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1. Dismissal and release.

2. Hospitalization.

3. Combination hospitalization and alternative treatment.

4. Alternative treatment.

5. Court should make finding of fact to support disposition.

1. Before ordering a course of treatment the Court must:
a. Inquire as to the desires of the individual.

b. Review a written alternative report prepared not more than 15 days before the hearing.

c. Receive a written report or oral testimony from supervising agency that they are capable of such supervision of Court orders, alternative treatment.

d. If the Order for Report on Alternative Treatment and Report is properly completed, it may satisfy the above requirements.

2. After Initial Hearing.
a. The Court may order:
1) Hospitalization up to 60 days.

2) Combined hospitalization (up to 60 days) and alternative treatment totaling up to 90 days.

3) Alternative treatment for up to 90 days.

4) Assisted outpatient treatment for up to 180 days.

5) Combined hospitalization (up to 60 days) and assisted outpatient treatment for up to 180 days.

6) Release from hospital.

b. The Court may act summarily, when notified of non-compliance or insufficiency of an alternative order. It may:
1) Order a transfer to another alternative treatment program.

2) Order a transfer to a hospital or facility for the remainder of the 60 days or 90 days whichever is less. Patient has right to demand hearing on Order.

a) The decision to release from the hospital to the alternative treatment is made by hospital director unless patient is a resident of a county having full management mental health board in which case the decision is made by the community mental health board director.

b) Appeal of a decision may be made to Department of Mental Health director in case of disagreement between hospital and Community Mental Health director. Department of Mental Health director's decision may be appealed to Probation Court on information provided by both parties. No hearing seems to be required for such an appeal.

c) If re-hospitalized for more than 10 days, the patient may object to hospitalization and require hearing.

3) Set matter for hearing.

4) The court may take action in case an individual is not complying with an assisted outpatient treatment order This could include hospitalization for not more than 10 days or transport to a preadmission screening unit and possible hospitalization for more than 10 days, but not exceeding the duration of the order for AOT or not longer than 90 days, whichever is less.

3. After subsequent hearings:
a. The Court may order after second hearing:
1) Hospitalization for 90 days.

2) Combined hospitalization and alternative treatment or assisted outpatient treatment for a period of not more than one year with hospitalization portion not to exceed 90 days.

3) Alternative treatment or assisted outpatient treatment for a period of not more than one year.

4) Release from hospital.

b. The court may order after third hearing:
1) Hospitalization for not more than one year.

2) Combined hospitalization and alternative treatment or assisted outpatient treatment for a period of not more than one year with hospitalization portion not to exceed 90 days.

3) Alternative treatment or assisted outpatient treatment for a period of not more than one year.

4) Release from hospital.

c. During the period of an order for combined hospitalization and alternative treatment for not more than one year, hospitalization may be used as clinically appropriate for a total of not more than 90 days.
1) Must be ordered by a psychiatrist.

2) The decision to hospitalize the individual or to return the individual to the alternative treatment program is made by director of alternative treatment program.

3) Court becomes involved only if patient refuses to comply with alternative order.

d. During either the one year alternative order of one year combined order, the patient has a six month periodic review. Patient may object to results of such review thereby triggering a hearing.

e. During either the one year alternative order or one year combined order the Court may act summarily when notified of non-compliance or insufficiency of an alternative. It may:

1) Order a transfer to another alternative treatment program.

2) Order a transfer to a hospital or facility for not more than the remainder of the 90 days of hospitalization or the remainder of the order, whichever is shorter.

a) The decision to release from the hospital to the alternative treatment is made by hospital director unless patient is a resident of a county having a full management mental health board in which case the decision is made by the community mental health board director.

b) Appeal of a decision may be made to Department of Mental Health director in case of disagreement between hospital and Community Mental Health director. Department of Mental Health director's decision may be appealed to Probate Court on information provided by both parties. No hearing seems to be required for such an appeal.

c) If re-hospitalized for more than 10 days, the patient may object to hospitalization and require hearing.

f. The court may take action in case an individual is not complying with an assisted outpatient treatment order This could include hospitalization for not more than 10 days or transport to a preadmission screening unit and possible hospitalization for more than 10 days, but not exceeding the duration of the order for AOT or not longer than 90 days, whichever is less.

g. Petitions must be filed not less than 14 days before the expiration of an order.

C. Periodic Reviews:

1. Each individual has a right to a six month periodic review.
a. On a one year hospitalization order.

b. On a one year alternative treatment order.

c. On a one year combined order.

2. Each individual on one year hospitalization, one year alternative treatment order, or one year combined order may submit a complaint to the provider of services at any time. A copy of the complaint and provider's response shall be filed with the Court.

3. Upon a hearing under either Sec. 484, if the individual is under an order of continuing hospitalization, the Court may:
a. Release.

b. Issue a one year combined order.

c. Issue a one year alternative treatment order.

d. Continue the order.

4. Upon a hearing under Sec. 484 if the individual is under a one year alternative treatment order or a one year combined order the Court may:
a. Continue the order.

b. Issue a new order for alternative treatment or an order for combined treatment for the remainder of the original order.

5. An assisted outpatient treatment order providing for alcohol or substance abuse testing shall be subject to review every 6 months.

D. Assisted Outpatient Treatment Order (AOT)

1. Pursuant to MCL 330.1433 an individual may petition the court for an assisted outpatient treatment order if the subject of the order is a person requiring treatment pursuant to MCL 330.1401(d)

2. An assisted outpatient treatment order includes case management services to provide care coordination.  Assisted outpatient treatment also could include:

a. Medication.

b. Periodic blood tests or urinalysis to determine compliance with prescribed medications.

c. Individual or group therapy.

d. Day or partial day programming activities.

e. Vocational, educational, or self-help training or activities.

f. Alcohol or substance abuse treatment and counseling.

g. Periodic testing for alcohol or illegal drugs for a person with a history of alcohol or substance abuse.

h. Supervision of living arrangements.

3. An assisted outpatient treatment order issued pursuant to MCL 330.1433 is not limited in duration unless limited by the court in its order.

4. The court may take action in case an individual is not complying with an assisted outpatient treatment order This could include hospitalization for not more than 10 days or transport to a preadmission screening unit and possible hospitalization for more than 10 days, but not exceeding the duration of the order for AOT or not longer than 90 days, whichever is less.

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Last Updated 3-18-05

Send your comments, questions and suggestions to Phil Harter at 161 E Michigan Avenue, Battle Creek, Michigan 49014 or e mail to pharter@calhouncountymi.gov