(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)  
R 330.7001 Definitions.  
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  
threaten, or sexually harass a recipient.  
to degrade,  
(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  
improving a recipient's physical functioning.  
of maintaining or  
(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  
observable physical  
symptomatology or as determined by a mental health professional.  
Page 1  
(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  
(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.  
Page 2  
(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  
(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  
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  
(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:  
Page 3  
(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.  
History: 1979 AC; 1983 AACS; 1998 AACS; 2007 AACS; 2009 AACS.  
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.  
R 330.7002 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7003 Informed consent.  
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  
Page 4  
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  
(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: 1979 AC; 1998 AACS.  
R 330.7005 Applicant request for second opinion; response; documentation.  
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  
History: 1998 AACS.  
R 330.7009 Civil rights.  
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.  
Page 5  
(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  
(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  
(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  
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.  
(c) Facilities shall assist election officials in determining a recipient's place of  
residence for voting purposes.  
(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.  
Page 6  
(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  
(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: 1979 AC; 1983 AACS; 1984 AACS; 1998 AACS; 2007 AACS.  
R 330.7011 Notification of rights.  
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: 1979 AC; 1998 AACS; 2007 AACS.  
R 330.7012 Provider confidentiality obligations.  
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: 1998 AACS.  
R 330.7014 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7017 Electroconvulsive therapy.  
Rule 7017. (1) A provider shall comply with both of the following provisions  
when administering electroconvulsive therapy:  
Page 7  
(a) A provider shall enter written documentation and signed consent in the clinical  
(b) A provider shall of  
obtain consent for  
stated number  
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: 1998 AACS.  
R 330.7029 Family planning and health information.  
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: 1979 AC; 1986 AACS; 1998 AACS.  
R 330.7032 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7035 Abuse or neglect of recipients.  
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: 1979 AC; 1998 AACS.  
Page 8  
R 330.7037 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7045 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7046 Summary reports of extraordinary incidents.  
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: 1998 AACS; 2007 AACS.  
R 330.7051 Confidentiality and disclosure.  
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  
(a) The information released.  
(b) To whom the information is released.  
(c) The purpose claimed by the person for requesting the information and  
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.  
Page 9  
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.  
Page 10  
(c) Other information designated in the policies of the provider.  
(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.  
History: 1979 AC; 1981 AACS; 1986 AACS; 1990 AACS; 1998 AACS.  
R 330.7125 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7135 Treatment by spiritual means.  
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  
(a) To use mechanical devices or chemical or organic compounds that are  
physically harmful.  
(b) To engage in activity prohibited by law.  
(c) To engage in activity that physically harms the recipient or others.  
(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  
Page 11  
(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: 1979 AC; 1998 AACS.  
R 330.7139 Resident's right to entertainment materials, information, and  
Rule 7139. (1) A provider shall not prevent  
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,  
(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  
(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: 1979 AC; 1998 AACS.  
R 330.7142 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7145 Rescinded.  
History: 1979 AC; 1998 AACS.  
Page 12  
R 330.7151 Rescinded.  
History: 1979 AC; 1990 AACS; 1998 AACS.  
R 330.7158 Medication.  
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.  
Page 13  
(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: 1979 AC; 1981 AACS; 1986 AACS; 1998 AACS; 2007 AACS.  
R 330.7161 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7165 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7171 Resident health, hygiene, and personal grooming.  
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.  
(c) An opportunity for shower or tub bath at least once every 2 days, unless  
medically contraindicated.  
(d) The services of a barber or a beautician on a regular basis.  
(e) If a male, the opportunity to shave daily.  
History: 1979 AC; 1981 AACS.  
R 330.7175 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7181 Rescinded.  
History: 1979 AC; 1990 AACS; 1998 AACS.  
R 330.7185 Rescinded.  
Page 14  
History: 1979 AC; 1998 AACS.  
R 330.7188 Rescinded.  
History: 1979 AC; 1983 AACS; 1998 AACS.  
R 330.7189 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7191 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7195 Rescinded.  
History: 1979 AC; 1990 AACS; 1998 AACS.  
R 330.7199 Written plan of services.  
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, or any use of psycho-active drugs for behavior  
control purposes shall be reviewed and approved by a specially constituted body  
Page 15  
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 has access 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  
(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 under section 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  
Page 16  
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: 1979 AC; 1984 AACS; 1986 AACS; 1990 AACS; 1998 AACS; 2007 AACS; 2009  
AACS; 2012 AACS.  
R 330.7205 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7227 Rescinded.  
History: 1979 AC; 1981 AACS; 1983 AACS; 1998 AACS.  
R 330.7229 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7231 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7235 Rescinded.  
History: 1979 AC; 1983 AACS; 1998 AACS.  
R 330.7239 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7243 Restraint seclusion, and physical management.  
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.  
(c) The name of the authorizing and ordering physician.  
(d) The date and time placed in temporary, authorized, and ordered restraint or  
Page 17  
(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  
observation is entered into the medical record of the recipient.  
monitoring and  
(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  
(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: 1979 AC; 1981 AACS; 1983 AACS; 1984 AACS; 1998 AACS; 2007 AACS; 2009 AACS.  
Page 18  
R 330.7251 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7253 Rescinded.  
History: 1979 AC; 1986 AACS; 1990 AACS; 1998 AACS.  
R 330.7254 Rescinded.  
History: 1979 AC; 1998 AACS.  
R 330.7260 Declaratory rulings.  
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  
(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: 1981 AACS.  
Page 19