DEPARTMENT OF HEALTH AND HUMAN SERVICES
POLICY AND PLANNING ADMINISTRATION
MICHIGAN PHYSICIAN ORDERS FOR SCOPE OF TREATMENT
Filed with the secretary of state on June 10, 2022
These rules take effect immediately upon filing with the secretary of state unless adopted under
section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL
24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after
filing with the secretary of state.
(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)
R 325.81, R 325.82, R 325.83, R 325.84, R 325.85, R 325.86, and R 325.87 are added to the
Michigan Administrative Code, as follows:
R 325.81 Definitions.
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.
March 21, 2022