maintain evidence of participation in the county, local, or regional disaster plan.

Approved protocols may be used to meet this requirement. These documents must be maintained by the operation and made available to the department upon request.

(d) Maintain written policies and procedures that address safety and accident reduction and comply with all applicable state and federal health and safety laws as prescribed on the department-approved agency inspection form. These procedures must be maintained by the operation and be available to the department upon request.

(e) Require that each individual staffing a licensed life support agency complies with the code and applicable medical control authority protocols.

(f) Require that a life support vehicle is not operated while transporting a patient unless the ambulance is staffed in accordance with section 20921(3), (4), and (5) of the code, MCL 333.20921.

(g) Require that a non-transport prehospital life support vehicle is not operated unless it is staffed in accordance with sections 20927(3) and 20941(6) of the code, MCL 333.20927 and 333.20941.

(h) Require that an aircraft transport vehicle is not operated unless it is staffed in accordance with section 20932(2) of the code, MCL 333.20932.

(i) Maintain evidence of an orientation process of emergency medical services personnel that familiarizes them with the agency's policies and procedures and trains them in the use and application of all the equipment carried in the licensed life support vehicle. At a minimum, the orientation process must include an introduction to personnel duties and responsibilities, in addition to medical control authority protocols.

(j) Maintain access to the current version of all applicable protocols for each medical control authority under which the agency operates.

(k) Complete and submit patient care records according to department-approved medical control authority protocols.

(l) Participate in data collection and quality improvement activities authorized under medical control authority protocols.

(m) Ensure that each licensed life support vehicle meets all applicable vehicle standards and state minimum equipment requirements prescribed by the department and department-approved medical control authority protocols.

(n) Require compliance with medcom requirements.

(o) Not knowingly respond to, or advertise its services for, prehospital emergency patients from outside its service area except for mutual aide requests.

(p) Require that each individual operating a licensed ground life support vehicle during an emergency response or patient transport has completed a department-approved vehicle operation education and competency assessment.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22133 Life support agency; licensure requirements {#sec-r-325.22133 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22133}

Rule 133. A life support agency shall comply with all the following:

(a) Ensure compliance with the code and these rules.

(b) Advise the department immediately of any changes that would alter the information contained on its licensure application, including any of the following:

(i) Change of ownership.

(ii) Change of facility name.

(iii) Change in vehicle status.

(iv) Change in agency licensure administrator contact information.

(v) Circumstances that preclude the life support agency from complying with staffing or minimum equipment requirements.

(vi) Change in communication ability to comply with medcom requirements.

(vii) Change in service area.

(c) A life support agency shall require that an individual whose license is at least equal to the level of vehicle license is in the patient compartment when transporting an emergency patient, or consistent with department-approved medical control authority protocols.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22134 Additional licensure requirements for life support agencies approved to administer medications {#sec-r-325.22134 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22134}

Rule 134. In addition to meeting the other licensure requirements of the code and these rules, a life support agency approved to administer medications by their local medical control authority shall do both of the following:

(a) Comply with the procedures of drug acquisition, storage, security, dispensing, and accountability in accordance with department-approved medical control authority protocols and federal and state law.

(b) If licensed at the limited advanced or advanced life support level, comply with the acquisition, storage, security, dispensing, and accountability procedures for intravenous solutions, tubing, and related apparatus in accordance with departmentapproved medical control authority protocols and in compliance with the federal and state law.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22135 Rotary aircraft ambulance operations; additional licensure requirements {#sec-r-325.22135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22135}

Rule 135. (1) In addition to meeting other licensure requirements of the code and these rules, an ambulance operation providing rotary aircraft transport shall do all the following:

(a) Meet all equipment requirements of the Federal Aviation Administration for the specific type of aircraft and flying conditions under which the aircraft will operate as specified by the air taxi certificate of operation of the aircraft transport provider.

(b) Maintain accurate medical flight records concerning the transportation of each emergency patient in intrastate flights or interstate flights originating in this state. The records must be available to the department and the medical control authority of the originating scene, when requested.

(c) Meet department licensure requirements and follow department-approved medical control authority protocols when providing on-scene emergency care.

(d) Meet department licensure requirements when providing interfacility transfers.

(e) Provide verification of Medicaid participation. A new provider not currently enrolled in Medicaid shall certify that proof of Medicaid participation is provided to the department within 6 months after the new provider begins offering services.

(2) An ambulance operation licensed in this state that provides rotary aircraft services or fixed wing ambulance service shall be accredited by a department-approved national accrediting organization within 2 years after beginning operation. During the provisional period between licensing and accreditation, the air ambulance operation must provide all the following:

(a) Written policies and procedures specifying the levels of patient care to be provided. The level of patient care provided must be commensurate with the education and experience of the staff and the capabilities of the base hospitals.

(b) Written patient care protocols including provisions for continuity of care.

(d) Written policies and procedures addressing the appropriate use of air ambulance’services in accordance with section 20932a of the code, MCL 333.20932a.

(e) A written communicable disease and infection control program.

(f) A written plan for dealing with situations involving hazardous materials.

(g) A planned and structured program for initial and continuing education and training, including didactic, clinical, and in-flight, for all scheduled staff members appropriate for the respective duties and responsibilities.

(h) Written policies and procedures addressing the integration of the air ambulance service with public safety agencies governing the base hospitals including, but not limited to, the federal aviation administration, medical control authorities, life support vehicles and disaster planning.

(i) A quality management program.

(j) A clinical database for utilization review and professional standards review organization.

(k) Procedures to screen patients to ensure appropriate utilization of the air ambulance service.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22136 Life support agency; issuance of license {#sec-r-325.22136 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22136}

Rule 136. Receipt of the completed application by the department serves as attestation by the life support agency that the agency and life support vehicles being licensed comply with the minimum standards required by the department. Upon approval of the application, the department shall issue a license to the life support agency.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22137 Ambulance operation; false advertising; conflict of interest {#sec-r-325.22137 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22137}

Rule 137. An ambulance operation may not do any of the following:

(a) Induce or seek to induce any person engaging an ambulance to patronize a longterm care facility, mortuary, or hospital.

(b) Advertise, or allow advertising of, within or on the premises of the ambulance operation or within or on an ambulance, the name or the services of an attorney, accident investigator, nurse, physician, long-term care facility, mortuary, or hospital. If 1 of those persons or facilities owns or operates an ambulance operation, then the person or facility may use its business name in the name of the ambulance operation and may display the name of the ambulance operation within or on the premises of the ambulance operation or within or on an ambulance.

(c) Advertise or disseminate information for the purpose of obtaining contracts under a name other than the name of the person holding an ambulance operation license, the trade, or assumed name of the ambulance operation.

(d) Use the terms "ambulance" or "ambulance operation" or a similar term to describe or refer to the person unless the department licenses the person under section 20920 of the code, MCL 333.20920.

(e) Advertise or disseminate information leading the public to believe that the person provides an ambulance operation, unless that person does in fact provide that service and is licensed by the department.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22138 Life support agency; renewal {#sec-r-325.22138 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22138}

Rule 138. (1) A life support agency shall complete an application for renewal and return the completed application to the department before the date of license expiration.

Failure to receive a notice for renewal from the department does not relieve the licensee of the responsibility to apply for renewal.

(2) The license of a life support agency and its life support vehicles expire on the same date.

(3) An application for licensure renewal received by the department after the license expiration date, but within 60 calendar days after the expiration date requires the life support agency to comply with section 20936 of the code, MCL 333.20936.

(4) A life support agency may provide emergency medical services during the 60 days following its license expiration date, whether or not the department has received an application for renewal.

(5) An application for licensure renewal not received by the department within 60 calendar days after the license expires must be considered revoked.

(6) Reinstatement of the life support agency and life support vehicle licenses require completion of a new application for licensure, including all fees prescribed in section 20936 (1) and (2) of the code, MCL 333.20936.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22139 Aircraft transport operations; additional licensure requirements {#sec-r-325.22139 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22139}

Rule 139. (1) In addition to meeting other licensure requirements of the code and these rules, an aircraft transport operation shall do all the following:

(a) Meet all equipment requirements of the Federal Aviation Administration for the specific type of aircraft and flying conditions under which the aircraft will operate, as specified by the air taxi certificate of operation of the aircraft transport provider.

(d) Provide verification of Medicaid participation. A new provider not currently enrolled in Medicaid shall certify that proof of Medicaid participation is provided to the department within 6 months after the new provider begins offering services.

(2) An aircraft transport operation licensed in this state shall be accredited by a department-approved national accrediting organization within 2 years of beginning operation. During the provisional period between licensing and accreditation, the aircraft transport operation shall provide all the following:

(b) Written patient care protocols including provisions for continuity of care.

(d) Written policies and procedures addressing the appropriate use of aircraft transport in accordance with section 20932a of the code, MCL 333.20932a.

(e) A written communicable disease and infection control program.

(f) A written plan for dealing with situations involving hazardous materials.

(h) Written policies and procedures addressing the integration of the air ambulance service with public safety agencies governing the base hospitals including, but not limited to, the Federal Aviation Administration, medical control authorities, life support vehicles and disaster planning.

(i) A quality management program.

(j) A clinical data base for utilization review and professional standards review organization.

(k) Procedures to screen patients to ensure appropriate utilization of the aircraft transport operation.

(3) An air ambulance service may operate a back-up air ambulance if the primary air ambulance or ambulances are not available or for a designated event with prior notification and approval from the local medical control authority.

(4) A back-up air ambulance must not be operated at the same time as the primary aircraft for the provision of air ambulance services except for a designated event or disaster.

PART 4. NONTRANSPORT PREHOSPITAL LIFE SUPPORT

OPERATIONS

History

History: 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22141 Nontransport prehospital life support operation; initial application for licensure {#sec-r-325.22141 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22141}

Rule 141. A nontransport prehospital life support operation and its vehicles shall be licensed by the department in accordance with section 20926 of the code.

Application for initial licensure shall include all of the following:

(a) Be on forms provided by the department and include the required fees and identification of level of life support of the operation.

(b) Specify each vehicle to be operated, the level of life support being provided by that vehicle, and include a certificate of insurance covering each vehicle as identified in subrule (5) of this rule.

(c) Provide as part of the application, the name and address of each medical control authority under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority in which it operates.Signature on the application of the emergency medical services medical director, from each medical control authority, shall be proof that the medical control authority agrees to provide medical control to the life support agency.

(d) Attest, as evidenced by signing the application, to all of the following:

(i) Radio communications for each vehicle are in compliance with the medcom requirements.

(ii) Each vehicle meets minimum equipment requirements.

(iii) Minimum staff requirements will be met in order to operate at least 1 vehicle on a 24 hour-a-day, 7 day-a-week basis, consistent with section 20927 (3) of the code.

(iv) Verification of compliance with subrules (3) and (4) of this rule, shall be available to the department upon request.

(e) Include evidence that the operation possesses not less than $1,000,000.00 insurance coverage or is under a self-insurance program authorized under 1951 PA 35, MCL 124.1 et seq. for property damage and personal injury.

(f) Include full disclosure of the operation ownership, including all of the following:

(i) Copies of documents relating to the official type of legal organization of the operation, stating whether it is an individual proprietorship, partnership, corporation, or subsidiary of any other corporation or unit of government. These documents shall be maintained by the operation and shall be available to the department upon request.

(ii) Copies of official registration of the entity with the secretary of state or other designated official in each state in which the agency is chartered, incorporated, or authorized to do business. These documents shall be maintained by the operation and shall be available to the department upon request.

(iii) Disclose all legally responsible individuals, owners, or officers of the operation at the time of license application, including any trade names under which the organization operates. These shall include, but not limited to the name or names under which the operation is known to the public.

(iv) Disclose all parent organizations and any person as defined in the code, that have at least a 10% interest in the applicant operation.

(g) Identify 1 individual who will serve as the primary contact person for the operation.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22142 Nontransport prehospital life support operation; operating requirements {#sec-r-325.22142 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22142}

Rule 142. In addition to requirements prescribed in the code and these rules, a nontransport prehospital life support operation shall do all of the following:

(a) Establish and maintain a written procedure that explains the steps that will be followed when a complaint is received by the operation. This procedure shall be maintained by the operation and shall be available to the department upon request.

(b) Maintain evidence of participation in the county, local, or regional disaster plan and response. Approved protocols may be used to satisfy this requirement. These documents shall be maintained by the operation and shall be available to the department upon request.

(d) Maintain written policies and procedures that address safety and accident reduction and comply with all applicable state and federal health and safety laws as prescribed on the department-approved agency inspection form. These procedures shall be maintained by the operation and shall be available to the department upon request.

(e) Require that each individual staffing a nontransport prehospital life support vehicle complies with the code and applicable medical control authority protocols.

(f) Require that a nontransport prehospital life support vehicle is not operated unless it is staffed in accordance with section 20927(3) of the code.

(g) Maintain evidence of an orientation process for emergency medical services personnel to familiarize them with the agency's policies and procedures and are trained in the use and application of all the equipment carried in the nontransport prehospital life support vehicle.At a minimum, this shall include an introduction to the duties to be performed as well as medical control authority protocols.

(h) Maintain a copy of all applicable protocols for each medical control authority under which the agency operates.

(i) Participate in data collection and quality improvement activities authorized under medical control authority protocols.

(j) Ensure that vehicles licensed by the operation meet all vehicle standards, and meet state equipment requirements prescribed by the department and department-approved medical control authority protocols.

(k) Require compliance with medcom requirements.

(l) Not knowingly respond to or advertise its services for prehospital emergency patients from outside its service area as defined in these rules, except for mutual aid requests.

(m) Require that an individual operating a licensed life support vehicle during an emergency response has completed a vehicle operation education and competency assessment.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22143 Nontransport prehospital life support operation; licensure requirements {#sec-r-325.22143 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22143}

Rule 143. A nontransport prehospital life support operation shall comply with all of the following:

(a) Provide not less than 1 staffed nontransport prehospital life support vehicle as defined in section 20921(3) of the code, at the agency licensure level, available for response to requests for emergency assistance 24-hours-a-day, 7-days-a-week.

(b) Respond or ensure a response is provided to each request for emergency assistance from within its service area.

(d) Immediately advise the department of any changes that would alter the information contained on its licensure application, including any of the following:

(i) Change of ownership.

(ii) Change of facility name.

(iii) Change in vehicle status.

(iv) Circumstances which preclude the nontransport prehospital life support operation from complying with subrule (1) of this rule or minimum equipment requirements.

(v) Change in ability to comply with medcom requirements.

(vi) Change in service area.

(e) Ensure compliance with the minimum staffing requirements prescribed in section 20927(3) of the code.

(f) Ensure that patient care and safety equipment carried on a nontransport vehicle meet the minimum requirements prescribed by the department and approved medical control authority protocols.

(g) Ensure that each vehicle is equipped with a communications system consistent with the medcom requirements developed by the department.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22144 Nontransport prehospital life support operations operating at limited advanced or advanced life support level; additional licensure requirements {#sec-r-325.22144 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22144}

Rule 144. In addition to meeting the other licensure requirements of the code and these rules, a nontransport prehospital life support agency at the limited advanced or advanced life support level shall do all of the following:

(a) Comply with the procedures of drug acquisition, storage, security, dispensing, and accountability in accordance with the criteria established by the medical control authority, in compliance with federal and state law, and approved by the department and R 325.22207(1)(k) and 325.22207(3).

(b) Comply with the acquisition, storage, security, dispensing and accountability procedures of intravenous solutions, tubing and related apparatus in accordance with medical control authority protocols and in compliance with the federal and state law.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22145 Nontransport prehospital life support operation; issuance of nontransport prehospital life support license {#sec-r-325.22145 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22145}

Rule 145. Receipt of the completed application by the department serves as attestation that the operation and vehicles being licensed comply with the minimum standards required by the department. Upon approval of the application, the department shall issue a license to the nontransport prehospital life support operation.

The license shall identify each vehicle being licensed. The license may be renewed on an annual basis.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22146 Nontransport prehospital life support operation; relicensure {#sec-r-325.22146 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22146}

Rule 146. (1) A nontransport prehospital life support operation shall complete an application for relicensure and return the completed application to the department before the date of license expiration. Failure to receive a notice for relicensure from the department does not relieve the licensee of the responsibility to apply for relicensure.

(2) The license of a nontransport prehospital life support operation and its vehicles shall expire on the same date.

(3) An application for licensure renewal received by the department after the license expiration date, but within 60 calendar days after the expiration date of the license, shall require the nontransport prehospital life support operation to comply with section 20936 of the code.

(4) A nontransport prehospital life support operation may provide emergency medical services during the 60 days following its license expiration date, whether or not the department has received an application.

(5) An application for licensure renewal not received by the department within 60 calendar days following the date of license expiration shall be considered revoked, effective on the sixty-first day.

(6) Reinstatement of the nontransport prehospital life support operation and vehicle licenses shall require completion of a new application for licensure, including all fees prescribed in section 20936 (1) and (2) of the code.

PART 5. AIRCRAFT TRANSPORT OPERATIONS

History

History: 2004 AACS.

Mich. Admin. Code R 325.22151 Aircraft transport operation; fixed wing; initial application for licensure {#sec-r-325.22151 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22151}

Rule 151. An aircraft transport operation and its vehicles shall be licensed by the department in accordance with section 20931 of the code. Application for initial licensure shall do all of the following:

(a) Be on forms provided by the department and include the required fees and identification of level of life support of the operation.

(b) Specify each aircraft transport vehicle to be operated, the level of life support being provided by the vehicle, and include a certificate of insurance covering each vehicle as prescribed in subrule (6) of this rule.

(c) Provide as part of the application, the name and address of each medical control authority under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority in which it operates. Signature on the application of the emergency medical services medical director, from each medical control authority, shall be proof that the medical control authority is in agrees to provide medical control to the life support agency.

(d) Attest, as evidenced by signing the application, to all of the following:

(i) Radio communications for each aircraft transport vehicle are in compliance with the medcom requirements.

(ii) Each vehicle meets minimum equipment requirements.

(iii) Minimum staff requirements will be met to operate each vehicle consistent with section 20932(2) of the code.

(e) Verify compliance with subrules (3) and (4) of this rule, and make available to the department upon request.

(f) Include evidence that the operation possesses not less than $10,000,000.00 insurance coverage or is under a self-insurance program authorized under 1951 PA 35, MCL 124.1 et seq., for property damage and personal injury.

(g) Include full disclosure of the operation ownership, including all of the following:

(i) Documents relating to the official type of legal organization of the operation, stating whether it is an individual proprietorship, partnership, corporation, or subsidiary of any other corporation or unit of government. These documents shall be maintained by the operation and shall be available to the department upon request.

(ii) Official registration of the entity with the secretary of state or other designated official in each state in which the agency is chartered, incorporated, or authorized to do business. These documents shall be maintained by the operation and shall be available to the department upon request.

(iii) Disclosure of all legally responsible individuals, owners, or officers of the aircraft transport operation at the time of license application, including any trade name under which the organization operates. These shall include, but not limited to, the name or names under which the aircraft transport operation is known to the public.

(iv) Disclosure of all parent organizations and any person as defined in the code that have at least a10% interest in the applicant operation.

(h) Identify 1 individual who will serve as the primary contact person for the operation.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22152 Aircraft transport operation; operating requirements {#sec-r-325.22152 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22152}

Rule 152. In addition to requirements prescribed in the code and these rules, an aircraft transport operation shall do all of the following:

(b) Maintain evidence which may show participation in the county, local, or regional disaster plan and response. Approved protocols may be used to satisfy this requirement. These documents shall be maintained by the operation and shall be available to the department upon request.

(d) Maintain written policies and procedures to address safety and accident reduction and comply with all applicable state and federal health and safety laws as prescribed on the department-approved agency inspection form. These procedures shall be maintained by the operation and shall be available to the department upon request.

(e) Require that each individual staffing an aircraft transport vehicle complies with the code and applicable medical control authority protocols.

(f) Require that an aircraft transport vehicle is not operated while transporting a patient unless the ambulance is staffed in accordance with section 20932(2) of the code.

(g) Ensure compliance with additional staffing requirements established by local medical control authority, and approved by the department, or as needed, and for life support during that transportation according to the written orders of the patient's physician.

(h) Maintain evidence of an orientation process for emergency medical services personnel to familiarize them with the agency's policies and procedures and are trained in the use and application of all the equipment carried in the vehicle. At a minimum, the evidence shall include an introduction to the duties to be performed as well as medical control authority protocols.

(i) Maintain a copy of all applicable protocols for each medical control authority under which the agency operates.

(j) Participate in data collection and quality improvement activities authorized under medical control authority protocols.

(k) Ensure that aircraft transport vehicles licensed by the operation meet all applicable vehicle standards, state equipment requirements as established by the department and department-approved medical control authority protocols.

(l) Require compliance with medcom requirements.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22153 Aircraft transport operation; licensure requirements {#sec-r-325.22153 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22153}

Rule 153. An aircraft transport operation shall comply with section 20932 of the code and all of the following:

(a) Provide an aircraft transport vehicle for patient transportation between health facilities, as needed, and for life support during that transportation according to the written orders of the patient's physician.

(b) Operate in accordance with the code, rules, and orders established by the patient's physician. The operation shall not provide life support at a level that exceeds its license, department approved medical control authority protocols, or violates those orders established by the patient's physician.

(d) Immediately advise the department of any changes that would alter the information contained on its licensure application, including any of the following:

(i) Change of ownership.

(ii) Change of facility name.

(iii) Change in vehicle status.

(iv) Circumstances which preclude the operation from providing patient transportation between health facilities, as needed, or for not being capable of meeting minimum staffing or equipment requirements.

(v) Change in ability to comply with medcom requirements.

(vi) Change in service area.

(e) While transporting a patient, ensure that the aircraft transport operation complies with the minimum staffing and equipment requirements prescribed in section 20932(2) of the code.

(f) Ensure that an aircraft transport vehicle is equipped with a communications system consistent with the medcom requirements developed by the department.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22154 Aircraft transport operations operating at limited advanced life support or advanced life support levels; additional licensure requirements {#sec-r-325.22154 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22154}

Rule 154. In addition to meeting licensure requirements of the code and these rules, an aircraft transport operation licensed at the limited advanced or advanced life support level shall do all of the following:

(a) Comply with the procedures of drug acquisition, storage, security, dispensing, and accountability in accordance with the criteria established by the medical control authority, federal and state law, and approved by the department and R 325.22207(1)(k) and 325.22207(3).

(b) Comply with the acquisition, storage, security, dispensing and accountability procedures of intravenous solutions, tubing, and related apparatus in accordance with medical control authority protocols and federal and state law.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22155 Aircraft transport operation; issuance of license {#sec-r-325.22155 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22155}

Rule 155. (1) Receipt of the completed application by the department serves as attestation to the department that the operation and aircraft transport vehicles being licensed are in compliance with the minimum standards required by the department.

Upon approval of the application, the department shall issue a license to the aircraft transport operation. The license shall include the vehicles being licensed. The license may be renewed on an annual basis.

(2) An aircraft transport operation providing fixed wing transport shall comply with R 325.22151 and shall do both of the following:

(a) The aircraft transport vehicle and equipment shall be in compliance with current federal aviation administration regulations for the specific type of aircraft and flying conditions under which the aircraft will operate, as specified by the air taxi certificate of operation of the aircraft transport provider.

(b) Maintain accurate medical flight records concerning the transportation of an emergency patient in intrastate flights or interstate flights originating in this state. The records shall be available to the department and the medical control authority of the originating scene, when requested.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22156 Aircraft transport operation; relicensure {#sec-r-325.22156 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22156}

Rule 156. (1) An aircraft transport operation shall complete an application for relicensure and return the completed application to the department before the date of license expiration. Failure to receive a notice for relicensure from the department does not relieve the licensee of the responsibility to apply for relicensure.

(2) The license of an aircraft transport operation and its vehicles shall expire on the same date.

(3) An application for licensure renewal received by the department after the license expiration date, but within 60 calendar days after the expiration date of the license, shall require the aircraft transport operation to comply with section 20936 of the code.

(4) An aircraft transport operation may provide emergency medical services during the 60 days following its license expiration date, whether or not the department has received an application.

(5) An application for licensure renewal not received by the department within 60 calendar days following the date of license expiration shall be considered revoked, effective on the sixty-first day.

(6) Reinstatement of the aircraft transport operation and vehicle licenses shall require completion of a new application for licensure, including all fees prescribed in section 20936(1) and (2) of the code.

PART 6. MEDICAL FIRST RESPONSE SERVICES

History

History: 2004 AACS.

Mich. Admin. Code R 325.22161 Medical first response service; initial application {#sec-r-325.22161 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22161}

Rule 161. A medical first response service and its vehicles shall be licensed by the department in accordance with section 20941 of the code and its application for initial licensure shall comply with all of the following:

(a) Be on forms provided by the department.

(b) Specify each medical first response vehicle to be operated and include a certificate of insurance for each vehicle as identified in subdivision (f) of this rule.

Each vehicle licensed shall meet minimum equipment and staffing requirements.

(c) Provide as part of the application, the name and address of each medical control authority under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority in which it operates. Signature on the application of the emergency medical services medical director, from each medical control authority, shall be proof that the medical control authority agrees to provide medical control to the life support agency.

(d) Attest, as evidenced by signing the application, to all of the following:

(i) Radio communications for each vehicle is in compliance with the medcom requirements.

(ii) Each vehicle meets minimum equipment requirements.

(iii) Minimum staff requirements will be met to operate each vehicle on a 24 houra-day, 7 day-a-week basis, consistent with section section 20906(10) of the code.

(e) Verification of compliance with subdivisions (c) and (d) of this rule, shall be available to the department upon request.

(f) Include evidence that the service possesses not less than $1,000,000.00 insurance coverage or is under a self-insurance program authorized under 1951 PA 35, MCL 124.1 et seq., for property damage and personal injury.

(g) Include full disclosure of the agency ownership, including all of the following:

(iii) Disclosure of all legally responsible individuals, owners, or officers of the service at the time of license application, including any trade names under which the organization operates. These shall include, but not limited to, the name or names that the medical first response service is known to the public.

(iv) Disclose all parent organizations and persons as defined in the code, that have at least a 10% interest in the applicant operation.

(h) Staff each vehicle with at least 1 medical first responder.

(i) Identify 1 individual who will serve as the primary contact person for the service.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22162 Medical first response services; operating requirements {#sec-r-325.22162 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22162}

Rule 162. In addition to requirements prescribed in the code and these rules, a medical first response service shall do all of the following:

(b) Maintain evidence of participation in the county, local, or regional disaster plan and response. Approved protocols may satisfy this requirement. These documents shall be maintained by the service and shall be available to the department upon request.

(d) Maintain written policies and procedures that address safety and accident reduction and comply with all applicable state and federal health and safety laws as prescribed on the department-approved agency inspection form. These procedures shall be maintained by the service and shall be available to the department upon request.

(e) Require that each individual staffing a medical first response vehicle is in compliance with the code and applicable medical control authority protocols.

(f) Maintain evidence of an orientation process for emergency medical services personnel that familiarizes them with the agency's policies and procedures and trains in the use and application of all equipment carried in the vehicle. At a minimum, this evidence must include a proper introduction to the duties to be performed as well as medical control authority protocols.

(g) Maintain a copy of all applicable protocols for each medical control authority under which the agency operates.

(h) Participate in data collection and quality improvement activities authorized under medical control authority protocols.

(i) Ensure that all vehicles meet state equipment requirements as established by the department and department-approved medical control authority protocols.

(j) Require compliance with medcom requirements.

(k) Not knowingly respond to or advertise its services for prehospital emergency patients from outside its service area as defined in these rules, except for mutual aid requests.

(l) Require that each individual operating a licensed life support vehicle during an emergency response has completed a vehicle operation education and competency assessment.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22163 Medical first response service; licensure requirements {#sec-r-325.22163 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22163}

Rule 163. A medical first response service shall comply with section 20941 of the code and do all of the following:

(a) Provide, at a minimum, 1 staffed vehicle available for response to requests for emergency assistance, 24-hours-a-day, 7-days-a-week.

(b) Respond or ensure a response is provided to each request for emergency assistance originating from within the bounds of its service area.

(d) Immediately advise the department of any changes that alters the information contained on its licensure application, including all of the following:

(i) Change of ownership.

(ii) Change of facility name.

(iii) Change in vehicle status.

(iv) Circumstances which preclude the medical first response service from complying with subdivision (a) of this rule or equipment requirements.

(v) Change in ability to comply with medcom requirements.

(vi) Change in service area.

(e) Ensure compliance with the minimum staffing requirements prescribed in section 20906(10) of the code.

(f) Ensure that patient care and safety equipment carried on a medical first response vehicle meets the minimum requirements prescribed by the department.

(g) Ensure that each vehicle is equipped with a communications system consistent with the medcom requirements developed by the department.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22164 Medical first response service; issuance of license {#sec-r-325.22164 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22164}

Rule 164. Receipt of the completed application by the department serves as attestation by the service that the service and vehicles being licensed are in compliance with the minimum standards required by the department. Upon approval of the application, the department shall issue a license to the medical first response service.

The license shall include the vehicles being licensed. The license may be renewed on an annual basis.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22165 Medical first response service; law enforcement; fire suppression agency {#sec-r-325.22165 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22165}

Rule 165. (1) A medical first response service means a person licensed by the department to respond under medical control to an emergency scene with a medical first responder and equipment required by the department before the arrival of the ambulance.

This includes a fire suppression agency only if it is dispatched for medical first response life support.

(2) A fire suppression agency shall be licensed as a life support agency, in accordance with R 325.22131, and provide life support as described in the code and these rules if it is dispatched to provide any care a medical first responder is qualified to provide under section 20906(8) of the code, MCL 333.20906.

(3) A law enforcement agency shall be licensed as a life support agency, in accordance with R 325.22131, and provide life support as described in the code and these rules if both of the following conditions are met:

(a) Holds itself out as a medical first response service.

(b) Is dispatched to provide medical first response life support.

(4) A law enforcement agency holds itself out as a medical first response service if it advertises or announces that it will provide patient care that may include any care a medical first responder is qualified to provide under section 20906(8) of the code, MCL 333.20906, or charges for those services.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22166 Medical first response service and vehicles; relicensure {#sec-r-325.22166 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22166}

Rule 166. (1) A medical first response service shall complete an application for relicensure and shall return the completed application to the department before the date of license expiration. Failure to receive a notice for relicensure from the department does not relieve the licensee of the responsibility to apply for relicensure.

(2) The license of a medical first response service and its vehicles shall expire on the same date.

(3) An application for licensure renewal received by the department after the license expiration date, but within 60 calendar days after the expiration date of the license, shall require the medical first response service to comply with section 20936 of the code.

(4) A medical first response service may provide emergency medical services during the 60 days following its license expiration date, whether or not the department has received an application.

(5) An application for licensure renewal not received by the department within 60 calendar days following the date of license expiration shall be considered revoked, effective on the sixty-first day.

(6) Reinstatement of the medical first response service and vehicle licenses shall require completion of a new application for licensure.

PART 7. AMBULANCE OPERATION UPGRADE LICENSE

History

History: 2004 AACS.

Mich. Admin. Code R 325.22171 Ambulance operation upgrade license; application process {#sec-r-325.22171 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22171}

Rule 171. An ambulance operation described in sections 20920 (7) to (12) of the code that applies for an ambulance operation upgrade license shall do all of the following:

(a) Have been a licensed ambulance operation at the transporting basic life support or transporting limited advanced life support on or before July 22, 1997.

(b) Have been owned, operated, or under contract to a local unit of government and providing first line emergency medical response to that local unit of government on or before July 22, 1997. Emergency services provided under an upgraded license shall be provided only to the local unit of government and only in response to a 9-1-1 call or other call for emergency transport within jurisdiction of local unit of government.

(c) A transporting basic ambulance operation shall staff and equip 1 or more ambulances for the transport of emergency patients at a life support level higher than basic life support.

(d) A transporting limited advanced ambulance operation shall staff and equip 1 or more ambulances for the transport of emergency patients at the advanced life support level.

(e) Make application for licensure to the department on forms prescribed by the department. Included with the application shall be the required $100.00 fee and identification of the current level of life support of the operation and the higher level of life support being sought. The application shall include verification of all of the following:

(i) The ambulance operation was licensed on, or before, July 22, 1997.

(ii) The ambulance operation was licensed, at a minimum, as a basic transporting ambulance operation on, or before, July 22, 1997.

(iii) The ambulance operation is owned, operated by, or under contract with a local unit of government.

(iv) Services described in the application shall be provided only to the local unit of government and only in response to 9-1-1 calls or other calls for emergency transport within the jurisdiction of the local unit of government.

(v) The ambulance operation complies with all patient care and radio equipment requirements for the level of upgrade requested.

(vi) The ambulance operation provides a description of the staffing for each vehicle under the upgrade provision.

(vii) The ambulance operation provides a 2-year plan of action to upgrade, on a full-time basis, to the higher level. A letter of commitment by the local unit of government supporting this plan of action shall be part of the plan.

(viii) The ambulance operation provides patient care protocols and a formal recommendation from the medical control authority under which the ambulance operation operates.

(ix) Quality monitoring procedures and use and protection of equipment protocols have been developed and approved by the medical control authority. Use and protection equipment protocols shall describe procedures the operation will use to limit access to the limited advanced or advanced, or both, equipment and supplies when not operating at the higher level.

(f) Provide additional information as prescribed by the department to process the application.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22172 Ambulance operation upgrade license; limited advanced life support; advanced life support; security, control, and exchange of pharmaceuticals {#sec-r-325.22172 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22172}

Rule 172. An ambulance operation upgrade licensed at the limited advanced or advanced life support level shall do all of the following:

(a) Comply with the procedures of drug acquisition, storage, security, dispensing, and accountability in accordance with the criteria established by the medical control authority, in compliance with federal and state law and approved by the department and R 325.22207(1)(k) and 325.22207(3).

(b) Comply with the acquisition, storage, security, dispensing and accountability procedures for intravenous solutions, tubing, and related apparatus in accordance with medical control authority protocols and federal and state law.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22173 Ambulance operation upgrade license; review process and licensure {#sec-r-325.22173 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22173}

Rule 173. An application submitted under R 325.22171 shall be reviewed by the emergency medical services coordination committee. The emergency medical services coordination committee shall make a recommendation to the department if an ambulance operation upgrade license should be granted to the applicant.

(a) If the emergency medical services coordination committee recommend a license upgrade, then the department shall conduct a communication and equipment inspection at the upgrade level before issuing a license (b) If the emergency medical services coordination committee does not recommend a license upgrade, then the department shall send a communication to the ambulance operation upgrade applicant identifying concerns and advising the operation of non-approval of licensure.

(d) The medical control authority under which the ambulance operation operates shall submit to the emergency medical services coordination committee an annual written progress report on the ambulance operation upgrade plan of action. The progress report shall include, but is not limited to, information on training, equipment, and personnel. The report shall demonstrate progress being made by the ambulance operation to achieve licensure and the higher level and comply with the 24-hour-a-day, 7-day-a-week requirements of the code.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22174 Ambulance operation upgrade license; renewal process {#sec-r-325.22174 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22174}

Rule 174. An ambulance operation upgrade license is renewable for 1 additional 2-year period provided the following requirements are met:

(a) The medical control authority has complied with R 325.22173(4).

(b) The ambulance operation has renewed and is currently licensed at the basic transporting life support or limited advanced transporting life support level.

(c) The ambulance operation meets the renewal upgrade licensure application requirements prescribed by the department, including the $100.00 fee.

(d) The ambulance operation submits, with the renewal upgrade licensure application, a progress report on the initial plan of action.

(e) Provides a description of the staffing for each vehicle under the upgrade license.

(f) Provides an updated 2-year plan of action to upgrade, on a full-time basis, to the higher level. A letter of commitment by the local unit of government supporting this plan of action shall be part of the plan.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22175 Ambulance operation upgrade license; revocation or denial of renewal {#sec-r-325.22175 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22175}

Rule 175. The department may revoke or fail to renew an ambulance operation upgrade license for a violation of the code or rules or for failure to comply with the plan of action filed with the department. The ambulance operation's regular license is not affected if the ambulance operation upgrade license is revoked or not renewed.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22176 Ambulance operation upgrade license; nonrenewal {#sec-r-325.22176 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22176}

Rule 176. An ambulance operation upgrade license that is not renewed or failure of the operation to achieve the higher level after the second 2-year period shall not provide life support at the higher level effective the day after the ambulance operation upgrade license expiration date.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22177 Ambulance operation upgrade license; advertisement {#sec-r-325.22177 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22177}

Rule 177. (1) An ambulance operation licensed under R 325.22173(1) shall not advertise or hold itself out as a full-time transporting limited-advanced or transporting advanced life support service unless the ambulance operation actually provides those services on a 24-hour-a-day, 7-days-a-week basis.

(2) An ambulance operation licensed under this rule that is providing services at the limited advanced or advanced life support level on a 24-hour-aday, 7-day-a-week basis and is advertising these services, shall not qualify for licensure under this rule. The ambulance operation shall make application to the department to upgrade its regular ambulance operation license to the level of licensure being provided.

PART 8. LIFE SUPPORT VEHICLES

History

History: 2004 AACS.

Mich. Admin. Code R 325.22181 Ground ambulance; requirements {#sec-r-325.22181 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22181}

Rule 181. (1) An ambulance operation shall maintain the manufacturer's certificate of compliance on file at the time of application to the department for licensure of each ground ambulance. The certificate of compliance must be executed by the final manufacturer of each ground ambulance and be on a form prescribed by the department.

(2) The manufacturer of a ground ambulance executing a certificate of compliance shall comply with the ambulance structural and mechanical specifications with 1 of the following standards that was in effect at the time of manufacture:

(a) Federal KKK-A-1822 standards, excluding the paint scheme.

(b) The Commission on Accreditation of Ambulance Services (CAAS) Ground Vehicle Standard for Ambulances (GVSA) in its entirety.

(3) The manufacturer shall maintain test data demonstrating compliance.

(4) Once licensed for service, an ambulance must not be required to meet later modified state vehicle standards during its use by the ambulance operation that obtained the license.

(5) A ground ambulance referred to in subrule (2) of this rule must not be modified to alter its original design upon which the certificate of compliance was based unless a new certificate is issued verifying that the modifications have not altered the integrity of the vehicle.

(6) The patient compartment of a ground ambulance that has met applicable standards at the time of manufacture may be remounted on to a different chassis. The remounter may be a member of 1 or more of the following: Ford Qualified Vehicle Modifier, Mercedes Benz Sprinter Preferred Upfitter, Ram Q Pro Programs, or the National Truck Equipment Association Member Verification Program.

(7) A new manufacturer’s certificate of compliance must be issued that identifies the new vehicle identification number and demonstrates compliance with either KKK, GVSA, or NFPA standards in accordance with subrule (2) of this rule.

History

History: 2004 AACS; 2018 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22182 Non-qualifying vehicles for licensure {#sec-r-325.22182 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22182}

Rule 182. (1) A ground ambulance that was originally manufactured before January 1, 1982, may not qualify for licensure by the department and must not be sold or donated in this state for use as a ground ambulance. This subrule does not apply to a ground ambulance that is currently licensed by the department and has been in continuous service before January 1, 1982.

(2) A ground ambulance manufactured after January 1, 1982, whose age from the date of manufacture exceeds 2 years, must have a safety inspection by a certified mechanic being sold to provide ground ambulance services. The inspection must be documented on a form developed by the department and include a notarized statement by the previous owner attesting that the ground ambulance has not been involved in a vehicular accident altering its safety. The documents required by this subrule must be submitted to the department by the purchaser as part of the application for licensure by the new owner.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22183 Life support vehicle sanitation {#sec-r-325.22183 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22183}

Rule 183. A life support agency shall require that equipment, linen, and supplies be cleaned or exchanged following each patient care use.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22184 Life support vehicles; displaying of name {#sec-r-325.22184 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22184}

Rule 184. (1) A life support agency name shall be prominently displayed on the left and right side of all licensed life support vehicles.

(2) If the life support agency is operated by or advertised with a name different than the life support agency name, then the name may be displayed on the left and right side of the life support vehicle below the name of the life support agency. The advertised name shall be smaller than the life support agency name.

(3) A life support agency that identifies a level of licensure in its name or brand that is higher than the level of life support provided by a specific licensed vehicle, shall prominently display the actual level of licensure of the vehicle on the sides of the vehicle.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22185 Life support vehicles; equipment requirements {#sec-r-325.22185 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22185}

Rule 185. (1) A ground ambulance, rotary ambulance, and aircraft transport vehicle shall be equipped with equipment and patient care supplies as prescribed by the department including temperature control in the patient compartment. The agency shall require that equipment is available and in working order on each vehicle.

(2) A nontransport and medical first response vehicle shall be equipped with patient care equipment and patient care supplies as prescribed by the department. The agency shall require that equipment is available and in working order on each vehicle.

(3) Each life support vehicle shall be equipped with communication capability in accordance with the medcom requirements.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22186 Life support vehicles; patient care and safety equipment; review {#sec-r-325.22186 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22186}

Rule 186. The department shall, with the advice of the emergency medical services coordination committee, annually review and modify, as necessary, the minimum equipment standards for life support vehicles.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22187 Rotary ambulance; requirements {#sec-r-325.22187 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22187}

Rule 187. A rotary ambulance must meet all the following standards:

(a) Be capable of on-scene response and transportation of emergency patients.

(b) Be staffed in accordance with section 20921(3), (4), and (5) of the code, MCL 333.20921.

(d) Possess access that allows for safe loading and unloading of a patient without excessive maneuvering of the patient.

(e) Be temperature controlled for the comfort of the patient.

(f) Have adequate lighting for patient care and observation.

(g) Be equipped with communication capability with hospitals, life support vehicles, and medical control in accordance with the medcom requirements.

(h) Be capable of carrying a minimum of 1 patient in a horizontal position.

(i) Securely store equipment and make the equipment readily accessible.

(j) Operate under the medical control authority.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22188 Rotary ambulance sanitation {#sec-r-325.22188 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22188}

Rule 188. A rotary ambulance operation shall require that any equipment, linen, and supplies be cleaned or exchanged following each patient care use.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22189 Aircraft transport vehicle; requirements {#sec-r-325.22189 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22189}

Rule 189. An aircraft transport vehicle must comply with all the following:

(a) Be authorized as part of a licensed aircraft transport operation.

(b) Be capable of carrying a minimum of 1 patient in a horizontal position.

(c) Provide a means of securing the litter while supporting a patient to the floor, walls, seats, specific litter rack, or any combination thereof.

(d) Ensure that the patient compartment has adequate lighting available for patient observation.

(e) Require that equipment is secured to the aircraft, readily accessible, and when not in use, securely stored.

(f) Ensure that the interior of each vehicle affords an adequate patient care and treatment area.

(g) Ensure that each vehicle is equipped with a cargo door or other entry that allows for loading and unloading of the patient without excessive maneuvering of the patient.

(h) Ensure that the interior of each vehicle is equipped with temperature control for the comfort of the patient.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22190 Life support vehicles; licensure and relicensure inspections; new and replacement vehicles; licensure at higher level of care {#sec-r-325.22190 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22190}

Rule 190. Life support vehicles must be inspected as follows:

(a) The department may conduct random renewal inspections of life support vehicles, including medical first response vehicles. Inspections are unannounced unless circumstances warrant notifying a life support agency in advance that an inspection of its life support vehicles will be conducted. The department shall determine if prior notification of an inspection is warranted. A vehicle license may be renewed without an inspection.

(b) Submission of a licensure renewal application is considered an attestation by the life support agency that the vehicle meets all licensure requirements.

(c) A life support agency that is adding a new or higher licensure level for a life support vehicle shall submit an application, on forms provided by the department, and include the required fee. New and higher level of care vehicles must be inspected before being placed into service. Upon receipt of the application and required fee, the department shall inspect new or upgrade vehicles within 15 days after receipt of the application.

(d) A life support agency that is replacing a life support vehicle shall submit an application, on forms provided by the department, and include the required fee. A replacement vehicle means a life support agency has removed a vehicle from service and has replaced the vehicle with another.

(e) Replacement vehicles may be placed into service upon submission of an application and the required fee to the department. Upon receipt of the application and required fee, the department shall inspect the replacement vehicle within 15 days after receipt of the application.

(f) With written notification in a format specified by the department, a rotary ambulance back-up vehicle may be put into service for 30 days before it must comply with subdivisions (a) to (e) of this rule.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22191 Life support vehicles inspected; non-compliance; corrective measures {#sec-r-325.22191 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22191}

Rule 191. If the department determines that a life support vehicle does not comply with the requirements of the code and these rules, then the following applies:

(a) If an agency has a vehicle determined to be noncompliant with minimum equipment items as identified on the inspection form, the agency has 24 hours to bring the vehicle into compliance and notify the department in writing of the corrections made.

The vehicle may be returned to service before a reinspection with approval of the department. A reinspection must occur within 15 days after notification by the life support agency.

(b) If an agency fails to bring a vehicle into compliance within 24 hours, the agency shall remove the vehicle from service until the life support agency submits a written explanation of corrective action to the department and the department reinspects the vehicle. A vehicle taken out of service shall not function as an ambulance or life support vehicle until the vehicle passes the department reinspection.

(c) If a vehicle remains out of compliance for more than 15 calendar days from the date of inspection, its license is automatically revoked. Reinstatement of the life support vehicle license requires reapplication for licensure, payment of the licensure fee prescribed in the code, and a reinspection of the vehicle.

(d)The department may immediately order a life support vehicle out of service if it determines that the health and welfare of a patient may be in jeopardy due to noncompliance with minimum equipment standards or defective and nonfunctional critical minimum equipment. A notice of that action be immediately provided to the life support agency by the department based upon the deficiencies found.

(e) A life support agency that takes corrective measures to bring a life support vehicle into compliance during the time of a department inspection will not receive notice of noncompliance. The inspection report must reflect that the corrective action and compliance have been met.

PART 9. COMMUNICATIONS REQUIREMENTS

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22192 Communications requirements; life support agencies {#sec-r-325.22192 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22192}

Rule 192. A life support agency providing emergency medical services shall use applicable communication systems consistent with its level of licensure in compliance with the code, these rules, and the medcom requirements as prescribed by the department.

History

History: 2004 AACS.

Mich. Admin. Code R 325.22193 Medcom requirements {#sec-r-325.22193 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22193}

Rule 193. Medcom requirements must be reviewed annually and updated, if necessary, with the advice and recommendations of the emergency medical services coordination committee.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22194 Illegal interception of radio communications {#sec-r-325.22194 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22194}

Rule 194. A person that receives any radio communication not intended for the general public may not use the contents of the communication for initiating an emergency medical service response as described in section 20963(2) of the code, MCL 333.20963.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22195 Communications system application process; life support agencies; medical control authorities {#sec-r-325.22195 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22195}

Rule 195. (1) A life support agency shall comply with the ambulance-tohospital radio communications system consistent with the medcom requirements in the medical control authorities in which they operate.

(2) A medical control authority shall comply with the ambulance-tohospital radio communications system approval process, as prescribed by the medcom requirements, under any of the following conditions:

(a) A medical control authority upgrades to provide limited advanced or advanced life support oversight.

(b) An existing medical control authority changes the infrastructure of its communication system affecting ambulance-to-hospital communications.

(c) A change is made in an existing communications system that results in an inability of an agency or hospital to communicate with each other.

PART 10. MEDICAL CONTROL AUTHORITY

History

History: 2004 AACS.

Mich. Admin. Code R 325.22201 Medical control authorities; designation {#sec-r-325.22201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22201}

Rule 201. (1) The department shall designate a medical control authority to provide medical control for emergency medical services for a particular geographic area. The medical control authority shall operate in accordance with the code.

(2) A medical control authority shall be administered by the following:

(a) Each hospital licensed under part 215 of the code, MCL 333.21501 to 333.21571, that operates a service for treating emergency patients 24-hours-a-day, 7days-a-week, may participate and serve on the medical control authority board in the ongoing planning and development activities of the medical control authority designated by the department.

(b) Each freestanding surgical outpatient facility licensed under part 208 of the code, MCL 333.20801 to 333.20821, that operates a service for treating emergency patients 24-hours-a-day, 7-days-a-week and meets standards established by the medical control authority may participate and serve on the medical control authority board in the ongoing planning and development activities of the medical control authority designated by the department. If a freestanding surgical outpatient facility participates in the medical control authority as described in this rule, the facility shall meet all applicable standards established by the medical control authority.

(3) Each hospital, off-campus emergency department with provider-based status, as described in R 325.22112(1)(c), and freestanding surgical outpatient facility shall comply with protocols for providing services to a patient before care of the patient is transferred to hospital personnel.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22202 Medical control authorities; authority board; advisory body; medical director; responsibilities; approval {#sec-r-325.22202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22202}

Rule 202. (1) A medical control authority shall be approved by the department, and do all the following:

(a) Develop bylaws that define the medical control authority organizational structure.

(b) Appoint a medical control authority board to administer the medical control authority. The majority of the board shall be comprised, at a minimum, of members of the hospitals and, when applicable, freestanding surgical outpatient facilities and off-campus emergency department with provider-based status, as described in R 325.22112(1)(c).

The board may include other entities as determined by the medical control authority bylaws.

(c) If the board also functions as the advisory body to the medical control authority as described in this rule, then the board shall include a representative of each type of life support agency and emergency medical services personnel functioning within the medical control authority's region.

(d) Appoint an advisory body, as that term is defined in section 20918(2) and (4) of the code, MCL 333.20918. The advisory body shall meet at least quarterly.

(e) Appoint a medical director, with the advice of the advisory body, in accordance with section 20918(3) of the code, MCL 333.20918. The medical director is responsible for medical control for the emergency medical services system served by the medical control authority. The medical control authority, with the advice of the advisory body, may appoint more than 1 physician to serve as medical director provided the individual meets all applicable criteria, or is approved by the department.

(f) Appoint a professional standards review organization to monitor and improve the quality of medical care.

(g) Hold each licensed life support agency and individual accountable to the medical control authority in the provision of emergency medical services, as that term is defined in department-approved protocols.

(h) Provide protocols for the practice of life support agencies and emergency medical services personnel as prescribed or approved by the department.

(i) Collect data as necessary to assess the quality and needs of emergency medical services throughout its medical control authority area.

(2) Each participating and nonparticipating hospital, off-campus emergency department with provider-based status, as described in R 325.22112(1)(c), and freestanding surgical outpatient facility within a medical control authority region shall follow all standards, policies, procedures, and protocols established by the medical control authority as approved by the department.

(3) Each medical control authority shall submit to the department current protocols for department review and approval. Department approval shall be on a 3-year cycle, or as defined by the department.

(4) The medical control authority shall notify the department if a life support agency is consistently unable to provide at least 1 life support vehicle 24-hours-a-day, 7-days-aweek.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22203 Medical control authority; denial, revocation, or suspension of designation {#sec-r-325.22203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22203}

Rule 203. (1) The department may deny, revoke, limit, or suspend designation of a medical control authority upon finding that the medical control authority meets 1 or more of the following:

(a) Is guilty of fraud or deceit in securing its medical control designation.

(b) Has failed to perform in accordance with the terms of its designation and its department-approved protocols.

(d) Has failed to develop protocols as identified in the code to protect the public health.

(2) If the department denies, revokes, limits, or suspends a medical control authority designation, then the department shall designate a medical control authority to serve that medical control authority area.

(3) The department shall provide notice of intent to deny, revoke, limit, or suspend medical control authority designation and provide for a hearing in accordance with the code and the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22204 Medical control authority; advisory body {#sec-r-325.22204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22204}

Rule 204. A medical control authority shall appoint an advisory body, as that term is defined in section 20918(2) and (4) of the code, MCL 333.20918. The advisory body shall, at a minimum, do all the following:

(a) Advise the medical control authority on the appointment of a medical director.

(b) Advise the medical control authority on the development of protocols.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22205 Medical control authority; medical director; responsibilities {#sec-r-325.22205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22205}

Rule 205. (1) The medical director is an agent of the medical control authority and is responsible for medical control for the emergency medical services system.

(2) The medical director shall ensure the provision of medical control. The medical director's signature on a life support agency's application for licensure or relicensure affirms that the medical control authority intends to provide medical control to the life support agency. If the medical director refuses to sign the life support agency application for licensure or relicensure, then the medical director shall notify the department in writing, within 5 business days, providing justification for denial based on a departmentapproved protocol. Refusal of a medical director to sign a life support agency application will result in denial justification review by the department.

(3) The medical director shall do all the following:

(a) Participate every 2 years in 1 department-approved educational program relating to medical control issues.

(b) Be responsible for the supervision, coordination, implementation, and compliance with protocols of the medical control authority.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22206 Medical control authority; region {#sec-r-325.22206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22206}

Rule 206. (1) Not more than 1 medical control authority may be approved in each designated region.

(2) A medical control authority shall obtain approval from the department to change or combine medical control authority areas, or to assume a temporary contractual responsibility for a portion of another medical control authority's region.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22207 Medical control authority; protocol development; promulgation of protocols; emergency protocol {#sec-r-325.22207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22207}

Rule 207. (1) Each medical control authority shall establish protocols, as that term is defined in section 20919 of the code, MCL 333.20919, which must include, but are not limited to all the following:

(a) The acts, tasks, or functions that may be performed by each level of emergency medical services personnel licensed under this part. Emergency medical services personnel shall not provide life support at a level that exceeds the life support agency license and approved medical control authority protocols.

(b) Procedures to ensure that life support agencies are providing clinical competency assessments to emergency medical services personnel before the individual provides emergency medical services within the medical control authority area.

(c) Medical protocols to require the appropriate dispatching of a life support agency based upon medical need and the capability of the emergency medical services system.

(d) A do-not-resuscitate protocol consistent with section 20919(1)(c) of the code, MCL 333.20919.

(e) A protocol consistent with part 56B of the code, MCL 333.5671 to 333.5685.

(f) Protocols defining the process, actions, and sanctions a medical control authority may use in holding life support agency or personnel accountable. This must include disciplinary action against a life support agency or emergency medical services personnel.

(g) Protocols defining the process to immediately remove medical control if the medical control authority determines that an immediate threat to the public health, safety, or welfare exists. These protocols must specify that a medical control authority has 3 business days to hold a hearing and make a determination.

(h) Protocols establishing that if medical control has been removed or suspended from a participant, that the participant shall not provide prehospital services in that until medical control is reinstated. If medical control is removed or suspended from a participant in the medical control authority, then the department and life support agency shall be notified within 1 business day of the removal. Medical control shall inform the department when medical control is reinstated.

(i) Protocols that ensure a quality improvement program as follows:

(i) The quality improvement program must include a requirement that each life support agency collects and submits data to the medical control authority.

(ii) Data must be reviewed by the medical control authority professional standards review organization.

(iii) Data must be protected in accordance with section 20919(1)(g) of the code, MCL 333.20919.

(j) Protocols that ensure an appeals process of a medical control decision is in effect.

(k) Protocols that specify that if life support agencies transport prehospital patients to hospitals outside of their originating medical control authority area, they will comply with their own medical control authority protocols.

(2) Each medical control authority shall develop standards for the withdrawal or restoration of a hospital or free-standing surgical outpatient facility, or off-campus emergency department with provider-based status, as described in R 325.22112(1)(c), to a medical control authority. The protocol must include a provision to notify the regional trauma network of the withdrawal or restoration of a facility.

(3) Each medical control authority shall develop specific protocols applicable to the acquisition, storage, and use of drugs, intravenous fluids, and medical devices. Protocols must include all of the following:

(a) All drugs must be under the control of a pharmacist licensed in this state affiliated with a participating medical control authority hospital, free-standing surgical outpatient facility, or off-campus emergency department with provider-based status, as described in R 325.22112(1)(c).

(b) The medical control authority participating pharmacy shall provide medication and intravenous fluid exchange services in accordance with the protocols developed by the individual medical control authority and approved by the medical control authority medical control director and the department.

(c) In the instance of a recall relating to medical control authority participating pharmacy supplied medications or devices, the pharmacy shall notify the medical control authorities.

(d) All medication storage containers must be numbered. Each medication storage container must be inspected and inventoried by a medical control authority-approved pharmacy at least annually.

(e) All medication storage containers must have at least the following information affixed to the outside of the container:

(i) The name of the medical control approved pharmacy that most recently restocked the container.

(ii) The date of the most recent restock.

(iii) The name and date of the medications with the earliest expiration dates.

(iv) Notation of the licensed pharmacy personnel who completed and sealed the medication container.

(f) The medical control authority participating facility or agency in possession of intravenous fluids, tubing, and supplies shall have a method for verifying and tracking that the supplies are within their expiration date and do not have any active recall notices.

(g) The medication containers must be stored in a method that maintains the stability, integrity, and effectiveness of the medication contained therein.

(4) Emergency protocols developed in accordance with section 20919(3)(e) of the code, MCL 333.20919, must be submitted to the department, within 5 business days, for review and must remain in effect for not more than 60 days unless approved by the department.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22208 Medical control authority protocols; department review; approval; adoption by medical control authority {#sec-r-325.22208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22208}

Rule 208. (1) A medical control authority shall circulate, not less than 60 days before adoption, a draft of proposed protocols to all affected life support agencies within the emergency medical services system under the medical control authority.

(2) A medical control authority shall submit a written draft of proposed protocols to the department for review by the quality assurance task force no later than the tenth day of any given month. A protocol received not later than the tenth day of a given month must be reviewed that month. A protocol received after the tenth day of a given month must be reviewed the next month following the date of receipt by the department.

(3) The department shall consider any written comments received from persons within the medical control authority when reviewing a protocol.

(4) The department shall provide written recommendations to the medical control authority within 60 days after receipt of a protocol in compliance with this rule, and comments, suggested changes, deletions, denial, or approval on the proposed protocol.

Protocols resubmitted with changes or modifications by the medical control authority fall under the 60-day response deadline as prescribed in this rule.

(5) Following department approval of a protocol, the medical control authority may formally adopt the protocol.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22209 Medical control authority; additional standards {#sec-r-325.22209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22209}

Rule 209. A medical control authority may adopt protocols that require additional or more stringent standards for life support agencies, equipment, and personnel than those already required by the department to enhance its system. If a life support agency or emergency medical services personnel within the medical control authority disagree with the proposed protocol, the medical control authority shall provide the department with the medical and economic considerations such enhancements may have on the local community. The quality assurance task force shall review and make recommendations to the department before department approval.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22210 Medical control authority; life support agencies and personnel; compliance with protocols {#sec-r-325.22210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22210}

Rule 210. (1) A medical control authority shall establish written protocols for the process, actions, and sanctions a medical control authority may use in holding a life support agency or personnel accountable. These protocols must include disciplinary action against a life support agency or emergency medical services personnel to ensure compliance with all protocols or to protect the public health, safety, or welfare.

(2) A medical control authority may exercise disciplinary action against a life support agency and its emergency medical services personnel that may result in the life support agency, or its personnel not being allowed to provide emergency medical services. The basis for these actions must be for noncompliance with policies, procedures, or protocols established by the medical control authority. The disciplinary action may include the suspension, limitation, or removal of a life support agency or its personnel to provide emergency medical services within the medical control authority area.

(3) If disciplinary action against an agency or individual results in the suspension, limitation, or removal of medical control, the medical control authority shall advise the department, in writing, of the action within 1 business day.

(4) If a suspension or removal of medical control to a life support agency or individual occurs by the medical control authority, the life support agency or individual may not operate or practice in that medical control authority region until medical control is restored by the medical control authority.

(5) If a suspension or removal of medical control to a life support agency or individual occurs by the medical control authority, the life support agency or individual shall not operate or practice in that medical control authority area until medical control is restored by the medical control authority.

(6) In cases of malfeasance, misfeasance, or nonfeasance on the part of the medical control authority, the department shall take action to preserve medical control in a medical control authority region.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22211 Medical control authority; quality improvement {#sec-r-325.22211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22211}

Rule 211. (1) A medical control authority shall establish a quality improvement protocol to ensure a quality improvement program is in place and functional.

(2) Data submitted by the life support agencies within the medical control authority area must be reviewed by the medical control authority professional standards review organization for the purpose of improving the quality of medical care within the medical control authority area.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22212 Medical control authority; appeals {#sec-r-325.22212 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22212}

Rule 212. (1) A medical control authority shall incorporate procedures for the appeal of decisions made by the authority against a life support agency and emergency medical services personnel. Once appeals to the medical control authority have been exhausted, the decision made by the medical control authority may be appealed to the statewide emergency medical services coordination committee. An appeal to the emergency medical services coordination committee must be filed with the department in writing not more than 30 calendar days following notification to the agency or individual of the final determination of the medical control authority. The emergency medical services coordination committee shall issue an opinion on whether the actions or decisions of the medical control authority comply with the department-approved protocols of the medical control authority and the code.

(2) If a decision of the medical control authority is appealed to the emergency medical services coordination committee, the medical control authority shall document their decision to the statewide emergency medical services coordination committee for their review.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22213 Medical control authority; data collection; data confidentiality {#sec-r-325.22213 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22213}

Rule 213. (1) A medical control authority shall collect data under the departmentapproved quality improvement protocol from each life support agency within the medical control authority area. Data collected must be reviewed by the medical control authority professional standards review organization to improve the quality of medical care within the medical control authority area and comply with section 20919(1)(g) of the code, MCL 333.20919. All data collected under section 20919(1)(g) of the code, MCL 333.20919, are confidential, not public record, not discoverable, and shall not be used as evidence in a civil action or administrative proceeding.

(2) A medical control authority shall submit data to the department as prescribed by the department and approved by the emergency medical services coordination committee.

(3) Medical control authorities shall have access to quality data residing within the Michigan Emergency Medical System Information System for incidents that occur within the medical control authority’s geographic area.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22214 Medical control authority; special studies {#sec-r-325.22214 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22214}

Rule 214. (1) A medical control authority that intends to establish a protocol involving skills, techniques, procedures, or equipment that is not included in this state's approved curriculum, may need to establish the practice as a special study. Determination that a proposed protocol is acceptable under current practice or requires a special study is decided by the quality assurance task force. A protocol may be approved as a medical control authority protocol under the following conditions:

(a) The medical control authority provides documentation that the skill, technique, procedure, or equipment complies with 1 of the following:

(i) The practice is recognized by a national organization as acceptable.

(ii) The practice has existing precedent in Emergency Medical System outside of this state.

(iii) There are published studies that support the safety and efficacy in its application of the practice within the emergency setting.

(b) The medical authority provides the educational outline that will be implemented to instruct the emergency medical services personnel in the new skill, technique, procedure, or equipment, as well as the verification of competency that will be utilized.

(c) A letter of support, justifying the need for the practice, signed by the medical director for the medical control authority participating in the practice implementation.

(d) The medical control authority submits protocols that will be used for the practice.

(e) The quality assurance task force may require data submission to this state for approval of the practice. If data is required for approval, the approval must be indicated as approval of the practice as a special study.

(2) A medical control authority that intends to establish a protocol involving skills, techniques, procedures, or equipment that is not included in this state’s approved curriculum, and is not consistent with its level of licensure requires a special study and must comply with all of the following:

(a) Provide any available studies or supporting documentation indicating the practice has been studied. Published studies supporting the safety and efficacy of its applications within the emergency setting must also be submitted.

(b) The medical control authority provides an educational outline that will be implemented to instruct the emergency medical services personnel in the new skill, technique, procedure, or equipment, as well as the verification of competency that will be utilized and the plan for continued competency assurance, such as a continuing education plan.

(c) Provide a letter of support, justifying the need for the practice, signed by the medical director for the medical control authority participating in the special study.

(d) The medical control authority shall submit protocols that will be used for the practice.

(e) Identify life support agencies involved in the special study, their licensure level, the number of emergency medical services personnel to be trained, and their respective licensure levels.

(f) Submit a timeline indicating the proposed duration of the study.

(g) Describe the proposed data to be submitted to this state during the study.

Generally, data submission is required quarterly.

(h) If the medical control authority designs the study to develop or contribute to generalizable knowledge, the medical control authority shall also submit documentation of Institutional Review Board approval, exemption, or not regulated status for the study.

(3) A medical control authority that intends to establish a protocol involving skills, techniques, procedures, or equipment that is not included in this state’s approved curriculum and is not consistent with either the level of licensure or scope of practice, involves human subject research under 45 CFR part 46, or intends to publish the human subject research, shall require a special study if it complies with all of the following:

(a) Provide any available studies or supporting documentation indicating the practice has been studied. Published studies supporting the safety or efficacy of its application within the emergency setting must also be submitted.

(b) Submit initial and refresher education requirements and provide an educational outline to be implemented to instruct the emergency medical services personnel in the new skill, technique, procedure, or equipment, as well as verification of competency that will be utilized. Refresher education requirements must include frequency and content of refresher to maintain proficiency in skill, technique, procedure, or equipment.

(c) Identify life support agencies involved, their licensure level, the number of emergency medical services personnel to be trained, and their respective licensure levels.

(d) If providing mutual aid outside its medical control authority region, the medical control authority shall have a written agreement with another medical control authority to continue to utilize its protocols.

(e) Identify the quality review process that will be implemented.

(f) Submit protocols that will be included in the special study.

(g) Identify data parameters to be collected and the quality review process that will be implemented. The medical control authority shall submit quarterly reports, and upon completion of the study, submit a final report to the department.

(h) Obtain and submit an institutional review board approval or an institutional review board official exemption. If the medical control authority used a randomized study, include the consent form, method of institutional review board approval, and institutional review board approval letter.

(4) A special study may be terminated by the department, with the advice of the quality assurance task force, for any of the following reasons:

(a) The special study jeopardizes the health, safety, or welfare of the citizens of this state.

(b) There is evidence of failure to follow study parameters.

(d) The medical control authority or medical director requests termination.

(e) There is not sufficient data to support continuation.

(5) A special study may be considered complete when outcomes have been met, the timeline has been completed, or the study has been terminated by the department with the advice of the quality assurance task force. A final report must be submitted to the department by the medical control authority when the study is complete, unless the study is terminated by the department. The medical control authority may request any of the following for the protocol being studied:

(a) That it become a standard protocol for the requesting medical control authority.

(b) That it become a standard protocol for this state.

(d) That it be terminated.

(6) Disposition of the protocol is determined by the quality assurance task force.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22215 Medical control authority; communication requirements {#sec-r-325.22215 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22215}

Rule 215. (1) A medical control authority shall comply with the ambulance-tohospital radio communications system approval process, as prescribed by the medcom requirements.

(2) Each medical control authority shall designate an individual or organization to be responsible for maintaining records of the telecommunications activities in support of medical control. The records must be in the form of electronic recordings and maintained for 60 days.

(3) The department may add additional frequencies or other methods of communications to the medcom requirements. The department, before implementation, shall approve new requirements and technologies for ambulance-to-hospital communication.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22216 Medical control authority; interface with public safety agencies; {#sec-r-325.22216 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22216}

authority for management of patient.

Rule 216. A medical control authority shall establish protocols that do all the following:

(a) Clarify that the authority for the management of a patient in an emergency is vested in the licensed health professional or licensed emergency medical services personnel at the scene of the emergency who has the most training specific to the provision of emergency medical care.

(b) Identify that when a life support agency is present at the scene of an emergency, authority for the management of an emergency patient in an emergency is vested in the physician responsible for medical control, until that physician relinquishes management of the patient to a licensed physician at the scene of an emergency.

(d) Specify that if an emergency is declared, the declaration that an emergency no longer exists may be made only by an individual licensed under the code or a health professional licensed under the code who has training specific to the provision of emergency medical services in accordance with department-approved protocols.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22217 Medical control authority; interfacility transfers {#sec-r-325.22217 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22217}

Rule 217. (1) A medical control authority may adopt a protocol that governs the transport of a patient from 1 health facility to another. If a medical control authority has not established department-approved protocols for the interfacility transport of a patient, then patient care must be determined according to written orders of the transferring physician within the scope of practice of the emergency medical services personnel.

(2) A life support agency is accountable to a medical control authority in which it has been approved to operate.

History

History: 2004 AACS; 2023 MR 10, Eff. May 26, 2023.

Mich. Admin. Code R 325.22218 Medical control authority; stretcher transport of nonemergency patients {#sec-r-325.22218 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22218}

Rule 218. With department approval, a medical control authority may implement a protocol that governs the treatment and stretcher transport of nonemergency patients.

History

History: 2023 MR 10, Eff. May 26, 2023.

R 325.22301 to R 325.22345 EMS - Personnel Licensure and Regulation Rules

Mich. Admin. Code R 325.22301 Definitions {#sec-r-325.22301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22301}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EMS, TRAUMA, AND PREPAREDNESS

EMERGENCY MEDICAL SERVICES PERSONNEL LICENSING

(By authority conferred on the director of the department of health and human services by section 20975 of the public health code, 1978 PA 368, MCL 333.20975 and Executive Reorganization Order No. 2015-1, MCL 400.227)

PART 1. GENERAL PROVISIONS

Rule 22301. (1) As used in these rules:

(a) “Advanced Emergency Medical Technician” means an emergency medical technician specialist.

(b) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(c) “Compliance conference” means a meeting that provides an opportunity for the licensee to show compliance with the code and these rules before to having the matter proceed to an administrative hearing.

(d) “Continuing education” means programs of education or training approved by the department for use by licensees to meet requirements for renewal or relicensure.

(e) “CPR credential” means a department-approved cardiac pulmonary resuscitation or CPR program for a health care provider or highest equivalent level of training.

(f) “Department” means the department of health and human services.

(g) "EMS" means emergency medical services.

(h) “NREMT” means the national registry of emergency medical technicians.

(i) "Ongoing education" or “continuing education” means education or training sessions, refresher courses, and other learning activities approved by the department and designed to assist individuals who are seeking licensure, or to assist personnel in maintaining and upgrading their knowledge and skills on an ongoing basis throughout the term of their licensure.

(j) “Ongoing education credits" means the unit of measure equal to 50 to 60 minutes of instruction that is assigned to a specific ongoing education topic.

(k) “On-site program sponsor approval” means compliance with the state-approved program criteria by which an educational program is reviewed to determine its compliance with preset educational goals, expectations, and equipment requirements.

(l) "Physician" means a doctor of medicine or doctor of osteopathy who possesses a valid license to practice medicine in this state.

(m) "Physician director" means a physician who serves as the medical advisor for an education program and is responsible for establishing the standards for emergency medical care instruction utilized in the program.

(n) “Professional development” means continuing education for licensed instructor coordinators.

(o) “Reciprocity” means the recognition of the licensing authority of one state by another state.

(p) “Relicensure” means the granting of a license to a person whose license has lapsed for failure to renew the license within 60 days after the expiration date.

(q) “Renewal” means continuation of a license based on completion of requirements and payment of any fees within the time limits established.

(r) “Subject matter expert” means a content expert with extensive knowledge and experience in the specific specialty topic.

(2) Terms defined in the code have the same meanings when used in these rules.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22302 Allegations and investigations {#sec-r-325.22302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22302}

Rule 22302. (1) If a person or entity believes that a violation of the code or a rule promulgated under the code exists, they may submit an allegation to the department in writing.

(2) A licensee or applicant must notify the department of any criminal conviction within 7 calendar days after the date of the conviction.

(3) A licensee or applicant must notify the department within 7 calendar days of any disciplinary or licensing action taken by any of the following:

(a) Any agency of this state.

(b) A state other than this state.

(d) A medical control authority.

(4) This applies to, but is not limited to, a disciplinary action that is stayed pending appeal. Failure of a licensee or applicant to notify the department under this rule may result in an administrative action under section 20958 of the code, MCL 333.20958.

(5) If the department determines, after reviewing an application or an allegation, that there is reasonable basis to believe that a violation of the code or a rule promulgated under the code exists, the department shall investigate the alleged violation.

(6) After an investigation is completed, the department shall do one or more of the following:

(a) Conduct a compliance conference.

(b) Issue a letter of reprimand.

(d) Issue a cease and desist order.

(e) Issue an enforcement action under part 201 or 209 of the code, MCL 333.20101 to 333.20211 and MCL 333.20901 to 333.20979, or the rules promulgated under those parts.

(f) Close the investigation with no action.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22303 Enforcement; fines {#sec-r-325.22303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22303}

Rule 22303. (1) A violation of the code or these rules by an individual licensee may result in an administrative fine of not more than $500.00 in accordance with section 2262 of the code, MCL 333.2262.

(2) A violation of the code or these rules as it relates to a continuing education program or initial education program may result in an administrative fine of not more than $1,000.00 in accordance with section 2262 of the code, MCL 333.2262.

(3) An individual whose license was suspended, denied, or revoked may apply to the department for reinstatement of his or her previous license by using the department prescribed application and reinstatement fee, which is equal to the licensure fees in section 20950(6) of the code, MCL 333.20950.

(4) The department may require that an applicant complete corrective measures or remedial education as a condition of reinstatement.

(5) The department shall not consider an application for reinstatement received before the expiration of the applicable period as established in the enforcement notice or final order issued by the department.

(6) After an eligible reinstatement application has been reviewed, the department shall do one or more of the following:

(a) Issue the license.

(b) Conduct a compliance conference.

(d) Issue an application denial in accordance with section 20958(1) of the code, MCL 333.20958.

PART 2. EMERGENCY MEDICAL SERVICES PERSONNEL LICENSING

History

History: 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22311 Examination application {#sec-r-325.22311 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22311}

Rule 22311. For an applicant to take the appropriate examination, an application for examination must be completed and submitted to the department or state-designated representative within 2 years of the course completion date.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22312 Licensure by examination {#sec-r-325.22312 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22312}

Rule 22312. (1) An applicant for licensure by examination must submit a completed application on a form provided by the department, with the required fee. In addition to meeting the requirements of the code and these rules, an applicant for licensure by examination must meet the following requirements:

(a) Completion of an appropriate education program at the level applied for, as approved under section 20912 of the code, MCL 333.20912, and the proof of completion sent directly from the education program to the department. The initial education course must have been taken within 2 years of application date.

(b) If the applicant is a first-time applicant, attain a passing score on the appropriate department-prescribed examination.

(2) The fees paid by an applicant who has not completed all requirements for licensure by examination within 2 years of the department’s receiving the application are forfeited to the department and the application is void.

(3) An individual who is guilty of fraud or deceit in procuring or attempting to procure licensure, including using falsified documents to gain admittance to a department-prescribed licensure examination, must be denied licensure for at least 3 years.

(4) An individual may not represent himself or herself as, function as, or perform the duties of, a licensed medical first responder, emergency medical technician, emergency medical technician specialist or paramedic until licensed by the department in accordance with the code and these rules.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22313 Licensure at lower levels {#sec-r-325.22313 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22313}

Rule 22313. A current EMS licensee who applies for a lower-level license must submit a new application for the lower-level license along with the fee and proof of having earned the required continuing education at the lower-level license.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22314 Licensure by reciprocity {#sec-r-325.22314 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22314}

Rule 22314. An applicant for licensure by reciprocity must submit a completed application provided by the department together with the required fee, and all of the following documentation:

(a) Verification of current licensure/certification/registration in any state that granted permission to practice.

(b) Successful completion of a department-prescribed examination that verifies passage of examinations or NREMT status, or both.

(c) Sanctions or grounds for sanctions by another state that may exist at time of application that will disqualify the applicant until the other state certifies that those sanctions or grounds for sanctions no longer exist for the applicant.

(d) Proof of training that is substantially equivalent to the state-prescribed curriculum. If deficiencies are noted, proof of continuing education or training in areas determined deficient by the department must be submitted.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22315 Licensure by national registry status only {#sec-r-325.22315 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22315}

Rule 22315. An applicant for licensure who has active NREMT status only and who has not been licensed in any other state must submit a completed application to the department, together with the required fee, and meet both of the following requirements:

(a) Verification of NREMT.

(b) Proof of training that is substantially equivalent to the state-prescribed curriculum. If deficiencies are noted, proof of continuing education or training in areas determined deficient by the department must be submitted.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22316 License renewal {#sec-r-325.22316 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22316}

Rule 22316. Not more than 60 days before the date of license expiration, the department shall transmit a renewal notice to the licensee. Failure of the licensee to receive notice for renewal does not relieve the licensee of the responsibility for renewing his or her license.

PART 3. CONTINUING EDUCATION REQUIREMENTS

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22321 License renewal or relicensure for medical first responders; continuing education {#sec-r-325.22321 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22321}

Rule 22321. (1) An applicant for license renewal as a medical first responder who has been licensed for the 3-year period immediately preceding the expiration date of the license or an applicant for relicensure as a medical first responder must accumulate at least 15 continuing education credit hours that are approved by the department under these rules during the 3 years preceding an application for renewal or relicensure.

(2) An applicant for license renewal or for relicensure under section 20954 of the code, MCL 333.20954, in addition to the requirements of subrule (1) of this rule, must have an appropriate and current CPR credential as determined by the department.

Continuing education credit for a CPR credential may be part of the medical continuing education category requirement.

(3) The categories of approved continuing education activities for medical first responders are prescribed by the department, in collaboration with the EMSCC, on a triennial basis.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22322 License renewal or relicensure for emergency medical technicians; continuing education {#sec-r-325.22322 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22322}

Rule 22322. (1) An applicant for license renewal as an emergency medical technician who has been licensed for the 3-year period immediately preceding the expiration date of the license or an applicant for relicensure as an emergency medical technician must accumulate at least 30 continuing education credit hours that are approved by the department under these rules during the 3 years preceding an application for renewal or relicensure.

(2) An applicant for license renewal or relicensure pursuant to section 20954 of the code, MCL 333.20954, in addition to the requirements of subrule (1) of this rule, must have an appropriate and current CPR credential as determined by the department.

Continuing education credit for a CPR credential may be part of the medical continuing education category requirement.

(3) The categories of approved continuing education activities for emergency medical technicians are prescribed by the department, in collaboration with the EMSCC, on a triennial basis.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22323 License renewal or relicensure for emergency medical technician specialists; continuing education {#sec-r-325.22323 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22323}

Rule 22323. (1) An applicant for license renewal as an emergency medical technician specialist who has been licensed for the 3-year period immediately preceding the expiration date of the license or an applicant for relicensure as an emergency medical technician specialist must accumulate at least 36 continuing education credit hours that are approved by the department under these rules during the 3 years preceding an application for renewal or relicensure.

Continuing education credit for a CPR credential may be part of the medical continuing education category requirement.

(3) The categories of approved continuing education activities for emergency medical technician specialists are prescribed by the department, in collaboration with the EMSCC, on a triennial basis.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22324 License renewal or relicensure for paramedics; continuing education {#sec-r-325.22324 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22324}

Rule 22324. (1) An applicant for license renewal or relicensure as a paramedic who has been licensed for the 3-year period immediately preceding the expiration date of the license or an applicant for relicensure as a paramedic must accumulate at least 45 continuing education credit hours that are approved by the department under these rules during the 3 years preceding an application for renewal or relicensure.

Continuing education credit for CPR credential may be part of the medical continuing education category requirement.

(3) The categories of approved continuing education activities for paramedics are prescribed by the department, in collaboration with the EMSCC, on a triennial basis.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22325 Certification of compliance; additional documentation {#sec-r-325.22325 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22325}

Rule 22325. (1) Submission of an application for renewal or relicensure constitutes the applicant’s certification of compliance with the requirements of these rules.

(2) The department may require an applicant or licensee to submit documentation to demonstrate compliance with the continuing education requirement. The applicant or licensee must maintain documentation of his or her compliance with the continuing education requirement for a period of 1 year after the expiration date of the license.

Failure to provide the documentation creates a rebuttable presumption that the licensee has made a false and fraudulent statement in applying for a license to practice emergency medical services. As provided under section 20958 of the code, MCL 333.20958, the department shall determine if failure to provide documentation of compliance with the continuing education requirement is a violation of section 20954 of the code, MCL 333.20954.

(3) Acceptable documentation of continuing education must include all the following:

(a) Name of the licensee participating in the program.

(b) Name of the sponsoring organization and instructor-coordinator number.

(d) Hours of continuing education credit awarded per required category.

(e) Date of the program.

(f) Signature of the instructor-coordinator or designee.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22326 Continuing education courses and programs; standards for approval {#sec-r-325.22326 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22326}

Rule 22326. (1) One continuing education credit hour may be earned for each 50 to 60 minutes of instruction at an approved education program that complies with this rule and R 325.22327. One half of a continuing education credit hour may be earned for each 25 to 30 minutes of instructions.

(2) Initial education program sponsors may be approved for up to 3 years for presentation of continuing education programs at the level consistent with education approval upon submission and approval of a continuing education sponsor application.

(3) The department approves and adopts, by reference, the standards and criteria of a nationally approved continuing education accrediting body, Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE). A copy of the publication is available for inspection and distribution to the public at no cost from the Department of Health and Human Services, P.O. Box 30207, Lansing, Michigan 48909- 0207. A printed copy is also available from CAPCE at no cost at P.O. Box 293835, Lewisville, Texas 75029 or https://capce.org/docs/Accred%20Guidebook.pdf .

(4) Medical first responders completing an emergency medical technician course, or emergency medical technicians and emergency medical technician specialists completing a paramedic program, may be awarded all the required ongoing education credit for the lower licensure level for the current renewal period. An emergency medical technician completing an advanced emergency medical technician program may be awarded all the required ongoing education credit hours for the lower-license level for the current renewal period.

(5) Continuing education credit hours may be awarded for continuing education programs approved by the Michigan boards of medicine, osteopathic medicine, nursing, or pharmacy toward the EMS license if directly related to the emergency medical scope of practice issues, as determined by the department.

(6) Five continuing education credit hours may be awarded for each semester credit earned for academic courses related to EMS that are offered either in an educational program approved by the Michigan boards of medicine, osteopathic medicine, or nursing, or in an approved physician assistant program.

(7) Three continuing education credit hours may be awarded for each term credit earned for academic courses related to EMS that are offered either in an educational program approved by the Michigan boards of medicine, osteopathic medicine, or nursing, or in an approved physician assistant program.

(8) Credit may be requested for programs offered by out-of-state or militarysponsored EMS agencies before license renewal.

(9) The department or its designee must publish a list of acceptable state or national programs sponsored by emergency medical organizations or other related organizations that do not meet any of the criteria listed in subrules (2) to (8) of this rule with preapproved credits indicated in the publication.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22327 Continuing education program sponsors {#sec-r-325.22327 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22327}

Rule 22327. (1) The department shall consider requests for approval of continuing education programs by instructor-coordinators, program sponsors, or other parties not covered in R 325.22326 who submit applications on a form provided by the department.

The department or its designee shall evaluate applications for approval based on, but not limited to, the following criteria:

(a) Educational goals or learning objectives.

(b) Time schedule and continuing education credits to be awarded.

(d) Documentation of qualifications of presenters.

(e) Use of appropriate and adequate facilities for a program.

(f) Program content that relates to the general subject of emergency medicine.

(g) Evaluation tools to be used in a program.

(2) All applications for approval to conduct continuing education courses must be submitted to the department or its designee on forms provided by the department at least 30 days before implementing the programs.

(3) Any individual attending out-of-state or military-sponsored ongoing education programs must submit a request for approval of the program to the department or its designee if continuing education credits are to be awarded.

(4) Continuing education sponsor approval may be granted for up to 3 years.

(5) Independent study such as continuing education articles in professional journals, ongoing serial productions, or interactive computer programs are acceptable, if the program is developed by a professional group such as an educational institution, corporation, professional association, or other approved provider of continuing education and meets all the following criteria:

(a) Requires a participant to make an active and appropriate response to the educational materials presented.

(b) Provides a test or evaluation tool.

PART 4. INSTRUCTOR-COORDINATORS

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22331 Licensure by examination; requirements {#sec-r-325.22331 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22331}

Rule 22331. (1) An applicant for licensure by examination shall submit a completed application and the requisite fee. In addition to meeting the other requirements of the code and these rules, an applicant must do all the following:

(a) Be licensed in this state as an EMS personnel.

(b) Demonstrate successful completion of an approved instructor-coordinator educational program.

(c) Have completed 3 years of full-time, part-time, on-call, or volunteer direct patient care with a licensed life support agency.

(d) Pass the examination set forth in R 325.22333.

(4) An individual shall not represent himself or herself as, function as, or perform the duties of, a licensed instructor-coordinator until licensed as an instructor-coordinator by the department in accordance with the code and these rules.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22332 Examination application for instructor-coordinator {#sec-r-325.22332 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22332}

Rule 22332. An application for examination as an instructor-coordinator must be completed and returned to the department within 2 calendar years of course completion.

A candidate for examination whose application is received more than 2 calendar years after course completion must successfully complete another instructor-coordinator course before being admitted into a subsequent examination.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22333 Instructor-coordinator examination {#sec-r-325.22333 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22333}

Rule 22333. The department or its designee must administer a written examination to graduates of an instructor-coordinator education course conducted by a departmentapproved education program.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22334 Failure to pass examination; education course required; reexamination {#sec-r-325.22334 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22334}

Rule 22334. An applicant who fails to attain a passing score on the written examination in 3 attempts must successfully complete an approved instructor-coordinator education course or refresher course before reapplying to the department for further examination.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22335 Licensure by endorsement {#sec-r-325.22335 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22335}

Rule 22335. (1) An applicant for licensure by endorsement must submit a completed application on a form provided by the department together with the requisite fee, and submit documentation of all the following:

(a) Verification of current licensure, certification, or registration in any state in which the applicant is granted permission to practice.

(b) Examination scores for a department-prescribed examination that verify passage of examinations.

(c) Proof of training that is substantially equivalent to the state-prescribed curriculum and qualifications described in R 325.22331(c). If deficiencies are noted, proof of continuing education or training in areas determined deficient by the department must be submitted.

(2) Sanctions or grounds for sanctions by another state will disqualify an applicant from licensure.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22336 Professional development for instructor-coordinators; requirements {#sec-r-325.22336 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22336}

Rule 22336. (1) All licensed instructor-coordinators must accrue 30 professional development credits in ongoing education programs specified by the department as appropriate for licensed instructor-coordinators. The professional development credits must be accrued during the 3-year licensure period.

(2) All professional development courses must be approved by the department or its designee before implementation if professional development credits are to be awarded.

(3) Instructor-coordinators shall earn 30 professional development hours in 1 of the following ways:

(a) Completion of a minimum 30-hour department-approved instructor-coordinator refresher course.

(b) Completion of the required 30 hours in department-approved professional development programs.

(c) Completion of a total of 30 hours in professional development and educational experience with a minimum of 20 hours in department-approved professional development programs and a minimum of 10 hours in educational experience as defined by the department.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22337 Instructor-coordinator license renewal or relicensure {#sec-r-325.22337 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22337}

Rule 22337. (1) Not more than 60 days before the date of license expiration, the department shall transmit a renewal notice to the licensee. Failure of the licensee to receive notice for renewal does not relieve the licensee of the responsibility for renewing his or her license.

(2) An applicant for license renewal or relicensure as an instructor-coordinator who has been licensed for the 3-year period immediately before the expiration date of the license or an applicant for relicensure, in addition to holding a current license as an emergency medical technician, emergency medical technician specialist, or paramedic, must accumulate during the 3 years before an application for renewal or relicensure at least 30 professional development credit hours in department-approved programs.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22338 Certification of compliance; additional documentation {#sec-r-325.22338 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22338}

Rule 22338. Instructor-coordinator renewal or relicensure must be done in accordance with R 325.22325.

PART 5. EDUCATION PROGRAM REQUIREMENTS

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22339 Education programs; requirements {#sec-r-325.22339 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22339}

Rule 22339. An emergency medical first responder, emergency medical technician, advanced emergency medical technician, or paramedic education program must comply with all the following requirements:

(a) Be under the direction of a physician director, except for emergency medical first responder education programs. Programs requiring emergency medical responder students to do clinicals must have physician direction and vaccination requirements.

(b) Be coordinated by a licensed instructor-coordinator who must ensure that an instructor-coordinator, qualified instructor, or subject matter expert is in attendance at all didactic and practical sessions.

(c) Qualified instructors and subject matter experts are subject to review and approval by the department through the program sponsor approval process.

(d) Complete an application prescribed by the department for educational program sponsor approval to conduct an education course at least 60 days before the start of the course.

(e) Advise the students before or at the first-class session that the education program and course are approved by the department.

(f) Conduct courses according to an on-site program sponsor approval process.

(g) Provide the department within 30 calendar days of course completion with a roster of students who successfully completed the course, including each student’s name and date of birth.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22340 Instructor-coordinator education program; requirements {#sec-r-325.22340 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22340}

Rule 22340. An instructor-coordinator education program must comply with all the following requirements:

(a) Be coordinated by a licensed instructor-coordinator who has coordinated at least 1 initial education program in the last 3 consecutive years.

(b) Utilize qualified instructional staff with appropriate expertise.

(d) Complete an application prescribed by the department to conduct an education course at least 60 days before the start of the course and be approved by the department through an on-site program sponsor approval before implementation.

(e) Conduct courses according to an on-site program sponsor approval process.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Rule 22341. An education program sponsor is responsible for the overall quality of the program and courses offered. The program sponsor, the instructor-coordinator, and the physician director are responsible for, but not limited to, all the following:

(a) Establishing admission requirements and conducting entry assessments.

(b) Establishing standards for successful course completion.

(c) Establishing standards for instructors and approval of all instructors, ensuring that all instructors meet or exceed the standards established in R 325.22344.

(d) Ensuring that the medical control authority in the region is informed of the program.

(e) Establishing clinical contracts specific to the level of the program and expected activities.

(f) Monitoring the activities of the emergency medical services instructorcoordinator based on standards developed by the program sponsor.

(g) Establishing an equal opportunity policy that at a minimum complies with state and federal law.

(h) Providing an adequate and appropriate instructional facility including making available equipment that is functional, in good repair, and is of a similar type to that currently on the list of required minimum equipment for life support vehicles.

(i) Developing examinations based on approved curricula.

(j) Developing a process for students to appeal decisions made by the staff or sponsor relative to their performance in the course. This process must be made available, in writing, to each student.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22342 Instructor-coordinator responsibilities {#sec-r-325.22342 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22342}

Rule 22342. (1) An instructor-coordinator for all emergency medical educational training courses must possess a current EMS license that is commensurate with the level of the training course being taught.

(2) The instructor-coordinator responsibilities include, but are not limited to, all the following:

(a) Complying with instructor-coordinator performance standards indicated in instructor-coordinator curriculum.

(b) Being responsible for course development, evaluation, and coordination of curricular elements, including those of a clinical nature, and assisting in the selection and evaluation of instructors, with the approval of the program sponsor and physician director.

(d) Assisting in the evaluation and selection of students.

(e) Evaluating and maintaining records of student performance.

(f) Maintaining and assuring the availability of equipment and training aids.

(g) Coordinating and maintaining records of clinical experience.

(h) Counseling and assisting students, as appropriate.

(i) Providing the department, within 30 calendar days of course completion, with a roster of students who successfully completed the course, including each student’s name and date of birth.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22343 Education program physician director; responsibilities {#sec-r-325.22343 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22343}

Rule 22343. The education program physician director responsibilities must include, but are not limited to, all the following:

(a) Conducting a periodic review of the organization and content of a course to ensure that current standards of emergency medical care are being utilized throughout the course.

(b) Working with the education sponsor and the instructor-coordinator in carrying out the responsibilities of course development, evaluation, and coordination of curricular elements, including those of a clinical nature, and selecting and evaluating instructors.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22344 Education program course instructor; requirements {#sec-r-325.22344 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22344}

Rule 22344. An education program course instructor must meet, at a minimum, both of the following requirements:

(a) Have a working and practical knowledge of the objectives and components of the education course relevant to his or her area of instruction.

(b) Be a licensed health professional with relevant and current clinical experience or possess educational expertise that is appropriate to his or her specific topic of instruction.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.22345 Department evaluation of education programs {#sec-r-325.22345 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.22345}

Rule 22345. (1) The department may evaluate an emergency medical services program at any time. An evaluation will be completed when any of the following occurs:

(a) A request for a new program is submitted.

(b) The failure rate on the required licensure examination for 1 calendar year of compiled statistics is more than 10% below the threshold established by the department.

(2) Evaluation processes may include any of the following:

(a) A site visit.

(b) A follow-up study of graduates and employers.

(3) An evaluation that is found to have deficiencies may result in any of the following:

(a) The creation of a program performance improvement plan with reports to the department.

(b) Program suspension for a period determined by the department.

History

History: 2004 AACS; 2023 MR 6, Eff. March 29, 2023.

Mich. Admin. Code R 325.23101 Rescinded {#sec-r-325.23101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23101}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23102 Rescinded {#sec-r-325.23102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23102}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23103 Rescinded {#sec-r-325.23103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23103}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23104 Rescinded {#sec-r-325.23104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23104}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23105 Rescinded {#sec-r-325.23105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23105}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23106 Rescinded {#sec-r-325.23106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23106}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23107 Rescinded {#sec-r-325.23107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23107}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23201 Rescinded {#sec-r-325.23201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23201}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23202 Rescinded {#sec-r-325.23202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23202}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23203 Rescinded {#sec-r-325.23203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23203}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23301 Rescinded {#sec-r-325.23301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23301}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23302 Rescinded {#sec-r-325.23302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23302}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23303 Rescinded {#sec-r-325.23303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23303}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23304 Rescinded {#sec-r-325.23304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23304}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23401 Rescinded {#sec-r-325.23401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23401}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23402 Rescinded {#sec-r-325.23402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23402}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23403 Rescinded {#sec-r-325.23403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23403}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23404 Rescinded {#sec-r-325.23404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23404}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23405 Rescinded {#sec-r-325.23405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23405}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23406 Rescinded {#sec-r-325.23406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23406}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23407 Rescinded {#sec-r-325.23407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23407}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23501 Rescinded {#sec-r-325.23501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23501}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23502 Rescinded {#sec-r-325.23502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23502}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23503 Rescinded {#sec-r-325.23503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23503}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23504 Rescinded {#sec-r-325.23504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23504}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23505 Rescinded {#sec-r-325.23505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23505}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23506 Rescinded {#sec-r-325.23506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23506}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23507 Rescinded {#sec-r-325.23507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23507}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23601 Rescinded {#sec-r-325.23601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23601}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23602 Rescinded {#sec-r-325.23602 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23602}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23603 Rescinded {#sec-r-325.23603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23603}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23701 Rescinded {#sec-r-325.23701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23701}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23702 Rescinded {#sec-r-325.23702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23702}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23703 Rescinded {#sec-r-325.23703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23703}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23704 Rescinded {#sec-r-325.23704 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23704}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23705 Rescinded {#sec-r-325.23705 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23705}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23706 Rescinded {#sec-r-325.23706 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23706}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23707 Rescinded {#sec-r-325.23707 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23707}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23801 Rescinded {#sec-r-325.23801 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23801}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23802 Rescinded {#sec-r-325.23802 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23802}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23803 Rescinded {#sec-r-325.23803 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23803}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23804 Rescinded {#sec-r-325.23804 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23804}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23805 Rescinded {#sec-r-325.23805 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23805}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23806 Rescinded {#sec-r-325.23806 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23806}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23807 Rescinded {#sec-r-325.23807 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23807}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23808 Rescinded {#sec-r-325.23808 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23808}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23901 Rescinded {#sec-r-325.23901 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23901}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23902 Rescinded {#sec-r-325.23902 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23902}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23903 Rescinded {#sec-r-325.23903 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23903}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23904 Rescinded {#sec-r-325.23904 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23904}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23905 Rescinded {#sec-r-325.23905 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23905}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.23906 Rescinded {#sec-r-325.23906 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.23906}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24001 Rescinded {#sec-r-325.24001 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24001}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24002 Rescinded {#sec-r-325.24002 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24002}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24003 Rescinded {#sec-r-325.24003 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24003}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24004 Rescinded {#sec-r-325.24004 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24004}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24005 Rescinded {#sec-r-325.24005 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24005}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24006 Rescinded {#sec-r-325.24006 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24006}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24007 Rescinded {#sec-r-325.24007 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24007}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24008 Rescinded {#sec-r-325.24008 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24008}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24009 Rescinded {#sec-r-325.24009 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24009}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24010 Rescinded {#sec-r-325.24010 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24010}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24011 Rescinded {#sec-r-325.24011 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24011}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24012 Rescinded {#sec-r-325.24012 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24012}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24013 Rescinded {#sec-r-325.24013 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24013}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24014 Rescinded {#sec-r-325.24014 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24014}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24015 Rescinded {#sec-r-325.24015 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24015}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24016 Rescinded {#sec-r-325.24016 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24016}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24017 Rescinded {#sec-r-325.24017 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24017}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24018 Rescinded {#sec-r-325.24018 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24018}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24020 Rescinded {#sec-r-325.24020 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24020}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24101 Rescinded {#sec-r-325.24101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24101}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24102 Rescinded {#sec-r-325.24102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24102}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24103 Rescinded {#sec-r-325.24103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24103}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24104 Rescinded {#sec-r-325.24104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24104}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24105 Rescinded {#sec-r-325.24105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24105}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24106 Rescinded {#sec-r-325.24106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24106}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24107 Rescinded {#sec-r-325.24107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24107}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24108 Rescinded {#sec-r-325.24108 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24108}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24109 Rescinded {#sec-r-325.24109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24109}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24110 Rescinded {#sec-r-325.24110 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24110}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24111 Rescinded {#sec-r-325.24111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24111}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24112 Rescinded {#sec-r-325.24112 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24112}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24113 Rescinded {#sec-r-325.24113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24113}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24114 Rescinded {#sec-r-325.24114 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24114}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24115 Rescinded {#sec-r-325.24115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24115}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24116 Rescinded {#sec-r-325.24116 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24116}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24117 Rescinded {#sec-r-325.24117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24117}

History

History: 1984 AACS; 2004 AACS.

Mich. Admin. Code R 325.24118 Rescinded {#sec-r-325.24118 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.24118}

History

History: 1984 AACS; 2004 AACS.

R 325.99101 to R 325.99409 Lead Hazard Controls

Mich. Admin. Code R 325.99101 Scope; application; rescission {#sec-r-325.99101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99101}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH LEGISLATION AND POLICY DEVELOPMENT

LEAD HAZARD CONTROL

(By authority conferred on the department of community health by sections 2226, 5461 to 5464, 5466, 5468 to 5470, 5473a, and 5475 to 5477 of 1978 PA 368, and Executive Reorganization Order No. 1996-1, being MCL 333.2226, 333.5461 to 333.5464, 333.5466, 333.5468 to 333.5470, 333.5473a, 333.5475 to 333.5477, and 330.3101)

PART 1. GENERAL PROVISIONS

Rule 101. (1) These rules apply to all activities defined by sections 5451 to 5477 of 1978 PA 368, MCL 333.5451 to 333.5477 and referred to in these rules as the "act."

(2) These rules provide specifications applicable to lead-based paint activities for all of the following:

(a) Training program requirements (b) Certification requirements.

(d) Notification requirements.

(e) Enforcement actions.

(3) These rules replace R 325.9901 to R 325.9925, which are hereby rescinded.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99102 Definitions {#sec-r-325.99102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99102}

Rule 102. (1) As used in these rules:

(a)"EBL environmental investigation" means both of the following:

(i) A study for case management purposes of the living environment of 1 or more children 6 years of age or less with an elevated blood lead level performed by an EBL investigator to identify causative lead exposures.

(ii) The provision of a report by the EBL investigator explaining the results of the study and options for remediation of exposures.

(b) EBL "investigator" means a certified risk assessor who has been endorsed by the department to conduct EBL environmental investigations.

(c) "Emergency renovation operations" means renovation activities, such as operations necessitated by non-routine failures of equipment, that were not planned but result from a sudden, unexpected event that, if not immediately attended to, presents a safety or public health hazard, or threatens equipment and/or property with significant damage.

(d) "Lead hazard control activity" means a measure or set of measures which are designed or performed specifically to reduce or eliminate lead-based paint hazards in target housing and child-occupied facilities. Lead hazard control activity includes, but is not limited to, abatement, interim controls and clearance examinations.

(e) "Pamphlet" means the US EPA's pamphlet number EPA 747-K-99-001, entitled "Protect Your Family From Lead in Your Home," or a true reproduction, or an equivalent pamphlet approved by the department.

(f) "Renovation" means the modification of an existing residential dwelling, or portion thereof, that results in the disturbance of painted surfaces, unless the activity is performed as part of an abatement as defined in the act. Renovation includes, but is not limited to, the removal or modification of building components, surface preparation of painted surfaces, and window or door replacement to improve structural or operational integrity.

(g) "Renovator" means any person who performs for compensation a renovation.

(2) Unless the context dictates otherwise, terms defined in sections 5453 to 5460 of the act have the same meanings when used in these rules.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99103 Recordkeeping {#sec-r-325.99103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99103}

Rule 103. (1) A person who is certified by the department, the act, and these rules shall maintain all records required by the act and these rules for not less than 3 years.

(2) A person or individual who prepares a report or plan required by these rules shall maintain the report or plan for not less than 3 years, and shall provide copies of the report or plan not later than 20 business days after completion of the activity for which the report or plan was prepared to both of the following persons:

(a) The building owner.

(b) The person who contracted for the person's or individual's services, if different than the owner.

(3) A training program shall maintain the records required by these rules for not less than 3½ years at the address specified on the training program accreditation application.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99104 Enforcement actions {#sec-r-325.99104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99104}

Rule 104. (1) Any person who violates the act or these rules or fails to satisfy agreed upon conditions for settlement of a violation shall be subject to 1 or more of the following enforcement actions, as determined by the department:

(a) Notice of noncompliance.

(b) Citation.

(d) Suspension of certification or accreditation by cease operations order.

(e) Summary suspension of certification or accreditation.

(f) Revocation of certification or accreditation.

(g) Criminal sanction in accordance with section 5477 of the act.

(h) Administrative fines.

(2) The department shall consider the circumstance, extent, probability of harm, and repetitive nature of the violation to determine the degree and severity of enforcement actions taken, including administrative fines.

(3) Not later than 15 working days after receipt of a citation issued under section 5476 of the act, a person who is alleged to have violated the act or these rules may appeal the alleged violation by petitioning the department. If the appeal is not resolved as a result of a pre-hearing conference, the person who is alleged to have violated the act or these rules may then petition the department for an administrative hearing not later than 15 working days after completion of the pre-hearing conference. The department shall conduct an administrative hearing in accordance with 1969 PA 306, MCL 24.201. A citation and associated administrative fine become final if the department does not receive a petition for either a pre-hearing conference or an administrative hearing within the time specified in this subrule of this rule.

PART 2. TRAINING PROGRAMS

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99201 Training program accreditation; disciplines; training manager; principal instructor {#sec-r-325.99201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99201}

Rule 201. (1) A person may seek accreditation for a training program to offerasd int training courses leading to certication of individuals pursuant to requirements in the act and these rules.

(2) A person seeking accreditation for a training program shall submit a written application to the department containing all of the following:

(a) If the applicant is a sole proprietorship or corporation, its "doing business as" or corporate identification number.

(b) The name of each principal position, partner, shareholder, member, or owner.

(d) A statement signed by the training program manager certifying that the training program meets the requirements established by the act and these rules.

(e) A copy of the quality control plan as defined in R 325.99204.

(f) The fee required by the act and these rules.

(g) A sample of the training completion certificate required by R 325.99202.

(3) A training program shall meet all of the following requirements in order to become accredited to offer courses in lead-based paint activities:

(a) Employ a training manager who has demonstrated experience, education, or training in the construction industry and has at least 1 of the following:

(i) Not less than 2 years of experience, education, or training in teaching workers or adults.

(ii) A bachelor's or graduate degree in any of the following:

(A) Building construction technology.

(B) Engineering.

(D) Safety.

(E) Public health.

(F) Education.

(G) Business administration or program management.

(H) A field related to any of the areas specified in this paragraph.

(iii) Two years of experience in managing a training program specializing in environmental hazards.

(b) Provide that the training manager described in subdivision (a) of this subrule designate a qualified principal instructor for each course who shall possess all of the following qualifications:

(i) Demonstrated experience, education, or training in teaching workers or adults.

(ii) Successful completion of the training course which has been accredited by EPA or EPA-authorized state or tribe, which they intend to instruct.

(iii) Demonstrated experience, education, or training in any of the following:

(A) Lead or asbestos abatement.

(B) Painting.

(D) Renovation.

(E) Remodeling.

(F) Occupational safety and health.

(G) Industrial hygiene.

(c) Provide that the principal instructor described in subdivision (b) of this subrule be responsible for the organization of the course and oversight of the teaching of all course material. A training manager may designate guest instructors as needed to provide instruction specific to the lecture, hands-on activities, or work practice components of a course.

(4) The following documents are recognized by the department as evidence that a training manager or a principal instructor has the education, work experience, training requirements, or demonstrated experience specifically listed in these rules, which documentation is not required to be submitted with the accreditation application but, if not submitted, shall be retained by the training program as required by the recordkeeping requirements of these rules:

(a) An official academic transcript or diploma as evidence of meeting the education requirements.

(b) A resume, letter of reference, or documentation of work experience, as evidence of meeting the work requirements.

(c) A certificate from a train-the-trainer course or a lead-specific training course, or both, as evidence of meeting training requirements.

(5) A person may seek accreditation for a training program to offer 1 or more of the following courses for lead-based paint activities:

(a) Core lead basics.

(b) Inspector.

(d) Supervisor.

(e) Worker.

(f) Project designer.

(g) Clearance technician.

(6) A person may also seek accreditation for a training program to offer refresher courses for each of the lead-based paint training activities described in subrule (5), of this rule except for core lead basics.

(7) A person seeking accreditation for a training course under subrule (5) of this rule shall submit a written application to the department containing all of the following:

(a) The name of the course for which accreditation is being sought.

(b) A copy of the student and instructor manuals, handouts, and other materials to be used for each course.

(d) A description of the facilities and equipment to be used for lecture and handson training.

(e) A description of the course examination, including blueprint, length, format, and passing score.

(f) A description of the activities and procedures that will be used for conducting the hands-on skills assessment for each course.

(g) A course outline describing the location within the course materials of each topic required by these rules.

(h) The fee required by the act.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99202 Training program requirements; facilities; course test; skills assessment; course certificate; audit by the department {#sec-r-325.99202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99202}

Rule 202. (1) A training program accredited under section 5462 of the act shall ensure the availability of, and provide adequate facilities for, the delivery of the lecture, course test, hands-on training and assessment activities including, but not limited to, providing training equipment that reflects current work practices and maintaining or updating the equipment and facilities of the training program, as needed.

(2) For each course offered, except the core lead basics course, the training program shall conduct a course test at the completion of the course and, if applicable, a hands-on skills assessment. Each individual enrolled in the training program shall successfully complete the hands-on skills assessment, if conducted for that course, and receive a passing score on the course test to pass a course.

(3) The training manager shall maintain the validity and integrity of the hands-on skills assessment to ensure that it accurately evaluates the trainees' performance of the work practices and procedures associated with the course topics contained in these rules, and the course test to ensure that it accurately evaluates the trainees' knowledge and retention of the course topics.

(4) The training program's course test shall be developed in accordance with the test blueprint submitted with the training program accreditation application.

(5) The training program shall issue course completion certificates to each individual who passes the training course. The course completion certificate shall include all of the following:

(a) The name and address of the individual, along with a unique identification number.

(b) The name of the particular course that the individual passed.

(d) Expiration date of course certificate (3 years from course completion).

(e) The name, address, and telephone number of the training program.

(f) Expiration date of the individual's eligibility to take the third-party examination (6 months from course completion).

(6) The training manager shall allow the department to audit the training program and courses to verify the contents of the application for accreditation.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99203 Training records {#sec-r-325.99203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99203}

Rule 203. (1) An accredited training program shall maintain, and make available to the department, upon request, all of the following records:

(a) Each document that demonstrates the qualification of a training manager or a principal instructor.

(b) Current curriculum and course materials and documents reflecting changes made to these materials.

(d) Information regarding how the hands-on skills assessment is conducted including, but not limited to, all of the following:

(i) The person conducting the hands-on skills assessment.

(ii) The method of grading the hands-on skills.

(iii) A description of the facilities used.

(iv) The pass/fail determination.

(e) The quality control plan.

(f) Any other material that was submitted to the department as part of the program's application for accreditation.

(g) Notifications of course schedules.

(h) Course participant information.

(i) Examination results.

(j) Copies of the certificates issued.

(2) The training program shall notify the department in writing within 30 days of changing the address specified on its training program accreditation application or transferring the records from that address.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99204 Quality control plan {#sec-r-325.99204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99204}

Rule 204. The training manager shall develop and implement a quality control plan designed to maintain and improve the quality of the training program. The quality control plan shall contain at least both of the following elements:

(a) Procedures for periodic revision of training materials and the course test to reflect innovations in the field.

(b) Procedures for the training manager's annual review of each principal instructor's competence.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99205 Core lead basics course requirements {#sec-r-325.99205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99205}

Rule 205. A training program accredited under section 5462 of the act shall provide a training course that meets all of the following requirements to become accredited for corelead basics:

(a) The training course shall last a minimum of 8 training hours.

(b) The training course shall include, at a minimum, all of the following course topics:

(i) The roles and responsibilities of lead-based paint professionals.

(ii) Background information on the nature of lead, its uses, adverse health effects, exposure monitoring methods, and sources of exposure to humans.

(iii) Background information on federal and state regulations and guidance that pertain to lead-based paint activities including generally applicable occupational health and safety standards.

(iv) The requirements and procedures for certification under the lead abatement act and these rules.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99206 Lead abatement worker training course requirements {#sec-r-325.99206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99206}

Rule 206. A training program accredited under section 5462 of the act shall provide a training course that meets the following requirements in order to become accredited for the discipline of lead worker:

(a) The training course shall last a minimum of 16 training hours, with a minimum of 8 hours devoted to hands-on training activities.

(b) The training course shall include, at a minimum, all of the following course topics:

(i) The role and responsibilities of a lead worker.

(ii) Lead exposure in construction standard, R 325.51991 and R 325.51992.

(iii) The following topics which have hands-on activities as an integral part of the course:

(A) Lead-based paint hazard control methods, both permanent and temporary, including restricted practices.

(B) Interior dust-lead hazard control methods, both permanent and temporary, and cleanup procedures.

(D) Personal protective equipment selection, use, and care.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99207 Lead abatement supervisor training course requirements {#sec-r-325.99207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99207}

Rule 207. A training program accredited under section 5462 of the act shall provide a training course that meets the following requirements to become accredited for the discipline of supervisor:

(a) The training course shall last a minimum of 8 training hours, with a minimum of 3 hours devoted to hands-on activities.

(b) The training course shall include, at a minimum, all of the following course topics:

(i) The role and responsibilities of a supervisor.

(ii) Liability and insurance issues relating to lead -based paint hazard control.

(iii) Cleanup and waste disposal.

(vi) Recordkeeping.

(v) The following topics which have hands-on activities as an integral part of the course:

(A) Risk assessment and inspection report interpretation.

(B) The development and implementation of an occupant protection plan and hazard control report.

(D) Clearance standards and testing, including retesting procedures.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99208 Inspector training course requirements {#sec-r-325.99208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99208}

Rule 208. A training program accredited under section 5462 of the act shall provide a training course that meets the following requirements to become accredited for the discipline of inspector:

(a) The training course shall last a minimum of 16 training hours, with a minimum of 6 hours devoted to hands-on training activities.

(b) The training course shall include, at a minimum, all of the following course topics:

(i) The role and responsibilities of an inspector.

(ii) Recordkeeping.

(iii) The following topics which also have hands-on activities as an integral part of the course:

(A) Most current lead-based paint inspection methods, including the selection of rooms and components for sampling or testing.

(B) Documented sampling methodologies, including X-ray fluorescence.

(D) Preparation of a final inspection report.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99209 Risk assessor training course requirements {#sec-r-325.99209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99209}

Rule 209. A training program accredited under section 5462 of the act shall provide a training course that meets all of the following requirements to become accredited for the discipline of risk assessor:

(a) The training course shall last a minimum of 16 training hours, with a minimum of 6 hours devoted to hands-on training activities.

(b) The training course shall include, at a minimum, all the following course topics:

(i) The role and responsibilities of a risk assessor.

(ii) Sources of environmental lead contamination such as paint, surface dust, soil, water, air, packaging, and food.

(iii) The collection of background information to perform a risk assessment.

(iv) Recordkeeping.

(v) The following topics which have hands-on activities as an integral part of the course:

(A) Visual inspection for the purposes of identifying potential sources of lead-based paint hazards.

(B) Most current sampling methods for other sources of lead exposure.

(C) The interpretation of lead-based paint and other lead sampling results, including applicable state or federal guidance or regulations pertaining to lead-based paint hazards.

(D) The development of lead hazard control options, both permanent and temporary, including operations and maintenance activities.

(E) Preparation of a final risk assessment report.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99210 Clearance technician training course requirements {#sec-r-325.99210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99210}

Rule 210. A training program accredited under section 5462 of the act shall provide a training course that meets all of the following requirements become accredited for the discipline of clearance technician:

(a) The training course shall last a minimum of 8 training hours with a minimum of 2 hours devoted to hands-on training activities.

(b) The training course shall include, at a minimum, all of the following course topics:

(i) The role, responsibilities, and limitations of a clearance technician.

(ii) Background information on federal, state, and local regulations and guidance that pertains to non-abatement lead hazard control activities.

(iii) Recordkeeping.

(iv) The following topics which have hands-on activities as an integral part of the course:

(A) Documented lead-based paint clearance sampling methodologies, including visual assessment, and selection of locations and components for sampling.

(B) Clearance standards and testing.

(D) Preparation of the clearance report.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99211 Project designer training course requirements {#sec-r-325.99211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99211}

Rule 211. A training program accredited under section 5462 of the act shall provide a training course that meets all of the following requirements to become accredited for the discipline of project designer:

(a) The training course shall last a minimum of 8 training hours.

(b) The training course shall include, at a minimum, all of the following topics:

(i) The role and responsibilities of a project designer.

(ii) The development and implementation of an occupant protection plan for large-scale lead hazard control projects. Hands-on activities shall be an integral part of this topic.

(iii) Lead-based paint hazard control methods, both permanent and temporary, for large-scale lead hazard control projects, including restricted practices (iv) Interior dust-lead hazard control methods, both permanent and temporary, and cleanup procedures for large-scale lead hazard control projects.

(v) Clearance standards and testing for large-scale lead hazard control projects.

(vi) Integration of lead-based paint hazard control methods with modernization and rehabilitation projects for large-scale lead hazard control projects.

(vii) Preparation of lead hazard control specifications for multi family housing and child-occupied facilities.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99212 Requirements for accreditation of refresher training {#sec-r-325.99212 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99212}

Rule 212. (1) To become accredited to offer a refresher training course for the disciplines described in R 325.99201, a training program shall ensure that its course of study includes, at a minimum, all of the following:

(a) A review of the curriculum topics of the initial courses prescribed in these rules or other rules promulgated by the department.

(b) An overview of current safety practices relating to lead-based paint activities in general, as well as specific information pertaining to the appropriate discipline.

(c) Current laws and regulations relating to lead-based paint activities in general, as well as specific information pertaining to the appropriate discipline.

(d) Current technologies relating to lead-based paint activities in general, as well as specific information pertaining to the appropriate discipline.

(2) A training program may apply for accreditation of a refresher course concurrently with its application for accreditation of the corresponding initial training course.

(3) Each refresher course, except for the project designer course, shall last a minimum of 8 training hours. The project designer refresher course shall last a minimum of 4 training hours. The supervisor and project designer refresher courses may be conducted concurrently if the materials for each are adequately covered.

(4) For each refresher course offered, the training program shall conduct a course test at the completion of the course.

(5) A training program's application for accreditation of the refresher course shall include all of the following information:

(a) A copy of the student and instructor manuals to be used for each course.

(b) A copy of the course agenda for each course.

(d) A copy of the course test blueprint for each course.

(e) A description of the activities and procedures that shall be used for conducting the assessment of hands-on skills for each course, if applicable.

(f) A copy of the quality control plan as described in R 325.99204.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99213 Reaccreditation of training program {#sec-r-325.99213 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99213}

Rule 213. (1) A training program seeking to maintain accreditation to offer courses in lead-based paint activities shall annually submit to the department both of the following: (a) An application containing all of the following information:

(i) The training program's name, address, and telephone number.

(ii) A list of courses for which the program is applying for reaccreditation.

(iii) A description of any changes to the training facility, equipment, course materials, or instructors since the program's last application was approved.

(iv) A statement signed by the program manager stating both of the following:

(A) The training program complies at all times with the requirements of the act and these rules.

(B) The recordkeeping and reporting requirements of these rules shall be followed.

(b) The fee or fees specified in the act and these rules.

(2) A training program seeking reaccreditation under subrule (1) of this rule shall submit the application, including the appropriate fees, not less than 45 days before the expiration date of the previous year's accreditation.

(3) The training program's accreditation shall not expire during the department's review or audit of a timely and sufficient reaccreditation application.

PART 3. CERTIFIED INDIVIDUALS AND FIRMS

History

History: 2005 AACS.

Mich. Admin. Code R 325.99301 Lead professional certification; disciplines; third party examination {#sec-r-325.99301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99301}

Rule 301. (1) An individual may seek certification by the department under section 5468 of the act to engage in lead-based paint activities in the following disciplines:

(a) Lead worker.

(b) Lead supervisor.

(d) Risk assessor.

(e) Clearance technician.

(f) Project designer.

(2) A certified risk assessor may seek endorsement by the department to conduct EBL environmental investigations as an EBL investigator. A certified risk assessor seeking endorsement under this subrule shall submit an application to the department demonstrating compliance with the requirements of R 325.99302 for EBL investigator.

(3) An individual seeking certification under subrule (1) of this rule to engage in lead-based paint activities shall pay the appropriate fees required under the act and submit an application to the department demonstrating either of the following:

(a) Compliance with the requirements of R 325.99302 for the specific discipline for which certification is sought.

(b) Possession of a valid lead-based paint certification, license, or equivalent, as determined by the department, issued by an EPA lead-based paint training and certification program, or a program that has been authorized by the EPA pursuant to 40 CFR part 745, in the specific discipline for which certification is sought, including successful completion of a third-party examination.

(4) If required by R 325.99302, an individual shall pass an appropriate third-party examination within 6 months after receiving a course completion certificate to be eligible for certification. An individual is not eligible to take the third party exam more than 3 times within the 6 months after receiving a course completion certificate.

(5) The fees for third-party certification exams shall be each of the following:

(a) Inspector/risk assessor combination $125.00.

(b) All other examinations $75.00 per discipline.

(6) An individual who fails to pass the third-party examination after 3 attempts within the 6 months after receiving a course completion certificate shall retake the appropriate initial training course from an accredited training program before reapplying for certification from the department.

(7) An individual who fails to pass the third-party examination within 3 years after completing the initial accredited training course shall retake the appropriate initial course from an accredited training program before applying for certification from the department.

(8) After an individual submits an application demonstrating that he or she meets the appropriate training, education, and experience requirements, and passes the appropriate certification exam, the department shall issue a certification document to the individual in the specific discipline for which certification is sought. To maintain certification, an individual shall be recertified pursuant to R 325.99304.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99302 Lead professional certification requirements; inspector; risk assessor; clearance technician; supervisor; worker; project designer; endorsement as EBL investigator {#sec-r-325.99302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99302}

Rule 302. (1) Individuals seeking certification as a lead abatement worker under section 5468 of the act shall meet all of the following requirements:

(a) Successfully complete both of the following courses:

(i) An accredited core lead basics course.

(ii) An accredited training course for lead abatement workers.

(b) Pass the third-party examination for lead abatement worker. Additional experience or education is not required.

(2) Individuals seeking certification as a lead abatement supervisor under section 5468 of the act shall meet all of the following requirements:

(a) Successfully complete all of the following courses:

(i) An accredited core lead basics course.

(ii) An accredited training course for workers.

(iii) An accredited training course for supervisors.

(b) Pass the third-party examination for supervisor.

(i) Not less than 1 year of experience as a certified lead abatement worker.

(ii) Not less than 2 years of experience in a related field, for example, lead, asbestos, environmental remediation work, building construction, or the building trades.

(3) Individuals seeking certification as a lead inspector under section 5468 of the act shall meet all of the following requirements:

(a) Possess a high school diploma, or equivalent.

(b) Successfully complete both of the following courses:

(i) An accredited core lead basics course.

(ii) An accredited training course for inspectors.

(4) Individuals seeking certification as a lead risk assessor under section 5468 of the act shall meet all of the following requirements:

(a) Successfully complete all of the following:

(i) An accredited core lead basics course.

(ii) An accredited training course for inspectors.

(iii) An accredited training course for risk assessors.

(b) Pass the third party examinations for both inspector and risk assessor, or a combination thereof, as determined by the department.

(i) Possess a bachelor's degree, and have not less than 1 year of experience in a related field, for example, lead, asbestos, building construction, or environmental remediation work.

(ii) Possess an associate's degree, and have not less than 2 years of experience in a related field, for example, lead, asbestos, building construction, or environmental remediation work.

(iii) Possess a high school diploma or equivalent and have not less than 3 years of experience in a related field, for example lead, asbestos, building construction, or environmental remediation work.

(iv) Be certified or registered as any 1 or more of the following:

(A) Industrial hygienist.

(B) Safety professional.

(D) Nurse.

(E) Sanitarian.

(F) Architect.

(G) Other related field, as determined by the department.

(5) Individuals seeking certification as a lead clearance technician under section 5468 of the act shall meet all of the following requirements:

(a) Successfully complete both of the following courses:

(i) An accredited core lead basics course.

(ii) An accredited training course for clearance technicians.

(b) Pass the third-party examination for clearance technician.

(i) A high school diploma, or equivalent.

(ii) Not less than 1 year experience in a related field, for example, lead remediation work, building construction, building trades, or structural inspection of residential dwellings.

(6) Individuals seeking certification as a lead project designer under section 5468 of the act shall meet all of the following requirements:

(a) Possess a current certification from the department for lead supervisor.

(b) Successfully complete an accredited training course for project designers.

(i) Not less than 4 years of experience in building construction and design or a related field.

(ii) Possess a bachelor's degree in engineering, architecture, or a related profession and not less than 1 year of experience in building construction and design or a related field.

(7) Individuals seeking endorsement as EBL investigator shall meet both of the following requirements:

(a) Possess a current certification from the department as risk assessor.

(b) Pass a written proficiency examination for EBL investigator.

(8) The department recognizes the following documents as evidence of meeting the requirements specified in this rule:

(a) Official academic transcripts or diploma as evidence of meeting the education requirements.

(b) Resumes, letters of reference, or documentation of work experience as evidence of meeting the work experience requirements.

(c) Course completion certificates from lead-specific or other related training courses issued by accredited training programs as evidence of meeting the training requirements.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99303 Lead abatement firm; certification {#sec-r-325.99303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99303}

Rule 303. (1) A person seeking certification by the department under section 5469 of the act to engage in lead abatement activities as a lead hazard control firm shall pay the appropriate application fee and submit an application to the department including all of the following information:

(a) Corporate identification number, certificate of sole proprietorship, or other business entity documentation acceptable to the department.

(b) Indication of applicant's liability insurance, if any.

(d) Proof that each employee or agent involved in lead-based paint activities has received training and certification as required by the act.

(e) If applicable, the name of each principal partner, shareholder, member, or owner.

(2) Not more than 90 days from the date of receipt of the person's completed application, the department shall approve or disapprove the person's request for certification as a lead hazard control firm. Within that time period, the department shall respond with either a certificate of approval or a letter describing the reasons for a disapproval.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99304 Recertification {#sec-r-325.99304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99304}

Rule 304. (1) In accordance with the act, a person or firm seeking to maintain certification to engage in lead abatement activities shall annually submit to the department, on forms provided by the department, all required information and pay the appropriate fees.

(2) Individuals seeking to engage in lead-based paint activities shall recertify with the department every 3 years.

(3) Persons seeking recertification under subrule (2) of this rule shall successfully complete an accredited refresher training course for the discipline for which they seek recertification, and successfully pass the third-party examination for that discipline within 6 months after completion of the training course. Individuals seeking to maintain certification as risk assessor must complete both the inspector and risk assessor refresher training courses, and pass both the inspector and risk assessor third-party examinations or a combination thereof.

(4) A person shall not be required to retake the core lead basics course in order to be eligible for recertification.

(5) Persons seeking to maintain endorsement to conduct EBL environmental investigations shall reapply to the department every 3 years.

(6) Person or persons who have failed to satisfy all agreed upon conditions for settlement of violations of the act or these rules may be denied recertification under this part.

PART 4. WORK PRACTICE STANDARDS

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99401 Work practice standards for conducting lead-based paint activities; documented methodologies; de minimis levels {#sec-r-325.99401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99401}

Rule 401. (1) Only a certified individual may perform any of the following lead-based paint activities:

(a) A lead-based paint investigation.

(b) A lead abatement activity.

(d) Clearance procedures.

(2) A certified individual shall perform an activity listed in subrule (1) of this rule in accordance with these rules and 1 or more of the following documented methodologies:

(a) The United States department of housing and urban development (HUD) publication entitled "Guidelines for the Evaluation and Control of Lead-Based Paint Hazards in Housing." A copy of this document may be obtained at no charge as of the date of adoption of these rules from HUD USER, P.O. Box 6091, Rockville, Maryland 20849; or www.hud.gov/offices/lead.

(b) Part 35 of title 24 of the code of federal regulations, entitled "Requirements for Notification, Evaluation and Reduction of Lead-Based Paint Hazards in Federally Owned Residential Property and Housing Receiving Federal Assistance." A copy of this document may be obtained at no charge as of the date of adoption of these rules from HUD USER, P.O. Box 6091, Rockville, Maryland 20849; or www.hud.gov/offices/lead.

(c) The American society for testing and materials' (ASTM) publication entitled "Standard Practices for Field Collection of Soil Samples for Lead Determination by Atomic Spectrometry Techniques," standard number E1727. A copy of this document may be obtained from the American Society for Testing and Materials, 100 Barr Harbor Drive, West Conshohocken, Pennsylvania 19428.

A copyright fee shall be charged by ASTM for this document, as of the date of adoption of these rules.

(d) The ASTM's publication entitled "Standard Practices for Field Collection of Settled Dust Samples Using Wipe Sampling Methods for Lead Determination by Atomic Spectrometry Techniques," standard number E1728. A copy of this document may be obtained from the American society for testing and materials, 100 Barr Harbor Drive, West Conshohocken, Pennsylvania 19428.

A copyright fee shall be charged by ASTM for this document, as of the date of adoption of these rules.

(e) Michigan department of community health document, entitled, "Environmental Investigations for Children with Elevated Blood Lead Levels," and herein referred to as the EBL field guide. A copy of this document may be obtained at no charge as of the date of adoption of these rules from the Michigan Department of Community Health, Lead Hazard Remediation Program, 3423 North Martin L. King, Jr. Boulevard, Lansing, Michigan 48906, or www.michigan.gov/leadsafe.

(3) Only an appropriate certified lead professional shall conduct any paint, dust, or soil sampling or testing as part of an activity described in subrule(1) of this rule. The certified professional shall use documented methodologies that incorporate adequate quality control procedures.

(4) Analytical procedures and facilities recognized by the EPA as capable of performing analyses for lead compounds in the applicable matrix shall be used to determine if any paint chip, dust, or soil samples collected as part of an activity described in subrule (1) of this rule contain detectable levels of lead that may be quantified numerically.

(5) Composite dust or paint samples shall not be used.

(6) Notification and work practice standards required by the lead abatement act or these rules do not apply when treating any of the following amounts of painted surfaces:

(a) Less than 2 square feet of interior painted surface per room, stairwell, hallway, porch, or room equivalent.

(b) Less than 20 square feet of painted surface on a building exterior.

(c) Less than 10% of the total surface area of painted surface on any type of interior component with a small surface area.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99402 Hazard and clearance levels {#sec-r-325.99402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99402}

Rule 402. (1)The department shall publish clearance levels established for the completion of lead hazard control activities as necessary to comply with corresponding levels established by federal regulations.

(2) Dust-lead hazard levels shall be the same levels as the clearance levels published by the department.

(3) The department shall publish soil-lead hazard levels as necessary for compliance with federal requirements.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99403 Lead inspection {#sec-r-325.99403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99403}

Rule 403. (1) Only a person certified by the department as an inspector or risk assessor shall conduct an inspection. The inspector or risk assessor shall conduct the inspection according to this rule.

(2) When conducting an inspection, an inspector or risk assessor shall select the following locations according to documented methodologies and shall test the locations for the presence of lead-based paint:

(a) Each interior and exterior component that has a distinct painting history, except for components that the inspector or risk assessor determines have been replaced after 1978 or do not contain lead-based paint.

(b) In a multifamily dwelling or child-occupied facility, each component that has a distinct painting history, and in every common area, except for components that the inspector or risk assessor determines have been replaced after 1978 or do not contain lead-based paint.

(3) The certified inspector or risk assessor shall prepare an inspection report for each inspection. The report shall be specific to the structure tested and include all of the following information:

(a) Table of contents.

(b) A plain-language conclusions section, designed to provide easy identification of all lead hazards, shall be positioned prominently near the front of the report. Results included in the conclusions section shall not be used to satisfy requirements for presentation of results described elsewhere in this rule. The conclusions section shall contain all of the following information in tabular format:

(i) Results of any environmental sampling that denote a positive indication of lead paint, grouped by sample methodology.

(ii) Applicable comparison standards.

(iii) Units of measurement.

(iv) A stand-alone description of each sampling location and component.

(d) Address of building.

(e) Date of construction.

(f) Apartment numbers, if applicable.

(g) Name, address, and telephone number of the owner or owners.

(h) Name, signature, and certification number of each certified inspector or risk assessor, or both, conducting testing.

(i) Name, address, and telephone number of the certified person employing each inspector or risk assessor, or both, if applicable.

(j) Each testing method and device and sampling procedure employed for paint analysis, including quality control data and, if used, the serial number of any X-ray fluorescence device.

(k) Specific locations of each painted component tested for the presence of lead-based paint.

(l) The results of the inspection expressed in terms appropriate to the sampling method used.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99404 Risk assessment {#sec-r-325.99404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99404}

Rule 404. (1) Only a person certified by the department as a risk assessor shall conduct a risk assessment. A risk assessor shall conduct the risk assessment according to this rule.

(2) The risk assessor shall make a visual inspection for risk assessment of a residential dwelling or child-occupied facility to locate the existence of lead-based paint hazards and assess the extent and causes of the hazards.

(3) The risk assessor shall collect background information regarding the physical characteristics of the residential dwelling or child-occupied facility and occupant use patterns that may cause lead-based paint exposure to 1 or more children age 6 years and under.

(4) The risk assessor shall test, using documented methodologies, each surface that has deteriorated paint for the presence of lead if the surface is determined to be in poor condition and to have a distinct painting history. A risk assessor shall also test, using documented methodologies, any additional surface for the presence of lead if the surface is determined to be a potential lead-based paint hazard and to have a distinct painting history.

(5) In residential dwellings, the risk assessor shall collect the following dust samples in not less than 6 representative rooms, hallways, stairwells, or room equivalents:

(a) One dust sample from the floor of each selected room, hallway, or stairwell.

(b) One dust sample from a window sill or trough, if available, in each selected room, hallway or stairwell. Dust samples from windows shall be collected by alternating the sill and trough in each room to the extent possible.

(c) If there are less than 6 rooms, hallways, stairwells, or room equivalents in the dwelling, then the risk assessor shall sample all rooms, hallways, and stairwells.

(6) For multifamily dwellings and child-occupied facilities, the risk assessor shall collect the dust samples required in subrule (5) of this rule in each selected unit. In addition, a risk assessor shall collect window and floor dust samples in the following locations:

(a) Common areas adjacent to the sampled residential dwelling or child-occupied facility.

(b) Other common areas in the building where the risk assessor determines that 1 or more children, age 6 and under, could reasonably be expected to come into contact with dust, regardless of the current occupancy by children in the dwelling.

(7) For child-occupied facilities, the risk assessor shall collect 1 dust sample from the window sill or trough and 1 dust sample from the floor in each room, hallway, or stairwell utilized, to the extent defined by a child-occupied facility, by 1or more children, age 6 and under; and in other common areas in the child-occupied facility where the risk assessor determines that 1 or more children, age 6 and under, could reasonably be expected to come into contact with dust to the extent defined by a child-occupied facility.

(8) The risk assessor shall collect soil samples and have the samples analyzed for lead concentrations in the all of following locations:

(a) Exterior play areas where bare soil is present.

(b) Dripline/foundation areas where bare soil is present (c) Yard locations in addition to those described in subdivisions (a) and (b) of this subrule where the area of bare soil exceeds 9 square feet.

(9) The risk assessor shall compare the lead levels from each sample, as determined by the approved analysis, with applicable hazard levels for lead in paint, dust and soil established in these rules. The risk assessor shall determine a lead hazard for the area represented by each sample which exceeds the hazard levels.

(10) The certified risk assessor shall prepare a risk assessment report which shall include all of the following information:

(a) Table of contents.

(b) A plain-language conclusions section designed to provide the reader with easy identification of all lead hazards shall be positioned prominently near the front of the report. Results included in the conclusions section shall not be used to satisfy requirements for presentation of results described elsewhere in this rule. The conclusions section shall contain all of the following information in tabular format:

(i) Results of any environmental sampling that denotes a lead hazard, grouped by sample methodology.

(ii) Applicable comparison standards.

(iii) Units of measurement.

(iv) A stand-alone description of each sampling location and component.

(d) Address of each building.

(e) Date of construction of buildings.

(f) Apartment number, if applicable.

(g) Name, address, and telephone number of each owner of each building.

(h) Name, signature, and certification identification of the certified risk assessor conducting the assessment.

(i) Name, address, and telephone number of the certified person employing each certified risk assessor, if applicable.

(j) Name, address, and telephone number of each recognized laboratory conducting analyses of collected samples.

(k) Results of the visual inspection.

(l) Testing method and sampling procedure for the paint analysis employed.

(m) Specific location of each painted component tested for the presence of lead.

(n) All data collected from on-site testing, including quality control data, and, if used, the serial number of any X-ray fluorescence device.

(o) All results of approved analysis on collected paint, soil, and dust samples.

(p) Any other sampling results.

(q) Any background information collected under subrule (3) of this rule.

(r) To the extent that they are used as part of the lead-based paint hazard determination, the results of any previous inspections or analyses for the presence of lead-based paint or other assessments of lead-based paint-related hazards.

(s) A description of the location, type, and severity of identified lead-based paint hazards, and any other potential lead hazards.

(t) A description of lead hazard control options for each identified lead hazard or potential hazard, and a suggested prioritization for addressing each hazard. If the use of an encapsulant or enclosure is recommended, then the report shall recommend a maintenance and monitoring schedule for the encapsulant or enclosure.

(11) A person shall provide a written disclosure to a client of any affiliation between the person who conducts the inspection, risk assessment, or any part thereof, and the person or persons who conduct the abatement of the same property.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99405 EBL environmental investigation {#sec-r-325.99405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99405}

Rule 405. (1) Only an individual endorsed by the department as an EBL investigator shall conduct an EBL environmental investigation. The EBL investigator shall conduct the EBL environmental investigation in accordance with the procedures in the Michigan department of community health document entitled, "Environmental Investigations for Children with Elevated Blood Lead Levels".

(2) The EBL investigator shall prepare an EBL environmental investigation report for each investigation in accordance with pertinent parts of the field guide, and shall include, but is not limited, the following information:

(a) Potential sources of exposure to lead to 1 or more children age 6 years or less.

(b) Methods of minimizing or eliminating exposures to lead to 1 or more children age 6 years or less.

(3) The EBL investigator shall provide the report required by subrule (2) of this rule to both of the following:

(a) The property owner.

(b) The parent or guardian of the child with an elevated blood lead level, if different than the property owner.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99406 Lead hazard control activities {#sec-r-325.99406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99406}

Rule 406. (1) Only an individual who has successfully completed either of the following training courses shall conduct non-abatement lead hazard control activities:

(a) A lead-safe work practices training course approved by HUD.

(b) An accredited lead abatement worker course.

(2) Only an individual certified by the department as a lead worker, lead supervisor, or project designer shall conduct lead abatement activities.

(3) Individuals performing lead hazard control activities shall conduct those activities according to this rule.

(4) A certified supervisor is required for each lead hazard control project. The certified supervisor shall be at the site during all lead abatement activities, and during all setup and cleaning activities for non-abatement lead hazard control work mandated by order of local municipality, government, or court.

(5) The certified supervisor shall ensure that all lead hazard control activities are conducted according to this rule and all other federal, state, and local requirements.

(6) A certified supervisor or project designer shall develop a written occupant protection plan for all lead abatement activities and all non-abatement lead hazard control projects specified in subrule (4) of this rule according to the following procedures:

(a) The occupant protection plan shall be specific to each residential dwelling or child-occupied facility and be developed before the lead hazard control activities begin. The certified supervisor shall maintain the occupant protection plan at the work site during all lead hazard control activities.

(b) The occupant protection plan shall describe the measures and management procedures that shall be taken during the lead hazard control project to protect the building occupants from exposure to any lead-based paint hazards.

(c) The procedures described in the occupant protection plan shall be implemented during the lead hazard control project.

History

History: 2005 AACS; 2007 AACS.

Mich. Admin. Code R 325.99407 Clearance procedures {#sec-r-325.99407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99407}

Rule 407. (1) A clearance examination shall be performed in target housing and child-occupied facilities following all lead hazard control activities.

(2) Only a certified inspector or risk assessor shall perform clearance procedures following abatement.

(3) A certified clearance professional who is completely independent of the lead hazard control firm shall conduct clearance procedures following any lead hazard control activity according to the following procedures:

(a) Conduct a visual inspection for clearance testing to determine if deteriorated painted surfaces described in the scope of hazard control work, or visible amounts of dust, debris, or residue are still present. If deteriorated painted surfaces described in the scope of hazard control work, or visible amounts of dust, debris, or residue are present, then the person conducting the lead hazard control activity shall eliminate the conditions before continuing the clearance procedures.

(b) After the visual inspection and any post-project cleanup required by subdivision (a) of this subrule, an independent clearance professional shall conduct clearance dust-lead sampling. Clearance sampling shall be conducted as appropriate based upon the extent or manner of lead hazard controls conducted in or to the residential dwelling or child-occupied facility. All of the following provisions apply to lead hazard control clearance sampling:

(i) After conducting lead hazard control activities using containment of work areas, the clearance professional shall take 1 dust sample from 1 window, if available, and 1 dust sample from the floor of not less than 4 rooms, hallways, stairwells, or room equivalents within the containment area.

Dust samples from windows shall be collected by alternating the sill and trough in each room, to the extent possible. In addition, the clearance professional shall take 1 dust sample from the floor outside the containment area. If there are less than 4 rooms, hallways, stairwells, or room equivalents within the containment area, then the clearance professional shall sample all rooms, hallways, and stairwells.

(ii) After conducting hazard control activities with no containment, the clearance professional shall take 1 dust sample from 1 window, if available, and 1 dust sample from the floor of not less than 4 rooms, hallways, stairwells, or room equivalents in the residential dwelling or child-occupied facility, to include sleeping areas of 1 or more children, 6 years of age or less. Dust samples from windows shall be collected by alternating the sill and trough in each room, to the extent possible. If there are less than 4 rooms, hallways, stairwells, or room equivalents within the residential dwelling or child-occupied facility, then the clearance professional shall sample all rooms, hallways, and stairwells.

(iii) The clearance professional shall take dust samples for clearance purposes using documented methodologies that incorporate adequate quality control procedures.

(iv) The clearance professional shall take dust samples for clearance purposes not less than 1 hour after completion of final lead hazard control cleanup activities.

(c) The clearance professional shall select the rooms, hallways, stairwells, or room equivalents for sampling according to documented methodologies, as is defined in rule 325.99401(2).

(d) The certified clearance professional shall compare the residual lead level, as determined by appropriate analysis, from each dust sample with applicable clearance levels for lead in dust. If the residual lead levels in a dust sample exceed the clearance levels, then the person conducting the lead hazard control activity shall reclean, and the clearance professional shall retest all the components represented by the failed sample until clearance levels are met.

(4) For multifamily dwellings and child-occupied facilities, the clearance professional shall collect the dust samples required in subrule (3) of this rule in each selected unit. In a multifamily dwelling that has more than 4 similarly constructed and maintained residential dwelling units, a certified inspector or risk assessor may conduct random sampling, in accordance with documented methodologies, for the purpose of clearance sampling, only if all of the following provisions are satisfied:

(a) The certified individuals who abate or clean the residential dwelling units do not know which residential dwelling will be selected for the random samples.

(b) A sufficient number of residential dwelling units are selected for dust sampling to provide a 95% level of confidence that not more than 5% or 50 of the residential dwelling units, whichever is smaller, in the randomly sampled population exceed the appropriate clearance levels.

(c) The randomly selected residential dwelling units are sampled and evaluated for clearance according to the procedures in this subrule.

(d) The similarly constructed and maintained residential dwelling units from which the sampled units are to be selected may not be re-occupied at any time following the completion of the hazard control activities until the successful completion of clearance procedures.

(5) For clearance sampling in multi-family dwellings and child-occupied facilities, a risk assessor or inspector shall also collect window and floor dust samples in the following locations:

(a) Common areas adjacent to the sampled residential dwelling or child-occupied facility.

(6) Following an exterior lead hazard control activity, the certified clearance professional shall conduct a visual inspection of all horizontal surfaces in the outdoor living area closest to the surfaces disturbed by the lead hazard control activities to ensure that visible dust and debris have been removed. The certified clearance professional shall also conduct a visual inspection to determine the presence of paint chips on the dripline or next to the foundation below any exterior abated surface. If visible dust, debris, or paint chips are present, then the person conducting the lead hazard control activity shall remove the visible dust, debris, or paint chips from the site and properly dispose of them according to all applicable federal, state, and local requirements.

(7) A certified clearance technician shall not perform any of the following clearance procedures:

(a) Clearance testing following abatement activities.

(b) Clearance testing in multi family dwellings which are comprised of more than 4 units.

(8) Following clearance testing of lead hazard control activities, the clearance professional shall prepare a clearance report. The clearance report shall include all of the following information:

(a) Address of the unit or units where lead hazard control activities were performed.

(b) The name, address, and phone number of the persons performing the lead hazard control activity.

(d) The name, address, and signature of each certified clearance professional conducting clearance sampling and the date of clearance testing.

(e) The results of clearance testing and the name of each recognized laboratory that conducted the analyses, where applicable.

History

History: 2005 AACS.

Mich. Admin. Code R 325.99408 Notifications {#sec-r-325.99408 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99408}

Rule 408. (1) Not less than 3 business days before commencing a lead hazard control activity, a person who conducts lead abatement activities shall notify the department, on forms provided by the department, regarding information the department considers necessary to conduct an unannounced site inspection, including schedule changes. The department shall approve emergency notification that is less than 3 business days in the following situations:

(a) In the case of court-ordered lead abatement.

(b) In other cases where the department waives the 3-business-day requirement to protect the health and safety of the public.

(c) In the case of an unavoidable change in a lead abatement activity that occurs less than 3 days before the activity begins.

(2) A person who conducts lead abatement activities shall not provide, in any case, the notification specified in subrule (1) of this rule less than 24 hours before commencing the activities.

(3) A person or individual who provides emergency notification shall receive confirmation of departmental approval of the emergency notification before initiating the activity.

(4) A person or individual who conducts a lead-based paint investigation shall notify the department, on forms provided by the department, regarding information the department considers necessary, by the fifteenth day of the month following the lead-based paint investigation.

(5) A training program that conducts lead training courses in any of the disciplines listed in R 325.99201, whether the courses are initial or refresher, shall notify the department, on forms provided by the department, not less than 7 calendar days before commencing training, regarding information the department considers necessary to conduct an unannounced site inspection. A training program shall also notify the department within 10 calendar days after a course is completed, on forms provided by the department, of the names of course participants and other information the department deems necessary. Training programs shall notify the department not less than 24 hours in advance of a course cancellation.

History

History: 2007 AACS.

Mich. Admin. Code R 325.99409 Pre-renovation education {#sec-r-325.99409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 325.99409}

(1) Not more than 60 days before commencing a renovation activity for compensation in target housing or child-occupied facility, the renovator shall do both of the following:

(a) Provide the owner of the dwelling or facility with US EPA pamphlet number EPA 747-K-99-001, entitled "Protect Your Family From Lead in Your Home," or a true reproduction, or an equivalent pamphlet approved by the department. If the owner does not occupy the dwelling unit, then the person performing renovation shall also provide an adult occupant of the housing unit with the pamphlet.

(b) Obtain a written acknowledgment of receipt of the pamphlet from the owner and, if applicable, the adult occupant of the unit or facility.

(2) If the renovator is unsuccessful in obtaining a written acknowledgment from the adult occupant described in subrule (1) of this rule, then the renovator shall certify in writing both of the following:

(a) The address of the dwelling unit described in subrule (1) of this rule.

(b) That the pamphlet was delivered to the dwelling unit, including the date and method of delivery. If the pamphlet was delivered by mail, then the renovator shall obtain a certificate of mailing not less than 7 days before the renovation.

(3) If the renovator, upon delivery of the pamphlet, is unsuccessful in obtaining a written acknowledgment from the adult occupant, the renovator may self-certify the delivery. The self-certification shall be written and include the reason for lack of success (for example, occupant refuses to sign, no adult occupant available), the method of delivery of the pamphlet, the signature of the renovator, and the date of signature.

(4) Not more than 60 days before commencing renovation activities in common areas of multi-family housing, the renovator shall do all of the following:

(a) Provide the owner with the pamphlet and comply with either of the following:

(i) Obtain, from the owner, a written acknowledgement that the owner has received the pamphlet.

(ii) Obtain a certificate of mailing at least 7 days prior to the renovation.

(b) Notify in writing, or ensure written notification of, each unit of the multifamily housing and make the pamphlet available upon request prior to the start of renovation. Such notification shall be accomplished by distributing written notice to each affected unit. The notice shall describe the general nature and locations of the planned renovation activities; the expected starting and ending dates; and a statement of how the occupant can obtain the pamphlet, at no charge, from the renovator.

(c) Prepare, sign, and date a statement describing the steps performed to notify all occupants of the intended renovation activities and to provide the pamphlet.

(d) If the scope, locations, or expected starting and ending dates of the planned renovation activities change after the initial notification, the renovator shall provide further written notification to the owners and occupants providing revised information on the ongoing or planned activities.

This subsequent notification must be provided before the renovator initiates work beyond that which was described in the original notification.

(5) The written acknowledgement required in this rule shall comply with all of the following:

(a) Include a statement recording the owner or occupants name and acknowledging receipt of the pamphlet prior to the start of renovation, the address of the unit undergoing renovation, the signature of the owner or occupant as applicable, and the date of signature.

(b) Be either a separate sheet or part of any written contract or service agreement for the renovation.

(c) Be written in the same language as the contract or agreement for the renovation or, in the case of owner occupied target housing, in the same language as the lease or rental agreement or the pamphlet.

(6) Renovators shall retain, and if requested, make available to the department all records necessary to demonstrate compliance with this rule for a period of 3 years following completion of the renovation activities in target housing or a child-occupied facility.

(7) The following sample language may be used for acknowledgements described in this rule:

(a) I have received a copy of the pamphlet, "Protect Your Family From Lead In Your Home", (or equivalent approved by the department) informing me of the potential risk of lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before the work began. __________________________ __________________________ Printed Name and Signature Date Unit Address (b) If an occupant is unavailable for signature or refuses to sign the acknowledgement of receipt of the pamphlet, then the renovator may, under subrule (3) of this rule, self-certify delivery of each instance. The following sample language may be used for self-certification:

(i) Refusal to sign I certify that I have made a good faith effort to deliver the pamphlet, "Protect Your Family From Lead In Your Home," (or approved equivalent) to the unit listed below at the dates and times indicated, and that the occupant refused to sign the acknowledgement. I further certify that I have left a copy of the pamphlet at the unit with the occupant.

Printed Name and Signature Date __________________________ Unit Address Attempted delivery dates and times: _____________________ (ii) Unavailable for signature I certify that I have made a good faith effort to deliver the pamphlet, "Protect Your Family From Lead In Your Home," (or approved equivalent) to the unit listed below at the dates and times indicated, and that the occupant was unavailable to sign the acknowledgement. I further certify that I have left a copy of the pamphlet at the unit with the occupant. ________________________ Printed Name and Signature Date __________________________ Unit Address Attempted delivery dates and times: _____________________

History

History: 2005 AACS; 2007 AACS.

R 327.1 to R 327.77 District and County Health Departments

Mich. Admin. Code R 327.41 Rescinded {#sec-r-327.41 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.41}

DEPARTMENT OF COMMUNITY HEALTH

COMMUNITY PUBLIC HEALTH AGENCY

DISTRICT AND COUNTY HEALTH DEPARTMENT

(By authority conferred on the department of public health by section 9 of Act No. 380 of the Public Acts of 1965, as amended, and section 2233 of Act No. 368 of the Public Acts of 1978, as amended, being SS16.109 and333.2233 of the Michigan Compiled Laws)

PART 1. SERVICES

R 327.1--R 327.10 Rescinded.

History: 1979 AC; 1984 AACS.

R 327.11--R 327.15 Rescinded.

History: 1954 ACS 52, Eff. Nov. 15, 1967; rescinded 1954 ACS 61, Eff. Feb. 16, 1970.

PART 2. PERSONNEL CLASSIFICATION AND QUALIFICATIONS

History

History: 1979 AC; 2014 AACS.

Mich. Admin. Code R 327.45 Rescinded {#sec-r-327.45 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.45}

History

History: 1979 AC; 2014 AACS.

Mich. Admin. Code R 327.47 Rescinded {#sec-r-327.47 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.47}

History

History: 1979 AC; 1980 AACS.

Mich. Admin. Code R 327.51 Nurses; classification {#sec-r-327.51 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.51}

Rule 51. A district or county health department shall employ nurses according to the following classifications:

(a) Licensed practical nurse.

(b) Registered nurse.

(d) Public health nurse supervisor.

(e) Public health nurse consultant.

(f) Public health nurse director.

History

History: 1979 AC.

Mich. Admin. Code R 327.53 Licensed practical nurses; qualifications {#sec-r-327.53 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.53}

Rule 53. A licensed practical nurse shall meet the following requirements:

(a) Graduation from a school of practical nursing approved by the state board of nursing at the time of graduation.

(b) Licensure to practice as a licensed practical nurse in Michigan.

History

History: 1979 AC.

Mich. Admin. Code R 327.55 Registered nurses; qualifications {#sec-r-327.55 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.55}

Rule 55. A registered nurse shall meet the following requirements:

(a) Graduation from a school of nursing approved by the state board of nursing.

(b) Licensure to practice as a registered nurse in Michigan.

History

History: 1979 AC.

Mich. Admin. Code R 327.57 Public health nurses; qualifications {#sec-r-327.57 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.57}

Rule 57. A public health nurse shall meet the following requirements:

(a) Completion of a baccalaureate degree program accredited by the national professional nursing organization for public health nursing preparation, or postbaccalaureate study which includes content approved by the national professional nursing organization for public health nursing preparation.

(b) Licensure to practice as a registered nurse in Michigan.

History

History: 1979 AC.

Mich. Admin. Code R 327.59 Public health nurse supervisors; qualifications {#sec-r-327.59 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.59}

Rule 59. A public health nurse supervisor shall qualify as a public health nurse, and in addition shall have:

(a) A master's degree from an institution with a program accredited by the national professional nursing organization or the American public health association which includes preparation in a specialized area of nursing practice, and in supervision or administration or both.

(b) Two years of public health nursing experience.

History

History: 1979 AC.

Mich. Admin. Code R 327.61 Public health nurse consultants; qualifications {#sec-r-327.61 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.61}

Rule 61. A public health nurse consultant shall qualify as a public health nurse supervisor, and shall have an additional 2 years of nursing supervisory or teaching experience.

History

History: 1979 AC.

Mich. Admin. Code R 327.63 Public health nurse directors; qualifications {#sec-r-327.63 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.63}

Rule 63. A public health nurse director shall qualify as a public health nurse consultant, and shall have an additional 1 year of experience in either nursing supervision, consultation, administration or any combination thereof.

History

History: 1979 AC.

Mich. Admin. Code R 327.65 Environmental health personnel; classification and qualifications {#sec-r-327.65 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.65}

Rule 65. A staff, supervisory, or administrative environmental health worker shall be classified, and shall meet the requirements, as specified in the following plan. (See following page.) **** For Graphic see attached file labeled "Figures" ****

History

History: 1979 AC.

Mich. Admin. Code R 327.67 Environmental health personnel; substitute qualifications {#sec-r-327.67 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.67}

Rule 67. (1) An environmental health worker with position designation AI may be given credit for 1 year of education for each 5 years of experience.

(2) An environmental health worker with 8 or more years of experience at position designation II or higher may qualify for any position requiring a graduate degree if he meets the professional registration requirements.

History

History: 1979 AC.

Mich. Admin. Code R 327.69 Environmental health personnel; modification of qualifications {#sec-r-327.69 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.69}

Rule 69. (1) If the education or experience requirements of a local civil service system or its equivalent vary from the requirements of the classification plan in R 327.65, the employing agency shall decide which requirements shall prevail.

(2) The classification plan listed in R 327.65 establishes only minimum position designations; higher position designations may be established by the employer.

History

History: 1979 AC.

Mich. Admin. Code R 327.71 Rescinded {#sec-r-327.71 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.71}

History

History: 1979 AC; 2014 AACS.

Mich. Admin. Code R 327.73 Rescinded {#sec-r-327.73 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.73}

History

History: 1979 AC; 2014 AACS.

Mich. Admin. Code R 327.75 Rescinded {#sec-r-327.75 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.75}

History

History: 1979 AC; 2014 AACS.

Mich. Admin. Code R 327.77 Rescinded {#sec-r-327.77 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 327.77}

History

History: 1979 AC; 2014 AACS.

R 330.1 to R 330.4 Child Death Scene Investigation

Mich. Admin. Code R 330.1 Definitions {#sec-r-330.1 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.1}

DEPARTMENT OF COMMUNITY HEALTH

HEALTH PROGRAMS ADMINISTRATION -BUREAU OF CHILDREN AND

FAMILY PROGRAMS

DETERMINATION OF DEATHS OF CHILDREN

(By authority conferred on the director of the Michigan Department of Community Health by section 52.205a of 2004 PA 179, section 8 of 1978 PA 312, sections 2226 and 5111 of 1978 PA 368, and Executive Reorganization Order Nos. 1996-1 and 1997-4, MCL 52.205a, 325.78, 333.2226(d), 333.5111, 330.3101, and 333.26324)

Rule 1. (1) As used in these rules:

(a)"County medical examiner" means the physician appointed by the board of commissioners in a county, responsible for investigating the cause and manner of deaths of individuals, in accordance with MCL 52.201 and 52.202.

(b) "Deputy county medical examiner" means the physician appointed by the board of commissioners in a county, and approved by the County Medical Examiner, responsible for investigating the cause and manner of deaths of individuals, in accordance with MCL 52.201 and 52.202.

(c) "Investigation of a death" means any of the following: gross external examination of the body, autopsy, toxicology, review of medical history, review of incident scene information, interviews with survivors and witnesses.

(d) "Manner" means how the cause of death arose and is classified on the death certificate. Natural deaths are caused exclusively by disease. If an injury, such as mechanical, chemical, electrical causes or contributes to death, then the death is classified on the death certificate as non-natural and is subclassified as accident, homicide, suicide or not determinable.

(e) "Cause of Death" means the actual disease, injury or complications that directly resulted in the death of an individual.

(f) "State of Michigan protocols to determine cause and manner of sudden and unexplained child deaths" means the state of Michigan's standard of investigation for determination of cause and manner of deaths of children under age two, when circumstances are sudden and unexplained. The protocol includes three components: the Incident Death Scene Investigation Guidelines, the Child Autopsy Checklist, and the Child's Medical History Case Review.

(g) "Incident death scene" means the location where the child was first found unresponsive, not breathing, or obviously dead.

(h) "SIDS" or "sudden infant death syndrome" means a cause of death defined as the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.

History

History: 2007 MR 17, Eff. Sept. 10, 2007.

Mich. Admin. Code R 330.2 Child death scene investigation protocol {#sec-r-330.2 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.2}

Rule 2. Before making a cause and manner determination on the death certificate of deaths of children under age 2, when the circumstances in these deaths are sudden and unexplained, the county medical examiner or deputy county medical examiner shall ensure that an incident death scene investigation, autopsy, and the medical history case review are completed, in accordance with the "2006 State of Michigan Protocols to Determine Cause and Manner of Sudden and Unexplained Child Deaths," which can be obtained at no cost from the Michigan Department of Community Health, Division of Family and Community Health, 109 West Michigan Avenue, Lansing, Michigan, 48913, or from the Michigan Public Health Institute, Child and Adolescent Health Program, at 2438 Woodlake Circle, Suite 240, Okemos, Michigan, 48864. These protocols may also be obtained on the internet at www.keepingkidsalive.org.

History

History: 2007 MR 17, Eff. Sept. 10, 2007.

Mich. Admin. Code R 330.3 Approval of alternate protocol {#sec-r-330.3 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.3}

Rule 3. A county medical examiner or deputy county medical examiner may utilize an alternate protocol for all cases within a county to determine cause and manner of sudden and unexplained deaths of children under age 2. An alternate protocol used by a county jurisdiction shall be approved by the department of community health before utilization.

History

History: 2007 MR 17, Eff. Sept. 10, 2007.

Mich. Admin. Code R 330.4 SIDS as cause of death {#sec-r-330.4 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.4}

Rule 4. A county medical examiner or deputy county medical examiner shall not declare cause of death as SIDS (Sudden Infant Death Syndrome) unless an autopsy, incident death scene investigation, and review of child's medical history are completed.

History

History: 2007 MR 17, Eff. Sept. 10, 2007.

R 330.131 to R 330.136 Chronic Disease Reporting

Mich. Admin. Code R 330.131 Definitions {#sec-r-330.131 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.131}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EPIDEMIOLOGY

DIVISION OF LIFECOURSE EPIDEMIOLOGY AND GENOMICS

MANDATORY REPORTING OF CHRONIC DISEASES

(By authority conferred on the director of the department of health and human services by sections 2221, 2226, 2233, and 5111 of the public health code, 1978 PA 368, MCL 333.2221, 333.2226, 333.2233, 333.5111, and section 8 of the critical health problems reporting act, 1978 PA 312, MCL 325.78)

Rule 131. (1) As used in these rules:

(a) “Chronic disease registry” means the database maintained by the department that contains patient-level health information about individuals with a diagnosed chronic disease, including, but not limited to, diagnostic and demographic information.

(b) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333. 25211.

(d) “Director” means the director of the department.

(e) "Health information" means information about an individual, whether oral or recorded in any form or medium that relates to the past, present, or future physical or mental health or condition of an individual, and the provision of health care to an individual. Health information includes aggregate information if, in the opinion of the department, it could potentially lead to reidentification of an individual.

(f) “Health professional" means an individual licensed under article 15 of the code, MCL 333.16101 to 333.18838, to work as a physician, a physician's assistant, or a nurse practitioner.

(g) "Local health department" means a health department established under the provisions of part 24 of the code, MCL 333.2401 to 333.2498.

(h) "Public health investigation" means the collection of medical, epidemiologic, exposure, and other information to determine the cause of illness or disability, which is used to determine appropriate actions to prevent or mitigate additional illness or disability.

(i) “Report” means documents or data containing health information provided to the department consistent with this ruleset.

(2) A term defined in the code has the same meaning when used in these rules.

History

History: 2024 MR 10, Eff. May 1, 2024.

Mich. Admin. Code R 330.132 Reportable information {#sec-r-330.132 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.132}

Rule 132. (1) Health professionals and health facilities must provide reports to the department in a format that ensures the inclusion of all patient information, if available and applicable, as follows:

(a) Last and first name and middle initial.

(b) Sex.

(d) Ethnicity.

(e) Birth date or age.

(f) Current residential address.

(g) Telephone number.

(h) If the individual is a minor, the name of the individual’s parent or guardian.

(i) Social security number.

(j) The date of symptom onset, if applicable.

(k) The date of diagnosis.

(l) The diagnosis, including diagnostic code.

(m) Prescribed medications, if they are available to the health professional or health facility, and the health professional or health facility is able to report them in the format prescribed by the department.

(n) Brief narrative of the patient’s signs and symptoms, clinical findings, results of other diagnostic tests, and clinical outcome, if available to the health professional or health facility.

(2) The reporting health professional shall provide the name, address, telephone, and other contact information, including, but not limited to, email communication, for the ordering physician or physicians as directed by the department.

(3) The reporting health facility shall provide the facility’s name, address, telephone, and other contact information, including, but not limited to, email communication, as directed by the department.

(4) Submitted reports must meet data quality, format, and timeliness standards prescribed by the department.

History

History: 2024 MR 10, Eff. May 1, 2024.

Mich. Admin. Code R 330.133 Reporting responsibilities {#sec-r-330.133 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.133}

Rule 133. (1) Health professionals and health facilities capable of reporting to the department via an electronic health record must do so on a real-time, ongoing basis.

(2) Health professionals and health facilities that do not submit reports consistent with subrule (1) of this rule shall provide reports to the department as follows:

(a) Reports must be made within 3 months following a request by the department or local health department.

(b) The department shall notify health professionals and health facilities when reports of a chronic disease must be submitted.

(3) Nothing in this rule should be construed to relieve a health professional or health facility from reporting to any other entity as required by state, federal, or local statutes or regulations or in accordance with accepted standard of practice, except that reporting in compliance with this rule satisfies the reporting requirements of section 5111 of the code , MCL 333.5111.

History

History: 2024 MR 10, Eff. May 1, 2024.

Mich. Admin. Code R 330.134 Chronic disease registry advisory board {#sec-r-330.134 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.134}

Rule 134. (1) The department shall create a chronic disease registry advisory board that convenes at the time and place instructed by the director and considers proposals and requests for the addition or removal of new reportable chronic diseases.

(2) The chronic disease registry advisory board shall consist of not less than 12 members appointed by the director as follows:

(a) One individual representing the Michigan Health and Hospital Association.

(b) Two individuals representing the department’s public health administration.

(d) One individual representing a local health department.

(e) One individual representing the Michigan State Medical Society.

(f) One individual representing emergency medical services.

(g) One individual representing the chronic disease academic community.

(h) One individual representing a minority-serving community-based organization.

(i) One individual representing a tribal health agency.

(j) One individual representing a health system or hospital in this state.

(k) One individual representing the general public.

(3) In addition to those representatives named in subrule (2), the director may appoint additional representatives to the board.

(4) As directed by the department, members of the board shall maintain and adhere to the chronic disease registry advisory board’s bylaws, including member term limits, member nominations, subcommittee formation, and other policies and procedures relevant to the board’s ongoing operations.

(5) The board shall examine the public health need for the collection of this information and may request assistance from the department to inform their recommendation regarding the addition or removal of a chronic disease as needed. This information may include requesting supplementary information from the individual or party proposing the chronic disease, convening subject-matter experts or individuals with knowledge of the particular condition, or assembling ad-hoc subcommittees.

(6) The board shall release its recommendations, including whether a chronic disease should be made reportable, to the director of the department. The board may review or modify their recommendation at any time prior to the director’s review. The director shall then approve, modify, or reject the recommendations of the board.

History

History: 2024 MR 10, Eff. May 1, 2024.

Mich. Admin. Code R 330.135 Investigation and quality assurance {#sec-r-330.135 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.135}

Rule 135. (1) The department, upon receiving a report under R 330.133, may request more information from the reporting entity. The reporting entity must provide the information to the department no later than 30 days after the request is made.

(2) The department shall consult with local health departments in the development of procedures for processing chronic disease reports and conducting follow-up investigations to ensure efficient, non-duplicative, and effective public health response.

(3) Requests by the department or local health departments for individual medical and epidemiologic information to validate the completeness and accuracy of reporting are specifically authorized. Persons or organizations that receive such requests must provide the information sought to the requesting organization promptly and no later than 30 days after the request is made.

(4) Health information from reported chronic disease cases shall be stored in a reasonably secure manner by the department.

History

History: 2024 MR 10, Eff. May 1, 2024.

Mich. Admin. Code R 330.136 Confidentiality of reports {#sec-r-330.136 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.136}

Rule 136. (1) To the maximum extent permitted by law, reports and health information collected under these rules are not public records and are exempt from disclosure under the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

(2) Reports and health information collected under this rule are medical records for the purpose of section 13(1)(l) of the freedom of information act, 1976 PA 442, MCL 15.243.

(3) Except as provided in subrule (5) of this rule, health information that is gathered in connection with an investigation is confidential and is not open to public inspection. All persons in possession of reports and health information collected under these rules shall maintain the confidentiality of reports and health information and shall not reveal the identity of any person.

(4) Records released to a legislative body must not contain information that identifies or could reasonably be expected to identify a specific individual.

(5) Information collected under these rules must be used for epidemiologic investigation and evaluation. The department and local health departments may release reports or information under any of the following conditions:

(a) The department receives written consent from the individual or consent from a minor’s parent or legal guardian after requesting the release of information.

(b) As necessary for the department to carry out its duties designated by the code.

(c) If necessary for the purpose of research designed to contribute to generalizable knowledge, with documented approval by the department’s institutional review board.

History

History: 2024 MR 10, Eff. May 1, 2024.

R 330.201 to R 330.214 Statewide Stemi System

Mich. Admin. Code R 330.201 Definitions; A to E {#sec-r-330.201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.201}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH ADMINISTRATION

BUREAU OF EMERGENCY PREPAREDNESS, EMS, AND SYSTEMS OF CARE

STATEWIDE STEMI SYSTEM

(By authority conferred on the director of the department of health and human services by sections 2233, 9227, and 20910 of the public health code, 1978 PA 368, MCL 333.2233, 333.9227 and 333.20910, and section 1186 of article 6 of 2022 PA 166.)

R 330.201, R 330.202, R 330.203, R 330.204, R 330.205, R 330.206, R 330.207, R 330.208, R 330.209, R 330.210, R 330.211, R 330.212, R 330.213, and R 330.214 are added to the Michigan Administrative Code, as follows:

PART 1. GENERAL PROVISIONS

Rule 1. As used in these rules:

(a) “ACC” means the American College of Cardiology.

(b) “Accreditation” means a process that a healthcare facility undergoes to demonstrate compliance with standards developed by a department-approved nationally recognized professional accrediting organization.

(c) “Administrative hearing” means a hearing conducted pursuant to the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.

(d) “AHA” means the American Heart Association.

(e) “Certification” means a process that a healthcare facility undergoes to meet predetermined standards of a department-approved nationally recognized professional certifying organization.

(f) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(g) “Department” means the department of health and human services.

(h) “Designation” means a status that is conferred by the department on STEMI centers and facilities that have been verified by a nationally recognized professional accrediting and certifying organization.

(i) “Disciplinary action” means an action taken by the department against a healthcare facility or a regional STEMI network for failure to comply with the code, rules, or protocols approved by the department.

(j) “ECG” or "electrocardiogram" means a test that measures the electrical activity of a heartbeat.

(k) “EMS” means emergency medical services.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.202 Definitions; F to N {#sec-r-330.202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.202}

Rule 2. As used in these rules:

(a) “Healthcare facility” means a facility licensed under section 20141 or 21511 of the code, MCL 333.20141 and 333.21511, that operates a service for treating emergency patients, 24 hours per day, 7 days per week.

(b) “Hold itself out” means an agency, healthcare facility, or STEMI care center or facility advertises, announces, or charges specifically for providing STEMI care services.

(c) “Inter-facility STEMI transfer” means identifying the group of STEMI patients that require additional STEMI resources with the goal of providing optimal care by the timely transfer of these patients to an appropriate level of care to optimize outcome.

(d) “MCA” or "medical control authority" means an organization designated by the department to provide medical control.

(e) “MCA area” means the geographic area comprised of a county, group of counties, or parts of an individual county, as designated by the department.

(f) “Medical control” means the supervision and coordination of emergency medical services through an MCA, as prescribed, adopted, and enforced through departmentapproved protocols, within an emergency medical system.

(g) “Non-designated healthcare facility” means a healthcare facility that has chosen not to be a part of this state’s STEMI system of care or a healthcare facility that the department has not designated as a STEMI center or facility.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.203 Definitions; P to V {#sec-r-330.203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.203}

Rule 3. (1) As used in these rules:

(a) “PCI” or “percutaneous coronary intervention” means a procedure used to open or widen a narrowed or blocked coronary artery to restore the blood flow that supplies the heart and is usually performed on an emergency basis for a STEMI patient.

(b) “Protocol” means a patient care standard, standing order, policy, or procedure for providing emergency medical services that is established by an MCA and approved by the department under section 20919 of the code, MCL 333.20919.

(c) “Provisional” means a one-time temporary time-limited status conferred on a facility by the department that most closely matches the current level of care based on the published criteria for accreditation or certification for which it is applying.

(d) “PSRO” or “professional standards review organization” means a committee established by a life support agency or an MCA for the purpose of improving the quality of medical care, as provided in section 1 of 1967 PA 270, MCL 331.531.

(e) “Quality improvement program” means actions taken by a life support agency, MCA, STEMI center or facility, or jointly between a life support agency, MCA, or STEMI center or facility with a goal of continuous improvement of medical care in accordance with the code. Actions must take place under a PSRO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(f) “Regional STEMI advisory council” means a committee established by a regional STEMI system whose function is to provide leadership and direction in matters related to STEMI system development in their region, and to monitor the performance of the STEMI agencies and healthcare facilities within the region, including, but not limited to, the review of STEMI deaths and preventable complications, and it is comprised of the following:

(i) MCA personnel.

(ii) EMS personnel.

(iii) Life support agency representatives.

(iv) Healthcare facility representatives.

(v) Physicians.

(vi) Nurses.

(vii) Consumers.

(g) “Regional STEMI plan” means a written plan prepared by a regional STEMI advisory council, and approved by the regional STEMI system, that is based on minimum criteria established by the department.

(h) “Regional STEMI system” means an organized group comprised of the local MCA within a region that integrates into the existing regional trauma network and is responsible for appointing a regional STEMI advisory council and creating a regional STEMI plan.

(i) “Regional systems of care authority” means an organization recognized by the department that is comprised of MCAs within a region and is also approved as the regional trauma network, which provides clinical oversight for the regional trauma system, regional stroke system, and regional STEMI system within the region.

(j) “RPSRO” or regional PSRO means a committee established by the regional STEMI system for the purpose of improving the quality of STEMI care within a recognized STEMI region as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(k) “Statewide STEMI care advisory subcommittee” means a STEMI care advisory subcommittee that acts as the department’s subject matter experts regarding the clinical and operational components of STEMI care.

(l) “Statewide STEMI registry” means a system for collecting data that the department manages, analyzes, and disseminates.

(m) “Statewide STEMI system of care” means a comprehensive and integrated arrangement of emergency services personnel, STEMI centers or facilities, equipment, services, communications, MCAs, and organizations necessary to provide STEMI care to all patients within a particular geographic region.

(n) “STEMI” means an ST-segment elevation myocardial infarction defined by symptoms of myocardial infarction associated with an ST-segment elevation on an ECG.

(o) “STEMI bypass” means to forego EMS transport of a patient to the nearest healthcare facility for a healthcare facility whose resources are more appropriate to the STEMI patient pursuant to direction given to pre-hospital emergency medical services by online medical direction or predetermined triage criteria as established by departmentapproved protocols.

(p) “STEMI care” means diagnostic evaluation, triage, acute intervention, emergency transport, and other acute care services for STEMI patients who potentially require emergent cardiac care, and may include education, risk reduction, and subacute STEMI management.

(q) “STEMI diversion” means the re-routing of a STEMI patient from a STEMI care center that has one or more of its essential resources currently functioning at maximum capacity, or is otherwise unavailable, to an alternate STEMI care center to serve the best interests of the STEMI patient.

(r) “STEMI receiving center” means a healthcare facility designated by the department as having met the criteria set forth by a department-approved nationally recognized professional accrediting and certifying organization as having the resources to provide PCI, treatment, and referral for emergency STEMI patients 24 hours per day, 365 days per year.

(s) “STEMI referral facility” means a healthcare facility designated by the department as having met the criteria set forth by a department-approved nationally recognized professional accrediting/certifying organization as having the resources to provide treatment and referral services for STEMI patients 24 hours per day, 365 days per year.

(t) “STEMI response” means an individual who has been identified as a potential STEMI patient and requires the utilization of the STEMI system of care.

(u) “TJC” means the Joint Commission.

(v) “Triage” means classifying patients according to the severity of their medical conditions.

(w) “Verification” means an evaluation process conducted by a national professional accrediting and certifying organization, or the department, to verify resources and improve STEMI care.

(2) A term defined in the code has the same meaning when used in these rules.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.204 Powers and duties of department {#sec-r-330.204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.204}

Rule 4. (1) The department, with the advice of the state EMS coordination committee and statewide STEMI care advisory subcommittee, shall do all the following:

(a) Implement an all-inclusive STEMI system throughout this state that allows for the care of all STEMI patients in an integrated system of healthcare in the pre-hospital and healthcare facility environments by personnel that are well trained and equipped to care for STEMI patients.

(b) Perform all the following:

(i) Establish regional systems of care authorities comprised of the MCAs in each region currently approved as regional trauma networks. The regional systems of care authority shall provide oversight for the regional trauma system, regional stroke system, and regional STEMI system.

(ii) Establish a statewide STEMI care quality improvement program using a statewide database.

(iii) Monitor the statewide STEMI system.

(iv) Ensure the coordination and performance of the regional STEMI systems.

(v) Set minimum standards for system performance and STEMI patient care.

(c) Develop a statewide process to establish regional STEMI systems comprised of the local MCAs, within a region, and in a manner that integrates the STEMI system into existing regional trauma, EMS, and medical control systems.

(d) Develop, implement, and maintain a state STEMI systems of care plan.

(e) Develop an in-state process for the verification of STEMI resources based on a department-approved nationally recognized professional certifying and accrediting organization’s current standards if resources are available.

(f) Develop a statewide process for the designation of STEMI centers and facilities.

(g) Develop an appeals process for healthcare facilities to contest their designation determination.

(h) Establish state STEMI care recommendations and approve regional STEMI protocols that are established and adopted by the local MCAs.

(i) Recognize the established regional STEMI systems.

(j) Provide system oversight of the STEMI care provided in each region in accordance with the following:

(i)Regional STEMI systems must be integrated into the established regional systems of care authority composed of the collaborating local MCAs in a region.

(ii) The regional systems of care authority shall apply to the department for approval and recognition as a regional STEMI system. The department, with the statewide STEMI care advisory subcommittee and state EMS coordination committee, shall review the regional STEMI system application for approval every 3 years.

(iii) The establishment of the regional STEMI system does not limit the transfer or transport of STEMI patients between regions of this state.

(k) Require STEMI triage protocol that is established and adopted by local MCA and regional STEMI systems and developed based on triage criteria prescribed by the department on the recommendation of the statewide STEMI care advisory subcommittee and state EMS coordination committee, and following the procedures established by the department under section 20919(3) of the code, MCL 333.20919.

(l) Develop a statewide STEMI verification process based on the verification standards of a nationally recognized professional accrediting and certifying organization for a predetermined period of time.

(m) Establish a mechanism for periodic re-designation of STEMI centers and facilities.

(n) Develop a comprehensive statewide STEMI data collection system.

(o) Formulate recommendations for the development of performance improvement plans by the regional STEMI systems, consistent with those in R 330.211.

(p) Develop a process for STEMI system performance improvement, including responsibility for monitoring compliance with standards, maintaining confidentiality, and providing periodic review of STEMI center and facility standards set forth by nationally recognized professional review organizations as specified in R 330.206 and R 330.211.

(q) Develop a process for the evaluation of STEMI system effectiveness based on standards as specified in R 330.211.

(r) Coordinate and integrate appropriate STEMI risk reduction strategies and programs.

(s) Support the state STEMI system of care and provide resources to carry out its responsibilities and functions.

(t) Support the training and education needs and resources of STEMI care personnel throughout this state.

(2) The department may deny, suspend, or revoke designation of a STEMI center or facility upon a finding including, but not limited to, any one of the following:

(a) Failure to comply with the rules or healthcare facilities rules and regulations, or both.

(b) Willful preparation or filing of false reports or records.

(d) Failure to meet designation criteria established in these rules.

(e) Unauthorized disclosure of medical or other confidential information.

(f) Alteration or inappropriate destruction of medical records.

(g) The healthcare facility no longer has the resources required to comply with the current level of designation conferred.

(h) The healthcare facility no longer cares for STEMI patients.

(i) A department-approved STEMI care verification body has determined that the STEMI center or facility no longer meets the STEMI center or facility verification criteria.

(j) Identified deficiencies are not remediated in the allowable time frame.

(3) The department shall provide notice of disciplinary action including, but not limited to, intent to deny, suspend, or revoke STEMI center or facility designation and provide for an appeals process in accordance with the code and sections 71 to 87 of the administrative procedures act of 1969, 1969 PA 306, MCL 24.271 to 24.287.

(4) In developing a statewide STEMI system of care, the department shall consider all the following factors:

(a) Efficient implementation and operation.

(b) Decrease in morbidity and mortality.

(d) Incorporation of national standards.

(e) Availability of funds for implementation.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.205 Participation in system; department prohibitions; coordinated care {#sec-r-330.205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.205}

Rule 5. A healthcare facility may participate in the system to the extent or level that it commits the resources necessary for the appropriate management of STEMI patients. The department shall not limit the number of healthcare facilities that seek to qualify for a given level of STEMI designation under this system to ensure that all STEMI patients are served by a system of coordinated care.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.206 STEMI center or facility verification; designation and re-designation {#sec-r-330.206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.206}

Rule 6. (1) A healthcare facility, which intends to hold itself out to provide STEMI care, shall obtain designation as a STEMI receiving center or STEMI referral facility. A healthcare facility shall not self-designate itself, advertise, or otherwise describe itself as a STEMI receiving center or STEMI referral facility without obtaining and maintaining that designation from the department. Facilities that are not designated by the department will be noted as non-designated healthcare facilities.

(2) The department shall re-designate the STEMI care capabilities of each STEMI center or facility based on verification and designation requirements in effect when the re-designation takes place.

(3) To obtain designation as a STEMI center or facility, the healthcare facility shall apply for designation to the department. A healthcare facility has a right to an administrative hearing if denied a specific STEMI center or facility level designation.

(4) The department shall designate the existing STEMI care resources of all participating healthcare facilities in the state, based on the following categories:

(a) A STEMI receiving center shall provide evidence of current certification or accreditation by a department-approved nationally recognized professional certifying and accrediting organization that the healthcare facility has the resources required to be certified as meeting all the criteria for a certified STEMI receiving center equivalent to a TJC-AHA comprehensive STEMI center or TJC-AHA primary heart attack center or an ACC chest pain center with PCI or a Corazon PCI/Catheterization program, or subsequent equivalent certification or accreditation as approved by the department with the advice of the STEMI advisory subcommittee, pursuant to R 330.204(1)(l), and all the following:

(i) Comply with data submission requirements in R 330.209 and R 330.210.

(ii) Participate in coordinating and implementing regional STEMI risk reduction plans.

(iii) Participate in the regional performance improvement process.

(iv) Provide staff assistance to the department for the state designation and verification process of STEMI referral centers when applicable pursuant to R 330.204(1)(l).

(b) A STEMI referral facility shall provide evidence of current certification or accreditation by a department-approved nationally recognized professional certifying and accrediting organization that the healthcare facility has the resources required to be certified as meeting all the criteria for a certified STEMI referral facility equivalent to a TJC-AHA acute heart attack ready center or an ACC non-PCI chest pain center or a Corazon chest pain center or subsequent equivalent certification or accreditation as approved by the department with the advice of the STEMI advisory subcommittee, pursuant to R 330.204(1)(l), and all the following:

(i) Comply with data submission requirements in R 330.209 and R 330.210.

(ii) Participate in coordinating and implementing regional STEMI risk reduction plans.

(iii) Participate in the regional performance improvement process.

(5) Healthcare facilities wishing to be re-designated as a STEMI receiving center shall independently obtain certification or accreditation by a department-approved nationally recognized professional certifying and accrediting organization at that level and comply with the standards that are incorporated by reference pursuant to R 330.204(1)(l), subrule (4)(a) of this rule, and all the following:

(a) Comply with data submission requirements in R 330.209 and R 330.210.

(b) Participate in coordinating and implementing regional STEMI risk reduction plans.

(d) Provide staff assistance to the department for the state designation and verification process of STEMI referral centers when applicable pursuant to R 330.204(1)(l).

(6) Healthcare facilities wishing to be re-designated as a STEMI referral facility shall independently obtain certification or accreditation by a department-approved nationally recognized professional certifying and accrediting organization at that level and comply with the standards that are incorporated by reference pursuant to R 330.204(1)(l) and R 330.206(4)(a) and all of the following:

(a) Comply with data submission requirements in R 330.209 and R 330.10.

(b) Participate in coordinating and implementing regional STEMI risk reduction plans.

(7) A hospital may apply to the department for one-time temporary, time-limited status as a provisional STEMI center or facility by submitting an application that includes evidence that the hospital meets the department-approved criteria for a provisional STEMI center or facility at the level that it is applying for. A hospital applying for provisional STEMI center or facility status requires the recommendation of the regional STEMI network system and notification to the statewide STEMI advisory subcommittee.

(8) The department may, with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, modify the criteria or establish additional levels of STEMI care resources as appropriate to maintain an effective state STEMI system of care and protect the public welfare. The department shall not establish criteria for the purpose of limiting the number of healthcare facilities that qualify for a particular STEMI center or facility level of designation under these rules.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.207 Triage and transport {#sec-r-330.207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.207}

Rule 7. (1) The department, with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, shall develop recommendations, based on standards pursuant to R 330.204, R 330.212, R 330.213, and R 330.214 for protocols that are established and adopted by local MCAs for the triage, transport, and inter-facility STEMI transfer of STEMI patients to the appropriate STEMI centers and facilities.

(2) The standards under R 330.204, R 330.212, R 330.213, and R 330.214 for the triage, transport, and the inter-facility STEMI transfer of STEMI patients provide recommended minimum standards of care for protocols that are established and adopted by the local MCAs and that must be utilized in the care during transport of STEMI patients. On an annual basis, or as needed, the department shall review and update these recommended minimum standards with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee.

(3) The department, with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, shall create regional STEMI systems that meet all of the following criteria and are responsible for developing triage and transport procedures within that geographical area:

(a) Each regional STEMI system must be integrated into the regional systems of care authority created within the existing trauma regions pursuant to R 325.132.

(b) Each regional STEMI system may create its own triage and transport criteria and protocols, destination criteria and protocols, and inter-facility STEMI transfer criteria and protocols, which are established and adopted by the local MCAs, provided they meet or exceed the standards that are incorporated by reference in these rules pursuant to R 330.212, R 330.213, and R 330.214, and are reviewed by the quality assurance task force and approved by the department.

This may include coordination of triage and transport criteria and protocols, which are established and adopted by local medical control, across geographic regions if in the best interest of providing optimal STEMI care to patients.

(c) STEMI care still must be provided to patients at healthcare facilities as necessary pursuant to 42 USC 1395dd and other applicable laws.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.208 STEMI care regions {#sec-r-330.208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.208}

Rule 8. (1) The department, with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, shall support the establishment and operational activities of the STEMI regions through the commitment of resources.

(2) Each region shall establish a regional STEMI system of care as prescribed and defined by R 330.201 to R 330.211.

(3) All MCAs within an area or region shall participate in the regional STEMI system of care, and life support agencies that care for STEMI patients shall be offered membership on the regional STEMI care advisory council. Regional STEMI care advisory councils must be operated in a manner that maximizes inclusion of their constituents. Regional STEMI care advisory councils must be operated in a manner that maximizes inclusion of their constituents and meets all of the following requirements:

(a) Not less than quarterly, a regional STEMI system of care shall submit evidence of ongoing activity, such as meeting notices and minutes, to the department. Annually, the regional STEMI care advisory council shall file a report with the department that describes ongoing progress toward regional STEMI care plan implementation and includes evidence that members of the regional STEMI care advisory council are currently involved in STEMI care.

(b) The regional STEMI system of care shall develop a regional STEMI care plan. The plan is subject to review by the statewide STEMI care advisory subcommittee and state EMS coordination committee and approval by the department.

(i) All counties within the regional STEMI system have been included unless a specific county, or portion thereof, has been aligned within an adjacent STEMI system, and all healthcare entities, MCAs, and life support agencies have had an opportunity to participate in the planning process.

(ii) All of the following components have been addressed:

(A) STEMI risk reduction.

(B) Communications.

(D) STEMI education.

(E) Infrastructure.

(F) Continuum of care.

(4) Each regional STEMI system of care shall appoint a RPSRO as defined in R 330.203(f).

(5) Each regional STEMI care advisory council shall develop performance improvement plans that are based on standards under R 330.211. The performance improvement plan shall be reviewed annually by the statewide STEMI care advisory subcommittee and state EMS coordination committee for recommendations to the department.

(6) Recommendations developed and proposed for implementation by a regional STEMI care advisory council must meet or exceed those that are established by the department with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, as based on standards that are incorporated by reference in these rules, pursuant to R 330.204(1)(o) and R 325.204(1)(p).

(7) The department shall recognize the regional STEMI system once it approves a completed regional work plan. The regional STEMI system approval process must consist of the following phases:

(a) The first phase is the application phase, which begins with the submission to the department of a completed regional plan for the regional STEMI system.

(b) The second phase is the review phase, which begins after the receipt of the regional plan and ends with a department recommendation to approve the regional STEMI system.

(c) The third phase is the final phase, with the department making a final decision regarding the regional STEMI system plan. This phase also includes an appeal procedure for the denial of an approval of application in accordance with the department’s administrative hearings requirements.

(8) If the application phase results in a recommendation to the department for approval by the statewide STEMI care advisory subcommittee and the state EMS coordination committee, and the department approves, then the department shall notify the regional STEMI system applicant of recommended action within 90 days after receipt by the department.

(9) Upon approval, a regional STEMI care advisory council shall implement the plan to include the following:

(a) Education of all entities about the plan components.

(b) On-going review of resources, process, and outcome data.

(10) The regional STEMI system approval is in effect for 3 years.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.209 Data collection {#sec-r-330.209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.209}

Rule 9. (1) The department, with the advice and recommendations of the statewide STEMI care advisory subcommittee and state EMS coordination committee, shall develop and maintain a statewide STEMI registry. The registry must contain all the following:

(a) Standard STEMI data elements and definitions as a minimum set of elements for data collection, with the addition of elements as recommended by the statewide STEMI care advisory subcommittee and approved by the department, including subsequent amendments and editions.

(b) A plan for data including the following:

(i) Notifying partners of data dictionary changes and new iterations annually.

(ii) Defining the data validation process for designated STEMI center and facility data submissions to the statewide STEMI registry.

(iii) Participating in state data collaboration activities.

(iv) Establishing and maintain processes for the following:

(A) Submitting data related to STEMI responses to the statewide STEMI registry according to the data submission timelines.

(B) Monitoring national standards, regional issues, STEMI centers and facilities, and RPSROs to determine the need for additional data metrics needed for system function.

(C) For those STEMI responses that met the inclusion criteria identified for data submission, submitting the following data elements to the department:

(1) Standard STEMI data elements approved by the department with the advice and recommendations of the statewide STEMI care advisory subcommittee.

(2) Subsequent amendments or additions recommended by the statewide STEMI care advisory subcommittee.

(v) Developing annual reports using regional and state data defined by the statewide STEMI care advisory subcommittee, which assesses the state STEMI system of care and regional STEMI systems.

(vi) Evaluating and importing additional data from existing databases as needed.

(vii) Supporting and evaluating probabilistic and deterministic data linkages.

(2) The department shall support the data collection and analysis process.

(3) Both of the following apply to STEMI center or facility participation in data submission:

(a) All designated STEMI centers or facilities shall participate in data submission.

(b) Participation as appropriate in the RPSRO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.210 Statewide STEMI registry {#sec-r-330.210 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.210}

Rule 10. (1) The purpose of the STEMI registry is to collect and analyze system data to evaluate the delivery of STEMI care, develop STEMI risk reduction strategies, and provide resources for STEMI research and education.

(2) The department shall coordinate data collected by the STEMI centers or facilities and emergency medical service providers. The department shall develop and publish a data submission manual that specifies all of the following:

(a) Data elements and definitions, including the standards under R 330.209(1)(a), and the following:

(i) Definitions of what constitutes a reportable STEMI case.

(ii) Method of submitting data to the department.

(iii) Timetables for data submission.

(iv) Data submission format.

(v) Protections for individual record confidentiality.

(b) Notification to STEMI centers and facilities of the required registry data sets and to update the STEMI centers and facilities and providers, as necessary, when the registry data set changes.

(3) All healthcare facilities shall submit to the department STEMI data determined by the department to be required for the department’s operation of the statewide STEMI registry. The department shall prescribe and provide both of the following:

(a) Standard reporting mechanisms to be used by all healthcare facilities.

(b) The form and content of records to be maintained and the information to be reported to the department.

(4) The department and regional STEMI care advisory councils shall use the STEMI registry data to identify and evaluate regional STEMI care and to prepare reports and analyses as requested by regional STEMI advisory councils, the statewide STEMI care advisory subcommittee, or the state EMS coordination committee.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.211 Regional performance improvement {#sec-r-330.211 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.211}

Rule 11. (1) Each regional STEMI system shall develop and implement a regional STEMI care performance improvement program. This program must include the standards that are incorporated by reference pursuant to R 330.204(1)(d), R 3330.204(1)(j), and R 330.208(5) and include the development of an annual process for reporting to the department a review of all region-wide policies, procedures, and protocols.

(2) Each regional STEMI system is responsible for monitoring, assessing, and evaluating the system to improve STEMI care, reduce death and disability, surveillance of STEMI incidence, and implementation of STEMI risk reduction initiatives.

(3) Each regional STEMI system shall appoint an RPSRO.

(4) Deviations from protocols established and adopted by local MCAs and approved by the department for STEMI patients must be addressed through a documented STEMI care performance improvement process established by a PSRO.

(5) Each regional STEMI care advisory council shall observe the confidentiality provisions of 45 CFR part 164, the health insurance portability and accountability act of 1996, Public Law 104-191, data confidentiality provisions under the code and any confidentiality provisions established by the RPSRO.

(6) The performance improvement program must include the standards under R 330.204(1)(p), R 330.208(5), and include all the following:

(a) Components of the regional STEMI care plan.

(b) Triage criteria and effectiveness.

(d) Data driven provision of care defined by available data metrics supported by the region, the statewide STEMI care advisory subcommittee, and the department.

(7) Each regional STEMI system is responsible for the ongoing evaluation of the system. Accordingly, each region shall develop a procedure for receiving information from the regional STEMI system constituents on the implementation of various components of that region’s STEMI system, and include the standards under R 330.204(1)(d) and R 325.208(5), and include all of the following:

(a) Components of the regional STEMI care plan.

(b) Triage criteria and effectiveness.

(d) Data analytics as defined by the department with the advice of the statewide STEMI care advisory subcommittee.

(9) The region shall ensure that all STEMI centers and facilities participate in this annual evaluation process and encourage all other hospitals that treat STEMI patients to do likewise. The region shall not release specific information related to an individual patient or practitioner. Aggregate system performance information and evaluation must be available for review.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.212 Destination protocols {#sec-r-330.212 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.212}

Rule 12. Local MCAs shall develop and submit STEMI patient destination protocols to the bureau of emergency preparedness, EMS, and systems of care for review by the statewide quality assurance task force appointed under section 20916 of the code, MCL 333.20916. After review and approval by the department, the MCAs must formally adopt and implement the protocol. The following factors must be used in evaluating destination protocols:

(a) STEMI patients must not be transported to a healthcare facility that does not participate in the state STEMI system of care unless there is no other reasonable alternative available.

(b) STEMI patients must be transported to the closest appropriate STEMI center or facility as identified in regional and local MCA protocols. In the event of a STEMI bypass, STEMI care must be provided to patients as necessary pursuant to 42 USC 1395dd or other applicable laws.

(c) If a STEMI receiving center is not within a reasonable distance from the incident scene, the STEMI patient must be transported to the closest appropriate STEMI referral facility.

(d) Each regional STEMI system shall make appropriate determinations for STEMI patient destination based on what is best for the patient.

(e) In areas of the state close to state borders, the most appropriate STEMI center or facility may be out of the state. If possible, transport STEMI patients within state borders.

Local protocols must address this issue.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.213 STEMI patient inter-facility STEMI transfer protocols {#sec-r-330.213 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.213}

Rule 13. (1) All designated STEMI centers and facilities shall maintain inter-facility STEMI transfer protocols for patients that are consistent with regional and local MCA protocols and that are compliant with 42 USC 1395dd.

(2) All STEMI centers and facilities shall develop and implement formal policies based on published guidelines for the transfer of STEMI patients who need a higher level of care.

(3) STEMI patients must be transported to an appropriate hospital designated as a STEMI receiving center or STEMI referral facility.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

Mich. Admin. Code R 330.214 Criteria for transfer protocols; criteria {#sec-r-330.214 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.214}

Rule 14. Designated STEMI centers and facilities shall contact the department for current STEMI patient transfer guidelines.

History

History: 2023 MR 22, Eff. Nov. 9, 2023.

R 330.251 to R 330.263 Statewide Stroke System

Mich. Admin. Code R 330.251 Definitions; A to D {#sec-r-330.251 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.251}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EMERGENCY PREPAREDNESS, EMS, AND SYSTEMS OF CARE EMS

AND SYSTEMS OF CARE SECTION

STATEWIDE STROKE SYSTEM

PART 1. GENERAL PROVISIONS

Rule 1. As used in this part:

(a) “Administrative hearing” means a hearing conducted pursuant to the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.

(b) “CMS” or “Centers for Medicare and Medicaid Services” means the program that is part of the United States Department of Health and Human Services.

(c) “Certification” means a process that a healthcare facility undergoes to demonstrate it has met predetermined standards of a department-approved, CMS-recognized professional certifying organization.

(d) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to333.25211.

(e) “Department” means the department of health and human services.

(f) “Designation” means a status that is conferred by the department on stroke centers that are verified by a CMS-recognized professional certifying organization.

(g) “Disciplinary action” means an action taken by the department against a healthcare facility or a regional stroke network for failure to comply with the code, rules, or protocols approved by the department.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.252 Definitions; E to O {#sec-r-330.252 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.252}

Rule 2. As used in this part:

(a) “EMS” means emergency medical services.

(b) “Healthcare facility” means a facility licensed under section 20141 or 21511 of the code, MCL 333.20141 and 333.21511, which operates a service for treating emergency patients, 24 hours per day, 7 days per week.

(c) “Hold itself out” means the agency, healthcare facility, or stroke care facility that advertises, announces, or charges specifically for providing stroke care.

(d) “Inter-facility transfer of stroke patient” means identifying the group of stroke patients that require additional stroke resources with the goal of providing optimal care to these patients by the timely transfer to an appropriate level of care to optimize the outcome.

(e) “MCA” or “medical control authority” means an organization designated by the department to provide medical control.

(f) “MCA area” means the geographic area comprised of a county, group of counties, or parts of an individual county as designated by the department.

(g) “Medical control” means the supervision and coordination of EMS through a MCA, as prescribed, adopted, and enforced through department-approved protocols, within an emergency medical system.

(h) “Non-designated healthcare facility” means a healthcare facility that has chosen not to be a part of this state's stroke system of care or a healthcare facility that the department has not designated as a stroke center.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.253 Definitions; P to V {#sec-r-330.253 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.253}

Rule 3. (1) As used in this part:

(a) “Protocol” means a patient care standard, standing order, policy, or procedure for providing EMS that is established by an MCA and approved by the department under section 20919 of the code, MCL 333.20919.

(b) “Provisional” means a one-time, temporary-time-limited status conferred on a facility by the department that most closely matches the current level of care based on the published criteria for certification for which it is applying.

(c)”PSRO” or “"professional standards review organization” means a committee established by a life support agency or MCA for the purpose of improving the quality of medical care, as provided in section 1 of 1967 PA, 270, MCL 331.531.

(d) “Quality improvement program” means actions taken by a life support agency, MCA, stroke center, or jointly between a life support agency, MCA, or stroke center with a goal of continuous improvement of medical care in accordance with the code. Actions must take place under a PRSO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(e) “RPSRO” or "regional PRSO” means a committee established by the regional stroke system for the purpose of improving the quality of stroke care within a recognized stroke region as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(f) “Regional stroke plan” means a written plan prepared by a regional stroke advisory council, and approved by the regional stroke system, that is based on minimum criteria established by the department.

(g) “RSAC” or “regional stroke advisory council” means a committee established by a regional stroke system whose function is to provide leadership and direction in matters related to stroke system development in their region, and to monitor the performance of the stroke agencies and healthcare facilities within the region, including, but not limited to, the review of stroke deaths and preventable complications, and it is comprised of the following:

(i) MCA personnel.

(ii) EMS personnel.

(iii) Life support agency representatives.

(iv) Healthcare facility representatives.

(v) Physicians.

(vi) Nurses.

(vii) Consumers.

(h) “Regional stroke system” means an organized group comprised of the local MCA within a region, that integrates into existing regional trauma network or regional systems of care authority and is responsible for appointing a regional stroke advisory council and creating a regional stroke plan.

(i) “Regional systems of care authority” means an organization recognized by the department, comprised of approved MCAs within a region, also approved as the Regional Trauma Network, which provides clinical oversight for the regional trauma system, regional stroke system and regional STEMI system within the region.

(j) “Statewide stroke care advisory subcommittee” means a stroke care advisory subcommittee that acts as the department’s subject matter experts for the clinical and operational components of stroke care. As the system matures and signals readiness to capitalize on efficiencies, the system will merge into the statewide stroke care advisory subcommittee and the statewide STEMI care advisory subcommittee into the statewide cardiovascular care advisory subcommittee.

(k) “Statewide stroke registry” means a system for collecting data that the department manages, analyzes, and disseminates results.

(l) “Statewide stroke system of care” means a comprehensive and integrated arrangement of emergency services personnel, stroke centers, equipment, services, communications, MCAs, and organizations necessary to provide stroke care to all patients within a particular geographic region.

(m) “STEMI” means an ST-segment elevation myocardial infarction defined by symptoms of myocardial infarction associated with an ST-segment elevation on an ECG.

(n) “Stroke” means a cerebrovascular disease that causes a sudden interference in the blood supply to the brain causing neuronal injury with neurological symptoms. This occurs when a blood vessel in the brain is blocked by a clot or a vessel rupture.

(o) “Stroke bypass” means to forego EMS transport of a patient to the nearest healthcare facility for facility whose resources are more appropriate to the stroke patient, pursuant to direction given to pre-hospital EMS by online medical direction or predetermined triage criteria, as established by department-approved protocols.

(p) “Stroke care” means diagnostic evaluation, triage, acute intervention, emergency transport and other acute care services for stroke patients who potentially require emergent medical or surgical intervention or treatment, and may include education, risk reduction, and subacute stroke management.

(q) “Stroke center” means a healthcare facility designated by the department as having met the criteria set forth by a department-approved, CMS-recognized professional certifying organization as being any of the following:

(i) Level I or comprehensive stroke center.

(ii) Level II or thrombectomy capable stroke center.

(iii) Level III or primary stroke center.

(iv) Level IV or acute stroke ready center.

(r) “Stroke diversion” means the re-routing of a stroke patient from a stroke care facility that has 1 or more of its essential resources currently functioning at maximum capacity, or is otherwise unavailable, to an alternate stroke care facility to serve the best interests of the stroke patient.

(s) “Stroke response” means an individual who has been identified as a potential stroke patient and requires the utilization of the stroke care system.

(t) “Triage” means classifying patients according to the severity of their medical conditions.

(u) “Verification” means an evaluation process conducted by a national professional certifying organization to verify resources and improve stroke care.

(2) A term defined in the code has the same meaning when used in these rules.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.254 Powers and duties of department {#sec-r-330.254 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.254}

Rule 4. (1) The department, with the advice of the state EMS coordination committee and statewide stroke care advisory subcommittee, shall do all the following:

(a) Implement an all-inclusive stroke system throughout this state that allows for the care of all stroke patients in an integrated system of healthcare in the pre-hospital and healthcare facility environments by personnel that are well trained and equipped to care for stroke patients.

(b) Perform all of following:

(ii) Establish a statewide stroke care quality improvement program using a statewide database.

(iii) Monitor the statewide stroke system.

(iv) Ensure the coordination and performance of the regional stroke systems.

(v) Set minimum standards for system performance and stroke patient care.

(c) Develop a statewide process to establish regional stroke systems comprised of the local MCAs within a region in a manner that integrates the stroke system into existing regional trauma, EMS, and medical control systems.

(d) Develop, implement, and maintain a state stroke systems of care plan.

(e) Develop a statewide process for the verification of stroke resources based on a stroke center’s current certification by a department-approved, CMS-recognized professional certifying organization.

(f) Develop a statewide process for the designation of stroke centers.

(g) Develop an appeals process for healthcare facilities to contest their designation determination.

(h) Establish state stroke care recommendations and approve regional stroke protocols that are established and adopted by the local MCA.

(i) Recognize the regional stroke systems providing system oversight of the stroke care provided in each region of this state.

(j) Regional stroke systems must be integrated into the established regional systems of care authority composed of the collaborating local MCAs in a region.

(k) The regional systems of care authority shall apply to the department for approval and recognition as a regional stroke system. The department, with the statewide stroke care advisory subcommittee and state EMS coordination committee, shall review the regional stroke system application for approval every 3 years.

(l) The establishment of the regional stroke system does not limit the transfer or transport of stoke patients between regions of the state.

(m) Require stroke triage protocols, which are established and adopted by local MCA and regional stroke systems and developed based on triage criteria prescribed by the department on the recommendation of the statewide stroke care advisory subcommittee and state EMS coordination committee, and following the procedures established by the department under section 20919(3) of the code, MCL 333.20919.

(n) Develop a statewide stroke verification process based on the verification standards of a CMS recognized professional certifying organization for a predetermined period of time.

(o) Establish a mechanism for periodic re-designation of stroke centers.

(p) Develop a comprehensive statewide stroke data collection system.

(q) Formulate recommendations for the development of performance improvement plans by the regional stroke systems, consistent with those in R 330.260.

(r) Develop a process for stroke system performance improvement, including responsibility for monitoring compliance with standards, maintaining confidentiality, and providing periodic review of stroke center standards set forth by nationally recognized professional review organizations.

The following standards are incorporated by reference in these rules, as specified in R 330.259, and R 330.260.

(t) Develop a process for the evaluation of stroke system effectiveness based on standards under R 330.260.

(u) Coordinate and integrate appropriate stroke risk reduction strategies and programs.

(v) Support the state stroke system of care and provide resources to carry out its responsibilities and functions.

(w) Support the training and education needs and resources of stroke care personnel throughout this state.

(2) The department may deny, suspend, or revoke designation of a stroke center on a finding including, but not limited to, any 1 of the following:

(a) Failure to comply with the rules or healthcare facilities rules and regulations, or both.

(b) Willful preparation or filing of false reports or records.

(d) Failure to meet designation criteria established in these rules.

(e) Unauthorized disclosure of medical or other confidential information.

(f) Alteration or inappropriate destruction of medical records.

(g) The healthcare facility no longer has the resources required to comply with the current level of designation conferred.

(h) The healthcare facility no longer cares for stroke patients.

(i) A department-approved stroke care verification body has determined that the stroke center no longer meets their stroke center verification criteria.

(j) Identified deficiencies are not remediated in the allowable timeframe.

(3) The department shall provide a notice of disciplinary action including, but not limited to an intent to deny, suspend, or revoke a stroke center designation and provide for an appeals process under sections 71 to 87 of the administrative procedure act of 1969, 1969 PA 306, MCL 24271 to 24.287.

(4) In developing a statewide stroke care system, the department shall consider all the following factors:

(a) Efficient implementation and operation.

(b) Decrease in morbidity and mortality.

(d) Incorporation of national standards.

(e) Availability of money for implementation.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.255 Stroke center verification; designation and re-designation {#sec-r-330.255 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.255}

Rule 5. (1) A healthcare facility that intends to hold itself out to provide stroke care shall not self-designate itself as a stroke center, advertise, or otherwise describe itself as a “designated stroke center” without obtaining and maintaining a designation from the department. Facilities that are not designated by the department will be noted as a non-designated healthcare facility.

(2) The department shall re-designate the stroke care capabilities of each stroke center based on verification and designation requirements in effect when the re-designation takes place.

(3) To obtain designation as a stroke center, the healthcare facility shall apply to the department.

A healthcare facility has a right to an administrative hearing if denied a specific stroke center level designation.

(4) The department shall designate the existing stroke care resources of all participating healthcare facilities in this state, based on the following categories:

(a) A level I or comprehensive stroke center shall provide evidence of current certification by a department-approved, CMS-recognized professional certifying organization that the healthcare facility has the resources required to be certified as meeting all the criteria, or subsequent equivalent certification as approved by the department, with the advice of the stroke advisory subcommittee, for an accredited comprehensive stroke center under R 330.254(1)(e). All the following apply to a level I stroke center:

(i) Comply with data submission requirements in R 330.258 and R 330.259.

(ii) Participate in coordinating and implementing regional stroke risk reduction plans.

(iii) Participate in the regional performance improvement process.

(iv) Provide staff assistance to the department for the designation and verification process of stroke centers when applicable under R 330.254(1)(e).

(b) A level II or thrombectomy capable stroke center shall provide evidence of current certification by a department-approved, CMS-recognized professional certifying organization that the healthcare facility has the resources required to be certified as meeting all the criteria, or subsequent equivalent certification as approved by the department with the advice of the stroke advisory subcommittee, for a certified thrombectomy capable stroke center under R 330.254 (1)(e), and all the following:

(i) Comply with data submission requirements in R 330.258 and R 330.259.

(ii) Participate in coordinating and implementing regional stroke risk reduction plans.

(iii) Participate in the regional performance improvement process.

(iv) Provide staff assistance to the department for the designation and verification process of stroke centers when applicable under R 330.254(1)(e).

(c) A level III or primary stroke center shall provide current certification by a departmentapproved, CMS-recognized professional certifying organization that the healthcare facility has the resources required to be certified as meeting all the criteria, or subsequent equivalent certification as approved by the department with the advice of the stroke advisory subcommittee, for a certified primary stroke center under R 330.254(1)(e), and all the following:

(i) Comply with data submission requirements in R 330.258 and R 330.259.

(ii) Participate in coordinating and implementing regional stroke risk reduction plans.

(iii) Participate in the regional performance improvement process.

(d) A level IV or acute stroke ready hospital stroke center shall provide current certification by a department-approved, CMS-recognized professional certifying organization that the healthcare facility has the resources required to be certified as meeting all the criteria, or subsequent equivalent certification as approved by the department with the advice of stroke advisory subcommittee, for a certified acute stroke ready hospital under R 330.254(1)(e). All the following apply to the level IV stroke center:

(i) Comply with data submission requirements in R 330.258 and R 330.259.

(ii) Participate in coordinating and implementing regional stroke risk reduction plans.

(iii) Participate in the regional performance improvement process.

(5) Healthcare facilities wishing to be re-designated as a level I or comprehensive stroke center shall independently obtain certification by a department-approved, CMS-recognized professional certifying organization at that level, and comply with the standards under R 330.254(1)(e), and all the following:

(a) Comply with data submission requirements in R 330.258 and R 330.259.

(b) Participate in coordinating and implementing regional stroke risk reduction plans.

(d) Provide staff assistance to the department for the designation and verification process of stroke centers when applicable under R 330.254(1)(e).

(6) Healthcare facilities wishing to be re-designated as a level II or thrombectomy capable stroke center shall independently obtain certification by a department-approved, CMS- recognized professional certifying organization at that level, and comply with the standards under R 330.254(1)(e) and all of the following:

(a) Comply with data submission requirements in R 330.258 and R 330.259.

(b) Participate in coordinating and implementing regional stroke risk reduction plans.

(d) Provide staff assistance to the department for the designation and verification process of stroke centers when applicable under R 330.254(1)(e).

(7) Healthcare facilities wishing to be re-designated as a level III or primary stroke center shall independently obtain certification by a department-approved, CMS-recognized professional certifying organization at that level and comply with the standards under R 330.254(1)(e), and the following:

(a) Comply with data submission requirements in R 330.258 and R 330.259.

(b) Participate in coordinating and implementing regional stroke risk reduction plans.

(8) Healthcare facilities wishing to be re-designated as a level IV or acute stroke ready stroke center shall independently obtain certification by a department-approved CMS recognized professional certifying organization at that level and comply with the under R 330.254 (1)(e), and the following:

(a) Comply with data submission requirements in R 330.258 and R 330.259.

(b) Participate in coordinating and implementing regional stroke risk reduction plans.

(9) A hospital may apply to the department for a one-time, temporary-time limited status as a provisional stroke center by submitting an application that includes evidence that the hospital meets the department-approved criteria for a provisional stroke center at the level that the hospital is applying. A hospital applying for provisional stroke center status requires the recommendation of the stroke network system and notification to the statewide stroke advisory committee.

(10) The department may, with the advice and recommendations of the statewide stroke care advisory committee and state EMS coordination committee, modify the criteria or establish additional levels of stroke care resources as appropriate to maintain an effective state stroke system of care and protect the public welfare. The department shall not establish criteria for the purpose of limiting the number of healthcare facilities that qualify for a particular stroke center level of designation under these rules.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.256 Triage and transport {#sec-r-330.256 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.256}

Rule 6. (1) The department, with the advice and recommendations of the statewide stroke care advisory subcommittee and state EMS coordinating committee, shall develop recommendations, based on standards in these rules, R 330.254, R 330.261, R 330.262, and R 330.263 for protocols that are established and adopted by local MCAs for the triage, transport, and inter-facility transfer of stroke patients to the appropriate stroke centers.

(2) The standards under R 330.254, R 330.261, R 330.262, and R 330.263 for the triage, transport, and the inter-facility transfer of stroke patients must provide recommended minimum standards of care for protocols that are established and adopted by local MCAs and that must be utilized in the care during transport of stroke patients. On an annual basis, or as needed, the department shall review and update these recommended minimum standards with the advice and recommendations of the statewide stroke care advisory subcommittee and the state EMS coordination committee.

(3) The department, with the advice and recommendations of the statewide stroke care advisory subcommittee and state EMS coordinating committee, shall create regional stroke systems that are responsible for developing triage and transport procedures within that geographical area. The triage and transport procedures must include both of the following:

(a) Each regional stroke system must be integrated into the regional systems of care authority created within the existing trauma regions under R 325.132.

(b) Each regional stroke system may create its own triage and transport criteria and protocols, destination criteria and protocols, and inter-facility transfer criteria and protocols, established and adopted by local MCAs, provided they meet or exceed the standards that are incorporated under R 330.261, R 330.262, and R 330.263, and are reviewed by the quality assurance task force and approved by the department. This may include coordination of triage and transport criteria and protocols, established, and adopted by local MCAs, across geographic regions, if in the best interest of providing optimal stroke care to patients.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.257 Stroke care regions {#sec-r-330.257 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.257}

Rule 7. (1) The department, with the advice and recommendations of the statewide stroke care advisory subcommittee and state EMS coordination committee, shall support the establishment and operational activities of the regional stroke system of care through the commitment of resources.

(2) Each region shall establish a regional stroke system of care as prescribed by this part.

(3) All MCA areas or regions shall participate in the regional stroke care system, and life support agencies that care for stroke patients shall be offered membership on the regional stroke care advisory council. Regional stroke care advisory councils must be operated in a manner that maximizes inclusion of their constituents. The following requirements must be met:

(a) Quarterly, a regional stroke system of care shall submit evidence of ongoing activity, such as meeting notices and minutes, to the department. Annually, the regional stroke system of care shall file a report with the department that describes ongoing progress toward regional stroke care plan implementation and includes evidence that members of the regional stroke care advisory council are currently involved in stroke care.

(b) The regional stroke system of care shall develop a regional stroke care plan. The plan is subject to review by the statewide stroke care advisory committee and the state EMS coordination committee for recommendation and approval by the department.

(i) All counties within the regional stroke system are included unless a specific county, or portion thereof, has been aligned within an adjacent system, and all healthcare entities, MCAs, and life support agencies have been given an opportunity to participate in the planning process.

(ii) All the following components are addressed:

(A) Stroke risk reduction.

(B) Communications.

(D) Stroke education.

(E) Infrastructure.

(F) Continuum of care.

(4) Each regional stroke system of care shall appoint a RPSRO.

(5) Each regional stroke care advisory council shall develop performance improvement plans that are based on standards under R 330.260. The statewide stroke care advisory subcommittee and state EMS coordination committee shall annually review the performance improvement plan and make recommendations to the department.

(6) Recommendations developed and proposed for implementation by a regional stroke care advisory council must meet or exceed those that are established by the department, with the advice and recommendations of the statewide stroke care advisory subcommittee and state EMS coordination committee, as based on standards under R 330.254(1)(n) and R 330.254(1)(o).

(7) The department shall recognize the regional stroke system once it approves a completed regional stroke plan. The regional stroke system approval process must consist of the following phases:

(a) The first phase is the application phase, which begins with the submission to the department of a completed regional plan for the regional stroke system.

(b) The second phase is the review phase, which begins after the receipt of the regional plan and ends with a department recommendation to approve the regional stroke system.

(c) The third phase is the final phase, with the department making a final decision regarding the regional stroke system plan. This phase also includes an appeal procedure for the denial of an approval of application in accordance with the department’s administrative hearings requirements.

(8) If the application phase results in a recommendation to the department for approval by the statewide stroke care advisory subcommittee and the state EMS coordination committee, and the department approves, the department shall notify the regional stroke system applicant of recommended action within 90 days after receipt by the department.

(9) After approval, a regional stroke care advisory council shall implement the plan to include both the following:

(a) Education of all entities about the plan components.

(b) On-going review of resources, process, and outcome data.

(10) The regional stroke system approval is effective for 3 years.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.258 Data collection {#sec-r-330.258 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.258}

Rule 8. (1) The department, with the advice and recommendations of the statewide stroke care advisory subcommittee and state EMS coordination committee, shall develop and maintain a statewide stroke registry. The registry must contain all the following:

(a) Standard stroke data elements and definitions as a minimum set of elements for data collection, with the addition of elements as recommended by the statewide stroke care advisory subcommittee and approved by the department, including subsequent amendments and editions.

(b) A plan for data that does all of the following:

(i) Notifies partners of data dictionary changes and new iterations annually.

(ii) Defines the data validation process for designated stroke center data submissions to the statewide stroke registry.

(iii) Participates in state data collaboration activities.

(iv) Establishes and maintains processes for the following:

(A) Submitting data related to stroke responses to the statewide stroke registry according to the data submission timelines.

(B) Monitoring national standards, regional issues, stroke center, and RPSRO to determine the need for additional data metrics needed for system function.

(C) For those stroke responses that met the inclusion criteria identified for data submission, submitting all of the following:

(1) Standard stroke data elements approved by the department with the advice and recommendations of statewide stroke care advisory subcommittee.

(2) Subsequent amendments or additions recommended by the statewide stroke care advisory subcommittee.

(v) Developing annual reports using regional and state data defined by the statewide stroke care advisory subcommittee that assess the state stroke system of care and regional stroke systems.

(vi) Evaluating and importing additional data from existing databases as needed.

(vii) Supporting and evaluating probabilistic and deterministic data linkages.

(2) The department shall support the data collection and analysis process.

(3) Both of the following apply to stroke center participation in data submission:

(a) All designated stroke centers shall participate in data submission.

(b) Participation as appropriate in the RPSRO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.259 Statewide stroke registry {#sec-r-330.259 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.259}

Rule 9. (1) The purpose of the stroke registry is to collect and analyze system data to evaluate the delivery of stroke care, develop stroke risk reduction initiatives, and provide resources for stroke research and education.

(2) The department shall coordinate data collected by the stroke centers and EMS providers. The department shall develop and publish a data submission manual that specifies all of the following:

(a) Data elements and definitions, including the standards under R 330.258(1)(a) and the following:

(i) Definitions of what constitutes a reportable stroke case.

(ii) Method of submitting data to the department.

(iii) Timetables for data submission.

(iv) Data submission format.

(v) Protections for individual record confidentiality.

(b) Notification of stroke centers of the required registry data sets and to update the stroke centers and providers as necessary, when the registry data set changes.

(3) All healthcare facilities shall submit to the department stroke data determined by the department to be required for the department’s operation of the statewide stroke registry. The department shall prescribe and provide both of the following:

(a) Standard reporting mechanisms used by all healthcare facilities.

(b) The form and content of records maintained and the information to be reported to the department.

(4) The department and regional stroke care advisory councils shall use the stroke registry data to identify and evaluate regional stroke care and to prepare reports and analyses as requested by regional stroke advisory councils, the statewide stroke care advisory subcommittee, or the state EMS coordination committee.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.260 Regional performance improvement {#sec-r-330.260 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.260}

Rule 10. (1) Each regional stroke system shall develop and implement a regional stroke care performance improvement program. This program must include the standards under R 330.254(1)(d) and R 330.257(5) and the development of an annual process for reporting to the department a review of all region-wide policies, procedures, and protocols.

(2) Each regional stroke system is responsible for monitoring, assessing, and evaluating the system to improve stroke care, reduce death and disability, surveillance of stroke incidence and implementation of stroke risk reduction initiatives.

(3) Each regional stroke system shall appoint an RPSRO.

(4) Deviations from protocols established and adopted by local MCAs and approved by the department for stroke patients must be addressed through a documented stroke care performance improvement process established by a PSRO.

(5) Each regional stroke care advisory council shall observe the confidentiality provisions of 45 CFR Part 164, the health insurance portability and accountability act of 1996, Public Law 104- 191, the data confidentiality provisions under the code, and any confidentiality provisions established by the RPSRO.

(6) The performance improvement process must include the standards under R 330.254(1)(d), and include all of the following system components to be evaluated:

(a) Components of the regional stroke care plan.

(b) Triage criteria and effectiveness.

(d) Data driven provision of care defined by available data metrics supported by the region, the statewide stroke care advisory subcommittee, and the department.

(7) Each regional stroke system is responsible for the ongoing evaluation of the stroke system of care. Accordingly, each region shall develop a procedure for receiving information from the regional stroke care system constituents on the implementation of various components of that region’s stroke care system, and include the standards under R 330.254(1)(e), and include all the following:

(a) Components of the regional stroke care plan.

(b) Triage criteria, and effectiveness.

(d) Data analytics as defined by the department with the advice of the statewide stroke care advisory subcommittee.

(8) Based on information received by the region in the evaluation process, the region shall annually prepare a report containing results of the evaluation and a performance improvement plan, if needed. The report must be made available to all regional stroke system constituents.

(9) The region shall ensure that all stroke centers participate in this annual evaluation process and encourage all other hospitals that treat stroke patients to participate. The region shall not release specific information related to an individual patient or practitioner. Aggregate system performance information and evaluation must be available for review.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.261 Destination protocols {#sec-r-330.261 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.261}

Rule 11. Local MCAs shall develop and submit stroke patient destination protocols to the bureau of emergency preparedness, EMS, and systems of care for review by the statewide quality assurance task force appointed under section 20916 of the code, MCL 333.20916. After review and approval by the department, the MCA shall formally adopt and implement the protocol. The following factors must be used in evaluating destination protocols:

(a) An evidence-based validated stroke assessment tool.

(b) Stroke patients shall not be transported to a healthcare facility that does not participate in the state stroke care system unless there is no other reasonable alternative available.

(c) Stroke patients shall be transported to the closest appropriate stroke center as identified in regional and local medical control protocols.

(d) If a level I, level II or level III stroke center is not within a reasonable distance from the incident scene, the stroke patient shall be transported to a level IV stroke center.

(e) Each region shall make appropriate determinations for stroke patient destination based on what is best for the patient.

(f) In areas of this state close to state borders, the most appropriate stroke center may be out of this state. If possible, transport stroke patients within state borders. Local protocols must address this issue.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.262 Stroke patient inter-facility transfer protocols {#sec-r-330.262 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.262}

Rule 12. (1) All designated stroke centers shall maintain inter-facility transfer protocols for stroke patients that are consistent with regional and local medical control protocol and are compliant with 42 USC 1395dd.

(2) All level IV stroke centers shall develop and implement formal policies based on published guidelines for the transfer of stroke patients who need care at a level III, level II, or level I stroke center.

(3) All level III stroke centers shall develop and implement formal policies based on published guidelines for the transfer of stroke patients who need care at a level II or level I stroke center.

(4) All level II stroke centers shall develop and implement formal policies based on published guidelines for the transfer of stroke patients who need care at a level I stroke center.

(5) Stroke patients shall be transported to a hospital designated as a stroke center.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

Mich. Admin. Code R 330.263 Criteria for transfer protocols; criteria {#sec-r-330.263 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.263}

Rule 13. (1) Designated stroke centers shall contact the department for current stroke patient transfer guidelines.

(2) Stroke care, including stroke bypass, must be provided to patients as necessary pursuant to 42 USC 1395dd or other applicable laws.

History

History: 2023 MR 21, Eff. Nov. 6, 2023.

R 330.301 to R 330.304 Universal Blood Lead Testing

Mich. Admin. Code R 330.301 Definitions {#sec-r-330.301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.301}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

BUREAU OF EPIDEMIOLOGY AND POPULATION HEALTH

DIVISION OF ENVIRONMENTAL HEALTH

UNIVERSAL LEAD TESTING

(By authority conferred on the director of the department of health and human services by sections 2233, 5474d, and 9227 of the public health code, 1978 PA 368, MCL 333.2233, 333.5474d, and 333.9227)

Rule 1. As used in these rules:

(a) “Blood lead reference value” means a blood lead level of 3.5 micrograms per deciliter.

(b) “Certificate of immunization” means the official record of a child’s immunizations available from the department, either in print or digital format in a provider’s office from the Michigan electronic immunization information system, as required by section 9206 of the public health code, 1978 PA 368, MCL 333.9206.

(d) “Lead poisoning” means the condition of having a blood lead level that is equal to or greater than the blood lead reference value.

(e) “Jurisdiction” means a legally defined county subdivision, which in this state includes cities and townships, that is defined as “Minor Civil Division” by the United States Census Bureau.

(f) “Michigan childhood lead poisoning surveillance system” means the web-based laboratory management application that houses the validated blood lead laboratory results of patients from clinical laboratories and portable analyzers.

(g) “Minor” is an individual less than 18 years of age.

(h) “Physician” means an individual licensed to engage in the practice of medicine, as that term is defined in section 17001 of the public health code, 1978 PA 368, MCL 333.17001, or the practice of osteopathic medicine and surgery under section 17501 of the public health code, 1978 PA 368, MCL 333.17501.

(i) “Test” and “tested” means a venous or capillary blood test for the presence of lead.

History

History: 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 330.302 Blood lead testing of a minor {#sec-r-330.302 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.302}

Rule 2. (1) A physician treating a minor patient shall test, or order a test, for lead in blood at the following ages:

(a) 12 months.

(b) 24 months.

(2) If a minor patient resides in 1 of the jurisdictions identified in R 330.303 as a geographic area where children are at high risk of lead poisoning, a physician treating the minor patient shall test, or order a test, for lead in blood of the minor between 48 months and 60 months of age.

(3) If a physician determines that a minor patient is at high risk for lead poisoning, the physician shall test, or order a test, for lead in blood of the minor as provided in subrules (4) and (5) of this rule.

(4) If either of the following factors that identify a minor at high risk for lead poisoning are present, a physician treating the minor shall test, or order a test, for lead in blood of the minor at least once in between the date of the minor’s most recent test and 72 months of age:

(a) The minor resides in a home where other minors have been tested and found to have lead poisoning.

(b) The minor resides in a home built before 1978.

(5) If a physician treating a minor patient determines that the minor is at high risk for lead poisoning through a parent’s attestation or through the physician’s own independent medical judgment, the physician shall test, or order a test, for lead in blood of the minor at least once between the time of that determination and 3 months following that determination.

(6) The department shall make available educational materials for physicians regarding health effects, risk factors, testing, and medical care for lead-exposed minors. The materials must include a written reference guide that summarizes risk factors for lead poisoning, for which additional blood lead testing may be indicated.

(7) If capillary blood lead test results are equal to or greater than the blood lead reference value, the physician shall test, or order a test, for lead in blood with venous blood. The venous blood lead test must be analyzed in a laboratory using a high complexity method, such as inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectroscopy.

History

History: 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 330.303 Geographic areas identified as high-risk of lead poisoning {#sec-r-330.303 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.303}

Rule 3. (1) As required under section 5474d of the public health code, 1978 PA 368, MCL 333.5474d, the following jurisdictions are identified as the geographic areas where there is a high risk of lead poisoning:

Jurisdiction (Minor Civil Division Type)

County Adrian (City) Lenawee Albion (City) Calhoun Allegan (City) Allegan Bad Axe (City) Huron Battle Creek (City) Calhoun Bay City (City) Bay Belding (City) Ionia Benton Harbor (City) Berrien Benton Township Berrien Bridgeport Township Saginaw Bronson (City) Branch Buena Vita Township Saginaw Calumet Twp Township Houghton Cato Twp (City) Montcalm Coldwater (City) Branch Colon Township Saint Joseph Constantine Township Saint Joseph Croswell (City) Sanilac Curtis Township Alcona Detroit (City) Wayne Dowagiac (City) Cass Eastpointe (City) Macomb Ecorse (City) Wayne Escanaba (City) Delta Evart (City) Osceola Flint (City) Genesee Galien Township Berrien Gladstone (City) Delta Grand Rapids (City) Kent Greenville (City) Montcalm Hamtramck (City) Wayne Harper Woods (City) Wayne Hartford (City) Van Buren Highland Park (City) Wayne Hillsdale (City) Hillsdale Homer Twp (City) Calhoun Hudson (City) Lenawee Imlay City (City) Lapeer Inkster (City) Wayne Ionia (City) Ionia Ironwood (City) Gogebic Ishpeming (City) Marquette Ithaca (City) Gratiot Jackson (City) Jackson Kalamazoo (City) Kalamazoo Lagrange Township Cass Lansing (City) Clinton, Eaton, Ingham Lansing Township Ingham Lapeer (City) Lapeer Leoni Township Jackson Lincoln Park (City) Wayne Ludington (City) Mason Manistee (City) Manistee Maple Valley Township Montcalm Medina Township Lenawee Menominee (City) Menominee Monroe (City) Monroe Morenci (City) Lenawee Mount Clemens (City) Macomb Mount Morris (City) Genesee Muskegon (City) Muskegon Muskegon Heights (City) Muskegon Niles (City) Berrien, Cass Owosso (City) Shiawassee Paw Paw Township Van Buren Pokagon Township Cass Pontiac (City) Oakland Port Huron (City) Saint Clair Port Huron Township Saint Clair Reed City (City) Osceola River Rouge (City) Wayne Saginaw (City) Saginaw Saint Louis (City) Gratiot Scottville (City) Mason Springfield (City) Calhoun Stanton (City) Montcalm Sturgis (City) Saint Joseph Summit Township Jackson Three Rivers (City) Saint Joseph Union Township Branch Wayne (City) Wayne Wright Township Hillsdale (2) The department shall make available on the department’s website a document that describes the data and analytical methods used to identify geographic areas that pose a high risk for childhood lead poisoning.

History

History: 2025 MR 9, Eff. April 30, 2025.

Mich. Admin. Code R 330.304 Blood lead testing records in the minor’s certificate of immunization {#sec-r-330.304 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 330.304}

Rule 4. (1) Blood lead test results must be included in the minor’s certificate of immunization.

(2) The department shall link all blood lead tests reported to the department, as required by section 5474 of the public health code, 1978 PA 368, MCL 333.5474 and R 325.9081 to R 325.9086, to the minor’s electronic immunization record in the Michigan electronic immunization information system.

(3) The physician shall be able to view the minor’s blood lead testing records when the minor’s electronic immunization record is accessed, and the minor’s most recent blood lead test results must be included in the printed copy of the minor’s certificate of immunization given to parents.

(4) If the blood lead test results are not otherwise reported to the department consistent with R 325.9081 to R 325.9086, the physician or individual other than the physician performing the test shall report those results to the department’s childhood lead poisoning prevention program for entry into the Michigan childhood lead poisoning surveillance system so that the results are linked to the minor’s record in the electronic immunization information system in this state.

History

History: 2025 MR 9, Eff. April 30, 2025.

R 333.13101 to R 333.13121 Body Art Facilities

Mich. Admin. Code R 333.13101 Definitions {#sec-r-333.13101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13101}

DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH ADMINISTRATION

BODY ART FACILITIES

(By authority conferred on the department of health and human services by sections 2226, 2233, 2235, and 13108 of the public health code, 1978 PA 368, MCL 333.2226, 333.2233, 333.2235, and 333.13108; section 5 of the critical health problems reporting act, 1978 PA 312, MCL 325.75; and section 24 of the Michigan occupational safety and health act, 1974 PA 154, MCL 408.1024)

PART 1. DEFINITIONS

Rule 1. (1) As used in these rules:

(a) “AAMI” means the Association for the Advancement of Medical Instrumentation.

(b) “Act” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(c) “Aftercare instructions” means verbal and written instructions given to the client, specific to the body art procedure or procedures rendered regarding the care of the body art and surrounding area.

(d) “ANSI” means American National Standards Institute.

(e) “Antiseptic” means a product that is labeled as useful in preventing diseases caused by microorganisms present on the skin or on mucosal surfaces, or both, of humans. These products must comply with section 201(g)(1)(B) of the federal food, drug, and cosmetic act, 21 USC 321. Antiseptic includes products meant to kill germs and may also be referred to as, but not limited to, the following:

(i) Antiseptic.

(ii) Antimicrobial.

(iii) Antibacterial.

(iv) Microbicide.

(v) Germicide.

(f) “Aseptic technique” means a set of specific practices and procedures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens.

(g) “ASTM” means the American Society for Testing and Materials International.

(h) “Autoclave” means a device that is intended to sterilize products by means of pressurized steam. An autoclave must comply with 1 or more of the 3 types of steam programs defined as B, N, and S by EN13060 / ISO 17665, and must be capable of sterilizing hollow items, or lumens. An autoclave can remove air from the load by means of any of the following:

(i) Gravity displacement.

(ii) Fractionated vacuum.

(iii) Steam flush-pressure pulse.

(i) “Automated instrument washer” means a mechanical washer designed specifically for the decontamination of instruments before sterilization. These devices must comply with ISO 15883-1/2. Automated instrument washer includes a washer-disinfector or washer-sterilizer.

(j) “Body art technician” means an individual who performs any of the following actions:

(i) Tattooing, including scarification.

(ii) Branding.

(iii) Body piercing.

(k) “Body jewelry” means an adornment placed into a body piercing and comprised of various materials including metals, non-metals, and organic materials as provided in R 333.13114.

(l) “Clean” means objects or surfaces are free from visible soil, organic material, or inorganic material, as usually accomplished by manual or mechanical means through water with detergents or enzymatic products.

(m) “Client” means an individual undergoing any of the following procedures:

(i) Tattooing, including scarification.

(ii) Branding.

(iii) Body piercing.

(n) “Contaminated” means the presence or the reasonably anticipated presence of blood or other potentially infectious material on an item.

(o) “Contaminated sharps” means any contaminated object that can penetrate the skin including, but not limited to, the following:

(i) Tattoo needles.

(ii) Body piercing needles.

(iii) Disposable razors.

(p) “Cycle number” means a unique number that corresponds to each individual autoclave cycle, is used as an identifier and may or may not include the date as part of the number.

(q) “Department” means the department of health and human services.

(r) “Disinfectant” means a tuberculocidal chemical or physical agent that kills vegetative forms of microorganisms, but not necessarily all microbial forms such as bacterial spores registered with the United States Environmental Protection Agency.

(s) “Disinfection” or “disinfected” means the process that kills most pathogenic microorganisms and other microorganisms on inanimate objects by physical or chemical means but does not ensure the margin of safety standards associated with sterilization processes.

(t) “EGLE” means the department of environment, Great Lakes, and energy.

(u) “EN” or “European standard” means a technical standard, established by consensus and approved by a recognized body that provides, for common and repeated use, rules, guidelines or characteristics for activities or their results, aimed at the achievement of the optimum degree of order in a given context.

(v) “Equipment” means all machinery, including fixtures, containers, tools, devices, sinks, and other apparatus used in connection with performing body art procedures.

(w) “Exposure” means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious material that may result from the performance of an individual’s assigned duties in the body art facility. It does not include incidental exposures that may take place on the job, which are neither reasonably nor routinely expected, and which the individual is not required to incur in the normal course of employment.

(x) “Foot-candles” mean a measurement of light intensity.

(y) “Gloves” means medical grade or exam grade, sterile or nonsterile, disposable, single-use, full-hand coverings worn for protection against disease transmission.

(z) “Hand washing” means physically removing or reducing most microorganisms from the intact skin of the hands. The temperature for handwashing must be not less than 85 degrees Fahrenheit.

(aa) “Hand washing sink” means a sink equipped to provide water with both hot and cold temperatures through a mixing valve or combination faucet, used solely for washing hands, arms, or prosthetics.

(bb) “Instruments” means needles, needles attached to the needle bars, body piercing needles, razors, scarification implements, and other devices that may come in contact with a client’s body or that may have possible exposure to blood or other potentially infectious material during the body art procedure.

(cc) “ISO” means the International Organization for Standardization.

(dd) “Material certificate” means all documents intended to state the specifics of a material used for body jewelry. Names for these documents include, but are not limited to, the following:

(i) Mill certificates.

(ii) ISO certificates.

(iii) Metal composition sheets.

(iv) Material certification sheets.

(ee) “Medical waste” means any of the following that are not generated from a household or care agency as required by part 138 of the act, MCL 333.13801 to 333.13832:

(i) Cultures and stocks of infectious agents and associated biologicals, including laboratory waste, biological production wastes, discarded live and attenuated vaccines, culture dishes, and related devices.

(ii) Liquid human and animal waste, including blood and blood products and body fluids.

(iii) Pathological waste.

(iv) Sharps.

(v) Contaminated wastes from animals, primarily research animals, that have been exposed to agents infectious to humans.

(ff) “MIOSHA standards” means the Michigan occupational safety and health standards promulgated by the Michigan occupational safety and health administration under the Michigan occupational safety and health act, 1974 PA 154, MCL 408.1001 to 408.1094.

(gg) “Mucosal surface” means the moisture-secreting membrane lining of all body cavities or passages that communicates with the exterior, including, but not limited to, the nose, mouth, vulva, and urethra.

(hh) “Municipal solid waste” means common trash or garbage that does not meet the definition of hazardous or biomedical waste.

(ii) “Non-critical violations” means any violation that is not a critical violation as that term is defined in section 13101 of the act, MCL 333.13101.

(jj) “Operator” means a person that controls any interest in, operates, or manages a body art facility and is responsible for compliance with these rules, whether or not actually performing body art activities.

(kk) “OPIM” or “other potentially infectious material” means human body fluids including, but not limited to, the following:

(i) Any body fluids visibly contaminated with blood.

(ii) Saliva in oral body art procedures.

(iii) Semen.

(iv) Vaginal secretions.

(v) All body fluids where it is difficult or impossible to differentiate between body fluids.

(ll) “Part 131” means part 131 of the act, MCL 333.13101 through 333.13112.

(mm) “Pathological waste” means any of the following:

(i) Human organs.

(ii) Tissues.

(iii) Body parts other than teeth.

(iv) Products of conception.

(v) Fluids removed by trauma or during surgery, autopsy, or another medical procedure and not fixed in formaldehyde.

(nn) “PPE” or “Personal protective equipment” means specialized clothing or equipment that is worn by an individual working in a body art facility to protect the individual from an exposure or hazard.

(oo) “Personnel” means employees, body artists, contracted body artists, and agents of the body art facility, whether or not actually performing body art activities.

(pp) “Procedure” means the act of performing body art.

(qq) “Procedure area” means the physical space that is used by 1 body art technician at a time to perform a procedure on 1 client at a time, and that contains all procedure surfaces, equipment, and instruments to perform the procedure.

(rr) “Procedure surface” means a surface utilized during the procedure that has the potential to become contaminated and that may require cleaning and disinfecting.

(ss) “Reprocessing” means a validated process used to render an instrument, which has been previously used or contaminated, fit for a subsequent single use. Reprocessing is designed to remove soil and contaminants by cleaning and to inactivate microorganisms by sterilization.

(tt) “Safety data sheet” means a document for a potentially harmful chemical that includes information such as the properties of each chemical; the physical hazards, health hazards, and environmental health hazards; protective measures; and safety precautions for handling, storing, and transporting the chemical under the Hazard Communication Standard, 29 CFR 1910.1200(g).

(uu) “Scarification” means the production of scars and includes the injury of the skin involving scratching, etching, or cutting of designs to produce a scar on a human being for ornamentation or decoration.

(vv) “Sharps” means objects that can purposely or accidentally cut or penetrate the skin or mucosa, including, but not limited to, presterilized single-use needles, scalpel blades, and razor blades.

(ww) “Sharps disposal container” means a puncture-resistant, leakproof on sides and bottom container made specifically to meet National Institute for Occupational Safety standards and can be closed for handling, storage, transportation, and disposal. A sharps container must be labeled with the international biohazard symbol.

(xx) “Single-use, disposable” means products or items that are intended for 1 time, 1 individual use, and are disposed of after use on each client, including, but not limited to, the following:

(i) Cotton swabs or cotton balls.

(ii) Tissues or paper products.

(iii) Paper or plastic cups.

(iv) Gauze and sanitary coverings.

(v) Razors.

(vi) Needles.

(vii) Scalpel blades.

(viii) Stencils, including marking pens, pencils, string, or other materials used for stencils.

(ix) Ink cups.

(x) Protective gloves.

(yy) “Smoke” or “smoking” means that term as defined in section 12601 of the act, MCL 333.12601.

(zz) “Sterilize” or “sterilization” means the complete elimination or destruction of all forms of microbial life including bacterial spores.

(aaa) “Ultrasonic cleaner” means a device that removes debris by a process called cavitation, in which waves of acoustic energy are propagated in aqueous solutions to disrupt the bonds that hold particulate matter to surfaces.

(bbb) “Vapor product” means a noncombustible product that employs a heating element, power source, electronic circuit, or other electronic, chemical, or mechanical means, regardless of shape or size, that can be used to produce vapor from nicotine or any other substance, and the use or inhalation of which simulates smoking. Vapor products include, but are not limited to, any of the following:

(i) Electronic cigarette.

(ii) Electronic cigar.

(iii) Electronic cigarillo.

(iv) Electronic pipe.

(v) Vapor cartridge or other container of nicotine or other substance in a solution or other form that is intended to be used with or in an electronic cigarette, electronic cigar, electronic cigarillo, electronic pipe, or similar product or device.

(2) The terms defined in the act have the same meaning when used in these rules.

PART 2. BODY ART FACILITY REQUIREMENTS; GENERAL

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13102 General purpose; violations {#sec-r-333.13102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13102}

Rule 2. These rules provide the applicable processes for the establishment and maintenance of a body art facility in this state and guidance on the inspection and enforcement process to the local health departments to ensure that public health, safety, and welfare is protected.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13103 Physician exemption {#sec-r-333.13103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13103}

Rule 3. The licensing and inspection rules do not apply to procedures that are utilized as a part of a patient’s treatment and are performed by or under the control, direction, and on-site supervision of a physician who is licensed in this state.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13104 Procedures allowed at licensed body arts facilities {#sec-r-333.13104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13104}

Rule 4. Tattooing, branding, or body piercing, as defined by the act and these rules, are the only procedures allowed within a body art facility.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13105 Body art facility; applications; renewal licenses; temporary body art facility licenses {#sec-r-333.13105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13105}

Rule 5. (1) Applications and the fee for licensure must be received not less than 30 days before tattooing, branding, or body piercing services are to be provided.

(2) The department shall notify license holders that their license is due for renewal by mail, or email if a facility email address is submitted.

(3) When submission for the renewal of a body art license application and licensing fee for a body art facility are received by the department, the department shall notify the local health department responsible for the jurisdiction in which the facility is located.

(4) Annual licenses and renewal licenses are effective for the calendar year applied for and do not imply or guarantee a license of 365 days after initial approval.

(5) Applications and the required fee for temporary licenses must be received not less than 30 days before the first day on which tattooing, branding, or body piercing services are to be provided at the temporary location, and temporary licenses expire after 11:59 p.m. on the final date described on the temporary license. No services are to be performed until an initial inspection has been completed and approved by the local health department.

(6) The license will be issued to a specific person at a specific location and is nontransferable. Mobile units will not be licensed as statewide transitory units.

(7) A renewal license will be issued to the facility upon application and payment provided the facility has had a satisfactory inspection within the previous licensing period.

(8) The license must be posted in the body art facility in a prominent and conspicuous area where it can be readily observed. Temporary facilities and newly approved permanent facilities must post their inspection report stating that the facility is approved for operation.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13106 Body art facility; inspections {#sec-r-333.13106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13106}

Rule 6. (1) A site plan submission by the applicant to the local health department and an initial inspection by the local health department representative responsible for the jurisdiction in which the body art facility is located are required for a new or a proposed remodel of a licensed body art facility.

(2) A detailed site plan must be reviewed by the local health department to determine whether the body art facility complies with the facility requirements found in R 333.13119.

(3) After passing an initial inspection, the local health department may allow the body art facility to begin offering approved procedures to clients provided the body art facility has applied for licensure in this state.

(4) Inspection of the body art facility must be conducted pursuant to section 13105 of the act, MCL 333.13105, under the department’s authority under section 2241 of the act, MCL 333.2241. The local health department must convey the results of that inspection to the department.

(5) Each local health department retains the right to perform additional inspections as determined necessary.

(6) The local health department or its representative shall report to the department on the status of an initial inspection, an annual renewal inspection, or a temporary license inspection as either pass or fail, and whether licensure is recommended by use of the department’s online reporting process.

(7) The inspection of a body art facility must document whether the body art facility has met the requirements in the act and rules and a recommendation of whether the facility should be licensed. This determination must be noted on the initial license or temporary license inspection report form completed by the local health department, and a copy of the signed and dated documentation must be given to the owner or operator at the end of the inspection. A signed copy of a department inspection report form stating the facility is approved to operate can be posted temporarily until a state-issued license is received.

(8) The inspection report must delineate inspection items that are violations. If violations are identified, the local health department must mark them on the form and note remedies for correction in the comment section of the inspection form.

(9) Violations noted on the inspection report may require an inspection by the local health department to ensure corrective action has been taken. If an inspection is needed, the time frame for the inspection must be noted in the comment section of the inspection report form.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13107 Variance {#sec-r-333.13107 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13107}

Rule 7. A variance may be granted to a licensed body art facility by the local health department under the conditions set forth in section 13111 of the act, MCL 333.13111.

PART 3. EMPLOYEE REQUIREMENTS; RECORDS

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13108 Body art facility requirements; adoption of MIOSHA standards; violations considered a critical violation {#sec-r-333.13108 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13108}

Rule 8. (1) Failure to comply with the requirements in this rule, including training, is a critical violation, which may lead to immediate closure or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) Pursuant to section 32(4) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.232, the department adopts by reference the following MIOSHA regulations:

(a) Occupational Health Standards “Part 430. Hazard Communication,” R 325.77001 to R 325.77004.

(b) General Industry Safety and Health Standard “Part 554. Bloodborne Infectious Diseases,” R 325.70001 to R 325.70018.

(3) The standards referenced in subrule (2) of this rule are available from the MIOSHA standards section at website: www.michigan.gov/mioshastandards at no charge.

(4) The standards are available for inspection, and copies of the standards may be obtained from the Department of Labor and Economic Opportunity, MIOSHA Standards Section, 530 West Allegan Street, P.O. Box 30645, Lansing, Michigan 48909-8143. Up to 5 copies of these standards may be obtained at no charge. For quantities greater than 5, the cost as of the time of the adoption of these rules is 4 cents per page.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13109 Requirements for body art technicians and other individuals with potential exposure to blood and OPIM; adoption of youth employment standards; violations considered critical violations {#sec-r-333.13109 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13109}

Rule 9. (1) Failure to comply with the requirements in this rule is a critical violation, which may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) A body art facility shall not employ a minor in violation of the youth employment standards act, 1978 PA 90, MCL 409.101 to 409.124.

(3) Body art technicians shall refuse body art services to an individual who shows signs of being under the influence of alcoholic liquor or a controlled substance.

(4) Body art technicians shall not perform tattooing, branding, or body piercing on nonintact skin, non-intact mucosal surfaces, or surfaces with a suspected rash or visible infection.

(5) Body art technicians shall not perform body art procedures on skin or mucosal surfaces that have been affected by any topical anesthetic, external analgesic, or another product that contains an anesthetic active ingredient, unless the product, dosage, and directions for use are appropriately prescribed by a licensed physician for use before or during body art procedures. Documentation of the prescription must be made part of the client record.

(6) Body art technicians shall not perform a procedure on the nipple or genital area of a minor regardless of written consent and presence of a parent or legal guardian of that minor.

(7) All personnel working in the body art facility with the potential for exposure to blood and OPIM shall ensure all the following:

(a) Maintain a high degree of cleanliness; conform to hygienic practices, including hand washing; and wear proper personal protective equipment with clean clothes when performing procedures.

(b) Maintain hair, skin, and clothes that are free of visible particulate matter and debris.

(8) If the clothes of a body art technician, or any other individual with the potential exposure to blood or OPIM, become visibly contaminated, contaminated clothing must be removed as soon as possible in a way that prevents additional exposure to the contaminated areas of the clothing. Contaminated clothing must be replaced with clean clothing before commencing any further procedures.

(9) Before assuming responsibilities, personnel with potential exposure shall meet the same requirements as body art technicians.

(10) All personnel working in the body art facility with the potential for exposure to blood and OPIM shall not be involved in procedures if they have any of the following that would result in uncontained drainage and contamination of body art instruments, equipment, procedure surfaces, or the client:

(a) Open wounds.

(b) Cuts.

(d) Burns.

(e) Skin abnormalities on any portion of the body.

(11) All personnel working in the body art facility with the potential for exposure to blood and OPIM, shall not do any of the following in work areas where tattooing, branding, or body piercing are performed or other areas where there is a likely exposure to blood and other OPIM:

(a) Eat.

(b) Drink.

(d) Use vapor products.

(e) Use marijuana.

(f) Apply cosmetics or lip balm.

(g) Handle contact lenses.

(h) Store food.

(12) Body art technicians and other individuals, such as assistants, with the potential for exposure to blood and OPIM shall perform appropriate hand washing when performing, setting up for, or cleaning up after procedures. At a minimum, hand washing must be performed at all of the following times:

(a) Immediately before donning gloves to set-up equipment and instruments used for conducting procedures.

(b) Immediately before donning gloves to perform a procedure.

(c) Immediately after removing gloves at the conclusion of performing a procedure and after removing gloves at the conclusion of procedures performed in the reprocessing area.

(d) When leaving the work area.

(e) As soon as possible after coming in contact with blood or OPIM or a potentially contaminated surface, including after cleaning and disinfecting after each client.

(f) Before and after the following activities:

(i) Eating (ii) Drinking.

(iii) Smoking.

(iv) Using vapor products.

(v) Applying cosmetics or lip balm.

(vi) Handling contact lenses.

(vii) Using the bathroom.

(viii) When hands are visibly soiled.

(13) Body art technicians shall perform tattooing, branding, or body piercing in a manner that minimizes splashing, spraying, or splattering of blood.

(14) When involved in procedures, body art technicians and other individuals involved in setting up for, performing, or cleaning up after procedures with the potential exposure to blood and OPIM, shall wear disposable medical-grade exam gloves using aseptic technique to ensure that the instruments and gloves are not contaminated to minimize the possibility of transmitting infections during procedures.

(15) A minimum of 1 pair of disposable, medical-grade exam gloves must be used for each of the following stages of the procedure:

(a) Set-up of equipment or instruments used for conducting procedures and skin preparation, applying stencils, or drawing designs on the skin of the procedure area.

(b) The procedure and post-procedure teardown.

(16) If personnel working in the body art facility involved in setting up for, performing, or cleaning up after procedures leaves the procedure area during a procedure, gloves must be removed before leaving the procedure area and a new pair of gloves put on when returning to the procedure area.

(17) When involved in procedures, if the body art technician’s glove or gloves, or the glove or gloves of another individual involved, is pierced or torn, or if the glove or gloves become potentially contaminated, the glove or gloves must be changed immediately.

(18) To ensure adequate protection for the technician, latex gloves must not be used in conjunction with petroleum-based products.

(19) All personnel working in the body art facility involved in performing the procedure must not use gloves in place of hand washing procedures.

(20) Gloves and other disposable PPE must be disposed of in an appropriate, covered waste receptacle.

(21) Reusable PPE must be placed in an appropriate provided receptacle for storage until it can be cleaned and disinfected.

(22) If an item or instrument used in a procedure is contaminated by coming in contact with a surface other than the procedure surface or the client, the item must be discarded or removed from service and replaced immediately with a new disposable item or a new sterilized item or instrument before the procedure continues.

(23) Body art technicians shall immediately dispose of all needles, including the needle bar, and other contaminated sharps including razors, directly into a conveniently placed and secured sharps disposal container. Body art technicians shall not do any of the following with a contaminated sharp:

(a) Bend.

(b) Recap.

(d) Shear.

(e) Disassemble (f) Manipulate.

(24) For individuals performing microblading or manual procedures, once the needle grouping is attached to the hand piece, it cannot be removed and must be fully disposed of into a sharps container.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Rule 10. (1) Failure to comply with the requirements in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) Before starting a procedure, the body art facility shall provide each client with the following department-approved documents to be completed:

(a) Disclosure statement and notice for filing complaints. This statement must include both the following:

(i) Risks and possible consequences of procedures.

(ii) Information on how to lodge complaints about the body art facility related to compliance with the department’s rules for body art facilities.

(b) Aftercare instructions and when to seek medical treatment, if necessary.

(i) If the client is a minor, proof of minor’s identification, parental or legal guardian identification, and a copy of documentation verifying the legal guardian’s relationship with the minor.

(ii) Documentation of completing a health questionnaire of the client’s medical condition as it relates to receiving body art and notification to follow-up with a physician, if necessary.

(iii) Client identification and contact information.

(iv) The design, location, type of procedure, and name of body art technician completing the procedure.

(v) An informed consent statement that documents the client’s receipt and completion of the documents in this subrule, including a signature obtained from the client or legal guardian.

(3) An individual shall not sell, give, or provide to a minor a tattooing, branding, or body piercing kit or other tattooing, branding, or body piercing device.

(4) Facility created or altered documents must be at least as comprehensive as stateprovided sample documents in order to be approved by the department.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13111 Client contact in event of communicable disease outbreak; disclosure {#sec-r-333.13111 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13111}

Rule 11. Pursuant to the authority under sections 2221, 2226, and 2231 of act, MCL 333.2221, 333.2226, and 333.2231, the body art facility shall request the client to provide contact information in the event of a communicable disease outbreak investigation, recalls, or other issues pertaining to the client’s health.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13112 Record retention {#sec-r-333.13112 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13112}

Rule 12. (1) All client and body art personnel records, print or digital form, must be retained in a confidential manner in compliance with the following:

(a) All paper records must be retained in a locked filing cabinet or a locked room.

(b) All electronic records must be password protected.

(i) Individuals working at the body art facility that need access to the client records in order to carry out the responsibilities of their position at the body art facility.

(ii) Department or local health department staff who need access to records to document body art facility compliance with requirements delineated in these rules, investigate a laboratory confirmed infection, investigate a communicable disease outbreak investigation, or investigate a complaint.

(iii) Other persons authorized by law to access the records.

(2) All client and body art personnel records must be retained on the business premises for 1 year. All records must be maintained for a minimum of 3 years. These records include, but are not limited to, the following:

(a) Safety data sheets for all hazardous chemicals that clients may be exposed to.

(b) Complete record keeping of all instruments, body jewelry, sharps, and inks used for tattooing, branding, or body piercing at the body art facility. Invoices or purchase orders can satisfy this requirement.

(3) After the 3-year minimum for record retention, all client and body art personnel records may be destroyed. Destruction of records include any of the following methods:

(a) Shredding (b) Incineration.

(d) Disposal in another manner that protects the confidentiality of all client and employee-related documents.

(4) Body art facilities that close and cease operations are required to retain records securely for 3 years. Destruction of records include any of the following methods:

(a) Shredding (b) Incineration.

(d) Disposal in another manner that protects the confidentiality of all client and employee-related documents.

(5) Body art facilities that are sold or where the business interest has been transferred to another body art facility shall transfer their records or properly dispose of their records in accordance with subrule (4) of this rule, depending on the conditions of the sale or transfer of the business interest.

PART 4. PROTECTIVE PROCEDURES; CRITICAL VIOLATIONS

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13113 Preparation and care of body art area; conducting procedure;violations considered critical violations {#sec-r-333.13113 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13113}

Rule 13. (1) Failure to comply with the requirements in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) If reusable instruments are used for procedures, the procedure area must have a separate disposable container or a container capable of being cleaned and disinfected available and used to hold and transport all post-procedure contaminated instruments and equipment from the procedure area to the reprocessing area.

(3) Procedure areas must be organized to prevent cross-contamination of clean, disinfected, or sterile instruments and equipment with contaminated equipment. The organization of the procedure area must include all the following:

(a) A cleaned and disinfected field that contains all cleaned, disinfected, and sterilized instruments and equipment and supplies to be used in the procedure.

(b) All supplies before the procedure begins organized in a manner to minimize contamination of the field.

(c) All sterilized supplies must remain in its sterile package or autoclave cartridge or cassette, or both, until opened in front of the client.

(4) Before a procedure is performed, the immediate skin area and the areas of the skin surrounding where the artist will be touching and where body art is to be placed must be cleaned and then prepared with an appropriate skin preparation antiseptic in accordance with the manufacturer’s instructions.

(5) Washing pads must be disposed of in a covered waste receptacle after a single use.

(6) If shaving is necessary, single-use, disposable razors must be used. Used razors must not be recapped or broken and must be immediately disposed of in an approved, properly labeled, and secured sharps disposal container.

(7) For an oral procedure, the mouth must be rinsed out with an oral antiseptic mouth rinse for at least 30 seconds.

(8) Topical anesthetics, external analgesics, or any other products containing an anesthetic active ingredient must not be applied to any skin or mucosal surface, unless the use is appropriately prescribed and delegated by a licensed physician in this state.

(9) Documentation of the prescription referenced in subrule (8) of this rule must be made part of the client record, and the delegation of duties to anyone other than a physician must comply with section 16215 of the act, MCL 333.16215.

(10) All tattoo pigments or inks, tattoo needles, piercing needles, and all other body art instruments and supplies used for procedures must be used according to the manufacturer’s instructions.

(11) All needles used for body art must be single-use, sterile needles. After use, needles, including the needle bar, or microblading handle must be immediately disposed of in an approved, properly labeled, and secured sharps disposal container.

(12) Expired needles must not be used for procedures.

(13) Expired needles must be disposed of in an approved, properly labeled, and secured sharps disposal container or must be re-packaged and re-sterilized as prescribed in R 333.13116, if approved by the needle manufacturer.

(14) All products and devices applied to the skin, including, but not limited to, stencils, markers, pencils, and pens, must be single-use and disposed of immediately after use. All bulk products must be portioned out for the individual in a manner to prevent contamination of the original container and its contents and must be discarded upon completion of the procedure.

(15) If rotary pen tattoo machines are used, only machines that utilize presterilized, single-use needle cartridge systems with appropriate backflow prevention devices, such as membranes or barriers, or those equipped with detachable, single-use disposable sterile combo couplers and detachable, single-use disposable casings or casings that can be cleaned and sterilized, are allowed for use.

(16) When employing a needle cartridge with an appropriate backflow prevention device, the rotary pen tattoo machine must be covered with an appropriate single-use disposable barrier while in operation, and it must be cleaned and disinfected immediately after each use.

(17) Cartridges used in rotary pen tattoo machines must have manufacturer-provided proof and verification of the backflow prevention device's effectiveness and have undergone testing to ensure compliance, or the artist must demonstrate effectiveness through field testing.

(18) To field test, a needle cartridge must be filled with fluid, such as water or ink, held upright with the tips or needles facing upwards, and the plunger operated at least 100 times to assess for any indications of backflow or leakage.

(19) The use of a rotary pen tattoo machine that utilizes a sponge at the opening of the chamber to prevent the entry of pigment, blood, or other potentially infectious materials into the machine is strictly prohibited.

(20) Sterilized instruments may not be used if the package integrity has been breached, compromised, is wet or stained, or the expiration date has been exceeded without first repackaging and re-sterilizing as prescribed in R 333.13116, if approved by the manufacturer.

(21) Immediately before and while a tattoo is applied, the quantity of tattoo pigment or ink to be used must be transferred from the tattoo pigment or ink bottle and placed in a single-use pigment container.

(22) Tattoo pigment or ink or other contaminated liquid must be absorbed by placing absorbent materials into the containers to absorb the liquid. On completion of the tattoo, these single-use, disposable pigment containers and their contents must be properly discarded.

(23) Tattoo pigment or ink must not be reused on another client or placed back in the original stock container.

(24) Tattoo pigment or ink bottles must be tightly closed when not in use. Tattoo pigments or ink may not be stored on the procedure surface. If tattoo pigment or ink bottles are stored in the procedure area, they may not be accessed during the performance of a procedure without first removing and disposing of contaminated gloves and performing hand washing. New gloves must be used to complete the procedure.

(25) Expired products must not be used for procedures and must be discarded on expiration. Products that have a secondary expiration date, such as a period of time after opening, must be labeled with both the date opened and the new expiration date and must be discarded on expiration.

(26) After performing a tattoo, the following actions must be performed:

(a) Excess pigment or ink must be removed from the skin with a clean, single-use, disposable paper towel or wipe.

(b) The completed tattoo must be washed with an appropriate cleansing solution.

(d) If an ointment is applied, the ointment must either be from a single-use packet or by using an applicator in such a way that the original container is not contaminated.

(e) A protective product or dressing appropriate to the procedure performed must be applied under the manufacturer’s instructions.

(f) In the event of excessive bleeding at any time during a procedure, all products used to check the flow of blood or to absorb blood must be unused, single-use items and must be disposed of immediately after use in appropriate, covered waste receptacles, unless the disposal product meets the definition of medical waste. Styptic pencils, alum blocks, or other solid styptics must not be used to stop excessive bleeding.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13114 Body art jewelry; prohibitions; composition; violations considered critical violations {#sec-r-333.13114 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13114}

Rule 14. (1) Failure to comply with the requirements in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) Material certificates from jewelry suppliers for jewelry used for piercings must meet the following:

(a) Be available to the department upon request.

(b) Be updated from the supplier for each new lot of material (3) Piercing guns, stud-and-clasp piercing systems, or other similar devices, instruments, or systems are prohibited in body piercings.

(4) All body jewelry used for piercing must be new and unused, cleaned in accordance with the jewelry manufacturer’s instructions, and sterilized before use. If the manufacturer does not provide instructions for use, the item must be inspected for cleanliness and sterilized in an autoclave according to the autoclave manufacturer’s instructions. Jewelry that is individually packaged and appropriately sterilized by the manufacturer does not need to be cleaned and autoclaved at the facility.

(5) The composition of body jewelry used for piercing must be comprised of only the following materials:

(a) Any and all materials that meet ASTM or ISO standards for implantation.

(b) Solid 14 karat or higher yellow, white, or rose gold that is nickel free and cadmium free. Gold jewelry used for piercing may not be any of the following:

(i) Plated, unless using materials approved by this standard over solid 14 karat or higher yellow, white, or rose gold that is nickel-free and cadmium-free.

(ii) Gold filled.

(iii) Gold overlay or vermeil.

(d) Unalloyed niobium that is ASTM B392 compliant.

(e) Lead free glass.

(6) All threaded or press-fit jewelry must have internal tapping.

(7) Body jewelry surfaces and ends must be smooth, and free of nicks, scratches, burrs, stamps, hallmarks, and visible polishing compounds.

(8) Metals must have a consistent finish on surfaces that frequently meet tissue.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13115 Cleaning and disinfection of procedure surfaces; violations considered critical violations {#sec-r-333.13115 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13115}

Rule 15. (1) Failure to follow the procedures in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) All procedure surfaces must be cleaned and disinfected with a disinfectant after each use and between clients, regardless of whether contamination is visible. Disinfectants must be used according to the manufacturer’s instructions.

(3) Non-procedure surfaces and equipment must not be touched during the procedure.

(4) If an object is likely to be touched or contaminated during the procedure, it must be covered with an appropriate barrier such as barrier film, a clip cord sleeve, dental bib, or table paper. A barrier used to cover equipment must be discarded at the end of each procedure.

(5) The underlying surface must be cleaned and disinfected after each use between clients and before a new barrier covering is applied.

(6) Cloth or fabric items must not be used in the procedure area.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13116 Cleaning, and sterilization procedures; violations considered critical violations {#sec-r-333.13116 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13116}

Rule 16. (1) Failure to follow the procedures in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) All equipment and devices used to clean and sterilize body art materials and instruments must be suitable for their intended use.

(3) For the cleaning of single-use, disposable instruments before sterilization, follow the instrument manufacturer’s instructions. If the manufacturer does not provide instructions for use, the item should be inspected for cleanliness and sterilized in an autoclave according to the autoclave manufacturer’s instructions.

(4) All reusable instruments are to be cleaned and sterilized after each use in the reprocessing area. When warm water is used, it should not exceed 104 degrees Fahrenheit or 40 degrees Celsius.

(5) All hinged equipment, such as piercing forceps, must be in the open position.

(6) Instruments must be disassembled.

(7) When using reusable instruments for body art procedures, the instruments must be cleaned as follows:

(a) Soaked or immersed in an enzymatic or other appropriate solution.

(b) Scrubbed to remove debris.

(d) Processed through an appropriately covered ultrasonic cleaner.

(e) Rinsed and dried.

(f) Inspected.

(g) Sterilized.

(8) Processes in subrule (7)(a) to (e) of this rule may be accomplished using an automated instrument washer.

(9) All sterilization loads must include a Class V or better chemical indicator.

(10) Chemical indicator results must be recorded for each sterilization cycle.

(11) After being cleaned, all reusable instruments used for body art must be processed for sterilization by either of the following methods:

(a) Contained in sterilization packaging and subsequently sterilized, with the date noted on packaging or indicator strips. This information must match up with the sterilization log and all sterilization packaging must have a color-changing chemical indicator.

(b) Sterilized without packaging, stored, and sterilized again immediately before use.

(12) After completing the sterilization process, sterilized instruments and jewelry must be stored in a cabinet, drawer, or tightly covered container reserved for the storage of sterilized instruments and jewelry.

(13) All instruments used for procedures must remain stored in either of the following:

(a) A sterile package marked with the cycle number until just before a procedure.

(b) A clean container ready for sterilization immediately before the procedure.

(14) The expiration date for reusable sterilized instruments must follow the packaging manufacturer’s instructions.

(15) Tools used for reassembly must be cleaned and disinfected immediately before use.

(16) All jewelry must be clean and disassembled before sterilization.

(17) Ultrasonic cleaners, instrument washers, and autoclaves must be used, cleaned, and maintained in accordance with manufacturer’s instructions, and a copy of the recommended procedures for the operation of the autoclave must be kept on file at the body art facility. All sterilization procedures must be compliant with ANSI/AAMI ST79 (4.28).

(18) All personnel working in the facility must comply with all of the following procedures when sterilizing non-disposable instruments and handling sterilized instruments:

(a) Either gloves or other required PPE must be worn when preparing materials for sterilization and loading materials into the autoclave.

(b) Appropriate hand washing must be performed immediately before preparing the materials for sterilization and loading materials into the autoclave.

(c) Appropriate hand washing must be performed before donning gloves, unloading materials from the autoclave, and placing them into storage.

(d) Appropriate hand washing must be performed before donning gloves and retrieving sterilized materials from the storage area in preparation for setting up for a procedure.

(19) A different pair of gloves must be used for each of the stages in subrule (18) of this rule for cleaning, disinfecting, and sterilization.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13117 Spore test; procedures; notification to local health department of positive spore test result; violations considered critical violations {#sec-r-333.13117 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13117}

Rule 17. (1) Failure to follow the procedures in this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(2) A license must not be issued until documentation of the autoclave’s ability to destroy spores is received by the department if on-site sterilization is performed at the facility.

(3) The owner or operator of a body art facility shall demonstrate that the autoclave used is capable of attaining sterilization by weekly spore detection tests. These tests must be verified through an independent laboratory. Test records must be retained by the owner or operator for a period of at least 3 years and be made available on request.

(4) If a spore test result is positive, the body art facility shall discontinue the use of that autoclave and shall not put that autoclave back into service until it has been serviced and a negative spore test has been recorded.

(5) In the event of a positive spore test, the following procedure must be followed:

(a) If the mechanical indicators, including time, temperature, and pressure, and chemical indicators, including internal and external, suggest that the autoclave is functioning properly, a single positive spore test may not indicate autoclave malfunction.

The autoclave must be removed from service and sterilization operating procedures reviewed to determine if operator error could be responsible.

(b) Document procedures taken to remedy the situation in the sterilization log.

(c) To the extent possible reprocess all items processed since the last negative spore test in a separate autoclave that has negative spore test results.

(d) Retest the autoclave by using biological, mechanical, and chemical indicators after correcting identified procedural problems.

(e) If the repeat spore test is negative, and mechanical and chemical indicators are within normal limits, put the autoclave back in service.

(f) If the repeat spore test remains positive, the following procedure is required:

(i) Do not use the autoclave until it has been inspected or repaired and the exact reason for the positive test has been determined. This work should be done by a factory authorized service professional who is certified to repair and maintain the specific autoclave that is being worked on.

(ii) Before placing the autoclave back in service, rechallenge the autoclave with biological indicator tests in 3 consecutive empty chamber sterilization cycles after the cause of the autoclave failure has been determined and corrected.

(iii) Maintain sterilization records, including sterilization cycles, maintenance, and spore tests.

(6) Until a negative spore test has been received, the body art facility shall use an alternative autoclave or either of the following:

(a) Instruments that have a sterilization date on or before the date before the last negative spore test was recorded.

(b) Only single-use, disposable and pre-sterilized instruments.

(7) The owner or operator of the body art facility shall notify the local health department that inspects body art facilities in the jurisdiction in which the body art facility is located of the positive spore test within 24 hours after the positive spore testing result.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13118 Medical waste; medical waste management plan; storage and containment; disposal procedures {#sec-r-333.13118 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13118}

Rule 18. (1) Pursuant to section 32(4) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.232, the department adopts by reference the EGLE regulations as they relate to medical waste regarding the on‐site generation, treatment, packaging, and storage of medical waste under part 138 of the act, MCL 333.13801 to 333.13832, and R 325.1541 to 325.1549.

(2) These standards may be obtained at no charge from the Michigan Department of Environment, Great Lakes, and Energy, Constitution Hall, 525 West Allegan Street P.O. Box 30473, Lansing, MI 48909-7973, or via the internet at the following website: https://www.michigan.gov/egle/-/media/Project/Websites/egle/Documents/Regulatory- Assistance/Guidebooks/MI-Guide-to-Environmental-Regulations/MI-Guide- Environmental-Regulations-Entire- Book.pdf?rev=690e0fdb00d64ac1b45c7c513333a6ee&hash=FC40A5A66A52C2F530B B391F3070D152 .

(3) All body art establishments shall register as a medical waste producing facility under part 138 of the act, MCL 333.13801 to 333.13832.

PART 5. FACILITY REQUIREMENTS

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13119 Facility requirements; violations considered critical violations {#sec-r-333.13119 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13119}

Rule 19. (1) For new body art facilities and for body art facilities undergoing renovation, an 8-1/2 by 11 or larger scale drawing and floor plan of the proposed facility or the proposed renovation of the facility must be submitted to the local health department that inspects body art facilities in the jurisdiction in which the body art facility is located. This drawing and a copy of the floor plan must show the accurate placement of each of the following, if applicable:

(a) Walls.

(b) Windows.

(d) Waiting area.

(e) Procedure area or areas.

(f) Bathroom or bathrooms.

(g) Reprocessing area.

(h) Equipment and instrument storage area or areas.

(i) Chairs.

(j) Tables.

(k) Sinks.

(l) Light fixtures.

(2) The scale drawing and floor plan in subrule (17) of this rule must be submitted to the local health department at least 30 days before the proposed opening or planned renovation.

(3) The owner or operator of the body art facility shall send the site plan to the local health department for approval before construction or renovation of the body art facility.

(4) Failure to follow the requirements in subrules (5) to (31) of this rule is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(5) All body art facilities shall be completely separated by solid walls extending from floor to ceiling, from any room or area used for human habitation, non-body art activities, or another activity that may cause potential contamination of work or procedure surfaces.

Doors between these rooms or areas must be self-closing and must remain closed unless entering or exiting the facility, room, or area.

(6) Exterior doors must be self-closing and windows equipped with screens in good repair if the windows are intended to be used for ventilation.

(7) If the body art facility has a check-in room, retail area, or waiting room and retail area, procedure areas must be separated from both the customer waiting area and retail area by a partition or barrier.

(8) There must be a minimum of 45 square feet of floor space for each body art technician’s procedure area in the facility.

(9) Walls, partitions, and floors of a body art facility must be smooth, non-absorbent, maintained in a clean condition, and in good repair.

(10) Carpeting is allowed in the check-in, waiting, or retail area if the area is separate from procedure areas.

(11) All procedure surfaces in the procedure area, including chairs, tables, benches, and counters, must be smooth, free of open holes or cracks, non-absorbent, in good repair, and must be of such construction as to be easily cleaned and disinfected after each use between clients.

(12) No reusable cloth or similar material items, including furniture, may be used in a procedure area.

(13) No multiple use materials may be employed for procedures unless they are nonabsorbent and can be cleaned and disinfected.

(14) The facility must be well-ventilated.

(15) The facility must be provided with an artificial light source equivalent to at least 20 foot-candles, 3 feet off the floor, except that 100 foot-candles must be provided at the level where the procedures are being performed, where instruments and sharps are either handled cleaned or assembled, or where handwashing stations are located.

(16) Spot lighting may be utilized to achieve the required degree of illumination for the purpose of conducting procedures. Fluorescent tube lighting over a procedure area must be protected from accidental breakage during a procedure by an appropriate covering.

(17) Body art facilities that use only single-use disposable instruments are not required to have a separate room or area for the sole purpose of reprocessing contaminated tools and equipment.

(18) If on-site sterilization of disposable instruments or new unused jewelry, or both, for piercing is performed at the facility, the cleaning and sterilization must occur in a location that is not subject to reasonably anticipated contamination.

(19) A lined, covered waste receptacle must be provided in every procedure area and restroom. The receptacles must be cleanable, kept clean, and have self-closing lids with hands-free controls. The receptacles must be emptied weekly or when needed. Municipal solid waste removal must meet all local or state regulations, or both.

(20) The facility must be free of pests, including insects, vermin, and rodents.

(21) An initial inspection of the premises is required before body art services can be performed in this new facility or renovated area.

(22) All sinks in the body art facility must only be used for their designated purpose.

(23) All sinks must be plumbed and connected directly to an approved water supply system and an approved sewage disposal system. Sinks must have warm running water under pressure. Portable sinks must not be approved in a permanent facility.

(24) Liquid soap and single-use, disposable paper towels must be readily accessible at handwashing sinks. There must be a covered waste receptacle by each sink for the disposal of paper towels.

(25) A separate permanent sink designated for hand washing only must be provided.

The sink must not be located in the lavatory.

(26) One hand sink must serve no more than 3 body art technicians with readily accessible and unobstructed access where the body artists can go to and from their workstations without having to touch anything with their hands.

(27) A body art facility must have a minimum of 1 lavatory with a toilet, a separate sink, and a self-closing door.

(28) Body art facilities that use reusable instruments must have a separate room or area for the sole purpose of reprocessing contaminated tools and instruments. Both of the following are required:

(a) This area must be separated from the remainder of the facility by a minimum of a wall or partition and must be an area that does not allow client access.

(b) The reprocessing area must be organized to prevent cross-contamination of clean, disinfected, or sterile equipment with dirty equipment.

(29) All chemical or cleaning supply containers, including skin antiseptics and cleansers, must be labeled with contents.

(30) Animals are not allowed in the body art facility except service animals in accordance with the Americans with Disabilities Act of 1990, 42 USC 12101to 12213, and 8 CFR 35.136(a). This subrule does not apply to aquariums located in the lobby or client waiting area.

(31) Live plants are not allowed in procedure areas or reprocessing areas.

(32) In addition to receiving construction and renovation authority, water supply, plumbing, and sewage disposal must also comply with the requirements of the local health authority under sections 2235 and 2433 of the act, MCL 333.2235 and 333.2433, and under sections 8a and 8b of the Stille-DeRossett-Hale single state construction code act, 1972 PA 230, MCL 125.1508a and 125.1508b.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13120 Temporary facility license requirements for owners and operators of body art facilities; facilities; violations considered critical violations {#sec-r-333.13120 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13120}

Rule 20. (1) An owner or operator may have more than 1 technician working under the temporary license if there is a single set-up where individual procedure areas are adjacent or contiguous with one another. If there are multiple procedure areas at the event that are not adjacent or contiguous with one another, the owner or operator shall apply for separate temporary licenses.

(2) If the local health department that has jurisdiction for the on-site inspection of a temporary license documents compliance in accordance with these rules, the department shall grant a license to the applicant for the operation of a temporary body art facility. A body art facility inspection report form approved, dated, and signed by the representative of the local health department that has jurisdiction for the inspection must be posted on site instead of a formalized department license.

(3) The temporary body art facility license must be posted in a prominent and conspicuous place within the temporary body art facility where it may be readily seen by all clients.

(4) The department-provided disclosure statement and notice for filing complaints must be posted in a prominent and conspicuous place where it may be readily seen by all clients.

(5) Failure to follow the following requirements is a critical violation that may lead to immediate closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a:

(a) The temporary body art facility must be contained in a completely enclosed structure protected from wind, dust, and outdoor elements.

(b) The temporary body art facility must comply with the requirements in these rules.

However, the following adaptations are allowed for requirements related to hand washing, facility size, lighting, and sterilization of instruments:

(i) The facility must have a minimum of 80 square feet of floor space. The space must have smooth, non-absorbent flooring that can be cleaned and disinfected or disposed of.

(ii) No more than 2 artists working at the same time in a single 80 square foot area.

(iii) Provide enough temporary hand washing sinks with warm water under pressure, liquid soap, and single-use disposable paper towels to adequately service the number of body art technicians present.

(iv) At least 100 foot-candles of light at the level where the procedure is to be performed and where instruments and sharps are assembled. Spot lighting may be used to achieve this required degree of illumination for the purpose of conducting procedures.

(v) Only single-use, disposable sterilized instruments must be used.

(vi) If new and unused jewelry or instruments are sterilized on site, there must be documentation that a spore test was performed on the autoclave not more than 7 days before the first date that the temporary license is in effect.

(vii) Sharps containers may be transported to an accepting medical waste treatment facility if in compliance with United States Department of Transportation materials of trade exemptions guidelines under 45 CFR parts 171 to 180.

PART 6. ENFORCEMENT

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

Mich. Admin. Code R 333.13121 Enforcement {#sec-r-333.13121 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 333.13121}

Rule 21. (1) Violations of these rules must be cited on the inspection report by the local health department for the jurisdiction in which the body art facility is located. The inspection report must delineate both critical and non-critical violations. Non-critical violations must be corrected by the next renewal inspection, or such period of time as specified. Critical violations must be corrected as required by the compliance schedule under section 13105a of the act, MCL 333.13105a.

(2) Critical violations, if not corrected in the time specified, may lead to closure, or suspension or revocation, or both, of the body art facility license, as provided under section 13105a of the act, MCL 333.13105a.

(3) The owner or operator may appeal an order to cease operation in writing to the department or local health department that recommended the cessation. The appeal must ask for a re-determination and request a follow-up inspection by the local health department.

(4) If the local health department denies the appeal redetermination based on a followup inspection, the state or local health department, whichever governmental entity has initiated the enforcement action, shall inform each applicant in writing of the right to a fair hearing under chapter 4 of the administrative procedures act of 1969, 1969 PA 306, MCL 24.271 to 24.288. The notice of right to a fair hearing must include the method by which a hearing must be requested, and that any positions or arguments on behalf of the individual may be presented personally or by legal counsel.

(5) On receipt of a letter from a body art facility requesting an administrative hearing regarding suspension of licensure, the state or local health department shall schedule a date and time for an administrative hearing and notify the department and the applicant.

(6) In addition to enforcement action authorized by law, a civil action may be brought for injunctive relief.

(7) Complaints concerning an unlicensed or licensed body art facility submitted to the department must be referred to the local health department that has jurisdiction for the complaint pursuant to the act.

History

History: 2025 MR 18, Eff. Sept. 11, 2025.

R 400.19101 to R 400.19706 Community Action Programs

Mich. Admin. Code R 400.19101 Definitions; A to C {#sec-r-400.19101 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19101}

DEPARTMENT OF HUMAN SERVICES

BUREAU OF COMMUNITY ACTION AND ECONOMIC OPPORTUNITY

COMMUNITY ACTION PROGRAMS

(By authority conferred on the department of human services by Executive Reorganization Order 1995-1 and 230 PA 1981, being MCL 400.1116)

PART 1. GENERAL PROVISIONS

Rule 101. As used in these rules:

(a) "Act" means 230 PA 1981, MCL 400.1101 to 400.1120.

(b) "Advisory board" means the board of a public community action agency which is established by a local unit or units of government and which is delegated certain policy and administrative responsibilities to assure decision-making and participation by low-income individuals 42 U.S.C § 9910(b).

(c)”Appeals Committee” means committee members selected by the governing/advisory board that review items in dispute and seek clarification or resolution to the dispute, with approval from the governing/advisory board.

(d) “Bureau” means the bureau of community action and economic opportunity.

(e)"Causes of poverty" means those personal or institutional factors, or both, that combine to limit the ability of individuals and families to acquire the basic necessities of life, such as food, shelter, medical care, and household energy.

(f) “Commission” means the commission on community action and economic opportunity.

(g) “Community" means the geographical area served by a grantee and may be any of the following:

(i) A village.

(ii) A township.

(iii) A city.

(iv) A county.

(v) A multicounty unit.

(h) "Community action agency" or "CAA" means an agency officially designated as such in the Community Services Block Grant Act, 42 U.S.C. 9901 et seq. as amended., or officially designated pursuant to section 8 of the act.

(i) "Community services block grant" or "CSBG" means the federal funding source to ameliorate the causes and conditions of poverty in communities within the state.

(j) "Community social and economic programs" means those programs provided under section 675 of the community services block grant act, subtitle B, Title IV of the omnibus budget reconciliation act of 1981, Public Law 97-35, 42 U.S.C. 9904 , such as the following:

(i) Programs that provide a range of services and activities that have a measurable and potentially major impact on reducing the causes of poverty in the community or in those areas of the community where the incidence of poverty is a particularly acute problem.

(ii) Programs that provide activities designed to assist low-income participants, including the elderly poor, to do all of the following:

(A) Secure and retain meaningful employment.

(B) Attain an adequate education.

(D) Obtain and maintain adequate housing and a suitable living environment.

(E) Obtain emergency assistance through loans or grants to meet immediate and urgent individual and family needs, including the need for any of the following:

(1) Health services.

(2) Nutritious food.

(3) Housing.

(4) Employment-related assistance.

(F) Remove obstacles and solve problems which block the achievement of selfsufficiency.

(G) Achieve greater participation in the affairs of the community.

(H) Make more effective use of other programs related to the purposes of the act.

(iii) Programs that provide, on an emergency basis, such supplies and services, nutritious foodstuffs, and related services as may be necessary to counteract conditions of hunger and malnutrition among the poor.

(iv) Programs that coordinate and establish linkages between governmental and other social services programs to assure the effective delivery of such services to low-income individuals.

(v) Programs that encourage the use of entities in the private sector of the community to ameliorate poverty in the community.

(k) "Conditions and effects of poverty" means social and economic circumstances affecting individuals and families, such as any of the following:

(i) Unemployment.

(ii) Underemployment.

(iii) Dilapidated housing.

(iv) Lack of education.

(v) Limited access to proper medical care.

(vi) Limited self-esteem.

(vii) Insufficient food.

(viii) Other conditions that foster a restrained quality of life.

(l) "Consumer sector" means the low-income, elderly, or handicapped persons who reside in the service area of a CAA and who are eligible to be served by the CAA.

(m) "Contract" means a written agreement directly with the bureau that establishes the type and priority of services being provided.

(n) "Contractor" means the party or parties specified in a contract to receive remuneration in return for goods or services rendered.

(o) “Corrective action activity” means the monitoring process used to correct administrative and programmatic deficiencies in an eligible entity.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19102 Definitions; D to W {#sec-r-400.19102 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19102}

Rule 102. As used in these rules:

(a) "Department" means the Michigan department of human services.

(b) "Designate" means formal approval of a proposed CAA by the executive director.

(d) "Eligibility entity” means an entity:

(i) that is an eligible entity described in section 673(1) as in effect on the day before the date of enactment of the Coats Human Services Reauthorization Act of 1998 as of the day before such date of enactment or is designated by the process described in section 676A, including an organization serving migrant or seasonal farmworkers that is so described or designated; and (ii) that has a tripartite board or other mechanism described in subsection (a) or (b), as appropriate, of section 676B.

(e) “Executive director" means the chief administrator of the bureau.

(f) "Governing board" means the board of directors of a private nonprofit CAA or of a CAA that is a public agency that has the same legal powers and responsibilities as the board of directors of any private, nonprofit organization.

(g) "Grant" means an award of funds by the bureau to a contractor agency for administrative and contract purposes or to another entity in accordance with criteria established by the bureau.

(h) "Grantee" means a local CAA, public agency, nonprofit private agency, nonprofit organization, or other entity that receives funds from the bureau.

(i) "Limited purpose agency" or "LPA" means an agency that is officially designated as such under the provisions of the Community Services Block Grant Act, 42 U.S.C. 9901 et seq. as amended.

(j) “Local Weatherization Operator” or “LWO” means an agency that provides weatherization services within the parameters of the established contract.

(k) “Low income person” means a person who is a member of a household that has a gross annual income that is equal to or less than the poverty standard for the same size household.

(l) “Management decision letter” means a written response to a corrective action plan submitted by a CAA.

(m)"Means test" means the measure of income, financial resources, or real property as a basis for establishing eligibility or service limits to a low-income person.

(n) “Monitoring” means the process used in order to determine whether eligible entities meet the performance goals, administrative standards, financial management requirements, and other requirements of federal, state, and local policies and requirements.

(o) "Nonprofit" means a nonprofit corporation that is registered and in good standing with the corporations division, Michigan department of licensing and regulatory affairs, pursuant to the provisions of 162 PA 1982, the nonprofit corporation act. This term includes religious organizations to which the provisions of 42 U.S.C. 9901 apply.

(p) “Poverty standard” means the federal poverty guidelines published annually in the federal register by the United States department of health and human services under its authority to revise the poverty line under section 673(2) of subtitle B of title VI of the omnibus budget reconciliation act of 1981, Public Law 97-35, 42 U.S.C. 9902.

(q) "Private sector" means representatives of business and industry, agriculture, labor, and religious and civic organizations.

(r) "Program cost" means all costs incurred by a grantee in managing, administering, and delivering services to low-income persons.

(s) "Program income" means gross income earned by the grantee from grantsupported activities.

(t) "Public sector" means representatives of units of local government and public agencies.

(u) "Rescission of designation" means the executive director’s removal of a grantee's status as a CAA and the loss of a grantee’s rights to consideration for formula funding from the bureau.

(v) "Self-sufficiency" means the achievement or maintenance of a reasonable degree of self-determination and independence that enables an individual to carry out the normal responsibilities and activities of daily life without sustained assistance from governmental or other agencies.

(w) “Service area” means the geographical area served by a community action agency.

(z) "Service provider" means an entity that is under contract to a grantee and that provides services to low-income persons.

(aa) "Service recipient" means a low-income person who receives services directly from a service provider.

(bb) “State plan” means the document required by the provisions of sections 5 and 10 of the act.

(cc) State program budget request" means state funds, federal block grants, and federal categorical grants that the legislature appropriates annually for community social and economic programs.

(dd) “Statewide database” means a shared electronic database used to store client eligibility information, demographic data, and national performance indicators.

(ee) “Supporting documentation” means additional documentation to support the activity, program, or expenditure. Examples include agency general ledgers, invoices, client applications, proof of contract deliverables, and other internal documentation.

(ff) “Weatherization”, Weatherization Assistance Program” or “WAP” is a program administered by the bureau as required in section 5(m) of the act to reduce the energy costs for low-income families, particularly for the elderly, people with disabilities and children.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19103 Terms defined in act {#sec-r-400.19103 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19103}

Rule 103. Terms defined in the act have the same meanings when used in these rules.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19104 Service delivery method {#sec-r-400.19104 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19104}

Rule 104. The primary structure or organization through which financial resources shall flow in providing services and programs to low-income persons under the provisions of the act and other applicable state or federal regulations consists of the following:

(a) The bureau that is administered by the executive director to perform those functions and responsibilities specified by the provisions of section 5 of the act.

(b) A network of local grantees to plan and allocate resources for services and programs to low-income persons. Grantees shall be agencies established in accordance with the provisions of section 8 of the act or other entities in accordance with applicable federal and state criteria.

(c) Other agencies, organizations, or consultants with the ability to provide self-help and other support services directly or indirectly to low-income persons. Such services shall be provided through contractual agreements.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19105 Grantee; written operating procedures {#sec-r-400.19105 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19105}

Rule 105. (1) A grantee that receives funding or delegated authority received under provisions of the act shall have written procedures to govern the conduct of its operations and functions. Grantee procedures shall describe the administrative and policy structure of the entity and the methods used in dealing with contractors or other agencies and shall incorporate those applicable policies of the bureau.

(2) A grantee's written procedures shall be adopted by official action of its governing/advisory board.

(3) A grantee, upon request, shall provide a copy of the procedures to each of its contractors and to the bureau without cost.

(4) A grantee shall attach an electronic copy of the procedures, within 30 days of the governing/advisory board’s approval, to the statewide database.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19106 Grantee reporting requirements {#sec-r-400.19106 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19106}

Rule 106. A grantee shall do all of the following:

(a) Submit, to the bureau, program and financial reports, including supporting documentation when requested by the bureau, to comply with state and federal requirements.

(b) Submit reports on time and in a manner prescribed by the bureau.

(c) Be responsible for obtaining and reporting necessary information from those entities with whom contracts have been made.

(d) Submit to the bureau by uploading an electronic copy to the statewide database, on a timely basis, changes in any of the follow:

(i) Corporate status.

(ii) Bylaws.

(iii) Governing board composition.

(iv) Governing board officers.

(v) Key staff.

(vi) Fiscal and administrative procedures.

(vii) The status of litigation against the agency.

(e) As required, obtain reports from contractors.

(f) Report any changes to its legal status pursuant to the provisions of the act or requirements issued by the state or federal government.

(g) Report any changes to the mission and the agency organizational structure to the bureau.

PART 2. BUREAU OF COMMUNITY ACTION AND ECONOMIC

OPPORTUNITY

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19201 Bureau; powers and duties {#sec-r-400.19201 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19201}

Rule 201. (1) The bureau shall perform those functions and responsibilities as provided in section 5 of the act and those conferred by the department.

(2) The bureau, through the executive director, shall issue written policies or guidelines regarding its administrative and management responsibilities pursuant to the following:

(a) The provisions of sections 24 to 26 of 306 PA 1969, MCL 24.224 to 24.226.

(b) Applicable federal program requirements and regulations for those federal programs administered by the bureau.

(3) The bureau shall issue guidelines to provide for all of the following:

(a) The systematic administration and management policies for all of the following:

(i) CAA designations or rescission of designations.

(ii) Grant applications.

(iii) Grant actions.

(iv) Payments.

(v) Reporting.

(vi) Closeout.

(vii) Monitoring of bureau administered grants or contracts.

(b) The general conduct of business with CAAs, other grantees, and contractors on an ongoing basis. Such guidelines shall include program and fiscal information to interpret, instruct, or otherwise provide guidance.

(d) The development and maintenance of applicable plans on the state and federal grant programs administered, including substantive content, period of applicability, public review, and methods for amendment.

(e) The processing of administrative complaints registered by grantees, service recipients, or contractors that are based on established policies or procedures.

(4) The bureau shall develop distribution formulae and criteria for use in allocating state and federal grant funds. The formulae and criteria shall be consistent with the act or other applicable state or federal requirements.

(5) The bureau shall establish guidelines for receiving and processing appeals requests for all of the following:

(a) Applicants who are denied a service funded by the bureau.

(b) Grantees that are denied a contract or have funding reduced or terminated for cause.

(d) Contractors that are denied a contract or have funding terminated for cause.

(6) The bureau shall develop interagency agreements pursuant to section 13 of the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19202 Low-income needs determination {#sec-r-400.19202 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19202}

Rule 202. (1) The bureau shall systematically determine the need for services to low-income persons on an ongoing basis by focusing on statewide, institutional, and community-based settings. Needs shall be based on demographic, social, and economic indicators.

(2) The bureau shall use data, findings, and conclusions resulting from the determination of need for all of the following:

(a) Preparing and developing the appropriate state plans.

(b) Establishing standards and criteria for grantee plans.

(d) Preparing the annual report to the governor, legislature, and the public under the provisions of section 5 of the act.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19203 Monitoring; performance assessments of community action agency activities {#sec-r-400.19203 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19203}

Rule 203. (1) The bureau shall conduct comprehensive on-site performance monitoring of each CAA once every 3 years or sooner, in addition to other types of monitoring including, but not limited to, desk monitoring and focused scope onsite monitoring. The monitoring shall accomplish all of the following:

(a) Determine the extent to which the CAA achieves desired results or benefits established by the legislature or other authorizing body.

(b) Assess the CAA's performance in attaining objectives that are made a part of the grant or contract agreement.

(c) Determine whether the CAA is acquiring, protecting, and using bureau-funded resources, such as personnel or equipment, economically and efficiently.

(d) Determine the causes, if any, of inefficiencies or uneconomical practices and provide remedial assistance.

(e) Determine whether the CAA has complied with laws or regulations applicable to its operation in an efficient and economical manner.

(f) Access other items as required by the bureau or state or federal government.

Continued funding shall be contingent upon satisfactory performance in all areas covered by the performance assessment in accordance with applicable federal and state laws or regulations.

(g) Assess the CAA’s financial capacity and compliance with cost and accounting standards as required by the federal office of management and budget.

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

(a) Assure that a grantee is given advance notice, in writing, of a scheduled monitoring, including all of the following information:

(i) The date scheduled for the on-site monitoring.

(ii) The scope of the on-site monitoring.

(iii) Criteria to be used in conducting the on-site monitoring.

(b) Assure that a written monitoring report will be submitted, within 60 days of the exit conference, to the grantee describing the bureau’s findings based on the on-site monitoring unless the executive director approves the extension.

(c) Assure that the grantee has the opportunity to respond to the office within 30 days of receipt of the bureau’s findings concerning any exceptions noted in the monitoring report unless the executive director approves the extension.

(3) Each monitoring report and management decision letter that is issued by the bureau may be used as a basis for any of the following actions:

(a) Corrective action to be taken by the grantee.

(b) Suspension, probation, or termination of grants or CAA status, or both, in accordance with applicable contracts and state and federal laws or regulations.

(4) Each monitoring report and management decision letter shall specify the changes, improvements, or corrections that have been made by the grantee since the previous comprehensive monitoring.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19204 Training and technical assistance {#sec-r-400.19204 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19204}

Rule 204. (1) The bureau shall provide training and technical assistance, either directly or through contracted arrangements, to grantees to improve program planning, program development, administration, and the mobilization of public and private resources.

(2) The bureau may provide assistance to units of local government, nonprofit, private agencies, or other public entities for the purpose of operating a CAA. Assistance may also be provided when it is necessary to establish a new CAA to serve a community.

(3) The bureau may assist CAAs with training and technical assistance for corrective action implementation, when necessary, to ensure compliance with grants and contracts.

(4) The bureau may assist CAAs to ensure responsiveness to local needs, including an ongoing procedure for obtaining input from the national and state networks of eligible entities.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19205 Administrative and financial management instructions {#sec-r-400.19205 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19205}

Rule 205. (1) To ensure maximum fund accountability and program effectiveness, the bureau shall provide periodic instructions to grantees regarding administrative and financial management concerns.

(2) The bureau shall maintain operating guidelines and policies to be available online that can be accessed through the statewide database.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19206 Rescinded {#sec-r-400.19206 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19206}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19207 Procedures for grantee contracts {#sec-r-400.19207 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19207}

Rule 207. (1) The bureau shall issue criteria for the effectuation of grants or contracts through a written grant or contract instrument.

(2) The bureau shall provide advance notice and issue information to those seeking financial assistance through the bureau on the following topics:

(a) The instructions required to officially request, make application for, or submit a proposal for, funding through a grant or contract.

(b) Requirements to qualify as an eligible applicant.

(d) Criteria for revising or amending the proposal before bureau action.

(e) Criteria for revising or amending the grant or contract instrument after action by the bureau.

(3) The bureau shall use a uniform grant or contract agreement instrument when making the award of financial assistance as provided in subrule (2) of this rule.

Specific requirements of state or federal law, rules, or regulations shall be referenced and made addenda of the grant or contract instrument.

(4) After review and approval of grantee program documents by the bureau, contracts shall be prepared and executed.

(5) The contract shall detail financial and programmatic reporting requirements, audit requirements, and other contract compliance items.

(6) The bureau shall ensure that information is provided to potential grantees for each state and federal program for which financial assistance is available as a grant or a contract.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19208 State plans; development; content {#sec-r-400.19208 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19208}

Rule 208. (1) The bureau shall be responsible for the development, maintenance, and implementation of state antipoverty plans in accordance with the following requirements:

(a) The provisions of section 5 of the act and other applicable state or federal requirements.

(b) The provisions of the community services block grant act of 1981, as amended, 42 U.S.C. 9901 et seq., and its implementing regulations.

(2) The state plans shall include all of the following:

(a) The duration or time frame the plans are to be in effect.

(b) The content to comply with applicable state and federal requirements or their implementing regulations.

(d) The funding formulas, pursuant to R 400.19201(4), shall be made an attachment to the plan.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19209 Procedures; annual proposal; CSBG funding {#sec-r-400.19209 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19209}

Rule 209. (1) The executive director shall annually distribute an application detailing the nature and extent of information required of applicants pursuant to R 400.19201(3)(a). The application shall include the identification of the proposed CSBG funding allocations to eligible communities or organizations.

(2) Federal CSBG funds administered by the bureau shall be allocated to eligible CAAs in accordance with the community services block grant act of 1981, as amended, 42 U.S.C. 9901 et seq., as amended, based on the following distribution requirements:

(a) Eligible Entities (CAAs) Funds: Not less than 90% of the state’s federal CSBG allotment shall be used by the bureau to make grants for the purposes described in section 672 of the CSBG Act of 1981 to eligible entities. The formula factor for distribution to low-income persons who reside in the designated service areas of the CAAs are measured by the most recent and available United States bureau of census poverty population data.

(b) State Administration Funds: Up to 5% of the state's annual CSBG allotment shall be used for state administration of the program.

(c) State Discretionary Funds: Up to 5% of the state’s annual CSBG allotment shall be used for state discretionary programs to include, but not limited to, supporting innovative programs and activities conducted by community action agencies or other neighborhood-based organizations to eliminate poverty, promote self-sufficiency, and promote community revitalization. Discretionary fund distribution may be made on a matching basis of state funds and local share of the applicant's total project budget.

(d) Other factors that the director and executive director consider appropriate after review and comment by the commission. Funding levels for other eligible nonprofit organizations shall be determined by the executive director after consultation with the director and the Michigan commission.

(3) For the purpose of these rules, entities that are eligible to receive CSBG funds include any of the following:

(a) An organization that is officially designated by the bureau’s executive director as a CAA under the provisions of the act and these rules.

(b) Limited-purpose agencies designated under the provisions of the Community Services Block Grant Act, 42 U.S.C. 9901 et seq., as amended.

(c) Any organization that receives financial assistance under the provisions of the Community Services Block Grant Act, 42 U.S.C. 9901 et seq., as amended.

(4) Grantee funding shall terminate in full or be limited in part, at the discretion of the bureau, if the bureau suffers a loss of funding or termination of a grant from which it funds grantees in full or in part. If the bureau suffers a loss of funding in full or in part, grantees shall be provided written notice that shall set forth the effective date of full termination or partial funding and describe any changes necessary in the grantee's approved program budget.

PART 3. COMMISSION ON ECONOMIC AND SOCIAL OPPORTUNITY

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19301 Commission composition, functions, and responsibilities {#sec-r-400.19301 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19301}

Rule 301. (1) The commission shall be composed as specified in the provisions of section 6 of the act. For the purposes of commission appointment, a low-income person, senior citizen, or handicapped person who is a consumer representative shall be eligible.

(2) The commission shall establish operating policies or guidelines to carry out its responsibilities specified in the provisions of section 7 of the act.

(3) The executive director or designee of the commission shall serve as executive secretary to the commission.

PART 4. COMMUNITY ACTION AGENCIES

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19401 Rescinded {#sec-r-400.19401 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19401}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19402 Community action agencies; responsibilities and functions {#sec-r-400.19402 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19402}

Rule 402. (1) Public and private nonprofit CAAs shall be responsible for those functions specified in the provisions of sections 9 of the act. Private nonprofit CAAs shall also be responsible for those functions specified in the provisions of section 11 of the act.

(2) CAAs shall develop a comprehensive and coordinated plan for the delivery of services to low-income persons in their respective service areas.

(3) CAAs may enter into cooperative agreements with public and private agencies to achieve coordination and cooperation in the planning and delivery of services to lowincome persons.

(4) Public and private nonprofit agencies designated by the bureau with the CAA status may receive funds and continuation of services in the provisions of section 15 of the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19403 Community action agencies; required procedures {#sec-r-400.19403 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19403}

Rule 403. A CAA shall be required to have procedures for all of the following:

(a) The agency's governing body or board of directors.

(b) The agency's advisory councils/board.

(d) The agency's financial procedures manual.

(e) The agency's handling of personnel/employee handbook.

(f) The agency's handling of equipment inventory.

(g) The agency’s handling of procurements, including a conflict of interest policy.

(h) The conduct of the agency’s public hearings, or public comment opportunities on the agency's CSBG application, advocacy on service area needs determinations, community needs assessments activities, or issues concerning low-income persons.

(i) The agency's handling of affirmative action-related matters.

(j) Guidance on limited English proficiency.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19404 Community action agencies; required procedures for appeals and appeals hearings {#sec-r-400.19404 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19404}

Rule 404. (1) A CAA shall establish an appeals mechanism that provides the opportunity to appeal an application for a low-income service if there has been a partial or complete denial of assistance and if all of the following provisions have been satisfied:

(i) The services denied are specific, tangible benefits for which the bureau provides funding.

(ii) Funds are currently available.

(iii) The grantee has authority to provide or disburse funds.

(iv) The applicant has completed a formal, written application for such services.

(v) The applicant falls within the program guidelines or believes that he or she can prove that he or she falls within the program guidelines.

(2) A CAA, through the action of its governing/advisory board, shall establish and issue an appeals procedure for the items covered by subrule (1)(a) and (b) of this rule that shall include all of the following:

(a) Written notice to the applicant, contractor, or service provider of the CAA's action to suspend, terminate, not renew, or deny a contract or service, including a notice of the right to appeal.

(b) Notice that information or a criterion on which the CAA’s action was based is available for review by affected parties.

(c) Notice that the affected party may appear in person or through a designated representative to appeal the grantee's action.

(d) Provision for, as the initial step of any appeal, a meeting with the Appeals Committee, which is selected by the governing/advisory board, within 30 days to review items in dispute and seek clarification or resolution to the dispute. A record of the meeting, including relevant facts, shall be maintained and a determination shall be rendered, in writing, by the Appeals Committee and approved by the governing/advisory board.

(e) A specification that appeals proceedings shall be conducted within an aggregate time frame of 60 days, within which time all of the following shall occur:

(i) A notice of the right to appeal shall be sent to the affected party within 20 days of the grantee's action.

(ii) Any formal appeal shall be requested, in writing, by the affected party or parties within 10 days of notice pursuant to the provisions of paragraph (i) of this subdivision.

(iii) Upon the receipt of an appeal request, a hearing shall be conducted. The decision rendered shall be provided, in writing, to the affected party or parties.

(f) Notice shall be provided that a grantee's hearing decision may be appealed to the bureau and that the bureau shall review and act on the appeal pursuant to the provisions of R 400.19201(5).

(g) A description of those circumstances under which a request for appeal hearing may be refused. Such circumstances shall be limited to the failure to comply with the appeal procedures required by this subrule or to lack of standing by the appellant.

(3) A CAA, through action of its governing /advisory board shall maintain administrative appeals procedures for items covered by the provisions of subrule (1)(c) of this rule, which shall include all of the following:

(a) Written notice to all denied applicants, contractors, or service providers of the administrative appeals process.

(b) Written notice that denied applicants, contractors, or service providers may appeal administrative complaints to the grantee’s governing advisory board.

(c) Written notice to the appellant of the governing /advisory board’s determination within 30 days of the appeal's filing date.

(d) Written notice of the decision shall include a statement that appellants may appeal the decision to the bureau within 10 days of the written notice provided by subdivision (c) of this subrule.

(4) The CAA, before final adoption of its procedures as required by subrules (2) and (3) of this rule, shall first submit the procedure to the bureau for review of content and form.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19405 Rescinded {#sec-r-400.19405 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19405}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19406 Rescinded {#sec-r-400.19406 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19406}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19407 Rescinded {#sec-r-400.19407 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19407}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19408 Rescinded {#sec-r-400.19408 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19408}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19409 Rescinded {#sec-r-400.19409 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19409}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19410 Rescinded {#sec-r-400.19410 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19410}

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19411 Community action agency board; membership responsibilities {#sec-r-400.19411 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19411}

Rule 411. (1) CAA boards shall be composed as specified in section 11 of the act.

For the purposes of board appointment, a low-income person, consumer sector representative, is a person eligible for a CAA service at the time of his or her appointment or an individual that is representative of low-income individuals and families in a neighborhood served. Low-income person, consumer sector representative, includes senior citizens and handicapped persons. Representatives from the public sector shall be elected officials or their designated representative. If the number of elected officials available and willing to serve is less than 1/3 of the membership of the board, appointed public officials may represent the public sector.

(2) Consumer sector representative board members shall be chosen in accordance with selection procedures that are adequate to assure that they represent the low-income persons in the community served by the CAA. Consumer sector representative board members shall not be selected by public officials. Consumer sector representative board members may be selected to either represent a specific area or neighborhood served by the CAA, or at large to represent the community served by the CAA, or to represent a particular organization designated by the board whose membership is composed predominantly of low-income persons. The selection procedures which may be used, either alone or in combination, include the following:

(a) Nominations and elections, either within neighborhoods or within the community as a whole.

(b) Selection of eligible low-income persons at a meeting or conference where the date, time, and place of such meeting or conference have been adequately publicized.

(c) Selection of eligible low-income representatives to a community-wide board by members of neighborhood or subarea boards who are themselves selected by low-income neighborhood or area residents.

(d) Selection on a small area basis, such as a city block, of representatives who in turn select low-income members for a community-wide board.

(e) Selection of eligible low-income representatives by existing organizations designated by a board whose membership is predominantly composed of low-income persons.

(f) Any other selection procedure which assures maximum participation of eligible consumers, subject to bureau review and approval.

(3) Public sector representatives, elected or appointed, selected to serve on the board shall have either general governmental responsibilities or responsibilities which require them to deal with poverty-related issues. Public sector representatives shall not be officials with only limited, specialized, or administrative responsibilities.

(4) Each public official or private or consumer sector representative selected to serve on the board may have 1 permanent designated representative to serve on the board either full-time or when he or she is unable to attend a meeting. The public or private-designated representatives shall be public or private sector officials themselves and have the full authority to act for the officials whom they represent at meetings of the board.

(5) A CAA may establish term limits for members of its board of directors in the CAA’s bylaws.

(6) A CAA board shall annually evaluate the policies and programs of the CAA and shall consider all of the following:

(a) Program effectiveness.

(b) Contract and program.

(d) Personnel systems.

(e) Financial systems.

(f) Property acquisition and management systems.

(g) Any other items required by the bureau to implement the act or as mandated by the legislature or the department.

(7) A public CAA that has established an advisory board shall do all of the following:

(a) Provide recommendations regarding the selection of the executive director of the CAA.

(b) Determine rules and procedures for the advisory board, subject to department and bureau policies.

(d) Provide recommendations regarding major personnel, organizational, fiscal, and program policies.

(e) Provide recommendations regarding overall program plans and priorities.

(f) Provide recommendations regarding approval of all program proposals and budgets.

(g) Provide recommendations regarding the arrangements for delegating the planning, conducting, or evaluating of a component of the work program.

(h) Exercise other responsibilities which the local designating officials delegate to the advisory board.

(8) The advisory board shall report directly to the local designating officials of the public CAA.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19412 Listing and identification of community action agencies {#sec-r-400.19412 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19412}

Rule 412. Each office of the CAA shall be listed in the local telephone directory or directories of widest service area distribution under the heading "community action agency" and shall be identified on its letterhead as a "community action agency."

History

History: 1990 AACS.

Mich. Admin. Code R 400.19413 Compliance with state and federal laws {#sec-r-400.19413 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19413}

Rule 413. To qualify for funding, grantees shall comply with all applicable state and federal laws.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19414 Public meeting requirements {#sec-r-400.19414 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19414}

Rule 414. All commission or CAA governing/advisory board business shall be conducted at public meetings pursuant to the provisions of section 14 of the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19415 Schedule and notice of meetings {#sec-r-400.19415 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19415}

Rule 415. CAA governing/advisory boards shall meet on a regular basis at least six times per year to conduct official business. The meetings shall be scheduled for the convenience of its members and the general public.

PART 5. FINANCIAL REQUIREMENTS

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19501 Notice of financial award {#sec-r-400.19501 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19501}

Rule 501. (1) The bureau shall issue a grant or contract agreement as a 2-party agreement for obligating funds.

(2) The grant or contract instrument agreement shall constitute the official document which specifies the terms of the agreement. The grant or contract agreement shall include all of the following:

(a) The total financial amount, including both of the following:

(i) Funds provided through the bureau as stated in the grant agreement or the “notice of funds available” form.

(ii) Funds, or services in place of funds, provided by the grantee or contractor.

(b) The conditions of the grant or contract, including all of the following:

(i) Beginning and ending dates for which the agreement is to be in effect.

(ii) Documentation of services to be provided or objectives to be achieved by the grant or contract.

(iii) Special conditions, if any, which may be specified as a part of bureau approval action.

(c) Dated signatures of the executive department representative and authorized representative of the grantee or contractor to bind the agreement.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19502 Modification of approved grants or contracts {#sec-r-400.19502 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19502}

Rule 502. (1) A grantee or contractor of the bureau shall submit a request and obtain prior approval of the executive director for any change which modifies the grant or contract agreement in any of the following ways:

(a) Changes the program scope, planned objectives, or the character of service delivery made part of the grant or contract agreement.

(b) Provides financial assistance to any person not authorized by the grant or contract instrument.

(c) Transfers to a third party the conduct of functions or responsibilities that are central to executing the purposes of the grant or contract.

(d) Alters the approved budget of the grant or contract, except as may occur through the limits of administrative discretion as provided in the agreement.

(2) Grantees or contractors of the bureau shall be notified by the executive director of the action on requests initiated under the provisions of subrule (1) of this rule.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19503 Grantee contracting responsibilities {#sec-r-400.19503 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19503}

Rule 503. A grantee shall do all of the following when contracting for services under provisions of a grant:

(a) Contract for services within 45 days after the effective date of the grant instrument executed with the bureau pursuant to the provisions of R 400.19501.

(b) Not alter the contract amount during the final 60 days of any fiscal year unless approved by the executive director.

(c) Retain a copy of each contract in the grantee’s office for review and audit for a period listed in the contract language.

(d) Obtain prior written approval from the bureau when proposing to contract with profit-making organizations involving bureau-administered funding of more than $25,000.00.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19504 Audits {#sec-r-400.19504 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19504}

Rule 504. A financial audit of grantee records shall be made not less than biennially. Audits are to be conducted in accordance with standards established by the American institute of certified public accountants and requirements issued by the executive director. Audit requirements shall include at least all of the following requirements:

(a) Audits shall be made to test the integrity of financial transactions and compliance with grant or contract terms.

(b) The bureau shall ensure that timely and appropriate resolution of negative audit findings and recommendations for reconciliation occur promptly.

(d) The bureau shall not authorize the expense of an independent audit which does not meet the standards cited in this rule.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19505 Audit and monitoring disallowances {#sec-r-400.19505 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19505}

Rule 505. A grantee is responsible for any costs disallowed as a result of the actions of its contractors. Resolution of disallowances shall be achieved between the grantee and the contractor of record.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19506 Determining reasonable, allowable, and allocable costs; written procedures {#sec-r-400.19506 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19506}

Rule 506. Pursuant to the provisions of R 400.19201(3)(a), procedures shall be issued by the executive director to all grantees for determining the reasonableness, allowability, and allocability of costs.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19507 Means test to deny or limit services; failure to contribute to cost of service as basis for denial or limitation of service {#sec-r-400.19507 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19507}

Rule 507. (1) A grantee shall not use a means test to deny or limit a service to eligible low-income persons unless specifically required by state law or federal regulation.

(2) A grantee shall not deny or limit a service to eligible low-income persons who do not contribute to the cost of the service unless authorized by specific state law or federal regulation.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19508 Program income {#sec-r-400.19508 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19508}

Rule 508. (1) A grantee shall maintain a record of all income derived through the provision of a bureau-funded service. The bureau shall issue procedures for recording program income pursuant to the provisions of R 400.19201(3)(c).

(2) Program income derived from a bureau-funded project shall be used to increase or expand services of the agency to low-income persons in accordance with applicable state or federal grant regulations.

(3) A grantee shall ensure that acceptable accounting procedures are established for recording the receipt and expenditure of program income.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19509 Fees for services {#sec-r-400.19509 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19509}

Rule 509. (1) A grantee may assess a service fee to persons who are not low-income persons unless they are volunteers in providing a service to low-income persons.

(2) A grantee shall do both of the following:

(a) Record fees for services as program income.

(b) Not claim for credit or payment as a part of the grant or contract for services rendered to noneligible persons.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19510 Payments to grantees or contractors {#sec-r-400.19510 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19510}

Rule 510. (1) The bureau shall only make payments for those authorized costs made in conformance with a fully executed grant or contract agreement and the “notice of funds available” when applicable.

(2) A grantee or contractor shall not receive payment for costs incurred until authorized pursuant to the provisions of subrule (1) of this rule.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19511 Withholding payments {#sec-r-400.19511 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19511}

Rule 511. The bureau may withhold payments to grantees under any of the following circumstances:

(a) Failure of the grantee to use funds for the purposes prescribed in the contract.

(b) Failure of the grantee to submit accurate and timely fiscal and programmatic reports as prescribed in the contract.

(d) Failure of the grantee to return fund balances to the bureau within 45 days of contract termination.

(e) Failure of the grantee to respond to monitoring findings, corrective action activities, management decision requirements, or audit citations within the time allotted.

(f) Failure of the grantee to return disallowed costs to the bureau within the time period mandated by the bureau.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19512 Purchase of equipment or property {#sec-r-400.19512 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19512}

Rule 512. Bureau grantees shall not use funds administered by the bureau to purchase or lease equipment or property not prescribed in the approved budget of the executed contract between the bureau and the grantee without prior approval from the bureau to a written request from the grantee.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19513 Suspension or termination of grant {#sec-r-400.19513 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19513}

Rule 513. (1) Criteria for suspending and terminating a grant shall be issued by the bureau.

(2) Criteria issued in accordance with the provisions of subrule (1) of this rule shall include at least all of the following information:

(a) Specific reasons for suspension or termination and instructions for corrective action to be taken.

(b) Specific conditions for payment or financial settlement.

(d) Specific rights of appeal available to the grantee under applicable contract provisions or state and federal laws or regulations.

(3) The bureau shall not pay for any financial obligations incurred by a grantee during the period of suspension, unless expressly authorized by the executive director.

(4) The bureau shall not pay a grantee for any financial obligation incurred after the effective date of a grant termination.

(5) The bureau may institute an emergency grant suspension if, considering its responsibility to protect the public interest, a delayed suspension date would be unreasonable. The bureau criteria for determining an emergency suspension shall include factors in the contract with the grantee and other relevant information.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19514 Standards for grantee financial management systems {#sec-r-400.19514 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19514}

Rule 514. Financial management systems of all bureau grantees shall provide for all of the following:

(a) Accurate, current, and complete disclosure of the financial results of all grant programs operated or administered by the agency.

(b) Records that adequately identify the source and application of funds for each grant-supported activity.

(d) A comparison of actual outlays with budgeted amounts for each grant.

(e) Accounting records, supported by source documentation, which shall be accessible to the bureau, of all funds administered by the agency.

(f) Timely notice and regular reports to the bureau of the status of any current or imminent litigation or other legal proceeding involving the grantee or the grantee's personnel that affects or may affect bureau-administered funds.

History

History: 1990 AACS.

Mich. Admin. Code R 400.19515 Standards for financial closeout procedures {#sec-r-400.19515 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19515}

Rule 515. Financial closeouts requirements for all bureau grantees include all of the following:

(a) All closing journal voucher activity shall be reviewed by the grantee's finance director and entered in the grantee's general ledger.

(b) Final trial balances shall be prepared by the grantee’s bookkeeper and shall be reviewed by its finance director before the preparation of the grantee's final financial report. A copy of the final trial balance shall be retained in the front of the grantee's general ledger.

(d) Appropriate grantee staff shall compare any interagency account balances with the control ledger to insure agreement.

(e) Appropriate grantee staff must adhere to proper document retention and storage procedures for electronic and physical files and shall assemble necessary documents for grantee audits, including all of the following documents:

(i) Copies of all grant actions, amendments, budgets, and contracts.

(ii) All bank statements and all monthly bank reconciliations.

(iii) Copies of all monthly trial balances and all monthly finance reports.

(iv) All claimed in-kind documentation, which shall be filed.

(v) All payment vouchers and journal vouchers, which shall be filed numerically.

(vi) Other documents as requested by the bureau.

(f) Following audits, a grantee shall place all program and financial documents listed in subdivision (e) of this rule into a records storage container for placement in a designated records retention area.

PART 6. COMMUNITY ACTION AGENCY (CAA) STATUS DESIGNATION,

RECISSION AND CHANGE

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19601 Designation of community action agencies status {#sec-r-400.19601 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19601}

Rule 601. The bureau shall designate, or rescind the designation of, CAAs pursuant to the provisions of section 8 of the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19602 Community action agency designation; responsibilities and functions {#sec-r-400.19602 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19602}

Rule 602. (1) A community action agency shall not be officially designated as such by the executive director, unless the community or entity is any of the following:

(a) A city, village, or township, or a combination of such units of government which are contiguous, with a population of not less than 150,000 people according to the most recent available census data.

(b) A county or a group of contiguous counties with a minimum of 100,000 people according to the most recent available census data.

(2) If, due to a boundary change, a community served by a CAA ceases to meet the requirements of subrule (1)(a) or (b) of this rule, the executive director, with the advice of the commission, shall determine if the loss in population constitutes grounds for withdrawing the executive director's official designation of the CAA serving the community. The executive director's decision shall take into consideration the past performance of the agency and the prospects for its continued viability and effectiveness.

(3) To be designated as a CAA, the governing/advisory board of the agency shall submit a request, in writing, to the executive director.

(4) The request or designation must identify a private non-profit organization.

(5) The executive director shall consider the requests or designation under subrules (3) and (4) of this rule approved if a response to the contrary is not received.

(6) An organization that requests state CAA designation shall, at the request of the department, conduct l or more public hearings to provide citizens in the service area the opportunity to review and comment on the organization’s ability to serve the community as a CAA.

(7) If a local unit of government is not served by a CAA, the bureau may fund an existing CAA or other eligible organization to serve the residents of the community.

(8) To attain or maintain its CAA designation, a CAA must establish a governing/advisory board of directors pursuant to the provisions of section 11 of the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19603 Request for change in designation or service areas of community action agency {#sec-r-400.19603 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19603}

Rule 603. (1) The CAA's governing/advisory board, for reasons such as poor fiscal or programmatic administration, specified in a written request, do any of the following:

(a) Request that the executive director rescind official designation of the CAA serving the community.

(b) Request to withdraw from the CAA's service area.

(2) The executive director may, for reasons such as poor fiscal and programmatic performance, suspend or terminate CAA status, or rescind designation based on Community Services Block Grant Act (42 U.S.C. 9901 et seq.) as amended.

(3) If a CAA is proposed to merge with another CAA, the executive director shall either approve or disapprove the written request within 90 business days pursuant to the procedure in the provisions of R 400.19606(3).

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19604 Replacement of an existing community action agency {#sec-r-400.19604 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19604}

Rule 604. (1) If another private non-profit organization is proposed to replace an existing CAA, the executive director shall either approve or disapprove the designation within 90 business days pursuant to the procedures in the provisions of R 400.19606(3).

If approved, the designation shall be provisional for 120 days. During this period, the proposed CAA shall establish required operating and management procedures, select and appoint members of the governing/advisory board, and formally adopt bylaws. A status report of these activities and related documents shall be submitted to the executive director within the 120-day provisional period. If the executive director is satisfied that all actions and plans are in order, the agency shall receive final designation as a CAA.

The executive director may extend the 120-day provisional period for an additional 60 days. The executive director shall take into consideration if the new CAA is capable of providing a broad range of services and activities in the unserved area that are designed to eliminate poverty and foster self-sufficiency and that the new CAA meets the tripartite board requirements.

(2) If another CAA is proposed to replace an existing CAA, the executive director shall either approve or disapprove the designation within 90 business days pursuant to the procedures in the provisions of R 400.19606(3). If approved, the designation shall be provisional for 120 days. During this period, the replacing CAA shall restructure its governing/advisory board and amend its bylaws and operating procedures to reflect the new service area. A status report of these activities and related documents shall be submitted to the executive director within the 120-day provisional period. If the executive director is satisfied that all actions and plans are in order, the agency shall receive final designation. The executive director may extend the 120-day provisional period for an additional 60 days.

(3) If another CAA is proposed to replace an existing CAA as an intermediate provider, the executive director shall either approve or disapprove the intermediate provider within 90 business days pursuant to the procedures in an open and fair request for proposal bid process. If approved, the CAA shall be provisional for 120 days. During this period, the intermediate provider CAA will set up operations to expand into the new service area. A status report of these activities and related documents shall be submitted to the executive director every 30-days during the provisional period. The executive director may extend the 120-day provisional period for an additional 60 days. A CAA may continue the expanded service area as intermediate provider without governing/advisory board restructuring and bylaw amendments until a permanent solution is implemented.

(4) A change in designation shall not take place unless a written transition plan or closedown plan, approved by the executive director, is followed. The party or parties responsible for the preparation and execution of the plan shall be identified by the executive director. A transition plan shall ensure the orderly transfer of program functions, obligations, records, authority, and funds from an existing CAA to a new CAA. A closedown plan shall ensure the orderly termination of program activities and disposition of funds, records, and property.

(5) The bureau may reallocate available resources, as necessary, when there has been a change in the designation of a CAA serving a community. The bureau, in making such a reallocation, shall take into consideration the financial obligations of the CAA being replaced and the fiscal needs of the new CAA.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19605 Serving unserved areas {#sec-r-400.19605 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19605}

Rule 605. (1) In any geographic area of the state not being served by an eligible entity, the governor may solicit applications from eligible entities and do any of the following, giving preference to entities identified in the Community Services Block Grant Act , 42 U.S.C. 9901 et seq., as amended:

(a) Request an existing eligible entity that is located and provides services in an area contiguous to the unserved area to serve the new area.

(b) If there is no existing eligible entity that is located and provides services in an area contiguous to the unserved area, request the eligible entity located closest to the area to be served or an existing eligible entity serving an area within reasonable proximity of the unserved area to provide services in the unserved area.

(c) If an existing eligible entity that is requested to serve the unserved area decides not to serve the area, designating any existing eligible entity or organization that has a governing/advisory board that meets the requirements in the provisions of R 400.19411, or any political subdivision of the state, to serve the new area. The governor's designation of an organization that has a governing/advisory board that meets the requirements in the provisions of R 400.19411, or a political subdivision of the state, to serve the unserved area qualifies the organization as an eligible entity under the act.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19606 Designating public hearing requirements {#sec-r-400.19606 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19606}

Rule 606. (1) Within 60 business days after receiving a written request pursuant to the provisions of R 400.19608, the executive director shall hold a public hearing. The public hearing shall be held in the affected community so that interested persons and organizations may express their opinions, either orally or in writing.

(2) The executive director shall implement the public hearing process as follows:

(a) Not less than 10 days before the hearing, the executive director shall publish a notice of the hearing in a newspaper or newspapers of general circulation available to interested persons or organizations. Notices shall also be posted in public places accessible to interested persons or organizations. The notice shall be mailed to each affected unit of local government and any CAA currently serving any part of the community.

(b) The notice shall indicate the type of request being considered and any tentative decision already made on the request.

(3) After the public hearing, the executive director must consult with and obtain the advice of the commission regarding the proposed action before making a final decision.

The commission shall be consulted at its first meeting following the public hearing.

History

History: 1990 AACS; 2014 AACS.

Mich. Admin. Code R 400.19607 Rescission of community action agency designation {#sec-r-400.19607 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19607}

Rule 607. (1) The executive director, pursuant to section 8(2) of the act, may rescind the designation of a CAA for cause if the agency fails to operate bureauadministered programs in compliance with these rules or applicable state and federal laws and regulations. Cause for rescission of a CAA designation may include a combination of any of the following factors:

(a) The agency's governing/advisory board does not exercise sufficient authority or leadership to ensure that bureau- administered funds are expended in accordance with applicable regulations, laws, or contractual obligations.

(b) The agency's administrative leadership does not demonstrate the administrative knowledge and skills required to ensure that the agency's fiscal, personnel, programs, or property management systems are adequate to support bureau-funded projects.

(d) The agency's general management systems are not adequate to support bureaufunded programs.

(e) The agency has not demonstrated the capacity for effective service delivery of bureau-funded programs.

(f) The agency has not sufficiently fulfilled its contractual obligations.

(g) The agency's liabilities significantly exceed its assets.

(h) The agency has filed for bankruptcy.

(i) The agency lacks community support and credibility with regard to its ability to competently administer bureau-funded programs.

(j) The agency is unable to make substantive improvement in problem areas following a bureau monitoring visit.

(2) An agency whose designation has been rescinded by the executive director shall lose its eligibility for formula funding and shall not use the term "community action agency" or "CAA" to refer to itself.

History

History: 2014 AACS.

Mich. Admin. Code R 400.19608 Designation appeal process {#sec-r-400.19608 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19608}

Rule 608. (1) The governing/advisory board of affected CAAs may appeal the decision of the executive director to designate a CAA or to rescind or change the designation of a CAA. The appeal shall be made in writing to the director.

(2) The director shall, within 10 business days of the notice of an appeal, assign the matter to a hearings officer for the purpose of holding a hearing and making findings of fact, conclusions of law, and a proposed decision.

(3) The hearing shall be conducted pursuant to the provisions of R 400.19701.

(4) The director shall provide notification of all appeals to the commission.

PART 7. GRANTEE APPEALS AND APPEALS HEARINGS

History

History: 2014 AACS.

Mich. Admin. Code R 400.19701 Notice of grantee right to appeal; right to appeals hearing {#sec-r-400.19701 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19701}

Rule 701. (1) The executive director shall provide written notice to each affected party of those bureau actions that are subject to appeal. All of the following actions are subject to appeal:

(a) Bureau action that denies an applicant's designation as a community action agency.

(b) Bureau action that rescinds a community action agency's designation.

(d) Bureau action that terminates or alters a contract of a state agency contractor, except as provided by the terms of the contract.

(2) The executive director shall notify the parties specified in subrule (1) of this rule of all bureau actions and those actions that may be appealed. Notice must be provided in writing and contain all of the following:

(a) A concise statement of the action and whether it may be appealed.

(b) The basis for the action which makes it subject to appeal.

(d) A statement to notify the affected party of the right to appeal and the time frame within which an appeal request shall be initiated.

(3) Each party who is notified of the right to an appeal and a hearing must be notified that the provisions of this rule and R 400.19702 to R 400.19706 shall govern the method of proceeding.

History

History: 2014 AACS.

Mich. Admin. Code R 400.19702 Request for hearing; timeliness {#sec-r-400.19702 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19702}

Rule 702. (1) A written notice of appeal and request for an appeals hearing shall be made to the executive director. Requests made by public or private agencies shall certify that the request is officially endorsed by the agency's governing/advisory board.

(2) The ability to make an appeal request shall not be limited or interfered with in any way. If needed, the bureau shall assist the party in filing and processing the request.

(3) Parties shall have 30 calendar days from the mailing of the notice to submit an appeal by certified mail and request an appeals hearing.

History

History: 2014 AACS.

Mich. Admin. Code R 400.19703 Denial or dismissal of request for hearing {#sec-r-400.19703 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19703}

Rule 703. (1) The executive director shall deny or dismiss the request for an appeals hearing under any of the following circumstances:

(a) A request was not submitted within 30 calendar days.

(b) A request is withdrawn by an aggrieved party through written notice before issuance of the final decision.

(d) The bureau has no jurisdiction over the matter.

(e) An issue is not appealable.

(2) Abandonment occurs if an aggrieved party, without good cause as determined by the hearing officer, fails to appear or be represented at the scheduled hearing.

(3) Written notice shall be given by the executive director to an aggrieved party stating the reasons for denial or dismissal as provided in subrule (1) of this rule.

Mich. Admin. Code R 400.19704 Hearings; place and notice {#sec-r-400.19704 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19704}

Rule 704. (1) A hearing shall be conducted at a reasonable time, date, and place, which will normally be in state facilities in Lansing.

(2) The bureau shall mail a notice of hearing to the aggrieved party or its representative of record not less than 10 business days before the hearing date and shall include all of the following:

(a) Time, date, and place of hearing.

(b) A citation of the provision of the regulation, rule, or law involved.

History

History: 2014 AACS.

Mich. Admin. Code R 400.19705 Hearing; conduct and proceedings {#sec-r-400.19705 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19705}

Rule 705. Proceedings in a hearing shall be conducted pursuant to the procedures applicable to contested cases under the administrative procedures act, 306 PA 1969, MCL 24.201 to 24.328.

History

History: 2014 AACS.

Mich. Admin. Code R 400.19706 Hearings; provision of copy of administrative procedures act {#sec-r-400.19706 omnilex-key=us-mi-regs-official--dept-health-and-human-services--R 400.19706}

Rule 706. At such times that the bureau takes action that may cause a grantee to file for an appeal hearing, the bureau shall forward to the grantee a copy of 306 PA 1969, MCL 24.201 to 24.328.

History

History: 2014 AACS.