[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6052720,"mediaKeyId","3378992-e8351afff23f7bfb8f7efedbec1b6d67","parentId",3378992,"title","Hospitals tell Senate panel Medicaid patients wait longer for psychiatric placement; MHA, Pine Rest urge changes to pre-admission screening","audioSeconds",1517,"startMs",1421000,"endMs",2938000,"viewUrl","/Search/View?dp=1&key=3378992-e8351afff23f7bfb8f7efedbec1b6d67&start=1421&end=2938","thumbnailUrl","https://assets.pipeline.soar.com/3378992-e8351afff23f7bfb8f7efedbec1b6d67/thumbnail_1421000.jpg","articleUrl","/articles/6052720/Michigan/Hospitals-tell-Senate-panel-Medicaid-patients-wait-longer-for-psychiatric-placement-MHA-Pine-Rest-urge-changes-to-pre-admission-screening","mediaUrl","https://secure.pipeline.soar.com/6052720-acf9ca9f7a4ec9a45005c1789e36246a/orig.mp4?Expires=1771159182&Signature=oziEHq8JJVU8Zdsnl2lwccY4xD~bR7N9vzN1mD~fguGAdeFOvAdA8jn-kAyNwrlFattREHwOvwB9bqOduu5pHp3APNWd-LTNBw5WzgYsqe1WObIRgOo0b3yzUr4NSmydu64vFcYKgGOYmTeEsUVwQ5C4B-I-k9e2NfqLOFvm1CUPFxynigUVuXgVUhpXqrLovgkr0C82sCzccSmX5cV6cg5UKvbVYRrjdSzTVSra1iz~ECE0~~nlOSCizls9uw1A47IpBaOlCHieQ9MAv-jpc6Q4mXXRZS3-hrKqKywnMU6N1U~6zmgQmgSdca51UYTvQR9N0lpqKiC7YTneE0V-UQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Michigan Legislature","date","2025-05-07T00:00:00Z","article","Hospital and behavioral health representatives told the Senate Committee on Health Policy on March 19 that Medicaid patients in behavioral health crisis wait longer — sometimes days — in emergency departments because community mental health agency (CMH) pre-admission screening processes are uneven and tied to payer rules.

Lauren Lapine, senior director of legislative and public policy at the Michigan Health & Hospital Association, said the association’s data collection found “on any given day there are over 155 patients that are waiting in emergency departments across the state for access to critical behavioral health services.” She told the committee that pediatric and geriatric patients board the longest and that Medicaid patients make up the largest share: “There are more than 8,000 patients that have Medicaid that are boarding in an emergency department over a calendar year compared to about 5,000 for those that are commercially insured,” she said.

Lapine described the statutory and contractual process that governs Medicaid behavioral health placements: a CMH must complete a pre-admission screening assessment within three hours for a Medicaid patient, and the CMH works on behalf of the prepaid inpatient health plan that decides payment. Lapine said hospitals often do not see that three-hour window met, and when CMH clinicians and hospital psychiatrists disagree about level of care, the disagreement can delay placement for days.

Kyle Hoffmaster, a registered nurse and director of patient access at Pine Rest Christian Mental Health Services, told the committee Pine Rest frequently has available beds but cannot receive patients because CMHs require that a screening be completed in an emergency department. Pine Rest operates urgent-care walk-in clinics and, he said, “we are adding additional stress and cost to families to go to emergency department, and in many instances, are adding additional stress to the EMS system to unnecessarily transport a patient to an emergency department.” He urged allowing clinically qualified hospital staff to complete the pre-admission screening if the CMH cannot meet the three-hour standard.

Committee members asked whether CMH staffing and standardization vary by county; both presenters said the process differs widely across CMHs and days of the week. Lapine and Hoffmaster said some CMHs treat the three-hour clock as starting when a voicemail is retrieved, which can mean patients wait the entire weekend before a screening begins.

Committee members and presenters raised models of community crisis response such as Common Ground and Pine Rest’s urgent care as examples of diversion that reduce arrests and emergency department stays, and members discussed state budget priorities for facility expansion. No committee amendments were offered; the committee adjourned and proceeded to other agenda items after the presentation.

The presentation identified procedural issues and urged legislative and administrative changes to standardize pre-admission screening, clarify when the three-hour clock starts and permit qualified hospital clinicians to perform screenings when CMHs cannot meet the statutory timeframe. Presenters said they are willing to work with lawmakers to design solutions but did not present specific draft statutory language at the hearing.","mediaType","Video","parentTitle","Health Policy 25-05-07","oneSentenceSummary","Hospital and behavioral health officials told the Senate Committee on Health Policy that Medicaid patients in crisis often wait longer in emergency departments because community mental health agencies do not consistently complete pre-admission screening assessments within the three-hour window required for Medicaid.","taxTitle","Health Policy, 2025 Senate Legislature MI, Michigan","taxId",80191,"location","Michigan","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6052725,"Senate committee advances four bills to expand assisted outpatient treatment and mediation for mental illness",979,445000,1424000,"/Search/View?dp=1&key=3378992-e8351afff23f7bfb8f7efedbec1b6d67&start=445&end=1424","https://assets.pipeline.soar.com/3378992-e8351afff23f7bfb8f7efedbec1b6d67/thumbnail_445000.jpg","/articles/6052725/Michigan/Senate-committee-advances-four-bills-to-expand-assisted-outpatient-treatment-and-mediation-for-mental-illness","https://secure.pipeline.soar.com/6052725-e3c8f535c00167254fe5f4a54bf93105/orig.mp4?Expires=1771159182&Signature=GTiZscvByLKgp-kzgAjyiLr9ba~ujB7cNGJAaUNd9MaEH6OuhxCti8AQP0nMxl7WHGQLqTicGhnBYA6rc6iF6q2k4tEH72lM7V0MXqjC-L8kheEBphfO28kVF0~~8yXpDsIzBpa9CJH5hCaZzSHnGq7DnRNfGvo76NlnlLwe-xEgK22K1CXoMAHJNqyLCHuqyQ~cUDR9GoR60Ej-e0i8-aczERXm6hkRyD7A6HaGQgM0FP-BZotmqfUC5fLcjBwwl5~wzNbF-a1GrtLWzXgmHdWEzHu-Fp6vNyk~KYd7kpTFeub1N3AZ-MH4kP0~Mi64Bxnky65xTpOKH6rRfKRi9g__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Committee on Health Policy on March 19 voted to report four bills — Senate Bills 219, 220, 221 and 222 — to the Senate floor with recommendations that they pass. The bills would expand access to assisted outpatient treatment by widening who may testify about a person’s need for AOT, increase use of mediation, allow AOT as a misdemeanor diversion in some cases and enable family members to petition for extensions of existing orders.

Judge Milton Mack, a retired probate judge and chair of the governor’s Mental Health Diversion Council, told the committee the bills are meant to “build on that success and remove barriers in order to maximize the use of assisted outpatient treatment as an alternative to hospitalization.” He said Michigan’s mental health code now permits family members to petition for outpatient treatment before hospitalization and argued the bills would make that option more practical in many counties where psychiatrists are scarce.

The legislation would add physicians, psychologists and psychiatric nurse practitioners or physician assistants working under psychiatrist supervision to the list of clinicians who may testify to a probate court about the need for AOT; a psychiatrist would still supervise preparation and implementation of any ordered AOT plan. Judge Mack said the current statute’s psychiatrist-only testimony requirement has made AOT petitions rare: “less than 5% of the petitions for treatment filed in Michigan at this time are for AOT only,” he said. He also said counties that have embraced outpatient alternatives have seen reduced hospitalizations and jail time; he cited Genesee County, where hospitalization has fallen “by as much as 70 percent.”

Senate Bill 220 would broaden the use of mediation for disputes over treatment, allowing providers to pursue mediation rather than immediately filing court petitions when a patient is noncompliant. Marianne Hough, a clinical social worker and board member of the Mental Health Association in Michigan, supported the bills and told the committee AOT and mediation could increase early intervention: “If we can find ways to get somebody treatment before they’re the point of considering, you know, looking at harm to self or others … AOT is a great tool,” she said.

Senate Bill 221 would permit voluntary use of AOT as an alternative to forensic evaluation in some misdemeanor cases, with dismissal of the underlying charge if the prosecutor and defendant do not object. Senate Bill 222 would allow family members — not only providers — to petition for extensions of existing involuntary treatment orders, addressing lapses when providers forget to file extension requests.

Committee members did not request amendments during the hearing. The clerk recorded unanimous 10-0 votes to report each bill to the floor with the recommendation that the bill pass. Motions were made by committee members: SB 219 (moved by Sen. Santana), SB 220 (moved by Sen. Bueno), SB 221 (moved by Sen. Cherry) and SB 222 (moved by Sen. Kleinfeld). Each bill’s roll call in committee recorded 10 yeas and 0 nays.

Support for the package was noted in submitted testimony and cards from multiple organizations, including the Michigan Health & Hospital Association, Disability Rights Michigan, PAAM and the Community Mental Health Association of Michigan.

If enacted, the measures would change who may initiate and attest to outpatient treatment orders and broaden nonjudicial avenues for resolving treatment disputes. No final floor action was taken at the committee meeting; each bill was merely reported out of committee for further consideration by the full Senate.","The Michigan Senate Committee on Health Policy voted unanimously to report four bills that would broaden who can petition and testify for assisted outpatient treatment (AOT), expand mediation options, permit AOT as an alternative in some misdemeanor cases and allow family petitions to extend treatment orders.","actionData","errors"]

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Hospitals tell Senate panel Medicaid patients wait longer for psychiatric placement; MHA, Pine Rest urge changes to pre-admission screening

Senate committee advances four bills to expand assisted outpatient treatment and mediation for mental illness